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Sample records for minex improvement program

  1. DETERMINATION OF OPTIMAL CONTOURS OF OPEN PIT MINE DURING OIL SHALE EXPLOITATION, BY MINEX 5.2.3. PROGRAM

    Directory of Open Access Journals (Sweden)

    Miroslav Ignjatović

    2013-04-01

    Full Text Available By examination and determination of optimal solution of technological processes of exploitation and oil shale processing from Aleksinac site and with adopted technical solution and exploitation of oil shale, derived a technical solution that optimize contour of the newly defined open pit mine. In the world, this problem is solved by using a computer program that has become the established standard for quick and efficient solution for this problem. One of the computer’s program, which can be used for determination of the optimal contours of open pit mines is Minex 5.2.3. program, produced in Australia in the Surpac Minex Group Pty Ltd Company, which is applied at the Mining and Metallurgy Institute Bor (no. of licenses are SSI - 24765 and SSI - 24766. In this study, authors performed 11 optimization of deposit geo - models in Minex 5.2.3. based on the tests results, performed in a laboratory for soil mechanics of Mining and Metallurgy Institute, Bor, on samples from the site of Aleksinac deposits.

  2. Brunswick improvement program

    International Nuclear Information System (INIS)

    Howe, P.W.

    1985-01-01

    The performance of the twin 790-MW Mark-4 boiling water reactors located at the Brunswick steam electric plant has historically been well below average. The plant experienced low availability, low capacity factors, high US Nuclear Regulatory Commission (NRC) violations, excessive radioactive waste generation, excessive licensee event reports (LERs), an unacceptable industrial safety record, poor SALP ratings, and numerous other deficiencies leading to unacceptable performance. In June 1982 it was determined that certain periodic tests (PT) had never been performed. While one unit was down for a refueling/modification outage, Carolina Power and Light (CP and L) elected to bring the other unit off line and perform an extensive self-examination. As a result, a number of needed improvements covering a wide range of plant activities were identified. CP and L elected to consolidate all the elements of the improvement into a single, plant-wide program. The consolidated program, called the Brunswick Improvement Program (BIP), was established. Major objectives of the BIP and measurable results are presented

  3. A Miniaturized Extruder to Prototype Amorphous Solid Dispersions: Selection of Plasticizers for Hot Melt Extrusion.

    Science.gov (United States)

    Lauer, Matthias E; Maurer, Reto; Paepe, Anne T De; Stillhart, Cordula; Jacob, Laurence; James, Rajesh; Kojima, Yuki; Rietmann, Rene; Kissling, Tom; van den Ende, Joost A; Schwarz, Sabine; Grassmann, Olaf; Page, Susanne

    2018-05-19

    Hot-melt extrusion is an option to fabricate amorphous solid dispersions and to enhance oral bioavailability of poorly soluble compounds. The selection of suitable polymer carriers and processing aids determines the dissolution, homogeneity and stability performance of this solid dosage form. A miniaturized extrusion device (MinEx) was developed and Hypromellose acetate succinate type L (HPMCAS-L) based extrudates containing the model drugs neurokinin-1 (NK1) and cholesterylester transfer protein (CETP) were manufactured, plasticizers were added and their impact on dissolution and solid-state properties were assessed. Similar mixtures were manufactured with a lab-scale extruder, for face to face comparison. The properties of MinEx extrudates widely translated to those manufactured with a lab-scale extruder. Plasticizers, Polyethyleneglycol 4000 (PEG4000) and Poloxamer 188, were homogenously distributed but decreased the storage stability of the extrudates. Stearic acid was found condensed in ultrathin nanoplatelets which did not impact the storage stability of the system. Depending on their distribution and physicochemical properties, plasticizers can modulate storage stability and dissolution performance of extrudates. MinEx is a valuable prototyping-screening method and enables rational selection of plasticizers in a time and material sparing manner. In eight out of eight cases the properties of the extrudates translated to products manufactured in lab-scale extrusion trials.

  4. 45 CFR 1355.35 - Program improvement plans.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program improvement plans. 1355.35 Section 1355.35... plans. (a) Mandatory program improvement plan. (1) States found not to be operating in substantial conformity shall develop a program improvement plan. The program improvement plan must: (i) Be developed...

  5. Containment performance improvement program

    International Nuclear Information System (INIS)

    Beckner, W.; Mitchell, J.; Soffer, L.; Chow, E.; Lane, J.; Ridgely, J.

    1990-01-01

    The Containment Performance Improvement (CPI) program has been one of the main elements in the US Nuclear Regulatory Commission's (NRC's) integrated approach to closure of severe accident issues for US nuclear power plants. During the course of the program, results from various probabilistic risk assessment (PRA) studies and from severe accident research programs for the five US containment types have been examined to identify significant containment challenges and to evaluate potential improvements. The five containment types considered are: the boiling water reactor (BMR) Mark I containment, the BWR Mark II containment, the BWR Mark III containment, the pressurized water reactor (PWR) ice condenser containment, and the PWR dry containments (including both subatmospheric and large subtypes). The focus of the CPI program has been containment performance and accident mitigation, however, insights are also being obtained in the areas of accident prevention and accident management

  6. 24 Command Fire Improvement Action Program Plan

    International Nuclear Information System (INIS)

    GRIFFIN, G.B.

    2000-01-01

    Fluor Hanford (FH) is responsible for providing support to the Department of Energy Richland Operations Office (RL) in the implementation of the Hanford Emergency Preparedness (EP) program. During fiscal year 2000, a number of program improvements were identified from various sources including a major range fire (24 Command Fire). Evaluations of the emergency preparedness program have confirmed that it currently meets all requirements and that performance of personnel involved is good, however the desire to effect continuous improvement resulted in the development of this improvement program plan. This program plan defines the activities that will be performed in order to achieve the desired performance improvements

  7. (AJST) THE BENEFICIATION OF MUMBWA PHOSPHATE DEPOSIT ...

    African Journals Online (AJOL)

    minerals, heavy media separation using Bromoform and subsequently flotation were applied in the beneficiation tests. ... of pegmatite bodies with high grade P2O5 were discovered by MINEX ..... presence of negatively charged ions such as.

  8. Evolution and outcomes of a quality improvement program.

    Science.gov (United States)

    Thor, Johan; Herrlin, Bo; Wittlöv, Karin; Øvretveit, John; Brommels, Mats

    2010-01-01

    The purpose of this paper is to examine the outcomes and evolution over a five-year period of a Swedish university hospital quality improvement program in light of enduring uncertainty regarding the effectiveness of such programs in healthcare and how best to evaluate it. The paper takes the form of a case study, using data collected as part of the program, including quality indicators from clinical improvement projects and participants' program evaluations. Overall, 58 percent of the program's projects (39/67) demonstrated success. A greater proportion of projects led by female doctors demonstrated success (91 percent, n=11) than projects led by male doctors (51 percent, n=55). Facilitators at the hospital continuously adapted the improvement methods to the local context. A lack of dedicated time for improvement efforts was the participants' biggest difficulty. The dominant benefits included an increased ability to see the "bigger picture" and the improvements achieved for patients and employees. Quality measurement, which is important for conducting and evaluating improvement efforts, was weak with limited reliability. Nevertheless, the present study adds evidence about the effectiveness of healthcare improvement programs. Gender differences in improvement team leadership merit further study. Improvement program evaluation should assess the extent to which improvement methods are locally adapted and applied. This case study reports the outcomes of all improvement projects undertaken in one healthcare organization over a five-year period and provides in-depth insight into an improvement program's changeable nature.

  9. Improved self-exclusion program: preliminary results.

    Science.gov (United States)

    Tremblay, Nicole; Boutin, Claude; Ladouceur, Robert

    2008-12-01

    The gambling industry has offered self-exclusion programs for quite a long time. Such measures are designed to limit access to gaming opportunities and provide problem gamblers with the help they need to cease or limit their gambling behaviour. However, few studies have empirically evaluated these programs. This study has three objectives: (1) to observe the participation in an improved self-exclusion program that includes an initial voluntary evaluation, phone support, and a mandatory meeting, (2) to evaluate satisfaction and usefulness of this service as perceived by self-excluders, (3) to measure the preliminary impact of this improved program. One hundred sixteen self-excluders completed a questionnaire about their satisfaction and their perception of the usefulness during the mandatory meeting. Among those participants, 39 attended an initial meeting. Comparisons between data collected at the initial meeting and data taken at the final meeting were made for those 39 participants. Data showed that gamblers chose the improved self-exclusion program 75% of the time; 25% preferred to sign a regular self-exclusion contract. Among those who chose the improved service, 40% wanted an initial voluntary evaluation and 37% of these individuals actually attended that meeting. Seventy percent of gamblers came to the mandatory meeting, which was a required condition to end their self-exclusion. The majority of participants were satisfied with the improved self-exclusion service and perceived it as useful. Major improvements were observed between the final and the initial evaluation on time and money spent, consequences of gambling, DSM-IV score, and psychological distress. The applicability of an improved self-exclusion program is discussed and, as shown in our study, the inclusion of a final mandatory meeting might not be so repulsive for self-excluders. Future research directives are also proposed.

