WorldWideScience

Sample records for external evaluators redesigned

  1. Evaluating treatment process redesign by applying the EFQM Excellence Model.

    Science.gov (United States)

    Nabitz, Udo; Schramade, Mark; Schippers, Gerard

    2006-10-01

    To evaluate a treatment process redesign programme implementing evidence-based treatment as part of a total quality management in a Dutch addiction treatment centre. Quality management was monitored over a period of more than 10 years in an addiction treatment centre with 550 professionals. Changes are evaluated, comparing the scores on the nine criteria of the European Foundation for Quality Management (EFQM) Excellence Model before and after a major redesign of treatment processes and ISO certification. In the course of 10 years, most intake, care, and cure processes were reorganized, the support processes were restructured and ISO certified, 29 evidence-based treatment protocols were developed and implemented, and patient follow-up measuring was established to make clinical outcomes transparent. Comparing the situation before and after the changes shows that the client satisfaction scores are stable, that the evaluation by personnel and society is inconsistent, and that clinical, production, and financial outcomes are positive. The overall EFQM assessment by external assessors in 2004 shows much higher scores on the nine criteria than the assessment in 1994. Evidence-based treatment can successfully be implemented in addiction treatment centres through treatment process redesign as part of a total quality management strategy, but not all results are positive.

  2. Evaluation of the Redesign of an Undergraduate Cell Biology Course

    Science.gov (United States)

    McEwen, Laura April; Harris, dik; Schmid, Richard F.; Vogel, Jackie; Western, Tamara; Harrison, Paul

    2009-01-01

    This article offers a case study of the evaluation of a redesigned and redeveloped laboratory-based cell biology course. The course was a compulsory element of the biology program, but the laboratory had become outdated and was inadequately equipped. With the support of a faculty-based teaching improvement project, the teaching team redesigned the…

  3. EVALUATION OF VALUE STREAM MAPPING IN MANUFACTURING SYSTEMS REDESIGNING

    OpenAIRE

    Serrano , Ibon; Ochoa Laburu , Carlos; De Castro , Rodolfo

    2008-01-01

    Abstract The Value Stream Mapping (VSM) technique, developed within the lean production paradigm, was presented as an innovative graphic technique to help practitioners redesign production systems. This paper presents the results of a project whose main purpose is to evaluate the real applicability of VSM to redesign disconnected flow lines based on manufacturing environments with a diversity of logistical problems. The research was developed using multiple case study methodology i...

  4. Developing an evaluation framework for clinical redesign programs: lessons learnt.

    Science.gov (United States)

    Samaranayake, Premaratne; Dadich, Ann; Fitzgerald, Anneke; Zeitz, Kathryn

    2016-09-19

    Purpose The purpose of this paper is to present lessons learnt through the development of an evaluation framework for a clinical redesign programme - the aim of which was to improve the patient journey through improved discharge practices within an Australian public hospital. Design/methodology/approach The development of the evaluation framework involved three stages - namely, the analysis of secondary data relating to the discharge planning pathway; the analysis of primary data including field-notes and interview transcripts on hospital processes; and the triangulation of these data sets to devise the framework. The evaluation framework ensured that resource use, process management, patient satisfaction, and staff well-being and productivity were each connected with measures, targets, and the aim of clinical redesign programme. Findings The application of business process management and a balanced scorecard enabled a different way of framing the evaluation, ensuring measurable outcomes were connected to inputs and outputs. Lessons learnt include: first, the importance of mixed-methods research to devise the framework and evaluate the redesigned processes; second, the need for appropriate tools and resources to adequately capture change across the different domains of the redesign programme; and third, the value of developing and applying an evaluative framework progressively. Research limitations/implications The evaluation framework is limited by its retrospective application to a clinical process redesign programme. Originality/value This research supports benchmarking with national and international practices in relation to best practice healthcare redesign processes. Additionally, it provides a theoretical contribution on evaluating health services improvement and redesign initiatives.

  5. Evaluating treatment process redesign by applying the EFQM Excellence Model

    NARCIS (Netherlands)

    Nabitz, Udo; Schramade, Mark; Schippers, Gerard

    2006-01-01

    OBJECTIVE: To evaluate a treatment process redesign programme implementing evidence-based treatment as part of a total quality management in a Dutch addiction treatment centre. METHOD: Quality management was monitored over a period of more than 10 years in an addiction treatment centre with 550

  6. Best practices in business process redesign: an overview and qualitative evaluation of successful redesign heuristics

    NARCIS (Netherlands)

    Reijers, H.A.; Limam Mansar, S.

    2005-01-01

    To implement business process redesign several best practices can be distinguished. This paper gives an overview of heuristic rules that can support practitioners to develop a business process design that is a radical improvement of a current design. The emphasis is on the mechanics of the process,

  7. Evaluating and redesigning teaching learning sequences at the introductory physics level

    Science.gov (United States)

    Guisasola, Jenaro; Zuza, Kristina; Ametller, Jaume; Gutierrez-Berraondo, José

    2017-12-01

    In this paper we put forward a proposal for the design and evaluation of teaching and learning sequences in upper secondary school and university. We will connect our proposal with relevant contributions on the design of teaching sequences, ground it on the design-based research methodology, and discuss how teaching and learning sequences designed according to our proposal relate to learning progressions. An iterative methodology for evaluating and redesigning the teaching and learning sequence (TLS) is presented. The proposed assessment strategy focuses on three aspects: (a) evaluation of the activities of the TLS, (b) evaluation of learning achieved by students in relation to the intended objectives, and (c) a document for gathering the difficulties found when implementing the TLS to serve as a guide to teachers. Discussion of this guide with external teachers provides feedback used for the TLS redesign. The context of our implementation and evaluation is an innovative calculus-based physics course for first-year engineering and science degree students at the University of the Basque Country.

  8. Reducing bending stress in external spur gears by redesign of the standard cutting tool

    DEFF Research Database (Denmark)

    Pedersen, Niels Leergaard

    2009-01-01

    For the design of gears the stress due to bending plays a significant role. The stress from bending is largest in the root of the gear teeth, and the magnitude of the maximum stress is controlled by the nominal bending stress and stress concentration due to the geometric shape of the tooth....... In this work the bending stress of involute teeth is minimized by shape optimizing the tip of the standard cutting tool. By redesign of the tip of the standard cutting tool we achieve that the functional part of the teeth stays the same while at the same time the root shape is changed so that a reduction...... of the stresses results. The tool tip shape is described by different parameterizations that use the super ellipse as the central shape. For shape optimization it is important that the shape is given analytically. The shape of the cut tooth that is the envelope of the cutting tool is found analytically...

  9. Measuring Externalities in Program Evaluation

    NARCIS (Netherlands)

    Janssens, Wendy

    2005-01-01

    Impact evaluations of development programmes usually focus on a comparison of participants with a control group. However, if the programme generates externalities for non-participants such an approach will capture only part of the programme's impact. Based on a unique large-scale quantitative survey

  10. Evaluation of a redesigned 3/4-inch uranium hexafluoride cylinder valve stem

    International Nuclear Information System (INIS)

    Zonner, L.A.; Wamsley, S.D.

    1978-01-01

    The performance of a redesigned 3/4-in. uranium hexafluoride cylinder valve stem has been evaluated at the Portsmouth Gaseous Diffusion Plant. Prototypes, machined from Monel bar stock and having a 45 0 tip angle instead of the 15 0 tip angle of the standard valve stem, were fabricated. Tests included: cyclic leak evaluation; flow restriction determination; wear testing with uranyl fluoride deposits in the valve seat; stress corrosion testing; field testing (in previously rejected valve bodies); and production leak testing. Because their overall test performance was excellent, actual production usage of the redesigned stems was initiated. The in-service performance of valves fitted with redesigned stems has been significantly superior to that of valves having the standard stems: rejection rates have been 0.7 and 16.6 percent, respectively. Recommendations are made to replace all 15 0 angle tip stems presently in service with new stems having a 45 0 angle tip and to specify the new stem tip design for future 3/4-in. valve purchases

  11. Malignant external otitis: CT evaluation

    International Nuclear Information System (INIS)

    Curtin, H.D.; Wolfe, P.; May, M.

    1982-01-01

    Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull

  12. Redesign of a computerized clinical reminder for colorectal cancer screening: a human-computer interaction evaluation

    Directory of Open Access Journals (Sweden)

    Saleem Jason J

    2011-11-01

    Full Text Available Abstract Background Based on barriers to the use of computerized clinical decision support (CDS learned in an earlier field study, we prototyped design enhancements to the Veterans Health Administration's (VHA's colorectal cancer (CRC screening clinical reminder to compare against the VHA's current CRC reminder. Methods In a controlled simulation experiment, 12 primary care providers (PCPs used prototypes of the current and redesigned CRC screening reminder in a within-subject comparison. Quantitative measurements were based on a usability survey, workload assessment instrument, and workflow integration survey. We also collected qualitative data on both designs. Results Design enhancements to the VHA's existing CRC screening clinical reminder positively impacted aspects of usability and workflow integration but not workload. The qualitative analysis revealed broad support across participants for the design enhancements with specific suggestions for improving the reminder further. Conclusions This study demonstrates the value of a human-computer interaction evaluation in informing the redesign of information tools to foster uptake, integration into workflow, and use in clinical practice.

  13. External Evaluation Measures for Subspace Clustering

    DEFF Research Database (Denmark)

    Günnemann, Stephan; Färber, Ines; Müller, Emmanuel

    2011-01-01

    research area of subspace clustering. We formalize general quality criteria for subspace clustering measures not yet addressed in the literature. We compare the existing external evaluation methods based on these criteria and pinpoint limitations. We propose a novel external evaluation measure which meets...

  14. Ergonomics evaluation as a powerful tool to redesign advanced interfaces of nuclear control rooms

    International Nuclear Information System (INIS)

    Santos, Isaac J.A.L. dos; Carvalho, Paulo V.R.; Oliveira, Mauro V.; Fernandes, Nelson; Oliveira, Helio C.L.; Grecco, Claudio H.S.; Mol, Antonio C.A.; Augusto, Silas C.; Teixeira, Douglas V.; Ferraz, Fernando T.

    2007-01-01

    Ergonomics is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system. Ergonomics contributes to the design and evaluation of tasks, jobs, products, environments and systems in order to make them compatible with the needs, abilities and limitations of people. In the safe operation of nuclear power plant the performance of the control room crews plays an important role. In this respect, well-designed human-system interfaces (HSI) are crucial for safe and efficient operation of the plant, reducing the occurrence of incidents, accidents and the risks for human error. The aim of this paper is to describe a case study in which a methodological framework was applied to redesign advanced interfaces of a nuclear simulator. (author)

  15. Commercial off-the-shelf consumer health informatics interventions: recommendations for their design, evaluation and redesign.

    Science.gov (United States)

    Marquard, Jenna L; Zayas-Cabán, Teresa

    2012-01-01

    The goal of this paper is to describe the successful application of a use case-based evaluation approach to guide the effective design, evaluation and redesign of inexpensive, commercial, off-the-shelf consumer health informatics (CHI) interventions. Researchers developed four CHI intervention use cases representing two distinct patient populations (patients with diabetes with high blood pressure, post-bariatric surgery patients), two commercial off-the-shelf CHI applications (Microsoft HealthVault, Google Health), and related devices (blood pressure monitor, pedometer, weight scale). Three patient proxies tested each intervention for 10 days. The patient proxies recorded their challenges while completing use case tasks, rating the severity of each challenge based on how much it hindered their use of the intervention. Two independent evaluators categorized the challenges by human factors domain (physical, cognitive, macroergonomic). The use case-based approach resulted in the identification of 122 challenges, with 12% physical, 50% cognitive and 38% macroergonomic. Thirty-nine challenges (32%) were at least moderately severe. Nine of 22 use case tasks (41%) accounted for 72% of the challenges. The study used two patient proxies and addressed two specific patient populations and low-cost, off-the-shelf CHI interventions, which may not perfectly generalize to a larger number of proxies, actual patient populations, or other CHI interventions. CHI designers can employ the use case-based evaluation approach to assess the fit of a CHI intervention with patients' health work, in the context of their daily activities and environment, which would be difficult or impossible to evaluate by laboratory-based studies.

  16. Evaluation of a pilot intervention to redesign the decentralised vaccine supply chain system in Nigeria.

    Science.gov (United States)

    Molemodile, Shola; Wotogbe, Maruchi; Abimbola, Seye

    2017-05-01

    Responsibility for immunisation in Nigeria is decentralised to sub-national governments. So far, they have failed to achieve optimal coverage for their populations. We evaluated a pilot intervention implemented between 2013 and 2014 to redesign a vaccine supply chain management system in Kano, Nigeria. The intervention included financing immunisation services from a designated pool of government and donor funds, a visibility tool to track vaccine stock, and a private vendor engaged to deliver vaccines directly to health facilities. The number of local government areas within the state with adequate vaccine stock increased from 21% to 98% after 10 months. To understand how the intervention achieved this outcome, we analysed immunisation coverage for the period and interviewed 18 respondents across different levels of government. We found that the intervention worked by improving ownership and accountability for immunisation by sub-national governments and their capacity for generating resources and management (of data and the supply chain). While the intervention focused on improving immunisation coverage, we identified gaps in the demand for services. Efforts to improve immunisation coverage and vaccine supply systems should streamline decentralised structures, empower sub-national governments with financial and technical capacity, and promote strategies to improve the demand and use of services.

  17. Redesign workshop

    DEFF Research Database (Denmark)

    Bornoe, Nis; Billestrup, Jane; Andersen, Jesper

    2014-01-01

    . The leading question was: “Can software developers contribute actively to alternative redesign suggestions?” Under the guidance of usability specialists, we found that the developers were able to constructively reconsider the existing design based on a top down approach. In this paper we report a hands...

  18. Radionuclide evaluation in malignant external otitis

    International Nuclear Information System (INIS)

    Wolosker, Sara; Penha Costa Marques, Marise da; Fonseca, Lea Miriam Barbosa da; Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ

    1996-01-01

    Malignant external otitis (MEO) is a severe infection of the external auditory canal that can result in osteomyelitis of the skull base. Twenty-eight patients with MEO (19 diabetics, 8 with AIDS and 1 with acute mielogenous leukemia) were evaluated using 99m Tc-MDP bone scintigraphy. 67 Ga citrate and computed tomography (CT) at the time of diagnosis for establishing the MEO extent. 67 Ga scans were obtained periodically in order to assess the evolution of the treatment. 99m Tc scans had shown high sensitivity and specificity in assessing the bone disease. Serial 67 Ga scans had shown to be valuable indicators of infection remission. CT scans provided poor diagnosis of early bone involvement. (author). 26 refs., 4 figs

  19. Curriculum Redesign in Veterinary Medicine: Part I.

    Science.gov (United States)

    Chaney, Kristin P; Macik, Maria L; Turner, Jacqueline S; Korich, Jodi A; Rogers, Kenita S; Fowler, Debra; Scallan, Elizabeth M; Keefe, Lisa M

    Curricular review is considered a necessary component for growth and enhancement of academic programs and requires time, energy, creativity, and persistence from both faculty and administration. At Texas A&M College of Veterinary Medicine & Biomedical Sciences (TAMU), the faculty and administration partnered with the university's Center for Teaching Excellence to create a faculty-driven, data-enhanced curricular redesign process. The 8-step process begins with the formation of a dedicated faculty curriculum design team to drive the redesign process and to support the college curriculum committee. The next steps include defining graduate outcomes and mapping the current curriculum to identify gaps and redundancies across the curriculum. Data are collected from internal and external stakeholders including veterinary students, faculty, alumni, and employers of graduates. Data collected through curriculum mapping and stakeholder engagement substantiate the curriculum redesign. The guidelines, supporting documents, and 8-step process developed at TAMU are provided to assist other veterinary schools in successful curricular redesign. This is the first of a two-part report that provides the background, context, and description of the process for charting the course for curricular change. The process involves defining expected learning outcomes for new graduates, conducting a curriculum mapping exercise, and collecting stakeholder data for curricular evaluation (steps 1-4). The second part of the report describes the development of rubrics that were applied to the graduate learning outcomes (steps 5-8) and engagement of faculty during the implementation phases of data-driven curriculum change.

  20. ExternE transport methodology for external cost evaluation of air pollution

    DEFF Research Database (Denmark)

    Jensen, S. S.; Berkowicz, R.; Brandt, J.

    The report describes how the human exposure estimates based on NERI's human exposure modelling system (AirGIS) can improve the Danish data used for exposure factors in the ExternE Transport methodology. Initially, a brief description of the ExternE Tranport methodology is given and it is summarised...

  1. Advancing Care Within an Adult Mental Health Day Hospital: Program Re-Design and Evaluation.

    Science.gov (United States)

    Taube-Schiff, Marlene; Mehak, Adrienne; Marangos, Sandy; Kalim, Anastasia; Ungar, Thomas

    2017-11-13

    Day hospital mental health programs provide alternate care to individuals of high acuity that do not require an inpatient psychiatric stay. Ensuring provision of best practice within these programs is essential for patient stabilization and recovery. However, there is scant literature to review when creating such a program. This paper provides an overview of the steps an acute care hospital took when designing and implementing new programming within a day hospital program. Qualitative data was collected following initial program rollout. This data helped to inform the ongoing modification of groups offered, group scheduling and content, as well as ensuring patient satisfaction and adequate skill delivery during the rollout period and beyond. The goal of this paper is to inform health service delivery for other programs when attempting to build or re-design a day hospital program.

  2. Economical evaluation of electricity generation considering externalities

    International Nuclear Information System (INIS)

    El-Kordy, M.N.; Badr, M.A.; Abed, K.A.; Ibrahim, Said M.A.

    2002-01-01

    The economics of renewable energy are the largest barrier to renewable penetration. Nevertheless, the strong desire to reduce environmental emissions is considered a great support for renewable energy sources. In this paper, a full analysis for the cost of the kWh of electricity generated from different systems actually used in Egypt is presented. Also renewable energy systems are proposed and their costs are analyzed. The analysis considers the external cost of emissions from different generating systems. A proposed large scale PV plant of 3.3 MW, and a wind farm 11.25 MW grid connected at different sites are investigated. A life cycle cost analysis for each system was performed using the present value criterion. The comparison results showed that wind energy generation has the lowest cost, followed by a combined cycle-natural gas fired system. A photovoltaic system still uses comparatively expensive technology for electricity generation; even when external costs are considered the capital cost of photovoltaic needs to be reduced by about 60% in order to be economically competitive. (Author)

  3. Evaluating and Redesigning Teaching Learning Sequences at the Introductory Physics Level

    Science.gov (United States)

    Guisasola, Jenaro; Zuza, Kristina; Ametller, Jaume; Gutierrez-Berraondo, José

    2017-01-01

    In this paper we put forward a proposal for the design and evaluation of teaching and learning sequences in upper secondary school and university. We will connect our proposal with relevant contributions on the design of teaching sequences, ground it on the design-based research methodology, and discuss how teaching and learning sequences designed…

  4. Does external evaluation of laboratories improve patient safety?

    Science.gov (United States)

    Noble, Michael A

    2007-01-01

    Laboratory accreditation and External Quality Assessment (also called proficiency testing) are mainstays of laboratory quality assessment and performance. Both practices are associated with examples of improved laboratory performance. The relationship between laboratory performance and improved patient safety is more difficult to assess because of the many variables that are involved with patient outcome. Despite this difficulty, the argument to continue external evaluation of laboratories is too compelling to consider the alternative.

  5. External Evaluation of Education and Teacher Work: The Brazilian Case

    Science.gov (United States)

    Rothen, José Carlos; da Cunha Malheiros Santana, Andréia

    2015-01-01

    This article aims to discuss whether external evaluations are instruments to ensure increased quality of public school education. It is part of a research that investigated how evaluation results and the resulting indices were used in two schools in the state of São Paulo (Brazil). The methodology adopted was the case study, using different…

  6. Cognitive requirements in the redesign of a TRIGA RC-1 control room: The role of the operators' evaluations

    International Nuclear Information System (INIS)

    Visciola, M.; Bagnara, S.; Ruggeri, R.

    1986-01-01

    When a control room undergoes to a redesign process it is of crucial importance to analyze how operators critically review it and which improvements they suggest. This is even more critical when presumably the same people will operate in the new 'redesigned' control room: Consistency in the mental models possessed by the operators of the plant functions and of their control should be emphasized. Consistency in the mental models can be assumed when redesign follows well-established guidelines drawn from experiences and studies carried out in very similar situations. However, this condition is not fulfilled when a nuclear research control room has to be redesigned, since available guidelines (e.g.; NUREG-0700) are based on studies conducted on nuclear power plant control rooms. These two types of facilities are of much difference as for activities performed in the control room, goals to be aimed at, costs and risks. As a consequence, the available guidelines cannot be safely applied to such a situation as the redesign of a TRIGA RC-1 control room. So, data have to be collected in order to allow the operators to efficiently and easily adapt to the new control room by consistently 'updating' their mental models. In the present study, these data have been collected through structured interviews, which consisted of a modified version of EPRI. The results can be summarized as follows: 1) The operators critically reviewed the present control room and underlined the lack of 'transparency' of the control system as for the plant's conditions and for the feedbacks about their own activities. 2) The operators' work analysis showed that they spend much of their time out of the control room. This means that, if the operators have to stay in the control room, they should be allowed to perform more and higher-level activities than those presently required, to prevent understimulation. So, the redesign should or allow and support the central control and maintenance, and other

  7. Implementation of the IHR Joint External Evaluation: Taiwan's Experiences.

    Science.gov (United States)

    Lo, Yi-Chun

    In February 2016, the World Health Organization developed the Joint External Evaluation (JEE) tool to independently assess country capacity to prevent, detect, and respond to public health threats as part of the International Health Regulations (IHR) (2005) monitoring and evaluation framework. In light of this, the Taiwan government actively engaged at least 19 government agencies or institutions and voluntarily implemented the JEE. An External Assessment Team consisting of 6 US subject matter experts conducted the external evaluation, including site visits, from June 21 to July 1, 2016. The results, published on October 18, 2016, are useful and will be translated into actions and change in the system. Based on Taiwan's experiences, early stakeholder engagement and an experts' pre-JEE pilot visit would contribute to a successful JEE process.

  8. Process design and redesign

    NARCIS (Netherlands)

    Reijers, H.A.; Dumas, M.; Aalst, van der W.M.P.; Hofstede, ter A.H.M.

    2005-01-01

    This chapter aims to provide concrete guidance in redesigning business processes. Two alternative methods are described, both of them suitable to boost business performance. The first one is based on a collection of best practices, as applied in various redesign projects. These best practices all

  9. The evaluation of external costs from energy sources

    International Nuclear Information System (INIS)

    Lee, R.; Valette, P.; Krupnick, A.; Markandya, A.

    1994-01-01

    The paper outlines the progress of the joint EC-US Fuel Cycle study. This study seeks to provide a methodological framework for precisely the evaluation of external costs over the complete fuel cycle, from fuel extraction to decommissioning, conservation technologies, solar and wind power. (authors). 19 refs., 4 figs

  10. External evaluation policies: emphasis in the cognitive and socioemotional competences

    Directory of Open Access Journals (Sweden)

    Elma Júlia Gonçalves de Carvalho

    2016-09-01

    Full Text Available This article presents reflections on the Brazilian policies for external evaluation with the aim to question the relevance of the emphasis that has been given to the different skills. Thereunto, we analyze the goals, the basis and the references of Brazilian main basic education test (Prova Brasil and the SENNA Project, relating them to the new capital requirements and directions of international organizations from the 1990s. According to the analysis, initially, external evaluations focused on the amount of knowledge obtained, and later began to be guided by the model of different types of skills, influencing the way teachers assess and handle knowledge, that is their pedagogical conceptions. The results show that the logic of competences corresponds to a trend in political and pedagogical directions of denial of scientific and cultural knowledge, and of the school role as responsible for the distribution, as equally as possible, of systematized knowledge.

  11. EXTERNAL EVALUATIONS IN LOMCE: TRANSPARENCY IN RURAL EDUCATION?

    Directory of Open Access Journals (Sweden)

    Rogeli Santamaría Luna

    2015-06-01

    Full Text Available This document is intended to reflect on some articles of the Organic Law 2/2006 of 3 May on Education last modified by Organic Law 8/2013, of 9 December, to improve educational quality. We have selected those linked to external evaluation and transparency were discussed. In turn, the publication of Law 19/2013, of December 9, transparency, access to public information and good governance, imposes new obligations on the administrations and should result in the availability and dissemination of reports, as well as results. Both laws can promote knowledge of rural school if current approaches to external evaluation in Spain who do not usually attend rural uniqueness or do so partially. Thus they contribute to hiding the rural school or show a negative image of it because they have poorly contextualized results.

  12. Evaluation of Logistics Centres Establishment: External and Internal Factors

    OpenAIRE

    Rasciauskaite, Daiva; Raudeliūnienė, Jurgita

    2011-01-01

    One of the most important research objects in comprehensive theories of strategic management for theoreticians and representatives of logistics is making appropriate competitive strategic decisions and achieving a competitive advantage in dynamic and uncertain business environment. The aim of the topic is to create the conceptual model of evaluation of logistics centres establishment, which allows complex assessment of external and internal factors of competition of logistics centres. The pro...

  13. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region

    Directory of Open Access Journals (Sweden)

    Albino Kalolo

    2015-12-01

    Full Text Available Background: Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective: In this paper, we describe a process evaluation protocol aimed at opening the ‘black box’ to evaluate the implementation processes of the Redesigned Community Health Fund (CHF program in the Dodoma region of Tanzania. Design: The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review, and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion: This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes.

  14. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region

    Science.gov (United States)

    Kalolo, Albino; Radermacher, Ralf; Stoermer, Manfred; Meshack, Menoris; De Allegri, Manuela

    2015-01-01

    Background Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective In this paper, we describe a process evaluation protocol aimed at opening the ‘black box’ to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania. Design The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes. PMID:26679408

  15. ILRS Website Redesign

    Science.gov (United States)

    Noll, C.; Lee, L.; Torrence, M.

    2011-01-01

    The International Laser Ranging Service (ILRS) website, http://ilrs.gsfc.nasa.gov, is the central source of information for all aspects of the service. The website provides information on the organization and operation of ILRS and descriptions of ILRS components, data, and products. Furthermore, the website and provides an entry point to the archive of these data and products available through the data centers. Links are provided to extensive information on the ILRS network stations including performance assessments and data quality evaluations. Descriptions of supported satellite missions (current, future, and past) are provided to aid in station acquisition and data analysis. The current format for the ILRS website has been in use since the early years of the service. Starting in 2010, the ILRS Central Bureau began efforts to redesign the look and feel for the website. The update will allow for a review of the contents, ensuring information is current and useful. This poster will detail the proposed design including specific examples of key sections and webpages.

  16. Dose evaluation for external exposure in radiation accidents

    International Nuclear Information System (INIS)

    Maruyama, Takashi

    1989-01-01

    Abnormal exposures including emergency and accidental are categorized into external exposure and internal contamination, although both of these may be associated with external contamination. From a point of view of lifesaving in the abnormal exposures, it is primarily important to evaluate radiation dose of exposed persons as soon as possible. This report reviews the status of early dosimetry in the accidental exposures and discusses the optimum methodology of the early dose determination for external exposures in abnormal exposures. Personal monitors generally give an indication of dose to an exposed person only at a single part of the body. The data obtained from the personal monitors should be interpreted with care and in the light of information about the circumstances of exposure. In most cases, the records of environmental monitors or the survey with area monitors provide valuable information on the radiation fields. In the some cases, the reconstruction of the abnormal exposure is required for the dose evaluation by means of phantom experiments. In the case of neutron exposures, activation products in the body or its components or personnel possession can be useful for the early dosimetry. If the dose received by the whole body is evaluated as being very high, clinical observations and biological investigations may be more important guide to initial medical treatment than the early dosimetry. For the dose evaluation of general public, depending on the size of abnormal exposure, information that could be valuable in the assessment of abnormal exposures will come from the early dose estimates with environmental monitors and radiation survey meters. (author)

  17. External evaluation in municipal level: The impacts of an experience

    Directory of Open Access Journals (Sweden)

    Luana Ferrarotto

    2015-11-01

    Full Text Available The external evaluation is a consolidated reality in our country. Besides the state and federal ones, there are some municipalities that develop their own evaluation programs. To contribute with the debate about the external evaluations, this article presents data from a research which aim was to identify the actions from the Educational Secretariat from a city in the State of São Paulo, Brazil, opposite to the results of PROMASE (Municipal Assessment of the Educational System and its impact in school’s units. It is still being analyzed the path taken by the program with the aim of explaining its conception of the teaching quality. This way, the qualitative research was chosen based on the interviews with the Educational Secretary, teachers and school’s managers. Accordingly with the Secretary, after PROMASE, actions since improvements in the buildings to curricular restructuring and continuing educational were made. Even without the rankings and performance payments, it is noticeable in schools the built of what is called “hidden” and “adjustment” rankings of the pedagogical and evaluative practices to the matrix and to the evaluative instrument of the program to improve the teaching quality and improve the index. For an evaluative system to bring contributions to the network, it is noticeable that the quality must be anchored to the social quality, which more than the index, establishes its own scale as a protagonist in the process of looking to itself, adverse to the blaming of the teachers for the standards tests results and that, consequently, favors the social, political, cultural and human formation of the students.

  18. Combining Internal and External Evaluation: A Case for School-Based Evaluation.

    Science.gov (United States)

    Nevo, David

    1994-01-01

    School-based evaluation, the focus of this article, is conceived of as neither a synonym for internal evaluation nor an antonym for external evaluation, but as a combination that is examined through a review of recent research. A school-based evaluation in Israel illustrates combining these approaches in a complementary way. (SLD)

  19. Subsurface barrier feasibility evaluation: External review meeting report

    International Nuclear Information System (INIS)

    Lindberg, S.L.; Rouse, J.K.

    1994-12-01

    The Westinghouse Hanford Company -- Tank Waste Remediation System Division (TWRS) Program is evaluating subsurface barrier technologies for potential use in supporting remediation of the Hanford Tank Farms for the US Department of Energy, Richland Operations Office (DOE-RL). An External Review Team (ERT) was assembled to perform an independent technical review of the work performed to-date supporting the evaluation process. A set of draft documents was forwarded to the ERT for their review, and a meeting was held August 10 through 12, 1994, to facilitate comments and resolutions. This document summarizes the meeting, the comments provided by the ERT, and the ongoing work to resolve the comments and support a pending decision by The US Department of Energy, Richland Operations Office; the Washington State Department of Ecology; and the US Environmental Protection Agency

  20. Multicenter, noninterventional, post-marketing surveillance study to evaluate dosing of recombinant human follicle-stimulating hormone using the redesigned follitropin alfa pen in women undergoing ovulation induction

    Science.gov (United States)

    Nawroth, Frank; Tandler-Schneider, Andreas; Bilger, Wilma

    2015-01-01

    This prospective, noninterventional, post-marketing surveillance study evaluated doses of recombinant human follicle-stimulating hormone (r-hFSH) using the redesigned follitropin alfa pen in women who were anovulatory or oligomenorrheic and undergoing ovulation induction (OI) alone or OI with intrauterine insemination. The primary endpoint was the proportion of patients who achieved monofollicular or bifollicular development (defined as one or two follicles ≥15 mm). Secondary endpoints included characteristics of ovulation stimulation treatment, such as mean total and mean daily r-hFSH doses. Data were analyzed for 3,193 patients from 30 German fertility centers. The proportion of patients with monofollicular or bifollicular development was 71.1% (n=2,270 of a total of 3,193 patients; intent-to-treat population). The mean±standard deviation total and daily doses of r-hFSH were 696.9±542.5 IU and 61.7±29.4 IU, respectively. The three doses prescribed most frequently were: 37.5 IU (n=703 from N=3,189; 22.0%), 50.0 IU (n=1,056 from N=3,189; 33.1%), and 75.0 IU (n=738 from N=3,189; 23.1%) on the first day of stimulation; and 37.5 IU (n=465 from N=3,189; 14.6%), 50.0 IU (n=922 from N=3,189; 28.9%), and 75.0 IU (n=895 from N=3,189; 28.1%) on the last day of stimulation. This noninterventional, post-marketing surveillance study found that monofollicular or bifollicular development was achieved in 71% of patients studied and the small dose increment (12.5 IU) of the redesigned follitropin alfa pen allowed individualized treatment of women undergoing OI. PMID:25926755

  1. Evaluation of external hazards to nuclear power plants in the United States: Other external events

    International Nuclear Information System (INIS)

    Kimura, C.Y.; Prassinos, P.G.

    1989-02-01

    In support of implementation of the Nuclear Regulatory Commission's Severe Accident Policy, the Lawrence Livermore National Laboratory (LLNL) has performed a study of the risk of core damage to nuclear power plants in the United States due to ''other external events.'' The broad objective has been to gain an understanding of whether ''other external events'' (the hazards not covered by previous reports) are among the major potential accident initiators that may pose a threat of severe reactor core damage or of large radioactive release to the environment from the reactor. The ''other external events'' covered in this report are nearby industrial/military facility accidents, on site hazardous material storage accidents, severe temperature transients, severe weather storms, lightning strikes, external fires, extraterrestrial activity, volcanic activity, earth movement, and abrasive windstorms. The analysis was based on two figures-of-merit, one based on core damage frequency and the other based on the frequency of large radioactive releases. 37 refs., 8 tabs

  2. Redesigning mental healthcare delivery : Is there an effect on organizational climate?

    NARCIS (Netherlands)

    Joosten, T.C.M.; Bongers, I.M.B.; Janssen, R.T.J.M.

    2014-01-01

    Objective Many studies have investigated the effect of redesign on operational performance; fewer studies have evaluated the effects on employees' perceptions of their working environment (organizational climate). Some authors state that redesign will lead to poorer organizational climate, while

  3. Optimizing enactment of nursing roles: redesigning care processes and structures

    Directory of Open Access Journals (Sweden)

    Jackson K

    2014-02-01

    Full Text Available Karen Jackson,1 Deborah E White,2 Jeanne Besner,1 Jill M Norris21Health Systems and Workforce Research Unit, Alberta Health Services, Calgary, Alberta, Canada; 2Faculty of Nursing, University of Calgary, Calgary, Alberta, CanadaBackground: Effective and efficient use of nursing human resources is critical. The Nursing Role Effectiveness Model conceptualizes nursing practice in terms of key clinical role accountabilities and has the potential to inform redesign efforts. The aims of this study were to develop, implement, and evaluate a job redesign intended to optimize the enactment of registered nurse (RN clinical role accountabilities.Methods: A job redesign was developed and implemented in a single medical patient care unit, the redesign unit. A mixed-methods design was used to evaluate the job redesign; a second medical patient care unit served as a control unit. Data from administrative databases, observations, interviews, and demographic surveys were collected pre-redesign (November 2005 and post-redesign (October 2007.Results: Several existing unit structures and processes (eg, model of care delivery influenced RNs' ability to optimally enact their role accountabilities. Redesign efforts were hampered by contextual issues, including organizational alignment, leadership, and timing. Overall, optimized enactment of RN role accountabilities and improvements to patient outcomes did not occur, yet this was predictable, given that the redesign was not successful. Although the results were disappointing, much was learned about job redesign.Conclusion: Potential exists to improve the utilization of nursing providers by situating nurses' work in a clinical role accountability framework and attending to a clear organizational vision and well-articulated strategic plan that is championed by leaders at all levels of the organization. Health care leaders require a clear understanding of nurses' role accountabilities, support in managing change, and

  4. Multicenter, noninterventional, post-marketing surveillance study to evaluate dosing of recombinant human follicle-stimulating hormone using the redesigned follitropin alfa pen in women undergoing ovulation induction

    Directory of Open Access Journals (Sweden)

    Nawroth F

    2015-04-01

    Full Text Available Frank Nawroth,1 Andreas Tandler-Schneider,2 Wilma Bilger3 1Centre for Reproductive and Prenatal Medicine, Endocrinology and Osteology, Hamburg, Germany; 2Center for Reproductive Medicine, Fertility Center Berlin, Berlin, Germany; 3Medical Affairs, Fertility, Endocrinology and General Medicine, Merck Serono GmbH, Darmstadt, Germany (an affiliate of Merck KGaA, Darmstadt, Germany Abstract: This prospective, noninterventional, post-marketing surveillance study evaluated doses of recombinant human follicle-stimulating hormone (r-hFSH using the redesigned follitropin alfa pen in women who were anovulatory or oligomenorrheic and undergoing ovulation induction (OI alone or OI with intrauterine insemination. The primary endpoint was the proportion of patients who achieved monofollicular or bifollicular development (defined as one or two follicles 15 mm. Secondary endpoints included characteristics of ovulation stimulation treatment, such as mean total and mean daily r-hFSH doses. Data were analyzed for 3,193 patients from 30 German fertility centers. The proportion of patients with monofollicular or bifollicular development was 71.1% (n=2,270 of a total of 3,193 patients; intent-to-treat population. The mean±standard deviation total and daily doses of r-hFSH were 696.9±542.5 IU and 61.7±29.4 IU, respectively. The three doses prescribed most frequently were: 37.5 IU (n=703 from N=3,189; 22.0%, 50.0 IU (n=1,056 from N=3,189; 33.1%, and 75.0 IU (n=738 from N=3,189; 23.1% on the first day of stimulation; and 37.5 IU (n=465 from N=3,189; 14.6%, 50.0 IU (n=922 from N=3,189; 28.9%, and 75.0 IU (n=895 from N=3,189; 28.1% on the last day of stimulation. This noninterventional, post-marketing surveillance study found that monofollicular or bifollicular development was achieved in 71% of patients studied and the small dose increment (12.5 IU of the redesigned follitropin alfa pen allowed individualized treatment of women undergoing OI. Keywords: ovulation

  5. Long-dated evaluation of the external costs of the nuclear; L'evaluation des couts externes a long terme de la filiere nucleaire: interets et limites

    Energy Technology Data Exchange (ETDEWEB)

    Le Dars, A.; Schneider, T

    2002-09-01

    Since the middle of the years 1990, the European Commission developed an ''ExternE'' methodology to propose an homogenous evaluation of the sanitary and environmental external costs of the various energy sectors in Europe. This document discusses the taking into account of the long-dated and analyzes the interests and the limits of the monetary evaluation, in terms of external costs, of the nuclear choice. It is organized in three chapters: 1. a presentation and a discussion on the various evaluation of the ''ExternE'' methodology; 2. a description of the available methods for the monetary evaluation of the long-dated impacts and more particularly the analysis of the monetary values actualization principle; 3. highlighted of the impacts for which the monetary evaluations exist. (A.L.B.)

  6. Long-dated evaluation of the external costs of the nuclear

    International Nuclear Information System (INIS)

    Le Dars, A.; Schneider, T.

    2002-09-01

    Since the middle of the years 1990, the European Commission developed an ''ExternE'' methodology to propose an homogenous evaluation of the sanitary and environmental external costs of the various energy sectors in Europe. This document discusses the taking into account of the long-dated and analyzes the interests and the limits of the monetary evaluation, in terms of external costs, of the nuclear choice. It is organized in three chapters: 1. a presentation and a discussion on the various evaluation of the ''ExternE'' methodology; 2. a description of the available methods for the monetary evaluation of the long-dated impacts and more particularly the analysis of the monetary values actualization principle; 3. highlighted of the impacts for which the monetary evaluations exist. (A.L.B.)

  7. Motivation Enhancement Through Work Redesign.

    Science.gov (United States)

    Oldham, Greg R., Kulik, Carol T.

    1983-01-01

    The possibility of redesigning the work experiences of faculty members in an effort to enhance their motivation, productivity, and personal and work satisfactions is examined. One approach to work redesign, job characteristics theory, is described. Several strategies are discussed. (Author/MLW)

  8. Finance leadership imperatives in clinical redesign.

    Science.gov (United States)

    Harris, John; Holm, Craig E; Inniger, Meredith C

    2015-03-01

    As physicians embrace their roles in managing healthcare costs and quality, finance leaders should seize the opportunity to engage physicians in clinical care redesign to ensure both high-quality performance and efficient resource use. Finance leaders should strike a balance between risk and reward to achieve a portfolio of clinical initiatives that is organizationally sustainable and responsive to current external drivers of payment changes. Because these initiatives should be driven by physicians, the new skill set of finance leaders should include an emphasis on relationship building to achieve consensus and drive change across an organization.

  9. A study of risk evaluation methodology selection for the external hazards

    International Nuclear Information System (INIS)

    Kuramoto, Takahiro; Yamaguchi, Akira; Narumiya, Yosiyuki

    2014-01-01

    Since the accident at Fukushima Daiichi Nuclear Power Plant caused by the Great East Japan Earthquake in March 2011, there has been growing demands for assessing the effects of external hazards, including natural events, such as earthquake and tsunami, and external human behaviors, and taking actions to address those external hazards. The newly established Japanese regulatory requirements claim design considerations associated with external hazards. The primary objective of the risk assessment for external hazards is to establish countermeasures against such hazards rather than grasping the risk figures. Therefore, applying detailed risk assessment methods, such as probabilistic risk assessment (PRA), to all the external hazards is not always the most appropriate. Risk assessment methods can vary in types including qualitative evaluation, hazard analysis (analyzing hazard frequencies or their influence), and margin assessment. To resolve these issues, a process has been established that enables us to identify the external hazards in a comprehensive and systematic manner, which have potential risks leading to core damage and to select an appropriate evaluation method according to the risks associated with each of the external hazards. This paper discusses the comprehensive and systematic identification process for the external hazards which have potential risks leading to core damage, and the approaches of selecting an appropriate evaluation method for each external hazard. This paper also describes some applications of specific risk evaluation methods. (author)

  10. Preliminary results on scintigraphic evaluation of malignant external otitis

    International Nuclear Information System (INIS)

    Malamitsi, J.; Maragoudakis, P.; Papafragou, K.; Koukouliou, V.; Kalatzis, Y.; Adamopoulos, G.; Proukakis, C.

    1993-01-01

    Malignant external otitis (MEO) is a potentially fatal otitis occurring in diabetic and immunosuppressed patients, which may cause cranial nerve palsies and massive thrombophlebitis of the brain. We studied five diabetic patients with the clinical diagnosis of external otitis who were suspected of having MEO and one diabetic patient presumed cured from MEO. All of them underwent methylene diphosphonate, nanocolloid and gallium single-photon emission tomography studies with quantitative analysis on the basis of regions of interest and count profile curves. This combined assessment helped us to diagnose and follow-up soft tissue and temporal bone infection, especially in the case of transsphenoidal extension of the disease, since conventional radiology and computed tomography were of no particular help. On the basis of these results, we consider scintigraphic demonstration of skull base infection as a fourth criterion of MEO given that the classical Chandler's triad (diabetes, granuloma, and Pseudomonas aeruginosa) is not always present. (orig.)

  11. Evaluation of the Match External Load in Soccer: Methods Comparison.

    Science.gov (United States)

    Castagna, Carlo; Varley, Matthew; Póvoas, Susana C A; D'Ottavio, Stefano

    2017-04-01

    To test the interchangeability of 2 match-analysis approaches for external-load detection considering arbitrary selected speeds and metabolic power (MP) thresholds in male top-level soccer. Data analyses were performed considering match physical performance of 60 matches (1200 player cases) of randomly selected Spanish, German, and English first-division championship matches (2013-14 season). Match analysis was performed with a validated semiautomated multicamera system operating at 25 Hz. During a match, players covered 10,673 ± 348 m, of which 1778 ± 208 m and 2759 ± 241 m were performed at high intensity, as measured using speed (≥16 km/h, HI) and metabolic power (≥20 W/kg, MPHI) notations. High-intensity notations were nearly perfectly associated (r = .93, P Player high-intensity decelerations (≥-2 m/s 2 ) were very largely associated with MPHI (r = .73, P physical match-analysis methods can be independently used to track match external load in elite-level players. However, match-analyst decisions must be based on use of a single method to avoid bias in external-load determination.

  12. Impact of external events on site evaluation: a probabilistic approach

    International Nuclear Information System (INIS)

    Jaccarino, E.; Giuliani, P.; Zaffiro, C.

    1975-01-01

    A probabilistic method is proposed for definition of the reference external events of nuclear sites. The external events taken into account are earthquakes, floods and tornadoes. On the basis of the available historical data for each event it is possible to perform statistical analyses to determine the probability of occurrence on site of events of given characteristics. For earthquakes, the method of analysis takes into consideration both the annual frequency of seismic events in Italy and the probabilistic distribution of areas stricken by each event. For floods, the methods of analysis of hydrological data and the basic criteria for the determination of design events are discussed and the general lines of the hydraulic analysis of a nuclear site are shown. For tornadoes, the statistical analysis has been performed for the events which occurred in Italy during the last 40 years; these events have been classified according to an empirical intensity scale. The probability of each reference event should be a function of the potential radiological damage associated with the particular type of plant which must be installed on the site. Thus the reference event could be chosen such that for the whole of the national territory the risk for safety and environmental protection is the same. (author)

  13. Application of Computer Simulation Modeling to Medication Administration Process Redesign

    OpenAIRE

    Huynh, Nathan; Snyder, Rita; Vidal, Jose M.; Tavakoli, Abbas S.; Cai, Bo

    2012-01-01

    The medication administration process (MAP) is one of the most high-risk processes in health care. MAP workflow redesign can precipitate both unanticipated and unintended consequences that can lead to new medication safety risks and workflow inefficiencies. Thus, it is necessary to have a tool to evaluate the impact of redesign approaches in advance of their clinical implementation. This paper discusses the development of an agent-based MAP computer simulation model that can be used to assess...

  14. Website Redesign: A Case Study.

    Science.gov (United States)

    Wu, Jin; Brown, Janis F

    2016-01-01

    A library website redesign is a complicated and at times arduous task, requiring many different steps including determining user needs, analyzing past user behavior, examining other websites, defining design preferences, testing, marketing, and launching the site. Many different types of expertise are required over the entire process. Lessons learned from the Norris Medical Library's experience with the redesign effort may be useful to others undertaking a similar project.

  15. Life Cycle Assessment, ExternE and Comprehensive Analysis for an integrated evaluation of the environmental impact of anthropogenic activities

    Energy Technology Data Exchange (ETDEWEB)

    Pietrapertosa, F.; Cosmi, C. [National Research Council, Institute of Methodologies for Environmental Analysis C.N.R.-I.M.A.A. C.da S.Loja, I-85050 Tito Scalo (PZ) (Italy); National Research Council, National Institute for the Physics of Matter, C.N.R.-I.N.F.M. Via Cinthia, I-80126 Naples (Italy); Macchiato, M. [Federico II University, Department of Physical Sciences, Via Cinthia, I-80126 Naples (Italy); National Research Council, National Institute for the Physics of Matter, C.N.R.-I.N.F.M. Via Cinthia, I-80126 Naples (Italy); Salvia, M.; Cuomo, V. [National Research Council, Institute of Methodologies for Environmental Analysis C.N.R.-I.M.A.A. C.da S.Loja, I-85050 Tito Scalo (PZ) (Italy)

    2009-06-15

    The implementation of resource management strategies aimed at reducing the impacts of the anthropogenic activities system requires a comprehensive approach to evaluate on the whole the environmental burdens of productive processes and to identify the best recovery strategies from both an environmental and an economic point of view. In this framework, an analytical methodology based on the integration of Life Cycle Assessment (LCA), ExternE and Comprehensive Analysis was developed to perform an in-depth investigation of energy systems. The LCA methodology, largely utilised by the international scientific community for the assessment of the environmental performances of technologies, combined with Comprehensive Analysis allows modelling the overall system of anthropogenic activities, as well as sub-systems, the economic consequences of the whole set of environmental damages. Moreover, internalising external costs into partial equilibrium models, as those utilised by Comprehensive Analysis, can be useful to identify the best paths for implementing technology innovation and strategies aimed to a more sustainable energy supply and use. This paper presents an integrated application of these three methodologies to a local scale case study (the Val D'Agri area in Basilicata, Southern Italy), aimed to better characterise the environmental impacts of the energy system, with particular reference to extraction activities. The innovative methodological approach utilised takes advantage from the strength points of each methodology with an added value coming from their integration as emphasised by the main results obtained by the scenario analysis. (author)

  16. Economic effect of fusion in energy market. Various externalities of energy systems and the integrated evaluation

    International Nuclear Information System (INIS)

    Ito, Keishiro

    2002-01-01

    The primacy of a nuclear fusion reactor in a competitive energy market remarkably depends on to what extent the reactor contributes to reduce the externalities of energy. The reduction effects are classified into two effects, which have quite dissimilar characteristics. One is an effect of environmental dimensions. The other is related to energy security. In this study I took up the results of EC's ExternE project studies as a representative example of the former effect. Concerning the latter effect, I clarified the fundamental characteristics of externalities related to energy security and the conceptual framework for the purpose of evaluation. In the socio-economical evaluation of research into and development investments in nuclear fusions reactors, the public will require the development of integrated evaluation systems to support the cost-effect analysis of how well the reduction effects of externalities have been integrated with the effects of technological innovation, learning, spillover, etc. (author)

  17. Identifying and Evaluating External Validity Evidence for Passing Scores

    Science.gov (United States)

    Davis-Becker, Susan L.; Buckendahl, Chad W.

    2013-01-01

    A critical component of the standard setting process is collecting evidence to evaluate the recommended cut scores and their use for making decisions and classifying students based on test performance. Kane (1994, 2001) proposed a framework by which practitioners can identify and evaluate evidence of the results of the standard setting from (1)…

  18. [The external evaluation of study quality: the role in maintaining the reliability of laboratory information].

    Science.gov (United States)

    Men'shikov, V V

    2013-08-01

    The external evaluation of quality of clinical laboratory examinations was gradually introduced in USSR medical laboratories since 1970s. In Russia, in the middle of 1990 a unified all-national system of external evaluation quality was organized known as the Federal center of external evaluation of quality at the basis of laboratory of the state research center of preventive medicine. The main positions of policy in this area were neatly formulated in the guidance documents of ministry of Health. Nowadays, the center of external evaluation of quality proposes 100 and more types of control studies and permanently extends their specter starting from interests of different disciplines of clinical medicine. The consistent participation of laboratories in the cycles of external evaluation of quality intrinsically promotes improvement of indicators of properness and precision of analysis results and increases reliability of laboratory information. However, a significant percentage of laboratories does not participate at all in external evaluation of quality or takes part in control process irregularly and in limited number of tests. The managers of a number of medical organizations disregard the application of the proposed possibilities to increase reliability of laboratory information and limit financing of studies in the field of quality control. The article proposes to adopt the national standard on the basis of ISO 17043 "Evaluation of compliance. The common requirements of professional competence testing".

  19. Cognitive Evaluation Theory: The Effects of External Rewards on Intrinsic Motivation of Gifted Students.

    Science.gov (United States)

    Rogers, Brenda T.

    1985-01-01

    E. Deci's cognitive evaluation theory, which suggests that external rewards undermine intrinsic interest in an activity, is applied to the decline of instrinsic motivation in gifted students. Implications for feedback, rewards, and teacher role are noted. (CL)

  20. EVALUATION OF WASTE PACKAGE EXTERNAL ENVIRONMENTAL CONDITION STUDY

    International Nuclear Information System (INIS)

    E. N. Lindner and E. F. Dembowski

    1998-01-01

    The U. S. Department of Energy (DOE) is studying Yucca Mountain as the possible site for a permanent underground repository for disposal of spent nuclear fuel (SNF) and other high-level waste (HLW). The emplacement of high-level radioactive waste in Yucca Mountain will release a large amount of heat into the rock above and below the repository. Due to this heat, the rock temperature will rise, and then decrease when the production of decay heat falls below the rate at which heat escapes from the hot zone. In addition to raising the rock temperature, the heat will vaporize water, which will condense in cooler regions. The condensate water may drain back toward the emplacement drifts or it may ''shed'' through the pillars between emplacement drifts. Other effects, such as coupled chemical and mechanical processes, may influence the movement of water above, within, and below the emplacement drifts. This study examined near field environmental parameters that could have an effect on the waste package, including temperature, humidity, seepage rate, pH of seepage, chemistry (dissolved salts/minerals) of seepage, composition of drift atmosphere, colloids, and biota. This report is a Type I analysis performed in support of the development of System Description Documents (SDDs). A Type I analysis is a quantitative or qualitative analysis that may fulfill any of a variety of purposes associated with the Monitored Geologic Repository (MGR), other than providing direct analytical support for design output documents. A Type I analysis may establish design input, as defined in the ''Quality Assurance Requirements and Description'' (QARD) (DOE 1998). This study establishes a technical basis for emplacement drift (i.e. at the waste package surface) environment criteria to be considered in the development of the waste package design. The information will support development of several SDDs and resolve emplacement drift external environment questions in the criteria of those

  1. Comparison and improvements of different Bayesian procedures to integrate external information into genetic evaluations

    NARCIS (Netherlands)

    Vandenplas, J.; Gengler, N.

    2012-01-01

    The aim of this research was to compare different Bayesian procedures to integrate information from outside a given evaluation system, hereafter called external information, and in this context estimated breeding values (EBV), into this genetic evaluation, hereafter called internal evaluation, and

  2. Redesigning the Way We Listen

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2014-01-01

    This paper is based on a research project-in-progress investigating curatorial practice as methodology for creating responsive interfaces to sound art practices. Sound art is a transdisciplinary practice. As such, it creates new domains that may be used for redesign-purposes. Not only do experien......This paper is based on a research project-in-progress investigating curatorial practice as methodology for creating responsive interfaces to sound art practices. Sound art is a transdisciplinary practice. As such, it creates new domains that may be used for redesign-purposes. Not only do...... experiences of sound alter; the way we listen to sound is transforming as well. Thus, the paper analyses and discusses two responsive sound interfaces and claim that curating as a transdisciplinary practice may frame what is termed in the paper as a domain-game redesigning the way the audience listens...

  3. Supplier's evaluation - internal and external audits and surveillance

    International Nuclear Information System (INIS)

    Fowler, J.L.; Derrick, R.

    1976-01-01

    The quality programme for SGHWR type reactors places responsibility upon all purchasers to evaluate potential suppliers' quality systems and to conduct audits and surveillance on the implementation of suppliers' quality assurance programmes during contract performance. This will be carried out in accordance with the requirements of Central Electricity Board standard QA42. It also places a responsibilty on every supplier to conduct in-house audits and surveillance of the effectiveness of his own quality assurance programmes. These procedures are discussed. (U.K.)

  4. An economic evaluation of nuclear power plant externalities, using the hedonic price approach

    OpenAIRE

    Kato, Hirotaka; Ueta, Kazuhiro

    2012-01-01

    This study evaluates the external costs of nuclear power plants in Japan. Using the hedonic price approach, we analyze changes in land price in Fukui Prefecture before and after the Fukushima nuclear accident. The land in question is located far from the Fukushima accident area and was not directly impacted by the accident itself. The results of this study reveal that the area affected by the nuclear power plant's negative externalities expanded following the accident, and that the intensity ...

  5. External school evaluation in Portugal : a glance at the impacts on curricular and pedagogical practices

    OpenAIRE

    Leite, Carlinda; Morgado, José Carlos; Seabra, Filipa

    2014-01-01

    Conferência realizada na Universidade do Minho, em Braga de 18-19 de outubro de 2013 Answering demands for an increase of accountability in terms of public education, and intending to lead to an improvement of the quality of education (Conselho Nacional de Educação, 2010), external school evaluation has been taking place in the continental territory of Portugal since 2006. All the schools having been evaluated once, in what is known as the 1st cycle of external evaluation, and a 2nd cycle ...

  6. [External cephalic version of breech fetus after 36 weeks of gestation - evaluation of efectiveness and complications].

    Science.gov (United States)

    Hruban, L; Janků, P; Jordánová, K; Gerychová, R; Huser, M; Ventruba, P; Roztočil, A

    2017-01-01

    Evaluation of success rate and the safety of external cephalic version after 36 weeks of gestation. Retrospective analysis. Department of Obstetrics and Gynecology, Masaryk University, University Hospital Brno. A retrospective analysis of external cephalic version attempts performed on a group of 638 singleton breech pregnancies after 36 weeks gestation in the years 2003-2016 at the Department of Gynecology and Obstetrics, Masaryk University, Brno. The effectiveness, number and type of complications, mode of delivery and perinatal result were observed. The effectiveness of external cephalic version from breech to head presentation was 47.8% (305 cases). After a successful external cephalic version 238 patients (78.0%) gave birth vaginally. After unsuccessful cephalic version 130 patients (39.0%) gave birth vaginally. The number of serious complications did not exceed 0,9% and did not affect perinatal outcomes. External cephalic version-related emergency cesarean deliveries occurred in 6 cases (2 placental abruption, 4 abnormal cardiotocography). The fetal outcome was good in all these cases. The death of the fetus in connection with the external version has not occurred in our file. Spontaneous discharge of amniotic fluid within 24 hours after procedure occurred in 5 cases (0.8%). The spontaneous onset of labor within 24 hours of procedure occurred in 5 cases (0.8%). The pH value of a. umbilicalis external version and in the group with unsuccessful external version in 9 cases. The Apgar score in the 5th minute external cephalic version of the fetus in the case of breech presentation after the 36th week of pregnancy is an effective and safe alternative for women who have a fear of the vaginal breech delivery. Performing the external cephalic version can reduce the rate of elective caesarean sections due to breech presentation at term.

  7. The Role of External Sources of Information in Children's Evaluative Food Categories

    Science.gov (United States)

    Nguyen, Simone P.

    2012-01-01

    Evaluative food categories are value-laden assessments, which reflect the healthfulness and palatability of foods (e.g. healthy/unhealthy, yummy/yucky). In a series of three studies, this research examines how 3- to 4-year-old children (N?=?147) form evaluative food categories based on input from external sources of information. The results…

  8. 10 CFR 501.67 - Petition redesignations.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Petition redesignations. 501.67 Section 501.67 Energy... Certifications § 501.67 Petition redesignations. OFE, with the petitioner's approval, will redesignate an exemption petition if the petitioner qualifies for an exemption other than the one originally requested...

  9. External Benefit Evaluation of Renewable Energy Power in China for Sustainability

    Directory of Open Access Journals (Sweden)

    Huiru Zhao

    2015-04-01

    Full Text Available China’s renewable energy power has developed rapidly in recent years. Evaluating the external benefits of renewable energy power can provide a reference for the Chinese government to set diverse development goals and to implement differentiated supporting policies for different renewable energy power types, which can promote their sustainable development. In this paper, a hybrid MCDM method was applied to evaluate the external benefits of China’s renewable energy power. Firstly, the impacts of renewable energy power accessing the power grid for multiple stakeholders in the electric power system were analyzed. Secondly, the external benefit evaluation index system for renewable energy power was built from the economic, social and environmental factors, based on the concept of sustainability. Then, the basic theory of the hybrid MCDM method employed in this paper was introduced in two parts: the superiority linguistic ratings and entropy weighting method for index weight determination and the fuzzy grey relation analysis for ranking alternatives. Finally, the external benefits of wind power, solar PV power and biomass power were evaluated. Taking a regional electric power system as an example, the results show that PV power has the greatest external benefit, followed by wind power and biomass power. Therefore, more policies supporting PV power should be put in place to promote the harmonious and sustainable development of the whole renewable energy power industry.

  10. Field Evaluation of the System Identification Approach for Tension Estimation of External Tendons

    Directory of Open Access Journals (Sweden)

    Myung-Hyun Noh

    2015-01-01

    Full Text Available Various types of external tendons are considered to verify the applicability of tension estimation method based on the finite element model with system identification technique. The proposed method is applied to estimate the tension of benchmark numerical example, model structure, and field structure. The numerical and experimental results show that the existing methods such as taut string theory and linear regression method show large error in the estimated tension when the condition of external tendon is different with the basic assumption used during the derivation of relationship between tension and natural frequency. However, the proposed method gives reasonable results for all of the considered external tendons in this study. Furthermore, the proposed method can evaluate the accuracy of estimated tension indirectly by comparing the measured and calculated natural frequencies. Therefore, the proposed method can be effectively used for field application of various types of external tendons.

  11. The establishment of bilateral external iliac artery stenosis model in experimental canines and its angiographic evaluation

    International Nuclear Information System (INIS)

    Xia Yonghui; Li Weixiao; Bi Yonghua; Xu Ke

    2011-01-01

    Objective: To establish an experimental canine model of bilateral external iliac artery stenosis by surgical method with absorbable suture. Methods: Under general anesthesia bilateral external iliac arteries were partly obstructed (about 50%) with absorbable suture in ten dogs. Three months later angiography was performed to evaluate the arterial stricture degree. Results: Bilateral external iliac artery stenosis model was successfully established in eight dogs and the other two dogs died within two weeks after the procedure. Angiography performed three months after the procedure showed that the stricture degree of arterial lumen was (60.6±12.5)%. Conclusion: Satisfactory experimental canine model of bilateral external iliac artery stenosis can be established by surgical method with absorbable suture. This method can be used for reference when peripheral artery stenosis model is to be prepared in larger animals. (authors)

  12. Alignment of the External Evaluation and Specific Features of Waldorf1 Pedagogy

    Directory of Open Access Journals (Sweden)

    Andrea Liszka

    2016-12-01

    Full Text Available Evaluation and assessment have increasing importance in education. Because of an international trend toward greater school autonomy, evaluation and assessment is fueling a need to monitor how schools are doing as, simultaneously, with demand is increasing for effectiveness, equity and quality in all fields of education, whether mainstream or alternative (OECD, 2013. This study aims to observe the state-required external evaluation of Waldorf kindergartens in Berlin, until now the only case in international practice in which the state has evaluated Waldorf/Steiner institutions’ professional work. The main question is how these institutions can preserve their own profiles during the external evaluation process. This question also has great importance in Hungary because a new state evaluation system has recently been introduced that will concern the Waldorf/Steiner schools.

  13. Evaluation of external hazards to nuclear power plants in the United States

    International Nuclear Information System (INIS)

    Kimura, C.Y.; Budnitz, R.J.