  10. DEVELOPING VENDOR IMPROVEMENT PROGRAM IN MALAYSIA AUTOMOTIVE COMPANY

    Directory of Open Access Journals (Sweden)

    SHUKRIAH ABDULLAH

    2016-04-01

    Full Text Available Improvement Program seek to do evaluation well, request to become sufficiently versed in evaluation or to integrate on improvement perspective in all phase of performance, from needs assessment to implementation and evaluation itself. The purpose of this program in the automotive company is to assist vendor as global manufacturer in preparation towards ASEAN Free Trade Agreement (AFTA 2015. This development vendor improvement program emphasize on the downtime reduction to below 200 minutes per month with the ultimate end of improving not only program or solutions but also the organizations and customer. A practical approach either planned or unplanned by the automotive company require policies and procedures that address the same consideration on the downtime identification. 20 top bottom rank vendor were determined based on the downtime performance, followed by classification into different group based on severity. To execute the vendor improvement program three among 20 top bottom rank vendors were selected due to willingness to participate and ease of data access in the program. Selected vendors have high ranking in terms of downtime. The case study method involved an interview and plant observation. The used of secondary data from the automotive company, and previous researcher are also utilised. This improvement program assists the automobile manufacturer to improve its supplier’s performance. The vendor improvement program is implemented through a whole supplier operation assessment.

  11. Software Engineering Program: Software Process Improvement Guidebook

    Science.gov (United States)

    1996-01-01

    The purpose of this document is to provide experience-based guidance in implementing a software process improvement program in any NASA software development or maintenance community. This guidebook details how to define, operate, and implement a working software process improvement program. It describes the concept of the software process improvement program and its basic organizational components. It then describes the structure, organization, and operation of the software process improvement program, illustrating all these concepts with specific NASA examples. The information presented in the document is derived from the experiences of several NASA software organizations, including the SEL, the SEAL, and the SORCE. Their experiences reflect many of the elements of software process improvement within NASA. This guidebook presents lessons learned in a form usable by anyone considering establishing a software process improvement program within his or her own environment. This guidebook attempts to balance general and detailed information. It provides material general enough to be usable by NASA organizations whose characteristics do not directly match those of the sources of the information and models presented herein. It also keeps the ideas sufficiently close to the sources of the practical experiences that have generated the models and information.

  12. Improving regulatory oversight of maintenance programs

    International Nuclear Information System (INIS)

    Cook, S.

    2008-01-01

    Safe nuclear power plant operation requires that risks due to failure or unavailability of Structures, Systems and Components (SSCs) be minimized. Implementation of an effective maintenance program is a key means for achieving this goal. In its regulatory framework, the important relationship between maintenance and safety is acknowledged by the CNSC. A high level maintenance program requirement is included in the Class I Facilities Regulations. In addition, the operating licence contains a condition based on the principle that the design function and performance of SSCs needs to remain consistent with the plant's design and analysis documents. Nuclear power plant licensees have the primary responsibility for safe operation of their facilities and consequently for implementation of a successful maintenance program. The oversight role of the Canadian Nuclear Safety Commission (CNSC) is to ensure that the licensee carries out that responsibility. The challenge for the CNSC is how to do this consistently and efficiently. Three opportunities for improvement to regulatory maintenance oversight are being pursued. These are related to the regulatory framework, compliance verification inspection activities and monitoring of self-reporting. The regulatory framework has been improved by clarifying expectations through the issuance of S-210 'Maintenance Programs for Nuclear Power Plants'. Inspection activities have been improved by introducing new maintenance inspections into the baseline program. Monitoring is being improved by making better use of self-reported and industry produced maintenance related performance indicators. As with any type of program change, the challenge is to ensure the consistent and optimal application of regulatory activities and resources. This paper is a summary of the CNSC's approach to improving its maintenance oversight strategy. (author)

  13. Maintenance improvement program

    International Nuclear Information System (INIS)

    Derbonne, D.R.; Plunkett, T.F.; Simpson, J.R.

    1989-01-01

    During fuel cycle 1 at River Bend station, considerable effort was expended to reduce corrective maintenance work orders (MWOs) to <1,000. This was done by complementing the plant staff with costly contract personnel. Coming out of the first refueling outage, most contract personnel were released. The change in MWO backlog started a steady rise. It became readily apparent that to avoid costly contract staff time, a maintenance improvement program (MIP) was necessary. The MIP Was primarily directed at two areas: crew efficiency improvements and improved preplanned MWO packages. The overall effect of the MIP was to achieve significant productivity improvements with reduced operation and maintenance cost by providing frequent accountability to all levels of maintenance supervision. The MIP also produced a feeling of pride among the maintenance department employees that had not really existed before. This was the best benefit of all

  14. Developing an Interdisciplinary, Team-Based Quality Improvement Leadership Training Program for Clinicians: The Partners Clinical Process Improvement Leadership Program.

    Science.gov (United States)

    Rao, Sandhya K; Carballo, Victoria; Cummings, Brian M; Millham, Frederick; Jacobson, Joseph O

    Although there has been tremendous progress in quality improvement (QI) education for students and trainees in recent years, much less has been published regarding the training of active clinicians in QI. The Partners Clinical Process Improvement Leadership Program (CPIP) is a 6-day experiential program. Interdisciplinary teams complete a QI project framed by didactic sessions, interactive exercises, case-based problem sessions, and a final presentation. A total of 239 teams composed of 516 individuals have graduated CPIP. On completion, participant satisfaction scores average 4.52 (scale 1-5) and self-reported understanding of QI concepts improved. At 6 months after graduation, 66% of survey respondents reported sustained QI activity. Three opportunities to improve the program have been identified: (1) increasing faculty participation through online and tiered course offerings, (2) integrating the faculty-focused program with the trainee curriculum, and (3) developing a postgraduate curriculum to address the challenges of sustained improvement.

  15. Examining quality improvement programs: the case of Minnesota hospitals.

    Science.gov (United States)

    Olson, John R; Belohlav, James A; Cook, Lori S; Hays, Julie M

    2008-10-01

    To determine if there is a hierarchy of improvement program adoption by hospitals and outline that hierarchy. Primary data were collected in the spring of 2007 via e-survey from 210 individuals representing 109 Minnesota hospitals. Secondary data from 2006 were assembled from the Leapfrog database. As part of a larger survey, respondents were given a list of improvement programs and asked to identify those programs that are used in their hospital. DATA COLLECTION/DATA EXTRACTION: Rasch Model Analysis was used to assess whether a unidimensional construct exists that defines a hospital's ability to implement performance improvement programs. Linear regression analysis was used to assess the relationship of the Rasch ability scores with Leapfrog Safe Practices Scores to validate the research findings. Principal Findings. The results of the study show that hospitals have widely varying abilities in implementing improvement programs. In addition, improvement programs present differing levels of difficulty for hospitals trying to implement them. Our findings also indicate that the ability to adopt improvement programs is important to the overall performance of hospitals. There is a hierarchy of improvement programs in the health care context. A hospital's ability to successfully adopt improvement programs is a function of its existing capabilities. As a hospital's capability increases, the ability to successfully implement higher level programs also increases.

  16. 76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

    Science.gov (United States)

    2011-06-13

    ... 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program..., 220, 225, and 226 RIN 0584-AC24 Child and Adult Care Food Program Improving Management and Program... management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and...

  17. C-E productivity improvement program

    International Nuclear Information System (INIS)

    Chiu, C.; Ching, B.; Van Haltern, M.L.

    1984-01-01

    This paper describes the C-E Productivity Improvement Program (CEPIP), which is a computer algorithm for heat rate monitoring and diagnostics for a nuclear power plant. CEPIP uses the pattern recognition technique to identify cause(s) of heat rate degradation. The benefits of such an automated program to the plant performance engineer include early identification of the degrading component(s), provision of necessary economic information (cost of energy loss) to the performance engineer so that he can decide when to repair the degrading components, and identification of operator actions resulting in heat rate degradation (such as closing the valve on the live steam extraction line for the second stage of reheat). In summary, CEPIP improves the overall plant performance by increasing the capacity factor. CEPIP was developed to meet the growing needs of the utilities for an automated performance program. The diagnostic capability has been verified by plant data

  18. 40 CFR 63.175 - Quality improvement program for valves.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for valves... alternative quality improvement programs specified in paragraphs (d) and (e) of this section. The decision to... § 63.168 and § 63.175. (1) If the owner or operator elects to continue the quality improvement program...

  19. Conducting a SWOT Analysis for Program Improvement

    Science.gov (United States)

    Orr, Betsy

    2013-01-01

    A SWOT (strengths, weaknesses, opportunities, and threats) analysis of a teacher education program, or any program, can be the driving force for implementing change. A SWOT analysis is used to assist faculty in initiating meaningful change in a program and to use the data for program improvement. This tool is useful in any undergraduate or degree…

  20. Making quality improvement programs more effective.

    Science.gov (United States)

    Shaw-Taylor, Yoku

    2014-01-01

    In the past 25 years, and as recent as 2011, all external evaluations of the Quality Improvement Organization (QIO) Program have found its impact to be small or difficult to discern. The QIO program costs about $200 million on average to administer each year to improve quality of healthcare for people of 65 years or older. The program was created to address questionable quality of care. QIOs review how care is provided based on performance measures. The paper aims to discuss these issues. In 2012, the author supported the production of quarterly reports and reviewed internal monitoring and evaluation protocols of the program. The task also required reviewing all previous program evaluations. The task involved many conversations about the complexities of the program, why impact is difficult to discern and possible ways for eventual improvement. Process flow charts were created to simulate the data life cycle and discrete event models were created based on the sequence of data collection and reporting to identify gaps in data flow. The internal evaluation uncovered data gaps within the program. The need for a system of specification rules for data conceptualization, collection, distribution, discovery, analysis and repurposing is clear. There were data inconsistencies and difficulty of integrating data from one instance of measurement to the next. The lack of good and reliable data makes it difficult to discern true impact. The prescription is for a formal data policy or data governance structure to integrate and document all aspects of the data life cycle. The specification rules for governance are exemplified by the Data Documentation Initiative and the requirements published by the Data Governance Institute. The elements are all in place for a solid foundation of the data governance structure. These recommendations will increase the value of program data. The model specifies which agency units must be included in the governance authority and the data team. The

  1. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

    Bradham, Tamala S.; Hoffman, Jeff; Houston, K. Todd; Guignard, Gayla Hutsell

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that consisted of 12 evaluative areas of EHDI programs. For the quality improvement area, a total of 218 items were listed by 47 EHDI coordinators, and themes were identified in each…

  2. Process Evaluation and Continuous Improvement in Community Youth Programs

    Directory of Open Access Journals (Sweden)

    Jennifer V. Trachtenberg

    2008-06-01

    Full Text Available A method of using process evaluation to provide improvement plans in order to promote community youth programs is described. The core elements of this method include the following: (1 collection and analysis of baseline data, (2 feedback provided to programs describing their strengths and limitations, (3 programs provided with assistance in preparing improvement plans in regard to their baseline data, and (4 follow-up evaluation assessed program changes based on their improvement plans and baseline data. A case study of an inner-city neighborhood youth center is used to demonstrate this method.

  3. Continuous Improvement in State Funded Preschool Programs

    Science.gov (United States)

    Jackson, Sarah L.

    2012-01-01

    State funded preschool programs were constantly faced with the need to change in order to address internal and external demands. As programs engaged in efforts towards change, minimal research was available on how to support continuous improvement efforts within the context unique to state funded preschool programs. Guidance available had…

  4. Attitudes and Motivations of Vocational Teachers Regarding Program Improvement.

    Science.gov (United States)

    Greenan, James P.; Wu, Mingchang; Mustapha, Ramlee B.; Ncube, Lisa B.

    1998-01-01

    Secondary vocational teachers in Indiana (n=186) indicated they were motivated to improve programs by concern for students, professional growth, and desire to keep current. They believed that program improvement enhances professional development, but lacked time to plan for improvement and were skeptical about administrators' ability to reduce…

  5. Continuous quality improvement program for hip and knee replacement.

    Science.gov (United States)

    Marshall, Deborah A; Christiansen, Tanya; Smith, Christopher; Squire Howden, Jane; Werle, Jason; Faris, Peter; Frank, Cy

    2015-01-01

    Improving quality of care and maximizing efficiency are priorities in hip and knee replacement, where surgical demand and costs increase as the population ages. The authors describe the integrated structure and processes from the Continuous Quality Improvement (CQI) Program for Hip and Knee Replacement Surgical Care and summarize lessons learned from implementation. The Triple Aim framework and 6 dimensions of quality care are overarching constructs of the CQI program. A validated, evidence-based clinical pathway that measures quality across the continuum of care was adopted. Working collaboratively, multidisciplinary experts embedded the CQI program into everyday practices in clinics across Alberta. Currently, 83% of surgeons participate in the CQI program, representing 95% of the total volume of hip and knee surgeries. Biannual reports provide feedback to improve care processes, infrastructure planning, and patient outcomes. CQI programs evaluating health care services inform choices to optimize care and improve efficiencies through continuous knowledge translation. © The Author(s) 2014.

  6. ACED Allegheny Home Improvement Loan Program (AHILP)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Allegheny Home Improvement Loan Program (AHILP) is the most affordable way for eligible Allegheny County residents to rehabilitate and improve their homes....

  7. Implementing a customer focused continual business improvement program to improve the maintenance process

    International Nuclear Information System (INIS)

    Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M.

    2006-01-01

    Global market pressures and increasing competition demands that successful companies establish a continual business improvement program as part of implementing its business strategy. Such programs must be driven by the definition of quality from the customer's perspective. This customer quality focus often requires a change in all aspects of the business including products, services, processes and culture. This paper will describe how Atomic Energy of Canada Limited implemented a Continual Business Improvement Program in their Nuclear Laboratories Business Unit. In particular, to review how the techniques were applied to improve the maintenance process and the status of the project. Customer (internal users of the processes at CRL) feedback has shown repeatedly there is dissatisfaction of the maintenance process. Customers complain about jobs not getting done to schedule or being deferred. A project has been launched with the following goals: to improve the maintenance process customer satisfaction and increase trades wrench time by 30 minutes / trade / day. DMAIC (Define-Measure-Analyze-Improve-Control) methodology was applied to find out the Root Cause(s) of the problem, provide solutions, and implement improvements. The expected Operational Benefits include: Executing work efficiently to quality standards and business performance of the site, improve maintenance efficiencies, reduce cycle time for maintenance process and improve process yield, and improve customer and employee satisfaction. (author)

  8. Implementing a customer focused continual business improvement program to improve the maintenance process

    Energy Technology Data Exchange (ETDEWEB)

    Kharshafdjian, G.; Fisher, C.; Beres, T.; Brooks, S.; Forbes, S.; Krause, M.; McAuley, K.; Wendorf, M. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)

    2006-07-01

    Global market pressures and increasing competition demands that successful companies establish a continual business improvement program as part of implementing its business strategy. Such programs must be driven by the definition of quality from the customer's perspective. This customer quality focus often requires a change in all aspects of the business including products, services, processes and culture. This paper will describe how Atomic Energy of Canada Limited implemented a Continual Business Improvement Program in their Nuclear Laboratories Business Unit. In particular, to review how the techniques were applied to improve the maintenance process and the status of the project. Customer (internal users of the processes at CRL) feedback has shown repeatedly there is dissatisfaction of the maintenance process. Customers complain about jobs not getting done to schedule or being deferred. A project has been launched with the following goals: to improve the maintenance process customer satisfaction and increase trades wrench time by 30 minutes / trade / day. DMAIC (Define-Measure-Analyze-Improve-Control) methodology was applied to find out the Root Cause(s) of the problem, provide solutions, and implement improvements. The expected Operational Benefits include: Executing work efficiently to quality standards and business performance of the site, improve maintenance efficiencies, reduce cycle time for maintenance process and improve process yield, and improve customer and employee satisfaction. (author)

  9. Status of the PSR improvement program

    International Nuclear Information System (INIS)

    Macek, R.J.; Fitzgerald, D.H.; Hoehn, M.V.; Ryder, R.D.; York, R.L.

    1993-01-01

    A program of improvements to increase intensity and improve reliability of the Los Alamos Proton Storage Ring (PSR) has been under way for several years. Reduction of stored beam loss rates by a factor of 4.6 since 1987 through exploitation of H 0 injection has allowed the average intensity to increase by a factor of two to 75μA. Reliability of the PSR and associated beam delivery systems has been improved by extensive rework of numerous subsystems. Radiation protection has been improved by additional shielding of Line D and extensive use of relatively fail-safe radiation detectors incorporated into an improved radiation security system

  10. Process improvement program evolves into compliance program at an integrated delivery system.

    Science.gov (United States)

    Tyk, R C; Hylton, P G

    1998-09-01

    An integrated delivery system discovered questionable practices when it undertook a process-improvement initiative for its revenue-to-cash cycle. These discoveries served as a wake-up call to the organization that it needed to develop a comprehensive corporate compliance program. The organization engaged legal counsel to help it establish such a program. A corporate compliance officer was hired, and a compliance committee was set up. They worked with counsel to develop the structure and substance of the program and establish a corporate code of conduct that became a part of the organization's policies and procedures. Teams were formed in various areas of the organization to review compliance-related activities and suggest improvements. Clinical and nonclinical staff attended mandatory educational sessions about the program. By approaching compliance systematically, the organization has put itself in an excellent position to avoid fraudulent and abusive activities- and the government scrutiny they invite.