    1987-12-01

    The Lawrence Livermore National Laboratory (LLNL) has performed a study of the risk of core damage to nuclear power plants in the United States due to externally initiated events. The broad objective has been to gain an understanding of whether or not each external initiator is among the major potential accident initiators that may pose a threat of severe reactor core damage or of large radioactive release to the environment from the reactor. Four external hazards were investigated in this report. These external hazards are internal fires, high winds/tornadoes, external floods, and transportation accidents. Analysis was based on two figures-of-merit, one based on core damage frequency and the other based on the frequency of large radioactive releases. Using these two figures-of-merit as evaluation criteria, it has been feasible to ascertain whether the risk from externally initiated accidents is, or is not, an important contributor to overall risk for the US nuclear power plants studied. This has been accomplished for each initiator separately. 208 refs., 17 figs., 45 tabs

  14. The External Cost Evaluation of the Nuclear Severe Accident Using CVM

    International Nuclear Information System (INIS)

    Lee, Yong Suk; Lee, Byung Chul

    2006-01-01

    The external cost of energy can be defined as 'the cost not included in the energy market price', such as air pollution, noise, etc. Within the evaluation of the external cost of nuclear energy, the estimation of the external cost of severe accident is one of the major topics to be addressed. For the evaluation of the external cost of severe accident, the effect of risk aversion of the public against the severe accident must be addressed, because people are more concerned about low probability - high consequence events than about high probability - low consequence events having the same mean damage. It is generally recognized that there is a discrepancy between the social acceptability of the risk and the average monetary value which corresponds in principle to the compensation of the consequences for each individual of the population affected by the accident. In this paper, the CVM (Contingent Valuation Method) is used to integrate the risk aversion in the external costs of nuclear severe accidents in Korea

  15. The Perceived Impact of External Evaluation: The System, Organisation and Individual Levels-Estonian Case

    Science.gov (United States)

    Seema, Riin; Udam, Maiki; Mattisen, Heli; Lauri, Liia

    2017-01-01

    The purpose of this article is to provide an overview of how the employees of higher education institutions perceive the impact of external evaluations. The study was conducted using the concurrent mixed method and involved 361 employees from Estonian universities and professional higher education institutions. The results indicated that…

  16. Effects of Internal and External Focus of Attention on Novices' Rehearsal Evaluations

    Science.gov (United States)

    Silvey, Brian A.; Montemayor, Mark

    2014-01-01

    The purpose of this study was to investigate the effects of internal and external focus of attention on novices' rehearsal evaluations. Thirty-two undergraduate instrumental music education students led bands in a series of three 6-minute rehearsals on their assigned excerpt. Prior to these rehearsals, participants were led in score study and…

  17. Application of Computer Simulation Modeling to Medication Administration Process Redesign

    Directory of Open Access Journals (Sweden)

    Nathan Huynh

    2012-01-01

    Full Text Available The medication administration process (MAP is one of the most high-risk processes in health care. MAP workflow redesign can precipitate both unanticipated and unintended consequences that can lead to new medication safety risks and workflow inefficiencies. Thus, it is necessary to have a tool to evaluate the impact of redesign approaches in advance of their clinical implementation. This paper discusses the development of an agent-based MAP computer simulation model that can be used to assess the impact of MAP workflow redesign on MAP performance. The agent-based approach is adopted in order to capture Registered Nurse medication administration performance. The process of designing, developing, validating, and testing such a model is explained. Work is underway to collect MAP data in a hospital setting to provide more complex MAP observations to extend development of the model to better represent the complexity of MAP.

  18. The evaluation of external data resources for business intelligence applications: the example of the Czech Republic

    Directory of Open Access Journals (Sweden)

    Veronika Jasikova

    2012-01-01

    Full Text Available Contemporary business requires relevant data for appropriate, effective and reliable decisions. The concept of Business Intelligence which has been successfully established in a lot of organisations necessitates gathering relevant internal as well as external data which are often hardly acquirable. The aim of this paper is to analyse both the quality and availability of the sample of the external data resources on the basis of selected criteria and to enable the evaluation of their potential. The research reveals that the resources are currently not as suitable and utilisable for the purposes of Business Intelligence as they are expected to be. Although there are exceptions such as data provided by particular governmental or national institutions, the majority of external data resources does not correspond to the requirements posed to their availability, credibility, update regularity, stability and technical accessibility.

  19. Redesigning Professional Development: Reconceptualising Teaching Using Social Learning Technologies

    Science.gov (United States)

    Cochrane, Thomas; Narayan, Vickel

    2013-01-01

    This article evaluates the use of a community of practice model for redesigning a lecturer professional development course investigating the impact of mobile web 2.0 technologies in higher education. The results show a significant change in lecturer conceptions of pedagogy were achieved by this approach. Drawing on our experience of two iterations…

  20. Integration of risk aversion in the evaluation of the external cost of a nuclear accident

    International Nuclear Information System (INIS)

    Eeckhoudt, L.; Schieber, C.; Schneider, Th.

    1998-01-01

    Full text of publication follows: the external costs of fuel cycles used in the production of electricity are those imposed on society and environment that are not accounted for by the producers and consumers of energy. Within the evaluation of the external cost of the nuclear fuel cycle, the evaluation of a nuclear accident has to be addressed. For this purpose, the basic approach consists in calculating the expected value of various occident scenarios. the main criticism of this approach is that there is a discrepancy between the social acceptability of the risk and the average monetary value which corresponds in principle to the compensation of the consequences for each individual of the population affected by the accident. The aim of this paper is to propose a methodology for the integration of risk aversion, relying on the expected utility approach, as well as a numerical application based on the French data for the external cost of a nuclear accident. Although a huge range of values has been published for the relative risk aversion coefficient, it seems reasonable to adopt a value of 2 for the specific case of nuclear accident. This leads to an estimated multiplying coefficient approximately equal to 20 to be applied to the expected external cost of a nuclear accident corresponding to a release of about 1% of the core. In this case, the external cost of the nuclear accident is estimated to 0.046 mECU/kWh (i.e. about 50% of the total external costs of the nuclear fuel cycle estimated at 0.1 mECU/kWh with a 3% discount rate), instead of 0.0023 mECU/kWh without taking into account risk aversion. (authors)

  1. External Dacryocystorhinostomy; Success Rate and Causes of Failure in Endoscopic and Pathologic Evaluations.

    Science.gov (United States)

    Ghasemi, Hassan; Asghari Asl, Sajedeh; Yarmohammadi, Mohammad Ebrahim; Jafari, Farhad; Izadi, Pupak

    2017-01-01

    External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative endoscopic and pathological evaluation. The current retrospective cross sectional study followed-up113 patients with external DCR and silicone intubation for three months. Silicone tubes were removed after the third months. Failure was confirmed based on the clinical findings and irrigation test. Paranasal sinus computed tomography (CT) scanning, and endoscopic and pathological evaluations were performed in the failed cases. Totally, 113 patients underwent external DCR. The patients included 71 females and 42 males. The mean age of the patients was 55.91 years; ranged from 18 to 86. Epiphora was the most common complaint before surgery (90.3%). Clinically, epiphora continued in 17 cases (15%), of which 94.11% had at least one sinus CT abnormality and 82.35% had at least one endoscopic abnormality. The most common endoscopic findings were deviated septum (70.6%), scar tissue (52.94%), concha bullosa (46.9%), septal adhesion (47.05%), enlarged middle turbinate (41.2%), and sump syndrome (11.7%). The failure was significantly associated with the chronicity of the initial symptoms (P-value=0.00). Pathologically, there were significant relationship amongst the failure rate, scar formation, and allergic rhinitis (P-values =0.00 and <0.05, respectively). Preoperative endonasal evaluation and consultation with an otolaryngologist can improve surgical outcomes and help to have a better conscious to intranasal abnormalities before external DCR surgery.

  2. Cervical external immobilization devices: evaluation of magnetic resonance imaging issues at 3.0 Tesla.

    Science.gov (United States)

    Diaz, Francis L; Tweardy, Lisa; Shellock, Frank G

    2010-02-15

    Laboratory investigation, ex vivo. Currently, no studies have addressed the magnetic resonance imaging (MRI) issues for cervical external immobilization devices at 3-Tesla. Under certain conditions significant heating may occur, resulting in patient burns. Furthermore, artifacts can be substantial and prevent the diagnostic use of MRI. Therefore, the objective of this investigation was to evaluate MRI issues for 4 different cervical external immobilization devices at 3-Tesla. Excessive heating and substantial artifacts are 2 potential complications associated with performing MRI at 3-Tesla in patients with cervical external immobilization devices. Using ex vivo testing techniques, MRI-related heating and artifacts were evaluated for 4 different cervical devices during MRI at 3-Tesla. Four cervical external immobilization devices (Generation 80, Resolve Ring and Superstructure, Resolve Ring and Jerome Vest/Jerome Superstructure, and the V1 Halo System; Ossur Americas, Aliso Viejo, CA) underwent MRI testing at 3-Tesla. All devices were made from nonmetallic or nonmagnetic materials. Heating was determined using a gelled-saline-filled skull phantom with fluoroptic thermometry probes attached to the skull pins. MRI was performed at 3-Tesla, using a high level of RF energy. Artifacts were assessed at 3-Tesla, using standard cervical imaging techniques. The Generation 80 and V1 Halo devices exhibited substantial temperature rises (11.6 degrees C and 8.5 degrees C, respectively), with "sparking" evident for the Generation 80 during the MRI procedure. Artifacts were problematic for these devices, as well. By comparison, the 2 Resolve Ring-based cervical external immobilization devices showed little or no heating (Tesla.

  3. SPECT imaging in evaluating extent of malignant external otitis: case report

    International Nuclear Information System (INIS)

    English, R.J.; Tu'Meh, S.S.; Piwnica-Worms, D.; Holman, B.L.

    1987-01-01

    Otitis externa, a benign inflammatory process of the external auditory canal, is general responsive to local therapy. Some patients however, develop a less controllable disease leading to chondritis and osteomyelitis of the base of the skull. The direct invasive characteristic of the disease has led to the descriptive term malignant external otitis (MEO), more appropriately called necrotizing or invasive external otitis. Malignant external otitis is caused by an aggressive pseudomonas or proteus infection that almost exclusively occurs in elderly diabetic patients. The primary imaging modalities previously used in the diagnosis and evaluation of MEO were standard planar scintigraphic techniques with technetium-99M (/sup 99m/Tc) bone agents and gallium-67 ( 67 Ga), and pluridirectional tomography. The advent of high resolution computed tomography (CT) effectively allowed demonstration of the soft tissue extension and bone destruction associated with MEO, but still suffered from the low sensitivity constraints of all radiographic techniques in determining early inflammatory bone involvement. Recent work suggests that scintigraphic detection of MEO with /sup 99m/Tc-MDP and 67 Ga, combined with the cross-sectional resolution of single photon emission computed tomography (SPECT) may be of value in planning treatment of this inflammatory condition

  4. Study on the measurements and evaluation of environmental external exposure after a nuclear accident

    International Nuclear Information System (INIS)

    Sakamoto, R.; Saito, K.; Tsutsumi, M.

    2001-01-01

    Several important issues which affect external exposure in contaminated Chernobyl areas have been investigated using field measurements and computational simulations since 1992. The objectives of the study were: 1) the development of a mobile survey method to collect radiation data over the contaminated wide areas in a shot time; 2) the verification of a method to infer external dose to the population; 3) the provision of basic data used for evaluation of external dose due to gamma ray using a Monte Carlo simulation method. To develop a method to rapidly measure radiation over wide areas and map the extend of fallout, a mobile survey system was constructed and tested; the conversion factors to convert the measured data to required quantities were examined; and finally a detailed contamination map was created. The field surveys were implemented by using a land rover and a helicopter. To infer external dose to inhabitants, radiation measurements were carried out in the living environments using accurate dose meters in addition to individual dose measurements using glass dosimeters. Individual doses were inferred from occupancy factors and dose rate data measured with portable dose rate meters in and around houses. The evaluated doses were compared to directly measured individual doses with glass dosimeters in the seven settlements. A good agreement was observed with an error margin of approximate 20%. Basic data used for the evaluation of environmental gamma-ray dose rate were calculated using a Monte Carlo method. The following two kinds of data have been provided from the calculation: a) conversion factors from the nuclide concentration in the ground to the air kerma rate at 1 m height; and b) shielding factors of a typical Chernobyl house for gamma radiation. (M. Suetake)

  5. Redesign of the Human Metabolic Simulator

    Science.gov (United States)

    Duffield, Bruce; Jeng, Frank; Lange, Kevin

    2004-01-01

    The National Aeronautics and Space Administration (NASA) is currently building a Human Metabolic Simulator (HMS) at the Johnson Space Center as part of the Advanced Life Support Air Revitalization Technology Evaluation Facility (ARTEF). The purpose of ARTEF is to evaluate Environmental Control and Life Support System Technologies for Advanced Missions. The HMS is needed to reproduce the primary metabolic effects of human respiration on an enclosed atmosphere when humans cannot be present and the impact of human presence on the system is required. A HMS was designed, built and successfully operated in 2000 but larger crew size requirements and the expense of upgrade of the current system necessitate redesign. This paper addresses the redesign. Several concepts were considered, ranging from chemical oxidation of a hydrocarbon like ethanol or ethyl acetate to carbon dioxide and water, oxidation of an iron-containing compound, or by using a fuel cell. For reasons of cost, simplicity, safety and other factors, the concept chosen includes: a molecular sieve packaged as an industrial oxygen concentrator to remove oxygen from the atmosphere, with direct carbon dioxide, water and heat injection. The water injection is done via heating water to steam with a heat exchanger and thermal effects are handled by directly adding heat to the air stream with a second heat exchanger. Both heat exchangers are supplied by a hot oil loop. The amount of oxygen removal, carbon dioxide addition, water addition and heat addition were calculated using metabolic profiles for respiration and heat, calculated using a series of empirical equations developed for International Space Station (ISS). Sketches of the Human Metabolic Simulator and the hot oil bath loop used to supply heat to the heat exchangers are included

  6. Influencing Organizational Commitment through Office Redesign

    Science.gov (United States)

    Morrow, Paula C.; McElroy, James C.; Scheibe, Kevin P.

    2012-01-01

    Prior research on the effects of office redesign on work-related outcomes has been largely a theoretical and yielded mixed and conflicting findings. Expanding on individual reactions to office design changes as specified by social interference theory, we propose that office redesign affects organizational commitment and this relationship is…

  7. 78 FR 27968 - Federal Management Regulation; Redesignations of Federal Buildings

    Science.gov (United States)

    2013-05-13

    ... Management Regulation; Redesignations of Federal Buildings AGENCY: Public Buildings Service (PBS), General... designation and redesignation of six Federal buildings. DATES: Expiration Date: This bulletin announcement expires July 30, 2013. The building designations and redesignations remains in effect until canceled or...

  8. Fracture Toughness Evaluation of Space Shuttle External Tank Thermal Protection System Polyurethane Foam Insulation Materials

    Science.gov (United States)

    McGill, Preston; Wells, Doug; Morgan, Kristin

    2006-01-01

    Experimental evaluation of the basic fracture properties of Thermal Protection System (TPS) polyurethane foam insulation materials was conducted to validate the methodology used in estimating critical defect sizes in TPS applications on the Space Shuttle External Fuel Tank. The polyurethane foam found on the External Tank (ET) is manufactured by mixing liquid constituents and allowing them to react and expand upwards - a process which creates component cells that are generally elongated in the foam rise direction and gives rise to mechanical anisotropy. Similarly, the application of successive foam layers to the ET produces cohesive foam interfaces (knitlines) which may lead to local variations in mechanical properties. This study reports the fracture toughness of BX-265, NCFI 24-124, and PDL-1034 closed-cell polyurethane foam as a function of ambient and cryogenic temperatures and knitline/cellular orientation at ambient pressure.

  9. Population Pharmacokinetics of Intravenous Paracetamol (Acetaminophen) in Preterm and Term Neonates: Model Development and External Evaluation.

    Science.gov (United States)

    Cook, Sarah F; Roberts, Jessica K; Samiee-Zafarghandy, Samira; Stockmann, Chris; King, Amber D; Deutsch, Nina; Williams, Elaine F; Allegaert, Karel; Wilkins, Diana G; Sherwin, Catherine M T; van den Anker, John N

    2016-01-01

    The aims of this study were to develop a population pharmacokinetic model for intravenous paracetamol in preterm and term neonates and to assess the generalizability of the model by testing its predictive performance in an external dataset. Nonlinear mixed-effects models were constructed from paracetamol concentration-time data in NONMEM 7.2. Potential covariates included body weight, gestational age, postnatal age, postmenstrual age, sex, race, total bilirubin, and estimated glomerular filtration rate. An external dataset was used to test the predictive performance of the model through calculation of bias, precision, and normalized prediction distribution errors. The model-building dataset included 260 observations from 35 neonates with a mean gestational age of 33.6 weeks [standard deviation (SD) 6.6]. Data were well-described by a one-compartment model with first-order elimination. Weight predicted paracetamol clearance and volume of distribution, which were estimated as 0.348 L/h (5.5 % relative standard error; 30.8 % coefficient of variation) and 2.46 L (3.5 % relative standard error; 14.3 % coefficient of variation), respectively, at the mean subject weight of 2.30 kg. An external evaluation was performed on an independent dataset that included 436 observations from 60 neonates with a mean gestational age of 35.6 weeks (SD 4.3). The median prediction error was 10.1 % [95 % confidence interval (CI) 6.1-14.3] and the median absolute prediction error was 25.3 % (95 % CI 23.1-28.1). Weight predicted intravenous paracetamol pharmacokinetics in neonates ranging from extreme preterm to full-term gestational status. External evaluation suggested that these findings should be generalizable to other similar patient populations.

  10. Evaluation of GafChromic EBT prototype B for external beam dose verification

    International Nuclear Information System (INIS)

    Todorovic, M.; Fischer, M.; Cremers, F.; Thom, E.; Schmidt, R.

    2006-01-01

    The capability of the new GafChromic EBT prototype B for external beam dose verification is investigated in this paper. First the general characteristics of this film (dose response, postirradiation coloration, influence of calibration field size) were derived using a flat-bed scanner. In the dose range from 0.1 to 8 Gy, the sensitivity of the EBT prototype B film is ten times higher than the response of the GafChromic HS, which so far was the GafChromic film with the highest sensitivity. Compared with the Kodak EDR2 film, the response of the EBT is higher by a factor of 3 in the dose range from 0.1 to 8 Gy. The GafChromic EBT almost does not show a temporal growth of the optical density and there is no influence of the chosen calibration field size on the dose response curve obtained from this data. A MatLab program was written to evaluate the two-dimensional dose distributions from treatment planning systems and GafChromic EBT film measurements. Verification of external beam therapy (SRT, IMRT) using the above-mentioned approach resulted in very small differences between the planned and the applied dose. The GafChromic EBT prototype B together with the flat-bed scanner and MatLab is a successful approach for making the advantages of the GafChromic films applicable for verification of external beam therapy

  11. Evaluation of external heat loss from a small-scale expander used in organic Rankine cycle

    International Nuclear Information System (INIS)

    Li Jing; Pei Gang; Li Yunzhu; Ji Jie

    2011-01-01

    With the scaling down of the Organic Rankine Cycle (ORC), the engine shaft power is not only determined by the enthalpy drop in the expansion process but also the external heat loss from the expander. Theoretical and experimental support in evaluating small-scale expander heat loss is rare. This paper presents a quantitative study on the convection, radiation, and conduction heat transfer from a kW-scale expander. A mathematical model is built and validated. The results show that the external radiative or convective heat loss coefficient was about 3.2 or 7.0 W/K.m 2 when the ORC operated around 100 o C. Radiative and convective heat loss coefficients increased as the expander operation temperature increased. Conductive heat loss due to the connection between the expander and the support accounted for a large proportion of the total heat loss. The fitting relationships between heat loss and mean temperature difference were established. It is suggested that low conductivity material be embodied in the support of expander. Mattress insulation for compact expander could be eliminated when the operation temperature is around 100 o C. - Highlights: → A close examination of external heat loss from a small expander is presented. → Theoretical analysis and experimental test were conducted. → The established formulas can be applied to other small ORC expanders. → The results are useful in further research of small-scale ORC.

  12. PSA approach for the evaluation of external hazards as part of CNSC Fukushima action items

    International Nuclear Information System (INIS)

    Xu, Michael; Yalaoui, Smain

    2014-01-01

    This paper introduces the PSA approach that Canadian licensees adopted to address the Canadian Nuclear Safety Commission (CNSC) Fukushima Action Items (FAIs) [1] with respect to external hazards evaluation. This paper focus on the FAIs specifically associated with the external hazard evaluation. It also briefly discusses the similarity and differences between the requirements of CNSC FAIs, the Western European Nuclear Regulators' Association (WENRA) Stress Test [2], and the USNRC 'Request for Information'[3]. This paper provides a status update on the completion of the FAIs by the Canadian licensees' and discusses the lessons learned from the implementation of these actions items. It also identifies the importance of a closer interaction between the CNSC and other government agencies for the characterization of as well as for the protection against the external natural hazards. It also highlights some other areas that include research projects on external hazards, combined methodologies from the licensees, etc. The views expressed in this paper are those of the authors and do not necessarily reflect those of CNSC, or any part thereof. All Canadian licensees are currently preparing their plant specific reports to address the relevant FAIs. Some preliminary hazards screening reports, as well as the reports for probabilistic seismic hazards analysis, external flood hazard and high wind hazard have been submitted to CNSC. CNSC, in conjunction other Canadian government agencies, are currently reviewing these reports to determine their acceptability. The licensees are expected to submit all required reports by the end of this year. In the meantime, other Fukushima actions requiring facility enhancements are underway for some licensees. These include: - acquiring additional emergency mitigating portable equipment, such as power generators and pumps, which can be stored onsite and offsite and used to bring reactors to a safe shutdown state, in the unlikely event of a

  13. The external dimension of the Sixth Environment Action Programme: an evaluation of implementing policy instruments: final report

    NARCIS (Netherlands)

    Adelle, C.; Fajardo del Castillo, T.; Pallemaerts, M.; Withana, S.; Van Den Bossche, K.

    2010-01-01

    This report evaluates the EU’s progress on the external dimension of the 6EAP, with a particular focus on the EU’s consumption and production of global natural resources. It explores the EU’s activities in pursuit of its objectives set out in the 6EAP which relate to the external dimension by

  14. External contamination and skin dose. From ICRP and regulations to skin dose evaluation in practice

    International Nuclear Information System (INIS)

    Le Coulteulx, I.; Apretna, D.; Beaugerie, M.; Fenolland, J.; Frey, R.; Gonin, M.; Landry, B.; Laporte, E.; Le Guen, B.; Leval, D.

    2006-01-01

    Dose limitation to the skin is an objective of radiation protection. Our aim is to propose in case of skin contamination in EDF NPPs a simply, quickly and reproducible procedure for evaluating skin dose. French regulation admit an annual limit for skin dose over one square centimeter equal to 500 mSv. ICRP Publication 26 and 60 recommend that dose assessment be performed only if skin dose might be equal to or more than 50 mSv at basal cells. To respect this recommendation, an alert value (A) must be determined. This value is the lowest value of measurement from which dose assessment has to be made, based on the hypothesis that uninterrupted work time in controlled area is no more than four hours. This alert value (A) has been established for three external detection equipments, and for the ten radionuclides commonly detected. In case of external contamination, a first measurement is performed. If the value exceeds value (A), other measurements are instituted because skin dose evaluation needs to know other parameters as: - the radioactivity of the most contaminated square centimeter of the skin, - the identity of the radionuclides and their relative proportion. At the same time, we have to evaluate the length of the exposure. At last, we use different compiled results in a program developed from excel software which allow to calculate automatically the skin dose. This work has allowed us to publish an occupational health guideline about the assessment of skin dose in case of external contamination in EDF NPPs and to create an information booklet for workers. The authors propose to examine used methodology and to demonstrate the software. (authors)

  15. Ultrasonographic evaluation of myometrial thickness and prediction of a successful external cephalic version.

    Science.gov (United States)

    Buhimschi, Catalin S; Buhimschi, Irina A; Wehrum, Mark J; Molaskey-Jones, Sherry; Sfakianaki, Anna K; Pettker, Christian M; Thung, Stephen; Campbell, Katherine H; Dulay, Antonette T; Funai, Edmund F; Bahtiyar, Mert O

    2011-10-01

    To test the hypothesis that myometrial thickness predicts the success of external cephalic version. Abdominal ultrasonographic scans were performed in 114 consecutive pregnant women with breech singletons before an external cephalic version maneuver. Myometrial thickness was measured by a standardized protocol at three sites: the lower segment, midanterior wall, and the fundal uterine wall. Independent variables analyzed in conjunction with myometrial thickness were: maternal age, parity, body mass index, abdominal wall thickness, estimated fetal weight, amniotic fluid index, placental thickness and location, fetal spine position, breech type, and delivery outcomes such as final mode of delivery and birth weight. Successful version was associated with a thicker ultrasonographic fundal myometrium (unsuccessful: 6.7 [5.5-8.4] compared with successful: 7.4 [6.6-9.7] mm, P=.037). Multivariate regression analysis showed that increased fundal myometrial thickness, high amniotic fluid index, and nonfrank breech presentation were the strongest independent predictors of external cephalic version success (Pexternal cephalic versions (fundal myometrial thickness: odds ratio [OR] 2.4, 95% confidence interval [CI] 1.1-5.2, P=.029; amniotic fluid index: OR 2.8, 95% CI 1.3-6.0, P=.008). Combining the two variables resulted in an absolute risk reduction for a failed version of 27.6% (95% CI 7.1-48.1) and a number needed to treat of four (95% CI 2.1-14.2). Fundal myometrial thickness and amniotic fluid index contribute to success of external cephalic version and their evaluation can be easily incorporated in algorithms before the procedure. III.

  16. The Life Cycle Evaluation Model of External Diseconomy of Open-loop Supply Chain

    Science.gov (United States)

    Liu, Qian; Hu, Tianjun

    2017-08-01

    In recent years, with the continuous deterioration of pollution, resource space is gradually narrowed, the number of waste items increased, people began to use the method of recycling on waste products to ease the pressure on the environment. This paper adopted the external diseconomy of open-loop supply chain as the research object and constructed the model by the life cycle evaluation method, comparative analysis through the case. This paper also concludes that the key to solving the problem is to realize the closed-loop supply chain and building reverse logistics system is of great significance.

  17. International Space Station (ISS) Potable Water Dispenser (PWD) Beverage Adapter (BA) Redesign

    Science.gov (United States)

    Edgerly, Rachel; Benoit, Jace; Shindo, David

    2012-01-01

    The Potable Water Dispenser used on the International Space Station (ISS) interfaces with food and drink packages using the Beverage Adapter and Needle. Unexpected leakage has been seen in this interface. The Beverage Adapter used on ]orbit was returned to the ground for Test, Teardown, and Evaluation. The results of that investigation prompted a redesign of the Beverage Adapter and Needle. The Beverage Adapter materials were changed to be more corrosion resistant, and the Needle was redesigned to preclude leakage. The redesigns have been tested and proven.

  18. Cognitive Evaluation of a Physician Data Query Tool for a National ICU Registry: Comparing Two Think Aloud Variants and Their Application in Redesign

    NARCIS (Netherlands)

    Peute, Linda W.; de Keizer, Nicolette F.; Jaspers, Monique W. M.

    2010-01-01

    Applying usability methods in formative evaluations of interactive healthcare information systems design is recognized as of extreme importance to the final success of these systems. However, it seems that the merits of specific methodological approaches for conducting these studies have received

  19. Measurement and evaluation of the external radiation level at reactor Kartini

    International Nuclear Information System (INIS)

    Atok Suhartanto; Suparno

    2013-01-01

    Measurement and evaluation of external radiation level at reactor Kartini in 2012 has been done. The purpose of this activity is to know the external radiation level as a result of the radioactive or radiation source usage, toward the operational of limit condition. The measurement is using survey meter Inspector 11086, factor of calibration 0.991 mR/h, at 9 locations is: Control room area, Thermal column facilities, Demineralizer, Beamport radiography facilities, bulk shielding Deck, Subcritical facilities, Reactor hall, Deck reactor and on the surface of reactor water tank . The highest room average measurement result in 9 working areas for 12 months continuously are at the reactor tank location is between 13.05±1.09 (xlO -2 mSv/hour) to 16.80±1.40 (x10 -2 mSv/hour), and the lowest measurement result in 1 location (control room) is 0.02±0.005 (x10 -2 mSv/hour) to 0.035±0.009 (x10 -2 mSv/hour). The Kartini reactor is involved in the control area which has potentially contaminated and has radiation exposure at the level of 6 mSv/year. Radiation Protection Officer that work in interval will received radiation exposure dosage of 8.4 mSv/year. This dosage is still below the Below Dosage Value which is recommended by, BAPETEN decree No, 4, 2013 about Protection and Radiation Safety in Nuclear Energy Application at 20 mSv/year. The result of the evaluation above shows that the external radiation which occurred in each area is still below the operational of limit condition that is written on the Kartini reactor safety analysis report, on document number: C7/05/B2/LAK/2010, revision 7. So that the workplace is safe for work monitored. (author)

  20. Redesigning mental healthcare delivery: is there an effect on organizational climate?

    Science.gov (United States)

    Joosten, T C M; Bongers, I M B; Janssen, R T J M

    2014-02-01

    Many studies have investigated the effect of redesign on operational performance; fewer studies have evaluated the effects on employees' perceptions of their working environment (organizational climate). Some authors state that redesign will lead to poorer organizational climate, while others state the opposite. The goal of this study was to empirically investigate this relation. Organizational climate was measured in a field experiment, before and after a redesign intervention. At one of the sites, a redesign project was conducted. At the other site, no redesign efforts took place. Two Dutch child- and adolescent-mental healthcare providers. Professionals that worked at one of the units at the start and/or the end of the intervention period. The main intervention was a redesign project aimed at improving timely delivery of services (modeled after the breakthrough series). Scores on the four models of the organizational climate measure, a validated questionnaire that measures organizational climate. Our analysis showed that climate at the intervention site changed on factors related to productivity and goal achievement (rational goal model). The intervention group scored worse than the comparison group on the part of the questionnaire that focuses on sociotechnical elements of organizational climate. However, observed differences were so small, that their practical relevance seems rather limited. Redesign efforts in healthcare, so it seems, do not influence organizational climate as much as expected.

  1. Evaluation of the external costs of energy production in the Helsinki metropolitan area

    International Nuclear Information System (INIS)

    Otterstroem, T.

    1995-01-01

    The aim of the research is to evaluate the external costs of energy production at Helsinki metropolitan area (Helsinki, Espoo, Vantaa). The previously developed valorization method for effects on population centres is adjusted. All the main health, material and environmental effects will be taken into account in the research. The effects of emissions of the energy production of the Helsinki metropolitan area on concentrations of the impurities in the air and through them on human and environment will be evaluated. The estimates will be based on the relativistic fuels consumption and the emission data of Helsinki metropolitan area. Life-cycle reasoning will be applied so that the emissions of the main components of the fuels used in the metropolitan area will be included in the estimation. The cost-effectiveness of the investments will be estimated by comparing the environmental investments of energy boards with the external costs. The methods of this work can be applied to estimation of the profitability of energy production plants from the point of view of national economy also elsewhere in the country

  2. Evaluation of dose conversion coefficients for external exposure using Taiwanese reference man and woman

    International Nuclear Information System (INIS)

    Chang, S.J.; Hung, S.Y.; Liu, Y.L.; Jiang, S.H.; Wu, J.

    2015-01-01

    Reference man has been widely used for external and internal dose evaluation of radiation protection. The parameters of the mathematical model of organs suggested by the International Commission of Radiological Protection (ICRP) are adopted from the average data of Caucasians. However, the organ masses of Asians are significantly different from the data of Caucasians, leading to potentially dosimetric errors. In this study, a total of 40 volunteers whose heights and weights corresponded to the statistical average of Taiwanese adults were recruited. Magnetic resonance imaging was performed, and T2-weighted images were acquired. The Taiwanese reference man and woman were constructed according to the measured organ masses. The dose conversion coefficients (DCFs) for anterior-posterior (AP), posterior-anterior (PA), right lateral (RLAT) and left lateral (LLAT) irradiation geometries were simulated. For the Taiwanese reference man, the average differences of the DCFs compared with the results of ICRP-74 were 7.6, 5.1 and 11.1 % for 0.1, 1 and 10 MeV photons irradiated in the AP direction. The maximum difference reached 51.7 % for the testes irradiated by 10 MeV photons. The size of the trunk, the volume and the geometric position of organs can cause a significant impact on the DCFs for external exposure of radiation. The constructed Taiwanese reference man and woman can be used in radiation protection to increase the accuracy of dose evaluation for the Taiwanese population. (authors)

  3. External beam radiotherapy of localized prostatic adenocarcinoma. Evaluation of conformal therapy, field number and target margins

    International Nuclear Information System (INIS)

    Lennernaes, B.; Rikner, G.; Letocha, H.; Nilsson, S.

    1995-01-01

    The purpose of the present study was to identify factors of importance in the planning of external beam radiotherapy of prostatic adenocarcinoma. Seven patients with urogenital cancers were planned for external radiotherapy of the prostate. Four different techniques were used, viz. a 4-field box technique and four-, five- or six-field conformal therapy set-ups combined with three different margins (1-3 cm). The evaluations were based on the doses delivered to the rectum and the urinary bladder. A normal tissue complication probability (NTCP) was calculated for each plan using Lyman's dose volume reduction method. The most important factors that resulted in a decrease of the dose delivered to the rectum and the bladder were the use of conformal therapy and smaller margins. Conformal therapy seemed more important for the dose distribution in the urinary bladder. Five- and six-field set-ups were not significantly better than those with four fields. NTCP calculations were in accordance with the evaluation of the dose volume histograms. To conclude, four-field conformal therapy utilizing reduced margins improves the dose distribution to the rectum and the urinary bladder in the radiotherapy of prostatic adenocarcinoma. (orig.)

  4. External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation.

    Science.gov (United States)

    Nanekrungsan, Kamonporn; Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

    2012-09-01

    This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (proot resorption (proot resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

  5. Assessment of external costs for transport project evaluation: Guidelines in some European countries

    Energy Technology Data Exchange (ETDEWEB)

    Petruccelli, Umberto, E-mail: umberto.petruccelli@unibas.it

    2015-09-15

    Many studies about the external costs generated by the transport system have been developed in the last twenty years. To standardize methodologies and assessment procedures to be used in the evaluation of the projects, some European countries recently have adopted specific guidelines that differ from each other in some aspects even sensibly. This paper presents a critical analysis of the British, Italian and German guidelines and is aimed at cataloguing the external cost types regarded and the assessment methods indicated as well as to highlight the differences of the results, in terms of applicability and reliability. The goal is to contribute to a European standardization process that would lead to the drafting of guidelines suited for all EU countries. - Highlights: • The analyzed guidelines agree on the methods to evaluate costs from air pollution, greenhouse gases and accidents. • They recommend respectively: dose-resp. approach; costs to reduce/permit emissions; whole direct, indirect and social costs. • For noise, DE guide indicates defensive expenditure or SP methods; IT guide, SP method; UK guide, the hedonic prices one. • For on territory impact, DE guide regards only the barrier effect; the IT one, also the soil consumption and system effects. • British guide proposes a qualitative methodology to estimate the impact on various landscapes and environments.

  6. Evaluation of an external exposure of a worker during manipulation with waste packages stored in Bohunice radioactive waste treatment centre

    International Nuclear Information System (INIS)

    Slimak, A.; Hrncir, T.; Necas, V.

    2012-01-01

    The paper briefly describes current state of radioactive waste management as well as radioactive waste treatment and conditioning technologies used in Bohunice Radioactive Waste Treatment Centre. Radioactive Waste management includes pretreatment, treatment, conditioning, storage, transport and disposal of radioactive waste. Presented paper deals with the evaluation of an external exposure of a worker during manipulation with fibre-reinforced concrete container stored under shelter object. The external exposure of a worker was evaluated using VISIPLAN 3D ALARA code. (Authors)

  7. External human induced events in site evaluation for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2004-01-01

    The purpose of the present Safety Guide is to provide recommendations and guidance for the examination of the region considered for site evaluation for a plant in order to identity hazardous phenomena associated with human induced events initiated by sources external to the plant. In some cases it also presents preliminary guidance for deriving values of relevant parameters for the design basis. This Safety Guide is also applicable for periodic site evaluation and site evaluation following a major human induced event, and for the design and operation of the site's environmental monitoring system. Site evaluation includes site characterization. Consideration of external events that could lead to a degradation of the safety features of the plant and cause a release of radioactive material from the plant and/or affect the dispersion of such material in the environment. And consideration of population issues and access issues significant to safety (such as the feasibility of evacuation, the population distribution and the location of resources). The process of site evaluation continues throughout the lifetime of the facility, from siting to design, construction, operation and decommissioning. The external human induced events considered in this Safety Guide are all of accidental origin. Considerations relating to the physical protection of the plant against wilful actions by third parties are outside its scope. However, the methods described herein may also have some application for the purposes of such physical protection. The present Safety Guide may also be used for events that may originate within the boundaries of the site, but from sources which are not directly involved in the operational states of the nuclear power plant units, such as fuel depots or areas for the storage of hazardous materials for the construction of other facilities at the same site. Special consideration should be given to the hazardous material handled during the construction, operation and

  8. Towards redesigning indigenous mung bean foods

    NARCIS (Netherlands)

    Dahiya, P.K.

    2013-01-01

    Redesigning traditional foods requires consideration of the various factors affecting the nutrient intake from such foods. Amongst these factors are adequate consumption, proper nutrient bioavailability and consumer satisfaction. These factors are related to traditional food quality at various

  9. A Pilot Study Evaluating "Dojo," a Videogame Intervention for Youths with Externalizing and Anxiety Problems.

    Science.gov (United States)

    Schuurmans, Angela A T; Nijhof, Karin S; Vermaes, Ignace P R; Engels, Rutger C M E; Granic, Isabela

    2015-10-01

    Externalizing problems, which are the main reason for youth referrals to mental health agencies, are highly persistent and predict a range of negative outcomes. Youths with externalizing problems are also frequently comorbid with anxiety. Among the most widely recognized evidence-based treatments is cognitive behavioral therapy (CBT). Although CBT principles seem to be sound, effect sizes remain moderate, suggesting improvements could be made to this conventional treatment approach. The main premise of the current pilot study is to investigate the feasibility of implementing a videogame intervention ("Dojo" [Gamedesk, Los Angeles, CA]) that incorporates CBT principles and aims to address the limitations of conventional CBT delivery models, with the ultimate goal of improving outcomes for this difficult-to-treat population. "Dojo" is an emotion management game that helps youths to recognize and control their physiological and emotional arousal. We explored the implementation and user experience of "Dojo" in a sample of eight adolescents in residential treatment for both externalizing and anxiety problems. Participants attended all sessions without complaints. They evaluated "Dojo" very positively and exhibited high compliance during the training sessions. We encountered some problems with session scheduling and obtaining mentor reports. Quantitative data show the predicted decrease in three out of four measurements. The smooth implementation, high user satisfaction, high self-reported compliance during training sessions, and initial outcome results all indicate the high potential "Dojo" holds as an innovative intervention. If additional rigorously designed randomized controlled trials prove to be successful, "Dojo" can be a cost-effective way to engage high-risk youths in effective intervention.

  10. External Reactor Vessel Cooling Evaluation for Severe Accident Mitigation in NPP Krsko

    International Nuclear Information System (INIS)

    Mihalina, M.; Spalj, S.; Glaser, B.

    2016-01-01

    The In-Vessel corium Retention (IVR) through the External Reactor Vessel Cooling (ERVC) is mean for maintaining the reactor vessel integrity during a severe accident, by cooling and retaining the molten material inside the reactor vessel. By doing this, significant portion of severe accident negative phenomena connected with reactor vessel failure could be avoided. In this paper, analysis of NPP Krsko applicability for IVR strategy was performed. It includes overview of performed plant related analysis with emphasis on wet cavity modification, plant's site specific walk downs, new applicable probabilistic and deterministic analysis, evaluation of new possibilities for ERVC strategy implementation regarding plant's post-Fukushima improvements and adequacy with plant's procedures for severe accident mitigation. Conclusion is that NPP Krsko could perform in-vessel core retention by applying external reactor vessel cooling strategy with reasonable confidence in success. Per probabilistic and deterministic analysis, time window for successful ERVC strategy performance for most dominating plant damage state scenarios is 2.5 hours, when onset of core damage is observed. This action should be performed early after transition to Severe Accident Management Guidance's (SAMG). For loss of all AC power scenario, containment flooding could be initiated before onset of core damage within related emergency procedure. To perform external reactor vessel cooling, reactor water storage tank gravity drain with addition of alternate water is needed to be injected into the containment. ERVC strategy will positively interfere with other severe accident strategies. There are no negative effects due to ERVC performance. New flooding level will not threaten equipment and instrumentation needed for long term SAMGs performance and eventually diluted containment sump borated water inventory will not cause return to criticality during eventual recirculation phase due to the

  11. Economic evaluation of environmental externalities in China’s coal-fired power generation

    International Nuclear Information System (INIS)

    Zhao, Xiaoli; Cai, Qiong; Ma, Chunbo; Hu, Yanan; Luo, Kaiyan; Li, William

    2017-01-01

    Serious environmental externalities exist in China’s power industry. Environmental economics theory suggests that the evaluation of environmental externality is the basis of designing an efficient regulation. The purposes of this study are: (1) to identify Chinese respondents’ preferences for green development of electric power industry and the socio-economic characteristics behind them; (2) to investigate the different attitudes of the respondents towards pollution and CO_2 reduction; (3) to quantitatively evaluate the environmental cost of China’s coal-fired power generation. Based on the method of choice experiments (CE) and the 411 questionnaires with 2466 data points, we found that Chinese respondents prefer PM2.5, SO_2 and NO_x reduction to CO_2 reduction and that the environment cost of coal-fired power plants in China is 0.30 yuan per kWh. In addition, we found that the socio-economic characteristics of income, education, gender, and environmental awareness have significant impacts on respondents’ choices. These findings indicate that the environmental cost of coal-fired power generation is a significant factor that requires great consideration in the formulation of electric power development policies. In addition, importance should also be attached to the implementation of green power price policy and enhancement of environmental protection awareness. - Highlights: • Chinese respondents have willingness to pay premium for green development. • The environment cost of coal-fired power plants in China is 0.30 yuan/kwh. • Chinese respondents prefer PM2.5, SO_2 and NO_x reduction to CO_2 reduction. • Environmental awareness has significant impacts on respondents’ preferences. • Income, education and gender affect the evaluation results.

  12. Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach

    Directory of Open Access Journals (Sweden)

    Moran Anna M

    2012-11-01

    Full Text Available Abstract Background Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a ‘trainee’ approach to introducing a podiatry assistant (PA role to a community setting in the Australian Capital Territory (ACT Government Health Service Directorate. Method A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Results Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of

  13. Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach.

    Science.gov (United States)

    Moran, Anna M; Nancarrow, Susan A; Wiseman, Leah; Maher, Kerryn; Boyce, Rosalie A; Borthwick, Alan M; Murphy, Karen

    2012-11-27

    Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a 'trainee' approach to introducing a podiatry assistant (PA) role to a community setting in the Australian Capital Territory (ACT) Government Health Service Directorate. A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs) from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of producing a PA whose skills were shaped by and directly

  14. Management of Late Onset Perthes: Evaluation of Distraction by External Fixator—5-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Ajai Singh

    2014-01-01

    Full Text Available Background. Hip distraction in Perthes’ disease unloads the joint, which negates the harmful effect of the stresses on the articular surfaces, which may promote the sound healing of the area of necrosis. We have examined the effect of arthrodiastasis on the preservation of the femoral head in older children with Perthes’ disease. Methods and Materials. Twelve children with age more than 8 years with Perthes’ disease of less than one year were treated with hip distraction by a hinged monolateral external fixator. Observation and Results. Mean duration of distraction was 13.9 days. These children were evaluated by clinicoradiological parameters for a mean period of 32.4 months. There was a significant improvement in the range of movements and mean epiphyseal index, but the change in the percentage of uncovered head femur was insignificant. There was significant improvement in Harris Hip score. Conclusions. Hip distraction by hinged monolateral external fixator seems to be a valid treatment option in cases with Perthes’ disease in the selected group of patients, where poor results are expected from conventional treatment.

  15. Evaluating external costs of human health and environmental impacts using IAEA model SIMPACTS

    International Nuclear Information System (INIS)

    Bobric, Elena; Jelev, Adrian

    2005-01-01

    SIMPACTS (Simplified Approach for Estimating Impacts and External Costs of Electricity Generation) model developed at the International Atomic Energy Agency is a powerful and convenient tool for evaluating external costs induced by different energy sources. The model was developed for industrial countries and for developing countries as well where studies of alternatives of sustainable energy policies are conducted. The SIMPACTS allow the decision making factors involved in energy policy to have reasonable estimates of environment impacts and relating costs appealing to a rather low number of input parameters. The paper aims at analyzing by means of SIMPACTS the environmental impact produced by Cernavoda NPP operation in two cases: a) the impact of the Cernavoda NPP itself; b) the impact of an hypothetical coal based power plant of the same power level and located on the Cernavoda NPP site. The SIMPACTS modules AIRPACTS and NUCPACTS were applied to assess the impacts on human health, agricultural crops and building materials from exposure to routine atmospheric emissions and as well to quantify and value the adverse effects on human health due to routine atmospheric release of radionuclides from the NPP, via radioactive waste ground disposal or resulting from accidents in nuclear facility, respectively. The conclusion of this study based on SIMPACTS model application to assess the health effects and damage cost per year is that the Cernavoda NPP presents the lower health effects and damage cost comparing with power plants of other types

  16. Evaluation of Group Intervention for Mothers/Caretakers of Kindergarten Children with Externalizing Behavioral Problems

    Directory of Open Access Journals (Sweden)

    Alessandra Turini Bolsoni-Silva

    2010-01-01

    Full Text Available Negative parental practices may influence the onset and maintenance of externalizing behavior problems, and positive parenting seem to improve children's social skills and reduce behavior problems. The objective of the present study was to describe the effects of an intervention designed to foster parents' social skills related to upbringing practices in order to reduce externalizing problems in children aged 4 to 6 years. Thirteen mothers and two care taker grandmothers took part in the study with an average of four participants per group. To assess intervention effects, we used a repeated measure design with control, pre, and post intervention assessments. Instruments used were: (a An interview schedule that evaluates the social interactions between parents and children functionally, considering each pair of child¿s and parent's behaviors as context for one another; (b A Social Skills Inventory; (c Child Behavior Checklist - CBCL. Intervention was effective in improving parent general social skills, decreasing negative parental practices and decreasing child behavior problems.

  17. A REDESIGN LAYOUT TO INCREASE PRODUCTIVITY OF A COMPANY

    Directory of Open Access Journals (Sweden)

    Vincentia Kitriastika

    2013-06-01

    Full Text Available This project is conducted in Company X, a passenger cars wheel producing company located in Sunter, North Jakarta. With a view of increasing the productivity of the company, the focus of this project will be redesigned the layout of the factory. The main problem encountered is that the goods are not produced in single location, causing a considerable hindrance in terms of time and distance, and hence efficiency. The redesigning layout process will use SLP method and flow analysis while supported by analysis of assembly line balancing to optimize the layout. Regarding the evaluation process, ARENA software will be used to simulate and identify the bottleneck in the production process, and comparing the layout alternatives to decide the best layout. The best chosen layout according to the simulation and SLP method that supported with flow analysis and assembly line balancing will be used as the master draft layout that will be proposed to Company X.

  18. Evaluation of Cost and Effectiveness of Decontamination Scenarios on External Radiation Exposure in Fukushima

    Energy Technology Data Exchange (ETDEWEB)

    Yasutaka, T.; Naito, W. [National Institute of Advanced Industrial Science and Technology (Japan)

    2014-07-01

    Despite the enormous cost associated with radiation decontamination, almost no quantitative assessment has been performed on the relationship between the potential reduction in long-term radiation exposure and the costs of the various decontamination strategies considered for the decontamination areas in Fukushima. In order to establish effective and pragmatic decontamination strategies for use in the radiation contaminated areas in Fukushima, a holistic approach for assessing decontamination strategies, their costs, and long-term external radiation doses is needed. The objective of the present study is to evaluate the cost and effectiveness of decontamination scenarios in the decontamination areas in Fukushima in regard to external radiation exposure. The choice of decontamination strategies in the decontamination areas should be based on a comprehensive analysis of multiple attributes such as radiological, economic, and socio-psychological attributes. The cost and effectiveness of the different decontamination strategies is not sole determinant of the decontamination strategies of the special decontamination area but is one of the most important attributes when making the policy decision. In the current study, we focus on radiological and economic attributes in determining decontamination strategies. A geographical information system (GIS) was used to relate the predicted external dose in the affected areas to the number of potential inhabitants and the land use in the areas. A comprehensive review of the costs of various decontamination methods was conducted as part of the analysis. The results indicate that aerial decontamination in the special decontamination areas in Fukushima would be effective for reducing the air dose rate to the target level in a short period of time in some but not all of the areas. In a standard scenario, the analysis of cost suggests that decontamination costs of decontamination in Fukushima was estimated to be up to approximately 5

  19. Evaluation of the external exposure to Rn-222 progeny in air

    International Nuclear Information System (INIS)

    Ali, E.M.; Taha, T.M.; Gomaa, M.A.; El-Hussein, A.M.; Ahmed, A.A.

    2003-01-01

    The aim of this paper is to evaluate the Rn-222 progeny annual effective dose, skin dose and effective doses to different organs such as Gonad, Lung, Red Marrow, Bone surface, Thyroid, and the Remainder. Dose Coefficients of external exposure to Rn-222 in air was used in mSv s/Bqm -3 to calculate the organ doses. The study was monitored for two places, Nuclear Research Center and Al-Minia University. We have confirmed that the inhalation modes, sleep, sitting, light and heavy exercise influence the activity inhalation rate Bq/hr. It varies from 0.3 to 39.6 Bq/hr., the organ doses of Pb-214 is higher than Bi-214/Po-214 and Po-218 respectively in the case of the organ dose relative to environmental media

  20. Malignant external otitis: the role of computed tomography and radionuclides in evaluation

    International Nuclear Information System (INIS)

    Mendelson, D.S.; Som, P.M.; Mendelson, M.H.; Parisier, S.C.

    1983-01-01

    Nine patients with malignant external otitis (MEO) were evaluated with Tc-99m bone scans, Ga-67 citrate scans, pluridirectional tomography, and computed tomographic (CT) scans in order to assess the role of each in the diagnosis and management of MEO. The Tc-99m and Ga-67 citrate scans were the most accurate studies in the initial identification of disease activity, while the return to normal or improvement of the Ga-67 citrate scan has been shown to correlate best with clinical resolution of MEO. CT demonstrated soft-tissue disease and central skull base osteomyelitis better than pluridirectional tomography. CT is excellent for localizing and following the progression of bone disease; however, because reossification of the skull base is a very slow process, CT cannot be used to follow accurately regression or inactivity of MEO affecting this area. CT is the best modality for following soft-tissue extension of MEO

  1. The Evolution of Nondestructive Evaluation Methods for the Space Shuttle External Tank Thermal Protection System

    Science.gov (United States)

    Walker, James L.; Richter, Joel D.

    2006-01-01

    Three nondestructive evaluation methods are being developed to identify defects in the foam thermal protection system (TPS) of the Space Shuttle External Tank (ET). Shearography is being developed to identify shallow delaminations, shallow voids and crush damage in the foam while terahertz imaging and backscatter radiography are being developed to identify voids and cracks in thick foam regions. The basic theory of operation along with factors affecting the results of these methods will be described. Also, the evolution of these methods from lab tools to implementation on the ET will be discussed. Results from both test panels and flight tank inspections will be provided to show the range in defect sizes and types that can be readily detected.

  2. External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

    International Nuclear Information System (INIS)

    Nanekrungsan, Kamonporn; Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

    2012-01-01

    This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

  3. External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Nanekrungsan, Kamonporn [Dept. of Dentistry, Overbrook Hospital, Chiang Rai (Thailand); Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus [Dept. of Chiang Mai University, Chiang Mai (Thailand)

    2012-09-15

    This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39{+-}1.27 (8.24{+-}7.22%) and 1.69{+-}1.14 mm (10.16{+-}6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

  4. Review and evaluation of performance measures for survival prediction models in external validation settings

    Directory of Open Access Journals (Sweden)

    M. Shafiqur Rahman

    2017-04-01

    Full Text Available Abstract Background When developing a prediction model for survival data it is essential to validate its performance in external validation settings using appropriate performance measures. Although a number of such measures have been proposed, there is only limited guidance regarding their use in the context of model validation. This paper reviewed and evaluated a wide range of performance measures to provide some guidelines for their use in practice. Methods An extensive simulation study based on two clinical datasets was conducted to investigate the performance of the measures in external validation settings. Measures were selected from categories that assess the overall performance, discrimination and calibration of a survival prediction model. Some of these have been modified to allow their use with validation data, and a case study is provided to describe how these measures can be estimated in practice. The measures were evaluated with respect to their robustness to censoring and ease of interpretation. All measures are implemented, or are straightforward to implement, in statistical software. Results Most of the performance measures were reasonably robust to moderate levels of censoring. One exception was Harrell’s concordance measure which tended to increase as censoring increased. Conclusions We recommend that Uno’s concordance measure is used to quantify concordance when there are moderate levels of censoring. Alternatively, Gönen and Heller’s measure could be considered, especially if censoring is very high, but we suggest that the prediction model is re-calibrated first. We also recommend that Royston’s D is routinely reported to assess discrimination since it has an appealing interpretation. The calibration slope is useful for both internal and external validation settings and recommended to report routinely. Our recommendation would be to use any of the predictive accuracy measures and provide the corresponding predictive

  5. Evaluation of the use of digital images for a national prostate core external quality assurance scheme.

    Science.gov (United States)

    Harnden, Patricia; Coleman, Derek; Moss, Sue; Kodikara, Sandhya; Griffin, Nick R; Melia, Jane

    2011-10-01

    To evaluate the use of virtual images as an alternative to glass slides to expand the number of participants in the External Quality Assurance Scheme for prostatic biopsies. Benign and neoplastic cases, previously circulated as glass slides, were selected to include cases that had demonstrated a high level of agreement (n = 10) and a lesser degree of agreement (n = 10). Whole slide virtual images were circulated to 68 pathologists; 51 responses were returned. The levels of agreement for the primary diagnosis and for Gleason grading of cancers were analysed using kappa statistics. Responses for glass slides versus images were compared for the 24 pathologists for whom data were available. Levels of agreement for diagnostic categories using virtual slides were moderate to substantial, comparable to those found using glass slides. The level of agreement for Gleason grades 8-10 was substantial, but for lower grades was fair or moderate, poorer than for the glass slide circulation. Circulation of virtual images of biopsy material is a suitable alternative to glass slide-based schemes for the evaluation of diagnostic consistency. The majority of participants agreed that the ability to evaluate limited diagnostic material outweighed the disadvantages of a virtual system. 2011 Blackwell Publishing Limited.

  6. Economic evaluation of externally fired gas turbine cycles for small-scale biomass cogeneration

    Energy Technology Data Exchange (ETDEWEB)

    Anheden, Marie [Royal Inst. of Tech., Stockholm (Sweden). Dept. of Chemical Engineering and Technology

    2001-01-01

    In this conceptual study, externally fired gas turbine (EFGT) cycles in combination with a biomass-fueled, atmospheric circulating fluidized bed (CFB) furnace are investigated for small scale heat and power production ({approx} 8 MW fuel input). Three cycle configurations are considered: closed cycle, with nitrogen, helium, and a helium/carbon dioxide mixture as working fluids; open cycle operating in parallel to the CFB system; and open cycle with a series connection to the CFB system. Intercooling, postcooling, and recuperation are employed with the goal of maximizing efficiency. Aside from a thermodynamic performance analysis, the study includes an economic analysis of both the closed and open externally fired gas turbine configurations, and comparisons are made with existing and emerging alternatives for small-scale biomass cogeneration. Simulation results show that thermodynamic performance varies slightly between the different configurations and working fluids, with electrical efficiencies of 31-38% (LHV) and total efficiency of 85-106% (LHV). The economic evaluation shows that the turbomachinery and the CFB furnace dominate the total plant cost, with each contributing about 1/3 of the total installed equipment cost. The specific capital cost for installation in Sweden in 1998 currency is calculated as 26-31 kSEK/kW{sub e} which is equivalent to 3 200-3 900 USD/kW{sub e} or 2 700-3 300 EUR/kW{sub e} .The cost of electricity, COE, is estimated to 590-670 SEK/MWh{sub e} (equivalent to 73-84 USD/MWh{sub e} or 62-71 EUR/MWh{sub e}) for 4 000 full load hours per year in a cogeneration application. Comparing the economic results for the externally fired gas turbine cycles in a slightly larger scale (40-50 MW{sub f}) to the economics of conventional biomass fired steam turbine cycles shows that the cost of electricity for the two plant configurations are roughly the same with a COE of 300-350 SEK/MWh{sub e}. It is believed that the economic performance of the EFGT

  7. Axial displacement of external and internal implant-abutment connection evaluated by linear mixed model analysis.

    Science.gov (United States)

    Seol, Hyon-Woo; Heo, Seong-Joo; Koak, Jai-Young; Kim, Seong-Kyun; Kim, Shin-Koo

    2015-01-01

    To analyze the axial displacement of external and internal implant-abutment connection after cyclic loading. Three groups of external abutments (Ext group), an internal tapered one-piece-type abutment (Int-1 group), and an internal tapered two-piece-type abutment (Int-2 group) were prepared. Cyclic loading was applied to implant-abutment assemblies at 150 N with a frequency of 3 Hz. The amount of axial displacement, the Periotest values (PTVs), and the removal torque values(RTVs) were measured. Both a repeated measures analysis of variance and pattern analysis based on the linear mixed model were used for statistical analysis. Scanning electron microscopy (SEM) was used to evaluate the surface of the implant-abutment connection. The mean axial displacements after 1,000,000 cycles were 0.6 μm in the Ext group, 3.7 μm in the Int-1 group, and 9.0 μm in the Int-2 group. Pattern analysis revealed a breakpoint at 171 cycles. The Ext group showed no declining pattern, and the Int-1 group showed no declining pattern after the breakpoint (171 cycles). However, the Int-2 group experienced continuous axial displacement. After cyclic loading, the PTV decreased in the Int-2 group, and the RTV decreased in all groups. SEM imaging revealed surface wear in all groups. Axial displacement and surface wear occurred in all groups. The PTVs remained stable, but the RTVs decreased after cyclic loading. Based on linear mixed model analysis, the Ext and Int-1 groups' axial displacements plateaued after little cyclic loading. The Int-2 group's rate of axial displacement slowed after 100,000 cycles.

  8. EVALUATION OF THERMAL INSULATION FOR THREE DIFFERENT MATERIALS USED IN CONSTRUCTION AND COMPLETION OF EXTERNAL WALLS

    Directory of Open Access Journals (Sweden)

    Marcio Carlos Navroski

    2010-05-01

    Full Text Available Summers increasingly hot are bringing large thermal problems within homes and businesses, leading to increased demand for installation of air conditioners and the consequent high energy consumption. Constructions with thermal insulation on its external walls thatcould reduce energy use or even supply the use of such equipment. Due to these factors the present study was to evaluate the insulation in three boxes built with different materials, one made of wooden boards with plain walls, and two built with plywood, wall insulation andinterior walls filled with rice husk and Styrofoam®. The boxes were built after placed in drying oven at 40 °C, then noted the temperature inside the same interval every five minutes using a digital thermometer. The box with inner Styrofoam® showed the lowest variation among the three evaluated, followed by the box of rice husk. These two materials also showed good thermal initial, unlike the box built only with wood, which showed a large interiorheating, lay in a drying oven.

  9. Motion-Base Simulator Evaluation of an Aircraft Using an External Vision System

    Science.gov (United States)

    Kramer, Lynda J.; Williams, Steven P.; Arthur, J. J.; Rehfeld, Sherri A.; Harrison, Stephanie

    2012-01-01

    Twelve air transport-rated pilots participated as subjects in a motion-base simulation experiment to evaluate the use of eXternal Vision Systems (XVS) as enabling technologies for future supersonic aircraft without forward facing windows. Three head-up flight display concepts were evaluated -a monochromatic, collimated Head-up Display (HUD) and a color, non-collimated XVS display with a field-of-view (FOV) equal to and also, one significantly larger than the collimated HUD. Approach, landing, departure, and surface operations were conducted. Additionally, the apparent angle-of-attack (AOA) was varied (high/low) to investigate the vertical field-of-view display requirements and peripheral, side window visibility was experimentally varied. The data showed that lateral approach tracking performance and lateral landing position were excellent regardless of AOA, display FOV, display collimation or whether peripheral cues were present. However, the data showed glide slope approach tracking appears to be affected by display size (i.e., FOV) and collimation. The monochrome, collimated HUD and color, uncollimated XVS with Full FOV display had (statistically equivalent) glide path performance improvements over the XVS with HUD FOV display. Approach path performance results indicated that collimation may not be a requirement for an XVS display if the XVS display is large enough and employs color. Subjective assessments of mental workload and situation awareness also indicated that an uncollimated XVS display may be feasible. Motion cueing appears to have improved localizer tracking and touchdown sink rate across all displays.

  10. Biofuel production system with operation flexibility: Evaluation of economic and environmental performance under external disturbance

    Science.gov (United States)

    Kou, Nannan

    grain) into a single primary product (ethanol). The traditional lower efficient (i.e. lower ethanol yield per bushel of corn and higher capital cost) wet-mill plant has a more diverse and adjustable product portfolio i.e. corn syrup, starch, and ethanol. The fact that only the dry-mill corn ethanol plants have bankrupted while the wet-mill corn ethanol plants have survived the late 2000s economy recession suggests that the higher conversion efficiency achieved by the dry-mill production mode has jeopardized operational flexibility, a design operational feature I agree that is indispensable for the biofuel plant's long term profit and viability. Based on the analysis of corn ethanol production, operational flexibility has been proposed as a key strategy for the next generation biofuel plants to improve its lifetime economic performance, as well as to enhance its survivability under external disturbances. This strategy requires the biofuel plant to adopt a flexible feedstock management, making it possible to utilize alternative types of biomass feedstock when the primary feedstock supply is disturbed. Biofuel plants also need to produce a wider range of final products that could meet the preference variation that either comes from the energy market or from the subsidy policy. Aspen Plus model based numerical simulations have been carried out for a thermochemical ethanol plant and a Fischer Tropsch plant (both are assumed to be located in southwest Indiana) to test this strategy under the external disturbances of extreme weather impact, different energy price projections and various subsidy policy combinations. For the thermochemical ethanol plant, effects of extreme weather conditions are mainly evaluated. It has been shown that this strategy could effectively increase the net present value of the biofuel plant and significantly decrease the GHG emission comparing with the traditional single-feedstock strategy, when the extreme weather conditions are considered. It has

  11. External Economies Evaluation of Wind Power Engineering Project Based on Analytic Hierarchy Process and Matter-Element Extension Model

    Directory of Open Access Journals (Sweden)

    Hong-ze Li

    2013-01-01

    Full Text Available The external economies of wind power engineering project may affect the operational efficiency of wind power enterprises and sustainable development of wind power industry. In order to ensure that the wind power engineering project is constructed and developed in a scientific manner, a reasonable external economies evaluation needs to be performed. Considering the interaction relationship of the evaluation indices and the ambiguity and uncertainty inherent, a hybrid model of external economies evaluation designed to be applied to wind power engineering project was put forward based on the analytic hierarchy process (AHP and matter-element extension model in this paper. The AHP was used to determine the weights of indices, and the matter-element extension model was used to deduce final ranking. Taking a wind power engineering project in Inner Mongolia city as an example, the external economies evaluation is performed by employing this hybrid model. The result shows that the external economies of this wind power engineering project are belonged to the “strongest” level, and “the degree of increasing region GDP,” “the degree of reducing pollution gas emissions,” and “the degree of energy conservation” are the sensitive indices.

  12. Business Process Redesign Using EDI: the BHP steel experience

    Directory of Open Access Journals (Sweden)

    Paula Swatman

    1994-05-01

    Full Text Available EDI should not be seen as a competitive weapon - it does not offer a sustainable competitive advantage to its users as did the earlier inter-organisational systems (such as the various airline reservation systems. Instead EDI provides a standardised infrastructure upon which an adopting organisation can reengineer its business processes and thus confers a long-term, strategic and comparative advantage upon such an adopter. The potential for sustained competitive advantage to be derived from EDI arises from its integration with the organisational structure of its implementor, depending upon the implementing organisation's ability to redesign its business processes appropriately. This paper examines the case of (arguably the most sophisticated EDI-using company in Australia, BHP Steel, demonstrating the advantages obtainable by an organisation using EDI as a foundation for its reengineered organisational structure and business processes and concludes that: • there are real benefits to be obtained from an inter organisational electronic trading strategy founded on EDI as the enabling mechanism - benefits which are considerably more extensive than EDI's comparatively simple technical nature would appear to offer; • organisational gateways utilising an Application Generic approach to system integration and isolating the communications issue by insisting on the use of international data communications standards do offer a realistic and successful solution to the problem of internal and external trade for large and sophisticated organisations; • the majority of these achievements would have been either unlikely or totally impossible without BHP Steel's commitment to organisation-wide Business Process Redesign.

  13. Development and validation of the ExPRESS instrument for primary health care providers' evaluation of external supervision.

    Science.gov (United States)

    Schriver, Michael; Cubaka, Vincent Kalumire; Vedsted, Peter; Besigye, Innocent; Kallestrup, Per

    2018-01-01

    External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test-retest design, the second for confirmatory factor analysis. We included 16 items in section A ('The most recent experience with an external supervisor'), and 13 items in section B ('The overall experience with external supervisors'). Item-content validity index was acceptable. In field test I, test-retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.

  14. Characteristics of a multisensor system for non invasive glucose monitoring with external validation and prospective evaluation.

    Science.gov (United States)

    Caduff, Andreas; Mueller, Martin; Megej, Alexander; Dewarrat, Francois; Suri, Roland E; Klisic, Jelena; Donath, Marc; Zakharov, Pavel; Schaub, Dominik; Stahel, Werner A; Talary, Mark S

    2011-05-15

    The Multisensor Glucose Monitoring System (MGMS) features non invasive sensors for dielectric characterisation of the skin and underlying tissue in a wide frequency range (1 kHz-100 MHz, 1 and 2 GHz) as well as optical characterisation. In this paper we describe the results of using an MGMS in a miniaturised housing with fully integrated sensors and battery. Six patients with Type I Diabetes Mellitus (age 44±16 y; BMI 24.1±1.3 kg/m(2), duration of diabetes 27±12 y; HbA1c 7.3±1.0%) wore a single Multisensor at the upper arm position and performed a total of 45 in-clinic study days with 7 study days per patient on average (min. 5 and max. 10). Glucose changes were induced either orally or by i.v. glucose administration and the blood glucose was measured routinely. Several prospective data evaluation routines were applied to evaluate the data. The results are shown using one of the restrictive data evaluation routines, where measurements from the first 22 study days were used to train a linear regression model. The global model was then prospectively applied to the data of the remaining 23 study days to allow for an external validation of glucose prediction. The model application yielded a Mean Absolute Relative Difference of 40.8%, a Mean Absolute Difference of 51.9 mg dL(-1), and a correlation of 0.84 on average per study day. The Clarke error grid analyses showed 89.0% in A+B, 4.5% in C, 4.6% in D and 1.9% in the E region. Prospective application of a global, purely statistical model, demonstrates that glucose variations can be tracked non invasively by the MGMS in most cases under these conditions. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Evaluation of external RNA controls for the standardisation of gene expression biomarker measurements

    Directory of Open Access Journals (Sweden)

    Elaswarapu Ramnath

    2010-11-01

    Full Text Available Abstract Background Gene expression profiling is an important approach for detecting diagnostic and prognostic biomarkers, and predicting drug safety. The development of a wide range of technologies and platforms for measuring mRNA expression makes the evaluation and standardization of transcriptomic data problematic due to differences in protocols, data processing and analysis methods. Thus, universal RNA standards, such as those developed by the External RNA Controls Consortium (ERCC, are proposed to aid validation of research findings from diverse platforms such as microarrays and RT-qPCR, and play a role in quality control (QC processes as transcriptomic profiling becomes more commonplace in the clinical setting. Results Panels of ERCC RNA standards were constructed in order to test the utility of these reference materials (RMs for performance characterization of two selected gene expression platforms, and for discrimination of biomarker profiles between groups. The linear range, limits of detection and reproducibility of microarray and RT-qPCR measurements were evaluated using panels of RNA standards. Transcripts of low abundance (≤ 10 copies/ng total RNA showed more than double the technical variability compared to higher copy number transcripts on both platforms. Microarray profiling of two simulated 'normal' and 'disease' panels, each consisting of eight different RNA standards, yielded robust discrimination between the panels and between standards with varying fold change ratios, showing no systematic effects due to different labelling and hybridization runs. Also, comparison of microarray and RT-qPCR data for fold changes showed agreement for the two platforms. Conclusions ERCC RNA standards provide a generic means of evaluating different aspects of platform performance, and can provide information on the technical variation associated with quantification of biomarkers expressed at different levels of physiological abundance

  16. Survey and evaluation of the external research and development programme 1977-1983 of the Swedish Radiation Protection Institute

    International Nuclear Information System (INIS)

    Persson, Lars.

    1993-01-01

    A review of the external research programme of SSI is undertaken. The main research programme is in this report divided into five subprogrammes according to the main programmes of the Institute. This report covers research projects reported 1977-1983. An evaluation of the impact of the R and D programme is included in the report. The external R and D research programme of SSI has had an important impact on the radiation protection work in Sweden. The methods for evaluation of research programmes are also discussed in the report

  17. A strategic planning methodology for aircraft redesign

    Science.gov (United States)

    Romli, Fairuz Izzuddin

    Due to a progressive market shift to a customer-driven environment, the influence of engineering changes on the product's market success is becoming more prominent. This situation affects many long lead-time product industries including aircraft manufacturing. Derivative development has been the key strategy for many aircraft manufacturers to survive the competitive market and this trend is expected to continue in the future. Within this environment of design adaptation and variation, the main market advantages are often gained by the fastest aircraft manufacturers to develop and produce their range of market offerings without any costly mistakes. This realization creates an emphasis on the efficiency of the redesign process, particularly on the handling of engineering changes. However, most activities involved in the redesign process are supported either inefficiently or not at all by the current design methods and tools, primarily because they have been mostly developed to improve original product development. In view of this, the main goal of this research is to propose an aircraft redesign methodology that will act as a decision-making aid for aircraft designers in the change implementation planning of derivative developments. The proposed method, known as Strategic Planning of Engineering Changes (SPEC), combines the key elements of the product redesign planning and change management processes. Its application is aimed at reducing the redesign risks of derivative aircraft development, improving the detection of possible change effects propagation, increasing the efficiency of the change implementation planning and also reducing the costs and the time delays due to the redesign process. To address these challenges, four research areas have been identified: baseline assessment, change propagation prediction, change impact analysis and change implementation planning. Based on the established requirements for the redesign planning process, several methods and

  18. A pilot study evaluating "Dojo", a videogame intervention for youths with externalizing and anxiety problems

    NARCIS (Netherlands)

    Schuurmans, A.T.; Nijhof, K.S.; Vermaes, I.P.R.; Engels, R.C.M.E.; Granic, I.

    2015-01-01

    OBJECTIVE: Externalizing problems, which are the main reason for youth referrals to mental health agencies, are highly persistent and predict a range of negative outcomes. Youths with externalizing problems are also frequently comorbid with anxiety. Among the most widely recognized evidence-based

  19. Ten Years of External Quality Audit in Australia: Evaluating Its Effectiveness and Success

    Science.gov (United States)

    Shah, Mahsood

    2012-01-01

    External quality audits are now being used in universities across the world to improve quality assurance, accountability for quality education and transparency of public funding of higher education. Some countries such as Australia, New Zealand, United Kingdom, Sweden and Denmark have had external quality audits for more than a decade but there…

  20. Food or Thought? Assessing Internal and External Factors Affecting Evaluations of Instructor Effectiveness

    Science.gov (United States)

    Wood, John; Kiggins, Ryan; Kickham, Kenneth

    2017-01-01

    Within the broader literature concerned with potential bias in student measures of instructor effectiveness, two broad types of bias have been shown to operate in a course: internal and external. Missing is an assessment of the relative influence of each bias type in the classroom. Do internal or external types of bias matter more or less to…

  1. Methods for external event screening quantification: Risk Methods Integration and Evaluation Program (RMIEP) methods development

    International Nuclear Information System (INIS)

    Ravindra, M.K.; Banon, H.

    1992-07-01

    In this report, the scoping quantification procedures for external events in probabilistic risk assessments of nuclear power plants are described. External event analysis in a PRA has three important goals; (1) the analysis should be complete in that all events are considered; (2) by following some selected screening criteria, the more significant events are identified for detailed analysis; (3) the selected events are analyzed in depth by taking into account the unique features of the events: hazard, fragility of structures and equipment, external-event initiated accident sequences, etc. Based on the above goals, external event analysis may be considered as a three-stage process: Stage I: Identification and Initial Screening of External Events; Stage II: Bounding Analysis; Stage III: Detailed Risk Analysis. In the present report, first, a review of published PRAs is given to focus on the significance and treatment of external events in full-scope PRAs. Except for seismic, flooding, fire, and extreme wind events, the contributions of other external events to plant risk have been found to be negligible. Second, scoping methods for external events not covered in detail in the NRC's PRA Procedures Guide are provided. For this purpose, bounding analyses for transportation accidents, extreme winds and tornadoes, aircraft impacts, turbine missiles, and chemical release are described

  2. Internal versus external preference analysis : an exploratory study on end-user evaluation

    NARCIS (Netherlands)

    Kleef, van E.; Trijp, van H.C.M.; Luning, P.A.

    2006-01-01

    Internal and external preference analysis emphasise fundamentally different perspectives on the same data. We extend the literature on comparisons between internal and external preference analysis by incorporating the perspective of the end user of the preference analysis results. From a conceptual

  3. Evaluation of hygienic-sanitary conditions of hospital nutrition and dietary services from the perspectives of internal and external auditors

    Directory of Open Access Journals (Sweden)

    Lize Stangarlin

    2013-09-01

    Full Text Available The objective of this study was to evaluate the hygienic-sanitary conditions of hospital nutrition and dietary services using external and internal auditors. Eleven hospitals were evaluated for their nutrition and dietary services using an evaluation checklist based on food safety requirements in the current legislation. The checklist was applied by an internal auditor (a technical supervisor and an external auditor (a professional with experience in food services between August and October 2011. According to the number of items on the evaluation checklist that were considered adequate, the hospital facilities were ranked as excellent, good, regular, bad, or very bad. The results obtained by the auditors were compared. According to these results, it can be said that most of the hospital nutrition and dietary services were rated as good for overall quality by the internal auditor, while the external auditor classified them as Regular. There was a clear difference between the evaluations of the auditors, both in terms of the number of items considered adequate and the overall requirements' average score. It can be concluded that hospital nutrition and dietary services should meet safety requirements in order to provide food. These facilities should have external audits conducted as a way to prevent routine problems from being perpetuated.

  4. Evaluation of the learning curve for external cephalic version using cumulative sum analysis.

    Science.gov (United States)

    Kim, So Yun; Han, Jung Yeol; Chang, Eun Hye; Kwak, Dong Wook; Ahn, Hyun Kyung; Ryu, Hyun Mi; Kim, Moon Young

    2017-07-01

    We evaluated the learning curve for external cephalic version (ECV) using learning curve-cumulative sum (LC-CUSUM) analysis. This was a retrospective study involving 290 consecutive cases between October 2013 and March 2017. We evaluated the learning curve for ECV on nulli and over para 1 group using LC-CUSUM analysis on the assumption that 50% and 70% of ECV procedures succeeded by description a trend-line of quadratic function with reliable R 2 values. The overall success rate for ECV was 64.8% (188/290), while the success rate for nullipara and over para 1 groups was 56.2% (100/178) and 78.6% (88/112), respectively. 'H' value, that the actual failure rate does not differ from the acceptable failure rate, was -3.27 and -1.635 when considering ECV success rates of 50% and 70%, respectively. Consequently, in order to obtain a consistent 50% success rate, we would require 57 nullipara cases, and in order to obtain a consistent 70% success rate, we would require 130 nullipara cases. In contrast, 8 to 10 over para 1 cases would be required for an expected success rate of 50% and 70% on over para 1 group. Even a relatively inexperienced physician can experience success with multipara and after accumulating experience, they will manage nullipara cases. Further research is required for LC-CUSUM involving several practitioners instead of a single practitioner. This will lead to the gradual implementation of standard learning curve guidelines for ECV.

  5. External evaluation of the Radiation Therapy Oncology Group brachial plexus contouring protocol: several issues identified

    International Nuclear Information System (INIS)

    Min, Myo; Carruthers, Scott; Zanchetta, Lydia; Roos, Daniel; Keating, Elly; Shakeshaft, John; Baxi, Siddhartha; Penniment, Michael; Wong, Karen

    2014-01-01

    The aims of the study were to evaluate interobserver variability in contouring the brachial plexus (BP) using the Radiation Therapy Oncology Group (RTOG)-approved protocol and to analyse BP dosimetries. Seven outliners independently contoured the BPs of 15 consecutive patients. Interobserver variability was reviewed qualitatively (visually by using planning axial computed-tomography images and anteroposterior digitally reconstructed radiographs) and quantitatively (by volumetric and statistical analyses). Dose–volume histograms of BPs were calculated and compared. We found significant interobserver variability among outliners in both qualitative and quantitative analyses. These were most pronounced for the T1 nerve roots on visual inspection and for the BP volume on statistical analysis. The BP volumes were smaller than those described in the RTOG atlas paper, with a mean volume of 20.8cc (range 11–40.7 cc) compared with 33±4cc (25.1–39.4cc). The average values of mean dose, maximum dose, V60Gy, V66Gy and V70Gy for patients treated with conventional radiotherapy and IMRT were 42.2Gy versus 44.8Gy, 64.5Gy versus 68.5Gy, 6.1% versus 7.6%, 2.9% versus 2.4% and 0.6% versus 0.3%, respectively. This is the first independent external evaluation of the published protocol. We have identified several issues, including significant interobserver variation. Although radiation oncologists should contour BPs to avoid dose dumping, especially when using IMRT, the RTOG atlas should be used with caution. Because BPs are largely radiologically occult on CT, we propose the term brachial-plexus regions (BPRs) to represent regions where BPs are likely to be present. Consequently, BPRs should in principle be contoured generously.

  6. Grid Computing BOINC Redesign Mindmap with incentive system (gamification)

    OpenAIRE

    Kitchen, Kris

    2016-01-01

    Grid Computing BOINC Redesign Mindmap with incentive system (gamification) this is a PDF viewable of https://figshare.com/articles/Grid_Computing_BOINC_Redesign_Mindmap_with_incentive_system_gamification_/1265350

  7. Course Redesign: An Evidence-Based Approach

    Science.gov (United States)

    Nomme, Kathy; Birol, Gülnur

    2014-01-01

    A first year non-majors biology course, with an enrollment of around 440 students, has been redesigned from a course of traditional content and teaching style to one that emphasizes biological concepts in current global issues and incorporates active learning strategies. We were informed by the education literature incorporating many aspects of…

  8. Mandated Preparation Program Redesign: Kentucky Case

    Science.gov (United States)

    Browne-Ferrigno, Tricia

    2013-01-01

    This case study presents a chronicle of events spanning a decade in Kentucky that led to state policy changes for principal preparation and details the response to those mandated changes by professors at the University of Kentucky. Professors' collaborative efforts resulted in a new teacher leadership program and redesigned principal certification…

  9. High School Redesign Gets Presidential Lift

    Science.gov (United States)

    Adams, Caralee J.

    2013-01-01

    President Barack Obama applauded high school redesign efforts in his State of the Union address and encouraged districts to look to successful models for inspiration. Last week, he followed up with a request in his fiscal 2014 budget proposal for a new, $300 million competitive-grant program. Recognition is widespread that high schools need to…

  10. RSA Monitoring Redesign Initiative Informational Booklet #1

    Science.gov (United States)

    US Department of Education, 2005

    2005-01-01

    This informational booklet contains background materials regarding the Rehabilitation Services Administration (RSA) initiative to redesign its monitoring system. The booklet is intended to expand the knowledge and understanding of those individuals selected to participate in the RSA-sponsored monitoring conference that was held August 24 and 25,…

  11. RSA Monitoring Redesign Initiative Informational Booklet #2

    Science.gov (United States)

    US Department of Education, 2005

    2005-01-01

    The U.S. Department of Education's Rehabilitation Services Administration (RSA) is undertaking a major initiative to substantially redesign its program monitoring and improvement system. The overriding goal is to improve vocational rehabilitation (VR) services and employment outcomes for individuals with disabilities through the development of a…

  12. Re-Designing Business Card Advertisements.

    Science.gov (United States)

    Schaub, Laura

    2001-01-01

    Discusses ways to turn information from a business card into an advertisement to be placed in a student publication. Addresses visual interest, typography, and other design issues. Includes several sample advertisements and a classroom activity involving redesigning a business card into an advertisement. (RS)

  13. A Flipped Classroom Redesign in General Chemistry

    Science.gov (United States)

    Reid, Scott A.

    2016-01-01

    The flipped classroom continues to attract significant attention in higher education. Building upon our recent parallel controlled study of the flipped classroom in a second-term general chemistry course ("J. Chem. Educ.," 2016, 93, 13-23), here we report on a redesign of the flipped course aimed at scaling up total enrollment while…

  14. Predicting Internalizing and Externalizing Symptoms in Children with ASD: Evaluation of a Contextual Model of Parental Factors

    Science.gov (United States)

    McRae, Elizabeth M.; Stoppelbein, Laura; O'Kelley, Sarah E.; Fite, Paula; Greening, Leilani

    2018-01-01

    Parental adjustment, parenting behaviors, and child routines have been linked to internalizing and externalizing child behavior. The purpose of the present study was to evaluate a comprehensive model examining relations among these variables in children with ASD and their parents. Based on Sameroff's Transactional Model of Development (Sameroff…

  15. How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations

    Directory of Open Access Journals (Sweden)

    Jenine R. Leal

    2017-06-01

    Full Text Available Abstract Background The rates of antimicrobial-resistant organisms (ARO continue to increase for both hospitalized and community patients. Few resources have been allocated to reduce the spread of resistance on global, national and local levels, in part because the broader economic impact of antimicrobial resistance (i.e. the externality is not fully considered when determining how much to invest to prevent AROs, including strategies to contain antimicrobial resistance, such as antimicrobial stewardship programs. To determine how best to measure and incorporate the impact of externalities associated with the antimicrobial resistance when making resource allocation decisions aimed to reduce antimicrobial resistance within healthcare facilities, we reviewed the literature to identify publications which 1 described the externalities of antimicrobial resistance, 2 described approaches to quantifying the externalities associated with antimicrobial resistance or 3 described macro-level policy options to consider the impact of externalities. Medline was reviewed to identify published studies up to September 2016. Main body An externality is a cost or a benefit associated with one person’s activity that impacts others who did not choose to incur that cost or benefit. We did not identify a well-accepted method of accurately quantifying the externality associated with antimicrobial resistance. We did identify three main methods that have gained popularity to try to take into account the externalities of antimicrobial resistance, including regulation, charges or taxes on the use of antimicrobials, and the right to trade permits or licenses for antimicrobial use. To our knowledge, regulating use of antimicrobials is the only strategy currently being used by health care systems to reduce antimicrobial use, and thereby reduce AROs. To justify expenditures on programs that reduce AROs (i.e. to formally incorporate the impact of the negative externality of

  16. Implementing a Redesign Strategy: Lessons from Educational Change.

    Science.gov (United States)

    Basom, Richard E., Jr.; Crandall, David P.

    The effective implementation of school redesign, based on a social systems approach, is discussed in this paper. A basic assumption is that the interdependence of system elements has implications for a complex change process. Seven barriers to redesign and five critical issues for successful redesign strategy are presented. Seven linear steps for…

  17. Evaluation of external radiation exposure of personnel involved in veterinary nuclear medicine

    International Nuclear Information System (INIS)

    Komatsubara, N.; Ito, N.; Natsuhori, M.; Sano, T.; Ishikawa, T.; Hatakeyama, S.; Futatsugawa, S.; Terasaki, K.; Hirayama, H.

    2005-01-01

    Veterinary nuclear medicine has been widely applied in the US and Europe, especially for dogs, cats, and horses. The needs of the nuclear medicine in veterinary practice are also growing in Japan. This study was performed in order to make a safety guideline for veterinary nuclear medicine in Japan. Two sorts of well often medically used radionuclide, 18 F and 99m Tc were chosen for evaluating the exposed doses of the veterinarian, the animal owner, and the general public. Air absorption doses around a physical phantom containing radioactive materials ( 18 F or 99m Tc) were measured by glass dosimeters. (Asahi Techno Glass Ltd.) It was verified that the measurement values were corresponding to the calculation values using EGS4. Then, canine pectoral and abdominal mathematical phantom was designed, external radiation exposure of the veterinarian, the animal owner and the public from the phantom containing radioactive materials were calculated by using EGS4. Calculated exposure doses were compared with the dose limit or the dose constraint. (20mSv/yr for the veterinarian: ICRP, 5mSv/yr for the animal owner: IAEA, and 1mSv/yr for the general public: ICRP 2 ). The future integration exposed doses of the animal owner and the public didn't exceed the dose constraint or the dose limit at the release after 24 hours of the radiopharmaceutical administering. In this study, all the calculation conditions were set up on the safety side. Therefore, it is thought that actual exposed doses lower considerably. The safety guideline for the veterinary nuclear medicine in Japan will be established by further application of this type of research. (author)

  18. System redesign of the immunization supply chain: Experiences from Benin and Mozambique.

    Science.gov (United States)

    Prosser, Wendy; Jaillard, Philippe; Assy, Emmanuelle; Brown, Shawn T; Matsinhe, Graça; Dekoun, Mawutondji; Lee, Bruce Y

    2017-04-19

    Evidence suggests that immunization supply chains are becoming outdated and unable to deliver needed vaccines due to growing populations and new vaccine introductions. Redesigning a supply chain could result in meeting current demands. The Ministries of Health in Benin in Mozambique recognized known barriers to the immunization supply chain and undertook a system redesign to address those barriers. Changes were made to introduce an informed push system while consolidating storage points, introducing transport loops, and increasing human resource capacity for distribution. Evaluations were completed in each country. Evaluation in each country indicated improved performance of the supply chain. The Effective Vaccine Management (EVM) assessment in Benin documented notable improvements in the distribution criteria of the tool, increasing from 40% to 100% at the district level. In Mozambique, results showed reduced stockouts at health facility level from 79% at baseline to less than 1% at endline. Coverage rates of DTP3 also increased from 68.9% to 92.8%. Benin and Mozambique are undertaking system redesign in order to respond to constraints identified in the vaccine supply chain. Results and learnings show improvements in supply chain performance and make a strong case for system redesign. These countries demonstrate the feasibility of system redesign for other countries considering how to address outdated supply chains. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  19. Perceptions on evaluative and formative functions of external supervision of Rwandan primary healthcare facilities: A qualitative study.

    Science.gov (United States)

    Schriver, Michael; Cubaka, Vincent Kalumire; Itangishaka, Sylvere; Nyirazinyoye, Laetitia; Kallestrup, Per

    2018-01-01

    External supervision of primary healthcare facilities in low- and middle-income countries often has a managerial main purpose in which the role of support for professional development is unclear. To explore how Rwandan primary healthcare supervisors and providers (supervisees) perceive evaluative and formative functions of external supervision. Qualitative, exploratory study. Focus group discussions: three with supervisors, three with providers, and one mixed (n = 31). Findings were discussed with individual and groups of supervisors and providers. Evaluative activities occupied providers' understanding of supervision, including checking, correcting, marking and performance-based financing. These were presented as sources of motivation, that in self-determination theory indicate introjected regulation. Supervisors preferred to highlight their role in formative supervision, which may mask their own and providers' uncontested accounts that systematic performance evaluations predominated supervisors' work. Providers strongly requested larger focus on formative and supportive functions, voiced as well by most supervisors. Impact of performance evaluation on motivation and professional development is discussed. While external supervisors intended to support providers' professional development, our findings indicate serious problems with this in a context of frequent evaluations and performance marking. Separating the role of supporter and evaluator does not appear as the simple solution. If external supervision is to improve health care services, it is essential that supervisors and health centre managers are competent to support providers in a way that transparently accounts for various performance pressures. This includes delivery of proper formative supervision with useful feedback, maintaining an effective supervisory relationship, as well as ensuring providers are aware of the purpose and content of evaluative and formative supervision functions.

  20. Lessons learned from EU stress tests evaluations with regard to external hazards

    International Nuclear Information System (INIS)

    Misak, J.

    2014-01-01

    The presentation was oriented to critical review of the lessons learned from the European Union (EU) Stress Test focusing on NPP robustness against external hazards. These lessons addressed: - organization of the stress tests, - scope and objectives of the stress tests, - peer review findings, recommendations and implications on the design in the area of external hazards, - further studies recommended in the area of external hazards and PSA, - relevant research areas identified by the SNETP Task Group in response to Fukushima accident. Some important conclusions were made in the final part of the presentation: - Vulnerability to the Fukushima Dai-ichi reactor accidents caused by external hazards and including their secondary effects was underestimated, - Lessons learned from Fukushima Dai-ichi reactor accidents, from the EU Stress Test and from peer reviews are to be reflected in safety improvements of operating plants and considered in new designs, - while no completely new phenomena were revealed from the Fukushima Dai-ichi reactor accidents, improvements in specific research areas (including external hazards and use of PSA) should be considered with high priority

  1. Effective healthcare process redesign through an interdisciplinary team approach.

    Science.gov (United States)

    Snyder, Rita; Huynh, Nathan; Cai, Bo; Vidal, José; Bennett, Kevin

    2013-01-01

    Healthcare process redesign is a complex and often high risk undertaking. Typically, there is a limited understanding of the baseline process and often inadequate tools by which to assess it. This can be confounded by narrow redesign team expertise that can result in unanticipated and/or unintended redesign consequences. Interdisciplinary research teams of healthcare, biostatistics, engineering and computer science experts provide broad support for a more effective and safer approach to healthcare process redesign. We describe an interdisciplinary research team focused on medication administration process (MAP)redesign and its achievements and challenges.

  2. The use of external electronic tags on fish: an evaluation of tag retention and tagging effects

    DEFF Research Database (Denmark)

    Jepsen, Niels; Thorstad, Eva B.; Havn, Torgeir

    2015-01-01

    External tagging of fish with electronic tags has been used for decades for a wide range of marine and freshwater species. In the early years of fish telemetry research, it was the most commonly used attachment method, but later internal implants became preferred. Recently, the number of telemetry...... unsuitable for surgical implantation, or when using tags with sensors recording the external environment. The most commonly reported problems with external tags are tissue damage, premature tag loss, and decreased swimming capacity, but the effects are highly context dependent and species specific. Reduced......, but particularly there are few studies on predation risk, social interactions, and studies distinguishing capture and handling effects from tagging effects. For PSATs, especially those that are large relative to fish size, there are particular problems with a high proportion of premature tag losses, reduced...

  3. Evaluation of stability of interface between CCM (Co-Cr-Mo) UCLA abutment and external hex implant.

    Science.gov (United States)

    Yoon, Ki-Joon; Park, Young-Bum; Choi, Hyunmin; Cho, Youngsung; Lee, Jae-Hoon; Lee, Keun-Woo

    2016-12-01

    The purpose of this study is to evaluate the stability of interface between Co-Cr-Mo (CCM) UCLA abutment and external hex implant. Sixteen external hex implant fixtures were assigned to two groups (CCM and Gold group) and were embedded in molds using clear acrylic resin. Screw-retained prostheses were constructed using CCM UCLA abutment and Gold UCLA abutment. The external implant fixture and screw-retained prostheses were connected using abutment screws. After the abutments were tightened to 30 Ncm torque, 5 kg thermocyclic functional loading was applied by chewing simulator. A target of 1.0 × 10 6 cycles was applied. After cyclic loading, removal torque values were recorded using a driving torque tester, and the interface between implant fixture and abutment was evaluated by scanning electronic microscope (SEM). The means and standard deviations (SD) between the CCM and Gold groups were analyzed with independent t-test at the significance level of 0.05. Fractures of crowns, abutments, abutment screws, and fixtures and loosening of abutment screws were not observed after thermocyclic loading. There were no statistically significant differences at the recorded removal torque values between CCM and Gold groups ( P >.05). SEM analysis revealed that remarkable wear patterns were observed at the abutment interface only for Gold UCLA abutments. Those patterns were not observed for other specimens. Within the limit of this study, CCM UCLA abutment has no statistically significant difference in the stability of interface with external hex implant, compared with Gold UCLA abutment.

  4. [THE VIRTUAL CYTOLOGIC SLIDES FOR EXTERNAL EVALUATION OF QUALITY OF IMPLEMENTATION OF CYTOLOGIC ANALYSES IN CLINICAL DIAGNOSTIC LABORATORIES: POSSIBILITIES AND PERSPECTIVES].

    Science.gov (United States)

    Djangirova, T V; Shabalova, I P; Pronichev, A N; Polyakov, E V

    2015-08-01

    The article considers application of technology of analysis of cytological slides in external quality control of clinical diagnostic laboratories. The advantages of virtual slides are demonstrated against other applied technologies of external evaluation of quality i.e. slide plate and digital micro-photography. The conditions of formation of virtual slides for external evaluation of quality of clinical diagnostic laboratories. The technology of their application is described. The success of practical application of considered technology in the Federal system of external evaluation of quality is emphasized.

  5. Including product features in process redesign

    DEFF Research Database (Denmark)

    Hvam, Lars; Hauksdóttir, Dagný; Mortensen, Niels Henrik

    2017-01-01

    do not take into account how the product features are applied throughout the process, which makes it difficult to obtain a comprehensive understanding of the activities in the processes and to generate significant improvements. The suggested approach models the product family using the so......This article suggests a visual modelling method for integrating models of product features with business process models for redesigning the business processes involving specifications of customer-tailored products and services. The current methods for redesigning these types of business processes......-called product variant master and the business process modelling notation for modelling the process flow. The product model is combined with the process map by identifying features used in each step of the process flow. Additionally, based on the information absorbed from the integrated model, the value stream...

  6. Application of participatory ergonomics to the redesign of the family-centred rounds process.

    Science.gov (United States)

    Xie, Anping; Carayon, Pascale; Cox, Elizabeth D; Cartmill, Randi; Li, Yaqiong; Wetterneck, Tosha B; Kelly, Michelle M

    2015-01-01

    Participatory ergonomics (PE) can promote the application of human factors and ergonomics (HFE) principles to healthcare system redesign. This study applied a PE approach to redesigning the family-centred rounds (FCR) process to improve family engagement. Various FCR stakeholders (e.g. patients and families, physicians, nurses, hospital management) were involved in different stages of the PE process. HFE principles were integrated in both the content (e.g. shared mental model, usability, workload consideration, systems approach) and process (e.g. top management commitment, stakeholder participation, communication and feedback, learning and training, project management) of FCR redesign. We describe activities of the PE process (e.g. formation and meetings of the redesign team, data collection activities, intervention development, intervention implementation) and present data on PE process evaluation. To demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures (e.g. family engagement, round efficiency) and patient outcome measures (e.g. patient satisfaction).

  7. Application of participatory ergonomics to the redesign of the family-centered rounds process

    Science.gov (United States)

    Xie, Anping; Carayon, Pascale; Cox, Elizabeth D.; Cartmill, Randi; Li, Yaqiong; Wetterneck, Tosha B.; Kelly, Michelle M.

    2015-01-01

    Participatory ergonomics (PE) can promote the application of human factors and ergonomics (HFE) principles to healthcare system redesign. This study applied a PE approach to redesigning the family-centered rounds (FCR) process to improve family engagement. Various FCR stakeholders (e.g., patients and families, physicians, nurses, hospital management) were involved in different stages of the PE process. HFE principles were integrated in both the content (e.g., shared mental model, usability, workload consideration, systems approach) and process (e.g., top management commitment, stakeholder participation, communication and feedback, learning and training, project management) of FCR redesign. We describe activities of the PE process (e.g., formation and meetings of the redesign team, data collection activities, intervention development, intervention implementation) and present data on PE process evaluation. To demonstrate the value of PE-based FCR redesign, future research should document its impact on FCR process measures (e.g., family engagement, round efficiency) and patient outcome measures (e.g., patient satisfaction). PMID:25777042

  8. Evaluation of personal dose equivalent 'HP(d)' in a external individual monitoring system for X and gamma radiation

    International Nuclear Information System (INIS)

    Santoro, C.; Antonio Filho, J.; Santos, M.A.P.

    2007-01-01

    The good of individual monitoring for external radiation is the assessment of occupational exposure from X and γ radiations in order to assure that the radiological conditions of the workplace are acceptable, safe and satisfactory. The evaluation of radiations doses for workers must not exceed dose limits specified for workers, according to national regulatory agencies. Nowadays, there are two external monitoring systems in use, both based on ICRU definitions. In the conventional system, the workers doses are evaluated in terms of Hx. The personal dosimeter is worn over chest surface and it is calibrated in function of air kerma. In the new system, the workers doses are evaluated in terms of HP(d) and the personal dosimeter is calibrated in function of phantom doses. The aim of this paper is to adapt an external dosimetry laboratory (based on photographic dosimetry) to evaluate the personal dosimeters in terms of HP(d). In this way, a simple methodology, based on linear programming, was utilized. In this adaptation, calibration curves were obtained for radiation qualities (W and N series) described by International Organization for Standardization (ISO 4037-1, 1995). These calibration curves offer a better accuracy on dose determinations and energy below 140 keV, improving the quality of service rendered the society. (author)

  9. Accounting for future redesign to balance performance and development costs

    International Nuclear Information System (INIS)

    Villanueva, D.; Haftka, R.T.; Sankar, B.V.

    2014-01-01

    Most components undergo tests after they are designed and are redesigned if necessary. Tests help designers find unsafe and overly conservative designs, and redesign can restore safety or increase performance. In general, the expected changes to the performance and reliability of the design after the test and redesign are not considered. In this paper, we explore how modeling a future test and redesign provides a company an opportunity to balance development costs versus performance by simultaneously designing the design and the post-test redesign rules during the initial design stage. Due to regulations and tradition, safety margin and safety factor based design is a common practice in industry as opposed to probabilistic design. In this paper, we show that it is possible to continue to use safety margin based design, and employ probability solely to select safety margins and redesign criteria. In this study, we find the optimum safety margins and redesign criterion for an integrated thermal protection system. These are optimized in order to find a minimum mass design with minimal redesign costs. We observed that the optimum safety margin and redesign criterion call for an initially conservative design and use the redesign process to trim excess weight rather than restore safety. This would fit well with regulatory constraints, since regulations usually impose minimum safety margins. - Highlights: • Modeling future tests and redesign allows balancing performance and development cost. • We optimize safety margins and redesign criteria for desired balance. • We design with safety margins, with probabilistic optimization to decide the margins. • Redesign also allowed the trade-off of conservativeness and performance. • In our case it paid to be conservative initially but redesign for more

  10. Outsourcing Physical Education in Primary Schools: Evaluating the Impact of Externally Provided Programmes on Generalist Teachers

    Science.gov (United States)

    Whipp, Peter R.; Hutton, Heidi; Grove, J. Robert; Jackson, Ben

    2011-01-01

    In place of generalist delivery, externally provided physical activity programmes (EPPAPs) are potentially an effective method for offering primary school students specialist physical education (PE) instruction, as well as providing training for generalist classroom teachers. In the present study, a group of generalist teachers were interviewed…

  11. Reinventing the Wheel: One Program's Approach to Redesign of Didactic Courses.

    Science.gov (United States)

    Hudak, Nicholas M; Scott, Victoria; Spear, Sherrie B; Hills, Karen J

    2015-12-01

    Curriculum and course redesign are expected and intentional efforts in health professions education. For physician assistant (PA) education, ongoing program self-assessment is a required accreditation standard and may guide deliberate changes within curriculum. The purpose of this article is to describe one PA program’s approach to the redesign of 4 courses into 3 courses that span the entire didactic phase. Significant lessons learned include the importance of planning ahead, identifying key players, documenting the process as part of ongoing self-assessment, competency mapping, and being prepared to make real-time modifications and changes based on course evaluations and faculty feedback. Our approach and guiding principles to the successful redesign of the didactic courses may provide both established and new PA educational programs with useful methods to apply in their own unique curricula.

  12. Regional Externalities

    NARCIS (Netherlands)

    Heijman, W.J.M.

    2007-01-01

    The book offers practical and theoretical insights in regional externalities. Regional externalities are a specific subset of externalities that can be defined as externalities where space plays a dominant role. This class of externalities can be divided into three categories: (1) externalities

  13. Magnetic evaluation of the external surface in cast heat-resistant steel tubes with different aging states

    Science.gov (United States)

    Arenas, Mónica P.; Silveira, Rosa M.; Pacheco, Clara J.; Bruno, Antonio C.; Araujo, Jefferson F. D. F.; Eckstein, Carlos B.; Nogueira, Laudemiro; de Almeida, Luiz H.; Rebello, João M. A.; Pereira, Gabriela R.

    2018-06-01

    Heat-resistant austenitic stainless steels have become the principal alloys for use in steam reformer tubes in the petrochemical industry due to its mechanical properties. These tubes are typically exposed to severe operational conditions leading to microstructural transformations such as the aging phenomenon. The combination of high temperatures and moderate stresses causes creep damages, being necessary to monitor its structural condition by non-destructive techniques. The tube external wall is also subjected to oxidizing atmospheres, favoring the formation of an external surface, composed by an oxide scale and a chromium depleted zone. This external surface is usually not taken into account in the tube evaluation, which can lead to erroneous estimations of the service life of these components. In order to observe the magnetic influence of this layer, two samples, exposed to different operational temperatures, were characterized by non-destructive eddy current testing (ECT), scanning DC-susceptometer and magnetic force microscopy (MFM). It was found that the external surface thickness influences directly in the magnetic response of the samples.

  14. Evaluation of Externality Costs in Life-Cycle Optimization of Municipal Solid Waste Management Systems

    DEFF Research Database (Denmark)

    Martinez Sanchez, Veronica; Levis, James W.; Damgaard, Anders

    2017-01-01

    The development of sustainable solid waste management (SWM) systems requires consideration of both economic and environmental impacts. Societal life-cycle costing (S-LCC) provides a quantitative framework to estimate both economic and environmental impacts, by including "budget costs...... suburban U.S. county of 500 000 people generating 320 000 Mg of waste annually. Estimated externality costs are based on emissions of CO2, CH4, N2O, PM2.5, PM10, NOx, SO2, VOC, CO, NH3, Hg, Pb, Cd, Cr (VI), Ni, As, and dioxins. The results indicate that incorporating S-LCC into optimized SWM strategy...... development encourages the use of a mixed waste material recovery facility with residues going to incineration, and separated organics to anaerobic digestion. Results are sensitive to waste composition, energy mix and recycling rates. Most of the externality costs stem from SO2, NOx, PM2.5, CH4, fossil CO2...

  15. Evaluation of the Biological Effects of Externally Tunable, Hydrogel Encapsulated Quantum Dot Nanospheres in Escherichia coli

    Directory of Open Access Journals (Sweden)

    Somesree GhoshMitra

    2011-08-01

    Full Text Available Quantum Dots (QDs have become an interesting subject of study for labeling and drug delivery in biomedical research due to their unique responses to external stimuli. In this paper, the biological effects of a novel hydrogel based QD nano-structure on E. coli bacteria are presented. The experimental evidence reveals that cadmium telluride (CdTe QDs that are encapsulated inside biocompatible polymeric shells have reduced or negligible toxicity to this model cell system, even when exposed at higher dosages. Furthermore, a preliminary gene expression study indicates that QD-hydrogel nanospheres do not inhibit the Green Fluorescent Protein (GFP gene expression. As the biocompatible and externally tunable polymer shells possess the capability to control the QD packing density at nanometer scales, the resulting luminescence efficiency of the nanostructures, besides reducing the cytotoxic potential, may be suitable for various biomedical applications.

  16. A Research Agenda for Evaluating Strength of Internal Preferences and External Influences in Consumer Smartphone Switching

    OpenAIRE

    Nykänen, Jussi Ilmari; Tuunainen, Virpi Kristiina; Tuunanen, Tuure

    2015-01-01

    This article proposes a research agenda to study what causes consumers to switch smartphone manufacturer and operating system brands. International consumer survey is planned for data collection and structural equation modeling method will be used to extrapolate whether internal preferences play a larger role than external influences in consumers’ switching behavior. The effects are expected to be moderated by behavioral control, subjective uncertainty and prior switching ex...

  17. Gravity versus manual external rotation stress view in evaluating ankle stability: a prospective study.

    Science.gov (United States)

    LeBa, Thu-Ba; Gugala, Zbigniew; Morris, Randal P; Panchbhavi, Vinod K

    2015-06-01

    The purpose of this prospective study was to determine whether gravity versus manual external rotation stress testing effectively detects widening of the medial clear space in isolated ankle fractures when compared with the uninjured contralateral side. Manual external rotation stress and gravity stress tests were performed on injured and uninjured ankles of ankle fracture patients in a clinic setting. Medial clear space measurements were recorded and differences between gravity and manual stress views were determined. Twenty consecutive patients with ankle injury were enrolled in the study. When compared with the uninjured side, gravity stress views showed a statistically significant (P = .017) increase in medial clear space widening (1.85 ± 1.07 mm) compared with manual stress view widening (1.35 ± 1.04 mm). This study suggests that gravity stress views are as effective as manual external rotation stress views in detecting medial clear space widening in isolated fibular fractures. Diagnostic, Level II: Prospective, comparative trial. © 2014 The Author(s).

  18. Participatory ergonomics in redesigning a dyeing tub for fabric dyers.

    Science.gov (United States)

    Parimalam, P; Premalatha, M R; Padmini, D S; Ganguli, A K

    2012-01-01

    The 'saree' worn by women in India and many South Asian countries is dyed using a tub, usually in small scale units employing low capital and a small number of workers. While using these tubs, workers adopt awkward postures over long periods of time which results in severe discomfort in the neck, shoulders and lower extremities. The purpose of the study was to redesign the dyeing tub using a participatory approach and to study the impact of the newly designed tub on the reported body discomfort and rate of production. Redesigning of the dyeing tub was carried out using three parallel participative processes--(1) eliciting the views of workers who use the tub, (2) interacting with the proprietors of the small scale dyeing units (the employers) and the tub manufacturers, and (3) iterative prototype tub development based on inputs from the first two processes. These processes facilitated involvement of the stake-holders and the acceptance of change. The final prototype was tested by nine workers for a period of three months to evaluate the reduction in body discomfort and increase in rate of production (output). Studies on the impact of the new tub showed a reduction in discomfort level from 'severe' to 'moderate', and a mean increase of 7.9% in the output, confirming the benefits of the participative approach to ergonomics intervention. The involvement, trust and credibility generated by the participative process facilitated the acceptance of the final design.

  19. Cybernetics: A Possible Solution for the "Knowledge Gap" between "External" and "Internal" in Evaluation Processes

    Science.gov (United States)

    Levin-Rozalis, Miri

    2010-01-01

    This paper addresses the issue of the knowledge gap between evaluators and the entity being evaluated: the dilemma of the knowledge of professional evaluators vs. the in-depth knowledge of the evaluated subjects. In order to optimize evaluative outcomes, the author suggests an approach based on ideas borrowed from the science of cybernetics as a…

  20. From Course Assessment to Redesign: A Hybrid-Vehicle Course as a Case Illustration

    Science.gov (United States)

    Stanton, Ken C.; Bradley, Thomas H.

    2013-01-01

    Assessment has become a central aspect of engineering education for evaluating student learning, attaining accreditation, and ensuring accountability. However, the final step of the assessment process, which requires assessment results be used to redesign courses and programmes, is appreciably underdeveloped in the literature. As such, this work…

  1. Effect of External Quality Assurance Evaluation for Chest Radiography: 3-Year Follow-Up in the Medical Institution for Pneumoconiosis

    International Nuclear Information System (INIS)

    Lee, Won Jeong; Choi, Soon Byung

    2012-01-01

    The aim of this study was to determine the effect of external quality assurance (QA) evaluation for chest radiography in the medical institution for pneumoconiosis (MIP). The chest radiography of the MIPs were evaluated for a radiological technique (RT), image quality (IQ), and reading environment (RE), during a 3-year follow up according to the Korean guidelines. Same methods were implemented each year to ensure that the results are reliable. RT, IQ, and RE were compared between examination and medical care (EMP), and only medical care (MCP) for pneumoconiosis, film-screen (FSR) and digital (DR) radiography. Uneducated and educated for QA during a 3-year follow up referencing with 2008 were realized. RT and IQ of the MIPs showed a significantly higher score in 2009 and 2010 compared with 2008 (p < 0.01). However, RE was not significantly improved. The score of RT, IQ, and RE of the EMPs were higher than those of MCPs every year, and FSR showed a lower score in all evaluations, although, more improvement was seen than the DR. The chest radiography of the MIPs showed a significant effect as a result of a repeated external QA evaluation. However, the MIPs need to transfer from FSR to DR, and maintain a continuous QA evaluation for the MCPs.

  2. An operations-partnered evaluation of care redesign for high-risk patients in the Veterans Health Administration (VHA): Study protocol for the PACT Intensive Management (PIM) randomized quality improvement evaluation.

    Science.gov (United States)

    Chang, Evelyn T; Zulman, Donna M; Asch, Steven M; Stockdale, Susan E; Yoon, Jean; Ong, Michael K; Lee, Martin; Simon, Alissa; Atkins, David; Schectman, Gordon; Kirsh, Susan R; Rubenstein, Lisa V

    2018-06-01

    Patient-centered medical homes have made great strides providing comprehensive care for patients with chronic conditions, but may not provide sufficient support for patients at highest risk for acute care use. To address this, the Veterans Health Administration (VHA) initiated a five-site demonstration project to evaluate the effectiveness of augmenting the VA's Patient Aligned Care Team (PACT) medical home with PACT Intensive Management (PIM) teams for Veterans at highest risk for hospitalization. Researchers partnered with VHA leadership to design a mixed-methods prospective multi-site evaluation that met leadership's desire for a rigorous evaluation conducted as quality improvement rather than research. We conducted a randomized QI evaluation and assigned high-risk patients to participate in PIM and compared them with high-risk Veterans receiving usual care through PACT. The summative evaluation examines whether PIM: 1) decreases VHA emergency department and hospital use; 2) increases satisfaction with VHA care; 3) decreases provider burnout; and 4) generates positive returns on investment. The formative evaluation aims to support improved care for high-risk patients at demonstration sites and to inform future initiatives for high-risk patients. The evaluation was reviewed by representatives from the VHA Office of Research and Development and the Office of Research Oversight and met criteria for quality improvement. VHA aims to function as a learning organization by rapidly implementing and rigorously testing QI innovations prior to final program or policy development. We observed challenges and opportunities in designing an evaluation consistent with QI standards and operations priorities, while also maintaining scientific rigor. This trial was retrospectively registered at ClinicalTrials.gov on April 3, 2017: NCT03100526. Protocol v1, FY14-17. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Clinical evaluation of nares-vocal cord distance and its correlation with various external body parameters

    Directory of Open Access Journals (Sweden)

    Bhuwan Sareen

    2015-01-01

    Full Text Available Background and Aims: The optimal visualisation of vocal cords during fibreoptic intubation may be utilised for the nares-vocal cord distance (NVD estimation. The present study was conducted to measure NVD and to correlate with various external body parameters. Methods: This study was conducted on 50 males and 50 females. We measured NVD and analysed its relationship with height, nares to tragus of ear distance (NED, nares to angle of mandible distance (NMD, sternal length (SL, thyro-mental distance (TMD, sterno-mental distance (SMD and arm span (AS. Results: The mean NVD of the males was 18.5 ± 1.5 cm, and that of the females was 15.9 ± 1.1 cm. The relationship between the NVD and body height (males P = 0.001, r = 0.463, females P = 0.000, r = 0.555, SL (males P = 0.000, r = 0.463, females P < 0.000, r = 0.801 or AS (males P = 0.000, r = 0.561, females P = 0.000, r = 0.499 showed a significant correlation but NED, NMD, TMD, SMD did not. After combining male and female groups, (n = 100, the correlation of NVD with external body parameters is as follows SL (r = 0.887, height (r = 0.791, AS (r = 0.769, weight (r = 0.531, SMD (r = 0.466, NED (r = 0.459, NMD (r = 0.391, TMD (r = 0.379. Conclusion: The relationship of NVD to external body parameters had strong correlation in all parameters in the combined group; whereas when gender was taken into consideration NVD correlated significantly only with SL, height and AS.

  4. Evaluation of external exposure in a radioactive waste deposit; Avaliacao da exposicao externa em um deposito de rejeitos radioativos

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Sergio Quinet de; Pereira, Wagner de Souza; Py Junior, Delcy de Azevedo; Dores, Luis Augusto de Carvalho Bresser; Dantas, Marcelino Vicente de Almeida; Silva, Ana Claudia Antunes; Garcia Filho, Oswaldo, E-mail: wspereira@inb.gov.b, E-mail: sergioquinet@inb.gov.b, E-mail: delcy@inb.gov.b, E-mail: luisdores@inb.gov.b, E-mail: marcelino@inb.go.b, E-mail: anasilva@inb.gov.b, E-mail: ogarcia@inb.gov.b [Industrias Nucleares do Brasil (UTM/INB), Pocos de Caldas, MG (Brazil). Unidade de Tratamento de Minerio

    2011-10-26

    The ore treatment unit (OTU) of Industrias Nucleares do Brasil (INB), located at Caldas municipality - Minas Gerais, Brazil, posses a radioactive deposit, coming mainly from the chemical processing of monazite sands for obtention of 'rare earths'. The main components of these waste are the 'torta II (thorium rich residues) and the 'mesothorium' ({sup 228}Ra rich residues) - conditioned in steel drums (200 liters), plastic pumps (100 liters) or underground silos. These loaders are deposited in waste loading warehouses existent at the OTU and periodic evaluations of the external exposure rates (mR/h) are part of the 'Programa de Monitoracao Radiologica Ocupacional' of the unit. This paper presents a brief history of origins of this waste deposit and the material found there, and also the result of a routine monitoring of the external exposure rates

  5. Key strategies and criteria to redesigning the nuclear fuel cycle

    International Nuclear Information System (INIS)

    Iakimets, V.N.

    1999-01-01

    Design of the nuclear fuel cycle (NFC) impacts future development of the nuclear industry on the one hand and the scale of the technological and environmental risk for future generations on the other hand. Adequate protection for humans and the biosphere will depend upon careful and unbiased design of the NFC. This paper addresses the two following problems: 1. What are the key strategies in restructuring nuclear power production itself in terms of choosing the safest possible variant of the NFC and identifying reasonable approaches to redesigning decision-making procedures for design, siting and operation, and decommissioning of new facilities, which have to be based on a strong legally approved citizen involvement. 2. What criteria should be used to evaluate any strategic or mid-term decisions related to the NFC, how can these be made operational, and what procedures may we apply to evaluate alternatives and select the most preferable one mutually acceptable to both citizens and nuclear specialists?

  6. A field evaluation of an external and neutrally buoyant acoustic transmitter for juvenile salmon: implications for estimating hydroturbine passage survival.

    Directory of Open Access Journals (Sweden)

    Richard S Brown

    Full Text Available Turbine-passed fish are exposed to rapid decreases in pressure which can cause barotrauma. The presence of an implanted telemetry tag increases the likelihood of injury or death from exposure to pressure changes, thus potentially biasing studies evaluating survival of turbine-passed fish. Therefore, a neutrally buoyant externally attached tag was developed to eliminate this bias in turbine passage studies. This new tag was designed not to add excess mass in water or take up space in the coelom, having an effective tag burden of zero with the goal of reducing pressure related biases to turbine survival studies. To determine if this new tag affects fish performance or susceptibility to predation, it was evaluated in the field relative to internally implanted acoustic transmitters (JSATS; Juvenile Salmon Acoustic Telemetry System used widely for survival studies of juvenile salmonids. Survival and travel time through the study reach was compared between fish with either tag type in an area of high predation in the Snake and Columbia rivers, Washington. An additional group of fish affixed with neutrally-buoyant dummy external tags were implanted with passive integrated transponder (PIT tags and recovered further downstream to assess external tag retention and injury. There were no significant differences in survival to the first detection site, 12 river kilometers (rkm downstream of release. Travel times were also similar between groups. Conversely, externally-tagged fish had reduced survival (or elevated tag loss to the second detection site, 65 rkm downstream. In addition, the retention study revealed that tag loss was first observed in fish recaptured approximately 9 days after release. Results suggest that this new tag may be viable for short term (<8 days single-dam turbine-passage studies and under these situations, may alleviate the turbine passage-related bias encountered when using internal tags, however further research is needed to

  7. A field evaluation of an external and neutrally buoyant acoustic transmitter for juvenile salmon: implications for estimating hydroturbine passage survival.

    Science.gov (United States)

    Brown, Richard S; Deng, Z Daniel; Cook, Katrina V; Pflugrath, Brett D; Li, Xinya; Fu, Tao; Martinez, Jayson J; Li, Huidong; Trumbo, Bradly A; Ahmann, Martin L; Seaburg, Adam G

    2013-01-01

    Turbine-passed fish are exposed to rapid decreases in pressure which can cause barotrauma. The presence of an implanted telemetry tag increases the likelihood of injury or death from exposure to pressure changes, thus potentially biasing studies evaluating survival of turbine-passed fish. Therefore, a neutrally buoyant externally attached tag was developed to eliminate this bias in turbine passage studies. This new tag was designed not to add excess mass in water or take up space in the coelom, having an effective tag burden of zero with the goal of reducing pressure related biases to turbine survival studies. To determine if this new tag affects fish performance or susceptibility to predation, it was evaluated in the field relative to internally implanted acoustic transmitters (JSATS; Juvenile Salmon Acoustic Telemetry System) used widely for survival studies of juvenile salmonids. Survival and travel time through the study reach was compared between fish with either tag type in an area of high predation in the Snake and Columbia rivers, Washington. An additional group of fish affixed with neutrally-buoyant dummy external tags were implanted with passive integrated transponder (PIT) tags and recovered further downstream to assess external tag retention and injury. There were no significant differences in survival to the first detection site, 12 river kilometers (rkm) downstream of release. Travel times were also similar between groups. Conversely, externally-tagged fish had reduced survival (or elevated tag loss) to the second detection site, 65 rkm downstream. In addition, the retention study revealed that tag loss was first observed in fish recaptured approximately 9 days after release. Results suggest that this new tag may be viable for short term (<8 days) single-dam turbine-passage studies and under these situations, may alleviate the turbine passage-related bias encountered when using internal tags, however further research is needed to confirm this.

  8. Evaluation of structural reliability for vacuum vessel under external pressure and electromagnetic force

    International Nuclear Information System (INIS)

    Minato, Akio

    1983-08-01

    Static and dynamic structural analyses of the vacuum vessel for a Swimming Pool Type Tokamak Reactor (SPTR) have been conducted under the external pressure (hydraulic and atmospheric pressure) during normal operation or the electromagnetic force due to plasma disruption. The reactor structural design is based on the concept that the adjacent modules of the vacuum vessel are not connected mechanically with bolts in the torus inboard region each other, so as to save the required space for inserting the remote handling machine for tightenning and untightenning bolts in the region and to simplify the repair and maintenance of the reactor. The structural analyses of the vacuum vessel have been carried out under the external pressure and the electromagnetic force and the structural reliability against the static and dynamic loads is estimated. The several configurations of the lip seal between the modules, which is required to make a plasma vacuum boundary, have been proposed and the structural strength under the forced displacements due to the deformation of the vacuum vessel is also estimated. (author)

  9. Enhancing policy innovation by redesigning representative democracy

    DEFF Research Database (Denmark)

    Sørensen, Eva

    2016-01-01

    Policy innovation is a key aspect of public innovation, which has been largely overlooked. Political leadership, competition and collaboration are key drivers of policy innovation. It is a barrier in traditional models of representative democracy that they provide weak conditions for collaboration....... Two Danish case studies indicate that collaboration between politicians and relevant and affected stakeholders can promote policy innovation, but also that a redesign of representative democracy is needed in order to establish a productive combination of political leadership, competition...... and collaboration in political life....

  10. Redesigning Health Information Systems in Developing Countries

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw; Kimaro, Honest; Aanestad, Margunn

    2008-01-01

    or no end user involvement results in a centralised HIS with an extensive, somewhat inappropriate, but also inflexible set of standards. Consequently, the HIS is not very useful for the wished-for decentralisation of health services, and there is an urgent need to redesign the existing HIS in order to make...... degree of control over a decentralised HIS, including budgets and the use of resources, should be delegated to the district administration. In order to achieve the aim of a locally relevant, well-working HIS, it is necessary that appropriate authority, capacity and decentralised allocation of resources...

  11. Redesigning Manufacturing Footprint from Dynamic Perspective

    DEFF Research Database (Denmark)

    Yang, Cheng; Farooq, Sami; Johansen, John

    2009-01-01

    footprint to address the constantly emerging new challenges by giving a holistic approach from dynamic perspective. Three Danish companies are presented. The way they developed their international manufacturing networks is analysed historically, and their redesigning of manufacturing footprint is expressed...... as how to re-assign portfolios of products and processes between specific plants within the same manufacturing network at one point in time. The strategic factors that have impact on such decisions are discussed and classified into two groups. Last, a holistic framework and a process model is presented...

  12. Development of redesign method of production system based on QFD

    Science.gov (United States)

    Kondoh, Shinsuke; Umeda, Yasusi; Togawa, Hisashi

    In order to catch up with rapidly changing market environment, rapid and flexible redesign of production system is quite important. For effective and rapid redesign of production system, a redesign support system is eagerly needed. To this end, this paper proposes a redesign method of production system based on Quality Function Deployment (QFD). This method represents a designer's intention in the form of QFD, collects experts' knowledge as “Production Method (PM) modules,” and formulates redesign guidelines as seven redesign operations so as to support a designer to find out improvement ideas in a systematical manner. This paper also illustrates a redesign support tool of a production system we have developed based on this method, and demonstrates its feasibility with a practical example of a production system of a contact probe. A result from this example shows that comparable cost reduction to those of veteran designers can be achieved by a novice designer. From this result, we conclude our redesign method is effective and feasible for supporting redesign of a production system.

  13. Procedure Redesign Methods : E3-Control: a redesign methodology for control procedures

    NARCIS (Netherlands)

    Liu, J.; Hofman, W.J.; Tan, Y.H.