  11. Interchange. Program Improvement Products Identified through Networking.

    Science.gov (United States)

    Ohio State Univ., Columbus. National Center for Research in Vocational Education.

    This catalog lists exemplary field-based program improvement products identified by the Dissemination and Utilization Products and Services Program (D&U) at the National Center for Research in Vocational Education. It is designed to increase awareness of these products among vocational educators and to provide information about them that…

  12. 75 FR 22576 - Minority Science and Engineering Improvement Program

    Science.gov (United States)

    2010-04-29

    ... DEPARTMENT OF EDUCATION [CFDA No. 84.120A] Minority Science and Engineering Improvement Program... the fiscal year (FY) 2009 grant slate for the Minority Science and Engineering Improvement Program. SUMMARY: The Secretary intends to use the grant slate developed in FY 2009 for the Minority Science and...

  13. Programs to improve plant performance

    International Nuclear Information System (INIS)

    Felmus, N.L.

    1987-01-01

    Looking toward the 1990's, we see a period in which our industry will face the challenge of improving the performance of the nuclear plants which are built and operating. The skills and technology are at hand to make good plant performance a reality and we believe the time has come to use them to achieve that end. As reserve margins decline, utilities and their regulators will increasingly seek to tap the unexploited capacity tied up in plants operating below their optimum availability. This paper describes a number of the programs, plant improvements and operations improvements which can yield a significant increase in nuclear plant availability and capacity factor now and into the 1990's. (author)

  14. Pediatric CT quality management and improvement program

    International Nuclear Information System (INIS)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik; Molvin, Lior Z.; Wang, Jia

    2014-01-01

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  15. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

    Larson, David B.; Chan, Frandics P.; Newman, Beverley; Fleischmann, Dominik [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Molvin, Lior Z. [Stanford Hospital and Clinics, Stanford, CA (United States); Wang, Jia [Stanford University, Environmental Health and Safety, Stanford, CA (United States)

    2014-10-15

    Modern CT is a powerful yet increasingly complex technology that continues to rapidly evolve; optimal clinical implementation as well as appropriate quality management and improvement in CT are challenging but attainable. This article outlines the organizational structure on which a CT quality management and improvement program can be built, followed by a discussion of common as well as pediatric-specific challenges. Organizational elements of a CT quality management and improvement program include the formulation of clear objectives; definition of the roles and responsibilities of key personnel; implementation of a technologist training, coaching and feedback program; and use of an efficient and accurate monitoring system. Key personnel and roles include a radiologist as the CT director, a qualified CT medical physicist, as well as technologists with specific responsibilities and adequate time dedicated to operation management, CT protocol management and CT technologist education. Common challenges in managing a clinical CT operation are related to the complexity of newly introduced technology, of training and communication and of performance monitoring. Challenges specific to pediatric patients include the importance of including patient size in protocol and dose considerations, a lower tolerance for error in these patients, and a smaller sample size from which to learn and improve. (orig.)

  16. Improving English Instruction through Neuro-Linguistic Programming

    Science.gov (United States)

    Helm, David Jay

    2009-01-01

    This study examines the background information and numerous applications of neuro-linguistic programming as it applies to improving English instruction. In addition, the N.L.P. modalities of eye movement, the use of predicates, and posturing are discussed. Neuro-linguistic programming presents all students of English an opportunity to reach their…

  17. 40 CFR 63.1035 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ...., piston, horizontal or vertical centrifugal, gear, bellows); pump manufacturer; seal type and manufacturer... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Quality improvement program for pumps... improvement program for pumps. (a) Criteria. If, on a 6-month rolling average, at least the greater of either...

  18. Dollar Summary of Prime Contract Awards with Principal Place of Performance Outside the U.S. by Country and Contractor, FY83.

    Science.gov (United States)

    1983-01-01

    52- MEHMET AKOENIZ IZOLASYON TAAHHUT TURKEY a8 96 MEHIET OZVEREN TURKEY 31 31 MINEX NUN MUT TURKEY 104 104 MITHAT YENIGUN TURKEY 1,640 1,640 I PRIME...CORP TURKEY 6,650 6,650 HUHENDISLIK ERE LTD STI TURKEY 130 130 MUSTAFA QOKALP TURKEY 109 109 NADIR SONEN TURKEY 30 30 ONAR I|NSAAV TI CARET VE SAAYII

  19. Characteristics of Volunteer Coaches in a Clinical Process Improvement Program.

    Science.gov (United States)

    Morley, Katharine E; Barysauskas, Constance M; Carballo, Victoria; Kalibatas, Orinta; Rao, Sandhya K; Jacobson, Joseph O; Cummings, Brian M

    The Partners Clinical Process Improvement Leadership Program provides quality improvement training for clinicians and administrators, utilizing graduates as volunteer peer coaches for mentorship. We sought to understand the factors associated with volunteer coach participation and gain insight into how to improve and sustain this program. Review of coach characteristics from course database and survey of frequent coaches. Out of 516 Partners Clinical Process Improvement Leadership Program graduates from March 2010 to June 2015, 117 (23%) individuals volunteered as coaches. Sixty-one (52%) individuals coached once, 31 (27%) coached twice, and 25 (21%) coached 3 or more times. There were statistically significant associations between coaching and occupation (P = .005), Partners Clinical Process Improvement Leadership Program course taken (P = .001), and course location (P = .007). Administrators were more likely to coach than physicians (odds ratio: 1.75, P = .04). Reasons for volunteering as a coach included further development of skills, desire to stay involved with program, and enjoying mentoring. Reasons for repeated coaching included maintaining quality improvement skills, expanding skills to a wider variety of projects, and networking. A peer graduate volunteer coach model is a viable strategy for interprofessional quality improvement mentorship. Strategies that support repeat coaching and engage clinicians should be promoted to ensure an experienced and diversified group of coaches.

  20. 40 CFR 63.176 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... type (e.g., piston, horizontal or vertical centrifugal, gear, bellows); pump manufacturer; seal type... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Quality improvement program for pumps... improvement program for pumps. (a) In Phase III, if, on a 6-month rolling average, the greater of either 10...

  1. An Improvement for Fuzzy Stochastic Goal Programming Problems

    Directory of Open Access Journals (Sweden)

    Shu-Cheng Lin

    2017-01-01

    Full Text Available We examined the solution process for linear programming problems under a fuzzy and random environment to transform fuzzy stochastic goal programming problems into standard linear programming problems. A previous paper that revised the solution process with the lower-side attainment index motivated our work. In this paper, we worked on a revision for both-side attainment index to amend its definition and theorems. Two previous examples were used to examine and demonstrate our improvement over previous results. Our findings not only improve the previous paper with both-side attainment index, but also provide a theoretical extension from lower-side attainment index to the both-side attainment index.

  2. Gap Analysis Approach for Construction Safety Program Improvement

    Directory of Open Access Journals (Sweden)

    Thanet Aksorn

    2007-06-01

    Full Text Available To improve construction site safety, emphasis has been placed on the implementation of safety programs. In order to successfully gain from safety programs, factors that affect their improvement need to be studied. Sixteen critical success factors of safety programs were identified from safety literature, and these were validated by safety experts. This study was undertaken by surveying 70 respondents from medium- and large-scale construction projects. It explored the importance and the actual status of critical success factors (CSFs. Gap analysis was used to examine the differences between the importance of these CSFs and their actual status. This study found that the most critical problems characterized by the largest gaps were management support, appropriate supervision, sufficient resource allocation, teamwork, and effective enforcement. Raising these priority factors to satisfactory levels would lead to successful safety programs, thereby minimizing accidents.

  3. Airport Improvement Program (AIP) : reauthorization issues for Congress

    Science.gov (United States)

    2010-01-01

    This report discusses the Airport Improvement Program and its complement, the PFC, within the broader context of airport capital development finance.5 After a brief history of federal support for airport construction and improvement, the report descr...

  4. UMTRA Project-Level Cost Reduction/Productivity Improvement Program manual

    International Nuclear Information System (INIS)

    1995-06-01

    Mission of the Uranium Mill Tailings Remedial Action (UMTRA) Project Cost Reduction/Productivity Improvement Program (CR/PIP) is to contribute to the UMTRA Project's environmental restoration mission by providing the means to achieve and recognize continuous improvements and cost savings. This manual includes program definition, description of UMTRA project organizational responsibilities and interfaces with existing project functions, guidance to contractors, and definition of project-level functions

  5. Career/Vocational Preparation for Students with Disabilities: A Program Improvement Guide.

    Science.gov (United States)

    Stodden, Robert A.