    2011-01-01

    This chapter highlights the core research methodology, e3-control, that is applied throughout the ITAIDE project for the purpose of control procedure redesign. We present the key concept of the e3-control methodology and its technical guidelines. Based on the output of this chapter, domain experts

  14. The system of personal monitoring and the evaluation of occupational exposure to external ionizing radiation in Cuba

    International Nuclear Information System (INIS)

    Molina, Daniel; Castro, Ailza; Martinez, Ernesto; Pernas, Rene

    2008-01-01

    Full text: Personal monitoring of workers is recommended or required by the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. In our country the personal monitoring of external exposure to ionizing radiation is carried out by External Dosimetry Laboratory (LDE) of the Center for Radiation Protection and Hygiene (CPHR). We have implemented an individual monitoring service based on thermoluminescence dosimetry system. The service includes whole body and extremity dosimeters. We have two systems; one is base on a manual Toledo TLD reader and the other on an automatic RADOS TLD system. This service is recognized by the National Regulatory Authority in the field of radiation protection and safety. We have implemented a quality assurance (QA) programme designed according to the recommendations of the ISO/IEC 17025 standards. The papers deals with the presentation of these QA programme which includes administrative data and information, technical checking of the equipment, acceptance tests of new dosimeters and equipment, issuing and processing of the dosimeters, dose evaluation, record keeping and reporting, traceability, handling of complaints, internal reviews and external audits. The papers also describe the results of occupational exposure for the different practices during 2006-2007 period. (author)

  15. BDD-based reliability evaluation of phased-mission systems with internal/external common-cause failures

    International Nuclear Information System (INIS)

    Xing, Liudong; Levitin, Gregory

    2013-01-01

    Phased-mission systems (PMS) are systems in which multiple non-overlapping phases of operations (or tasks) are accomplished in sequence for a successful mission. Examples of PMS abound in applications such as aerospace, nuclear power, and airborne weapon systems. Reliability analysis of a PMS must consider statistical dependence across different phases as well as dynamics in system configuration, failure criteria, and component behavior. This paper proposes a binary decision diagrams (BDD) based method for the reliability evaluation of non-repairable binary-state PMS with common-cause failures (CCF). CCF are simultaneous failure of multiple system elements, which can be caused by some external factors (e.g., lightning strikes, sudden changes in environment) or by propagated failures originating from some elements within the system. Both the external and internal CCF is considered in this paper. The proposed method is combinatorial, exact, and is applicable to PMS with arbitrary system structures and component failure distributions. An example with different CCF scenarios is analyzed to illustrate the application and advantages of the proposed method. -- Highlights: ► Non-repairable phased-mission systems with common-cause failures are analyzed. ► Common-cause failures caused by internal or external factors are considered. ► A combinatorial algorithm based on binary decision diagrams is suggested

  16. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    Directory of Open Access Journals (Sweden)

    Chia-Der Lin

    2015-09-01

    Full Text Available Introduction: Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods: A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results: The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions: Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a

  17. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    Science.gov (United States)

    Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

    2015-01-01

    Introduction Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a physician. PMID

  18. Evaluation of multimodality treatment for advanced pancreatic cancer. Special reference to intraoperative vs. external radiation therapy

    International Nuclear Information System (INIS)

    Wakasugi, Hideyuki; Funakoshi, Akihiro; Seo, Yousuke; Iguchi, Haruo; Wada, Susumu

    1999-01-01

    Intraoperative radiation therapy (IORT)+postoperative external beam radiation therapy (ERT) with chemotherapy and ERT alone with chemotherapy have been performed in our hospital for unresectable, especially locally advanced, pancreatic cancer. We compared the former method with the latter. Chemotherapy was performed together with radiation, using 5-FU, CDDP, and MMC. IORT+ERT was successful in only half of the treated patients, while ERT alone was successful in almost all of the patients. As a result, the doses of radiation were often shorter in patients treated by the former method compared to the latter method. Both methods, when completed for locally advanced pancreatic cancer (stage IVa), produced good effects on tumor markers, tumor size and pain. Furthermore, the latter method was better than the former in improving the survival time and quality of life (QOL). Therefore, ERT is a practical and useful method for patients with locally advanced pancreatic cancer. (author)

  19. Evaluation of external exposures of the population of Ozyorsk, Russia, with luminescence measurements of bricks.

    Science.gov (United States)

    Woda, Clemens; Jacob, P; Ulanovsky, A; Fiedler, I; Mokrov, Y; Rovny, S

    2009-11-01

    Recently discovered historical documents indicate that large releases of noble gases (mainly (41)Ar and radioactive isotopes of Kr and Xe) from the Mayak Production Association (MPA) over the period from 1948 to 1956 may have caused considerable external exposures of both, inhabitants of Ozyorsk and former inhabitants of villages at the upper Techa River. To quantify this exposure, seven brick samples from three buildings in Ozyorsk, located 8-10 km north-northwest from the radioactive gas release points, were taken. The absorbed dose in brick was measured in a depth interval of 3-13 mm below the exposed surface of the bricks by means of the thermoluminescence (TL) and the optically stimulated luminescence (OSL) method. Generally, luminescence properties using TL were more favorable for precise dose determination than using OSL, but within their uncertainties the results from both methods agree well with each other. The absorbed dose due to natural radiation was assessed and subtracted under the assumption of the bricks to be completely dry. The weighted average of the anthropogenic dose for all samples measured by TL and OSL is 10 +/- 9 and 1 +/- 9 mGy, respectively. An upper limit for a possible anthropogenic dose in brick that would not be detected due to the measurement uncertainties is estimated at 24 mGy. This corresponds to an effective dose of about 21 mSv. A similar range of values is obtained in recently published dispersion calculations that were based on reconstructed MPA releases. It is concluded that the release of radioactive noble gases from the radiochemical and reactor plants at Mayak PA did not lead to a significant external exposure of the population of Ozyorsk. In addition, the study demonstrates the detection limit for anthropogenic doses in ca. 60-year-old bricks to be about 24 mGy, if luminescence methods are used.

  20. Education within public management in South Africa: A focus on external Whole-School Evaluation process’ contribution in Mpumalanga province

    Directory of Open Access Journals (Sweden)

    Richard Siphamandla Ryan Mathaba

    2015-08-01

    Full Text Available The study focused on the role played by public sector management in South Africa towards the country’s total development and improvement. This article also analyses how through the Whole School Evaluation (WSE process, the education system in South Africa seeks to ensure that the schooling is effective. This paper examines public management, public administration as well as new public management (NPM. The aim is to illustrate a view of how education fits in the broader public management and how the WSE process assists schooling in South Africa and Mpumalanga in particular. This is to ensure that the schooling is effective and contribute towards service delivery and the country’s overall development and improvement. Furthermore, WSE as a process, is viewed through five of NPM undisputable and debatable characteristics of accountability for performance; performance measurement; performance auditing; policy analysis and evaluation; and strategic planning and management. Public management functions and public management principles are discussed from a point of how the WSE process strives to ensure that it complies with these function and principles, and how this compliance benefit school improvement. This paper came to a number of conclusions regarding education within public management from a WSE perspective. Firstly, education through the external WSE process conforms to this principle of New Public Management in that evaluation is aimed at improving the quality of education. Also, the external WSE, as a process, and education in general, through the NPM principles can be performed within public management. Furthermore, external WSE conforms to public management principles as well as Batho Pele principles.

  1. Evaluation of surface and shallow depth dose reductions using a Superflab bolus during conventional and advanced external beam radiotherapy.

    Science.gov (United States)

    Yoon, Jihyung; Xie, Yibo; Zhang, Rui

    2018-03-01

    The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom. For the solid water phantom measurements, surface dose reduction caused by the Superflab bolus was achieved only in out-of-field area and on the incident side of the beam, and the dose reduction increased with bolus thickness. The dose reduction caused by the bolus was more significant at closer distances from the beam. Most of the dose reductions occurred in the first 2-cm depth and stopped at 4-cm depth. For clinical PMRT treatment plans, surface dose reductions using a 1-cm Superflab bolus were up to 31% and 62% for volumetric-modulated arc therapy and 4-field IMRT, respectively, but there was no dose reduction for Tomotherapy. A Superflab bolus can be used to reduce surface and shallow depth doses during external beam radiotherapy when it is placed out of the beam and on the incident side of the beam. Although we only validated this dose reduction strategy for PMRT treatments, it is applicable to any external beam radiotherapy and can potentially reduce patients' risk of developing radiation-induced side effects. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  2. Using business process redesign to reduce wait times at a university hospital in the Netherlands.

    Science.gov (United States)

    Elkhuizen, Sylvia G; Burger, Matthe P M; Jonkers, Rene E; Limburg, Martien; Klazinga, Niek; Bakker, Piet J M

    2007-06-01

    Business process redesign (BPR) has been applied to implement more customer-focused and cost-effective care. In 2002, two pilot projects to improve patient care processes for two specific patient groups were conducted at the Academic Medical Center, a 1,000-bed university hospital in Amsterdam. The BPR consisted of process analysis, identification of bottlenecks and goals for redesign, selection of interventions, and evaluation of effects. After identifying and selecting interventions with the greatest expected benefits, changes were implemented and effects were evaluated. For gynecologic oncology patients, access time (from telephone call to first visit) was reduced from 14 days to changes in communication and planning were sufficient to eliminate bottlenecks in the gynecologic oncology project, the dyspnea project required a radical redesign of processes. Experience since these projects suggests that process redesign may have only marginal impact when the greatest bottleneck occurs, as was the case for the two BPR projects, at the point of access to central diagnostic facilities.

  3. Evaluation of functional outcome of pilon fractures managed with limited internal fixation and external fixation: A prospective clinical study.

    Science.gov (United States)

    Meena, Umesh Kumar; Bansal, Mahesh Chand; Behera, Prateek; Upadhyay, Rahul; Gothwal, Gyan Chand

    2017-11-01

    The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures. All patients were treated with combined limited internal fixation and ankle spanning external fixation. All fractures in this series united with an average time period of union of 18.3weeks (ranging from 13 weeks to 30 weeks). There was no non-union in any case. There was malunion in 4 cases, varus malunion (>5 degree) in 2 cases and recurvatum in another 2 cases). Excellent to good functional results were observed in 88% cases based on the modified Ovadia and Beals score. The mean ankle dorsiflexion and planter flexion movements were 10.2±5.3 degrees and 27.4±7.2 degrees respectively. infections occurred in 6 patients which included 4 pin tract infections and 2 superficial wound infection, all 6 healed after removal of pin tract and with oral antibiotics. The technique of combined external fixation with internal fixation is safe and effective management option for intra-articular distal tibial fractures.

  4. The use of current risk analysis tools evaluated towards preventing external domino accidents

    NARCIS (Netherlands)

    Reniers, Genserik L L; Dullaert, W.; Ale, B. J.M.; Soudan, K.

    Risk analysis is an essential tool for company safety policy. Risk analysis consists of identifying and evaluating all possible risks. The efficiency of risk analysis tools depends on the rigueur of identifying and evaluating all possible risks. The diversity in risk analysis procedures is such that

  5. Laboratory Performance Evaluation in Terms of Water Analysis Through an External Quality Control

    International Nuclear Information System (INIS)

    Rakotozafy, L.V.; Ramaherison, H.; Andriamahenina, N.J.; Rasoazanany, E.O.; Ravoson, H.N.; Raoelina Andriambololona

    2015-01-01

    This paper presents the results of participation of Institut National des Sciences et Techniques Nucleaires-Madagascar (INSTN-Madagascar) in interlaboratory comparisons organized annually, since 2007, by Southern African Development Community WaterLab Association. The following text describes an overview of the utility of provided proficiency testing programs used as an external quality control with respect to proving consistency and reliability of water analysis at INSTN-Madagascar. Total reflection X-Ray Fluorescence spectrometry and Atomic Absorption Spectrometry are both used to measure the following trace metals: Al, Cr, Mn, Fe, Ni, Co, Cu, Zn, As, Cd, Pb. The analysis of minor and major ions such as Cl - , F - , NO 3 - , SO 4 2- , PO 4 3- ,K + , Na + , Ca 2+ , Mg 2+ are conducted by using Ion Chromatography. To illustrate, graphical distributions of z-scores calculated from the results of water measurements are presented. During the consecutive proficiency testing rounds, INSTN-Madagascar has succeeded to have more than 80% of the values within tolerance limits on 2007, 2008, 2010, 2011, 2012 and 2013. This paper shows some of the considerations for participating to proficiency testing exercises which could be used to obtain certain value from the schemes.

  6. Potential Benefits and Downsides of External Healthcare Performance Evaluation Systems: Real-Life Perspectives on Iranian Hospital Evaluation and Accreditation Program

    Directory of Open Access Journals (Sweden)

    Ebrahim Jaafaripooyan

    2014-09-01

    Full Text Available Background Performance evaluation is essential to quality improvement in healthcare. The current study has identified the potential pros and cons of external healthcare evaluation programs, utilizing them subsequently to look into the merits of a similar case in a developing country. Methods A mixed method study employing both qualitative and quantitative data collection and analysis techniques was adopted to achieve the study end. Subject Matter Experts (SMEs and professionals were approached for two-stage process of data collection. Results Potential advantages included greater attractiveness of high accreditation rank healthcare organizations to their customers/purchasers and boosted morale of their personnel. Downsides, as such, comprised the programs’ over-reliance on value judgment of surveyors, routinization and incurring undue cost on the organizations. In addition, the improved, standardized care processes as well as the judgmental nature of program survey were associated, as pros and cons, to the program investigated by the professionals. Conclusion Besides rendering a tentative assessment of Iranian hospital evaluation program, the study provides those running external performance evaluations with a lens to scrutinize the virtues of their own evaluation systems through identifying the potential advantages and drawbacks of such programs. Moreover, the approach followed could be utilized for performance assessment of similar evaluation programs.

  7. Potential pros and cons of external healthcare performance evaluation systems: real-life perspectives on Iranian hospital evaluation and accreditation program.

    Science.gov (United States)

    Jaafaripooyan, Ebrahim

    2014-09-01

    Performance evaluation is essential to quality improvement in healthcare. The current study has identified the potential pros and cons of external healthcare evaluation programs, utilizing them subsequently to look into the merits of a similar case in a developing country. A mixed method study employing both qualitative and quantitative data collection and analysis techniques was adopted to achieve the study end. Subject Matter Experts (SMEs) and professionals were approached for two-stage process of data collection. Potential advantages included greater attractiveness of high accreditation rank healthcare organizations to their customers/purchasers and boosted morale of their personnel. Downsides, as such, comprised the programs' over-reliance on value judgment of surveyors, routinization and incurring undue cost on the organizations. In addition, the improved, standardized care processes as well as the judgmental nature of program survey were associated, as pros and cons, to the program investigated by the professionals. Besides rendering a tentative assessment of Iranian hospital evaluation program, the study provides those running external performance evaluations with a lens to scrutinize the virtues of their own evaluation systems through identifying the potential advantages and drawbacks of such programs. Moreover, the approach followed could be utilized for performance assessment of similar evaluation programs.

  8. New Trends for Re-design the IT Companies

    Directory of Open Access Journals (Sweden)

    Florin Ionita

    2008-07-01

    Full Text Available As it is known, the management adaptability to the changes taking place in the environment where it is acting represents a key factor for survival and development of an organization. As a reaction to the external signals, the internal change may be superficial when it affects only the development of activity in different sectors, or might be profound, when it changes the main processes and rules of the business and even the philosophy of the company’s existence. Speaking about structural changes, one of the most common approaches of the modern management is the re-design of the business architecture. The new architectural models such as Service Oriented Architecture (SOA, presented in this paper, come with important advantages, but their implementation is not always very easy. This paper tries to present some of the most common encountered contextual characteristics which are able to start the implementation of Service Oriented Architecture, some advantages of this concept as well as some practical approaches of implementing.

  9. Environmental externalities: Applying the concept to Asian coal-based power generation. [Includes external environmental and societal costs and methods of evaluating them

    Energy Technology Data Exchange (ETDEWEB)

    Szpunar, C.B.; Gillette, J.L.

    1993-03-01

    This report examines the concept of environmental externality. It discusses various factors -- the atmospheric transformations, relationship of point-source emissions to ambient air quality, dose-response relationships, applicable cause-and-effect principles, and risk and valuation research -- that are considered by a number of state utilities when they apply the environmental externality concept to energy resource planning. It describes a methodology developed by Argonne National Laboratory for general use in resource planning, in combination with traditional methods that consider the cost of electricity production. Finally, it shows how the methodology can be applied in Indonesia, Thailand, and Taiwan to potential coal-fired power plant projects that will make use of clean coal technologies.

  10. Perceptions on evaluative and formative functions of external supervision of Rwandan primary healthcare facilities

    DEFF Research Database (Denmark)

    Schriver, Michael; Cubaka, Vincent Kalumire; Itangishaka, Sylvere

    2018-01-01

    : Evaluative activities occupied providers' understanding of supervision, including checking, correcting, marking and performance-based financing. These were presented as sources of motivation, that in self-determination theory indicate introjected regulation. Supervisors preferred to highlight their role...

  11. Tools for evaluating Veterinary Services: an external auditing model for the quality assurance process.

    Science.gov (United States)

    Melo, E Correa

    2003-08-01

    The author describes the reasons why evaluation processes should be applied to the Veterinary Services of Member Countries, either for trade in animals and animal products and by-products between two countries, or for establishing essential measures to improve the Veterinary Service concerned. The author also describes the basic elements involved in conducting an evaluation process, including the instruments for doing so. These basic elements centre on the following:--designing a model, or desirable image, against which a comparison can be made--establishing a list of processes to be analysed and defining the qualitative and quantitative mechanisms for this analysis--establishing a multidisciplinary evaluation team and developing a process for standardising the evaluation criteria.

  12. Do the Math: Course Redesign's Impact on Learning and Scheduling

    Science.gov (United States)

    Squires, John; Faulkner, Jerry; Hite, Carl

    2009-01-01

    The math department at Cleveland State Community College embarked upon course redesign in 2008. As a result of this project, student engagement, learning, and success rates have increased dramatically. By including both developmental and college level math courses in the redesign, the department has been able to implement innovative scheduling and…

  13. Controlling Curriculum Redesign with a Process Improvement Model

    Science.gov (United States)

    Drinka, Dennis; Yen, Minnie Yi-Miin

    2008-01-01

    A portion of the curriculum for a Management Information Systems degree was redesigned to enhance the experiential learning of students by focusing it on a three-semester community-based system development project. The entire curriculum was then redesigned to have a project-centric focus with each course in the curriculum contributing to the…

  14. 76 FR 16233 - Interpretive Rule Regarding Electronic Contributor Redesignations

    Science.gov (United States)

    2011-03-23

    ... audit, the Commission recently determined that a specific redesignation practice provided the same degree of assurance of the contributor's identity and the contributor's intent to redesignate the... that this process provided assurance of contributor identity and intent equivalent to a written...

  15. Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice.

    Science.gov (United States)

    Tonna, Antonella; McCaig, Dorothy; Diack, Lesley; West, Bernice; Stewart, Derek

    2014-10-01

    The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. To develop consensus guidance to facilitate service redesign around pharmacist prescribing. UK hospital practice. The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

  16. Critical evaluation of the external occupational exposure in nuclear medicine services in Brazil

    International Nuclear Information System (INIS)

    Kubo, Ana Luiza Silva Lima

    2016-01-01

    Currently in Brazil (2016), there are 421 Nuclear Medicine Services (NMS). In nuclear medicine, the possibility of occupational internal contamination and external exposure is unavoidable. The chest individual monitoring, to estimate the effective dose, is mandatory, but the extremity monitoring is not always made. The aim of this study was to conduct a survey of data for external exposure of NMS professionals in Brazil from 1987 to 2010, analysing them in terms of trends and comparing them with measurements carried out in this work and in other countries. Although most of the NMS is still located in large urban centres (54% in the Southeast region), there is no state without any NMS. The increasing number of NMS has generated the need for more professionals. In the year 1987, they were 755 workers and, in 2010, 4134, with the following distribution of specialties: 29% of Nuclear Medicine Technicians (NMT), 23% of Nursing professionals, 29% of Physicians and 3% of Physicists. The average annual effective dose reached more than 3.0 mSv in some regions of the country, from 1987 to 2010, but tends to 1.0 mSv in 2010. The highest doses, as expected, are received by NMT and Nursing. The professionals who handle radiopharmaceuticals have their hands much more exposed than the chest. During 2010, only 31% of NMT and 16% of Nursing used extremity dosimeters as compared to chest dosimeters. The data from the measurements indicate that not all individual dosimeters are used properly. Generally, both in the measurements as in national registries, the hand doses were higher for professionals who prepared the radiopharmaceutical (NMT) than those who injected (Nursing). The value measured by chest dosimeters can be used to estimate the equivalent dose to the eye lenses, except for NMT at preparation practices at conventional NMS, where the equivalent dose of the lens is about 2 times higher than the dose at the chest. The most exposed areas of the hands are the tips of the index

  17. Evaluation of pressure pain threshold after external stabilizer application at masseurs

    Directory of Open Access Journals (Sweden)

    Andrzej Milańczyk

    2015-09-01

    Full Text Available Introduction. Physiotherapists are professional group exposed to physical musculo-skeletal overloads and disorders. These disorders reducing their productivity are the most common reason for work disability. The aim of this study was to assess the pressure pain threshold [PPT kPa1] after pneumatic external stabilizer Exonik V.2 application.Material and methods. Ten masseurs of Lower Silesia rehabilitation centers participated in the present study. During examination the PPT of muscles was determined twice: at the end of the 40-hour work week – on Friday, during which the subjects did not use stabilizer Exonic V.2, and after using it within the next 40-hour work week at the end of the last day – on Friday. Results. A statistically significant increase in the average values of the PPT recorded in the reference points located on the same side of the spinous processes of the spine, from the series 2 of measurements, compared with a series 1 (p0.05 was observed. These changes have also been defined as percentage average values, which were higher on the left side than the right side. Comparable percentage changes for the lumbar (L and thoracic (Th were noticed with higher mean values on the right side of the lumbar and on the left side in the thoracic. Conclusions. The obtained results prove the benefits of the application of a stabilizer Exonik V.2 which reduces muscle soreness measured by PPT. This study should be extended to higher number of subjects characterized by same age and work experience.

  18. Evaluation of the external and internal workload in female futsal players

    Directory of Open Access Journals (Sweden)

    Marco Beato

    2017-04-01

    Full Text Available Match analysis technology has been extensively used in football, but there is limited literature on its use in futsal. Despite its increased popularity, the female futsal game model has never been quantified. The aim of this study was to quantify locomotor and mechanical activities performed during a non-competitive female futsal match, measuring the differences between the first and second half. Sixteen female futsal players of the Italian 2nd division were enrolled (age 27±5 years, height 1.65±0.09 m, body weight 56.9±7.7 kg, BMI 20.9±1.9, fat mass 21.5±2.9%. Locomotor and mechanical activities were recorded by means of the 10 Hz GPS StatSports system. Games were performed on a 38x18 m synthetic grass outdoor pitch. Significant differences were found between the first and second half in total distance (1424±114 and 1313±113 m, p<0.05, relative velocity (70±6 and 64±6 m min-1, p<0.05, high speed running (28±16 and 22±19 m, p<0.05 and high metabolic distance (80 ± 29 and 69 ± 28 m, p<0.05. The match analysis of female futsal matches provides useful information about its external load demands. Female futsal players decreased the workload in the second half compared to the first one during this non-competitive match. It was found that fatigue impairs the performance in the second part of the game. Coaches and physical trainers can obtain useful information to design training programmes taking into account the quantification of locomotor and mechanical activities performed in this study.

  19. Does a grill menu redesign influence sales, nutrients purchased, and consumer acceptance in a worksite cafeteria?

    OpenAIRE

    Maya K. Vadiveloo; Vasanti S. Malik; Donna Spiegelman; Walter C. Willett; Josiemer Mattei

    2017-01-01

    Worksite cafeterias are compelling venues to improve diet quality through environmental changes.We conducted a pre-post study to evaluate how a cafeteria-initiated grill menu redesign influenced sales, revenue, and nutrient content of foods purchased. Secondly, we evaluated consumer opinions about menu changes to inform practices for worksite environment interventions. Monthly sales data (2012–2015) were used to compute gross sales and revenue of entrées and side dishes pre-post menu changes....

  20. Evaluation of the absorbed doses in conditions of external and internal contamination with radionuclides

    International Nuclear Information System (INIS)

    Milivojevic, K.; Stojanovic, D.; Markovic, P.

    1981-01-01

    In experimental conditions of contamination with radionuclides of the skin and skin injuries, an evaluation of the degree of local irradiation in decontamined region and doses absorbed in organs of selective accumulating was carried out by use of mathematical models and tissue-equivalent thermoluminescent dosemeters. The evaluation of the absorbed doses based on conception, that in adequate analyses of decontamination effect, as a most efficient medico-prophilactic measure from local and total irradiation, should be taken into account the total body burden of the penetrated radionuclide, selective accumulating in critical organs or tissues, as well as the residual radioactivity in decontaminated region. (author)

  1. Redesign of a Low Energy Probe Head

    CERN Document Server

    Rao, Yi-Nong; Ries, Thomas

    2005-01-01

    The present situation of the low energy probe LE2 in TRIUMF cyclotron is that the thickness of the finger 5 is uniform over a radial length of 3.25 inch and its weight which amounts to ~447 g is affecting its re-circulating ball mechanism and causing it to fall below the median plane over its range of movement. We therefore re-design it in order to reduce its weight. First, we made simulations and determined the optimum thickness of the probe head vs its radial length. These simulation results are found to be in good agreement with experimental measurements made. Finally, we calculated the temperature rise caused by the beam power dumped on the probe, and figured out the maximum current of beam that can be dumped on the finger.

  2. Safety in the redesigning of production lines

    DEFF Research Database (Denmark)

    Dyhrberg, Mette Bang; Broberg, Ole; Jacobsen, Peter

    2006-01-01

    This paper is a case study report on how safety considerations were handled in the process of redesigning a production line. The design process was characterized as a specification and negotiation process between engineers from the company and the supplier organization. The new production line...... became safer, but not as a result of any intentional plan to integrate safety aspects into the design process. Instead, the supplier’s design of a new piece of equipment had a higher built-in safety level. The engineering team in the company was aware of the importance of safety aspects neither...... in the specification material nor in their face-to-face meetings with the supplier. Safety aspects were not part of their work practice. On this basis, it was suggested that formal guidelines or procedures for integrating safety in the design of production lines would have no effect. Instead, the researchers set up...

  3. A method of computerized evaluation of CT based treatment plans in external radiotherapy

    International Nuclear Information System (INIS)

    Heufelder, J.; Zink, K.; Scholz, M.; Kramer, K.D.; Welker, K.

    2003-01-01

    Selection of an optimal treatment plan requires the comparison of dose distributions and dose-volume histograms (DVH) of all plan variants calculated for the patient. Each treatment plan consists generally of 30 to 40 CT slices, making the comparison difficult and time consuming. The present study proposes an objective index that takes into account both physical and biological criteria for the evaluation of the dose distribution. The DHV-based evaluation index can be calculated according to the following four criteria: ICRU conformity (review of the differences between the dose in the planning target volume and the ICRU recommendations); mean dose and dose homogeneity of the planning target volume; the product of tumour complication probability (TCP) and normal tissue complication probability (NTCP); and finally a criterion that takes into account the dose load of non-segmented tissue portions within the CT slice. The application of the objective index is demonstrated for two different clinical cases (esophagus and breast carcinoma). During the evaluation period, the objective index showed a good correlation between the doctor's decision and the proposed objective index. Thus, the objective index is suitable for a computer-based evaluation of treatment plans. (orig.) [de

  4. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

    Directory of Open Access Journals (Sweden)

    Amann Matthias

    2007-11-01

    Full Text Available Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC measurement by the pulmonary artery catheter (PAC. However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA only requires access to the radial or femoral artery using a standard arterial catheter and does not need an external calibration. We validated this technique in critically ill patients in the intensive care unit (ICU using COPAC as the method of reference. Methods We studied 20 critically ill patients, aged 16 to 74 years (mean, 55.5 ± 18.8 years, who required both arterial and pulmonary artery pressure monitoring. COPAC measurements were performed at least every 4 hours and calculated as the average of 3 measurements, while COAP values were taken immediately at the end of bolus determinations. Accuracy of measurements was assessed by calculating the bias and limits of agreement using the method described by Bland and Altman. Results A total of 164 coupled measurements were obtained. Absolute values of COPAC ranged from 2.80 to 10.80 l/min (mean 5.93 ± 1.55 l/min. The bias and limits of agreement between COPAC and COAP for unequal numbers of replicates was 0.02 ± 2.92 l/min. The percentage error between COPAC and COAP was 49.3%. The bias between percentage changes in COPAC (ΔCOPAC and percentage changes in COAP (ΔCOAP for consecutive measurements was -0.70% ± 32.28%. COPAC and COAP showed a Pearson correlation coefficient of 0.58 (p PAC and ΔCOAP was 0.46 (p Conclusion Although the COAP algorithm shows a minimal bias with COPAC over a wide range of values in an inhomogeneous group of critically ill patients, the scattering of the data remains relative wide. Therefore, the used algorithm (V 1.03 failed to

  5. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

    Science.gov (United States)

    Prasser, Christopher; Bele, Sylvia; Keyl, Cornelius; Schweiger, Stefan; Trabold, Benedikt; Amann, Matthias; Welnhofer, Julia; Wiesenack, Christoph

    2007-01-01

    Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC) measurement by the pulmonary artery catheter (PAC). However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP) device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA) only requires access to the radial or femoral artery using a standard arterial catheter and does not need an external calibration. We validated this technique in critically ill patients in the intensive care unit (ICU) using COPAC as the method of reference. Methods We studied 20 critically ill patients, aged 16 to 74 years (mean, 55.5 ± 18.8 years), who required both arterial and pulmonary artery pressure monitoring. COPAC measurements were performed at least every 4 hours and calculated as the average of 3 measurements, while COAP values were taken immediately at the end of bolus determinations. Accuracy of measurements was assessed by calculating the bias and limits of agreement using the method described by Bland and Altman. Results A total of 164 coupled measurements were obtained. Absolute values of COPAC ranged from 2.80 to 10.80 l/min (mean 5.93 ± 1.55 l/min). The bias and limits of agreement between COPAC and COAP for unequal numbers of replicates was 0.02 ± 2.92 l/min. The percentage error between COPAC and COAP was 49.3%. The bias between percentage changes in COPAC (ΔCOPAC) and percentage changes in COAP (ΔCOAP) for consecutive measurements was -0.70% ± 32.28%. COPAC and COAP showed a Pearson correlation coefficient of 0.58 (p < 0.01), while the correlation coefficient between ΔCOPAC and ΔCOAP was 0.46 (p < 0.01). Conclusion Although the COAP algorithm shows a minimal bias with COPAC over a wide range of values in an inhomogeneous group of critically ill patients, the scattering of the data remains relative wide. Therefore

  6. Redesigning current instruments as a precondition for a more effective environmental protection

    Directory of Open Access Journals (Sweden)

    Adžemović Mesud R.

    2017-01-01

    Full Text Available The problems of environment and evaluation of natural capital belong to the phenomenology of externalities, and the requirements of environmental economics are ever more oriented towards the elaboration of the ecological–economic category of the externalization of internal expenses, wherefrom reasons for the introduction of ecological–economic instruments, before all payments for pollutions, ensue. Demystification of the negative conviction relating ecological payments as taxes is very important, since it must be shown that ecological payments correct, mitigate or remove externalities. Environmental protection is a complex system and it consists in a set of rules, measures and instruments that are applied for the surveillance of pollution sources, and shaping of instruments for environmental protection is a complex process intended for the accomplishment of established ecological goals. Among all instruments available for bridging the gap of internalization and exerting a significant effect on polluters to diminish their emissions of pollution, the ecological and economic ones are most important. The results of our investigation have demonstrated that it is necessary to reshape the current set of instruments regarding protection of vital functions of nature and an efficient environmental protection, and one of the key cognitions is that the scientific and professional public must not be excluded from the appraisals of creating and redesigning the instruments of environmental protection. These assertions have their foundation in the premise that the significance of elements of the social dimension in sustainable development is to a great extent determined by the level of environmental degradation and reduction in capacity of renewable sources. The paper, approach and data processing of the conducted research offer a new model and new elements of methodology for establishing the state and quality of the environment, whereby social

  7. Biotype assessment and evaluation as a method to quantify the external costs related to surface brown coal mining

    International Nuclear Information System (INIS)

    Kabrna, M.; Peleska, O.

    2009-01-01

    Externalities express the uncompensated effects of human individuals on each other and on nature. Externalities include costs and benefits which impact human individuals and environment and are not included in the costs and benefits of their creators and are often defined as the differences between social costs or revenues from economic activity and private costs or revenues. Surface brown coal mining can be characterized by a large range of adverse environmental effects. In order to compensate for the environmental damage caused by mining activities in the Czech Republic, various environmental fees paid by mining companies were introduced to the Czech legislation. The Hessian method of quantifying impacts on the environment is an expert methods that is appropriate for the evaluating environmental damage caused by large-scale impacts on landscape. This paper described the methodology of the Hessian method and its application to a selected opencast mine in north-western Bohemia called the Vrsany-Sverma mine. The paper also discussed current environmental charges in the Czech Republic. It was concluded that the calculated amount of environmental damage caused by surface mining balances the amount of environmental fees currently paid by mining companies. 4 refs., 1 tab.

  8. Evaluation of external exposure during building and operation of concrete bridges constructions that reuse the conditionally released steels - 59120

    International Nuclear Information System (INIS)

    Panik, Michal; Necas, Vladimir

    2012-01-01

    This paper presents ongoing results of the project presented at ICEM'10 [1] related to the topics of reusing the conditionally released materials from decommissioning. The subject of the reuse of conditionally released materials in this case is modeling of bridge constructions which reuse the conditionally released steel in the form of reinforcement bars for the concrete bridges. A general approach for the project was presented at ICEM'10. The activities of the project continue in evaluating the individual effective doses from the external exposure based on reused conditionally released steels separately for public and for professionals (the internal exposure will be evaluated in next stages of the project). Evaluated scenarios are related to critical groups of professionals constructing the bridges (worker's scenarios). The computer code VISIPLAN 3D ALARA 4.0 planning tool was used for the calculation of the individual effective dose for professionals. Various limits of the annual individual effective dose are used for the evaluation of calculation results. The aim of the ongoing modeling is to develop a set of data of maximal radioactivity concentration for individual radionuclides in the conditionally released steel used in the bridges model constructions in order not to exceed the limits for the individual effective dose. (authors)

  9. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    Science.gov (United States)

    Leontjevas, Ruslan; Gerritsen, Debby L; Koopmans, Raymond T C M; Smalbrugge, Martin; Vernooij-Dassen, Myrra J F J

    2012-06-01

    A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). Before effect analyses, to evaluate AiD process data on sampling quality (recruitment and randomization, reach) and intervention quality (relevance and feasibility, extent to which AiD was performed), which can be used for understanding internal and external validity. In this article, a model is presented that divides process evaluation data into first- and second-order process data. Qualitative and quantitative data based on personal files of residents, interviews of nursing home professionals, and a research database were analyzed according to the following process evaluation components: sampling quality and intervention quality. Nursing home. The pattern of residents' informed consent rates differed for dementia special care units and somatic units during the study. The nursing home staff was satisfied with the AiD program and reported that the program was feasible and relevant. With the exception of the first screening step (nursing staff members using a short observer-based depression scale), AiD components were not performed fully by NH staff as prescribed in the AiD protocol. Although NH staff found the program relevant and feasible and was satisfied with the program content, individual AiD components may have different feasibility. The results on sampling quality implied that statistical analyses of AiD effectiveness should account for the type of unit, whereas the findings on intervention quality implied that, next to the type of unit, analyses should account for the extent to which individual AiD program components were performed. In general, our first-order process data evaluation confirmed internal and external validity of the AiD trial, and this evaluation enabled further statistical fine tuning. The importance of

  10. The evaluation of upper body muscle activity during the performance of external chest compressions in simulated hypogravity

    Science.gov (United States)

    Krygiel, Rebecca G.; Waye, Abigail B.; Baptista, Rafael Reimann; Heidner, Gustavo Sandri; Rehnberg, Lucas; Russomano, Thais

    2014-04-01

    BACKGROUND: This original study evaluated the electromyograph (EMG) activity of four upper body muscles: triceps brachii, erector spinae, upper rectus abdominis, and pectoralis major, while external chest compressions (ECCs) were performed in simulated Martian hypogravity using a Body Suspension Device, counterweight system, and standard full body cardiopulmonary resuscitation (CPR) mannequin. METHOD: 20 young, healthy male subjects were recruited. One hundred compressions divided into four sets, with roughly six seconds between each set to indicate 'ventilation', were performed within approximately a 1.5 minute protocol. Chest compression rate, depth and number were measured along with the subject's heart rate (HR) and rating of perceived exertion (RPE). RESULTS: All mean values were used in two-tailed t-tests using SPSS to compare +1 Gz values (control) versus simulated hypogravity values. The AHA (2005) compression standards were maintained in hypogravity. RPE and HR increased by 32% (p training regimes in case of a serious cardiac event in hypogravity.

  11. Evaluation by PIXE external beam-of the leaching efficiency for a thermo stated column for the sand treatment

    International Nuclear Information System (INIS)

    Aspiazu, J.; Vite, J.; Vivero, R.; Mendez, B.

    1995-01-01

    The purpose of this paper was to measure the leaching efficiency for a thermo stated column designed to extract metals in muds originated by foundry process. The results obtained were useful to contemplate different alternatives helping to solve the problem of stocking enormous volumes of polluted sand produced by industries. Samples of residual sands and muds (treated sands) coming from an engine factory and from a thermo stated column respectively, were irradiated using an external beam of 3.55 MeV energy protons. From the quantitative analysis PIXE (Proton Induced X-ray Emission), it was possible to establish the level of pollution in sands due to the foundry processes and to evaluate the leaching efficiency of the output liquid phase from the thermo stated column. For polluted sands, certain cases were observed for which the efficiency was not enough to decrease the level of pollution in, e.g., Cu, Zn, Br and Pb. (Author)

  12. Evaluation of magnetic fluid hyperthermia (MFH) combined with external radiation in an orthotopic rat model of prostate cancer

    International Nuclear Information System (INIS)

    Johannsen, M.; Thiesen, B.; Taymoorian, K.; Gneveckow, U.; Waldoefner, N.; Koch, M.; Scholz, R.; Lein, M.; Jung, K.; Loening, S.A.; Jordan, A.

    2005-01-01

    Full text: Magnetic fluid hyperthermia (MFH) is a new concept of cancer treatment based on AC magnetic field-induced excitation of biocompatible superparamagnetic nanoparticles. Preliminary studies of MFH using nanoscaled aminosilan-coated magnetites have demonstrated the feasibility of minimally invasive MFH in the Dunning tumor model. Here we evaluated the effect of two sequential MFH treatments, combined with external radiation, in an orthotopic Dunning R3327-MatLyLu prostate cancer model. MFH led to a significant growth inhibition in this orthotopic model of the aggressive MatLyLu tumor variant. Furthermore, combined MFH and radiation with 20 Gy equally effective in inhibiting tumor growth as radiation with 60 Gy, suggesting a significant synergistic effect. Intratumoral deposition of magnetic fluids was found to be stable, allowing for serial MFH treatments without repeated injection. The optimal treatment schedules of this combination regarding temperatures, sequencing and fractionation need to be defined in further experimental studies. (author)

  13. Evaluation by PIXE external beam of the leaching efficiency for a thermo stated column for the sand treatment

    International Nuclear Information System (INIS)

    Aspiazu, J.; Vite, J.; Vivero, R.; Mendez, B.

    1995-01-01

    The purpose of this paper was to measure the leaching efficiency for a thermo stated column designed to extract metals in muds originated by foundry processes. The results obtained were useful to contemplate different alternatives helping to solve the problem of stocking enormous volumes of polluted sand produced by industries. Samples of residual sands and muds (treated sands) coming from an engine factory and from a thermo stated column respectively, were irradiated using an external beam of 3.55 MeV energy protons. From the quantitative analysis PIXE (Proton Induced X-ray Emission), it was possible to establish the level of pollution in sands due to the foundry processes and to evaluate the leaching efficiency of the output liquid phase from the thermo stated column. For polluted sands, certain cases were observed for which the efficiency was not enough to decrease the level of pollution in e.g., Cu, Zn, Br y Pb. (Author)

  14. TIMES-SS - A mechanistic evaluation of an external validation study using reaction chemistry principles

    DEFF Research Database (Denmark)

    Roberts, David W.; Patlewicz, Grace; Dimitrov, Sabcho D.

    2007-01-01

    The TImes MEtabolism Simulator platform used for predicting skin sensitization (TIMES-SS) is a hybrid expert system that was developed at Bourgas University using funding and data from a consortium comprised of industry and regulators. TIMES-SS encodes structure-toxicity and structure...... chemicals in the murine local lymph node assay (LLNA) and then compared with predictions made by TIMES-SS. The results were promising with an overall good concordance (83%) between experimental and predicted values. The LLNA results were evaluated with respect to reaction chemistry principles...... for sensitization. Additional testing on a further four chemicals was carried out to explore some of the specific reaction chemistry findings in more detail. Improvements for TIMES-SS, where appropriate, were put forward together with proposals for further research work. TIMES-SS is a promising tool to aid...

  15. Evaluation of marginal bone loss of dental implants with internal or external connections and its association with other variables: A systematic review.

    Science.gov (United States)

    de Medeiros, Rodrigo Antonio; Pellizzer, Eduardo Piza; Vechiato Filho, Aljomar José; Dos Santos, Daniela Micheline; da Silva, Emily Vivianne Freitas; Goiato, Marcelo Coelho

    2016-10-01

    Different factors can influence marginal bone loss around dental implants, including the type of internal and external connection between the implant and the abutment. The evidence needed to evaluate these factors is unclear. The purpose of this systematic review was to evaluate marginal bone loss by radiographic analysis around dental implants with internal or external connections. A systematic review was conducted following the criteria defined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a population, intervention, comparison, and outcome(s) (PICO) question was defined: does the connection type (internal or external) influence marginal bone loss in patients undergoing implantation? An electronic search of PubMed/MEDLINE and Scopus databases was performed for studies in English language published between January 2000 and December 2014 by 2 independent reviewers, who analyzed the marginal bone loss of dental implants with an internal and/or external connection. From an initial screening yield of 595 references and after considering inclusion and exclusion criteria, 17 articles were selected for this review. Among them, 10 studies compared groups of implants with internal and external connections; 1 study evaluated external connections; and 6 studies analyzed internal connections. A total of 2708 implants were placed in 864 patients. Regarding the connection type, 2347 implants had internal connections, and 361 implants had external connections. Most studies showed lower marginal bone loss values for internal connection implants than for external connection implants. Osseointegrated dental implants with internal connections exhibited lower marginal bone loss than implants with external connections. This finding is mainly the result of the platform switching concept, which is more frequently found in implants with internal connections. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry

  16. An integrated lean-methods approach to hospital facilities redesign.

    Science.gov (United States)

    Nicholas, John

    2012-01-01

    Lean production methods for eliminating waste and improving processes in manufacturing are now being applied in healthcare. As the author shows, the methods are appropriate for redesigning hospital facilities. When used in an integrated manner and employing teams of mostly clinicians, the methods produce facility designs that are custom-fit to patient needs and caregiver work processes, and reduce operational costs. The author reviews lean methods and an approach for integrating them in the redesign of hospital facilities. A case example of the redesign of an emergency department shows the feasibility and benefits of the approach.

  17. Analytical evaluation of two-phase natural circulation flow characteristics under external reactor vessel cooling

    International Nuclear Information System (INIS)

    Park, Jong Woon

    2009-01-01

    This work proposes an analytical method of evaluating the effects of design and operating parameters on the low-pressure two-phase natural circulation flow through the annular shaped gap at the reactor vessel exterior surface heated by corium (molten core) relocated to the reactor vessel lower plenum after loss of coolant accidents. A natural circulation flow velocity equation derived from steady-state mass, momentum, and energy conservation equations for homogeneous two-phase flow is numerically solved for the core melting conditions of the APR1400 reactor. The solution is compared with existing experiments which measured natural circulation flow through the annular gap slice model. Two kinds of parameters are considered for this analytical method. One is the thermal-hydraulic conditions such as thermal power of corium, pressure and inlet subcooling. The others are those for the thermal insulation system design for the purpose of providing natural circulation flow path outside the reactor vessel: inlet flow area, annular gap clearance and system resistance. A computer program NCIRC is developed for the numerical solution of the implicit flow velocity equation.

  18. Evaluation of External Memory Access Performance on a High-End FPGA Hybrid Computer

    Directory of Open Access Journals (Sweden)

    Konstantinos Kalaitzis

    2016-10-01

    Full Text Available The motivation of this research was to evaluate the main memory performance of a hybrid super computer such as the Convey HC-x, and ascertain how the controller performs in several access scenarios, vis-à-vis hand-coded memory prefetches. Such memory patterns are very useful in stencil computations. The theoretical bandwidth of the memory of the Convey is compared with the results of our measurements. The accurate study of the memory subsystem is particularly useful for users when they are developing their application-specific personality. Experiments were performed to measure the bandwidth between the coprocessor and the memory subsystem. The experiments aimed mainly at measuring the reading access speed of the memory from Application Engines (FPGAs. Different ways of accessing data were used in order to find the most efficient way to access memory. This way was proposed for future work in the Convey HC-x. When performing a series of accesses to memory, non-uniform latencies occur. The Memory Controller of the Convey HC-x in the coprocessor attempts to cover this latency. We measure memory efficiency as a ratio of the number of memory accesses and the number of execution cycles. The result of this measurement converges to one in most cases. In addition, we performed experiments with hand-coded memory accesses. The analysis of the experimental results shows how the memory subsystem and Memory Controllers work. From this work we conclude that the memory controllers do an excellent job, largely because (transparently to the user they seem to cache large amounts of data, and hence hand-coding is not needed in most situations.

  19. External evaluation of the Dimension Vista 1500® intelligent lab system.

    Science.gov (United States)

    Bruneel, Arnaud; Dehoux, Monique; Barnier, Anne; Boutten, Anne

    2012-09-01

    Dimension Vista® analyzer combines four technologies (photometry, nephelometry, V-LYTE® integrated multisensor potentiometry, and LOCI® chemiluminescence) into one high-throughput system. We assessed analytical performance of assays routinely performed in our emergency laboratory according to the VALTEC protocol, and practicability. Precision was good for most parameters. Analytical domain was large and suitable for undiluted analysis in most clinical settings encountered in our hospital. Data were comparable and correlated to our routine analyzers (Roche Modular DP®, Abbott AXSYM®, Siemens Dimension® RxL, and BN ProSpec®). Performance of nephelometric and LOCI modules was excellent. Functional sensitivity of high-sensitivity C-reactive protein and cardiac troponin I were 0.165 mg/l and 0.03 ng/ml, respectively (coefficient of variation; CV < 10%). The influence of interfering substances (i.e., hemoglobin, bilirubin, or lipids) was moderate, and Dimension Vista® specifically alerted for interference according to HIL (hemolysis, icterus, lipemia) indices. Good instrument performance and full functionality (no reagent or sample carryover in the conditions evaluated, effective sample-volume detection, and clot detection) were confirmed. Simulated routine testing demonstrated excellent practicability, throughput, ease of use of software and security. Performance and practicability of Dimension Vista® are highly suitable for both routine and emergency use. Since no volume detection and thus no warning is available on limited sample racks, pediatric samples require special caution to the Siemens protocol to be analyzed in secured conditions. Our experience in routine practice is also discussed, i.e., the impact of daily workload, "manual" steps resulting from dilutions and pediatric samples, maintenances, flex hydration on instrument's performance on throughput and turnaround time. © 2012 Wiley Periodicals, Inc.

  20. The redesigned Bulletin is on its way

    CERN Multimedia

    2006-01-01

    In May, you will discover a redesigned CERN Bulletin. Starting with the first May issue (No. 19-20/2006), the format of the Bulletin will change completely. The page layout will be more attractive, reminiscent of a proper newspaper, with pictograms to identify the different sections. The information provided will also be more visible. The Bulletin was much in need of a makeover as its current layout dates back to 1976! The introduction of the new format will coincide with the introduction of a new means of distribution. You will still receive the electronic version of the Bulletin every week directly on your computer. However, in order to avoid the waste from the dozens of copies that linger unread in people's mailboxes, the paper version will be available at a series of distribution points around the Laboratory. You will find the Bulletin along with the Staff Association newsletter at the cafeteria closest to your office. The Bulletin will be available from the following distribution points: On the Meyrin...

  1. Ergonomic Redesign of an Industrial Control Panel

    Directory of Open Access Journals (Sweden)

    S Raeisi

    2016-07-01

    Full Text Available Operator's role in industrial control centers takes place in time, which is one of the most important determinants of whether an expected action is going to be successful or not. In certain situations, due to the complex nature of the work, the existing interfaces and already prepared procedures do not meet the dynamic requirements of operator's cognitive demands, making the control tasks unnecessarily difficult. This study was conducted to identify ergonomic issues with a specific industrial control panel, and redesign its layout and elements to enhance its usability. Task and link analysis methodologies were implemented. All essential functions and supporting operations were identified at the required trivial levels. Next, the weight of any possible link between the elements of the panel was computed as a composite index of frequency and importance. Finally, all components were rearranged within a new layout, and a computerized mockup was generated. A total of 8 primary tasks was identified, including 4 system failure handling tasks, switching between manual and automated modes, and 3 types of routine vigilance and control tasks. These tasks were broken down into 28 functions and 145 supporting operations, accordingly. Higher link values were observed between hand rest position and 2 elements. Also, 6 other components showed robust linkages. In conclusion, computer modeling can reduce the likelihood of accidents and near misses in industrial control rooms by considering the operators' misperception or mental burden and correcting poor design of the panels and inappropriate task allocation.

  2. Case management redesign in an urban facility.

    Science.gov (United States)

    Almaden, Stefany; Freshman, Brenda; Quaye, Beverly

    2011-01-01

    To explore strategies for improving patient throughput and to redesign case management processes to facilitate level of care transitions and safe discharges. Large Urban Medical Center in South Los Angeles County, with 384 licensed beds that services poor, underserved communities. Both qualitative and quantitative methods were applied. Combined theoretical frameworks were used for needs assessment, intervention strategies, and change management. Observations, interviews, surveys, and database extraction methods were used. The sample consisted of case management staff members and several other staff from nursing, social work, and emergency department staff. Postintervention measures indicated improvement in reimbursements for services, reduction in length of stay, increased productivity, improved patients' access to care, and avoiding unnecessary readmission or emergency department visits. Effective change management strategies must consider multiple factors that influence daily operations and service delivery. Creating accountability by using performance measures associated with patient transitions is highlighted by the case study results. The authors developed a process model to assist in identifying and tracking outcome measures related to patient throughput, front-end assessments, and effective patient care transitions. This model can be used in future research to further investigate best case management practices.

  3. Redesign of the DFT/MRCI Hamiltonian

    Energy Technology Data Exchange (ETDEWEB)

    Lyskov, Igor; Kleinschmidt, Martin; Marian, Christel M., E-mail: Christel.Marian@hhu.de [Institute of Theoretical and Computational Chemistry, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf (Germany)

    2016-01-21

    The combined density functional theory and multireference configuration interaction (DFT/MRCI) method of Grimme and Waletzke [J. Chem. Phys. 111, 5645 (1999)] is a well-established semi-empirical quantum chemical method for efficiently computing excited-state properties of organic molecules. As it turns out, the method fails to treat bi-chromophores owing to the strong dependence of the parameters on the excitation class. In this work, we present an alternative form of correcting the matrix elements of a MRCI Hamiltonian which is built from a Kohn-Sham set of orbitals. It is based on the idea of constructing individual energy shifts for each of the state functions of a configuration. The new parameterization is spin-invariant and incorporates less empirism compared to the original formulation. By utilizing damping techniques together with an algorithm of selecting important configurations for treating static electron correlation, the high computational efficiency has been preserved. The robustness of the original and redesigned Hamiltonians has been tested on experimentally known vertical excitation energies of organic molecules yielding similar statistics for the two parameterizations. Besides that, our new formulation is free from artificially low-lying doubly excited states, producing qualitatively correct and consistent results for excimers. The way of modifying matrix elements of the MRCI Hamiltonian presented here shall be considered as default choice when investigating photophysical processes of bi-chromophoric systems such as singlet fission or triplet-triplet upconversion.

  4. A randomized CIE L*a*b* evaluation of external bleaching therapy effects on fluorotic enamel stains.

    Science.gov (United States)

    Knösel, Michael; Attin, Rengin; Becker, Klaus; Attin, Thomas

    2008-05-01

    To evaluate the effect of external bleaching on the color and luminosity of fluorotic stains and adjacent, normally mineralized enamel areas by means of CIE L*a*b* colorimetry. Eighteen adolescents with mild to moderate fluorotic stains were randomly assigned to either bleaching group A (n = 9) or control group B. Eligibility criteria were fluorotic stained maxillary incisors or canines and the informed consent of the participants and their guardians. Using a colorimeter, CIE L*a*b* values of maxillary incisors and canines were assessed at baseline (T1) in the center of the fluorotic stained area (F1) and at adjacent, normally mineralized enamel areas (F2). Then, external bleaching with Illumine office (30% hydrogen peroxide, Dentsply DeTrey) was performed for 60 minutes, followed by color reassessment (T2). After 14 days (T3), a 2-week home bleaching period with a daily bleaching time of 1 hour with Illumine home (15% carbamide peroxide, Dentsply DeTrey) was conducted with subsequent color determination (T4). After completion of bleaching therapy, 96.0% of all fluorotic areas (F1) and 100% of normal enamel areas (F2) showed a significant change within group A, compared to 29.4% in control group B. Comparing the collective DeltaE (L*, a*, b*) of F1 and F2, 60.0% of all areas showed significant differences after completion of bleaching therapy, compared to 88.0% initially. Of group B sites, 82.4% showed color differences in the beginning (T1) and 88.2% at the end (T4). Whereas a single 1-hour session of in-office bleaching with 30% hydrogen peroxide does not significantly affect the color and luminosity of fluorotic teeth, a 14-day period of home bleaching leads to an assimilation of the color of the fluorotic stain with the color of surrounding enamel areas due to different responses of sound and fluorotic enamel to the bleaching regime.

  5. A redesigned follitropin alfa pen injector for infertility: results of a market research study

    Directory of Open Access Journals (Sweden)

    Abbotts C

    2011-06-01

    Full Text Available Carole Abbotts1, Cristiana Salgado-Braga2, Céline Audibert-Gros31Pharmaceutical Marketing Research Consultancy, London, UK; 2Fertility and Endocrinology Global Business Unit, 3Business Intelligence, Merck Serono SA, Geneva, SwitzerlandBackground: The purpose of this study was to evaluate patient-learning and nurse-teaching experiences when using a redesigned prefilled, ready-to-use follitropin alfa pen injector.Methods: Seventy-three UK women of reproductive age either administering daily treatment with self-injectable gonadotropins or about to start gonadotropin treatment for infertility (aged 24–47 years; 53 self-injection-experienced and 20 self-injection-naïve and 28 nurses from UK infertility clinics were recruited for the study. Following instruction, patients and nurses used the redesigned follitropin alfa pen to inject water into an orange and completed questionnaires to evaluate their experiences with the pen immediately after the simulated injections.Results: Most (88%, n = 64 patients found it easy to learn how to use the pen. Among injection-experienced patients, 66% (n = 35 agreed that the redesigned pen was easier to learn to use compared with their current method and 70% (n = 37 also said they would prefer its use over current devices for all injectable fertility medications. All nurses considered the redesigned pen easy to learn and believed it would be easy to teach patients how to use. Eighty-six percent (n = 24 of the nurses thought it was easy to teach patients to determine the remaining dose to be dialed and injected in a second pen if the initial dose was incomplete. Compared with other injection devices, 96% (n = 27 thought it was "much easier" to "as easy" to teach patients to use the redesigned pen. Based on ease of teaching, 68% (n = 19 of nurses would choose to teach the pen in preference to any other injection method. Almost all (93%, n = 26 nurses considered that having the same pen format for a range of

  6. Redesigning Menstrual Education Programs Using Attitudes toward Menstruation.

    Science.gov (United States)

    Kieren, Dianne K.

    1992-01-01

    Critiques current menstrual education efforts and reviews current data about the nature of adolescent girls' attitudes toward menstruation as the basis for redesigning comprehensive, effective menstrual education programs. (Author)

  7. Evaluation of ECG-gated [(11)C]acetate PET for measuring left ventricular volumes, mass, and myocardial external efficiency.

    Science.gov (United States)

    Hansson, Nils Henrik; Tolbod, Lars; Harms, Johannes; Wiggers, Henrik; Kim, Won Yong; Hansen, Esben; Zaremba, Tomas; Frøkiær, Jørgen; Jakobsen, Steen; Sørensen, Jens

    2016-08-01

    Noninvasive estimation of myocardial external efficiency (MEE) requires measurements of left ventricular (LV) oxygen consumption with [(11)C]acetate PET in addition to LV stroke volume and mass with cardiovascular magnetic resonance (CMR). Measuring LV geometry directly from ECG-gated [(11)C]acetate PET might enable MEE evaluation from a single PET scan. Therefore, we sought to establish the accuracy of measuring LV volumes, mass, and MEE directly from ECG-gated [(11)C]acetate PET. Thirty-five subjects with aortic valve stenosis underwent ECG-gated [(11)C]acetate PET and CMR. List mode PET data were rebinned into 16-bin ECG-gated uptake images before measuring LV volumes and mass using commercial software and compared to CMR. Dynamic datasets were used for calculation of mean LV oxygen consumption and MEE. LV mass, volumes, and ejection fraction measured by CMR and PET correlated strongly (r = 0.86-0.92, P PET (P PET-based MEE, corrected for bias, correlated fairly with PET/CMR-based MEE (r = 0.60, P PET-based MEE bias was strongly associated with LV wall thickness. Although analysis-related improvements in accuracy are recommended, LV geometry estimated from ECG-gated [(11)C]acetate PET correlate excellently with CMR and can indeed be used to evaluate MEE.

  8. Methodology and findings of the NRC's materials licensing process redesign

    International Nuclear Information System (INIS)

    Rathbun, P.A.; Brown, K.D.; Madera, J.R.; Moriarty, M.; Pelchat, J.M.; Usilton, W.K.; Whitten, J.E.; Vacca, P.C.

    1996-04-01

    This report describes the work and vision of the team chartered to redesign the process for licensing users of nuclear materials. The Business Process Redesign team was chartered to improve the speed of the existing licensing process while maintaining or improving public safety and to achieve required resource levels. The report describes the team's methods for acquiring and analyzing information about the existing materials licensing process and the steps necessary to radically change this process to the envisioned future process

  9. Enzyme (re)design: lessons from natural evolution and computation.

    Science.gov (United States)

    Gerlt, John A; Babbitt, Patricia C

    2009-02-01

    The (re)design of enzymes to catalyze 'new' reactions is a topic of considerable practical and intellectual interest. Directed evolution (random mutagenesis followed by screening/selection) has been used widely to identify novel biocatalysts. However, 'rational' approaches using either natural divergent evolution or computational predictions based on chemical principles have been less successful. This review summarizes recent progress in evolution-based and computation-based (re)design.

  10. Redesigning Care Delivery with Patient Support Personnel: Learning from Accountable Care Organizations

    Science.gov (United States)

    Gorbenko, Ksenia O.; Fraze, Taressa; Lewis, Valerie A.

    2017-01-01

    INTRODUCTION Accountable care organizations (ACOs) are a value-based payment model in the United States rooted in holding groups of healthcare providers financially accountable for the quality and total cost of care of their attributed population. To succeed in reaching their quality and efficiency goals, ACOs implement a variety of care delivery changes, including workforce redesign. Patient support personnel (PSP)—non-physician staff such as care coordinators, community health workers, and others—are critical to restructuring care delivery. Little is known about how ACOs are redesigning their patient support personnel in terms of responsibilities, location, and evaluation. METHODS We conducted semi-structured one-hour interviews with 25 executives at 16 distinct ACOs. The interviews were recorded, transcribed, and coded for themes, using a qualitative coding and analysis process. RESULTS ACOs deployed PSP to perform four clusters of responsibilities: care provision, care coordination, logistical help with transportation, and social and emotional support. ACOs deployed these personnel strategically across settings (primary care, inpatient services, emergency department, home care and community) depending on their population needs. Most ACOs used personnel with the same level of training across settings. Few ACOs planned to conduct a comprehensive evaluation of their PSP to optimize their value. DISCUSSION ACO strategies in workforce redesign indicate a shift from a physician-centered to a team-based approach. Employing personnel with varying levels of clinical training to perform different tasks can help further optimize care delivery. More robust evaluation of the deployment of PSP and their performance is needed to demonstrate cost-saving benefits of workforce redesign. PMID:28217305

  11. Certification of health care organisations, assessment of professional practices and external radiotherapy;Certification des etablissements de sante, evaluation des pratiques professionnelles et radiotherapie externe

    Energy Technology Data Exchange (ETDEWEB)

    Abdelmoumene, N.; Le Moign, R. [Haute Autorite de Sante (HAS), 75 - Paris (France)

    2009-12-15

    In France, accreditation of health care organisations (HCOs) is mandatory every 4 years. It is based on a systemic approach and, since 2004, includes professional practice appraisal (EPP) against good practice guidelines. However, following an incident in Epinal, a new quality assurance criterion was introduced in 2007 for external radiotherapy (ERT) on top of the annual inspection of patient radiation protection by the Nuclear Safety Authority. In the accreditation procedure starting January 2010, ERT work organisation will come under 'high-risk activity' (criterion 26b) and radio-vigilance will be included in the adverse events reporting system (8i). In addition, ERT will have to comply with many generic criteria on quality and safety improvement. For example, practice appraisal of all clinical activities will become routine. Thus, besides self-assessment against criteria 26b and 8i, ERT professionals will have report the impact of their quality improvement actions on patient care. They will be able to freely choose the area for improvement, as long as it is in line with the HCO's overall quality and safety plan. In oncology, multidisciplinary team meetings for deciding on the treatment plan, as well as mortality and morbidity meetings providing feedback, are compulsory (28a). Appraisal of appropriateness of care (28b) and indicator-based practice appraisal (28c) complete the process. In conclusion, the generic practice appraisal approach that is part of the French HCO accreditation procedure can contribute toward improving health care and education, but it has not been designed for in-depth assessment of complex, multidisciplinary clinical practice such as ERT. Such assessment requires a specific clinical audit and specialized auditors. (authors)

  12. Advisory Committee on the Redesign of the Space Station

    Science.gov (United States)

    1993-06-01

    The Space Station Program was initiated in 1984 to provide for permanent human presence in an orbiting laboratory. This program evolved into Space Station Freedom, later identified as a component to facilitate a return of astronauts to the Moon, followed by the exploration of Mars. In March 1993 the Clinton Administration directed NASA to undertake an intense effort to redesign the space station at a substantial cost savings relative to Space Station Freedom. The Advisory Committee on the Redesign of the Space Station was established in March 1993 to provide independent assessment of the advantages and disadvantages of the redesign options. The results of the Committee's work is described. Discussion describes the mission that the Administration has articulated for the Space Station Program and the scientific and technical characteristics that a redesigned station must possess to fulfill those objectives. A description of recommended management, operations, and acquisition strategies for the redesigned program is provided. The Committee's assessment of the redesign options against five criteria are presented. The five criteria are technical capabilities, research capabilities, schedule, cost, and risk. A discussion of general mission risk is included.

  13. A Proposal of a Method to Measure and Evaluate the Effect to Apply External Support Measures for Owners by Construction Management Method, etc

    Science.gov (United States)

    Tada, Hiroshi; Miyatake, Ichiro; Mouri, Junji; Ajiki, Norihiko; Fueta, Toshiharu

    In Japan, various approaches have been taken to ensure the quality of public works or to support the procurement regime of the governmental agencies, as a means to utilize external resources, which include the procurement support service or the construction management (CM) method. Although discussions on these measures to utilize external resources (hereinafter referred to as external support measure) have been going on, as well as the follow-up surveys showing the positive effects of such measures have been conducted, the surveys only deal with the matters concerning the overall effects of the external support measure on the whole, meaning that the effect of each item of the tasks have not been addressed, and that the extent it dealt with the expectations of the client is unknown. However, the effective use of the external support measure in future cannot be achieved without knowing what was the purpose to introduce the external support measure, and what effect was expected on each task item, and what extent the expectation fulfilled. Furthermore, it is important to clarify not only the effect as compared to the client's expectation (performance), but also the public benefit of this measure (value improvement). From this point of view, there is not an established method to figure out the effect of the client's measure to utilize external resources. In view of this background, this study takes the CM method as an example of the external support measure, and proposes a method to measure and evaluate the effect by each task item, and suggests the future issues and possible responses, in the aim of contributing the promotion, improvement, and proper implementation of the external support measures in future.