    This program improvement guide is designed to assist district and school level interdisciplinary planning teams to improve career/vocational programs for students with disabilities. Its focus is on the integration of best practices within the educational program continuum to achieve positive student outcomes. The guide includes three sections.…

  6. Umatilla River Subbasin Fish Habitat Improvement Program, 2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-05-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration agreements, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat conditions. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and re-construction aimed at improving fish habitat, through the restoration of stable channel function. This report provides a summary of Program activities for the 2005 calendar year (January 1 through December 31, 2005), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance (O&M), and (4) Monitoring and Evaluation (M&E). This report also summarizes activities associated with Program Administration, Interagency Coordination, and Public Education.

  7. The Data-to-Action Framework: A Rapid Program Improvement Process

    Science.gov (United States)

    Zakocs, Ronda; Hill, Jessica A.; Brown, Pamela; Wheaton, Jocelyn; Freire, Kimberley E.

    2015-01-01

    Although health education programs may benefit from quality improvement methods, scant resources exist to help practitioners apply these methods for program improvement. The purpose of this article is to describe the Data-to-Action framework, a process that guides practitioners through rapid-feedback cycles in order to generate actionable data to…

  8. Strategic Planning to Improve EHDI Programs

    Science.gov (United States)

    White, Karl R.; Blaiser, Kristina M.

    2011-01-01

    Because newborn hearing screening has become the standard of care in the United States, every state has established an early hearing detection and intervention (EHDI) program responsible for establishing, maintaining, and improving the system of services needed to serve children with hearing loss and their families. While significant developments…

  9. Umatilla River Subbasin Fish Habitat Improvement Program, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

    2006-02-01

    This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and reconstruction aimed at improving fish habitat, by restoring stable channel function. This report provides a summary of Program activities for the 2004 calendar year (January 1 through December 31, 2004), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance, and (4) Monitoring and Evaluation. This report also summarizes Program Administrative, Interagency Coordination, and Public Education activities.

  10. Improvements to the adaptive maneuvering logic program

    Science.gov (United States)

    Burgin, George H.

    1986-01-01

    The Adaptive Maneuvering Logic (AML) computer program simulates close-in, one-on-one air-to-air combat between two fighter aircraft. Three important improvements are described. First, the previously available versions of AML were examined for their suitability as a baseline program. The selected program was then revised to eliminate some programming bugs which were uncovered over the years. A listing of this baseline program is included. Second, the equations governing the motion of the aircraft were completely revised. This resulted in a model with substantially higher fidelity than the original equations of motion provided. It also completely eliminated the over-the-top problem, which occurred in the older versions when the AML-driven aircraft attempted a vertical or near vertical loop. Third, the requirements for a versatile generic, yet realistic, aircraft model were studied and implemented in the program. The report contains detailed tables which make the generic aircraft to be either a modern, high performance aircraft, an older high performance aircraft, or a previous generation jet fighter.

  11. Employing continuous quality improvement in community-based substance abuse programs.

    Science.gov (United States)

    Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

    2012-01-01

    This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

  12. Propositional Optimal Trajectory Programming for Improving Stability ...

    African Journals Online (AJOL)

    Propositional Optimal Trajectory Programming for Improving Stability of Hermite Definite Control System. ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) ... Knowledge of systems operation subjected to heat diffusion constraints is required of systems analysts. In an instance that ...

  13. Safety implications of standardized continuous quality improvement programs in community pharmacy.

    Science.gov (United States)

    Boyle, Todd A; Ho, Certina; Mackinnon, Neil J; Mahaffey, Thomas; Taylor, Jeffrey M

    2013-06-01

    Standardized continuous quality improvement (CQI) programs combine Web-based technologies and standardized improvement processes, tools, and expectations to enable quality-related events (QREs) occurring in individual pharmacies to be shared with pharmacies in other jurisdictions. Because standardized CQI programs are still new to community pharmacy, little is known about how they impact medication safety. This research identifies key aspects of medication safety that change as a result of implementing a standardized CQI program. Fifty-three community pharmacies in Nova Scotia, Canada, adopted the SafetyNET-Rx standardized CQI program in April 2010. The Institute for Safe Medication Practices (ISMP) Canada's Medication Safety Self-Assessment (MSSA) survey was administered to these pharmacies before and 1 year into their use of the SafetyNET-Rx program. The nonparametric Wilcoxon signed-rank test was used to explore where changes in patient safety occurred as a result of SafetyNETRx use. Significant improvements occurred with quality processes and risk management, staff competence, and education, and communication of drug orders and other information. Patient education, environmental factors, and the use of devices did not show statistically significant changes. As CQI programs are designed to share learning from QREs, it is reassuring to see that the largest improvements are related to quality processes, risk management, staff competence, and education.

  14. Improving Indicators in a Brazilian Hospital Through Quality-Improvement Programs Based on STS Database Reports

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

    Full Text Available ABSTRACT OBJECTIVE: To report the initial changes after quality-improvement programs based on STS-database in a Brazilian hospital. METHODS: Since 2011 a Brazilian hospital has joined STS-Database and in 2012 multifaceted actions based on STS reports were implemented aiming reductions in the time of mechanical ventilation and in the intensive care stay and also improvements in evidence-based perioperative therapies among patients who underwent coronary artery bypass graft surgeries. RESULTS: All the 947 patients submitted to coronary artery bypass graft surgeries from July 2011 to June 2014 were analyzed and there was an improvement in all the three target endpoints after the implementation of the quality-improvement program but the reduction in time on mechanical ventilation was not statistically significant after adjusting for prognostic characteristics. CONCLUSION: The initial experience with STS registry in a Brazilian hospital was associated with improvement in most of targeted quality-indicators.

  15. Targeting utility customers to improve energy savings from conservation and efficiency programs

    International Nuclear Information System (INIS)

    Taylor, Nicholas W.; Jones, Pierce H.; Kipp, M. Jennison

    2014-01-01

    Highlights: • Improving DSM program impacts by targeting high energy users. • DSM energy savings potential hinges on pre-participation performance. • Targeting can benefit different utilities and energy efficiency programs. • Overall performance can be improved by up to 250% via targeting strategies. - Abstract: Electric utilities, government agencies, and private interests in the US have committed and continue to invest substantial resources – including billions of dollars of financial capital – in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. While most of these programs are deemed to be cost effective, and therefore in the public interest, opportunities exist to improve cost effectiveness by targeting programs to those customers with the greatest potential for energy savings. This article details an analysis of three DSM programs offered by three Florida municipal electric utilities to explore such opportunities. First, we estimate programs’ energy savings impacts; second, we measure and compare energy savings across subgroups of program participants as determined by their pre-intervention energy performance, and third, we explore potential changes in program impacts that might be realized by targeting specific customers for participation in the DSM programs. All three programs resulted in statistically significant average (per-participant) energy savings, yet average savings varied widely, with the customers who performed best (i.e., most efficient) before the intervention saving the least energy and those who performed worst (i.e., least efficient) before the intervention saving the most. Assessment of alternative program participation scenarios with varying levels of customer targeting suggests that program impacts could be increased by as much as 80% for a professional energy audit program, just over 100% for a high-efficiency heat pump upgrade program, and nearly 250% for an attic insulation

  16. How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program.

    Science.gov (United States)

    Cho, Yu Kyung

    2016-07-01

    In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary.

  17. Parametric Study for MOV Performance Improvement Using PPM Program

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seungho; Seon, Juhyoung; Han, Bongsub [SOOSAN INDUSTRIES, Seoul (Korea, Republic of)

    2016-10-15

    Nuclear power plants mainly use Air Operated Valve(hereinafter referred to as AOV) and Motor Operator Valve(hereinafter referred to as MOV) for protecting system, blocking and controlling flow. Field test(static, dynamic test) results and performance prediction program are used to evaluate if MOV currently installed on nuclear power plants has the operational performance. The improvement of operating performance for Flexible Gate valve was confirmed on changing input variables of performance program(PPM). here are several methods through reviewing design basis, changes operating procedures and maintenance work of stem(or packing, etc.) to improve operating performance of MOV generally installed in the nuclear power plants. This study verified the changes of the MOV operating performance through the improvement of stem and hydraulic parts(seat, guide etc.). Especially, MOV operating performance was much greater improved when the Disk Seat Angle was decreasing. Generally, improvement work to minimize friction of seat, disk and guide is limited and dynamic diagnostic testing has to be performed with change in valve factor for improvement of hydraulic parts.

  18. Continuous improvement program in ENUSA: personnel participation and six sigma

    International Nuclear Information System (INIS)

    Montes Navarro, J.

    1998-01-01

    Since the beginning of its activities ENUSA has been a company committed with the quality of its products and services. To talk about quality is something inherent in ENUSA's daily work ENUSA's position in the market depends on its capacity to satisfy customers expectations with the best products and services, as a result of an efficient management of its processes. The word quality in its broadest sense, means that any activity can be improved. ENUSA has implemented a continuous improvement program as part of its company change project. That program consists of six basic steps: 1.- Managers commitment. 2.- Organization for continuous improvement. 3.- Quality goals. 4.- Training and informing. 5.- Personnel participation. 6.- Methodology. ENUSA has introduced these six steps during 1997-98 period. It is important to point out the commitment degree at all the company levels, focusing the organization to the continuous improvement in a multifunctional way, following the business processes: - Board of Directors - Quality Steering Committee - Quality Improvement Groups (GMC) - Quality Operative Groups (GOC) - Suggestions Mailboxes The following GMC's have been set up and are operative. - Manufacturing GMC - Supplies GMC - Installation GMC - Design GMC - Quality System GM - Projects GMC - Administrative GMC These GMC's have established thirty-six Quality Operative Groups which carry out the improvement projects. The methodology chosen by ENUSA is known as ''SIX SIGMA''. Six sigma programs have proved their huge power in big companies as MOTOROLA and, recently, GE being recognized in all the quality fields. It is, by itself, a change program in which a quality improvement methods is structured with an excellent view of processes, products and services. (Author)

  19. Health-Improving Rehabilitation Program of Pysical Education at Higher School

    Directory of Open Access Journals (Sweden)

    V. M. Naskalov

    2013-01-01

    Full Text Available The research is aimed to explore the efficiency of innovative technologies and increase the health-improving effect as a result of physical training in ecologically unfavorable conditions. A health-improving rehabilitation program, containing a set of modern means of physical rehabilitation and recreation in combination with physical exercises, was worked out to carry out the pedagogical experiment. The program includes the hydromassage, stretching exercises with biomechanical stimulation and exercises for developing weightlifting abilities. Apart from this, the interval hypoxic training was used in ‘artificially created’ favorable ecological conditions for detoxication. The students at Polotsk State University took part in the experiment. Among the assessment criteria applied by the author, there are generally acknowledged methods identifying the development of physical qualities, external respiration functions, body fat and other components composition. The experiment revealed that the innovative program had enhanced the health-improving effect compared to the traditional training programs, which was expressed by the statistically valid increase of the students’ speed- strength characteristics, flexibility, external respiration functions as well as the body fat decrease. Therefore, in order to increase a health-improving effect of physical training, the author recommends considering the specific ecological and hygienic conditions of a particular region to create the corresponding programs for group and individual health protection and recovery. The research findings can be used in physical education process at universities situated in the regions with unfavorable ecological conditions. 

  20. Report: EPA Improved Its National Security Information Program, but Some Improvements Still Needed

    Science.gov (United States)

    Report #16-P-0196, June 2, 2016. The EPA will continue to improve its national security information program by completing information classification guides that can be used uniformly and consistently throughout the agency.

  1. Improving Urban Minority Girls' Health Via Community Summer Programming.

    Science.gov (United States)

    Bohnert, Amy M; Bates, Carolyn R; Heard, Amy M; Burdette, Kimberly A; Ward, Amanda K; Silton, Rebecca L; Dugas, Lara R

    2017-12-01

    Summertime has emerged as a high-risk period for weight gain among low-income minority youth who often experience a lack of resources when not attending school. Structured programming may be an effective means of reducing risk for obesity by improving obesogenic behaviors among these youth. The current multi-method study examined sedentary time, physical activity, and dietary intake among low-income urban minority girls in two contexts: an unstructured summertime setting and in the context of a structured 4-week community-based summer day camp program promoting physical activity. Data were analyzed using paired-sample t tests and repeated-measure analyses of variance with significance at the p time of over 2 h/day and dairy consumption when engaged in structured summer programming. All improvements were independent of weight status and age, and African-American participants evidenced greater changes in physical activity during programming. The study concludes that structured, community-based summertime programming may be associated with fewer obesogenic behaviors in low-income urban youth and may be a powerful tool to address disparities in weight gain and obesity among high-risk samples.

  2. Federal Aviation Administration weather program to improve aviation safety

    Science.gov (United States)

    Wedan, R. W.

    1983-01-01

    The implementation of the National Airspace System (NAS) will improve safety services to aviation. These services include collision avoidance, improved landing systems and better weather data acquisition and dissemination. The program to improve the quality of weather information includes the following: Radar Remote Weather Display System; Flight Service Automation System; Automatic Weather Observation System; Center Weather Processor, and Next Generation Weather Radar Development.

  3. Teacher training program for medical students: improvements needed

    Directory of Open Access Journals (Sweden)

    van Diggele C

    2015-04-01

    Full Text Available Christie van Diggele,1 Annette Burgess,2 Craig Mellis21The University of Sydney, Sydney, NSW, Australia; 2Sydney Medical School – Central, The University of Sydney, Sydney, NSW, AustraliaIntroduction: Skills in peer teaching, assessment, and feedback are increasingly documented internationally as required graduate attributes in medicine. Yet these skills are rarely taught in medical schools. We sought to design and deliver a short but effective teacher training (TT program for medical students that could be easily integrated into the professional development curriculum. This study sought to evaluate such a pilot program, based on student perception.Methods: The study took place at a major metropolitan teaching hospital, where 38 medical students were invited to attend a voluntary, newly designed four-module TT program. In total, 23/38 (61% of invited students attended. Mixed methods were used for evaluation. Questionnaires were completed by 21/23 (91% of students, and 6/23 (26% of students participated in a focus group.Results: Students reported that as a result of the program they felt more confident to facilitate small group teaching activities and to provide feedback to peers using the suggested frameworks. Students would like the program to contain more in-depth educational theory and to allow a more time for small group learning activities. They would also like to see opportunities for participation across all clinical schools.Conclusion: The TT program was successful in increasing student awareness of educational theory and practice, thereby improving their confidence in teaching and assessing their peers and making them feel better prepared for their careers as medical practitioners. Key improvements to the program are needed in terms of more in-depth theory and more time spent on small group learning. This might be achieved by complementing the course with e-learning.Keywords: teacher training, medical students, peer teaching, peer

  4. Iraqi Police Development Program: Opportunities for Improved Program Accountability and Budget Transparency

    Science.gov (United States)

    2011-10-24

    support, and aviation) raise red flags about the program’s fund requirements. This report identifies opportunities for improved program...tum now to the PSC audit coordination issue you raised. SIGlR unfailingly coordinates aJI of its State-related audits with State OIG prior to

  5. Budget Impact of a Comprehensive Nutrition-Focused Quality Improvement Program for Malnourished Hospitalized Patients.

    Science.gov (United States)

    Sulo, Suela; Feldstein, Josh; Partridge, Jamie; Schwander, Bjoern; Sriram, Krishnan; Summerfelt, Wm Thomas

    2017-07-01

    Nutrition interventions can alleviate the burden of malnutrition by improving patient outcomes; however, evidence on the economic impact of medical nutrition intervention remains limited. A previously published nutrition-focused quality improvement program targeting malnourished hospitalized patients showed that screening patients with a validated screening tool at admission, rapidly administering oral nutritional supplements, and educating patients on supplement adherence result in significant reductions in 30-day unplanned readmissions and hospital length of stay. To assess the potential cost-savings associated with decreased 30-day readmissions and hospital length of stay in malnourished inpatients through a nutrition-focused quality improvement program using a web-based budget impact model, and to demonstrate the clinical and fiscal value of the intervention. The reduction in readmission rate and length of stay for 1269 patients enrolled in the quality improvement program (between October 13, 2014, and April 2, 2015) were compared with the pre-quality improvement program baseline and validation cohorts (4611 patients vs 1319 patients, respectively) to calculate potential cost-savings as well as to inform the design of the budget impact model. Readmission rate and length-of-stay reductions were calculated by determining the change from baseline to post-quality improvement program as well as the difference between the validation cohort and the post-quality improvement program, respectively. As a result of improved health outcomes for the treated patients, the nutrition-focused quality improvement program led to a reduction in 30-day hospital readmissions and length of stay. The avoided hospital readmissions and reduced number of days in the hospital for the patients in the quality improvement program resulted in cost-savings of $1,902,933 versus the pre-quality improvement program baseline cohort, and $4,896,758 versus the pre-quality improvement program in the

  6. Planning, Conducting, and Documenting Data Analysis for Program Improvement

    Science.gov (United States)

    Winer, Abby; Taylor, Cornelia; Derrington, Taletha; Lucas, Anne

    2015-01-01

    This 2015 document was developed to help technical assistance (TA) providers and state staff define and limit the scope of data analysis for program improvement efforts, including the State Systemic Improvement Plan (SSIP); develop a plan for data analysis; document alternative hypotheses and additional analyses as they are generated; and…

  7. Chapter 7. Assessing soil factors in wildland improvement programs

    Science.gov (United States)

    Arthur R. Tiedemann; Carlos F. Lopez

    2004-01-01

    Soil factors are an important consideration for successful wildland range development or improvement programs. Even though many soil improvement and amelioration practices are not realistic for wildlands, their evaluation is an important step in selection of adapted plant materials for revegetation. This chapter presents information for wildland managers on: the...