  14. Isokinetic evaluation of internal/external tibial rotation strength after the use of hamstring tendons for anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Armour, Tanya; Forwell, Lorie; Litchfield, Robert; Kirkley, Alexandra; Amendola, Ned; Fowler, Peter J

    2004-01-01

    Evaluation of the knee after an anterior cruciate ligament reconstruction with the use of the semitendinosus and gracilis (hamstring) autografts has primarily focused on flexion and extension strength. The semitendinosus and gracilis muscles contribute to internal tibial rotation, and it has been suggested that harvest of these tendons for the purpose of an anterior cruciate ligament reconstruction contributes to internal tibial rotation weakness. Internal tibial rotation strength may be affected by the semitendinosus and gracilis harvest after anterior cruciate ligament reconstruction. Prospective evaluation of internal and external tibial rotation strength. Inclusion criteria for subjects (N = 30): unilateral anterior cruciate ligament reconstruction at least 2 years previously, a stable anterior cruciate ligament (problems after initial knee reconstruction, a normal contralateral knee, and the ability to comply with the testing protocol. In an attempt to minimize unwanted subtalar joint motion, subjects were immobilized using an ankle brace and tested at angular velocities of 60 degrees /s, 120 degrees /s, and 180 degrees /s at a knee flexion angle of 90 degrees . The mean peak torque measurements for internal rotation strength of the operative limb (60 degrees /s, 17.4 +/- 4.5 ft-lb; 120 degrees /s, 13.9 +/- 3.3 ft-lb; 180 degrees /s, 11.6 +/- 3.0 ft-lb) were statistically different compared to the nonoperated limb (60 degrees /s, 20.5 +/- 4.7 ft-lb; 120 degrees /s, 15.9 +/- 3.8 ft-lb; 180 degrees /s, 13.4 +/- 3.8 ft-lb) at 60 degrees /s (P = .012), 120 degrees /s (P = .036), and 180 degrees /s (P = .045). The nonoperative limb demonstrated greater strength at all speeds. The mean torque measurements for external rotation were statistically similar when compared to the nonoperated limb at all angular velocities. We have shown through our study that patients who undergo surgical intervention to repair a torn anterior cruciate ligament with the use of autogenous

  15. Reducing and Sustaining Duplicate Medical Record Creation by Usability Testing and System Redesign.

    Science.gov (United States)

    Khunlertkit, Adjhaporn; Dorissaint, Leonard; Chen, Allen; Paine, Lori; Pronovost, Peter J

    2017-10-25

    Duplicate medical record creation is a common and consequential health care systems error often caused by poor search system usability and inappropriate user training. We conducted two phases of scenario-based usability testing with patient registrars working in areas at risk of generating duplicate medical records. Phase 1 evaluated the existing search system, which led to system redesigns. Phase 2 tested the redesigned system to mitigate potential errors before health system-wide implementation. To evaluate system effectiveness, we compared the monthly potential duplicate medical record rates for preimplementation and postimplementation months. The existing system could not effectively handle a misspelling, which led to failed search and duplicate medical record creation. Using the existing system, 96% of registrars found commonly spelled patient names whereas only 69% successfully found complicated names. Registrars lacked knowledge and usage of a phonetic matching function to assist in misspelling. The new system consistently captured the correct patient regardless of misspelling, but search returned more potential matches, resulting in, on average, 4 seconds longer to select common names. Potential monthly duplicate medical record rate reduced by 38%, from 4% to 2.3% after implementation of the new system, and has sustained at an average of 2.5% for 2 years. Usability testing was an effective method to reveal problems and aid system redesign to deliver a more user friendly system, hence reducing the potential for medical record duplication. Greater standards for usability would ensure that these improvements can be realized before rather than after exposing patients to risks.

  16. Evaluation and correction of uncertainty due to Gaussian approximation in radar - rain gauge merging using kriging with external drift

    Science.gov (United States)

    Cecinati, F.; Wani, O.; Rico-Ramirez, M. A.

    2016-12-01

    It is widely recognised that merging radar rainfall estimates (RRE) with rain gauge data can improve the RRE and provide areal and temporal coverage that rain gauges cannot offer. Many methods to merge radar and rain gauge data are based on kriging and require an assumption of Gaussianity on the variable of interest. In particular, this work looks at kriging with external drift (KED), because it is an efficient, widely used, and well performing merging method. Rainfall, especially at finer temporal scale, does not have a normal distribution and presents a bi-modal skewed distribution. In some applications a Gaussianity assumption is made, without any correction. In other cases, variables are transformed in order to obtain a distribution closer to Gaussian. This work has two objectives: 1) compare different transformation methods in merging applications; 2) evaluate the uncertainty arising when untransformed rainfall data is used in KED. The comparison of transformation methods is addressed under two points of view. On the one hand, the ability to reproduce the original probability distribution after back-transformation of merged products is evaluated with qq-plots, on the other hand the rainfall estimates are compared with an independent set of rain gauge measurements. The tested methods are 1) no transformation, 2) Box-Cox transformations with parameter equal to λ=0.5 (square root), 3) λ=0.25 (square root - square root), and 4) λ=0.1 (almost logarithmic), 5) normal quantile transformation, and 6) singularity analysis. The uncertainty associated with the use of non-transformed data in KED is evaluated in comparison with the best performing product. The methods are tested on a case study in Northern England, using hourly data from 211 tipping bucket rain gauges from the Environment Agency and radar rainfall data at 1 km/5-min resolutions from the UK Met Office. In addition, 25 independent rain gauges from the UK Met Office were used to assess the merged products.

  17. Evaluating health inequity interventions: applying a contextual (external) validity framework to programs funded by the Canadian Health Services Research Foundation.

    Science.gov (United States)

    Phillips, Kaye; Müller-Clemm, Werner; Ysselstein, Margaretha; Sachs, Jonathan

    2013-02-01

    Including context in the measurement and evaluation of health in equity interventions is critical to understanding how events that occur in an intervention's environment might contribute to or impede its success. This study adapted and piloted a contextual validity assessment framework on a selection of health inequity-related programs funded by the Canadian Health Services Research Foundation (CHSRF) between 1998 and 2006. The two overarching objectives of this study were (1) to determine the relative amount and quality of attention given to conceptualizing, measuring and validating context within CHSRF funded research final reports related to health-inequity; and (2) to contribute evaluative evidence towards the incorporation of context into the assessment and measurement of health inequity interventions. The study found that of the 42/146 CHSRF programs and projects, judged to be related to health inequity 20 adequately reported on the conceptualization, measurement and validation of context. Amongst these health-inequity related project reports, greatest emphasis was placed on describing the socio-political and economical context over actually measuring and validating contextual evidence. Applying a contextual validity assessment framework was useful for distinguishing between the descriptive (conceptual) versus empirical (measurement and validation) inclusion of documented contextual evidence. Although contextual validity measurement frameworks needs further development, this study contributes insight into identifying funded research related to health inequities and preliminary criteria for assessing interventions targeted at specific populations and jurisdictions. This study also feeds a larger critical dialogue (albeit beyond the scope of this study) regarding the relevance and utility of using evaluative techniques for understanding how specific external conditions support or impede the successful implementation of health inequity interventions. Copyright

  18. Does a grill menu redesign influence sales, nutrients purchased, and consumer acceptance in a worksite cafeteria?

    Directory of Open Access Journals (Sweden)

    Maya K. Vadiveloo

    2017-12-01

    Full Text Available Worksite cafeterias are compelling venues to improve diet quality through environmental changes.We conducted a pre-post study to evaluate how a cafeteria-initiated grill menu redesign influenced sales, revenue, and nutrient content of foods purchased. Secondly, we evaluated consumer opinions about menu changes to inform practices for worksite environment interventions. Monthly sales data (2012–2015 were used to compute gross sales and revenue of entrées and side dishes pre-post menu changes. Alternative protein sources replaced red meat; nutrient composition and nutrients purchased were compared using Food Pro software. Consumer responses were queried using online surveys; open-ended responses were analyzed using NVivo. Differences in sales and nutrient content pre-post menu redesign were tested with Wilcoxon Rank Sum tests. Gross sales of entrées (61 vs. 222servings/month; p=0.01 and side dishes (120 vs. 365servings/month; p=0.001 increased more than three-fold post-menu changes. Revenue from entrées (312 vs. 1144USD/month; p=0.01 and side dishes (238 vs. 914USD/month; p=0.001 also increased; per entrée, consumers purchased significantly more unsaturated fat (5g, and less saturated fat (3g and sodium (100mg. For side dishes, they purchased fewer calories (48kcal and unsaturated fat (2.9g, but more fiber (1.8g, and sodium (260mg. Four themes emerged from consumer responses: the importance of 1 variety, novelty, choice; 2 cost, affordability, value; 3 health; and 4 food quality, taste. Menu redesign can improve nutrient content, while also increasing sales and revenue. Multi-dimensional assessment of the nutritional, consumer, and retailer implications is desirable practice for enacting similar environmental changes. Keywords: Worksite health promotion, Food environment change, Consumer satisfaction, Menu redesign, Sales and revenue

  19. Redesigning a control room from an ergonomic point of view : a case study of user participation in a chemical plant

    NARCIS (Netherlands)

    Schaaf, van der T.W.; Kragt, H.; Kragt, H.

    1992-01-01

    A field study in a chemical industry was conducted to redesign a control room with panel instrumentation into one with visual display units (VDUs). The authors had been asked to advise the project team and to participate in the application. First, a general evaluation of the central control room

  20. Evaluation of internal and external doses from $^{11}C$ produced in the air in high energy proton accelerator tunnels

    CERN Document Server

    Endo, A; Kanda, Y; Oishi, T; Kondo, K

    2001-01-01

    Air has been irradiated with high energy protons at the 12 GeV proton synchrotron to obtain the following parameters essential for the internal dose evaluation from airborne /sup 11/C produced through nuclear spallation reactions: the abundance of gaseous and particulate /sup 11/C, chemical forms, and particle size distribution. It was found that more than 98% of /sup 11/C is present as gas and the rest is aerosol. The gaseous components were only /sup 11/CO and /sup 11/CO/sub 2/ and their proportions were approximately 80% and 20%, respectively. The particulate /sup 11/C was found to be sulphate and/or nitrate aerosols having a log-normal size distribution; the measurement using a diffusion battery showed a geometric mean radius of 0.035 mu m and a geometric standard deviation of 1.8 at a beam intensity of 6.8*10/sup 11/ proton.pulse /sup -1/ and an irradiation time of 9.6 min. By taking the chemical composition and particle size into account, effective doses both from internal and from external exposures pe...

  1. Structural integrity evaluation of X52 gas pipes subjected to external corrosion defects using the SINTAP procedure

    International Nuclear Information System (INIS)

    Adib-Ramezani, H.; Jeong, J.; Pluvinage, G.

    2006-01-01

    In the present study, the SINTAP procedure has been proposed as a general structural integrity tool for semi-spherical, semi-elliptical and long blunt notch defects. The notch stress intensity factor concept and SINTAP structural integrity procedure are employed to assess gas pipelines integrity. The external longitudinal defects have been investigated via elastic-plastic finite element method results. The notch stress intensity concept is implemented into SINTAP procedure. The safety factor is calculated via SINTAP procedure levels 0B and 1B. The extracted evaluations are compared with the limit load analysis based on ASME B31G, modified ASME B31G, DNV RP-F101 and recent proposed formulation [Choi JB, Goo BK, Kim JC, Kim YJ, Kim WS. Development of limit load solutions for corroded gas pipelines. Int J Pressure Vessel Piping 2003;80(2):121-128]. The comparison among extracted safety factors exhibits that SINTAP predictions are located between lower and upper safety factor bounds. The SINTAP procedure including notch-based assessment diagram or so-called 'NFAD' involves wide range of defect geometries with low, moderate and high stress concentrations and relative stress gradients. Finally, some inspired and advanced viewpoints have been investigated

  2. Structural integrity evaluation of X52 gas pipes subjected to external corrosion defects using the SINTAP procedure

    Energy Technology Data Exchange (ETDEWEB)

    Adib-Ramezani, H. [Ecole Polytechnique de l' Universite d' Orleans, CNRS-CRMD, 8 rue Leonard de Vinci, 45072 Orleans Cedex 2 (France)]. E-mail: hradib_2000@yahoo.com; Jeong, J. [Ecole Polytechnique de l' Universite d' Orleans, CNRS-CRMD, 8 rue Leonard de Vinci, 45072 Orleans Cedex 2 (France); Pluvinage, G. [Laboratoire de Fiabilite Mecanique (LFM), Universite de Metz-ENIM, 57045 Metz (France)

    2006-06-15

    In the present study, the SINTAP procedure has been proposed as a general structural integrity tool for semi-spherical, semi-elliptical and long blunt notch defects. The notch stress intensity factor concept and SINTAP structural integrity procedure are employed to assess gas pipelines integrity. The external longitudinal defects have been investigated via elastic-plastic finite element method results. The notch stress intensity concept is implemented into SINTAP procedure. The safety factor is calculated via SINTAP procedure levels 0B and 1B. The extracted evaluations are compared with the limit load analysis based on ASME B31G, modified ASME B31G, DNV RP-F101 and recent proposed formulation [Choi JB, Goo BK, Kim JC, Kim YJ, Kim WS. Development of limit load solutions for corroded gas pipelines. Int J Pressure Vessel Piping 2003;80(2):121-128]. The comparison among extracted safety factors exhibits that SINTAP predictions are located between lower and upper safety factor bounds. The SINTAP procedure including notch-based assessment diagram or so-called 'NFAD' involves wide range of defect geometries with low, moderate and high stress concentrations and relative stress gradients. Finally, some inspired and advanced viewpoints have been investigated.

  3. A posteriori registration and subtraction of periapical radiographs for the evaluation of external apical root resorption after orthodontic treatment.

    Science.gov (United States)

    Kreich, Eliane Maria; Chibinski, Ana Cláudia; Coelho, Ulisses; Wambier, Letícia Stadler; Zedebski, Rosário de Arruda Moura; de Moraes, Mari Eli Leonelli; de Moraes, Luiz Cesar

    2016-03-01

    This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment.

  4. A posterior registration and subtraction of periapical radiographs for the evaluation of external apical root resorption after orthodontic treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kreich, Eliane Maria; Chibinski, Ana Claudia; Coelho, Ulisses; Wambier, Leticia Stadler; Zedebski, Rosaio De Arruda Moura [School of Dentistry, Ponta Grossa State University, Ponta Grossa, Parana (Brazil); De Moraes, Mari Eli Leonelli; De Moraes, Luiz Cesar [Dept. of Dental Radiology, School of Dentistry, State University of Sao Paulo, Sao Jose dos Campos, Sao Paulo (Brazil)

    2016-03-15

    This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment.

  5. A posterior registration and subtraction of periapical radiographs for the evaluation of external apical root resorption after orthodontic treatment

    International Nuclear Information System (INIS)

    Kreich, Eliane Maria; Chibinski, Ana Claudia; Coelho, Ulisses; Wambier, Leticia Stadler; Zedebski, Rosaio De Arruda Moura; De Moraes, Mari Eli Leonelli; De Moraes, Luiz Cesar

    2016-01-01

    This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment

  6. Evaluation for In-Vessel Retention Capabilities with In-Vessel Injection and External Reactor Vessel Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Seong; Ryu, In Chul; Moon, Young Tae [KEPCO Engineering and Construction Co. Ltd., Deajeon (Korea, Republic of)

    2016-10-15

    If the accident has not progressed to the point of substantial changes in the core geometry, establishing adequate cooling is as straightforward as re-establishing flow through the reactor core. However, if the accident has progressed to the point where the core geometry is substantially altered as a result of material melting and relocation, as was the case in the TMI-2 accident, the means of cooling the debris are not as straightforward. From this time on, the reactor core was either completely or nearly covered by water, with high pressure injection flow initiated shortly after three hours into the accident. However, the core debris was not coolable in this configuration and a substantial quantity of molten core material drained into the bypass region, with approximately twenty metric tons of molten debris draining into the reactor pressure vessel (RPV) lower head. Hence, the core configuration developed at approximately three hours into the accident was not coolable, even submerged in water. The purpose of this paper is to evaluate in-vessel retention capabilities with in-vessel injection (IVI) and external reactor vessel cooling (ERVC) available in a reactor application by using the integrated severe accident analysis code. The MAAP5 models were improved to facilitate evaluation of the in-vessel retention capability of APR1400. In-vessel retention capabilities have been analyzed for the APR1400 using the MAAP5.03 code. The results show that in-vessel retention is feasible when in-vessel injection is initiated within a relatively short time frame under the simulation condition used in the present study.

  7. Evaluation for In-Vessel Retention Capabilities with In-Vessel Injection and External Reactor Vessel Cooling

    International Nuclear Information System (INIS)

    Lee, Jeong Seong; Ryu, In Chul; Moon, Young Tae

    2016-01-01

    If the accident has not progressed to the point of substantial changes in the core geometry, establishing adequate cooling is as straightforward as re-establishing flow through the reactor core. However, if the accident has progressed to the point where the core geometry is substantially altered as a result of material melting and relocation, as was the case in the TMI-2 accident, the means of cooling the debris are not as straightforward. From this time on, the reactor core was either completely or nearly covered by water, with high pressure injection flow initiated shortly after three hours into the accident. However, the core debris was not coolable in this configuration and a substantial quantity of molten core material drained into the bypass region, with approximately twenty metric tons of molten debris draining into the reactor pressure vessel (RPV) lower head. Hence, the core configuration developed at approximately three hours into the accident was not coolable, even submerged in water. The purpose of this paper is to evaluate in-vessel retention capabilities with in-vessel injection (IVI) and external reactor vessel cooling (ERVC) available in a reactor application by using the integrated severe accident analysis code. The MAAP5 models were improved to facilitate evaluation of the in-vessel retention capability of APR1400. In-vessel retention capabilities have been analyzed for the APR1400 using the MAAP5.03 code. The results show that in-vessel retention is feasible when in-vessel injection is initiated within a relatively short time frame under the simulation condition used in the present study

  8. Redesign and commissioning of sexual health services in England - a qualitative study.

    Science.gov (United States)

    Walker, I F; Leigh-Hunt, N; Lee, A C K

    2016-10-01

    Responsibility for the commissioning of sexual and reproductive health (SRH) services transferred from the National Health Service to local authorities in England in 2013. This transfer prompted many local authorities to undertake new procurements of these SRH services. This study was undertaken to capture some of the lessons learnt in order to inform future commissioning and system redesign. A qualitative study was carried out involving semi-structured interviews. Interviews were conducted with 13 local authority sexual health commissioners in Yorkshire and the Humber from 11 interviews. Thematic analysis was used to identify themes from transcripts of the interviews with the 13 participants. Key themes identified were as follows: the challenge and complexity to those new to clinical commissioning; the prerequisites of robust infrastructural inputs to undertake the process, including technical expertise, a dependable project team, with clarity over the timescales and the budget; the requirement for good governance, stakeholder engagement and successful management of relationships with the latter; and the need to focus on the outcomes, aiming for value for money and improved system performance. Several key issues emerged from our study that significantly influenced the outcome of the redesign and commissioning process for sexual health services. An adapted model of the Donabedian evaluation framework was developed to provide a tool to inform future system redesign. Our model helps identify the key determinants for successful redesign in this context which is essential to both mitigate potential risks and maximize the likelihood of successful outcomes. Our model may have wider applications. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. Attitudes of Academic Staff towards Their Own Work and towards External Evaluation, from the Perspective of Self-Determination Theory: Estonian Case

    Science.gov (United States)

    Seema, Riin; Udam, Maiki; Mattisen, Heli

    2016-01-01

    The purpose of this study was to ascertain the attitudes of academic staff towards their own work as well as towards external evaluations. The study was based on (1) an analysis of assessment reports of institutional accreditations conducted by the Estonian Quality Agency for Higher and Vocational Education and (2) self-determination theory on…

  10. Evaluation of body image and self-esteem in patients with external fixation devices: a Turkish perspective.

    Science.gov (United States)

    Büyükyilmaz, Funda; Sendir, Merdiye; Salmond, Susan

    2009-01-01

    This descriptive study aimed to describe the body image and self-esteem of patients with external fixation devices. Fifty patients with external fixation devices who came for follow-up to the Ilizarov Outpatient Clinic of a university hospital in Turkey were included in this study. Data were collected by using a Demographic Questionnaire Form, Multidimensional Body-Self Relations Questionnaire (MBSRQ), and Coppersmith Self-Esteem Inventory. The perceived body image (197.58 +/- 25.14) and self-esteem (65.28 +/- 17.97) of the patients with external fixation devices were in the moderate range. There was no significant correlation between body image and self-esteem. Self-esteem was correlated with one's perception of whether external fixation impacted one's appearance and whether one wanted to avoid being seen by certain individuals because of the appearance of the external fixator. The study highlighted that body image disturbance and threats to self-esteem are not universal with the use of external fixation and need to be assessed individually.

  11. Evaluation of the utilization of external radiotherapy in the treatment of localized prostate cancer in Andalusia, Spain.

    Science.gov (United States)

    Expósito, José; Linares, Isabel; Castillo, Isabel; Martínez, Miguel; Vargas, Pilar; Herruzo, Ismael; Medina, José Antonio; Palacios, Amalia; Bayo, Eloísa; Peracaula, Francisco; Jaén, Javier; Sánchez, José Antonio; Ortiz, María José

    2015-12-30

    Around 27,000 new cases of prostate cancer are diagnosed every year in Spain and 5400 die from this disease. Radiotherapy (RT), alone or combined, has proven to be effective as initial treatment in patients with localized disease. Our objective was to evaluate the use of external beam RT (EBRT) in our region, comparing the indication rate and irradiation rate and examining variability in its application among hospitals. We conducted a review of RT guidelines and indication studies for prostate cancer (% expected irradiation). Data were gathered from all twelve public healthcare centers in Andalusia (Spain) on RT-treated prostate cancer patients during 2013 (% actual irradiation) and from nine of the centers on RT discharge reports. Information was classified according to type of hospital, tumor risk category and RT treatment (technique, dosage, volume, toxicity). The estimated RT rate was 67 % (1289/1917), 43 % were aged > 70 years, 44.7 % had ECOG performance status of 0); 44.7 % had high-risk tumors; 57 % underwent RT associated with hormone therapy; 70 % of patients receiving RT were treated with 3D planning (30 % IGRT); and doses were 70-76 Gy in 70 % of cases and >76 Gy in 10.7 %. Acute gastrointestinal and genitourinary toxicities were < grade 2 in 79 and 89 % of patients, respectively. An irradiation rate significantly below the mean for the study was found in four provinces. There was a significant difference among provinces in the distribution of risk groups. Underutilization of EBRT was estimated to be around 30 % in prostate cancer patients, with an elevated variability in irradiation rates among hospitals related to differences in available technology and in the distribution of patients with different risk levels. These data should be a matter of concern to regional health managers, given the negative and measurable impact on the survival of patients.

  12. Evaluation of the utilization of external radiotherapy in the treatment of localized prostate cancer in Andalusia, Spain

    International Nuclear Information System (INIS)

    Expósito, José; Linares, Isabel; Castillo, Isabel; Martínez, Miguel; Vargas, Pilar; Herruzo, Ismael; Medina, José Antonio; Palacios, Amalia; Bayo, Eloísa; Peracaula, Francisco; Jaén, Javier; Sánchez, José Antonio; Ortiz, María José

    2015-01-01

    Around 27,000 new cases of prostate cancer are diagnosed every year in Spain and 5400 die from this disease. Radiotherapy (RT), alone or combined, has proven to be effective as initial treatment in patients with localized disease. Our objective was to evaluate the use of external beam RT (EBRT) in our region, comparing the indication rate and irradiation rate and examining variability in its application among hospitals. We conducted a review of RT guidelines and indication studies for prostate cancer (% expected irradiation). Data were gathered from all twelve public healthcare centers in Andalusia (Spain) on RT-treated prostate cancer patients during 2013 (% actual irradiation) and from nine of the centers on RT discharge reports. Information was classified according to type of hospital, tumor risk category and RT treatment (technique, dosage, volume, toxicity). The estimated RT rate was 67 % (1289/1917), 43 % were aged > 70 years, 44.7 % had ECOG performance status of 0); 44.7 % had high-risk tumors; 57 % underwent RT associated with hormone therapy; 70 % of patients receiving RT were treated with 3D planning (30 % IGRT); and doses were 70–76 Gy in 70 % of cases and >76 Gy in 10.7 %. Acute gastrointestinal and genitourinary toxicities were < grade 2 in 79 and 89 % of patients, respectively. An irradiation rate significantly below the mean for the study was found in four provinces. There was a significant difference among provinces in the distribution of risk groups. Underutilization of EBRT was estimated to be around 30 % in prostate cancer patients, with an elevated variability in irradiation rates among hospitals related to differences in available technology and in the distribution of patients with different risk levels. These data should be a matter of concern to regional health managers, given the negative and measurable impact on the survival of patients

  13. PSYCHOLOGICAL VALENCES IN THE DESIGN AND REDESIGN OF JOBS

    Directory of Open Access Journals (Sweden)

    Alic BIRCA

    2016-09-01

    Full Text Available This paper addresses the design and redesign of jobs under psychological aspect. For many years, the design and redesign of jobs have been treated more economically, i.e. by reducing staff costs. Although in the short-term, this approach has had positive economic effects, in the long-term the economic effects have been negative. Starting from this point of view, the authors attempt to highlight the problems that the psychological aspects involve in the design and redesign of jobs. Given the psychological aspects in the design of jobs aspects, are taken into consideration, certain problems that can have a far greater impact on organizational performance, may be anticipated and excluded.

  14. APPLICATION OF AUGMENTED REALITY IN FACADE REDESIGN PRESENTATION

    Directory of Open Access Journals (Sweden)

    PEJIĆ Petar

    2015-06-01

    Full Text Available Augmented Reality (AR is a computer technology where the perception of the user is enhanced by the seamless blending between real environment and computer-generated virtual objects coexisting in the same space. When it comes to a redesign of the existing facades, it is necessary to create a visual presentation of the proposed changes. For this reason, contemporary architectural approach assumes creating a digital 3D model of the newly designed facade. Since the façade redesign is a real world change, the AR can be used for newly designed facade project presentation. In this paper a case study of the AR application for façade redesign presentation of a single family house located in Babušnica (Serbia is presented.

  15. The Role of the IT Department in Organizational Redesign.

    Science.gov (United States)

    Petersen, Lone Stub

    2015-01-01

    Focus within eHealth research is often on development and implementation. However, the role of information systems maintenance and management is often neglected. In order for the IT department to accommodate the needs of the hospitals and continuous change of organization and practice there is a need for developing an understanding of the complex relationship between the IT department and clinical practice. In this paper the concept of redesign is used to deepen our understanding of IT related organizational change in healthcare organizations. In the paper I argue that the IT department is a central partner, steward and power in organizational change and learning in hospitals as the IT department serve both as a barrier and a catalyst of change and flexibility in the organization through management of information systems maintenance and redesign. Therefore it is important to consider and secure appropriate forms for stewarding redesign and learning in cooperation between the health care organizations and the IT department.

  16. Delivering Sustainability Through Supply Chain Distribution Network Redesign

    Directory of Open Access Journals (Sweden)

    Denise Ravet

    2013-09-01

    Full Text Available Purpose - Companies could gain (cost, service, green/sustainable competitive advantage through the supply chain network. The goal of this article is to study how to deliver sustainability through the supply chain distribution network redesign.Design/methodology/approach - A literature review is conducted to examine research relating to sustainable supply chain strategies and supply chain distribution network redesign.Findings - A study of the supply chain literature reveals the importance to rethink the supply chain distribution network design and to treat sustainability as integral to operations.

  17. Process efficiency. Redesigning social networks to improve surgery patient flow.

    Science.gov (United States)

    Samarth, Chandrika N; Gloor, Peter A

    2009-01-01

    We propose a novel approach to improve throughput of the surgery patient flow process of a Boston area teaching hospital. A social network analysis was conducted in an effort to demonstrate that process efficiency gains could be achieved through redesign of social network patterns at the workplace; in conjunction with redesign of organization structure and the implementation of workflow over an integrated information technology system. Key knowledge experts and coordinators in times of crisis were identified and a new communication structure more conducive to trust and knowledge sharing was suggested. The new communication structure is scalable without compromising on coordination required among key roles in the network for achieving efficiency gains.

  18. Use of external cost assessment and multi-criteria decision analysis for comparative evaluation of options for electricity supply

    International Nuclear Information System (INIS)

    Hirschberg, S.; Dones, R.; Gantner, U.

    2001-01-01

    The paper addresses external cost and multi-criteria analyses carried out for selected future electricity generating systems of interest under the Swiss conditions. The external cost estimates are based on an application of the 'impact pathway approach', enhanced by earlier experience from extensive Life Cycle Assessment (LCA). The estimated total costs, i.e. the sum of internal and external costs, may serve as a measure of economic and environmental efficiency of energy systems. The multi-criteria approach allows a more explicit consideration of the social dimension, which is highly important for the decision-making process. The applications of multi-criteria analyses illustrate the sensitivity of the results to the range of preferences expressed in the energy debate. Certain patterns in system ranking can be observed in spite of these sensitivities. Both total cost assessment and multi-criteria analysis are found to be useful, complementary instruments to support procedures for decision-making. (author)

  19. Use of external cost assessment and multi-criteria decision analysis for comparative evaluation of options for electricity supply

    International Nuclear Information System (INIS)

    Hirschberg, Stefan; Dones, Roberto; Gantner, Urs

    2000-01-01

    This paper addresses external cost and multi-criteria analyses carried out for selected future electricity generating systems of interest under the Swiss. conditions. The external cost estimates are based on an application of the 'impact pathway approach', enriched by earlier experience from extensive Life Cycle Assessment (LCA). The estimated total costs, i.e. the sum of internal and external costs may serve as a measure of economic and environmental efficiency of energy systems. The multi-criteria approach allows a more explicit consideration of the social dimension, highly important for the decision process. The applications of multi-criteria analysis illustrate the sensitivity of the results to a range of preferences expressed in the energy debate. Certain patterns in systems ranking can be observed in spite of these sensitivities. Both total cost assessment and multi-criteria analysis are found to be useful, complementary instruments to support the decision process. (author)

  20. Hybrid Correlation Energy (HyCE): An Approach Based on Separate Evaluations of Internal and External Components.

    Science.gov (United States)

    Ivanic, Joseph; Schmidt, Michael W

    2018-06-04

    A novel hybrid correlation energy (HyCE) approach is proposed that determines the total correlation energy via distinct computation of its internal and external components. This approach evolved from two related studies. First, rigorous assessment of the accuracies and size extensivities of a number of electron correlation methods, that include perturbation theory (PT2), coupled-cluster (CC), configuration interaction (CI), and coupled electron pair approximation (CEPA), shows that the CEPA(0) variant of the latter and triples-corrected CC methods consistently perform very similarly. These findings were obtained by comparison to near full CI results for four small molecules and by charting recovered correlation energies for six steadily growing chain systems. Second, by generating valence virtual orbitals (VVOs) and utilizing the CEPA(0) method, we were able to partition total correlation energies into internal (or nondynamic) and external (or dynamic) parts for the aforementioned six chain systems and a benchmark test bed of 36 molecules. When using triple-ζ basis sets it was found that per orbital internal correlation energies were appreciably larger than per orbital external energies and that the former showed far more chemical variation than the latter. Additionally, accumulations of external correlation energies were seen to proceed smoothly, and somewhat linearly, as the virtual space is gradually increased. Combination of these two studies led to development of the HyCE approach, whereby the internal and external correlation energies are determined separately by CEPA(0)/VVO and PT2/external calculations, respectively. When applied to the six chain systems and the 36-molecule benchmark test set it was found that HyCE energies followed closely those of triples-corrected CC and CEPA(0) while easily outperforming MP2 and CCSD. The success of the HyCE approach is more notable when considering that its cost is only slightly more than MP2 and significantly cheaper

  1. Development and Application of a Stepwise Assessment Process for Rational Redesign of Sequential Skills-Based Courses.

    Science.gov (United States)

    Gallimore, Casey E; Porter, Andrea L; Barnett, Susanne G

    2016-10-25

    Objective. To develop and apply a stepwise process to assess achievement of course learning objectives related to advanced pharmacy practice experiences (APPEs) preparedness and inform redesign of sequential skills-based courses. Design. Four steps comprised the assessment and redesign process: (1) identify skills critical for APPE preparedness; (2) utilize focus groups and course evaluations to determine student competence in skill performance; (3) apply course mapping to identify course deficits contributing to suboptimal skill performance; and (4) initiate course redesign to target exposed deficits. Assessment. Focus group participants perceived students were least prepared for skills within the Accreditation Council for Pharmacy Education's pre-APPE core domains of Identification and Assessment of Drug-related Problems and General Communication Abilities. Course mapping identified gaps in instruction, performance, and assessment of skills within aforementioned domains. Conclusions. A stepwise process that identified strengths and weaknesses of a course, was used to facilitate structured course redesign. Strengths of the process included input and corroboration from both preceptors and students. Limitations included feedback from a small number of pharmacy preceptors and increased workload on course coordinators.

  2. Environmental external effects from wind power based on the EU ExternE methodology

    DEFF Research Database (Denmark)

    Ibsen, Liselotte Schleisner; Nielsen, Per Sieverts

    1998-01-01

    of the Danish part of the project is to implement the framework for externality evaluation, for three different power plants located in Denmark. The paper will focus on the assessment of the impacts of the whole fuel cycles for wind, natural gas and biogas. Priority areas for environmental impact assessment......The European Commission has launched a major study project, ExternE, to develop a methodology to quantify externalities. A “National Implementation Phase”, was started under the Joule II programme with the purpose of implementing the ExternE methodology in all member states. The main objective...

  3. Evaluating Learners's Ability to Use Technology in Distance Education: The Case of External Degree Programme of the University of Nairobi

    Science.gov (United States)

    Omito, Ouma

    2016-01-01

    The study was aimed at investigating the students' ability to use technology for distance education with specific reference to the University of Nairobi's External Degree Program. To achieve this, one specific objective was formulated: To find out the student teacher's readiness to accept and utilize technology for learning purposes in relation to…

  4. Evaluation of dose from external irradiation for individuals living in areas affected by the Fukushima Daiichi nuclear plant accident

    International Nuclear Information System (INIS)

    Naito, Wataru; Uesaka, Motoki; Yamada, Chie; Ishii, Hideki

    2015-01-01

    In order to effectively and appropriately manage external radiation doses in the affected areas of Fukushima, it is important to identify when, where and how much exposure occurred. It is also necessary to quantitatively measure external exposure and air dose rates for different activity patterns in individuals living and working in Japanese-style buildings. The authors used a new personal dosemeter (D-shuttle) along with a global positioning system and geographical information system to relate personal dose rate with activity patterns and air dose rate. Hourly individual doses obtained by D-shuttle can provide an effective communication tool for those who want to identify when and how much exposure occurs. Personal monitoring of 26 volunteers showed that personal doses obtained from D-shuttle were ∼30 % of cumulative air dose estimated by data from the airborne monitoring survey. This analysis showed that, for most study volunteers, the exposure from staying at home represented about half of the total cumulative dose. This suggests that even though the peak exposure doses may be observed outside of working hours, to develop appropriate countermeasures for external dose reduction, it is thus important to identify the contributions of individuals' time-activities. This study provides a valuable basis for developing a realistic and pragmatic method to estimate external doses of individuals in Fukushima. (authors)

  5. The creation of process redesigns by selecting, transforming and replacing process parts

    NARCIS (Netherlands)

    Netjes, M.; Reijers, H.A.; Aalst, van der W.M.P.

    2008-01-01

    For companies to sustain competitive advantages, it is required to redesign and improve business processes continuously by monitoring and analyzing process enactment results. Furthermore, organizational structures must be redesigned according to the changes in business processes. However, there are

  6. 77 FR 40358 - Federal Management Regulation; FMR Bulletin PBS-2012-03; Redesignations of Federal Buildings...

    Science.gov (United States)

    2012-07-09

    ... Management Regulation; FMR Bulletin PBS-2012-03; Redesignations of Federal Buildings: Correction AGENCY: Public Buildings Service (PBS), General Services Administration (GSA). ACTION: Notice of a bulletin..., 2012, a bulletin announcing the designation and redesignation of three Federal buildings. Inadvertently...

  7. Multi-Stakeholder Collaboration in the Redesign of Family-Centered Rounds Process

    Science.gov (United States)

    Xie, Anping; Carayon, Pascale; Cartmill, Randi; Li, Yaqiong; Cox, Elizabeth D.; Plotkin, Julie A.; Kelly, Michelle M.

    2014-01-01

    A human factors approach to healthcare system redesign emphasizes the involvement of multiple healthcare stakeholders (e.g., patients and families, healthcare providers) in the redesign process. This study explores the experience of multiple stakeholders with collaboration in a healthcare system redesign project. Interviews were conducted with ten stakeholder representatives who participated in the redesign of the family-centered rounds process in a pediatric hospital. Qualitative interview data were analyzed using a phenomenological approach. A model of collaborative healthcare system redesign was developed, which defined four phases (i.e., setup of the redesign team, preparation for meetings, collaboration in meetings, follow-up after meetings) and two outcomes (i.e., team outcomes, redesign outcomes) of the collaborative process. Challenges to multi-stakeholder collaboration in healthcare system redesign, such as need to represent all relevant stakeholders, scheduling of meetings and managing different perspectives, were identified. PMID:25124394

  8. Structural analysis of 177-FA redesigned surveillance specimen holder tube

    International Nuclear Information System (INIS)

    Pryor, C.W.; Thoren, D.E.; Vames, G.J.; Harris, R.J.

    1976-08-01

    Because of in-service operational problems, the surveillance specimen holder tubes described in B and W topical report BAW-10051 have been redesigned. This report describes the new design and structural analysis for normal operation and upset loading conditions. The results of the analysis demonstrate the adequacy of the new surveillance specimen holder tubes for their design life of 40 years

  9. Redesigning School Accountability and Support: Progress in Pioneering States

    Science.gov (United States)

    Cook-Harvey, Channa M.; Stosich, Elizabeth Leisy

    2016-01-01

    How might policymakers and educators utilize the work already being done as states redesign their accountability systems? The 2015 reauthorization of the Elementary and Secondary Education Act (ESEA), brought much needed attention to the performance of traditionally underserved subgroups of students. Supported by greater flexibility under ESEA…

  10. A Lightweight Structure Redesign Method Based on Selective Laser Melting

    Directory of Open Access Journals (Sweden)

    Li Tang

    2016-11-01

    Full Text Available The purpose of this paper is to present a new design method of lightweight parts fabricated by selective laser melting (SLM based on the “Skin-Frame” and to explore the influence of fabrication defects on SLM parts with different sizes. Some standard lattice parts were designed according to the Chinese GB/T 1452-2005 standard and manufactured by SLM. Then these samples were tested in an MTS Insight 30 compression testing machine to study the trends of the yield process with different structure sizes. A set of standard cylinder samples were also designed according to the Chinese GB/T 228-2010 standard. These samples, which were made of iron-nickel alloy (IN718, were also processed by SLM, and then tested in the universal material testing machine INSTRON 1346 to obtain their tensile strength. Furthermore, a lightweight redesigned method was researched. Then some common parts such as a stopper and connecting plate were redesigned using this method. These redesigned parts were fabricated and some application tests have already been performed. The compression testing results show that when the minimum structure size is larger than 1.5 mm, the mechanical characteristics will hardly be affected by process defects. The cylinder parts were fractured by the universal material testing machine at about 1069.6 MPa. These redesigned parts worked well in application tests, with both the weight and fabrication time of these parts reduced more than 20%.

  11. Redesigning a Large Introductory Course to Incorporate the GAISE Guidelines

    Science.gov (United States)

    Woodard, Roger; McGowan, Herle

    2012-01-01

    In 2005, the "Guidelines for Assessment and Instruction in Statistics Education" (GAISE) college report described several recommendations for teaching introductory statistics. This paper discusses how a large multi-section introductory course was redesigned in order to implement these recommendations. The experience described discusses…

  12. Computational redesign of a mononuclear zinc metalloenzyme for organophosphate hydrolysis

    DEFF Research Database (Denmark)

    Khare, Sagar D.; Kipnis, Yakov; Greisen, Per Junior

    2012-01-01

    The ability to redesign enzymes to catalyze noncognate chemical transformations would have wide-ranging applications. We developed a computational method for repurposing the reactivity of metalloenzyme active site functional groups to catalyze new reactions. Using this method, we engineered a zinc...

  13. Redesign of a Life Span Development Course Using Fink's Taxonomy

    Science.gov (United States)

    Fallahi, Carolyn R.

    2008-01-01

    This study compared a traditional lecture-based life span development course to the same course redesigned using Fink's (2003) taxonomy of significant learning. The goals, activities, and feedback within the course corresponded to Fink's 6 taxa (knowledge, application, integration, human dimension, caring, learning how to learn). Undergraduates in…

  14. On Engineering Support for Business Process Modelling and Redesign

    NARCIS (Netherlands)

    Doumeingts, G.; Franken, H.M.; de Weger, M.K.; Browne, J.; Quartel, Dick; Ferreira Pires, Luis

    1997-01-01

    Currently, there is an enormous (research) interest in business process redesign (BPR). Several management-oriented approaches have been proposed showing how to make BPR work. However, detailed descriptions of empirical experience are few. Consistent engineering methodologies to aid and guide a

  15. Is State-Mandated Redesign an Effective and Sustainable Solution?

    Science.gov (United States)

    Young, Michelle D.

    2013-01-01

    There is a pervasive and ongoing perception that leadership preparation is a problem. Important questions remain about the intentions, capacity, and impact of state departments of education engaged in leadership preparation program redesign. In this essay, I take up several issues concerning this state policy work, including whether a one size…

  16. Usability Testing in a Library Web Site Redesign Project.

    Science.gov (United States)

    McMullen, Susan

    2001-01-01

    Discusses the need for an intuitive library information gateway to meet users' information needs and describes the process involved in redesigning a library Web site based on experiences at Roger Williams University. Explains usability testing methods that were used to discover how users were interacting with the Web site interface. (Author/LRW)

  17. Redesigning Schools to Raise Achievement. Item Number 39-0464

    Science.gov (United States)

    American Federation of Teachers, 2003

    2003-01-01

    The primary goal of the American Federation of Teachers' (AFT) Redesigning Schools to Raise Achievement (RSRA) project is to build capacity at the state, district, school, and classroom levels to improve student achievement to meet the goals of the 2001 No Child Left Behind Act. This checklist highlights some of the opportunities and support…

  18. Evaluation of the internal and external biofidelity of current rear impact ATDs to response targets developed from moderate-speed rear impacts of PMHS.

    Science.gov (United States)

    Moorhouse, Kevin; Donnelly, Bruce; Kang, Yun-Seok; Bolte, John H; Herriott, Rodney

    2012-10-01

    The goal of this study is to evaluate both the internal and external biofidelity of existing rear impact anthropomorphic test devices (BioRID II, RID3D, Hybrid III 50th) in two moderate-speed rear impact sled test conditions (8.5g, 17 km/h; 10.5g, 24 km/h) by quantitatively comparing the ATD responses to biomechanical response targets developed from PMHS testing in a corresponding study. The ATDs and PMHS were tested in an experimental seat system that is capable of simulating the dynamic seat back rotation response of production seats. The experimental seat contains a total of fourteen load cells installed such that external loads from the ATDs and PMHS can be measured to evaluate external biofidelity. The PMHS were instrumented to correspond to the instrumentation contained in the ATDs so that direct comparison between ATDs and PMHS could be made to evaluate internal biofidelity. The NHTSA Biofidelity Ranking system was used to quantitatively evaluate the biofidelity of the ATDs and an additional tool was introduced and utilized which allows for the biofidelity score to be partitioned into components of amplitude, phase, and shape. For internal biofidelity, the BioRID II and RID3D were more biofidelic than the Hybrid III in the 17 km/h test, and the BioRID II was most biofidelic in the 24 km/h test. For external biofidelity, the BioRID II was most biofidelic in the 17 km/h test, while both the BioRID II and the RID3D were more biofidelic than the Hybrid III in the 24 km/h test. Overall, the BioRID II demonstrated the best biofidelity in both the 17 km/h and 24 km/h tests.

  19. Simulation for Nurse Anesthesia Program Selection: Redesigned

    Science.gov (United States)

    Roebuck, John Arthur

    2017-01-01

    Purpose: This project is meant to answer the research question: What applicant character traits do Nurse Anesthesia Program Directors and Faculty identify as favorable predictors for successful completion of a nurse anesthesia program, and what evaluation methods are best to evaluate these traits in prospective students? Methods: A prospective…

  20. Using the Principles of SoTL to Redesign an Advanced Evolutionary Biology Course

    Directory of Open Access Journals (Sweden)

    Michael deBraga

    2015-03-01

    Full Text Available A primary goal of university instruction is the students’ demonstration of improved, highly developed critical thinking (CT skills. However, how do faculty encourage CT and its potential concomitant increase in student workload without negatively impacting student perceptions of the course? In this investigation, an advanced biology course is evaluated after structural changes (implemented in 2010 met with a poor student evaluation of the course and the instructor. This analysis first examines the steps used to transform a course to encourage CT and then explains how it can be assessed. To accomplish these goals, the instructor collaborated with an educational developer to redesign the course using a philosophy informed by SoTL. This approach, as we see it, represents a set of principles that demand transparency in the development and application of strategies whose aim is to encourage student learning. However, the SoTL approach would be insufficient to simply promote a set of strategies without some mechanism for evaluating its efficacy. Therefore, we designed a “Graded Response” (GR multiple-choice test to measure CT development and hence to properly evaluate whether the strategies embedded in our SoTL-informed course redesign have adequately met our goals.

  1. 77 FR 35393 - Federal Management Regulation; FMR Bulletin PBS-2012-03; Redesignations of Federal Buildings

    Science.gov (United States)

    2012-06-13

    ... Management Regulation; FMR Bulletin PBS-2012-03; Redesignations of Federal Buildings AGENCY: Public Buildings... bulletin announces the designation and redesignation of three Federal buildings. Expiration Date: This bulletin announcement expires October 31, 2012. The building designation and redesignations remains in...

  2. 76 FR 54772 - Federal Management Regulation; FMR Bulletin PBS-2011-B2; Redesignations of Federal Buildings

    Science.gov (United States)

    2011-09-02

    ... Management Regulation; FMR Bulletin PBS-2011-B2; Redesignations of Federal Buildings AGENCY: Public Buildings... announces the designation and redesignation of two Federal buildings. Expiration Date: This bulletin announcement expires January 31, 2012. The building designation and redesignation remains in effect until...

  3. 75 FR 69080 - Federal Management Regulation; FMR Bulletin PBS-2010-B5; Redesignations of Federal Buildings

    Science.gov (United States)

    2010-11-10

    ... Management Regulation; FMR Bulletin PBS-2010-B5; Redesignations of Federal Buildings AGENCY: Public Buildings... announces the designation and redesignation of two Federal buildings. DATES: Expiration Date: This bulletin announcement expires April 30, 2011. The building designation and redesignation remains in effect until...

  4. 76 FR 6792 - Federal Management Regulation; FMR Bulletin PBS-2011-B1; Redesignations of Federal Buildings

    Science.gov (United States)

    2011-02-08

    ... Management Regulation; FMR Bulletin PBS-2011-B1; Redesignations of Federal Buildings AGENCY: Public Buildings... announces the redesignations of three Federal buildings. DATES: Expiration Date: This bulletin announcement expires June 30, 2011. The building redesignations remain in effect until canceled or superseded by...

  5. 75 FR 44264 - Federal Management Regulation; FMR Bulletin PBS-2010-B4; Redesignation of Federal Building

    Science.gov (United States)

    2010-07-28

    ... Management Regulation; FMR Bulletin PBS-2010-B4; Redesignation of Federal Building AGENCY: Public Buildings... announces the redesignation of a Federal building. DATES: Expiration Date: This bulletin expires December 31, 2010. However, the building redesignation announced by this bulletin will remain in effect until...

  6. 76 FR 59600 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Redesignation of Lake and...

    Science.gov (United States)

    2011-09-27

    ...] Approval and Promulgation of Air Quality Implementation Plans; Indiana; Redesignation of Lake and Porter... redesignation of the Lake and Porter Counties, Indiana portion (Lake and Porter Counties) of the Chicago-Gary... or standard). EPA is proposing to approve the redesignation request for Lake and Porter Counties...

  7. Business process redesign at a mental healthcare institute: a coulored petri net approach

    NARCIS (Netherlands)

    Jansen-Vullers, M.H.; Reijers, H.A.; Jensen, K.

    2005-01-01

    Business Process Redesign aims to radically improve the performance of business processes. One of the approaches to derive such an improved process design is an evolutionary approach, making use of redesign heuristics (Reijers, 2003). Simulation of the redesigned business process comes into play if

  8. Piezosurgery in External Dacryocystorhinostomy.

    Science.gov (United States)

    Czyz, Craig N; Fowler, Amy M; Dutton, Jonathan J; Cahill, Kenneth V; Foster, Jill A; Hill, Robert H; Everman, Kelly R; Nabavi, Cameron B

    Dacryocystorhinostomy (DCR) can be performed via an external or endoscopic approach. The use of ultrasonic or piezosurgery has been well described for endoscopic DCRs but is lacking for external DCRs. This study presents a case series of external DCRs performed using piezosurgery evaluating results and complications. Prospective, consecutive case series of patients undergoing primary external DCR for lacrimal drainage insufficiency. A standard external DCR technique was used using 1 of 2 piezosurgery systems for all bone incision. All patients received silicone intubation to the lacrimal system. Surgical outcome was measured in terms of patient-reported epiphora as follows: 1) complete resolution, 2) improvement >50%, 3) improvement 50% improvement. There were 4 patients (7%) who had <50% improvement. There was 1 (2%) intraoperative complication and 2 (4%) postoperative complications recorded. Piezourgery is a viable modality for performing external DCRs. The lack of surgical complications shows a potential for decreased soft tissues damage. The surgical success rate based on patient-reported epiphora is similar to those published for mechanical external DCRs. This modality may benefit the novice surgeon in the reduction of soft and mucosal tissue damage.

  9. Biomechanical responses of PMHS in moderate-speed rear impacts and development of response targets for evaluating the internal and external biofidelity of ATDS.

    Science.gov (United States)

    Kang, Yun-Seok; Bolte, John H; Moorhouse, Kevin; Donnelly, Bruce; Herriott, Rodney; Mallory, Ann

    2012-10-01

    The objectives of this study were to obtain biomechanical responses of post mortem human subjects (PMHS) by subjecting them to two moderate-speed rear impact sled test conditions (8.5g, 17 km/h; 10.5g, 24 km/h) while positioned in an experimental seat system, and to create biomechanical targets for internal and external biofidelity evaluation of rear impact ATDs. The experimental seat was designed to measure external loads on the head restraint (4 load cells), seat back (6 load cells), and seat pan (4 load cells) such that subject dynamic interaction with the seat could be evaluated. This seat system was capable of simulating the dynamic characteristics of modern vehicle seat backs by considering the moment-rotation properties of a typical passenger vehicle, thus providing a more realistic test environment than using a rigid seat with a non-rotating seat back as done in previous studies. Instrumentation used to measure biomechanical responses of the PMHS included both accelerometers and angular rate sensors (ARS). A total of fourteen sled tests using eight PMHS (males 175.8 ± 6.2 cm of stature and 78.4 ± 7.2 kg of weight) provided data sets of seven PMHS for both test conditions. The biomechanical responses are described at both speeds, and cervical spine injuries are documented. Biomechanical targets are also created for internal and external biofidelity evaluation of rear impact anthropomorphic test devices (ATDs).

  10. Evaluation of the Induced Activity in Air by the External Proton Beam in the Target Room of the Proton Accelerator Facility of Proton Engineering Frontier Project

    International Nuclear Information System (INIS)

    Lee, Cheol Woo; Lee, Young Ouk; Cho, Young Sik; Ahn, So Hyun

    2007-01-01

    One of the radiological concerns is the worker's exposure level and the concentration of the radionuclides in the air after shutdown, for the safety analysis on the proton accelerator facility. Although, the primary radiation source is the protons accelerated up to design value, all of the radio-nuclide is produced from the secondary neutron and photon induced reaction in air. Because, the protons don't penetrate the acceleration equipment like the DTL tank wall or BTL wall, secondary neutrons or photons are only in the air in the accelerator tunnel building because of the short range of the proton in the materials. But, for the case of the target rooms, external proton beams are occasionally used in the various experiments. When these external proton beams travel through air from the end of the beam transport line to the target, they interact directly with air and produce activation products from the proton induced reaction. The external proton beam will be used in the target rooms in the accelerator facility of the Proton Accelerator Frontier Project (PEFP). In this study, interaction characteristics of the external proton beam with air and induced activity in air from the direct interaction of the proton beam were evaluated

  11. Use of calculations in the hygienic evaluation and prediction of external γ-irradiation levels of population

    International Nuclear Information System (INIS)

    Karpov, V.I.

    1980-01-01

    The estimation method of the annual average equivalent dose of population external irradiation calculated per 1 person and collective dose using the data of gamma radiation in buildings and inhabited points is proposed. The modified ratio (from the report of UN Scientific Committee, 1977) for the determination of external irradiation dose per 1 person is given. Dynamics and value of population exposure are determined. Particular solutions with a number of corresponding approximating functions are proposed for concrete rural and urban conditions. It is shown that with the construction of stone buildings collective dose growth considerably passes ahead of the population growth. Dynamics of the population radiation dose is forecasted upto 2000 year. It is shown that the cumulative error does not exceed +-25%

  12. Evaluation of off-axis wedge correction factor using diode dosimeters for estimation of delivered dose in external radiotherapy

    International Nuclear Information System (INIS)

    Allahverdi, Mahmoud; Shirazi, Alireza; Geraily, Ghazale; Mohammadkarim, Alireza; Esfehani, Mahbod; Nedaie, Hasanali

    2012-01-01

    An in vivo dosimetry system, using p-type diode dosimeters, was characterized for clinical applications of treatment machines ranging in megavoltage energies. This paper investigates two different models of diodes for externally wedged beams and explains a new algorithm for the calculation of the target dose at various tissue depths in external radiotherapy. The values of off-axis wedge correction factors were determined at two different positions in the wedged (toward the thick and thin edges) and in the non-wedged directions on entrance and exit surfaces of a polystyrene phantom in 60 Co and 6 MV photon beams. Depth transmission was defined on the entrance and exit surfaces to obtain the off-axis wedge correction factor at any depth. As the sensitivity of the diodes depends on physical characteristics (field size, source-skin distance (SSD), thickness, backscatter), correction factors were applied to the diode reading when measuring conditions different from calibration situations. The results indicate that needful correction factors for 60 Co wedged photons are usually larger than those for 6 MV wedged photon beams. In vivo dosimetry performed with the proposed algorithms at externally wedged beams has negligible probable errors (less than 0.5%) and is a reliable method for patient dose control. (author)

  13. Evaluation of off-axis wedge correction factor using diode dosimeters for estimation of delivered dose in external radiotherapy

    Directory of Open Access Journals (Sweden)

    Mahmoud Allahverdi

    2012-01-01

    Full Text Available An in vivo dosimetry system, using p-type diode dosimeters, was characterized for clinical applications of treatment machines ranging in megavoltage energies. This paper investigates two different models of diodes for externally wedged beams and explains a new algorithm for the calculation of the target dose at various tissue depths in external radiotherapy. The values of off-axis wedge correction factors were determined at two different positions in the wedged (toward the thick and thin edges and in the non-wedged directions on entrance and exit surfaces of a polystyrene phantom in 60 Co and 6 MV photon beams. Depth transmission was defined on the entrance and exit surfaces to obtain the off-axis wedge correction factor at any depth. As the sensitivity of the diodes depends on physical characteristics [field size, source-skin distance (SSD, thickness, backscatter], correction factors were applied to the diode reading when measuring conditions different from calibration situations . The results indicate that needful correction factors for 60 Co wedged photons are usually larger than those for 6 MV wedged photon beams. In vivo dosimetry performed with the proposed algorithms at externally wedged beams has negligible probable errors (less than 0.5% and is a reliable method for patient dose control.

  14. The Relationship Between Core Members' Social Capital and Perceived and Externally Evaluated Prestige and Cooperation Among HIV/AIDS-Related Civil Society Organizations in China.

    Science.gov (United States)

    Wang, Danni; Xu, Xiaoru; Mei, Guangliang; Ma, Ying; Chen, Ren; Qin, Xia; Hu, Zhi

    2017-03-01

    The purpose of this study was to investigate whether the core members' social capital was associated with individually perceived and externally evaluated prestige and cooperation among the HIV/AIDS-related civil society organizations (CSOs). To accomplish this, a cross-sectional study using multistage sampling was carried out in eight provinces of China. Data were collected from the 327 core members via questionnaires and self-evaluated performance of the respondents were evaluated and measured. The interviews were conducted with all core members and the supervisory staff of the local Centers for Disease Control and Prevention. Multivariate logistic regression analysis indicated that social support (adjusted odds ratio [a OR] = 1.87) and organizational commitment (a OR = 1.57) were significantly associated with a higher odds of prestige performance in self-evaluation. Furthermore, social support (a OR = 1.65), trust (a OR = 1.33), and organizational commitment (a OR = 1.52) were significantly correlated with cooperation performance. Trust was positively associated with the cooperation performance on external evaluation. These findings may provide a new perspective on challenges that the CSOs face in response to a growing HIV/AIDS epidemic in China. Social capital may increase performance and accelerate organizational growth, ultimately improving HIV/AIDS prevention and care.

  15. Redesigning Curricula in Geology and Geophysics

    Science.gov (United States)

    Sparks, D. W.; Ewing, R. C.; Fowler, D.; Macik, M.; Marcantonio, F.; Miller, B.; Newman, J.; Olszewski, T.; Reece, R.; Rosser, S.

    2015-12-01

    In the summer of 2014, the Texas A&M Department of Geology and Geophysics partnered with the Texas A&M Center for Teaching Excellence to implement TAMU's curriculum revision process: a data-informed, faculty-driven, educational-developer-supported rebuilding of our degree programs and course offerings. The current curricula (B.S. and B.A. in Geology, B.S. in Geophysics) were put into place in 1997, following the merger of two separate departments. The needs and capabilities of the Department and the student body have changed significantly since that time: more than 50% turnover of the faculty, a rapidly-changing job climate for geologists and geophysicists, and a nearly five-fold increase in the undergraduate population to over 500 majors in Fall 2015. Surveys of former students, employers and faculty at other universities revealed more reasons to address the curriculum. Some of the most desired skills are also those at which our graduates feel and are perceived to be least prepared: oral communication and the ability to learn software packages (skills that are most challenging to teach with growing class sizes). The challenge facing the Department is to accommodate growing student numbers while maintaining strength in traditional instructor-intensive activities such as microscopy and field mapping, and also improving our graduates' non-geological skills (e.g., communication, software use, teamwork, problem-solving) to insulate them from volatility in the current job market. We formed the Curriculum Study Group, consisting of faculty, graduate students, advisors and curriculum experts, to gather and analyze data and define the knowledge and skill base a graduate of our department must have. In addition to conducting external surveys, this group interviewed current students and faculty to determine the strengths and weaknesses of our program. We developed program learning goals that were further specified into over fifty criteria. For each criteria we defined

  16. Study of evaluation methods for in-vessel corium retention through external vessel cooling and safety of reactor cavity

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Hoon; Chang, Soon Heung; Kim, Soo Hyung; Kim, Kee Poong; Lee, Hyoung Wook; Jang, Kwang Keol; Jeong, Yong Hoon; Kim, Sang Jin; Lee, Seong Jin [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of); Park, Jae Hong [Korea Institute of Nuclear Safety, Taejon (Korea, Republic of)

    2001-03-15

    In this work, assessment system for methodology for reactor pressure vessel integrity is developed. Assessment system is make up of severe accident assessment code which can calculate the conditions of plant and structural analysis code which can assess the integrity of reactor vessel using given plant conditions. An assessment of cavity flooding using containment spray system has been done. As a result, by the containment spray, cavity can be flooded successfully and CCI can be reduced. The technical backgrounds for external vessel cooling and corium cooling on the cavity are summarized and provided in this report.

  17. Study of evaluation methods for in-vessel corium retention through external vessel cooling and safety of reactor cavity

    International Nuclear Information System (INIS)

    Huh, Hoon; Chang, Soon Heung; Kim, Soo Hyung; Kim, Kee Poong; Lee, Hyoung Wook; Jang, Kwang Keol; Jeong, Yong Hoon; Kim, Sang Jin; Lee, Seong Jin; Park, Jae Hong

    2001-03-01

    In this work, assessment system for methodology for reactor pressure vessel integrity is developed. Assessment system is make up of severe accident assessment code which can calculate the conditions of plant and structural analysis code which can assess the integrity of reactor vessel using given plant conditions. An assessment of cavity flooding using containment spray system has been done. As a result, by the containment spray, cavity can be flooded successfully and CCI can be reduced. The technical backgrounds for external vessel cooling and corium cooling on the cavity are summarized and provided in this report

  18. Decision support for redesigning wastewater treatment technologies.

    Science.gov (United States)

    McConville, Jennifer R; Künzle, Rahel; Messmer, Ulrike; Udert, Kai M; Larsen, Tove A

    2014-10-21

    This paper offers a methodology for structuring the design space for innovative process engineering technology development. The methodology is exemplified in the evaluation of a wide variety of treatment technologies for source-separated domestic wastewater within the scope of the Reinvent the Toilet Challenge. It offers a methodology for narrowing down the decision-making field based on a strict interpretation of treatment objectives for undiluted urine and dry feces and macroenvironmental factors (STEEPLED analysis) which influence decision criteria. Such an evaluation identifies promising paths for technology development such as focusing on space-saving processes or the need for more innovation in low-cost, energy-efficient urine treatment methods. Critical macroenvironmental factors, such as housing density, transportation infrastructure, and climate conditions were found to affect technology decisions regarding reactor volume, weight of outputs, energy consumption, atmospheric emissions, investment cost, and net revenue. The analysis also identified a number of qualitative factors that should be carefully weighed when pursuing technology development; such as availability of O&M resources, health and safety goals, and other ethical issues. Use of this methodology allows for coevolution of innovative technology within context constraints; however, for full-scale technology choices in the field, only very mature technologies can be evaluated.