  8. Closing the Loop on a Continuous Program Improvement Process

    Science.gov (United States)

    Booth, Vickie; Booth, Larry

    2010-01-01

    The WebBSIT, a Bachelor of Science in Information Technology, is a fully online degree offered through a consortium of five University System of Georgia institutions. This paper begins by summarizing the change management system developed for continuous program improvement. Analysis of data should drive improvement, closing the loop. The balance…

  9. The soybean and mungbean improvement programs at AVRDC

    International Nuclear Information System (INIS)

    Shanmugasundaram, S.; Ahn, G.S.

    1983-01-01

    At the Asian Vegetable Research and Development Center (AVRDC) Soybean, Glycine max (L.) Merr. and mungbean, Vigna radiata (L.) Wilczek are included in the Legume Program for improvement. Germplasm collection in soybean and mungbean are 9,524 and 5,108 respectively. Developing improved selections with early, uniform maturity, high yield, wide adaptability and resistance to diseases and insects are the major breeding objectives for the tropics and subtropics. Genetic diversity and genetic resources are available in the germplasm for most of the desired traits both in soybean as well as mungbean. However, for traits such as soybean rust resistance in soybean and resistance to insects in mungbean are rare. Limited amount of radiation breeding is being employed in cooperation with Korean Atomic Energy Agency to obtain desirable genes in both species. A number of AVRDC identified accessions and breeding lines are being used by the national programs to develop improved cultivars. AVRDC developed breeding selections have been released as new cultivars in Costa Rica, Fiji, Korea, India, Indonesia, Malaysia and Taiwan. (author)

  10. Student Feedback of Career Development Workshops for Program Improvement

    Science.gov (United States)

    LeBeau, J. E.; Pressley, S. N.

    2016-12-01

    A number of techniques are employed each year to evaluate the effectiveness of and to identify opportunities for improvement in the Laboratory for Atmospheric Research (LAR) REU program at Washington State University. For example, information gathered from pre-/post-surveys and pre-/post-interviews provides information regarding students' perceptions and levels of experience with the scientific process, career and academic goals, and motivation for joining the REU program. Poster session rubrics assess students' abilities to summarize their experiences in a professional setting. Alumni surveys gauge former participants' perceptions of the REU experience. One seemingly simple and highly useful, but often less documented, component of the evaluation process for program improvement is the use of workshop feedback forms. Weekly workshops are designed to provide students with enhanced knowledge and skills in the area of atmospheric chemistry as well as research design skills, academic and career guidance, and presentation skills. According to previous years' evaluation reports, workshops are largely beneficial to students for learning new skills. Yet, students suggest a number of recommendations that may benefit any REU program, such as: providing slides beforehand to provide a framework for the upcoming workshop, having instructors speak in more student-friendly language, covering higher-level topics, and including more hands-on, instructor-guided practice during the workshops. Thus, workshop feedback forms provide meaningful feedback to increase learning outcomes and enhance the REU student experience. This presentation will offer ideas gathered from over five years of workshop feedback forms that, while somewhat specific to workshops offered for the LAR REU, can offer faculty and PIs insight into the student experience, enhancing their ability to improve programming and achieve greater learning outcomes.

  11. Ontario's emergency department process improvement program: the experience of implementation.

    Science.gov (United States)

    Rotteau, Leahora; Webster, Fiona; Salkeld, Erin; Hellings, Chelsea; Guttmann, Astrid; Vermeulen, Marian J; Bell, Robert S; Zwarenstein, Merrick; Rowe, Brian H; Nigam, Amit; Schull, Michael J

    2015-06-01

    In recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long-Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital-based teams' experiences during the ED process improvement program implementation and the teams' perceptions of the key factors that influenced the program's success or failure. A qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed. Twenty-four interviews were coded and analyzed. The results are organized according to participants' experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project. Several key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the

  12. CINDA-3G: Improved Numerical Differencing Analyzer Program for Third-Generation Computers

    Science.gov (United States)

    Gaski, J. D.; Lewis, D. R.; Thompson, L. R.

    1970-01-01

    The goal of this work was to develop a new and versatile program to supplement or replace the original Chrysler Improved Numerical Differencing Analyzer (CINDA) thermal analyzer program in order to take advantage of the improved systems software and machine speeds of the third-generation computers.

  13. A simulation-based training program improves emergency department staff communication.

    Science.gov (United States)

    Sweeney, Lynn A; Warren, Otis; Gardner, Liz; Rojek, Adam; Lindquist, David G

    2014-01-01

    The objectives of this study were to evaluate the effectiveness of Project CLEAR!, a novel simulation-based training program designed to instill Crew Resource Management (CRM) as the communication standard and to create a service-focused environment in the emergency department (ED) by standardizing the patient encounter. A survey-based study compared physicians' and nurses' perceptions of the quality of communication before and after the training program. Surveys were developed to measure ED staff perceptions of the quality of communication between staff members and with patients. Pretraining and posttraining survey results were compared. After the training program, survey scores improved significantly on questions that asked participants to rate the overall communication between staff members and between staff and patients. A simulation-based training program focusing on CRM and standardizing the patient encounter improves communication in the ED, both between staff members and between staff members and patients.

  14. Survey of Munitions Response Technologies

    Science.gov (United States)

    2006-06-01

    item. EMI detectors are operated in either time domain (TD) or frequency domain (FD). A common example of a hand-held EMI sensor is the 3-1 metal ...held Digital Emerging Fisher 1266-X Metal Detector Hand-held Analog Established Foerster MINEX 2FD 4.500 Hand-held Analog Established Minelab...ferrous and nonferrous metallic objects. • Effective in detecting near-surface objects. • Can be effective in geology that challenges magnetometers

  15. Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs.

    Science.gov (United States)

    Wells, Timothy S; Ozminkowski, Ronald J; McGinn, Michael P; Hawkins, Kevin; Bhattarai, Gandhi R; Serxner, Seth A; Greame, Chris

    2017-06-01

    Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes.

  16. Digital Competition Game to Improve Programming Skills

    Science.gov (United States)

    Moreno, Julian

    2012-01-01

    The aim of this paper is to describe a digital game with an educational purpose in the subject of computer programming, which enables students to reinforce and improve their abilities on the concepts of sequencing, defined iteration and nesting. For its design, a problem solving approach was followed and a score comparing mechanism was implemented…

  17. Crash Data Improvement Program : An RSPCB Peer Exchange

    Science.gov (United States)

    2011-08-04

    This report provides a summary of the Crash Data Improvement Program (CDIP) peer : exchange sponsored by the Federal Highway Administrations (FHWA) Office of Safety : on August 4, 2011. The peer exchange was hosted in conjunction with the annual :...

  18. Transportation Improvement Program of the Mid-Ohio Regional Planning Commission

    Science.gov (United States)

    1996-06-20

    The MORPC Transportation Improvement program (TIP) is a staged, multi-year schedule of regionally significant transportation improvements in the Columbus area. The Federal-aid Highway Act of 1962 and the federal Urban Mass Transportation Act of 1964 ...

  19. Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.

    Science.gov (United States)

    McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D

    2018-04-01

    Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.

  20. Motivation for Evaluation: A roadmap for Improving Program Efficacy

    Science.gov (United States)

    Taber, J. J.; Bohon, W.; Bravo, T. K.; Dorr, P. M.; Hubenthal, M.; Johnson, J. A.; Sumy, D. F.; Welti, R.; Davis, H. B.

    2016-12-01

    Over the past year, the Incorporated Research Institutions for Seismology (IRIS) Education and Public Outreach (EPO) program has undertaken a new effort to increase the rigor with which it evaluates its programs and products. More specifically we sought to make evaluation an integral part of our EPO staff's work, enable staff to demonstrate why we do the activities we do, enhance the impact or our products and programs, and empower staff to be able to make evidence-based claims. The challenges we faced included a modest budget, finding an applicable approach to both new and legacy programs ranging from formal and informal education to public outreach, and implementing the process without overwhelming staff. The Collaborative Impact Analysis Method (IAM; Davis and Scalice, 2015) was selected as it allowed us to combine the EPO staff's knowledge of programs, audiences and content with the expertise of an outside evaluation expert, through consultations and a qualitative rubric assessing the initial state of each product/program's evaluation. Staff then developed action plans to make incremental improvements to the evaluation of programs over time. We have found that this approach promotes the development of staff knowledge and skills regarding evaluation, provides a common language among staff, increases enthusiasm to collect and share data, encourages discussions of evaluative approaches when planning new activities, and improves each program's ability to capture the intended and unintended effects on the behaviors, attitudes, skills, interests, and/or knowledge of users/participants. We will share the initial IAM Scores for products and programs in the EPO portfolio, along with examples of the action plans for several key products and programs, and the impact that implementing those actions plans has had on our evaluations. Davis, H. & Scalice, D. (2015). Evaluate the Impact of your Education and Outreach Program Using the Quantitative Collaborative Impact Analysis

  1. Implementing 'Continuous Improvement' in the U.S. Nuclear Regulatory Commission's Decommissioning Program

    International Nuclear Information System (INIS)

    Orlando, D. A.; Buckley, J. T.; Johnson, R. L.; Gillen, D. M.