  19. Evaluation of the occupational exposure to external sources of ionizing radiation in Cuba in the period 2001-2005

    International Nuclear Information System (INIS)

    Molina P, D.; Martinez H, E.; Castro S, A.

    2006-01-01

    The single radiological surveillance of the occupational exposure to external radiation sources in Cuba it is carried out by the Radiation Protection and Hygiene Center (CPHR). The data corresponding to the external exposure are presented. The service it covers to all the occupationally exposed workers (TOEs) of the country that work fundamentally the radiodiagnostic practices, nuclear medicine, radiotherapy and research. The purpose of this work is to carry out an analysis of the occupational exposures of the TOE of the country starting of the results registered by the service of single radiological surveillance in the period 2001 to 2005, keeping in mind the indicators used by the UNSCEAR. The annual average effective dose (E) for each practice is shown. The obtained results showed that the values of annual average effective dose (E) its are bigger for the radiodiagnostic practices, radiotherapy and nuclear medicine. In a general way, all the E values are inferior to 2.00 mSv. The number of TOEs that overcame the 20 mSv established as annual dose limit, it went inferior to 1% of the controlled total universe. (Author)

  20. ExternE: Externalities of energy Vol. 1. Summary

    International Nuclear Information System (INIS)

    Holland, M.; Berry, J.

    1995-01-01

    There is a growing requirement for policy analysts to take account of the environment in their decision making and to undertake the specified cost-benefit analysis. Within the European Union this is reflected in the 5th Environmental Action Programme, and the Commission's White Paper entitled 'Growth, competitiveness, employment and the ways forward to the 21st century'. This has led to a need for evaluation of environmental externalities. The ExternE Project commenced in 1991 as the European part of a collaborative study between the European Commission and the US Department of Energy. It aims to be the first systematic approach to the evaluation of external costs of a wide range of different fuel cycles. The project will result in an operational accounting framework for the quantification and monetarisation of priority environmental and other externalities. This framework will allow the calculation of the marginal external costs and benefits for specific power plants, at specific sites using specified technologies. There are three major phases in the project. Phase 1 was undertaken in collaboration with the US Department of Energy. In this phase the teams jointly developed the conceptual approach and methodology and shared scientific information for application to a number of fuel cycles. On the European side work concentrated on the nuclear and coal fuel cycles which together were expected to raise many of the fundamental issues in fuel cycle analysis. The project is currently nearing completion of Phase 2. During this phase the methodology has been applied to a wide range of different fossil, nuclear and renewable fuel cycles for power generation and energy conservation options. Also a series of National Implementation Programmes is underway in which the methodology and accounting framework are being applied to reference sites throughout Europe. In addition the general methodology is being extended to address the evaluation of externalities associated with

  1. Externalities of fuel cycles 'ExternE' project. Summary report

    International Nuclear Information System (INIS)

    Holland, M.; Berry, J.

    1994-01-01

    There is a growing requirement for policy analysts to take account of the environment in their decision making and to undertake the specified cost-benefit analysis. Within the European Union this is reflected in the 5th Environmental Action Programme, and the Commission's White Paper entitled 'Growth, competitiveness, employment and the ways forward to the 21st century'. This has led to a need for evaluation of environmental externalities. The ExternE Project commenced in 1991 as the European part of a collaborative study between the European Commission and the US Department of Energy. It aims to be the first systematic approach to the evaluation of external costs of a wide range of different fuel cycles. The project will result in an operational accounting framework for the quantification and monetarisation of priority environmental and other externalities. This framework will allow the calculation of the marginal external costs and benefits for specific power plants, at specific sites using specified technologies. There are three major phases in the project. Phase I was undertaken in collaboration with the US Department of Energy. In this phase the teams jointly developed the conceptual approach and methodology and shared scientific information for application to a number of fuel cycles. On the European side work concentrated on the nuclear and coal fuel cycles which together were expected to raise many of the fundamental issues in fuel cycle analysis. The project is currently nearing completion of Phase 2. During this phase the methodology has been applied to a wide range of different fossil, nuclear and renewable fuel cycles for power generation and energy conservation options. Also a series of National Implementation Programmes are underway in which the methodology and accounting framework are being applied to reference sites throughout Europe. In addition the general methodology is being extended to address the evaluation of externalities associated with

  2. Redesigning ambulatory care business processes supporting clinical care delivery.

    Science.gov (United States)

    Patterson, C; Sinkewich, M; Short, J; Callas, E

    1997-04-01

    The first step in redesigning the health care delivery process for ambulatory care begins with the patient and the business processes that support the patient. Patient-related business processes include patient access, service documentation, billing, follow-up, collection, and payment. Access is the portal to the clinical delivery and care management process. Service documentation, charge capture, and payment and collection are supporting processes to care delivery. Realigned provider networks now demand realigned patient business services to provide their members/customers/patients with improved service delivery at less cost. Purchaser mandates for cost containment, health maintenance, and enhanced quality of care have created an environment where every aspect of the delivery system, especially ambulatory care, is being judged. Business processes supporting the outpatient are therefore being reexamined for better efficiency and customer satisfaction. Many health care systems have made major investments in their ambulatory care environment, but have pursued traditional supporting business practices--such as multiple access points, lack of integrated patient appointment scheduling and registration, and multiple patient bills. These are areas that are appropriate for redesign efforts--all with the customer's needs and convenience in mind. Similarly, setting unrealistic expectations, underestimating the effort required, and ignoring the human elements of a patient-focused business service redesign effort can sabotage the very sound reasons for executing such an endeavor. Pitfalls can be avoided if a structured methodology, coupled with a change management process, are employed. Deloitte & Touche Consulting Group has been involved in several major efforts, all with ambulatory care settings to assist with the redesign of their business practices to consider the patient as the driver, instead of the institution providing the care.

  3. Acceptance of lean redesigns in primary care: A contextual analysis.

    Science.gov (United States)

    Hung, Dorothy; Gray, Caroline; Martinez, Meghan; Schmittdiel, Julie; Harrison, Michael I

    Lean is a leading change strategy used in health care to achieve short-term efficiency and quality improvement while promising longer-term system transformation. Most research examines Lean intervention to address isolated problems, rather than to achieve broader systemic changes to care delivery. Moreover, no studies examine contextual influences on system-wide Lean implementation efforts in primary care. The aim of this study was to identify contextual factors most critical to implementing and scaling Lean redesigns across all primary care clinics in a large, ambulatory care delivery system. Over 100 interviews and focus groups were conducted with frontline physicians, clinical staff, and operational leaders. Data analysis was guided by a modified Consolidated Framework for Implementation Research (CFIR), a popular implementation science framework. On the basis of expert recommendations, the modified framework targets factors influencing the implementation of process redesigns. This modified framework, the CFIR-PR, informed our identification of contextual factors that most impacted Lean acceptance among frontline physicians and staff. Several domains identified by the CFIR-PR were critical to acceptance of Lean redesigns. Regarding the implementation process acceptance was influenced by time and intensity of exposure to changes, "top-down" versus "bottom-up" implementation styles, and degrees of employee engagement in developing new workflows. Important factors in the inner setting were the clinic's culture and style of leadership, along with availability of information about Lean's effectiveness. Last, implementation efforts were impacted by individual and team characteristics regarding changed work roles and related issues of professional identity, authority, and autonomy. This study underscores the need for change leaders to consider the contextual factors that surround efforts to implement Lean in primary care. As Lean redesigns are scaled across a system

  4. Redesigning photosynthesis to sustainably meet global food and bioenergy demand

    Science.gov (United States)

    Ort, Donald R.; Merchant, Sabeeha S.; Alric, Jean; Barkan, Alice; Blankenship, Robert E.; Bock, Ralph; Croce, Roberta; Hanson, Maureen R.; Hibberd, Julian M.; Long, Stephen P.; Moore, Thomas A.; Moroney, James; Niyogi, Krishna K.; Parry, Martin A. J.; Peralta-Yahya, Pamela P.; Prince, Roger C.; Redding, Kevin E.; Spalding, Martin H.; van Wijk, Klaas J.; Vermaas, Wim F. J.; von Caemmerer, Susanne; Weber, Andreas P. M.; Yeates, Todd O.; Yuan, Joshua S.; Zhu, Xin Guang

    2015-01-01

    The world’s crop productivity is stagnating whereas population growth, rising affluence, and mandates for biofuels put increasing demands on agriculture. Meanwhile, demand for increasing cropland competes with equally crucial global sustainability and environmental protection needs. Addressing this looming agricultural crisis will be one of our greatest scientific challenges in the coming decades, and success will require substantial improvements at many levels. We assert that increasing the efficiency and productivity of photosynthesis in crop plants will be essential if this grand challenge is to be met. Here, we explore an array of prospective redesigns of plant systems at various scales, all aimed at increasing crop yields through improved photosynthetic efficiency and performance. Prospects range from straightforward alterations, already supported by preliminary evidence of feasibility, to substantial redesigns that are currently only conceptual, but that may be enabled by new developments in synthetic biology. Although some proposed redesigns are certain to face obstacles that will require alternate routes, the efforts should lead to new discoveries and technical advances with important impacts on the global problem of crop productivity and bioenergy production. PMID:26124102

  5. Development of TPNCIRC code for Evaluation of Two-Phase Natural Circulation Flow Performance under External Reactor Vessel Cooling Conditions

    International Nuclear Information System (INIS)

    Choi, A-Reum; Song, Hyuk-Jin; Park, Jong-Woon

    2015-01-01

    During a severe accident, corium is relocated to the lower head of the nuclear reactor pressure vessel (RPV). Design concept of retaining the corium inside a nuclear reactor pressure vessel (RPV) through external cooling under hypothetical core melting accidents is called external reactor vessel cooling (ERVC). In this respect, validated two-phase natural circulation flow (TPNC) model is necessary to determine the adequacy of the ERVC design and operating conditions such as inlet area, form losses, gap distance, riser length and coolant conditions. The most important model generally characterizing the TPNC are void fraction and two-phase friction factors. Typical experimental and analytical studies to be referred to on two-phase circulation flow characteristics are those by Reyes, Gartia et al. based on Vijayan et al., Nayak et al. and Dubey et al. In the present paper, two-phase natural circulation (TPNC) flow characteristics under external reactor vessel cooling (ERVC) conditions are studied using two existing TPNC flow models of Reyes and Gartia et al. incorporating more improved void fraction and two-phase friction models. These models and correlations are integrated into a computer program, TPNCIRC, which can handle candidate ERVC design parameters, such as inlet, riser and downcomer flow lengths and areas, gap size between reactor vessel and surrounding insulations, minor loss factors and operating parameters of decay power, pressure and subcooling. Accuracy of the TPNCIRC program is investigated with respect to the flow rate and void fractions for existing measured data from a general experiment and ULPU specifically designed for the AP1000 in-vessel retention. Also, the effect of some important design parameters are examined for the experimental and plant conditions. Using the flow models and correlations are integrated into a computer program, TPNCIRC, a number of correlations have been examined. This seems coming from the differences of void fractions

  6. EVALUATION OF THE GOVERNANCE OF EXTERNAL SUPERVISORY INSTITUTIONS TOWARDS SOCIAL SECURITY AGENCY (BADAN PENYELENGGARA JAMINAN SOSIAL/BPJS FOR HEALTHCARE

    Directory of Open Access Journals (Sweden)

    Dyani D.A.M.

    2017-09-01

    Full Text Available Since the formation of the Social Security Agency (Badan Penyelenggara Jaminan Sosial/BPJS for Healthcare has found the public spotlight rising with its management; including the regulatory body BPJS for Healthcare activities. BPJS for Healthcare external supervisors such as DJSN, OJK, BPK are entities established according to the Law of the Republic of Indonesia 24 Year 2011. However, there are views on neutrality, independence, and supervisor capability. By using Soft System Methodology, this research invites us to understand the problem situation and what efforts should be taken in managing the complexity. This paper will analyze the co-operation with collaborative governance perspective as a cooperative approach in overseeing BPJS for Healthcare. The focus of this paper is in the stage of identifying a series of factors that are crucial within the collaborative process itself, which includes shared understanding as stated by Ansel & Gash (2008 and Emerson & Nabatchi (2015.

  7. Didactic revision of the operative magnitudes system ICRU for the evaluation of the equivalent dose in radiation external fields

    International Nuclear Information System (INIS)

    Alvarez R, J. T.

    2014-10-01

    In this work is presented in a didactic way the operative magnitudes system ICRU, showing as these magnitudes carry out an appropriate estimate of the effective equivalent doses H E and the effective dose. The objective is to present the basic concepts of the dosimetry for radiation external fields with purposes of radiological protection, because the assimilation lack and technological development of this dosimetric magnitudes system has persisted for near 50 years, in terms of practice of the radiological protection in Mexico. Also, this system is an essential part of safety basic standards of the IAEA and ICRP recommendations 26, 60, 74 and 103, as well as of the ICRU 25, 39, 43, 51 and 57. (Author)

  8. Comparative evaluation of in vitro mechanical properties of different designs of epoxy-pin external skeletal fixation systems.

    Science.gov (United States)

    Tyagi, Surbhi Kuldeep; Aithal, Hari Prasad; Kinjavdekar, Prakash; Amarpal; Pawde, Abhijit Motiram; Srivastava, Tuhin; Tyagi, Kanti Prakash; Monsang, Shongsir Warson

    2014-03-01

    To compare in vitro biomechanical properties of different designs of epoxy-pin external skeletal fixator (ESF) constructs. Mechanical testing study. Four epoxy-pin ESF design constructs (uniplanar [EU], multiplanar-I [EM-I], multiplanar-II [EM-II], and circular [EC]) were mechanically tested in compression, bending, and torsion. Four different designs of free-form epoxy-pin external fixator constructs were developed using 1.5 mm K-wires and epoxy resin mounted in an ultra-high density polyethylene rod (20 mm diameter). Three-point fixation was done in each fragment, and the distance between fixation wires, and between the rod and the side bars was kept constant in all the designs. A 5 mm gap was maintained at the center of the fixation rod to simulate an unstable fracture condition. The fixator constructs (n = 12 of each design) were subjected to mechanical testing in axial compression, bending, or torsion. Load-deformation curves were generated and mechanical properties were compared between construct types. EU was the weakest design. Under compression, constructs EM-I, EM-II, and EC were similar. Under bending, EM-I and EM-II had similar strength, whereas EC was strongest. Under torsion, EC was strongest, followed by EM-II, EM-I, and EU; EM-II provided double the rotational stability of EM-I. Overall, EC followed by EM-II epoxy-pin fixator designs had better mechanical strength. © Copyright 2014 by The American College of Veterinary Surgeons.

  9. Strength in unity: the power of redesign to align the hospital team.

    Science.gov (United States)

    Bell, Anthony; Cochrane, Alastair; Courtice, Sally; Flanigan, Kathy; Mathur, Mandeep; Wilckens, Daniel

    2014-06-01

    The aim of Queen Elizabeth II Jubilee Hospital (QEII) redesign project (QEII United) was to enhance timely access to an inpatient bed and maximise opportunities to value add during the inpatient episode of care. A tripartite relationship between the hospital team, system manager and external consultants. The team, QEII United, was formed to 'diagnose, solve and implement' change under the unifying metaphorical banner of a football team. A marketing strategy and communication plan targeted the key 'players' and outlined the 'game plan'. Baseline data were collected, analysed and reported in keeping with key aims. Strategies for systems improvement implementation were attached to key performance indicators (KPIs). Thematic KPIs were developed to embed internal process change to reflect the contributions made towards the National Emergency Access Target (NEAT) at each stage of the patient journey. As such, access block of under 20%, morning discharge rates of 50% before midday, reduced length of stay for selected elective orthopaedic and general medical diagnostic related groupings (DRGs; i.e. relative stay index ≤1) and hospital in the home (HITH) utilisation rates 1.5% of all admissions were all met. Key to sustainability was the transfer of clinical redesign skills to hospital staff and the fostering of emergent ground up leadership. QEII United's success has been underpinned by the development of themed solution areas developed by the hospital staff themselves. Robust baseline data analysis used in combination with nationally available benchmarking data provided a quantitative starting point for the work. The collaborative elements of the program re-energised the hospital team, who were kept informed by targeted communications, to establish quick wins and build trust and momentum for the more challenging areas.

  10. Modes of interannual variability in northern hemisphere winter atmospheric circulation in CMIP5 models: evaluation, projection and role of external forcing

    Science.gov (United States)

    Frederiksen, Carsten S.; Ying, Kairan; Grainger, Simon; Zheng, Xiaogu

    2018-04-01

    Models from the coupled model intercomparison project phase 5 (CMIP5) dataset are evaluated for their ability to simulate the dominant slow modes of interannual variability in the Northern Hemisphere atmospheric circulation 500 hPa geopotential height in the twentieth century. A multi-model ensemble of the best 13 models has then been used to identify the leading modes of interannual variability in components related to (1) intraseasonal processes; (2) slowly-varying internal dynamics; and (3) the slowly-varying response to external changes in radiative forcing. Modes in the intraseasonal component are related to intraseasonal variability in the North Atlantic, North Pacific and North American, and Eurasian regions and are little affected by the larger radiative forcing of the Representative Concentration Pathways 8.5 (RCP8.5) scenario. The leading modes in the slow-internal component are related to the El Niño-Southern Oscillation, Pacific North American or Tropical Northern Hemisphere teleconnection, the North Atlantic Oscillation, and the Western Pacific teleconnection pattern. While the structure of these slow-internal modes is little affected by the larger radiative forcing of the RCP8.5 scenario, their explained variance increases in the warmer climate. The leading mode in the slow-external component has a significant trend and is shown to be related predominantly to the climate change trend in the well mixed greenhouse gas concentration during the historical period. This mode is associated with increasing height in the 500 hPa pressure level. A secondary influence on this mode is the radiative forcing due to stratospheric aerosols associated with volcanic eruptions. The second slow-external mode is shown to be also related to radiative forcing due to stratospheric aerosols. Under RCP8.5 there is only one slow-external mode related to greenhouse gas forcing with a trend over four times the historical trend.

  11. Evaluation of gamma prime volume fractions and lattice misfits in a nickel base superalloy using the external standard X-ray diffraction method

    Energy Technology Data Exchange (ETDEWEB)

    Tiley, J., E-mail: jaimie.tiley@wpafb.af.mil [Air Force Research Laboratory, Materials and Manufacturing Directorate, WPAFB, OH (United States); Viswanathan, G.B. [Air Force Research Laboratory, Materials and Manufacturing Directorate, WPAFB, OH (United States); Hwang, J.Y. [Materials Engineering Department, University of North Texas, Denton, TX (United States); Shiveley, A. [Air Force Research Laboratory, Materials and Manufacturing Directorate, WPAFB, OH (United States); Banerjee, R. [Materials Engineering Department, University of North Texas, Denton, TX (United States)

    2010-11-25

    The unconstrained lattice parameters and volume fractions of {gamma}' for a low misfit nickel based superalloy were evaluated using X-ray diffraction techniques. Extraction techniques were used to provide unconstrained {gamma}' powders for both water quenched and slow cooled samples that were aged at 760 deg. C for 0, 25, 50, 100, and 200 h. The external standard method was used to determine the volume fraction for the unaged water quenched sample and the slow cooled sample aged for 200 h. These two extremes in processing conditions provided an increase in the total volume fraction of {gamma}'.

  12. Experiences of first-year nursing students during an education redesign: findings from the Oregon Consortium for Nursing Education.

    Science.gov (United States)

    Ostrogorsky, Tanya L; Raber, Anjanette M

    2014-01-01

    The aim of this article is to summarize first-year students' (n = 908) experience during a nursing education redesign. Oregon Consortium for Nursing Education (OCNE) began its redesign of nursing education in 2000, long before the current national calls for nursing education reform. As OCNE moved from planning to implementation, a comprehensive evaluation of the students, the program, and curriculum ensued. Data were collected from first-year nursing students each spring from 2007-2010 using a standardized survey instrument that included demographic, attitudinal, and opinion-based survey items. Results indicated fellow students, course lectures and interaction, and faculty and courses were rated areas of satisfaction. Areas needing improvement included advising and facilities, administration, quality of instruction and curriculum, and overall program effectiveness. Mean scaled and open-ended responses from each area are reported.

  13. Participatory redesign of work organisation in hospital nursing: A study of the implementation process.

    Science.gov (United States)

    Stab, Nicole; Hacker, Winfried

    2018-05-01

    The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.

  14. Redesigning a Ministry of Health's organizational structure: exploring implementation challenges through Botswana's experiences.

    Science.gov (United States)

    Seitio-Kgokgwe, Onalenna; Gauld, Robin D C; Hill, Philip C; Barnett, Pauline

    2016-04-01

    The Botswana's Ministry of Health redesigned and adopted a new organizational structure in 2005, which was poorly implemented. This article explores factors that influenced the implementation of this organizational structure. This article draws from data collected through in-depth interviews with 54 purposively selected key informants comprising policy makers, senior managers and staff of the Ministry of Health (N = 40) and senior officers from various stakeholder organizations (N = 14). Participants generally felt that the review of the Ministry of Health organizational structure was important. The previous structure was considered obsolete with fragmented functions that limited the overall performance of the health system. The new organizational structure was viewed to be aligned to current national priorities with potential to positively influence performance. Some key weaknesses identified included lack of consultation and information sharing with workers during the restructuring process, which affected the understanding of their new roles, failure to mobilize key resources to support implementation of the new structure and inadequate monitoring of the implementation process. Redesigning an organizational structure is a major change. There is a need for effective and sustained leadership to plan, direct, coordinate, monitor and evaluate the implementation phase of the reform. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  15. A University Web Portal redesign applying accessibility patterns. Breaking Down Barriers for Visually Impaired Users

    Directory of Open Access Journals (Sweden)

    Hernán Sosa

    2015-08-01

    Full Text Available Definitely, the WWW and ICTs have become the preferred media for the interaction between society and its citizens, and public and private organizations have today the possibility of deploying their activities through the Web. In particular, university education is a domain where the benefits of these technological resources can strongly contribute in caring for students. However, most university Web portals are inaccessible to their user community (students, professors, and non-teaching staff, between others, since these portals do not take into account the needs of people with different capabilities. In this work, we propose an accessibility pattern driven process to the redesign of university Web portals, aiming to break down barriers for visually impaired users. The approach is implemented to a real case study: the Web portal of Universidad Nacional de la Patagonia Austral (UNPA. The results come from applying accessibility recommendations and evaluation tools (automatic and manual from internationally recognized organizations, to both versions of the Web portal: the original and the redesign one.

  16. Innovation in ambulatory care: a collaborative approach to redesigning the health care workplace.

    Science.gov (United States)

    Johnson, Paula A; Bookman, Ann; Bailyn, Lotte; Harrington, Mona; Orton, Piper

    2011-02-01

    To improve the quality of patient care and work satisfaction of the physicians and staff at an ambulatory practice that had recently started an innovative model of clinical care for women. The authors used an inclusive process, collaborative interactive action research, to engage all physicians and staff members in assessing and redesigning their work environment. Based on key barriers to working effectively and integrating work and family identified in that process, a pilot project with new work practices and structures was developed, implemented, and evaluated. The work redesign process established cross-occupational care teams in specific clinical areas. Members of the teams built skills in assessing clinical operations in their practice areas, developed new levels of collaboration, and constructed new models of distributed leadership. The majority of participants reported an improvement in how their area functioned. Integrating work and family/personal life-particularly practices around flexible work arrangements-became an issue for team discussion and solutions, not a matter of individual accommodation by managers. By engaging the workforce, collaborative interactive action research can help achieve lasting change in the health care workplace and increase physicians' and staff members' work satisfaction. This "dual agenda" may be best achieved through a collaborative process where cross-occupational teams are responsible for workflow and outcomes and where the needs of patients and providers are integrated.

  17. Productivity Change and Externalities

    DEFF Research Database (Denmark)

    Kravtsova, Victoria

    2014-01-01

    This paper contributes to the analysis of the impact of externalities on the host country's total factor productivity by taking into account different dimensions of spillover effects. Namely, engagement in exporting and foreign ownership is generally perceived as being beneficial to individual...... firms and the economy as a whole. The approach used in the current research accounts for different internal as well as external factors that individual firms face and evaluates the effect on changes in productivity, technology as well as the efficiency of domestic firms. The empirical analysis focuses...... on Hungary. While the country leads the group of post-socialist countries in the amount of attracted foreign direct investments (FDI) the effect of this policy on the economy remains unclear. The research finds that different externalities play a different role in productivity, technological and efficiency...

  18. ExternE: Externalities of energy Vol. 5. Nuclear

    International Nuclear Information System (INIS)

    Dreicer, M.; Tort, V.; Manen, P.

    1995-01-01

    Since the early 1970s, there has been increased interest in the environmental impacts that are caused by the generation of electricity. The comparative risk assessment studies at that time used mainly deaths and injuries as impact indicators. By the end of the 1980s studies changed to the assessment of the costs imposed on society and the environment that were not included in the market price of the energy produced, the so-called external costs. The preliminary studies that were published set the conceptual basis, grounded in neo-classical economics, for the valuation of the health and environmental impacts that could be assessed. As a consequence of the many questions raised by the methodologies employed by these early studies, Directorate General XII (DG XII) of the Commission of the European Communities established a collaborative research programme with the United States Department of Energy to identify an appropriate methodology for this type of work. Following the completion of this collaboration, the DG XII programme has continued as the ExternE project. The main objective of the work carried out at CEPN was to develop an impact pathway methodology for the nuclear fuel cycle that would be consistent with the methodologies developed for other fuel cycles, without loosing the nuclear-specific techniques required for a proper evaluation. In this way, comparisons between the different fuel cycles would be possible. This report presents the methodology and demonstration of the results in the context of the French nuclear fuel cycle. The United States team at Oak Ridge National Laboratory has previously issued a draft report on the results of their assessment. The French fuel cycle was broken down into 8 separate stages. Reference sites and 1990s technology were chosen to represent the total nuclear fuel cycle, as it exists today. In addition, the transportation of material between the sites was considered. The facilities are assessed for routine operation, except

  19. Evaluation of the toroidal torque driven by external non-resonant non-axisymmetric magnetic field perturbations in a tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Kasilov, Sergei V. [Fusion@ÖAW, Institut für Theoretische Physik—Computational Physics, Technische Universität Graz Petersgasse 16, A–8010 Graz (Austria); Institute of Plasma Physics National Science Center “Kharkov Institute of Physics and Technology” ul. Akademicheskaya 1, 61108 Kharkov (Ukraine); Kernbichler, Winfried; Martitsch, Andreas F.; Heyn, Martin F. [Fusion@ÖAW, Institut für Theoretische Physik—Computational Physics, Technische Universität Graz Petersgasse 16, A–8010 Graz (Austria); Maassberg, Henning [Max-Planck Institut für Plasmaphysik, D-17491 Greifswald (Germany)

    2014-09-15

    The toroidal torque driven by external non-resonant magnetic perturbations (neoclassical toroidal viscosity) is an important momentum source affecting the toroidal plasma rotation in tokamaks. The well-known force-flux relation directly links this torque to the non-ambipolar neoclassical particle fluxes arising due to the violation of the toroidal symmetry of the magnetic field. Here, a quasilinear approach for the numerical computation of these fluxes is described, which reduces the dimension of a standard neoclassical transport problem by one without model simplifications of the linearized drift kinetic equation. The only limiting condition is that the non-axisymmetric perturbation field is small enough such that the effect of the perturbation field on particle motion within the flux surface is negligible. Therefore, in addition to most of the transport regimes described by the banana (bounce averaged) kinetic equation also such regimes as, e.g., ripple-plateau and resonant diffusion regimes are naturally included in this approach. Based on this approach, a quasilinear version of the code NEO-2 [W. Kernbichler et al., Plasma Fusion Res. 3, S1061 (2008).] has been developed and benchmarked against a few analytical and numerical models. Results from NEO-2 stay in good agreement with results from these models in their pertinent range of validity.

  20. Evaluation of the internal oblique, external oblique, and transversus abdominalis muscles in patients with ankylosing spondylitis: an ultrasonographic study.

    Science.gov (United States)

    Üşen, Ahmet; Kuran, Banu; Yılmaz, Figen; Aksu, Neşe; Erçalık, Cem

    2017-11-01

    The objectives of the study are to compare abdominal muscle thickness in ankylosing spondylitis (AS) patients with healthy subjects and determine the factors affecting these muscle thickness. Thirty-five male patients with a previous diagnosis of AS according to the Modified New York criteria and a control group consisting of 35 healthy male individuals were included in this cross-sectional and case-control study. Thicknesses of the internal oblique (IO), external oblique (EO), and transversus abdominalis (TrA) muscles were measured with ultrasound (US). AS patients were classified according to the International Physical Activity Questionnaire (IPAQ). There were 35 AS patients with a mean age of 35.17 ± 8.05 years and 35 healthy subjects with a mean age 32.57 ± 7.05 years. No significant difference was observed between the groups in terms of abdominal muscle thicknesses (p > 0.005). When the AS patients were classified according to the IPAQ scores, thicknesses of the IO and TrA muscles were significantly lower in patients who had the low level of IPAQ scores (p < 0.05). In the light of our first and preliminary results, muscle thickness of the IO, EO, and TrA muscles were similar in AS patients to healthy subjects. However, AS patients who had lower level of physical activity have also reduced thickness of IO and TrA muscles.

  1. Real external predictivity of QSAR models: how to evaluate it? Comparison of different validation criteria and proposal of using the concordance correlation coefficient.

    Science.gov (United States)

    Chirico, Nicola; Gramatica, Paola

    2011-09-26

    The main utility of QSAR models is their ability to predict activities/properties for new chemicals, and this external prediction ability is evaluated by means of various validation criteria. As a measure for such evaluation the OECD guidelines have proposed the predictive squared correlation coefficient Q(2)(F1) (Shi et al.). However, other validation criteria have been proposed by other authors: the Golbraikh-Tropsha method, r(2)(m) (Roy), Q(2)(F2) (Schüürmann et al.), Q(2)(F3) (Consonni et al.). In QSAR studies these measures are usually in accordance, though this is not always the case, thus doubts can arise when contradictory results are obtained. It is likely that none of the aforementioned criteria is the best in every situation, so a comparative study using simulated data sets is proposed here, using threshold values suggested by the proponents or those widely used in QSAR modeling. In addition, a different and simple external validation measure, the concordance correlation coefficient (CCC), is proposed and compared with other criteria. Huge data sets were used to study the general behavior of validation measures, and the concordance correlation coefficient was shown to be the most restrictive. On using simulated data sets of a more realistic size, it was found that CCC was broadly in agreement, about 96% of the time, with other validation measures in accepting models as predictive, and in almost all the examples it was the most precautionary. The proposed concordance correlation coefficient also works well on real data sets, where it seems to be more stable, and helps in making decisions when the validation measures are in conflict. Since it is conceptually simple, and given its stability and restrictiveness, we propose the concordance correlation coefficient as a complementary, or alternative, more prudent measure of a QSAR model to be externally predictive.

  2. Measurements and evaluation of the risks due to external radiation exposures and to intake of activated elements for operational staff engaged in the maintenance of medical cyclotrons.

    Science.gov (United States)

    Calandrino, R; del Vecchio, A; Parisi, R; Todde, S; De Felice, P; Savi, A; Pepe, A; Mrskova, A

    2010-06-01

    The aim of this paper is to assess the activation phenomena and to evaluate the risk of external exposure and intake doses for the maintenance staff of two medical cyclotrons. Two self-shielded cyclotrons are currently operating in the facility for the routine production of (11)C and (18)F. Four radiochemistry laboratories are linked to the cyclotrons by means of shielded radioisotope delivery lines. Radiopharmaceuticals are prepared both for the PET Diagnostic Department, where four CT-PET scanners are operating with a mean patient workload of 40 d(-1) and for [(18)F]FDG external distribution, to provide radiopharmaceuticals for other institutions. In spite of the fact that air contamination inside the radiochemistry laboratories during the synthesis represents the largest 'slice of the pie' in the evaluation of annual intake dose, potential contamination due to the activated particulate, generated during cyclotron irradiation by micro-corrosion of targets and other components potentially struck by the proton beam and generated neutrons, should be considered. In this regard, the most plausible long-lived (T(1/2) > 30 d) radioisotopes formed are: (97)Tc, (56)Co, (57)Co, (58)Co, (60)Co, (49)V, (55)Fe, (109)Cd, (65)Zn and (22)Na. The results for the operating personnel survey has revealed only low-level contamination for (65)Zn in one test, together with minor (18)F intake, probably due to the environmental dispersion of the radioisotope during the [(18)F]FDG synthesis.

  3. Weightbearing vs Gravity Stress Radiographs for Stability Evaluation of Supination-External Rotation Fractures of the Ankle.

    Science.gov (United States)

    Seidel, Angela; Krause, Fabian; Weber, Martin

    2017-07-01

    Isolated lateral malleolar fractures may result from a supination-external rotation (SER) injury of the ankle. Stable fractures maintain tibiotalar congruence due to competent medial restraints and can be treated nonoperatively with excellent functional results and long-term prognosis. Stability might be assessed with either stress radiographs or weightbearing radiographs. A consecutive series of patients with closed SER fractures (presumed AO 44-B1) were prospectively enrolled from 2008 to 2015. Patients with clearly unstable fractures (medial clear space more than 7 mm) on the initial nonweightbearing radiograph were excluded and operated on. All other patients were examined with a gravity stress and a weightbearing anteroposterior radiograph. Borderline instability of the fracture was assumed when the medial clear space was 4 to 7 mm. Those were treated nonoperatively. Of 104 patients with isolated lateral malleolar fractures of the SER type, 14 patients were treated operatively because of clear instability (displacement) on the initial radiographs. Of the nonoperative patients, 44 patients demonstrated borderline instability on the gravity stress but stability on the weightbearing radiograph ("gravity borderline"); the remaining 46 were stable in both tests ("gravity stable"). At an average follow-up of 23 months, no significant differences were seen in the American Orthopaedic Foot & Ankle Society hindfoot score (92 points gravity-borderline group vs 93 points gravity-unstable group), the Foot Functional Index score (11 vs 10 points), the Short Form 36 (SF-36) physical component (86 vs 85 points), and SF-36 mental component (84 vs 81 points). Radiographically, all fractures had healed with anatomic congruity of the ankle. Weightbearing radiographs provided a reliable basis to decide about stability and nonoperative treatment in isolated lateral malleolar fractures of the SER type with excellent clinical and radiographic outcome at short-term follow-up. Gravity

  4. Space Shuttle Redesigned Solid Rocket Motor nozzle natural frequency variations with burn time

    Science.gov (United States)

    Lui, C. Y.; Mason, D. R.

    1991-01-01

    The effects of erosion and thermal degradation on the Space Shuttle Redesigned Solid Rocket Motor (RSRM) nozzle's structural dynamic characteristics were analytically evaluated. Also considered was stiffening of the structure due to internal pressurization. A detailed NASTRAN finite element model of the nozzle was developed and used to evaluate the influence of these effects at several discrete times during motor burn. Methods were developed for treating erosion and thermal degradation, and a procedure was developed to account for internal pressure stiffening using differential stiffness matrix techniques. Results were verified using static firing test accelerometer data. Fast Fourier Transform and Maximum Entropy Method techniques were applied to the data to generate waterfall plots which track modal frequencies with burn time. Results indicate that the lower frequency nozzle 'vectoring' modes are only slightly affected by erosion, thermal effects and internal pressurization. The higher frequency shell modes of the nozzle are, however, significantly reduced.

  5. External coating of colonic anastomoses

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Achiam, Michael Patrick; Rosenberg, Jacob

    2012-01-01

    Colon anastomotic leakage remains both a frequent and serious complication in gastrointestinal surgery. External coating of colonic anastomoses has been proposed as a means to lower the rate of this complication. The aim of this review was to evaluate existing studies on external coating of colonic...

  6. External costs of electricity

    International Nuclear Information System (INIS)

    Rabl, A.; Spadaro, J.V.

    2005-01-01

    This article presents a synthesis of the ExternE project (External costs of Energy) of the European community about the external costs of power generation. Pollution impacts are calculated using an 'impact pathways' analysis, i.e. an analysis of the emission - dispersion - dose-response function - cost evaluation chain. Results are presented for different fuel cycles (with several technological variants) with their confidence intervals. The environmental impact costs are particularly high for coal: for instance, in France, for coal-fired power plants it is of the same order as the electricity retail price. For natural gas, this cost is about a third of the one for coal. On the contrary, the environmental impact costs for nuclear and renewable energies are low, typically of few per cent of the electricity price. The main part of these costs corresponds to the sanitary impacts, in particular the untimely mortality. In order to avoid any controversy about the cost evaluation of mortality, the reduction of the expectation of life due to the different fuel cycles is also indicated and the risks linked with nuclear energy are presented using several comparisons. (J.S.)

  7. Environmental externalities related to power production on biogas and natural gas based on the EU ExternE methodology

    DEFF Research Database (Denmark)

    Nielsen, Per Sieverts; Ibsen, Liselotte Schleisner

    1998-01-01

    This paper assesses the environmental impacts and external costs from selected electricity generation systems in Denmark. The assessment is carried out as part of the ExternE National Implementation, which is the second phase of the ExternE project and involves case studies from all Western...... European countries. The project use a “bottom-up” methodology to evaluate the external costs associated with a wide range of different fuel cycles. The project has identified priority impacts, where most are impacts from air emissions. Externalities due to atmospheric emissions are calculated through...

  8. Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

    OpenAIRE

    Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

    2015-01-01

    Introduction: Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements.Methods: A redesigned clinical mentoring program ...

  9. The benefits of redesigning Benin's vaccine supply chain.

    Science.gov (United States)

    Brown, Shawn T; Schreiber, Benjamin; Cakouros, Brigid E; Wateska, Angela R; Dicko, Hamadou M; Connor, Diana L; Jaillard, Philippe; Mvundura, Mercy; Norman, Bryan A; Levin, Carol; Rajgopal, Jayant; Avella, Mélanie; Lebrun, Caroline; Claypool, Erin; Paul, Proma; Lee, Bruce Y

    2014-07-07

    New vaccine introductions have put strains on vaccine supply chains around the world. While increasing storage and transportation may be the most straightforward options, it is also important to consider what financial and operational benefits can be incurred. In 2012, suboptimal vaccine coverage and impending vaccine introductions prompted the Republic of Benin's Ministry of Health (MOH) to explore ways to improve their vaccine supply chain. Working alongside the Beninese MOH, we utilized our computational model, HERMES, to explore the impact on cost and vaccine availability of three possible options: (1) consolidating the Commune level to a Health Zone level, (2) removing the Commune level completely, and (3) removing the Commune level and expanding to 12 Department Stores. We also analyzed the impact of adding shipping loops during delivery. At baseline, new vaccine introductions without any changes to the current system increased the logistics cost per dose ($0.23 to $0.26) and dropped the vaccine availability to 71%. While implementing the Commune level removal scenario had the same capital costs as implementing the Health Zone scenario, the Health Zone scenario had lower operating costs. This increased to an overall cost savings of $504,255 when implementing shipping loops. The best redesign option proved to be the synergistic approach of converting to the Health Zone design and using shipping loops (serving ten Health Posts/loop). While a transition to either redesign or only adding shipping loops was beneficial, implementing a redesign option and shipping loops can yield both lower capital expenditures and operating costs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Process Evaluation to Explore Internal and External Validity of the "Act in Case of Depression" Care Program in Nursing Homes

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.F.J.

    2012-01-01

    Background: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): " Act in case of Depression" (AiD). Objective: Before effect analyses, to evaluate AiD

  11. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). OBJECTIVE: Before effect analyses, to evaluate AiD

  12. Hazard curve evaluation method development for a forest fire as an external hazard on nuclear power plants

    International Nuclear Information System (INIS)

    Okano, Yasushi; Yamano, Hidemasa

    2016-01-01

    A method to obtain a hazard curve of a forest fire was developed. The method has four steps: a logic tree formulation, a response surface evaluation, a Monte Carlo simulation, and an annual exceedance frequency calculation. The logic tree consists domains of 'forest fire breakout and spread conditions', 'weather conditions', 'vegetation conditions', and 'forest fire simulation conditions.' Condition parameters of the logic boxes are static if stable during a forest fire or not sensitive to a forest fire intensity, and non-static parameters are variables whose frequency/probability is given based on existing databases or evaluations. Response surfaces of a reaction intensity and a fireline intensity were prepared by interpolating outputs from a number of forest fire propagation simulations by fire area simulator (FARSITE). The Monte Carlo simulation was performed where one sample represented a set of variable parameters of the logic boxes and a corresponding intensity was evaluated from the response surface. The hazard curve, i.e. an annual exceedance frequency of the intensity, was therefore calculated from the histogram of the Monte Carlo simulation outputs. The new method was applied to evaluate hazard curves of a reaction intensity and a fireline intensity for a typical location around a sodium-cooled fast reactor in Japan. (author)

  13. Redesign av Escola forlag sine skoleordbøker

    OpenAIRE

    Heggen, Inger Helene

    2007-01-01

    Rapporten består av en litteraturstudie (med begrepsavklaringer og en gjennomgang av ordboktypografiens historie – med hovedvekt på engelsk ordboktypografi), en analyse av ettspråklige ordbøker i dag (både norske og engelske), og en analyse av Escola Forlags ordbøker (bokmål og nynorsk utgave). Til slutt – en demononstrasjon av min resulterende redesign av ordbøkene (omslag og innmat). Her har det vært særlig viktig å tydeliggjøre oppslagsordene og oppslagsordenes underelementer s...

  14. Redesign and modernization of radioactive waste administration systems in Ukraine

    Energy Technology Data Exchange (ETDEWEB)

    Nieder-Westermann, Gerald H.; Walther, Thorsten; Krone, Juergen [DBE Technology GmbH, Peine (Germany)

    2016-06-15

    The European Commission (EC) has undertaken a series of projects to render assistance to Ukraine in modernizing and redesigning the Ukrainian approach to the administration, management and ultimately disposal of all forms of radioactive waste, including waste associated with the Chornobyl accident as well as waste generated as part of the Ukrainian energy infrastructure and from industrial and medical applications. One of the most recently completed projects focused on modernizing Ukraine's management and administrative systems responsible for the disposal of radioactive waste.

  15. Redesign and modernization of radioactive waste administration systems in Ukraine

    International Nuclear Information System (INIS)

    Nieder-Westermann, Gerald H.; Walther, Thorsten; Krone, Juergen

    2016-01-01

    The European Commission (EC) has undertaken a series of projects to render assistance to Ukraine in modernizing and redesigning the Ukrainian approach to the administration, management and ultimately disposal of all forms of radioactive waste, including waste associated with the Chornobyl accident as well as waste generated as part of the Ukrainian energy infrastructure and from industrial and medical applications. One of the most recently completed projects focused on modernizing Ukraine's management and administrative systems responsible for the disposal of radioactive waste.

  16. Evaluation of the response of concurrent high dose rate intracavitary brachytherapy with external beam radiotherapy in management of early stage carcinoma cervix.

    Science.gov (United States)

    Patidar, Arvind Kumar; Kumar, H S; Walke, Rahul V; Hirapara, Pushpendra H; Jakhar, Shankar Lal; Bardia, M R

    2012-10-01

    To evaluate local disease control and early complications of concomitant brachytherapy with external beam-radiotherapy in early stage carcinoma cervix. Fifty patients of early stage carcinoma cervix (FIGO-IB/IIA) were randomly divided into study group concomitant external beam irradiation (EBRT) and HDR-ICBT (intra-cavitary brachytherapy, xrt = 50 Gy/25 Fr, HDR 5.2 Gy*5 Fr) and the control group EBRT followed by HDR-ICBT (xrt = 50 Gy/25 Fr, HDR 7.5 Gy*3 Fr). Acute reactions and local disease response were compared between treatment and at 6-month follow up. Median overall treatment times were 38 and 61 days in the study and the control groups, respectively. Acute skin reactions and diarrhea were more in the study but manageable. At the completion of the study, there were 80 and 68 % complete responses, 16 and 20 % partial responses, 0 and 8 % stable diseases in the study group and the control group, respectively. Response was better in the study group but statistically insignificant. Larger number of patients and longer follow up are required to arrive at concrete conclusion.

  17. The Cancer of the Prostate Risk Assessment (CAPRA) in patients treated with external beam radiation therapy: Evaluation and optimization in patients at higher risk of relapse

    International Nuclear Information System (INIS)

    Halverson, Schuyler; Schipper, Matthew; Blas, Kevin; Lee, Vivien; Sabolch, Aaron; Olson, Karin; Sandler, Howard M.; Feng, Felix Y.; Hamstra, Daniel A.

    2011-01-01

    Background: The Cancer of the Prostate Risk Assessment (CAPRA) was developed to predict freedom from biochemical failure (FFBF) following radical prostatectomy (RP). Its utility following external beam radiation therapy (EBRT) has not been externally evaluated. Methods: A retrospective study of 612 patients treated with dose-escalated EBRT at University of Michigan Medical Center. Results: Compared to the derivation cohort, EBRT treated patients had higher-risk disease (28% with CAPRA of 6–10 vs. 5%, respectively). A total of 114 patients (19%) had BF with 5-year BF ranging from 7% with CAPRA 0–3 to 35% with CAPRA 7–10. For RT patients the risk of BF at 5-year was similar to 4 surgical cohorts for CAPRA scores 0–2 but lower for all CAPRA scores ⩾ 3. The difference favoring RT increased with increasing CAPRA score reaching a 27–50% absolute improved at 5-years for CAPRA scores of 6–10. On multivariate analysis each CAPRA point increased the risk of BF (p < 0.0001) while Gleason pattern 5 in the biopsy also increased BF (p = 0.01) and long-term androgen deprivation therapy (ADT) significantly reduced the risk of BF (p = 0.015). Conclusions: Compared to surgical series the risk of BF was lower with dose-escalated EBRT with the greatest difference at the highest CAPRA scores.

  18. Radiographic evaluation of vessel count and density with quantitative magnetic resonance imaging during external breast expansion in Asian women: A prospective clinical trial.

    Science.gov (United States)

    Myung, Yujin; Kwon, Heeyeon; Pak, Changsik; Lee, Hobin; Jeong, Jae Hoon; Heo, Chan Yeong

    2016-12-01

    Breast augmentation with fat transfer does not bear the risks associated with silicone implantation. The method can potentially be especially useful in Asian women, who often reject augmentation mammoplasty with implants. This prospective clinical trial evaluated the effects of external breast expansion on breast density and vessel count using magnetic resonance imaging. Thirty-four enrolled patients were instructed to apply one of two devices, the conventional BRAVA device (used in the AESTES trial) or a novel external expansion device (EVERA) designed for Asian women, continuously for 8 h per day for 12 weeks. For external expansion, the pressure was set to 25 mmHg. Follow-up examinations were performed for 4 weeks after completion of the expansion. The ratio between the fibroglandular and adipose tissues of the breast was measured using T1-weighted MRI, and the number of vessels in the breast tissue was determined before and after the treatment by contrast MRI. Additionally, the volume of the breast was measured by laser scanning before, during, and after the device application. The obtained measurements were compared within and between the groups at different time points. Six patients dropped out, while 28 completed the trial without major side effects or adverse events. External expansion significantly increased breast vessel count in both the EVERA and AESTES groups (p = 0.019, p = 0.022). However, it did not significantly change breast density in either group (p = 0.186, p = 0.638). No significant intergroup differences were noted in vessel count (p = 0.874) or density (p = 0.482). Breast volume increases after 12 weeks of application were statistically significant in both groups, with mean changes of 81 ± 22 cc (AESTES) and 98 ± 30 cc (EVERA) (p Asian women. Level II, therapeutic study. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Technology Transfer External Metrics, Research, Success Stories, and Participation on Evaluation Team for the Reusable Launch Vehicle (RLV)

    Science.gov (United States)

    Trivoli, George W.

    1996-01-01

    This research report is divided into four sections. The first section is related to participation on the team that evaluated the proposals for the X-33 project and the Reusable Launch Vehicle (RLV) during mid-May; prior to beginning the 1996 Summer Faculty Fellowship. The second section discusses the various meetings attended related to the technology evaluation process. The third section is related to various research and evaluation activities engaged in by this researcher. The final section discusses several success stories this researcher aided in preparing. Despite the fact that this researcher is not an engineer or science faculty, invaluable knowledge and experience have been gained at MSFC. Although related to the previous summer's research, the research has been new, varied, and challenging. This researcher was fortunate to have had maximum interaction with NASA colleague, David Cockrell. It would be a privilege and honor to continue a relationship with the Technology Transfer Office. In addition, we will attempt to aid in the establishment of a continuous formalized relationship between MSFC and Jacksonville State University. Dr. David Watts, Vice President for Academic Affairs, J.S.U., is interested in having the Technology Division cooperating with MSFC in sharing information and working tech transfer inquiries. The principal benefits gained by this researcher include the opportunity to conduct research in a non-academic, real world environment. In addition, the opportunity to be involved in aiding with the decision process for the choice of the next generation of space transportation system was a once in a lifetime experience. This researcher has gained enhanced respect and understanding of MSFC/NASA staff and facilities.

  20. Costing analysis and anthropological assessment of the vaccine supply chain system redesign in the Comé District (Benin).

    Science.gov (United States)

    Huang, Xiao Xian; Guillermet, Elise; Le Gargasson, Jean-Bernard; Alfa, Daleb Abdoulaye; Gbodja, Romule; Sossou, Adanmavokin Justin; Jaillard, Phillippe

    2017-04-19

    At the end of 2013, a pilot experiment was carried out in Comé health zone (HZ) in an attempt to optimize the vaccine supply chain. Four commune vaccine storage facilities were replaced by one central HZ facility. This study evaluated the incremental financial needs for the establishment of the new system; compared the economic cost of the supply chain in the Comé HZ before and after the system redesign; and analyzed the changes induced by the pilot project in immunization logistics management. The purposive sampling method was used to draw a sample from 37 health facilities in the zone for costing evaluation. Data on inputs and prices were collected retrospectively for 2013 and 2014. The analysis used an ingredient-based approach. In addition, 44 semi-structured interviews with health workers for anthropological analysis were completed in 2014. The incremental financial costs amounted to US$55,148, including US$50,605 for upfront capital investment and US$4543 for ongoing recurrent costs. Annual economic cost per dose administered (including all vaccines distributed through the Expanded Program on Immunization (EPI)) in the Comé HZ increased from US$0.09 before system redesign to US$0.15 after implementation, mainly due to a high initial investment and the operational cost of HZ mobile warehouse. Interviews with health workers suggested that the redesigned system was associated with improvements in motivation and professional awareness due to training, supportive supervision, and improved work conditions. The system redesign involved a considerable investment at HZ level. Benefits were found in the reduction of transportation costs to health posts (HP) and commune health center (CHC) levels, and the strengthening of health workers professional skills at all levels in Comé. The redesigned system contributed to a decrease in funding needs at HP and CHC levels. The benefits of the investment need to be examined after the introduction of new vaccines and after a

  1. The ExternE project: methodology, objectives and limitations

    International Nuclear Information System (INIS)

    Rabl, A.; Spadaro, J.V.

    2002-01-01

    This paper presents a summary of recent studies on external costs of energy systems, in particular the ExternE (External Costs of Energy) Project of the European Commission. To evaluate the impact and damage cost of a pollutant, one needs to carry out an impact pathway analysis; this involves the calculation of increased pollutant concentrations in all affected regions due to an incremental emission (e.g. μg/m 3 of particles, using models of atmospheric dispersion and chemistry), followed by the calculation of physical impacts (e.g. number of cases of asthma due to these particles, using a dose-response function). The entire so-called fuel chain (or fuel cycle) is evaluated and compared on the basis of delivered end use energy. Even though the uncertainties are large, the results provide substantial evidence that the classical air pollutants (particles, NO x and SO x ) from the combustion of fossil fuels impose a heavy toll, in addition to the cost of global warming. The external costs are especially large for coal; even for 'good current technology' they may be comparable to the price of electricity. For natural gas the external costs are about a third to a half of coal. The external costs of nuclear are small compared to the price of electricity (at most a few %), and so are the external costs of most renewable energy systems. (authors)

  2. Does a grill menu redesign influence sales, nutrients purchased, and consumer acceptance in a worksite cafeteria?

    Science.gov (United States)

    Vadiveloo, Maya K; Malik, Vasanti S; Spiegelman, Donna; Willett, Walter C; Mattei, Josiemer

    2017-12-01

    Worksite cafeterias are compelling venues to improve diet quality through environmental changes. We conducted a pre-post study to evaluate how a cafeteria-initiated grill menu redesign influenced sales, revenue, and nutrient content of foods purchased. Secondly, we evaluated consumer opinions about menu changes to inform practices for worksite environment interventions. Monthly sales data (2012-2015) were used to compute gross sales and revenue of entrées and side dishes pre-post menu changes. Alternative protein sources replaced red meat; nutrient composition and nutrients purchased were compared using Food Pro software. Consumer responses were queried using online surveys; open-ended responses were analyzed using NVivo. Differences in sales and nutrient content pre-post menu redesign were tested with Wilcoxon Rank Sum tests. Gross sales of entrées (61 vs. 222 servings/month; p = 0.01) and side dishes (120 vs. 365 servings/month; p = 0.001) increased more than three-fold post-menu changes. Revenue from entrées (312 vs. 1144 USD/month; p = 0.01) and side dishes (238 vs. 914 USD/month; p = 0.001) also increased; per entrée, consumers purchased significantly more unsaturated fat (5 g), and less saturated fat (3 g) and sodium (100 mg). For side dishes, they purchased fewer calories (48 kcal) and unsaturated fat (2.9 g), but more fiber (1.8 g), and sodium (260 mg). Four themes emerged from consumer responses: the importance of 1) variety, novelty, choice; 2) cost, affordability, value; 3) health; and 4) food quality, taste. Menu redesign can improve nutrient content, while also increasing sales and revenue. Multi-dimensional assessment of the nutritional, consumer, and retailer implications is desirable practice for enacting similar environmental changes.

  3. Data processing for the evaluation of the thickness of protective barriers : Case of radiology rooms and external beam radiotherapy

    International Nuclear Information System (INIS)

    RANDRIANANTOANDRO, R.G.G.

    2004-01-01

    The regulation requires that the legal persons who have an intention to use radiation sources shall submit a notification to the Regulatory Authority of such an intention, which shall take the form of a licence or an authorization. The documents of radiological safety including design, construction, clinical utilisation...are attached to this notification. This work intends to assess the thickness of protection barrier and to suggest a facility design in radiology and in radiotherapy which comply with the safety standards. Because the steps of the thickness evaluation require a lot of calculation and abacs, the computer is used for this processing with Visual Basic. [fr

  4. Redesign of a supply network by considering stochastic demand

    Directory of Open Access Journals (Sweden)

    Juan Camilo Paz

    2015-09-01

    Full Text Available This paper presents the problem of redesigning a supply network of large scale by considering variability of the demand. The central problematic takes root in determining strategic decisions of closing and adjusting of capacity of some network echelons and the tactical decisions concerning to the distribution channels used for transporting products. We have formulated a deterministic Mixed Integer Linear Programming Model (MILP and a stochastic MILP model (SMILP whose objective functions are the maximization of the EBITDA (Earnings before Interest, Taxes, Depreciation and Amortization. The decisions of Network Design on stochastic model as capacities, number of warehouses in operation, material and product flows between echelons, are determined in a single stage by defining an objective function that penalizes unsatisfied demand and surplus of demand due to demand changes. The solution strategy adopted for the stochastic model is a scheme denominated as Sample Average Approximation (SAA. The model is based on the case of a Colombian company dedicated to production and marketing of foodstuffs and supplies for the bakery industry. The results show that the proposed methodology was a solid reference for decision support regarding to the supply networks redesign by considering the expected economic contribution of products and variability of the demand.

  5. Digital prototyping technique applied for redesigning plastic products

    Science.gov (United States)

    Pop, A.; Andrei, A.

    2015-11-01

    After products are on the market for some time, they often need to be redesigned to meet new market requirements. New products are generally derived from similar but outdated products. Redesigning a product is an important part of the production and development process. The purpose of this paper is to show that using modern technology, like Digital Prototyping in industry is an effective way to produce new products. This paper tries to demonstrate and highlight the effectiveness of the concept of Digital Prototyping, both to reduce the design time of a new product, but also the costs required for implementing this step. The results of this paper show that using Digital Prototyping techniques in designing a new product from an existing one available on the market mould offers a significantly manufacturing time and cost reduction. The ability to simulate and test a new product with modern CAD-CAM programs in all aspects of production (designing of the 3D model, simulation of the structural resistance, analysis of the injection process and beautification) offers a helpful tool for engineers. The whole process can be realised by one skilled engineer very fast and effective.

  6. BEPS redesign of 168 commercial buildings: summary report

    Energy Technology Data Exchange (ETDEWEB)

    Stoops, J.L.; Deringer, J.J.; Moreno, S.; Misuriello, H.P.

    1984-05-01

    The objective of this report is to present, in usable form, summary data from the Building Energy Performance Standards (BEPS) Phase II commercial buildings energy research conducted in 1978-1979. Summary data presented were obtained from two major research efforts: the BEPS Phase II Redesign experiment; and the related research on ASHRAE Standard 90-75R. The bulk of this report consists of data tabulations of key energy parameters for the 168 sample buildings, which were tabulated from computer-stored files of the 1978-1979 data. Two kinds of tabulations are included: numerical tabulations that extracted information from the computer-stored data base for the 168 sample buildings; and graphic presentations of the computer-generated data, plus data extracted from other sources. The intent is to provide a single data compendium of key energy-related factors from the 1978 redesign experiment and the associated 1978-1979 ASHRAE Standard 90-75R research. This report also supplements the information for which there was not space in the magazine articles. Thus, for some building types, additional analysis, comments, and data tabulations are included that could not be included in the articles because space was limited. These additional analysis items are not consistent across building types because both the energy conservation opportunities and the design strategies applied by the building designers varied considerably by building type. The chapters have been entered individually into EDB and ERA.

  7. Five Key Leadership Actions Needed to Redesign Family Medicine Residencies.

    Science.gov (United States)

    Kozakowski, Stanley M; Eiff, M Patrice; Green, Larry A; Pugno, Perry A; Waller, Elaine; Jones, Samuel M; Fetter, Gerald; Carney, Patricia A

    2015-06-01

    New skills are needed to properly prepare the next generation of physicians and health professionals to practice in medical homes. Transforming residency training to address these new skills requires strong leadership. We sought to increase the understanding of leadership skills useful in residency programs that plan to undertake meaningful change. The Preparing the Personal Physician for Practice (P4) project (2007-2014) was a comparative case study of 14 family medicine residencies that engaged in innovative training redesign, including altering the scope, content, sequence, length, and location of training to align resident education with requirements of the patient-centered medical home. In 2012, each P4 residency team submitted a final summary report of innovations implemented, overall insights, and dissemination activities during the study. Six investigators conducted independent narrative analyses of these reports. A consensus meeting held in September 2012 was used to identify key leadership actions associated with successful educational redesign. Five leadership actions were associated with successful implementation of innovations and residency transformation: (1) manage change; (2) develop financial acumen; (3) adapt best evidence educational strategies to the local environment; (4) create and sustain a vision that engages stakeholders; and (5) demonstrate courage and resilience. Residency programs are expected to change to better prepare their graduates for a changing delivery system. Insights about effective leadership skills can provide guidance for faculty to develop the skills needed to face practical realities while guiding transformation.

  8. External evaluation on Monju Core Confirmation Test in FY 2010 (the Technical Committee on Monju Research Utilization)

    International Nuclear Information System (INIS)

    2011-06-01

    This report describes the review made by the 'Technical Committee on Monju Research Utilization' on the results of Core Confirmation Test conducted from May to July in 2010. The committee consists of technical specialists in the relevant engineering domains from various Japanese industries and universities. The Committee was convened twice in 2010, in August and December, where the each item of the Core Confirmation Test was explained by individual personnel in charge, and the outline and the detailed analysis were discussed, respectively. Evaluations were made by the Committee after the questions and answers. Main points of the evaluations are listed below: After the 14 year stand-by, the Core Confirmation Test has been successfully completed within a brief duration of 3 months, with provision of precious technical data for future development and commercialization of FBRs. Safety has been confirmed and valuable data for analysis code validation have been acquired on an FBR core containing 1.5%wt of Am-241. It is significant that the newly released nuclear data library, JENDL-4.0 has been validated based on studies of capture cross section of Am-241 and of fission cross section of Pu-239. Finally, the chief examiner of the Committee stated his expectation for advancement of Japanese FBR technologies with the JAEA's leadership based of achievements on Monju, to be reflected on subsequent FBR developments. (author)

  9. Individual external monitoring system for gamma and X ray evaluation of the individual dose equivalent 'HP(10)', utilizing a photographic dosimetry technique

    International Nuclear Information System (INIS)

    Santoro, Christiana; Filho, Joao Antonio

    2008-01-01

    Full text: Individual monitoring evaluates external sources of ionizing radiation X, γ, β and n, to which workers are occupationally exposed, for ensuring safe and acceptable radiological conditions in their places of employment. The dose received by workers should attend the limits authorized by national regulatory organs. Nowadays, there are two radiometric unit systems, based on resolutions of the National Nuclear Energy Commission (NNEC) and the International Commission on Radiation Units and Measurements (ICRU); in the conventional (NNEC) system, the doses received by workers are evaluated through the individual dose H x , where dosemeters used on surface of thorax are calibrated in terms of air kerma; in the recent system (ICRU), the doses are evaluated through the individual dose equivalent H P (d), where dosemeters are calibrated in terms of dose from phantom. The recent system improves the method of evaluation, by taking into account the scattering effect and absorption of radiation in the human body. This work adapts a photographic dosimetry service to the recent ICRU publications, for evaluation of individual monitoring, in function of the individual dose equivalent H P (10) of strong penetrating radiation. For this, a methodology based on linear programming and determination of calibration curves is used for radiation capacities, wide (W) and narrow (N) spectra, as described by the International Organization for Standardization (ISO 4037-1, 1995). These calibration curves offer better accuracy in the determination of doses and energy, which will improve the quality of the service given to society. The results show that the values of individual dose equivalent, evaluated at intervals of 0.2 to 200 mSv, have lower significant uncertainties (10%) than those recommended by the ICRP 75, for individual monitoring; therefore, the evaluation system for developed doses attends the new recommendations proposed by International Commissions. From what has been

  10. Re-Design and Beat Testing of the Man-Machine Integration Design and Analysis System: MIDAS

    Science.gov (United States)

    Shively, R. Jay; Rutkowski, Michael (Technical Monitor)

    1999-01-01

    The Man-machine Design and Analysis System (MIDAS) is a human factors design and analysis system that combines human cognitive models with 3D CAD models and rapid prototyping and simulation techniques. MIDAS allows designers to ask 'what if' types of questions early in concept exploration and development prior to actual hardware development. The system outputs predictions of operator workload, situational awareness and system performance as well as graphical visualization of the cockpit designs interacting with models of the human in a mission scenario. Recently, MIDAS was re-designed to enhance functionality and usability. The goals driving the redesign include more efficient processing, GUI interface, advances in the memory structures, implementation of external vision models and audition. These changes were detailed in an earlier paper. Two Beta test sites with diverse applications have been chosen. One Beta test site is investigating the development of a new airframe and its interaction with the air traffic management system. The second Beta test effort will investigate 3D auditory cueing in conjunction with traditional visual cueing strategies including panel-mounted and heads-up displays. The progress and lessons learned on each of these projects will be discussed.

  11. Medipix3RX: Characterizing the Medipix3 Redesign With Synchrotron Radiation

    CERN Document Server

    Gimenez, Eva N; Blaj, Gabriel; Campbell, Michael; Dolbnya, Igor; Frodjh, Erik; Horswell, Ian; Llopart, Xavier; Marchal, Julien; McGrath, John; Omar, David; Plackett, Richard; Sawhney, Kawal; Tartoni, Nicola

    2015-01-01

    The Medipix3RX is the latest version of the Medipix3 photon counting ASICs, which implements two new operational modes, with respect to the Medipix2 ASIC, aimed at eliminating charge shared events (referred to as Charge Summing Mode (CSM)) and at providing spectroscopic information (referred to as Colour Mode (CM)). The Medipix3RX is a redesign of the Medipix3v0 ASIC and corrects for the underperformance of CSM features observed in the previous version. This paper presents the results from synchrotron X-rays tests to evaluate the Medipix3RX ASIC performance. The newly implemented CSM algorithm eliminates the charge sharing effect at the same time as allocating the event to the readout pixel corresponding to the sensor pixel where the X-ray photon impinged. The new pixel trimming circuit led to a reduced dispersion between pixels. Further results of the linearity for all the gain modes, energy resolution and pixel uniformity are also presented.

  12. Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error.

    Science.gov (United States)

    Raab, Stephen S; Grzybicki, Dana Marie; Sudilovsky, Daniel; Balassanian, Ronald; Janosky, Janine E; Vrbin, Colleen M

    2006-10-01

    Our objective was to determine whether the Toyota Production System process redesign resulted in diagnostic error reduction for patients who underwent cytologic evaluation of thyroid nodules. In this longitudinal, nonconcurrent cohort study, we compared the diagnostic error frequency of a thyroid aspiration service before and after implementation of error reduction initiatives consisting of adoption of a standardized diagnostic terminology scheme and an immediate interpretation service. A total of 2,424 patients underwent aspiration. Following terminology standardization, the false-negative rate decreased from 41.8% to 19.1% (P = .006), the specimen nondiagnostic rate increased from 5.8% to 19.8% (P Toyota process change led to significantly fewer diagnostic errors for patients who underwent thyroid fine-needle aspiration.

  13. Numerical and theoretical evaluations of AC losses for single and infinite numbers of superconductor strips with direct and alternating transport currents in external AC magnetic field

    Science.gov (United States)

    Kajikawa, K.; Funaki, K.; Shikimachi, K.; Hirano, N.; Nagaya, S.

    2010-11-01

    AC losses in a superconductor strip are numerically evaluated by means of a finite element method formulated with a current vector potential. The expressions of AC losses in an infinite slab that corresponds to a simple model of infinitely stacked strips are also derived theoretically. It is assumed that the voltage-current characteristics of the superconductors are represented by Bean's critical state model. The typical operation pattern of a Superconducting Magnetic Energy Storage (SMES) coil with direct and alternating transport currents in an external AC magnetic field is taken into account as the electromagnetic environment for both the single strip and the infinite slab. By using the obtained results of AC losses, the influences of the transport currents on the total losses are discussed quantitatively.

  14. Validation and evaluation of measuring methods for the 3D documentation of external injuries in the field of forensic medicine.

    Science.gov (United States)

    Buck, Ursula; Buße, Kirsten; Campana, Lorenzo; Schyma, Christian

    2018-03-01

    Three-dimensional (3D) measurement techniques are gaining importance in many areas. The latest developments brought more cost-effective, user-friendly, and faster technologies onto the market. Which 3D techniques are suitable in the field of forensic medicine and what are their advantages and disadvantages? This wide-ranging study evaluated and validated various 3D measurement techniques for the forensic requirements. High-tech methods as well as low-budget systems have been tested and compared in terms of accuracy, ease of use, expenditure of time, mobility, cost, necessary knowhow, and their limitations. Within this study, various commercial measuring systems of the different techniques were tested. Based on the first results, one measuring system was selected for each technique, which appeared to be the most suitable for the forensic application or is already established in forensic medicine. A body of a deceased, a face and an injury of a living person, and a shoe sole were recorded by 11 people with different professions and previous knowledge using the selected systems. The results were assessed and the personal experiences were evaluated using a questionnaire. In addition, precision investigations were carried out using test objects. The study shows that the hand-held scanner and photogrammetry are very suitable for the 3D documentation of forensic medical findings. Their moderate acquisition costs and easy operation could lead to more frequent application in forensic medicine in the future. For special applications, the stripe-light scanner still has its justification due to its high precision, the flexible application area, and the high reliability. The results show that, thanks to the technological advances, the 3D measurement technology will have more and more impact on the routine of the forensic medical examination.

  15. External quality assessment in the voluntary counseling and testing centers in the Brazilian Amazon using dried tube specimens: results of an effectiveness evaluation

    Directory of Open Access Journals (Sweden)

    Andréa Mônica Brandão Beber

    2015-06-01

    Full Text Available INTRODUCTION : In 2011, the Brazilian Ministry of Health rolled out a program for the external quality assessment of rapid human immunodeficiency virus (HIV tests using the dried tube specimen (DTS method (EQA-RT/DTS-HIV. Our objective was to evaluate the implementation of this program at 71 voluntary counseling and testing centers (VCTCs in the Brazilian Legal Amazonian area one year after its introduction. METHODS : Quantitative and qualitative study that analyzed secondary data and interviews with healthcare workers (HCWs (n=39 and VCTC coordinators (n=32 were performed. The assessment used 18 key indicators to evaluate the three dimensions of the program's logical framework: structure, process, and result. Each indicator was scored from 1-4, and the aggregate results corresponding to the dimensions were expressed as proportions. The results were compared to the perceptions of the HCWs and coordinators regarding the EQA-RT/DTS-HIV program. RESULTS: The aggregate scores for the three dimensions of structure, process, and result were 91.7%, 78.6%, and 95%, respectively. The lowest score in each dimension corresponded to a different indicator: access to Quali-TR online system 39% (structure, registration in Quali-TR online system 38.7% (process, and VCTC completed the full process in the program's first round 63.4% (result. Approximately 36% of the HCWs and 52% of the coordinators reported enhanced trust in the program for its rapid HIV testing performance. CONCLUSIONS: All three program dimensions exhibited satisfactory results (>75%. Nevertheless, the study findings highlight the need to improve certain program components. Additionally, long-term follow-ups is needed to provide a more thorough picture of the process for external quality assessment.

  16. Evaluation of the Efficacy and Tolerability of Oral Ciprofloxacin used in the Comprehensive Treatment of External Bacterial Otitis: An Observational Prospective Study.

    Science.gov (United States)

    Gurov, Alexander Vladimirovich; Kriukov, Andrey Ivanovich; Kunelskaya, Vera Yakovlevna; Isotova, Galina Nikolaevna; Shadrin, Georgiy Borisovich; Luchsheva, Yuliya Vladislavovna; Yakimov, Vladislav Olegovich; Garg, Amit; Akku, Shyam Prasad; Gupta, Namita

    2017-10-01

    Introduction  Otitis Externa is common ear infection with a prevalence of 1%. Objective  The objective of this study is to evaluate the clinical and microbiological efficacy and safety profile with oral ciprofloxacin in the external bacterial otitis (EBO) management. Methods  This is a prospective observational study conducted with EBO outpatients referred to the otorhinolaryngology center in Moscow between March and August 2013. Our study included patients from two cohorts, acute external bacterial otitis (AEBO) - Group 1 - and exacerbation of chronic otitis externa (CEBO) - Group 2. We administered Ciprofloxacin 500 mg twice daily with standard topical EBO treatment for up to 10 days. Patients underwent evaluation on study visit days 1, 3, 5, and 10 for the severity. Bacteriological examination of ear canal cultures took place on Day 1 and Day 10. Results  We collected data from 60 EBO outpatients (AEBO: N  = 30 and CEBO: N  = 30). Swimming was the major risk factor associated with the disease in addition to the most common pathogenic organisms - Staphylococcus aureus and Pseudomonas aeruginosa . was We attained complete resolution of the inflammatory process in 28 (93%) and 27 (90%) patients in the AEBO and CEBO group, respectively. We confirmed this by microbiological test with almost complete eradication of the causative organisms. Overall, we observed good positive dynamics of ear canal with no major side effects. Conclusion  We found that Ciprofloxacin 500 mg, when administered orally twice daily for 7 to 10 days in otitis externa patients is clinically and microbiologically effective and comparatively safer than other antimicrobials.

  17. Consistent Set of Experiments from ICSBEP Handbook for Evaluation of Criticality Calculation Prediction of Apparatus of External Fuel Cycle with Different Fuel

    Energy Technology Data Exchange (ETDEWEB)

    Golovko, Yury E. [FSUE ' SSC RF-IPPE' , 249033, Bondarenko Square 1, Obninsk (Russian Federation)

    2008-07-01

    Experiments with plutonium, low enriched uranium and uranium-233 from the ICSBEP1 Handbook are being considered in this paper. Among these experiments it was selected only those, which seem to be the most relevant to the evaluation of uncertainty of critical mass of mixtures of plutonium or low enriched uranium or uranium-233 with light water. All selected experiments were examined and covariance matrices of criticality uncertainties were developed along with some uncertainties were revised. Statistical analysis of these experiments was performed and some contradictions were discovered and eliminated. Evaluation of accuracy of prediction of criticality calculations was performed using the internally consistent set of experiments with plutonium, low enriched uranium and uranium-233 remained after the statistical analyses. The application objects for the evaluation of calculational prediction of criticality were water-reflected spherical systems of homogeneous aqueous mixtures of plutonium or low enriched uranium or uranium-233 of different concentrations which are simplified models of apparatus of external fuel cycle. It is shows that the procedure allows to considerably reduce uncertainty in k{sub eff} caused by the uncertainties in neutron cross-sections. Also it is shows that the results are practically independent of initial covariance matrices of nuclear data uncertainties. (authors)

  18. Patients-people-place: developing a framework for researching organizational culture during health service redesign and change.

    Science.gov (United States)

    Gale, Nicola K; Shapiro, Jonathan; McLeod, Hugh S T; Redwood, Sabi; Hewison, Alistair

    2014-08-20

    Organizational culture is considered by policy-makers, clinicians, health service managers and researchers to be a crucial mediator in the success of implementing health service redesign. It is a challenge to find a method to capture cultural issues that is both theoretically robust and meaningful to those working in the organizations concerned. As part of a comparative study of service redesign in three acute hospital organizations in England, UK, a framework for collecting data reflective of culture was developed that was informed by previous work in the field and social and cultural theory. As part of a larger mixed method comparative case study of hospital service redesign, informed by realist evaluation, the authors developed a framework for researching organisational culture during health service redesign and change. This article documents the development of the model, which involved an iterative process of data analysis, critical interdisciplinary discussion in the research team, and feedback from staff in the partner organisations. Data from semi-structured interviews with 77 key informants are used to illustrate the model. In workshops with NHS partners to share and debate the early findings of the study, organizational culture was identified as a key concept to explore because it was perceived to underpin the whole redesign process. The Patients-People-Place framework for studying culture focuses on three thematic areas ('domains') and three levels of culture in which the data could be organised. The framework can be used to help explain the relationship between observable behaviours and cultural artefacts, the values and habits of social actors and the basic assumptions underpinning an organization's culture in each domain. This paper makes a methodological contribution to the study of culture in health care organizations. It offers guidance and a practical approach to investigating the inherently complex phenomenon of culture in hospital organizations

  19. Evaluation of 222Rn concentration of the internal and external environments of residences at Monte Alegre municipality, Para, Brazil

    International Nuclear Information System (INIS)

    Melo, Vicente de Paula

    1999-01-01

    The human being is constantly exposed to the natural radioactivity in the environment where he lives. This radioactivity comes mainly from materials present in the terrestrial crust that possess in their constitution chemical elements belonging to the radioactive families of uranium and thorium. The use of such materials for the construction of houses constitutes an important exposure form to the natural radiation, above all to the radioactive gas 222 Rn, that it is exhaled from them. The Brazilian soil is composed, among other, of minerals that contain appreciable concentrations of these elements. The inhabitants of Monte Alegre town in Para, located at 2 deg 00' 24,9 'S ; 54 deg 04 ' 13,5 W , used in the construction of their houses stones obtained from an area 20 km distant of Monte Alegre, denominated Ingles de Souza, located at 01 deg 56' 4 0,1 S; 54 deg 12 149,7 W, where a small residential village, denominated National Agricultural Colony of Para (CANP), is located. The objective of this work was to evaluate the indoor concentration of 222 Rn in the residences of Monte Alegre and CANP. Determinations of the 238 U and 226 Ra concentrations, measurements of the radon flux in samples of stones and soils of the two regions, as well as measurements to the gamma dose close of the soil and inside the residences, were also carried out. The average results of the radon concentration in the air of the investigated residences did not exceed the limits of 200 Bq. m 3 (action level) and 600 Bq. m 3 (intervention level) recommended by the International Commission on Radiological Protection (ICRP). The concentrations of natural radionuclides and the radon flux determined at the village showed values 17 times higher than those found at the urban area of Monte Alegre, while the average indoor gamma dose rate in the village residences was 0.86 mSv/a. (author)

  20. 77 FR 73575 - Approval and Promulgation of Air Quality Implementation Plans; West Virginia; Redesignation of...

    Science.gov (United States)

    2012-12-11

    ...) (supplemented at 57 FR 18070, April 28, 1992) and has provided further guidance on processing redesignation requests in the following documents: 1. ``Procedures for Processing Requests to Redesignate Areas to... interpolation between VISTAS/ASIP 2012 and 2018 modeling inventory. The 2022 EGU inventory for PM 2.5 , NO X...

  1. Learning to Redesign Teacher Education: A Conceptual Framework to Support Program Change

    Science.gov (United States)

    Anagnostopoulos, Dorothea; Levine, Thomas; Roselle, Rene; Lombardi, Allison

    2018-01-01

    University-based teacher education faces intensifying pressure to prove its effectiveness. This has prompted renewed interest in program redesign. In this article, we argue that enacting meaningful redesign requires university-based teacher educators to learn new ways of thinking and acting not only with teacher candidates but also with their…

  2. An evolutionary approach for business process redesign : towards an intelligent system

    NARCIS (Netherlands)

    Netjes, M.; Limam Mansar, S.; Reijers, H.A.; Aalst, van der W.M.P.; Cardoso, J.; Cordeiro, J.; Filipe, J.

    2007-01-01

    Although extensive literature on BPR is available, there is still a lack of concrete guidance on actually changing processes for the better. It is our goal to provide a redesign approach which describes and supports the steps to derive from an existing process a better performing redesign. In this

  3. Outsourcing of Corporate Information Services: Implications for Redesigning Corporate Library Services.

    Science.gov (United States)

    Agada, John

    1996-01-01

    Examines the trend in outsourcing information services and suggests it threatens the survival of corporate libraries. Topics include changes in the competitive corporate environment; characteristics of outsourceable services; managing change; redesigning the corporate librarian's role; and implications for redesigning corporate information…

  4. 76 FR 76302 - Approval and Promulgation of Air Quality Implementation Plans; Indiana; Redesignation of Lake and...

    Science.gov (United States)

    2011-12-07

    ...] Approval and Promulgation of Air Quality Implementation Plans; Indiana; Redesignation of Lake and Porter...). ACTION: Final rule. SUMMARY: EPA is taking several related actions affecting Lake and Porter Counties and... redesignation of Lake and Porter Counties to attainment of the 1997 annual PM 2.5 standard. EPA is approving, as...

  5. Redesigning Schools to Raise Achievement. Where We Stand. Item Number 39-0232

    Science.gov (United States)

    American Federation of Teachers, 2006

    2006-01-01

    This document contains resolution text adopted by the American Federation of Teachers (AFT) in July 1998 regarding Redesigning Low-Performing Schools. A Question & Answer section follows the resolution, addressing the following issues: (1) Union support for redesign or closure of low-performing schools; (2) Indicators of low-performing schools…

  6. SU-E-T-403: Evaluation of the Beam Performance of a Varian TrueBeam Linear Accelerator Under External Device-Based Gated Delivery Conditions

    International Nuclear Information System (INIS)

    Kobulnicky, K; Pawlak, D; Purwar, A

    2015-01-01

    Purpose: To examine the beam performance of a Varian TrueBeam linear accelerator under external device-based gated delivery conditions. Methods: Six gating cycles were used to evaluate the gating performance of a standard production TrueBeam system that was not specially tuned in any way. The system was equipped with a factory installed external gating interface (EXGI). An in-house EXGI tester box was used to simulate the input gating signals. The gating cycles were selected based on long beam-on and short beam-off times, short beam-on and long beam-off times, or equal beam on and off times to check linac performance. The beam latencies were measured as the time difference between the logic high gating signal and the first or last target pulses with an oscilloscope. Tissue-Phantom Ratio, beam flatness, and dose distributions from 5 different plans were measured using the 6 different gating durations and the un-gated irradiation. A PTW 729 2-D array was used to compare 5 plans versus the un-gated delivery with a 1%/1mm gamma index passing criteria. Results: The beam latencies of the linac were based off of 20 samples for beam-on and beam-off, for each gating cycle. The average beam-on delays were measured to be between 57 and 66msec, with a maximum of 88 msec. The beam off latencies averaged between 19 and 26msec, with a maximum of 48 msec. TPR20,10 measurements showed beam energy stability within 0.5% of the un-gated delivery. Beam flatness was better than 2.5% for all gated cycles. All but two deliveries, the open field with 4 seconds on, 1 second off, and a five field IMRT plan with 0.5 seconds on, 2.5 seconds off, had >90% passing rate. Conclusion: TrueBeam demonstrates excellent beam stability with minimal beam latencies under external device-based gated operations. Dosimetric measurements show minimal variation in beam energy, flatness, and plan delivery. Authors are employees of Varian Medical Systems, Inc

  7. SU-E-T-403: Evaluation of the Beam Performance of a Varian TrueBeam Linear Accelerator Under External Device-Based Gated Delivery Conditions

    Energy Technology Data Exchange (ETDEWEB)

    Kobulnicky, K; Pawlak, D; Purwar, A [Varian Medical Systems, Inc., Palo Alto, CA (United States)

    2015-06-15

    Purpose: To examine the beam performance of a Varian TrueBeam linear accelerator under external device-based gated delivery conditions. Methods: Six gating cycles were used to evaluate the gating performance of a standard production TrueBeam system that was not specially tuned in any way. The system was equipped with a factory installed external gating interface (EXGI). An in-house EXGI tester box was used to simulate the input gating signals. The gating cycles were selected based on long beam-on and short beam-off times, short beam-on and long beam-off times, or equal beam on and off times to check linac performance. The beam latencies were measured as the time difference between the logic high gating signal and the first or last target pulses with an oscilloscope. Tissue-Phantom Ratio, beam flatness, and dose distributions from 5 different plans were measured using the 6 different gating durations and the un-gated irradiation. A PTW 729 2-D array was used to compare 5 plans versus the un-gated delivery with a 1%/1mm gamma index passing criteria. Results: The beam latencies of the linac were based off of 20 samples for beam-on and beam-off, for each gating cycle. The average beam-on delays were measured to be between 57 and 66msec, with a maximum of 88 msec. The beam off latencies averaged between 19 and 26msec, with a maximum of 48 msec. TPR20,10 measurements showed beam energy stability within 0.5% of the un-gated delivery. Beam flatness was better than 2.5% for all gated cycles. All but two deliveries, the open field with 4 seconds on, 1 second off, and a five field IMRT plan with 0.5 seconds on, 2.5 seconds off, had >90% passing rate. Conclusion: TrueBeam demonstrates excellent beam stability with minimal beam latencies under external device-based gated operations. Dosimetric measurements show minimal variation in beam energy, flatness, and plan delivery. Authors are employees of Varian Medical Systems, Inc.

  8. Redesigning a Flexible Material Master Data Application with Language Dependency

    Directory of Open Access Journals (Sweden)

    Mihaela Muntean

    2016-06-01

    Full Text Available Based on some inconveniences identified within a material master data application of theSAP MM module, the current paper proposes an alternative technical solution for designing thepopup layout screen of the material master data application with respect to language dependency.The application should present the text of all tabs, areas and fields in the desired language based onthe user logon preferences. Also it has been implemented a possibility to sort the data in the desiredorder, so the customer isn’t forced, as before, to search for a certain field, when updating certainmaterials. The proposed solution suggests the use of five database tables, combined within threemaintenance views, which build a view cluster. The advantage of the redesigned application consistsof easier maintainability of the data (fields, areas and tabs can be easily added, deleted, reorderedand renamed and all the data within the view cluster can be translated into any language supportedby the system.

  9. Redesign of CERN LINAC3 RFQ for Lead 29+

    CERN Document Server

    Benedetti, Stefano; Lallement, Jean-Baptiste; Lombardi, Alessandra; CERN. Geneva. ATS Department

    2018-01-01

    CERN Linac3 is at the heart of the CERN Heavy Ion Facility, providing 4.2 MeV/u ion beams to the Low Energy Ion Ring (LEIR). It mostly accelerates 208Pb29+, though in recent years runs were performed with 40Ar11+ and 129Xe22+, in view of the raising interest of the physics community towards lighter ions experiments. In the framework of the LHC Injectors Upgrade (LIU) project, measurements and beam dynamics simulations showed that a transmission bottleneck of Linac3 is represented by the RFQ. As this accelerator was originally designed for 208Pb25+, the lower beam rigidity of the heavy ions currently in used – and planned to be used – permits a redesign of the RFQ aimed at increasing its transverse acceptance, and thus the transmitted beam current. The methodology adopted and the results of this study are presented.

  10. A simulated annealing approach for redesigning a warehouse network problem

    Science.gov (United States)

    Khairuddin, Rozieana; Marlizawati Zainuddin, Zaitul; Jiun, Gan Jia

    2017-09-01

    Now a day, several companies consider downsizing their distribution networks in ways that involve consolidation or phase-out of some of their current warehousing facilities due to the increasing competition, mounting cost pressure and taking advantage on the economies of scale. Consequently, the changes on economic situation after a certain period of time require an adjustment on the network model in order to get the optimal cost under the current economic conditions. This paper aimed to develop a mixed-integer linear programming model for a two-echelon warehouse network redesign problem with capacitated plant and uncapacitated warehouses. The main contribution of this study is considering capacity constraint for existing warehouses. A Simulated Annealing algorithm is proposed to tackle with the proposed model. The numerical solution showed the model and method of solution proposed was practical.

  11. Implementing Business Process Redesign: early lessons from the Australian experience

    Directory of Open Access Journals (Sweden)

    Marianne Broadbent

    1995-05-01

    Full Text Available Business Process Redesign (BPR is a change management approach aimed at achieving quantum improvements in business performance. Industry interest levels in BPR are high as a direct result of current difficulties in the global economic climate and tight business conditions. Integral to BPR is the availability of new stable technologies which both stimulate and enable process changes. This paper highlights the experiences of a number of Australian firms which have implemented BPR. A ten step framework for BPR is presented together with a series of caveats. BPR is a difficult, messy and often non-linear activity which challenges many of the ways organisations operate. Information Technology plays a pivotal role in BPR as both an enabler and disenabler for change. Lessons emerging from early Australian experiences with BPR focus on the role of executive sponsorship, consultants, measurements, education and training, technology and people involved in the change process.

  12. A Journey to Improved Inpatient Glycemic Control by Redesigning Meal Delivery and Insulin Administration.

    Science.gov (United States)

    Engle, Martha; Ferguson, Allison; Fields, Willa

    2016-01-01

    The purpose of this quality improvement project was to redesign a hospital meal delivery process in order to shorten the time between blood glucose monitoring and corresponding insulin administration and improve glycemic control. This process change redesigned the workflow of the dietary and nursing departments. Modifications included nursing, rather than dietary, delivering meal trays to patients receiving insulin. Dietary marked the appropriate meal trays and phoned each unit prior to arrival on the unit. The process change was trialed on 2 acute care units prior to implementation hospital wide. Elapsed time between blood glucose monitoring and insulin administration was analyzed before and after process change as well as evaluation of glucometrics: percentage of patients with blood glucose between 70 and 180 mg/dL (percent perfect), blood glucose greater than 300 mg/dL (extreme hyperglycemia), and blood glucose less than 70 mg/dL (hypoglycemia). Percent perfect glucose results improved from 45% to 53%, extreme hyperglycemia (blood glucose >300 mg/dL) fell from 11.7% to 5%. Hypoglycemia demonstrated a downward trend line, demonstrating that with improving glycemic control hypoglycemia rates did not increase. Percentage of patients receiving meal insulin within 30 minutes of blood glucose check increased from 35% to 73%. In the hospital, numerous obstacles were present that interfered with on-time meal insulin delivery. Establishing a meal delivery process with the nurse performing the premeal blood glucose check, delivering the meal, and administering the insulin improves overall blood glucose control. Nurse-led process improvement of blood glucose monitoring, meal tray delivery, and insulin administration does lead to improved glycemic control for the inpatient population.

  13. Hubble Space Telescope EVA Power Ratchet Tool redesign

    Science.gov (United States)

    Richards, Paul W.; Park, Chan; Brown, Lee

    The Power Ratchet Tool (PRT) is a self contained, power-driven, 3/8 inch drive ratchet wrench which will be used by astronauts during Extravehicular Activities (EVA). This battery-powered tool is controlled by a dedicated electonic controller. The PRT was flown during the Hubble Space Telescope (HST) Deployment Mission STS-31 to deploy the solar arrays if the automatic mechanisms failed. The PRT is currently intended for use during the first HST Servicing Mission STS-61 as a general purpose power tool. The PRT consists of three major components; the wrench, the controller, and the battery module. Fourteen discrete combinations of torque, turns, and speed may be programmed into the controller before the EVA. The crewmember selects the desired parameter profile by a switch mounted on the controller. The tool may also be used in the manual mode as a non-powered ratchet wrench. The power is provided by a silver-zinc battery module, which fits into the controller and is replaceable during an EVA. The original PRT did not meet the design specification of torque output and hours of operation. To increase efficiency and reliability the PRT underwent a redesign effort. The majority of this effort focused on the wrench. The original PRT drive train consisted of a low torque, high speed brushless DC motor, a face gear set, and a planocentric gear assembly. The total gear reduction was 300:1. The new PRT wrench consists of a low speed, high torque brushless DC motor, two planetary gear sets and a bevel gear set. The total gear reduction is now 75:1. A spline clutch has also been added to disengage the drive train in the manual mode. The design changes to the controller will consist of only those modifications necessary to accomodate the redesigned wrench.

  14. Evaluation of the treatment planning system of three-dimensional conformal external radiotherapy in Hospital Mexico of San Jose, Costa Rica

    International Nuclear Information System (INIS)

    Venegas Rojas, Deybith

    2014-01-01

    An evaluation and analysis are realized of dosimetry of the treatment planning system (TPS) of three-dimensional conformal external radiotherapy in the Servicio de Radioterapia of the Hospital Mexico of Costa Rica. An evaluation procedure is proposed based on IAEA-TECDOC-1540 document, and may continue to be applied periodically in this or other radiotherapy services. Tests realized have checked the representation of distances and electronics densities transferred to the TPS, match with those of real objects. The 16 tests applied have represented situations of real treatments with different configurations and beam modifiers in the equipment used daily. The tests have measured the absorbed dose to water in different significant points at different depths, using photon beams of 6 MeV and 18 MeV. The physical parameters of the tests were simulated. The absorbed dose has been calculated at specified points. The XiO and Eclipse TPS have been used with the calculation algorithms: Superposition, Convolution and AAA. The results of the calculations are evaluated with statistical methods and comparing them with the measurements of absorbed dose. A generalized tendency has been detected toward negative relative errors, implying an underestimation of the dose by the TPS; due to a difference found in the accelerator output factor respect to its commissioning. The AAA algorithm has determined a better performance, although with greater difficulties of calculus in the region of build-up. Convolution and Superposition algorithms have had similar performances and both have presented problems in high depths and out of edges of the fields. The result of the dosimetric evaluation has been satisfactory in real conditions of equipment; but several particularities have been found that should be reviewed and adjusted. The precision of the TPS has been adequate in the majority of situations important for treatment planning. [author] [es

  15. Morphometric evaluation of external root resorption of mandibular second molar teeth adjacent to the impacted third molars in CBCT imaging of Tehran\\'s population between 2011-2014

    Directory of Open Access Journals (Sweden)

    Fatemeh Ezoddini Ardakani

    2017-04-01

    Full Text Available Introduction: Presence of external root resorption in second molars associated with impacted mandibular third molars was not rare. The neglect of this issue may leads to penetration of the pulp and loss of the second molars. The aim of this study was to investigate the incidence and risk factors affecting the external root resorption in second molars associated with mandibular impacted third molars were inclined mesially and horizontally by Cone Beam Computer Tomography (CBCT images. Methods: In this cross sectional study the samples consisted of 231 scans with mesially and horizontally impacted mandibular third molars. Incidence of external root resorption of second molars and the effects of age, gender and clinical parameters such as location and intensity of external root resorption were considered. Moreover, depth and inclination of impacted mandibular third molar were evaluated by CBCT. The data were analyzed by Chi-square test. Results: The overall incidence of external root resorption in the second molars was 22.08%. Incidence of external root resorption in second molars was significantly related to gender and inclination of third molar. The relations between external root resorption and impaction depth of third molar or the patient's age was not statistically significant. However, the relationship between external root resorption and the intensity or depth of impacted third molar and location of root resorption was statistically meaningful. Conclusion: Patient’s gender and horizontal inclination of third molars are the most important factors affecting the presence of external root resorption in the second molars associated with mesially and horizontally impacted mandibular third molars.

  16. Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

    Science.gov (United States)

    Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

    2018-01-01

    To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We

  17. In vitro mechanical evaluation of a novel pin-sleeve system for external fixation of distal limb fractures in horses: a proof of concept study.

    Science.gov (United States)

    Brianza, Stefano; Brighenti, Vittoria; Boure, Ludovic; Sprenger, Victor; Pearce, Simon; Schwieger, Karsten

    2010-07-01

    To evaluate the efficacy of a novel pin-sleeve cast (PSC) system for external fixation of distal limb fractures in horses and to compare it with the transfixation pin cast (TPC) system. Experimental. One bone substitute each was used for the TPC and PSC systems. The PSC was tested in 4 configurations characterized by different pin preloads. Specimens were loaded in axial compression in the elastic range. Variables compared statistically were: bone substitute axial displacement and axial strain measured above implants with strain gauges. Pin preload was correlated with the variables investigated. Load to failure and a fatigue tests supplemented the investigation. The PSC configuration with the highest pin preload showed a significantly lower axial displacement compared with the TPC. No significant differences were observed between all other PSC configurations and the TPC. All PSC systems had a significant decrease in recorded strain compared with the TPC system. Pin axial preload inversely correlated with axial displacement but had no effect on axial strain. In the failure test, the PSC encountered plastic deformation earlier than the TPC. In the fatigue test, the PSC ran >200,000 cycles. Preliminary in vitro tests showed that the PSC system significantly reduced peri-implant strain while concurrently having comparable axial displacement to the TPC system. The PSC system has the potential to reduce the risk of pin loosening in horses.

  18. Ultrasound evaluation of muscle thickness changes in the external oblique, internal oblique, and transversus abdominis muscles considering the influence of posture and muscle contraction.

    Science.gov (United States)

    Sugaya, Tomoaki; Abe, Yota; Sakamoto, Masaaki

    2014-09-01

    [Purpose] The aim of this study was to investigate muscle thickness changes in the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) muscles between the neutral position and trunk rotation, under a state of rest without voluntary contractions, and isometric contractions to both sides with resistance of 50% of the maximum trunk rotation strength. [Subjects] The subjects of this study were 21 healthy young men. [Methods] Muscle thickness changes in the EO, IO, and TrA in each position and state were evaluated by ultrasound. The range of motion at maximum trunk rotation and the maximum strength of trunk rotation were measured using a hand-held dynamometer. [Results] In the neutral position and at 50% trunk rotation to the right side, the thicknesses of the IO and TrA significantly increased with resistance. In both states, the thicknesses of the IO and TrA significantly increased at 50% trunk rotation to the right side. [Conclusion] The muscular contractions of the IO and TrA were stronger during ipsilateral rotation than in the neutral position and with resistance than at rest. Moreover, the muscular contraction was strongest in the resistive state during ipsilateral rotation.

  19. Identification and verification of critical performance dimensions. Phase 1 of the systematic process redesign of drug distribution.

    Science.gov (United States)

    Colen, Hadewig B; Neef, Cees; Schuring, Roel W

    2003-06-01

    Worldwide patient safety has become a major social policy problem for healthcare organisations. As in other organisations, the patients in our hospital also suffer from an inadequate distribution process, as becomes clear from incident reports involving medication errors. Medisch Spectrum Twente is a top primary-care, clinical, teaching hospital. The hospital pharmacy takes care of 1070 internal beds and 1120 beds in an affiliated psychiatric hospital and nursing homes. In the beginning of 1999, our pharmacy group started a large interdisciplinary research project to develop a safe, effective and efficient drug distribution system by using systematic process redesign. The process redesign includes both organisational and technological components. This article describes the identification and verification of critical performance dimensions for the design of drug distribution processes in hospitals (phase 1 of the systematic process redesign of drug distribution). Based on reported errors and related causes, we suggested six generic performance domains. To assess the role of the performance dimensions, we used three approaches: flowcharts, interviews with stakeholders and review of the existing performance using time studies and medication error studies. We were able to set targets for costs, quality of information, responsiveness, employee satisfaction, and degree of innovation. We still have to establish what drug distribution system, in respect of quality and cost-effectiveness, represents the best and most cost-effective way of preventing medication errors. We intend to develop an evaluation model, using the critical performance dimensions as a starting point. This model can be used as a simulation template to compare different drug distribution concepts in order to define the differences in quality and cost-effectiveness.

  20. Hanford External Dosimetry Program

    International Nuclear Information System (INIS)

    Fix, J.J.

    1990-10-01

    This document describes the Hanford External Dosimetry Program as it is administered by Pacific Northwest Laboratory (PNL) in support of the US Department of Energy (DOE) and its Hanford contractors. Program services include administrating the Hanford personnel dosimeter processing program and ensuring that the related dosimeter data accurately reflect occupational dose received by Hanford personnel or visitors. Specific chapters of this report deal with the following subjects: personnel dosimetry organizations at Hanford and the associated DOE and contractor exposure guidelines; types, characteristics, and procurement of personnel dosimeters used at Hanford; personnel dosimeter identification, acceptance testing, accountability, and exchange; dosimeter processing and data recording practices; standard sources, calibration factors, and calibration processes (including algorithms) used for calibrating Hanford personnel dosimeters; system operating parameters required for assurance of dosimeter processing quality control; special dose evaluation methods applied for individuals under abnormal circumstances (i.e., lost results, etc.); and methods for evaluating personnel doses from nuclear accidents. 1 ref., 14 figs., 5 tabs

  1. TIMES-SS - A promising tool for the assessment of skin sensitization hazard. A characterization with respect to the OECD validation principles for (Q)SARs and an external evaluation for predictivity

    DEFF Research Database (Denmark)

    Patlewicz, Grace; Dimitrov, Sabcho D.; Low, Lawrence K.

    2007-01-01

    principles are met and in particular the results from an external evaluation exercise that was recently carried out. As part of this exercise, data were generated for 40 new chemicals in the murine local lymph node assay (LLNA) and then compared with predictions made by TIMES-SS. The results were promising...

  2. Redesigned front end for the upgrade at CHESS

    International Nuclear Information System (INIS)

    Headrick, R.L.; Smolenski, K.W.

    1996-01-01

    We will report on beamline front-end upgrades for the 24-pole wiggler beamlines at CHESS. A new design for primary x-ray beamstops based on a tapered, water-cooled copper block has been implemented and installed in the CHESS F beamline. The design uses a horizontally tapered open-quote open-quote V close-quote close-quote shape to reduce the power density on the internal surfaces and internal water channels in the block to provide efficient water cooling. Upstream of the beam stops, we have installed a new photoelectron style beam position monitor with separate monitoring of the wiggler and dipole vertical beam positions and with micron-level sensitivity. The monitor close-quote s internal surfaces are designed to absorb the full x-ray power in case of beam missteering, and the uncooled photoelectron collecting plates are not visible to the x-ray beam. A graphite prefilter has been installed to protect the beryllium windows that separate the front end from the x-ray optics downstream. The redesigned front end is required by the upgrade of the Cornell storage ring, now in progress, which will allow stored electron and positron currents of 300 mA by 1996, and 500 mA by 1998. At 500 mA, the wiggler power output will be over 32 kW. copyright 1996 American Institute of Physics

  3. REDESIGN OF CERNS QUADRUPOLE RESONATOR FOR TESTING OF SUPERCONDUCTING SAMPLES

    CERN Document Server

    Del Pozo Romano, Veronica

    2017-01-01

    The quadrupole resonator (QPR) was constructed in 1997 to measure the surface resistance of niobium samples at 400 MHz, the technology and RF frequency chosen for the LHC. It allows measurement of the RF properties of superconducting films deposited on disk-shaped metallic substrates. The samples are used to study different coatings which is much faster than the coating, stripping and re-coating of sample cavities. An electromagnetic and mechanical re-design of the existing QPR has been done with the goal of doubling the magnetic peak fields on the samples. Electromagnetic simulations were carried out on a completely parametrized model, using the existings QPR as baseline and modifying its dimensions. The aim was to optimize the measurement range and resolution by increasing the ratio between the magnetic peak fields on the sample and in the cavity. Increasing the average magnetic field on the sample leads to a more homogenous field distribution over the sample. Some of the modifications were based on t...

  4. Job crafting: Towards a new model of individual job redesign

    Directory of Open Access Journals (Sweden)

    Maria Tims

    2010-12-01

    Research purpose: The purpose of the study was to fit job crafting in job design theory. Motivation for the study: The study was an attempt to shed more light on the types of proactive behaviours of individual employees at work. Moreover, we explored the concept of job crafting and its antecedents and consequences. Research design, approach and method: A literature study was conducted in which the focus was first on proactive behaviour of the employee and then on job crafting. Main findings: Job crafting can be seen as a specific form of proactive behaviour in which the employee initiates changes in the level of job demands and job resources. Job crafting may be facilitated by job and individual characteristics and may enable employees to fit their jobs to their personal knowledge, skills and abilities on the one hand and to their preferences and needs on the other hand. Practical/managerial implications: Job crafting may be a good way for employees to improve their work motivation and other positive work outcomes. Employees could be encouraged to exert more influence on their job characteristics. Contribution/value-add: This article describes a relatively new perspective on active job redesign by the individual, called job crafting, which has important implications for job design theories.

  5. Redesigning assembly stations using ergonomic methods as a lean tool.

    Science.gov (United States)

    Eswaramoorthi, M; John, Mervyn; Rajagopal, C Arjun; Prasad, P S S; Mohanram, P V

    2010-01-01

    With the current state of the global economy, demand for various products plummeting. To sustain in the market, companies have to reduce cost and improve quality. Today, companies have started implementing new philosophies like TQM, TPM, six sigma and lean manufacturing techniques to remain competitive in the market. Lean manufacturing is an emerging philosophy which continuously strives to reduce waste. The main objective of analyzing the assembly line with a lean perspective is to identify the areas related to human interface with other systems that could lead to the generation of waste. Improper workplace design leads to unreasonable mental or physical burden and results in waste generation like slow work (delay and inventory), and defects, which is named as muri waste. An attempt has been made in this paper to locate muri waste and create a "Lean assembly line". The proposed method, based on the use of Rapid Upper Limb Assessment (RULA) with CATIA V5 platform, has allowed the measurement of a large set of operator posture parameters and assessment of ergonomic stresses. Based on the results, the process stations in the assembly line were redesigned to prevent the generation of waste.

  6. Re-designing the PhEDEx security model

    CERN Document Server

    Wildish, Anthony

    2013-01-01

    PhEDEx. the data-placement tool used by the CMS experiment at the LHC, was conceived in a more trusting time. The security model was designed to provide a safe working environment for site agents and operators, but provided little more protection than that. CMS data was not sufficiently protected against accidental loss caused by operator error or software bugs or from loss of data caused by deliberate manipulation of the database. Operations staff were given high levels of access to the database, beyond what should have been needed to accomplish their tasks. This exposed them to the risk of suspicion should an incident occur. Multiple implementations of the security model led to difficulties maintaining code, which can lead to degredation of security over time.In order to meet the simultaneous goals of protecting CMS data, protecting the operators from undue exposure to risk, increasing monitoring capabilities and improving maintainability of the security model, the PhEDEx security model was redesigned and r...

  7. Rational redesign of the biodegradative enzyme cytochrome P450 cam:

    International Nuclear Information System (INIS)

    Ornstein, R.; Paulsen, M.; Bass, M.; Arnold, G.

    1991-03-01

    Cytochromes P450, a superfamily of monooxygenase enzymes present in all kingdoms of living organisms, are very versatile with respect to substrate range and catalytic functionality. Many recalcitrant halogenated hydrocarbons, on DOE sites and throughout the nation, result in serious environmental impact. Cytochromes P450 have been shown to be catalytically capable of, at least partial, dehalogenation of some such compounds. Clearly, however, their active site stereochemistry and related functional components are not well suited for this role because the rates of dehalogenation are generally rather modest. The evolution of modified active site and access channel structures may proceed very slowly if multiple genetic changes are simultaneously required for enzyme adaptation. Since each mutational event is by itself a rare event, a basic premise of our research is that designing multiple changes into an enzyme may be more timely than waiting for them to occur biologically either via natural selection or under laboratory-controlled conditions. Starting with available high-resolution x-ray crystal structures, molecular modeling and molecular dynamics simulations have been used to probe the basic structure/function principles and conformational fluctuations of the biodegradative enzyme, cytochrome P450cam (camphor hydroxylase from Pseudomonas putida) and active site mutants, to provide the fundamental understanding necessary for rational engineering of the enzyme for modified substrate specificity. In the present paper, we review our progress to data, in the area of molecular dynamics simulations and active site redesign of P450cam. 36 refs., 2 figs

  8. Bus network redesign for inner southeast suburbs of Melbourne, Australia

    Science.gov (United States)

    Pandangwati, S. T.; Milyanab, N. A.

    2017-06-01

    Public transport is the most effective mode of transport in the era of climate change and oil depletion. It can address climate change issues by reducing urban greenhouse gas emission and oil consumption while at the same time improving mobility. However, many public transport networks are not effective and instead create high operating costs with low frequencies and occupancy. Melbourne is one example of a metropolitan area that faces this problem. Even though the city has well-integrated train and tram networks, Melbourne’s bus network still needs to be improved. This study used network planning approach to redesign the bus network in the City of Glen Eira, a Local Government Area (LGA) in the southeastern part of Metropolitan Melbourne. The study area is the area between Gardenvale North and Oakleigh Station, as well as between Caulfield and Patterson Stations. This area needs network improvement mainly because of the meandering bus routes that run within it. This study aims to provide recommendations for improving the performance of bus services by reducing meandering routes, improving transfer point design and implementing coordinated timetables. The recommendations were formulated based on a ‘ready-made’ concept to increase bus occupancy. This approach can be implemented in other cities with similar problems and characteristics including those in Indonesia.

  9. Redesigning NASA Earthdata to Become Powered by EOSDIS Components

    Science.gov (United States)

    Bagwell, R.; Siarto, J.; Wong, M. M.; Murphy, K. J.; McLaughlin, B. D.

    2014-12-01

    Two years ago, NASA's Earth Science Data and Information Systems (ESDIS) Project launched the Earthdata website (https://earthdata.nasa.gov) in order to make Earth Observing System Data and Information System (EOSDIS) data, data products, data tools, and services available to a broad range of user communities across Earth science disciplines to foster collaboration and learning amongst the communities. Earthdata is being redesigned to be the one-stop shop in providing Earth science data, services, and information to the Earth science community. The goal is to move from the current static, manually-intensive content format to a dynamic, data-driven website in order to provide a more flexible and usable design website infrastructure that leverages EOSDIS components such as the User Registration System (URS), the Common Metadata Repository (CMR) and the Global Imagery Browse Services (GIBS). This will reorganize information content to make the website easier to use and to make easily accessible the high-value Earth science content throughout the site. The website will also easily accept and incorporate upcoming new projects such as the Earthdata Search Client and the Sea Level Change Portal.

  10. Re-designing the PhEDEx Security Model

    Science.gov (United States)

    C-H, Huang; Wildish, T.; X, Zhang

    2014-06-01

    PhEDEx, the data-placement tool used by the CMS experiment at the LHC, was conceived in a more trusting time. The security model provided a safe environment for site agents and operators, but offerred little more protection than that. Data was not sufficiently protected against loss caused by operator error or software bugs or by deliberate manipulation of the database. Operators were given high levels of access to the database, beyond what was actually needed to accomplish their tasks. This exposed them to the risk of suspicion should an incident occur. Multiple implementations of the security model led to difficulties maintaining code, which can lead to degredation of security over time. In order to meet the simultaneous goals of protecting CMS data, protecting the operators from undue exposure to risk, increasing monitoring capabilities and improving maintainability of the security model, the PhEDEx security model was redesigned and re-implemented. Security was moved from the application layer into the database itself, fine-grained access roles were established, and tools and procedures created to control the evolution of the security model over time. In this paper we describe this work, we describe the deployment of the new security model, and we show how these enhancements improve security on several fronts simultaneously.

  11. Redesigning nursing work in long-term care environments.

    Science.gov (United States)

    Hall, L M; O'Brien-Pallas, L

    2000-01-01

    The authors present a highly statistically oriented argument for examining work attitudes and activities among three groups of caregivers [RNs, RPNs, and HCAs] working in long-term care. The investigators used both work sampling, written surveys, and interviews with a sample of 46 caregivers in a large university-affiliated LTC facility in Toronto, Canada. While RNs stated their strong affinity for direct patient care activities, they perform the lowest percentage of direct care, chiefly due to their accountability for planning and coordinating the care provided by others. The HCAs who provided the bulk of direct patient care "valued it the least," apparently finding little gratification with this aspect of their role. This study suggests that there is a need to examine and clarify work roles and perceptions for all caregivers as part of any work redesign process. A higher level of RN involvement in direct patient care activities, along with "attention to enhancing the importance" of these activities for staff employed in the HCA role, could be beneficial.

  12. Redesigning Health Care Practices to Address Childhood Poverty.

    Science.gov (United States)

    Fierman, Arthur H; Beck, Andrew F; Chung, Esther K; Tschudy, Megan M; Coker, Tumaini R; Mistry, Kamila B; Siegel, Benjamin; Chamberlain, Lisa J; Conroy, Kathleen; Federico, Steven G; Flanagan, Patricia J; Garg, Arvin; Gitterman, Benjamin A; Grace, Aimee M; Gross, Rachel S; Hole, Michael K; Klass, Perri; Kraft, Colleen; Kuo, Alice; Lewis, Gena; Lobach, Katherine S; Long, Dayna; Ma, Christine T; Messito, Mary; Navsaria, Dipesh; Northrip, Kimberley R; Osman, Cynthia; Sadof, Matthew D; Schickedanz, Adam B; Cox, Joanne

    2016-04-01

    Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address them. Identification of needs can be accomplished with a variety of established screening tools. Interventions may include resource directories, best maintained in collaboration with local/regional public health, community, and/or professional organizations; programs embedded in the practice (eg, Reach Out and Read, Healthy Steps for Young Children, Medical-Legal Partnership, Health Leads); and collaboration with home visiting programs. Changes to health care financing are needed to support the delivery of these enhanced services, and active advocacy by child health providers continues to be important in effecting change. We highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty. Copyright © 2016 Academic Pediatric Association. All rights reserved.

  13. Redesigning a collection system for 'small' consumer electronics

    International Nuclear Information System (INIS)

    Melissen, Frans W.

    2006-01-01

    This paper establishes that the collection system within the recycling scheme for consumer electronics in the Netherlands has not been entirely successful in convincing consumers to hand in their used appliances by means of dedicated collection routes. Particularly regarding small appliances, consumers are persisting in their habit of discarding their appliances by means of the refuse bag/bin for regular household waste. Therefore, the current collection system has been unable to direct consumer behavior in the desired direction. Consequently, the layout of the current system is reviewed and redesigned in order to tackle this problem. This design effort applies the Triad model (behavioral model) in the analysis stage and the Morphological Chart method (design tool) in the synthesis stage, and results in a concrete proposal for a new system. Finally, the applicability of this design approach beyond the specific circumstances of the case study presented in this paper is discussed. This case represents only one example of the broader, worldwide challenge to design appropriate collection systems to direct consumer behavior in desired directions. It is argued that the approach presented in this paper could be a valuable contribution to research dealing with this challenge

  14. A redesign of OGC Symbology Encoding standard for sharing cartography

    Directory of Open Access Journals (Sweden)

    Erwan Bocher

    2018-01-01

    Full Text Available Despite most Spatial Data Infrastructures offering service-based visualization of geospatial data, requirements are often at a very basic level leading to poor quality of maps. This is a general observation for any geospatial architecture as soon as open standards as those of the Open Geospatial Consortium (OGC are applied. To improve the situation, this paper does focus on improvements at the portrayal interoperability side by considering standardization aspects. We propose two major redesign recommendations. First to consolidate the cartographic theory at the core of the OGC Symbology Encoding standard. Secondly to build the standard in a modular way so as to be ready to be extended with upcoming future cartographic requirements. Thus, we start by defining portrayal interoperability by means of typical-use cases that frame the concept of sharing cartography. Then we bring to light the strengths and limits of the relevant open standards to consider in this context. Finally we propose a set of recommendations to overcome the limits so as to make these use cases a true reality. Even if the definition of a cartographic-oriented standard is not able to act as a complete cartographic design framework by itself, we argue that pushing forward the standardization work dedicated to cartography is a way to share and disseminate good practices and finally to improve the quality of the visualizations.

  15. Re-designing the PhEDEx security model

    International Nuclear Information System (INIS)

    Huang C-H; Wildish, T; Zhang X

    2014-01-01

    PhEDEx, the data-placement tool used by the CMS experiment at the LHC, was conceived in a more trusting time. The security model provided a safe environment for site agents and operators, but offerred little more protection than that. Data was not sufficiently protected against loss caused by operator error or software bugs or by deliberate manipulation of the database. Operators were given high levels of access to the database, beyond what was actually needed to accomplish their tasks. This exposed them to the risk of suspicion should an incident occur. Multiple implementations of the security model led to difficulties maintaining code, which can lead to degredation of security over time. In order to meet the simultaneous goals of protecting CMS data, protecting the operators from undue exposure to risk, increasing monitoring capabilities and improving maintainability of the security model, the PhEDEx security model was redesigned and re-implemented. Security was moved from the application layer into the database itself, fine-grained access roles were established, and tools and procedures created to control the evolution of the security model over time. In this paper we describe this work, we describe the deployment of the new security model, and we show how these enhancements improve security on several fronts simultaneously.

  16. Cupryphans, metal-binding, redox-active, redesigned conopeptides.

    Science.gov (United States)

    Barba, Marco; Sobolev, Anatoli P; Romeo, Cristina; Schininà, M Eugenia; Pietraforte, Donatella; Mannina, Luisa; Musci, Giovanni; Polticelli, Fabio

    2009-03-01

    Contryphans are bioactive peptides, isolated from the venom of marine snails of the genus Conus, which are characterized by the short length of the polypeptide chain and the high degree of unusual post-translational modifications. The cyclization of the polypeptide chain through a single disulphide bond, the presence of two conserved Pro residues, and the epimerization of a Trp/Leu residue confer to Contryphans a stable and well-defined structure in solution, conserved in all members of the family, and tolerant to multiple substitutions. The potential of Contryphans as scaffolds for the design of redox-active (macro)molecules was tested by engineering a copper-binding site on two different variants of the natural peptide Contryphan-Vn. The binding site was designed by computational modeling, and the redesigned peptides were synthesized and characterized by optical, fluorescence, electron spin resonance, and nuclear magnetic resonance spectroscopy. The novel peptides, named Cupryphan and Arg-Cupryphan, bind Cu(2+) ions with a 1:1 stoichiometry and a K(d) in the 100 nM range. Other divalent metals (e.g., Zn(2+) and Mg(2+)) are bound with much lower affinity. In addition, Cupryphans catalyze the dismutation of superoxide anions with an activity comparable to other nonpeptidic superoxide dismutase mimics. We conclude that the Contryphan motif represents a natural robust scaffold which can be engineered to perform different functions, providing additional means for the design of catalytically active mini metalloproteins.

  17. Analysis of social relations among organizational units derived from process models and redesign of organization structure

    NARCIS (Netherlands)

    Choi, I.; Song, M.S.; Kim, K.M.; Lee, Y-H.

    2007-01-01

    Despite surging interests in analyzing business processes, there are few scientific approaches to analysis and redesign of organizational structures which can greatly affect the performance of business processes. This paper presents a method for deriving and analyzing organizational relations from

  18. Redesigning Acquisition Processes: A New Methodology Based on the Flow of Knowledge and Information

    National Research Council Canada - National Science Library

    Kock, Ned F; Murphy, Frederic

    2001-01-01

    Current business process redesign practices, in the defense sector as well as in business in general, are based on several assumptions inherited from Taylor s scientific management method, including...

  19. Feasibility study for the redesign of MDOT's pavement management systems software.

    Science.gov (United States)

    2011-04-01

    In August of 2006 the Mississippi Department of Transportation (MDOT) initiated State Study No. 191, entitled Feasibility : Study for the Redesign of MDOTs Pavement Management System (PMS) Software. At the initiation of this study, the : Dep...

  20. Lean thinking across a hospital: redesigning care at the Flinders Medical Centre.

    Science.gov (United States)

    Ben-Tovim, David I; Bassham, Jane E; Bolch, Denise; Martin, Margaret A; Dougherty, Melissa; Szwarcbord, Michael

    2007-02-01

    Lean thinking is a method for organising complex production processes so as to encourage flow and reduce waste. While the principles of lean thinking were developed in the manufacturing sector, there is increasing interest in its application in health care. This case history documents the introduction and development of Redesigning Care, a lean thinking-based program to redesign care processes across a teaching general hospital. Redesigning Care has produced substantial benefits over the first two-and-a-half years of its implementation, making care both safer and more accessible. Redesigning Care has not been aimed at changing the specifics of clinical practice. Rather, it has been concerned with improving the flow of patients through clinical and other systems. Concepts that emerged in the manufacturing sector have been readily translatable into health care. Lean thinking may play an important role in the reform of health care in Australia and elsewhere.

  1. Organizational Contexts and Texts: The Redesign of the Midwest Bell Telephone Bill.

    Science.gov (United States)

    Keller-Cohen, Deborah

    1987-01-01

    Offers a retrospective view of organizational factors affecting the redesign of the Midwest Bell Telephone Bill. Shows how financial considerations, organizational time frame, and employee training and experience influenced the bill's development process. (MM)

  2. OhioHealth web site wins awards. Draws leadership recognition for outstanding redesign.

    Science.gov (United States)

    Rees, Tom

    2004-01-01

    OhioHealth, Columbus, Ohio, has redesigned its web site, making it especially useful and appealing to women. For the collaborative effort, which included the Mayo Clinic and The VIA Group, Portland Maine, it has received numerous awards.

  3. Avaliação ultrassonográfica do meato acústico em cães Ultrasonographic evaluation of the external ear in dogs

    Directory of Open Access Journals (Sweden)

    Polyanne Cramer Schmidlin

    2010-04-01

    Full Text Available O propósito deste trabalho foi determinar a viabilidade da ultrassonografia para avaliar o canal auditivo externo de cães, aferindo a espessura e arquitetura da parede do conduto auditivo e bula timpânica. Foram avaliados 10 cães da raça Retriever do Labrador não portadores de otite externa. O exame foi realizado com o aparelho de ultrassonografia bidimensional e transdutor linear de 14 MHz, com todos os animais sob efeito de anestesia geral. O exame foi efetivado antes e depois do conduto ser preenchido com solução salina, promovendo uma janela acústica anecóica. A artéria maxilar foi identificada com o Doppler colorido o que facilitou a localização da bula timpânica em todos os cães. A definição da imagem da parede proximal ao transdutor foi pior quando comparada à parede distal r em todos os animais, isto devido à proximidade da parede com a face de leitura do transdutor. Nos cães que apresentavam uma maior quantidade de cerúmen a superfície do epitélio estava com uma camada hiperecóica mais evidente. A membrana timpânica não foi identificada em nenhum animal. Conclui-se que ultrassonografia é viável e deve ser mais pesquisada na contribuição diagnóstica das doenças óticas em cães.The purpose of this study was to determine the viability of ultrasonographic evaluation of the external ear in dogs. The thickness and architecture of the ear wall and tympanic bulla of 10 Labrador Retrievers without ear disease was evaluated. The examination was performed with an ultrasound system and a 14 MHz bidimentional linear-array transducer and general anesthesia, before and after the infusion of saline solution into the ear canal. The maxillary artery was identified with color Doppler and helped to establish the location of the tympanic bulla in all dogs. The proximal wall was less well-defined when compared with the distal wall of the ear canal. Dogs with increased ceruminal content within the ear canal showed a hypoechoic

  4. From Telecourses to Online Courses: A Story of Redesign | Du cours télévisé au cours en ligne : une histoire de redesign

    Directory of Open Access Journals (Sweden)

    Claude Potvin

    2015-11-01

    Full Text Available This case deals with the redesign of a standard telecourse - printed material, professional studio video recordings and phone tutoring – into an online course. The redesign involved an adjunct professor in the Humanities having some experience in distance education but little with learning technologies. It was a two-year project including the grant application process. The main issues included replacing television-based content with multimedia content; understanding the complexity of interactions between materials, students, and tutors; and adapting traditional assessment approaches to online instruments and methods.

  5. A conceptual redesign of an inter-building fuel transfer cask

    International Nuclear Information System (INIS)

    Klann, R.T.; Picker, B.A. Jr.

    1993-01-01

    The Inter-Building Fuel Transfer Cask, referred to as the IBC, is a lead shielded cask for transporting subassemblies between buildings on the Argonne National Laboratory-West site near Idaho Falls, Idaho. The cask transports both newly fabricated and spent reactor subassemblies between the Experimental Breeder Reactor-2 (EBR-2), the Fuel Cycle Facility (FCF) and the Hot Fuel Examination Facility (HFEF). The IBC will play a key role in the Integral Fast Reactor (IFR) fuel recycling demonstration project. The existing IBC technology, designed and fabricated in the late fifties, is outdated and is a source of personnel exposure at ANL-W. The current IBC system requires forced argon cooling and has extremely limited passive cooling capabilities due to existing design features. A conceptual redesign of the IBC has been performed. The objective of the conceptual design was to increase the passive heat removal capabilities, reduce the personnel radiation exposure and incorporate enhanced safety features into the design. The heat transfer, radiation and thermal-hydraulic properties of the IBC were analytically modeled to determine the principal factors controlling the design. The scoping studies that were performed determined the vital physical characteristics (i.e., size, shielding, pumps, etc.) of the IBC conceptual design. The conceptual design for the IBC allows subassemblies with up to 800 Watts of decay heat to be passively cooled, a significant increase over the existing system. The new design which incorporates better passive cooling mechanisms will prevent inadvertent damage to the subassembly during postulated loss-of-power and loss-of-flow accident scenarios. The new design also decreases the radiation hazard to personnel by having fewer external systems, a better shield plug design, and surfaces that are easier to decontaminate. The control and monitoring system will also be state-of-the-art technology

  6. Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home

    Science.gov (United States)

    2011-01-01

    Redesign, and Team Solutions to Achieve the Patient Centered Medical Home LTC Nicole Kerkenbush, MHA, MN Army Medical Department, Office of the...TITLE AND SUBTITLE Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home 5a. CONTRACT...Describe how these tools are being used to implement the Patient Centered Medical Home care model 2 2011 MHS Conference MEDCOM AHLTA Provider Satisfaction

  7. Redesign of the SNS Modulator H-Bridge for Utilization of Press-Pack IGBTs

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, Mark A.; Burkhart, Craig; /SLAC; Anderson, David E.; /Oak Ridge

    2008-09-25

    The power conversion group at SLAC is currently redesigning the H-bridge switch plates of the High Voltage Converter Modulators at the Spallation Neutron Source. This integral part to the modulator operation has been indentified as a source of several modulator faults and potentially limits reliability with pulse width modulation operation. This paper is a presentation of the design and implementation of a redesigned switch plate based upon press-pack IGBTs.

  8. Methodology and findings of the NRC`s materials licensing process redesign

    Energy Technology Data Exchange (ETDEWEB)

    Rathbun, P.A.; Brown, K.D.; Madera, J.R.; Moriarty, M.; Pelchat, J.M.; Usilton, W.K.; Whitten, J.E.; Vacca, P.C.

    1996-04-01

    This report describes the work and vision of the team chartered to redesign the process for licensing users of nuclear materials. The Business Process Redesign team was chartered to improve the speed of the existing licensing process while maintaining or improving public safety and to achieve required resource levels. The report describes the team`s methods for acquiring and analyzing information about the existing materials licensing process and the steps necessary to radically change this process to the envisioned future process.

  9. Externalities of energy. Swedish implementation of the ExternE methodology

    International Nuclear Information System (INIS)

    Nilsson, Maans; Gullberg, M.

    1998-01-01

    The growing interest for developing economic instruments for efficient environmental policies has opened up a large area of multi-disciplinary research. ExternE is an example of this research, combining disciplines such as engineering, ecology, immunology and economics expertise to create new knowledge about how environmental pressures from energy production affect our nature and society. The ExternE Project aims to identify and, as far as possible quantify the externalities of energy production in Europe. The Stockholm Environment Institute has carried out a preliminary aggregation: -Coal Fuel Cycle: centred around Vaesteraas Kraftvaermeverk, Vaesteraas. This is the largest co-generation plant in Sweden, with four blocks and a maximum co-generation output of 520 MW electricity and 950 MW heat. The analysis is carried out on boiler B4. -Biomass Fuel Cycle: centred around Haendeloeverket, Norrkoeping. This plant predominately burns forestry residues, but a variety of fuels are combusted. Haendeloeverket has an installed capacity of 100 MW electricity and 375 MW heat, in a total of three boilers and two back-pressure turbines. The analysis is carried out on boiler P13. -Hydro Fuel Cycle: Klippens Kraftstation, Storuman. Built in 1990-1994, it is the youngest hydro power station in Sweden. It has been designed and built with significant efforts to account for and protect environmental values. Installed capacity is 28 MW. The environmental impact assessment from the construction of this plant is carried out, but the evaluation is still not finalized. The preliminary aggregation aimed to test whether ExternE results could be used to make estimates for the entire Swedish electricity production system. Hence, national results as well as results from other partner countries in ExternE has been applied

  10. Prospective evaluation of a 12-week walking exercise program and its effect on fatigue in prostate cancer patients undergoing radical external beam radiotherapy.

    Science.gov (United States)

    Truong, Pauline T; Gaul, Catherine A; McDonald, Rachel E; Petersen, Ross B; Jones, Stuart O; Alexander, Abraham S; Lim, Jan T W; Ludgate, Charles

    2011-08-01

    To evaluate tolerability and compliance to a walking exercise program and its effect on fatigue during and after radical external beam radiation therapy (EBRT) for prostate cancer. A total of 50 subjects with prostate cancer undergoing EBRT over 6 to 8 weeks were prospectively accrued to an exercise intervention group, matched for age and clinical characteristics to 30 subjects in a historical control group who underwent EBRT with no specific exercise intervention. Starting 1 week before EBRT, exercise participants performed moderate-intensity walking targeting 60% to 70% age-predicted maximum heart rate, at least 20 min/d, 3 d/wk over 12 weeks. The Brief Fatigue Inventory was administered at baseline, mid-EBRT (week 3-4), end-EBRT (week 6-8), and 6 months post-EBRT. Of 50, 42 (84%) of exercise participants completed the walking program. There were no cardiovascular complications, musculoskeletal injuries, or other adverse events. A total of 89% subjects reported "Good-Excellent" satisfaction during and up to 6 months post-EBRT. Fatigue in control subjects escalated from baseline to end-EBRT, remaining high at 6 months post-EBRT (P[r] = 0.03). In contrast, mean total fatigue scores in exercise subjects were stable from baseline up to 6 months post-EBRT (P = 0.52). Trends for higher fatigue interference with quality of life were observed in the control group as compared with the exercise group. Moderate-intensity walking exercise during radical EBRT is safe and feasible. The high convenience and satisfaction ratings, in conjunction with the observed fatigue trends, indicate that this activity has the potential to attenuate fatigue and improve quality of life for patients with localized prostate cancer undergoing curative therapy.

  11. Diagnostic value of two modes of cone-beam computed tomography in evaluation of simulated external root resorption: an in vitro study

    Energy Technology Data Exchange (ETDEWEB)

    Dalili, Zahra; Taramsari, Mehran; Mehr, Seyed Zoheir Mousavi; Salamat, Fatemeh [Guilan University of Medical Sciences, Rasht (Iran, Islamic Republic of)

    2012-03-15

    Field of view and voxel resolution of cone beam computed tomography (CBCT) might affect the diagnostic capability. This study was performed to compare between the standard and HiRes zoom modes in the diagnosis of external root resorption (ERR) using CBCT. Sixty three small cavities (0.25 mm depth and 0.5 mm diameter) were simulated on the buccal, lingual, and proximal surfaces at three different levels of 16 roots of teeth. After covering the root with nail varnish, the roots were inserted in the sockets and the model was placed in a water-containing lacuna. CBCT scans were taken in both standard and HiRes zoom modes using NewTom VG (QR srl Company, Verona, Italy). Then, an observer assessed the images to determine the presence or absence of the cavities. This process was repeated by increasing the size and depth of cavities to 0.5 mm depth and 1 mm diameter. Data were analyzed by McNemar test. The sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio in evaluation of the simulated cavities were calculated. There was a significant difference between the two imaging modes in diagnosing the shallow cavities (p=0.02). The sensitivity of the standard zoom in detecting the shallow cavities was lower than that of the HiRes zoom. The likelihood ratio of the HiRes zoom was higher in the diagnosis of both cavity types. This study suggested that a smaller voxel size in the HiRes zoom mode of CBCT is preferred for diagnosis of ERR.

  12. Evaluation of the outcomes of endovascular management for patients with head and neck cancers and associated carotid blowout syndrome of the external carotid artery

    International Nuclear Information System (INIS)

    Chang, F.-C.; Luo, C.-B.; Lirng, J.-F.; Lin, C.-J.; Wu, H.-M.; Hung, S.-C.; Guo, W.-Y.; Teng, M.M.H.; Chang, C.-Y.

    2013-01-01

    Aim: To evaluate factors related to the technical and haemostatic outcomes of endovascular management in patients with head and neck cancers (HNC) associated with carotid blowout syndrome (CBS) of the external carotid artery (ECA). Materials and methods: Between 2002 and 2011, 34 patients with HNC with CBS involving branches of the ECA underwent endovascular therapy. Treatment included embolization with microparticles, microcoils, or acrylic adhesives. Fisher's exact test was used to examine demographic features, clinical and angiographic severities, and clinical and imaging findings as predictors of endovascular management outcomes. Results: Technical success and immediate haemostasis were achieved in all patients. Technical complications were encountered in one patient (2.9%). Rebleeding occurred in nine patients (26.5%). Angiographic vascular disruption grading from slight (1) to severe (4) revealed that the 18 patients with acute CBS had scores of 2 (2/18, 11.1%), 3 (3/18, 16.7%), and 4 (13/18, 72.2%). The 16 patients with impending and threatened CBS had scores of 1 (1/16, 6.25%), 2 (5/16, 31.25%), and 3 (10/16, 62.5%; p = 0.0003). For the 25 patients who underwent preprocedural computed tomography (CT)/magnetic resonance imaging (MRI) examinations within 3 months of treatment, the agreement between clinical and imaging findings reached the sensitivity, specificity, and kappa values for recurrent tumours (1, 0.7143, 0.7826), soft-tissue defect (0.9091, 0.3333, 0.2424), and sinus tract/fistula (0.4737, 0, 0.4286). Conclusion: Endovascular management for patients with CBS of the ECA had high technical success and safety but was associated with high rebleeding rates. We suggest applying aggressive post-procedural follow-up and using preprocedural CT/MRI to enhance the periprocedural diagnosis

  13. Instrument evaluation no. 16. Nuclear enterprises portable doserate meter type PDR4 and external probes types BP1/1, BP8 and GP9

    International Nuclear Information System (INIS)

    Burgess, P.H.; Iles, W.J.

    1979-08-01

    The various radiations encountered in radiological protection cover a wide range of energies and radiation measurements have to be carried out under an equally broad spectrum of environmental conditions. This report is one of a series intended to give information on the performance characteristics of radiological protection instruments, to assist in the selection of appropriate instruments for a given purpose, to interpret the results obtained with such instruments, and, in particular, to know the likely sources and magnitude of errors that might be associated with measurements in the field. The radiation, electrical and environmental characteristics of radiation protection instruments are considered together with those aspects of the construction which make an instrument convenient for routine use. To provide consistent criteria for instrument performance, the range of tests performed on any particular class of instrument, the test methods and the criteria of acceptable performance are based broadly on the appropriate Recommendations of the International Electrotechnical Commission. The radiations in the tests are, in general, selected from the range of reference radiations for instrument calibration being drawn up by the International Standards Organisation. Normally, each report deals with the capabilities and limitations of one model of instrument and no direct comparison with other instruments intended for similar purposes is made, since the significance of particular performance characteristics largely depends on the radiations and environmental conditions in which the instrument is to be used. The results quoted here have all been obtained from tests on instruments in routine production, with the appropriate measurements being made by the NRPB. This report presents the evaluation of Nuclear Enterprises Portable Doserate Meter Type PDR4 and External Probes Types BP1/1, BP8 and GP9

  14. Regulating multiple externalities

    DEFF Research Database (Denmark)

    Waldo, Staffan; Jensen, Frank; Nielsen, Max

    2016-01-01

    Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory instrume......Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory...

  15. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K; Maelkki, H; Wihersaari, M; Pirilae, P [VTT Energy, Espoo (Finland); Hongisto, M [Imatran Voima Oy, Vantaa (Finland); Siitonen, S [Ekono Energy Ltd, Espoo (Finland); Johansson, M [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  16. ExternE National Implementation Finland

    International Nuclear Information System (INIS)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P.; Hongisto, M.; Siitonen, S.; Johansson, M.

    1999-01-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  17. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P. [VTT Energy, Espoo (Finland); Hongisto, M. [Imatran Voima Oy, Vantaa (Finland); Siitonen, S. [Ekono Energy Ltd, Espoo (Finland); Johansson, M. [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  18. Concept for the redesign of ECOMAN (standby losses) - Final report; Konzepte fuer Redesign ECOMAN (Standby-Verluste) - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Ernst, D.; Haerri, V.V.; Riesen, H.

    2008-04-15

    A lot of electronic devices are equipped with a so called standby mode. In this mode a device can easily be brought into full functionality directly, by remote control or by timer. Unfortunately, the standby mode implies a high consumption of electrical energy that could be reduced 10 to 20 times by an adequate technology. In Switzerland these losses amount to approximately 1,900 GWh. The so called ECOMAN is an electronic device which can reduce these losses effectively and comfortably. Due to political pressure the producers of electronic devices are forced to find solutions for the problem of standby losses. The ECOMAN would thus be of less importance because the problem would be solved at its roots. This fact and the wish to have a better performance led to a new definition of this device. The ECOMAN has to be improved and shall offer additional functions. E.g. it shall protect the devices from fire hazard or serve as control in the field of building automation. The new concepts were well accepted by the producer who already realized the specification of the first phase of redesign, which serves as basis for the further development of integration. (author)

  19. External Otitis (Swimmer's Ear)

    Science.gov (United States)

    ... otitis. Fungal external otitis (otomycosis), typically caused by Aspergillus niger or Candida albicans, is less common. Boils are ... in the ear. Fungal external otitis caused by Aspergillus niger usually causes grayish black or yellow dots (called ...

  20. ExternE: Externalities of energy Vol. 2. Methodology

    International Nuclear Information System (INIS)

    Berry, J.; Holland, M.; Watkiss, P.

    1995-01-01

    This report describes the methodology used by the ExternE Project of the European Commission (DGXII) JOULE Programme for assessment of the external costs of energy. It is one of a series of reports describing analysis of nuclear, fossil and renewable fuel cycles for assessment of the externalities associated with electricity generation. Part I of the report deals with analysis of impacts, and Part II with the economic valuation of those impacts. Analysis is conducted on a marginal basis, to allow the effect of an incremental investment in a given technology to be quantified. Attention has been paid to the specificity of results with respect to the location of fuel cycle activities, the precise technologies used, and the type and source of fuel. The main advantages of this detailed approach are as follows: It takes full and proper account of the variability of impacts that might result from different power projects; It is more transparent than analysis based on hypothetically 'representative' cases for each of the different fuel cycles; It provides a framework for consistent comparison between fuel cycles. A wide variety of impacts have been considered. These include the effects of air pollution on the natural and human environment, consequences of accidents in the workplace, impacts of noise and visual intrusion on amenity, and the effects of climate change arising from the release of greenhouse gases. Wherever possible we have used the 'impact pathway' or 'damage function' approach to follow the analysis from identification of burdens (e.g. emissions) through to impact assessment and then valuation in monetary terms. This has required a detailed knowledge of the technologies involved, pollutant dispersion, analysis of effects on human and environmental health, and economics. In view of this the project brought together a multi-disciplinary team with experts from many European countries and the USA. The spatial and temporal ranges considered in the analysis are

  1. ASH External Web Portal (External Portal) -

    Data.gov (United States)

    Department of Transportation — The ASH External Web Portal is a web-based portal that provides single sign-on functionality, making the web portal a single location from which to be authenticated...

  2. Evaluation of single- and dual-porosity models for reproducing the release of external and internal tracers from heterogeneous waste-rock piles.

    Science.gov (United States)

    Blackmore, S; Pedretti, D; Mayer, K U; Smith, L; Beckie, R D

    2018-05-30

    Accurate predictions of solute release from waste-rock piles (WRPs) are paramount for decision making in mining-related environmental processes. Tracers provide information that can be used to estimate effective transport parameters and understand mechanisms controlling the hydraulic and geochemical behavior of WRPs. It is shown that internal tracers (i.e. initially present) together with external (i.e. applied) tracers provide complementary and quantitative information to identify transport mechanisms. The analysis focuses on two experimental WRPs, Piles 4 and Pile 5 at the Antamina Mine site (Peru), where both an internal chloride tracer and externally applied bromide tracer were monitored in discharge over three years. The results suggest that external tracers provide insight into transport associated with relatively fast flow regions that are activated during higher-rate recharge events. In contrast, internal tracers provide insight into mechanisms controlling solutes release from lower-permeability zones within the piles. Rate-limited diffusive processes, which can be mimicked by nonlocal mass-transfer models, affect both internal and external tracers. The sensitivity of the mass-transfer parameters to heterogeneity is higher for external tracers than for internal tracers, as indicated by the different mean residence times characterizing the flow paths associated with each tracer. The joint use of internal and external tracers provides a more comprehensive understanding of the transport mechanisms in WRPs. In particular, the tracer tests support the notion that a multi-porosity conceptualization of WRPs is more adequate for capturing key mechanisms than a dual-porosity conceptualization. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. The Influence of External User Interdependence of Financial Statements, Possibility of Clients Facing Financial Difficulties, and Auditor Evaluation of Management Integrity To Acceptable Audit Risk.

    Directory of Open Access Journals (Sweden)

    Andini Sih Afsari Utami

    2016-12-01

    Full Text Available The purpose of this research is to analyze. Analyses the influence of external users reliance on financial statements, likelihood of financial difficulties and management integrity toward acceptable audit risk were performed with 10 public accountant office who had listed from Direktorat IAPI 2013. The sample used the “Gay” theory. The analyzed method in this research uses multiple linear. The result shown that performing external users reliance on financial statements significantly influences toward acceptable audit risk, likelihood of financial difficulties significantly influences toward acceptable audit risk, and management integrity significantly influences toward acceptable audit risk.

  4. PROPOSAL FOR ERGONOMIC REDESIGN IN THE SEED MANUAL CLEANING AREA AND CORN RECEPTION AND MISSING AREA

    Directory of Open Access Journals (Sweden)

    Karina Luna-Soto

    2017-07-01

    Full Text Available The project is presented at a Seeds plant in the region of Los Mochis, Sinaloa, with the purpose of giving proposals for improvements, through different studies, in order to find optimal solutions for workers with better performance time to carry out the corresponding activities. In the company it is necessary to have a work area in which the operator is comfortable, also to protect the health, and to increase the productivity of the same one. For this reason the study was conducted to know the problems that are generated by an inadequate workstation, in order to obtain a better quality and to have the adequate information on how to do the work without risk. In the development of this study, different techniques of ergonomic evaluation were applied, such as Yoshitake, 4 luke points and Corlet & Bishop Mapping for the analysis of fatigue and possible CTD (Cumulative Trauma Disorders. Once analyzed, proceeded to take anthropometric measures for the redesign of the workstation, focusing mainly on the seat of workers.

  5. Redesign, construction and characterization of the new neutron radiography facility of the RA-6

    International Nuclear Information System (INIS)

    Marin, J.; Sanchez, F.A.; Blaumann, H.

    2012-01-01

    Neutron radiography is a non-destructive test in which it is registered an image of the attenuation experienced by a collimated neutron beam while it passes through a sample. The image is generated by using a neutron-sensitive screen. The applications of this technique are wide, some of them include: services to industries, study of explosives, study of pieces belonging to cultural heritage and studies of the distribution of hydrogen. The actual neutron radiography facility is placed in the RA-6 reactor at the Centro Atomico Bariloche. Due to the reactor's nucleus change and the subsequent power raise, it has been necessary to redesign the facility. During the last year the pieces that constitute it had been designed and built. In April 2012 the facility has been mounted. The system employed is of on-line neutron radiographies. The maximum area of study is of 20 cm x 20 cm. The images obtained are registered by a CCD camera, whose maximum resolution is of 2776 x 2074 pixels and 65536 gray levels. In this work the initial steps towards characterization of the facility are presented, these include neutron fluxes and dose rates levels determinations. Also, in order to evaluate the functionality, images of several objects have been taken, as the one shown in Fig. 7. The results obtained reveal the good performance of the facility and its wide potential (author)

  6. Four years of training in family medicine: implications for residency redesign.

    Science.gov (United States)

    Sigmon, J Lewis; McPherson, Vanessa; Little, John M

    2012-09-01

    In light of the ongoing consideration for extending the length of residency education in family medicine in the United States, this paper reports the findings from a retrospective, qualitative study of six family physicians that elected to extend their residency training from 3 to 4 years. Each participant completed a written questionnaire and a structured personal interview focusing on various aspects of career development resulting from the additional year of training. The authors independently evaluated these interviews to identify major themes. All the participants were found to have been involved in teaching medicine, valued a more flexible and expanded curriculum, and appreciated their individualized curricula-based on their respective career interests. Given the opportunity, each would opt again for a fourth year of training. There were mixed opinions as to whether the fourth year should be required of all family medicine residents. Other perceived benefits reported were: a better opportunity to find a personally satisfactory practice, additional time for gaining clarity about career plans, and a higher beginning salary as a result of the additional skills and experiences gained. This study of mid-career physicians supports that a fourth-year (PGY4) curriculum in family medicine may enhance subsequent career satisfaction. Further studies of residents in other PGY4 training programs are necessary to assess outcomes comparing our findings as well as guide the discipline's leaders in residency redesign.

  7. Prospective evaluation of the prevalence and severity of fatigue in patients with prostate cancer undergoing radical external beam radiotherapy and neoadjuvant hormone therapy.

    Science.gov (United States)

    Truong, Pauline T; Berthelet, Eric; Lee, Junella C; Petersen, Ross; Lim, Jan T W; Gaul, Catherine A; Pai, Howard; Blood, Paul; Ludgate, Charles M

    2006-06-01

    To prospectively evaluate the prevalence and severity of fatigue and its impact on quality of life (QOL) during and after radical external beam radiotherapy (RT) for prostate cancer. Twenty-eight men with prostate cancer undergoing RT over 6-8 consecutive weeks were prospectively accrued. The Brief Fatigue Inventory (BFI), a validated fatigue assessment tool, was administered at five time points: baseline (week 1), middle of RT (week 3-4), end of RT (last week of RT), and follow-up (median 6.5 weeks after RT). The BFI contained nine questions, each using 0-10 ratings to quantify fatigue severity and interference with six QOL domains. The prevalence of moderate-severe fatigue was plotted as a function of time. Mean sum and subscale scores at each time point were compared to baseline scores using Wilcoxon tests. Linear regression analyses were performed to assess associations between fatigue scores and age, tumor and treatment characteristics. The median age was 69 years (range 57-84), Gleason score 7 (range 6-10), and presenting PSA 9.0 ng/mL (range 2.5 ng/mL-103.0 ng/mL). Patients were treated once daily to a median dose of 74 Gy (range 60 Gy-78 Gy) over a median of 37 fractions (range 30-39). Hormone therapy was used in all patients (median duration 12.2 months). The prevalence of moderate-severe present fatigue increased from 7% at baseline to 8% at mid-RT and 32% at RT completion. Compared to baseline (mean score 11.5), fatigue increased significantly mid-RT (mean score 14.6, p = 0.03) and peaked at the end of RT (mean score 23.5, p = 0.001). Fatigue significantly interfered with walking ability, normal work, daily chores, and enjoyment of life only at the end of RT. After RT completion, fatigue improved but remained higher compared to baseline at 6.5 weeks of follow-up (mean score 15.0, p = 0.02). On linear regression analysis, age, Gleason score, PSA, T-stage, hormone therapy duration, RT dose and fractions were not significantly associated with mean fatigue

  8. Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis.

    Science.gov (United States)

    Samandara, Aikaterini; Papageorgiou, Spyridon N; Ioannidou-Marathiotou, Ioulia; Kavvadia-Tsatala, Smaragda; Papadopoulos, Moschos A

    2018-05-15

    Orthodontically induced external root resorption (OIRR) is a pathologic consequence of orthodontic tooth movement. However, the limitations of two-dimensional radiography suggest that cone beam computed tomography (CBCT) with its three-dimensional capabilities might be more suitable to assess OIRR. The aim of this study was to assess in an evidence-based manner data on linear or volumetric OIRR measurements of permanent teeth by means of CBCT, during and/or after the end of orthodontic treatment. Unrestricted electronic and hand searches were performed up to January 2017 in 15 databases. Randomized clinical trials, prospective, and retrospective non-randomized studies assessing OIRR during and/or after orthodontic treatment using CBCT in human patients were included. After duplicate study selection, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses, followed by subgroup, meta-regression, and sensitivity analyses were also performed in order to evaluate factors that affect OIRR. A total of 33 studies (30 datasets) were included in the qualitative analysis while data from 27 of them were included in the quantitative analysis. Direct comparisons from randomized trials found little to no influence of appliance-related factors on OIRR. Explorative analyses including non-randomized studies found a pooled OIRR of 0.79 mm based on all included studies and 0.86 mm when OIRR was assessed at the end of orthodontic treatment. Statistically significant differences in OIRR were found according to tooth type or jaw, inclusion of extractions, treatment duration, and diagnostic accuracy of the CBCT. Based on the results of this study, CBCT seems to be a reliable tool to examine OIRR during or at the end of orthodontic treatment. Although the average OIRR measured with CBCT seems to lack clinical relevance, there are certain factors that may affect OIRR following orthodontic treatment. Nevertheless, due to data

  9. Aerodynamic Analysis and Three-Dimensional Redesign of a Multi-Stage Axial Flow Compressor

    Directory of Open Access Journals (Sweden)

    Tao Ning

    2016-04-01

    Full Text Available This paper describes the introduction of three-dimension (3-D blade designs into a 5-stage axial compressor with multi-stage computational fluid dynamic (CFD methods. Prior to a redesign, a validation study is conducted for the overall performance and flow details based on full-scale test data, proving that the multi-stage CFD applied is a relatively reliable tool for the analysis of the follow-up redesign. Furthermore, at the near stall point, the aerodynamic analysis demonstrates that significant separation exists in the last stator, leading to the aerodynamic redesign, which is the focus of the last stator. Multi-stage CFD methods are applied throughout the three-dimensional redesign process for the last stator to explore their aerodynamic improvement potential. An unconventional asymmetric bow configuration incorporated with leading edge re-camber and re-solidity is employed to reduce the high loss region dominated by the mainstream. The final redesigned version produces a 13% increase in the stall margin while maintaining the efficiency at the design point.

  10. Externalities of energy and atomic power

    International Nuclear Information System (INIS)

    2006-09-01

    Energy technology ensures not only energy supply but also has great impacts on society and environments. Economical value and effect evaluation alone doesn't mean appropriate so the evaluation of 'externalities' should be appreciated. In order to assess atomic power in this context, the Atomic Energy Society of Japan set up a research committee on 'externalities of energy and atomic power' from April 2002 to March 2006, whose activities were described in this report. In addition to environmental effects and environmental externalities, four areas were newly studied as follows: (1) biological effects of low dose rate exposure and externalities, (2) externalities as social/economical effects including stable supply and security, (3) energy technologies evaluation and (4) social choice and decision-making. (T. Tanaka)

  11. Assessment of generalizability, applicability and predictability (GAP) for evaluating external validity in studies of universal family-based prevention of alcohol misuse in young people: systematic methodological review of randomized controlled trials.

    Science.gov (United States)

    Fernandez-Hermida, Jose Ramon; Calafat, Amador; Becoña, Elisardo; Tsertsvadze, Alexander; Foxcroft, David R

    2012-09-01

    To assess external validity characteristics of studies from two Cochrane Systematic Reviews of the effectiveness of universal family-based prevention of alcohol misuse in young people. Two reviewers used an a priori developed external validity rating form and independently assessed three external validity dimensions of generalizability, applicability and predictability (GAP) in randomized controlled trials. The majority (69%) of the included 29 studies were rated 'unclear' on the reporting of sufficient information for judging generalizability from sample to study population. Ten studies (35%) were rated 'unclear' on the reporting of sufficient information for judging applicability to other populations and settings. No study provided an assessment of the validity of the trial end-point measures for subsequent mortality, morbidity, quality of life or other economic or social outcomes. Similarly, no study reported on the validity of surrogate measures using established criteria for assessing surrogate end-points. Studies evaluating the benefits of family-based prevention of alcohol misuse in young people are generally inadequate at reporting information relevant to generalizability of the findings or implications for health or social outcomes. Researchers, study authors, peer reviewers, journal editors and scientific societies should take steps to improve the reporting of information relevant to external validity in prevention trials. © 2012 The Authors. Addiction © 2012 Society for the Study of Addiction.

  12. External radiation surveillance

    International Nuclear Information System (INIS)

    Antonio, E.J.

    1995-01-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site

  13. External radiation surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  14. Evaluation of the internal and external responsiveness of the Pressure Ulcer Scale for Healing (PUSH) tool for assessing acute and chronic wounds.

    Science.gov (United States)

    Choi, Edmond P H; Chin, Weng Yee; Wan, Eric Y F; Lam, Cindy L K

    2016-05-01

    To examine the internal and external responsiveness of the Pressure Ulcer Scale for Healing (PUSH) tool for assessing the healing progress in acute and chronic wounds. It is important to establish the responsiveness of instruments used in conducting wound care assessments to ensure that they are able to capture changes in wound healing accurately over time. Prospective longitudinal observational study. The key study instrument was the PUSH tool. Internal responsiveness was assessed using paired t-testing and effect size statistics. External responsiveness was assessed using multiple linear regression. All new patients with at least one eligible acute or chronic wound, enrolled in the Nurse and Allied Health Clinic-Wound Care programme between 1 December 2012 - 31 March 2013 were included for analysis (N = 541). Overall, the PUSH tool was able to detect statistically significant changes in wound healing between baseline and discharge. The effect size statistics were large. The internal responsiveness of the PUSH tool was confirmed in patients with a variety of different wound types including venous ulcers, pressure ulcers, neuropathic ulcers, burns and scalds, skin tears, surgical wounds and traumatic wounds. After controlling for age, gender and wound type, subjects in the 'wound improved but not healed' group had a smaller change in PUSH scores than those in the 'wound healed' group. Subjects in the 'wound static or worsened' group had the smallest change in PUSH scores. The external responsiveness was confirmed. The internal and external responsiveness of the PUSH tool confirmed that it can be used to track the healing progress of both acute and chronic wounds. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  15. A pilot evaluation of external quality assessment of GenoType MTBDRplus versions 1 and 2 using dried culture spot material.

    Science.gov (United States)

    Gous, N; Isherwood, L E; David, A; Stevens, W; Scott, L E

    2015-04-01

    Dried culture spots (DCS) of inactivated Mycobacteria strains designed as part of an external quality assessment (EQA) program for the GeneXpert system has applications to other molecular tuberculosis (TB) diagnostic platforms. DCS tested on the GenoType MTBDRplus and Mycobacterium CM assays performed well with MTBDRplus version 2 but require increased bacterial concentration for use with version 1. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  16. WVNS Tank Farm Process Support: Experimental evaluation of an inert gas (nitrogen) to mitigate external corrosion of high-level waste storage tanks

    International Nuclear Information System (INIS)

    Elmore, M.R.

    1996-02-01

    Corrosion of the carbon steel waste storage tanks at West Valley Nuclear Services continues to be of concern, especially as the planned duration of waste storage time increases and sludge washing operations are conducted. The external surfaces of Tanks 8D-1 and 8D-2 have been exposed for more than 10 years to water that has intruded into the tank vaults. Visual inspection of the external tank surfaces using a remote video camera has shown indications of heavy corrosion in localized areas on the tank walls. Tests on mild steel specimens under simulated tank vault conditions showed that corrosion is related to the availability of oxygen for the corrosion reactions; consequently, removing oxygen as one of the reactants should effectively eliminate corrosion. In terms of the waste tanks, excluding oxygen from the annular vault space, such as by continuous flushing with an inert gas, should substantially decrease corrosion of the external surfaces of the mild steel tanks (100% exclusion of oxygen is probably not practicable). Laboratory corrosion testing was conducted at Pacific Northwest National Laboratory to give a preliminary assessment of the ability of nitrogen-inerting to reduce steel corrosion. This report summarizes test results obtained after 18-month corrosion tests comparing open-quotes nitrogen-inertedclose quotes corrosion with open-quotes air-equilibratedclose quotes corrosion under simulated tank vault conditions

  17. A study in usability: redesigning a health sciences library's mobile site.

    Science.gov (United States)

    Rosario, Jovy-Anne; Ascher, Marie T; Cunningham, Diana J

    2012-01-01

    A mobile site redesign was conducted at a medium-sized academic health sciences library with the goal of creating a site that meets the mobile information needs of its users. The redesign phases included (1) needs assessment, (2) usability testing, and (3) site design. The survey results showed that Apple devices were the most prevalent; the most desirable activities performed on a mobile site were searching for articles, accessing full-text articles and e-books, searching databases, and searching the catalog. These activities guided the development of the usability testing tasks and the redesign. All phases were completed within six months, and the total project cost was $50 for incentive purchases. Copyright © Taylor & Francis Group, LLC

  18. An evaluation of data-driven motion estimation in comparison to the usage of external-surrogates in cardiac SPECT imaging

    International Nuclear Information System (INIS)

    Mukherjee, Joyeeta Mitra; Johnson, Karen L; Pretorius, P Hendrik; King, Michael A; Hutton, Brian F

    2013-01-01

    Motion estimation methods in single photon emission computed tomography (SPECT) can be classified into methods which depend on just the emission data (data-driven), or those that use some other source of information such as an external surrogate. The surrogate-based methods estimate the motion exhibited externally which may not correlate exactly with the movement of organs inside the body. The accuracy of data-driven strategies on the other hand is affected by the type and timing of motion occurrence during acquisition, the source distribution, and various degrading factors such as attenuation, scatter, and system spatial resolution. The goal of this paper is to investigate the performance of two data-driven motion estimation schemes based on the rigid-body registration of projections of motion-transformed source distributions to the acquired projection data for cardiac SPECT studies. Comparison is also made of six intensity based registration metrics to an external surrogate-based method. In the data-driven schemes, a partially reconstructed heart is used as the initial source distribution. The partially-reconstructed heart has inaccuracies due to limited angle artifacts resulting from using only a part of the SPECT projections acquired while the patient maintained the same pose. The performance of different cost functions in quantifying consistency with the SPECT projection data in the data-driven schemes was compared for clinically realistic patient motion occurring as discrete pose changes, one or two times during acquisition. The six intensity-based metrics studied were mean-squared difference, mutual information, normalized mutual information (NMI), pattern intensity (PI), normalized cross-correlation and entropy of the difference. Quantitative and qualitative analysis of the performance is reported using Monte-Carlo simulations of a realistic heart phantom including degradation factors such as attenuation, scatter and system spatial resolution. Further the

  19. Bone scanning in severe external otitis

    International Nuclear Information System (INIS)

    Levin, W.J.; Shary, J.H. III; Nichols, L.T.; Lucente, F.E.

    1986-01-01

    Technetium99 Methylene Diphosphate bone scanning has been considered an early valuable tool to diagnose necrotizing progressive malignant external otitis. However, to our knowledge, no formal studies have actually compared bone scans of otherwise young, healthy patients with severe external otitis to scans of patients with clinical presentation of malignant external otitis. Twelve patients with only severe external otitis were studied with Technetium99 Diphosphate and were compared to known cases of malignant otitis. All scans were evaluated by two neuroradiologists with no prior knowledge of the clinical status of the patients. Nine of the 12 patients had positive bone scans with many scans resembling those reported with malignant external otitis. Interestingly, there was no consistent correlation between the severity of clinical presentation and the amount of Technetium uptake. These findings suggest that a positive bone scan alone should not be interpreted as indicative of malignant external otitis

  20. Aplikasi Ergonomic Function Deployment (Efd Pada Redesign Alat Parut Kelapa Untuk Ibu Rumah Tangga

    Directory of Open Access Journals (Sweden)

    Roberta Zulfhi Surya

    2015-04-01

    Ergonomic Function Deployment (Efd Application In Coconut Grater Redesign For HousewifeAbstract. Pulverizing (coconut grated is one of daily kitchen worksconducted by housewives. A common existing coconut grater which is available on the market is normally works using a crank system. Housewives have complaints of pain in the limbs, especially the hands, waist and back after using this grater. This study aims to improve the design of coconut grater with Ergonomic Function Deployment (EFD based system and determine the housewife musculoskeletal decline as users. Further, to examine pulverizing time difference after redesign. The study was conducted at RT. 001 RW. 005 West Tembilahan Hulu village, subdistrict Tembilahan Indragiri Hilir. The method use in this study is same design subject (treatment by subjects design with co added Colton equation. Atotal of 12 housewives were used and subjected to the calculation. A grater redesign with EFD system was obtained by creating House of Ergonomic (HOE matrices and determining the anthropometric data. Whilst musculoskeletal disorders were obtained by generating Nordic Body Map (NBMworksheets questionnaire. Moreover, pulverizing time was obtained by testing coconut graterused before and after redesign. Results of the study showed that the redesign tool based on Ergonomic Function Deployment (EFD systemwasfound to be more convenient form which five ergonomics aspects required was fulfilled: effective, convenient, safe, healthy, and efficient (ENASE. Housewife musculoskeletal complaints decreased by 0.285% or 17.39%. This study also shows that coconut pulverizing time is 5 minutes faster and increased by 30.10% after redesigning the coconut grater crank system.

  1. On analysis and redesign of bolted L-flanged connections

    DEFF Research Database (Denmark)

    Pedersen, Niels Leergaard

    2017-01-01

    and the tensile force in the bolt. In the literature and also in standards,different models are presented for this important non-linear response. In the present paper, a simplified expression for the non-linear force response is presented based on finite element calculations using contact analysis. The L......-flange connection is in essence a bad design because it leads to a non-optimal ratio between external force and bolt force. Furthermore,bolt bending results in an even higher bolt stress resulting in a reduction of strength. The present paper presents simple modifications of the L-flange design that considerably...

  2. Preliminary design package for residential heating/cooling system: Rankine air conditioner redesign

    Science.gov (United States)

    1978-01-01

    A summary of the preliminary redesign and development of a marketable single family heating and cooling system is presented. The interim design and schedule status of the residential (3-ton) redesign, problem areas and solutions, and the definition of plans for future design and development activities were discussed. The proposed system for a single-family residential heating and cooling system is a single-loop, solar-assisted, hydronic-to-warm-air heating subsystem with solar-assisted domestic water heating and a Rankine-driven expansion air-conditioning subsystem.

  3. Experiences of primary care physicians and staff following lean workflow redesign.

    Science.gov (United States)

    Hung, Dorothy Y; Harrison, Michael I; Truong, Quan; Du, Xue

    2018-04-10

    In response to growing pressures on primary care, leaders have introduced a wide range of workforce and practice innovations, including team redesigns that delegate some physician tasks to nonphysicians. One important question is how such innovations affect care team members, particularly in view of growing dissatisfaction and burnout among healthcare professionals. We examine the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. This included co-locating physician and medical assistant dyads, delegating significant responsibilities to nonphysician staff, and mandating greater coordination and communication among all care team members. The redesigns were implemented and scaled in three phases across 46 primary care departments in a large ambulatory care delivery system. We fielded 1164 baseline and 1333 follow-up surveys to physicians and other nonphysician staff (average 73% response rate) to assess workforce engagement (e.g., job satisfaction, motivation), perceptions of the work environment, and job-related burnout. We conducted multivariate regressions to detect changes in experiences after the redesign, adjusting for respondent characteristics and clustering of within-clinic responses. We found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, they also experienced higher levels of burnout and perceptions of the workplace as stressful. Trends were the same for both occupational groups, but the increased reports of stress were greater among physicians. Additionally, members of all clinics, except for the pilot site that developed the new workflows, reported higher burnout, while perceptions of workplace stress increased in all clinics after the redesign. Our findings partially align with expectations of work redesign as a route to improving physician and staff experiences in delivering care. Although teamwork and engagement

  4. Preliminary design package for residential heating/cooling system--Rankine air conditioner redesign

    Energy Technology Data Exchange (ETDEWEB)

    1978-12-01

    This report contains a summary of the preliminary redesign and development of a marketable single-family heating and cooling system. The objectives discussed are the interim design and schedule status of the Residential (3-ton) redesign, problem areas and solutions, and the definition of plans for future design and development activities. The proposed system for a single-family residential heating and cooling system is a single-loop, solar-assisted, hydronic-to-warm-air heating subsystem with solar-assisted domestic water heating and a Rankine-driven expansion air-conditioning subsystem.

  5. Methods for evaluating physical processes in strong external fields at e{sup +}e{sup -} colliders. Furry picture and quasi-classical approach

    Energy Technology Data Exchange (ETDEWEB)

    Porto, Stefano [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; Hartin, Anthony [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Moortgat-Pick, Gudrid [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)

    2013-04-15

    Future linear colliders designs, ILC and CLIC, are expected to be powerful machines for the discovery of Physics Beyond the Standard Model and subsequent precision studies. However, due to the intense beams (high luminosity, high energy), strong electromagnetic fields occur in the beam-beam interaction region. In the context of precision high energy physics, the presence of such strong fields may yield sensitive corrections to the observed electron-positron processes. The Furry picture of quantum states gives a conceptually simple tool to treat physics processes in an external field. A generalization of the quasi-classical operator method (QOM) as an approximation is considered too.

  6. 25 CFR 20.203 - Can a tribe incorporate assistance from other sources into a tribal redesign plan?

    Science.gov (United States)

    2010-04-01

    ...-477 federal funding sources) in the plan. ... 25 Indians 1 2010-04-01 2010-04-01 false Can a tribe incorporate assistance from other sources... tribe incorporate assistance from other sources into a tribal redesign plan? Yes, when a tribe redesigns...

  7. Multicenter external validation of two malignancy risk prediction models in patients undergoing 18F-FDG-PET for solitary pulmonary nodule evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Perandini, Simone; Soardi, G.A.; Signorini, M.; Motton, M.; Montemezzi, S. [Azienda Ospedaliera Universitaria Integrata di Verona, UOC Radiologia, Ospedale Maggiore di Borgo Trento, Verona (Italy); Larici, A.R.; Del Ciello, A. [Universita Cattolica del Sacro Cuore, Dipartimento di Scienze Radiologiche, Roma (Italy); Rizzardi, G. [Ospedale Humanitas Gavazzeni, UO Chirurgia Toracica, Bergamo (Italy); Solazzo, A. [Ospedale Humanitas Gavazzeni, UO Radiologia, Bergamo (Italy); Mancino, L.; Zeraj, F. [Ospedale dell' Angelo di Mestre, UO Pneumologia, Venezia (Italy); Bernhart, M. [Ospedale dell' Angelo di Mestre, UO Radiologia, Venezia (Italy)

    2017-05-15

    To achieve multicentre external validation of the Herder and Bayesian Inference Malignancy Calculator (BIMC) models. Two hundred and fifty-nine solitary pulmonary nodules (SPNs) collected from four major hospitals which underwent 18-FDG-PET characterization were included in this multicentre retrospective study. The Herder model was tested on all available lesions (group A). A subgroup of 180 SPNs (group B) was used to provide unbiased comparison between the Herder and BIMC models. Receiver operating characteristic (ROC) area under the curve (AUC) analysis was performed to assess diagnostic accuracy. Decision analysis was performed by adopting the risk threshold stated in British Thoracic Society (BTS) guidelines. Unbiased comparison performed In Group B showed a ROC AUC for the Herder model of 0.807 (95 % CI 0.742-0.862) and for the BIMC model of 0.822 (95 % CI 0.758-0.875). Both the Herder and the BIMC models were proven to accurately predict the risk of malignancy when tested on a large multicentre external case series. The BIMC model seems advantageous on the basis of a more favourable decision analysis. (orig.)

  8. Multicenter external validation of two malignancy risk prediction models in patients undergoing 18F-FDG-PET for solitary pulmonary nodule evaluation

    International Nuclear Information System (INIS)

    Perandini, Simone; Soardi, G.A.; Signorini, M.; Motton, M.; Montemezzi, S.; Larici, A.R.; Del Ciello, A.; Rizzardi, G.; Solazzo, A.; Mancino, L.; Zeraj, F.; Bernhart, M.

    2017-01-01

    To achieve multicentre external validation of the Herder and Bayesian Inference Malignancy Calculator (BIMC) models. Two hundred and fifty-nine solitary pulmonary nodules (SPNs) collected from four major hospitals which underwent 18-FDG-PET characterization were included in this multicentre retrospective study. The Herder model was tested on all available lesions (group A). A subgroup of 180 SPNs (group B) was used to provide unbiased comparison between the Herder and BIMC models. Receiver operating characteristic (ROC) area under the curve (AUC) analysis was performed to assess diagnostic accuracy. Decision analysis was performed by adopting the risk threshold stated in British Thoracic Society (BTS) guidelines. Unbiased comparison performed In Group B showed a ROC AUC for the Herder model of 0.807 (95 % CI 0.742-0.862) and for the BIMC model of 0.822 (95 % CI 0.758-0.875). Both the Herder and the BIMC models were proven to accurately predict the risk of malignancy when tested on a large multicentre external case series. The BIMC model seems advantageous on the basis of a more favourable decision analysis. (orig.)

  9. Evaluation of hip internal and external rotation range of motion as an injury risk factor for hip, abdominal and groin injuries in professional baseball players

    Directory of Open Access Journals (Sweden)

    Xinning Li

    2015-12-01

    Full Text Available Normal hip range of motion (ROM is essential in running and transfer of energy from lower to upper extremities during overhead throwing. Dysfunctional hip ROM may alter lower extremity kinematics and predispose athletes to hip and groin injuries. The purpose of this study is characterize hip internal/external ROM (Arc and its effect on the risk of hip, hamstring, and groin injuries in professional baseball players. Bilateral hip internal and external ROM was measured on all baseball players (N=201 in one professional organization (major and minor league during spring training. Players were organized according to their respective positions. All injuries were documented prospectively for an entire MLB season (2010 to 2011. Data was analyzed according to position and injuries during the season. Total number of players (N=201 with an average age of 24±3.6 (range=17-37. Both pitchers (N=93 and catchers (N=22 had significantly decreased mean hip internal rotation and overall hip arc of motion compared to the positional players (N=86. Players with hip, groin, and hamstring injury also had decreased hip rotation arc when compared to the normal group. Overall, there is a correlation between decreased hip internal rotation and total arc of motion with hip, hamstring, and groin injuries.

  10. Re-designing the Mozambique vaccine supply chain to improve access to vaccines.

    Science.gov (United States)

    Lee, Bruce Y; Haidari, Leila A; Prosser, Wendy; Connor, Diana L; Bechtel, Ruth; Dipuve, Amelia; Kassim, Hidayat; Khanlawia, Balbina; Brown, Shawn T

    2016-09-22

    Populations and routine childhood vaccine regimens have changed substantially since supply chains were designed in the 1980s, and introducing new vaccines during the "Decade of Vaccine" may exacerbate existing bottlenecks, further inhibiting the flow of all vaccines. Working with the Mozambique Ministry of Health, our team implemented a new process that integrated HERMES computational simulation modeling and on-the-ground implementers to evaluate and improve the Mozambique vaccine supply chain using a system-re-design that integrated new supply chain structures, information technology, equipment, personnel, and policies. The alternative system design raised vaccine availability (from 66% to 93% in Gaza; from 76% to 84% in Cabo Delgado) and reduced the logistics cost per dose administered (from $0.53 to $0.32 in Gaza; from $0.38 to $0.24 in Cabo Delgado) as compared to the multi-tiered system under the current EPI. The alternative system also produced higher availability at lower costs after new vaccine introductions. Since reviewing scenarios modeling deliveries every two months in the north of Gaza, the provincial directorate has decided to pilot this approach diverging from decades of policies dictating monthly deliveries. Re-design improved not only supply chain efficacy but also efficiency, important since resources to deliver vaccines are limited. The Mozambique experience and process can serve as a model for other countries during the Decade of Vaccines. For the Decade of Vaccines, getting vaccines at affordable prices to the market is not enough. Vaccines must reach the population to be successful. Copyright © 2016. Published by Elsevier Ltd.

  11. The flipped classroom: a course redesign to foster learning and engagement in a health professions school.

    Science.gov (United States)

    McLaughlin, Jacqueline E; Roth, Mary T; Glatt, Dylan M; Gharkholonarehe, Nastaran; Davidson, Christopher A; Griffin, LaToya M; Esserman, Denise A; Mumper, Russell J

    2014-02-01

    Recent calls for educational reform highlight ongoing concerns about the ability of current curricula to equip aspiring health care professionals with the skills for success. Whereas a wide range of proposed solutions attempt to address apparent deficiencies in current educational models, a growing body of literature consistently points to the need to rethink the traditional in-class, lecture-based course model. One such proposal is the flipped classroom, in which content is offloaded for students to learn on their own, and class time is dedicated to engaging students in student-centered learning activities, like problem-based learning and inquiry-oriented strategies. In 2012, the authors flipped a required first-year pharmaceutics course at the University of North Carolina Eshelman School of Pharmacy. They offloaded all lectures to self-paced online videos and used class time to engage students in active learning exercises. In this article, the authors describe the philosophy and methodology used to redesign the Basic Pharmaceutics II course and outline the research they conducted to investigate the resulting outcomes. This article is intended to serve as a guide to instructors and educational programs seeking to develop, implement, and evaluate innovative and practical strategies to transform students' learning experience. As class attendance, students' learning, and the perceived value of this model all increased following participation in the flipped classroom, the authors conclude that this approach warrants careful consideration as educators aim to enhance learning, improve outcomes, and fully equip students to address 21st-century health care needs.

  12. [External cephalic version].

    Science.gov (United States)

    Navarro-Santana, B; Duarez-Coronado, M; Plaza-Arranz, J

    2016-08-01

    To analyze the rate of successful external cephalic versions in our center and caesarean sections that would be avoided with the use of external cephalic versions. From January 2012 to March 2016 external cephalic versions carried out at our center, which were a total of 52. We collected data about female age, gestational age at the time of the external cephalic version, maternal body mass index (BMI), fetal variety and situation, fetal weight, parity, location of the placenta, amniotic fluid index (ILA), tocolysis, analgesia, and newborn weight at birth, minor adverse effects (dizziness, hypotension and maternal pain) and major adverse effects (tachycardia, bradycardia, decelerations and emergency cesarean section). 45% of the versions were unsuccessful and 55% were successful. The percentage of successful vaginal delivery in versions was 84% (4% were instrumental) and 15% of caesarean sections. With respect to the variables studied, only significant differences in birth weight were found; suggesting that birth weight it is related to the outcome of external cephalic version. Probably we did not find significant differences due to the number of patients studied. For women with breech presentation, we recommend external cephalic version before the expectant management or performing a cesarean section. The external cephalic version increases the proportion of fetuses in cephalic presentation and also decreases the rate of caesarean sections.

  13. Redesign of Work for Educational Purposes and for Quality of Working Life

    Science.gov (United States)

    Taylor, James C.

    1976-01-01

    Examples of successful implementation of sociotechnical design of workplaces indicate that workplaces can be redesigned to achieve a closer match between employee values and organizational work roles. Organizational effectiveness does not seem to be sacrificed as a consequence of such action. (Author/JDS)

  14. Preliminary Assessment of the Emporium Model in a Redesigned Engineering Mechanics Course

    Science.gov (United States)

    Rais-Rohani, Masoud; Walters, Andrew

    2014-01-01

    A lecture-based engineering mechanics course (Statics) is redesigned using the Emporium model. Whereas students study the material outside of class via asynchronous online delivery of the content and instructional videos, they do all the other activities (e.g., assignments, tests) either individually or in groups inside the classroom. Computer-…

  15. A Study on Situated Cognition: Product Dissection's Effect on Redesign Activities

    Science.gov (United States)

    Grantham, Katie; Okudan Kremer, Gül E.; Simpson, Timothy W.; Ashour, Omar

    2013-01-01

    Situated cognition theory describes the context of a learning activity's effect on learner's cognition. In this paper, we use situated cognition theory to examine the effect of product dissection on product redesign activities. Two specific research questions are addressed: 1) Does situated cognition, in the form of product dissection, improve…

  16. Responding to the Concerns of Student Cultural Groups: Redesigning Spaces for Cultural Centers

    Science.gov (United States)

    McDowell, Anise Mazone; Higbee, Jeanne L.

    2014-01-01

    This paper describes the engagement of a student committee in redesigning an entire floor of a university union to accommodate student cultural centers and provide space in a fair and equitable manner. The reorganization focused on the process as well as the task of allocating space, with an emphasis on the opportunity to foster the development of…

  17. Case-based reasoning as a technique for knowledge management in business process redesign

    NARCIS (Netherlands)

    Limam Mansar, S.; Reijers, H.A.; Marir, F.

    2003-01-01

    Business Process Redesign (BPR) helps rethinking a process in order to enhance its performance. Practitioners have been developing methodologies to support BPR implementation. However, most methodologies lack actual guidance on deriving a process design threatening the success of BPR. In this paper,

  18. Which kind of knowledge is suitable for redesigning hospital logistic processes?

    NARCIS (Netherlands)

    Maruster, L; Jorna, RJ; Miksch, S; Hunter, J; Keravnou, E

    2005-01-01

    A knowledge management perspective is rarely used to model a process. Using the cognitive perspective on knowledge management in which we start our analysis with events and knowledge (bottom-up) instead of with processes and units (top-down), we propose a new approach for redesigning hospital

  19. Redesigning Romance: The Making and Analysis of a Critical Literacy Comic in South Africa.

    Science.gov (United States)

    Shariff, Patricia Watson; Janks, Hilary

    2001-01-01

    Examines the making and redesigning of the romance stories (in comic-book form) in drama in education workshops conducted in a rural South African high school. Brings together practice and theory that were independently conceived, so that they can mutually inform one another. Analyses the narrative outline which kick-started the comic development…

  20. Application of Evidence-Centered Assessment Design to the Advanced Placement Redesign: A Graphic Restatement

    Science.gov (United States)

    Bejar, Isaac I.

    2010-01-01

    The foregoing articles constitute what I consider a comprehensive and clear description of the redesign process of a major assessment. The articles serve to illustrate the problems that will need to be addressed by large-scale assessments in the twenty-first century. Primary among them is how to organize the development of such assessments to meet…

  1. Strategies for Aligning Physicians to System Redesign Goals at Eight Safety-Net Systems.

    Science.gov (United States)

    Zallman, Leah; Bearse, Adriana; Neal, Natasha; VanDeusen Lukas, Carol; Hacker, Karen

    2014-12-01

    Facing recent economic and regulatory pressures, safety-net systems (SNSs) are redesigning their organizations to improve care delivery, remain financially viable, and maintain competitive positions. Aligning physicians with redesign goals is a priority, particularly as many SNSs shift toward patient-centered, population health-focused models. No previous work has examined efforts to align physicians to safety net redesign efforts. This qualitative study, conducted at eight SNSs, examined challenges faced in a changing health care environment, as well as strategies and resources to address them. Strategies clustered in two categories: physician role definition and organizational infrastructure. Physician role definition strategies were (1) changing payment and employment arrangements, (2) changing clinical roles, (3) increasing physician involvement in quality improvement, and (4) strengthening physician leadership in clinical and quality roles. Organizational infrastructure strategies were (1) ensuring medical center leadership support and integration, (2) utilizing data to drive physician behavior, and (3) addressing competing allegiances with academia. All sites reported multifaceted approaches but differed in specific strategies employed, facilitators noted, and challenges encountered. The findings highlight the need to implement multiple strategies to align physicians in redesign efforts. They suggest that all health systems, whether SNSs or not, can capitalize on qualities of physicians and existing infrastructural and leadership elements to achieve physician alignment. However, they must contend with and address challenges of competing allegiance (for example, academic, physician organization, hospital), as well as resistance to changing clinical roles and payment structures.

  2. Simulation modelling for food supply chain redesign; integrated decision making on product quality, sustainability and logistics

    NARCIS (Netherlands)

    van der Vorst, J.G.A.J.; Tromp, S.O.; van der Zee, D.J.

    2009-01-01

    Food supply chains are confronted with increased consumer demands on food quality and sustainability. When redesigning these chains the analysis of food quality change and environmental load of new scenarios is as important as the analysis of efficiency and responsiveness requirements. Simulation

  3. Redesigning the work system of rubber industries based on total ergonomics and ergo-micmac integration

    Science.gov (United States)

    Setiawan, H.

    2018-01-01

    The factory capacity achievement and the bottleneck reduction of production process at wet-blanket workstations are influenced by the balance of life quality rates and worker’s productivity, along with the worker’s ability and limitations, tasks, organization and work environment. The life quality of workers is indicated by: the reduction of workload, and fatigue. Meanwhile, work productivity is measured by increasing production results per work shift. The optimization of the quality of life and productivity of workers is achieved by redesigning the system and workstations based on ergonomics integrating Total Ergonomics with Ergo-MicMac (Micro Ergonomics and Macro Ergonomics), which includes redesigning wet-blanket folding worktable, regulating the system pattern of working in pairs, giving official break time, giving extra nutritious intakes such as sweet tea and snack Pempek, giving personal protective equipments, and redesigning physical working environments.This study was an experimental study, with treatment by subject design involving 30 workers sampled at a workstation condition before and after Ergonomics based redesign. The findings and conclusions of the study were derived from the reduction of the workload by 16.06%, fatigue by 18.84% and the increase of production results per work shift by 20.29%.

  4. A Product Analysis Method and Its Staging to Develop Redesign Competences

    Science.gov (United States)

    Hansen, Claus Thorp; Lenau, Torben Anker

    2013-01-01

    Most product development work in industrial practice is incremental, i.e., the company has had a product in production and on the market for some time, and now time has come to design an upgraded variant. This type of redesign project requires that the engineering designers have competences to carry through an analysis of the existing product…

  5. Applying cognitive load theory to the redesign of a conventional database systems course

    Science.gov (United States)

    Mason, Raina; Seton, Carolyn; Cooper, Graham

    2016-01-01

    Cognitive load theory (CLT) was used to redesign a Database Systems course for Information Technology students. The redesign was intended to address poor student performance and low satisfaction, and to provide a more relevant foundation in database design and use for subsequent studies and industry. The original course followed the conventional structure for a database course, covering database design first, then database development. Analysis showed the conventional course content was appropriate but the instructional materials used were too complex, especially for novice students. The redesign of instructional materials applied CLT to remove split attention and redundancy effects, to provide suitable worked examples and sub-goals, and included an extensive re-sequencing of content. The approach was primarily directed towards mid- to lower performing students and results showed a significant improvement for this cohort with the exam failure rate reducing by 34% after the redesign on identical final exams. Student satisfaction also increased and feedback from subsequent study was very positive. The application of CLT to the design of instructional materials is discussed for delivery of technical courses.

  6. Creative thinking of design and redesign on SEAT aircraft cabin testbed: a case study

    NARCIS (Netherlands)

    Tan, C.F.; Chen, W.; Rauterberg, G.W.M.

    2009-01-01

    this paper, the intuition approach in the design and redesign of the environmental friendly innovative aircraft cabin simulator is presented.. The aircraft cabin simulator is a testbed that used for European Project SEAT (Smart tEchnologies for Stress free Air Travel). The SEAT project aims to

  7. Business process redesign in healthcare : towards an evidence-based holistic approach

    NARCIS (Netherlands)

    Vanwersch, R.J.B.; Mans, R.S.; Reijers, H.A.; Shiharzi, A.

    2012-01-01

    The redesign of business processes has become the key challenge for many healthcare organizations. This paper argues that current main research streams fail to assist healthcare practitioners in facing this challenge. More specifically, the main research streams fail to support practitioners in

  8. Redesigning business processes : a methodology based on simulation and process mining techniques

    NARCIS (Netherlands)

    Maruster, L.; van Beest, N.R.T.P.

    2009-01-01

    Nowadays, organizations have to adjust their business processes along with the changing environment in order to maintain a competitive advantage. Changing a part of the system to support the business process implies changing the entire system, which leads to complex redesign activities. In this

  9. Effects of a Redesigned Classroom on Play Behaviour among Preschool Children

    Science.gov (United States)

    Acer, Dilek; Gözen, Göksu; Firat, Zehra Saadet; Kefeli, Hatice; Aslan, Büsra

    2016-01-01

    Current research exists regarding the play behaviour of students in various settings and with varying abilities. Regardless, there needs to be improved understanding of how students' play behaviour is affected when their classroom environment is significantly redesigned. This study examined, over a 21-week period between December 2013 and May…

  10. Intuitive thinking of design and redesign on innovative aircraft cabin simulator

    NARCIS (Netherlands)

    Tan, C.F.; Chen, W.; Rauterberg, G.W.M.

    2009-01-01

    In this paper, the intuition approach in the design and redesign of the environmental friendly innovative aircraft cabin simulator is presented. The simulator is a testbed that was designed and built for research on aircraft passenger comfort improvement of long haul air travel. The simulation

  11. Performance-Based Task Assessment of Higher-Order Proficiencies in Redesigned STEM High Schools

    Science.gov (United States)

    Ernst, Jeremy V.; Glennie, Elizabeth; Li, Songze

    2017-01-01

    This study explored student abilities in applying conceptual knowledge when presented with structured performance tasks. Specifically, the study gauged proficiency in higher-order applications of students enrolled in earth and environmental science or biology. The student sample was drawn from a Redesigned STEM high school model where a tested…

  12. Supporting the full BPM life-cycle using process mining and intelligent redesign

    NARCIS (Netherlands)

    Netjes, M.; Reijers, H.A.; Aalst, van der W.M.P.; Siau, K.

    2007-01-01

    Abstract. Business Process Management (BPM) systems provide a broad range of facilities to enact and manage operational business processes. Ideally, these systems should provide support for the complete BPM life-cycle: (re)design, configuration, execution, control, and diagnosis by the FileNet P8

  13. 77 FR 56859 - Federal Register Notification of Redesignation of Potential Wilderness as Wilderness, Ross Lake...

    Science.gov (United States)

    2012-09-14

    ... Register Notification of Redesignation of Potential Wilderness as Wilderness, Ross Lake National Recreation..., Ross Lake National Recreation Area, and Lake Chelan National Recreation Area as the Stephen Mather... acres of potential wilderness within Ross Lake National Recreation Area, including approximately 1,667...

  14. Using business process redesign to reduce wait times at a university hospital in the Netherlands

    NARCIS (Netherlands)

    Elkhuizen, Sylvia G.; Burger, Matthe P. M.; Jonkers, Rene E.; Limburg, Martien; Klazinga, Niek; Bakker, Piet J. M.

    2007-01-01

    BACKGROUND: Business process redesign (BPR) has been applied to implement more customer-focused and cost-effective care. In 2002, two pilot projects to improve patient care processes for two specific patient groups were conducted at the Academic Medical Center, a 1,000-bed university hospital in

  15. The Power of Professionally Situated Practice Analysis in Redesigning Organisations: A Psychosociological Approach

    Science.gov (United States)

    Scaratti, Giuseppe; Gorli, Mara; Ripamonti, Silvio

    2009-01-01

    Purpose: This paper seeks to provoke thoughts around the possibility of using the lever of practices and situated knowledge to trigger organisational change and to redesign it with the involvement of the whole organisation. Design/methodology/approach: The paper presents connections between a psychosociological approach and a practice-based…

  16. Redesigning Schools to Reach Every Student with Excellent Teachers: Financial Planning Summary

    Science.gov (United States)

    Public Impact, 2012

    2012-01-01

    This brief summarizes the ways that schools and their teachers can simultaneously reach more students with excellent teaching, expand teachers' career opportunities, and sustainably fund higher pay and other priorities. This is based on Public Impact's school models that use job redesign and technology to extend the reach of excellent teachers to…

  17. A Behavioral Analysis of the Laboratory Learning Process: Redesigning a Teaching Unit on Recrystallization.

    Science.gov (United States)

    Mulder, T.; Verdonk, A. H.

    1984-01-01

    Reports on a project in which observations of student and teaching assistant behavior were used to redesign a teaching unit on recrystallization. Comments on the instruction manual, starting points for teaching the unit, and list of objectives with related tasks are included. (JN)

  18. The Power of Structural and Symbolic Redesign: Creating a Collaborative Learning Community in Higher Education.

    Science.gov (United States)

    Geltner, Beverley B.

    This paper describes efforts to redesign a graduate program of educational administration and leadership at Oakland University in Rochester, Michigan, shaped by contributions of researchers in contemporary management and leadership theory, feminist pedagogy, action research, and educational reform. A culture of collaboration, inclusion, and…

  19. 78 FR 48087 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Redesignation of the Canton...

    Science.gov (United States)

    2013-08-07

    ... specific examples to illustrate your concerns, and suggest alternatives. 7. Explain your views as clearly... 172(c)(9) contingency measures is not applicable for purposes of redesignation. Id. Section 172(c)(3... area demonstrates maintenance of the NAAQS without part D NSR. A detailed rationale for this view is...

  20. Re-Designing University Courses to Support Collaborative Knowledge Creation Practices

    Science.gov (United States)

    Lakkala, Minna; Toom, Auli; Ilomäki, Liisa; Muukkkonen, Hanni

    2015-01-01

    Higher education institutions should not only aim to educate academic experts who master their own fields, but also give their students generic skills important in the current society. New teaching methods are required to support the development of such skills. The study examined how a group of voluntary university lecturers re-designed their…