    2006-01-01

    The United States Nuclear Regulatory Commission's (US NRC's) comprehensive decommissioning program encompasses the decommissioning of all US NRC licensed facilities, ranging from the termination of routine licenses for sealed sources, to the closure of complex materials sites and nuclear power reactor facilities. Of the approximately 200 materials licenses that are terminated each year, most are routine and require little, if any, remediation to meet the US NRC unrestricted release criteria. However, some present technical and policy challenges that require large expenditures of resources, including a few complex materials sites that have requested license termination under the restricted-use provisions of 10 CFR 20.1403. Fiscal constraints to reduce budgeted resources in the decommissioning program, as well as concerns over the time to complete the decommissioning process have led to actions to improve the program and use resources more efficiently. In addition, the US NRC's Strategic Plan requires efforts to identify and implement improvements to US NRC programs in order to improve efficiency, effectiveness, timeliness, and openness, of the US NRC's activities, while maintaining the necessary focus on safety. Decommissioning regulations, and more recently the analysis of several issues associated with implementing those regulations, also have been significant catalysts for improvements in the decommissioning program. Actions in response to these catalysts have resulted in a program focused on the management of complex sites in a comprehensive, consistent, and risk-informed manner, as opposed to the past practice of focusing on sites deemed to be problematic. This paper describes the current status of the decommissioning of US NRC-licensed nuclear facilities, including an overview of recent decommissioning project completion efforts. It provides a detailed summary of past, current, and future improvements in the US NRC decommissioning program including the

  2. AIF programs supporting industry self-improvement

    International Nuclear Information System (INIS)

    Szalay, R.A.; Bivens, A.C.

    1985-01-01

    The Atomic Industrial Forum (AIF) report ''Nuclear Power in America's Future'' identifies those actions that must be taken by both government and industry if the nuclear power option is to be preserved. This includes initiatives that: 1) reduce construction costs and lead times; 2) establish a national energy policy that reflects the role of electricity and the nuclear power component; 3) provide better financial arrangements; 4) reform licensing and regulation; 5) enhance the light water reactor design; 6) inform the public on the benefits and contributions of nuclear power; and 7) complete the fuel cycle. In attempting to solve nuclear power's problems, the AIF has programs that support and push these needed actions. Much of the initiative must be taken by industry to enhance the nuclear power option. This paper discusses some AIF initiatives and programs that support industry self-improvement

  3. Report: EPA’s Fleet Management Program Needs Improvement

    Science.gov (United States)

    Report #15-P-0001, October 6, 2014. If oversight of the EPA’s fleet is not improved, the $6 million-per-year program could be ineffective and inefficient in supporting the agency’s mission and reporting data to the federal system.

  4. Comprehensive review of an accelerated nursing program: a quality improvement project.

    Science.gov (United States)

    Nugent, Elinor; LaRocco, Susan

    2014-01-01

    Accelerated second-degree programs are designed to provide entry into baccalaureate nursing program for people who have achieved bachelor's degree in another field. These programs were often designed to respond to nursing shortages at local and national levels. Programs commonly use a cohort model and move students through an intensive structure combining classroom and clinical requirement with a 2-year period. The accelerated second-degree nursing program, Accelerated Entry Level to Nursing program at our small liberal arts college, was considered to be successful. The program had excellent graduation rates and National Council Licensure Examination for Registered Nurses pass rates, indicating that the program was preparing the graduate to thrive in the practice setting. The program had been in existence for more than 7 years, with highly competitive admissions and high student satisfaction. The objective of this study was to provide a quality improvement assessment process to capture quantitative and qualitative information about the graduates. This information would be used to inform our own nursing education department and would provide metrics and information for nurse leaders regarding the rigor of these programs and the potential of graduates. Continuous quality improvement is a vital component in nursing education as well as in the clinical setting. With this in mind, a comprehensive review was undertaken by the nursing faculty during the eighth year of the highly successful accelerated nursing program in a small liberal arts college. This quality improvement project was designed to review existing metrics and to collect additional data through survey and focus groups in order to capture experiences of the program graduates. Graduates of the accelerated program from 2005 to 2011 were included in this study. Faculty who teach in the program participated in focus groups. From 2005 to 2011, there have been a total of 196 graduates in 8 cohorts; 194 surveys

  5. Evolution and development of a deliverability improvement program for gas storage

    International Nuclear Information System (INIS)

    Maddox, T.D.; Sikorski, D.L.

    1994-01-01

    With the implementation in November 1993 of FERC Order 636, the responsibilities and contractual obligations for a Gas Transmission Company operating Gas Storage have changed. Among these responsibilities is the ability to deliver gas from storage in a timely manner as specified by gas storage contracts. To ensure that their deliverability obligations are met, a program has been implemented to review well performance and to re-work wells where deliverability can economically be improved. This program is aimed at maintaining or improving deliverability from wells and monitoring their future performance. Re-working existing wells has proven to be an economically successful method of maintaining deliverability compared to drilling new wells to meet this purpose. Re-working can be broken into two groups of wells: wells that have mechanical problems that need to be corrected or wells that need some type of stimulation treatment. In developing a rework program, several things need to be addressed such as: a candidate recognition program, the design of the work to be performed, execution of that work, and the evaluation of the results obtained along with the economics. The Deliverability Improvement Program is in its third year. It has developed from a small pilot program to a substantial part of normal storage activities. The purpose of this paper is to review the processes used to find candidates to work on and an evaluation of work performed

  6. Improving utility conservation programs: outcomes, interventions, and evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Condelli, L; Archer, D; Aronson, E; Curbow, B; McLeod, B; Pettigrew, T F; White, L T; Yates, S

    1984-06-01

    Four major California utility companies have active energy conservation programs mandated by the State's Public Utilities Commission (CPUC). These companies evaluate their programs and send reports of the evaluations to the CPUC. A review of 213 of these reports revealed a marketing research approach toward promoting conservation. Advertising and informational campaigns characterize most programs, and attitudes and self-reported behavior were the major outcome measures. This approach is shown to be ineffective. Suggestions for improvement include: (1) the use of actual energy consumption as the primary outcome measure in evaluating conservation programs; (2) the abandonment of conventional advertising, and the use of it only for the promotion of ''hard'' interventions; (3) increased use of social diffusion methods to disseminate information; (4) the design of more effective educational material by incorporating cognitive social psychological principles; and (5) the utilization of ''hard'' interventions that have a direct, verifiable link to conservation.

  7. A Quality Improvement Collaborative Program for Neonatal Pain Management in Japan

    Science.gov (United States)

    Yokoo, Kyoko; Funaba, Yuuki; Fukushima, Sayo; Fukuhara, Rie; Uchida, Mieko; Aiba, Satoru; Doi, Miki; Nishimura, Akira; Hayakawa, Masahiro; Nishimura, Yutaka; Oohira, Mitsuko

    2017-01-01

    Background: Neonatal pain management guidelines have been released; however, there is insufficient systematic institutional support for the adoption of evidence-based pain management in Japan. Purpose: To evaluate the impact of a collaborative quality improvement program on the implementation of pain management improvements in Japanese neonatal intensive care units (NICUs). Methods: Seven Japanese level III NICUs participated in a neonatal pain management quality improvement program based on an Institute for Healthcare Improvement collaborative model. The NICUs developed evidence-based practice points for pain management and implemented these over a 12-month period. Changes were introduced through a series of Plan-Do-Study-Act cycles, and throughout the process, pain management quality indicators were tracked as performance measures. Jonckheere's trend test and the Cochran-Armitage test for trend were used to examine the changes in quality indicator implementations over time (baseline, 3 months, 6 months, and 12 months). Findings: Baseline pain management data from the 7 sites revealed substantial opportunities for improvement of pain management, and testing changes in the NICU setting resulted in measurable improvements in pain management. During the intervention phase, all participating sites introduced new pain assessment tools, and all sites developed electronic medical record forms to capture pain score, interventions, and infant responses to interventions. Implications for Practice: The use of collaborative quality improvement techniques played a key role in improving pain management in the NICUs. Implications for Research: Collaborative improvement programs provide an attractive strategy for solving evidence-practice gaps in the NICU setting. PMID:28114148

  8. A Continuous Quality Improvement Airway Program Results in Sustained Increases in Intubation Success.

    Science.gov (United States)

    Olvera, David J; Stuhlmiller, David F E; Wolfe, Allen; Swearingen, Charles F; Pennington, Troy; Davis, Daniel P

    2018-02-21

    Airway management is a critical skill for air medical providers, including the use of rapid sequence intubation (RSI) medications. Mediocre success rates and a high incidence of complications has challenged air medical providers to improve training and performance improvement efforts to improve clinical performance. The aim of this research was to describe the experience with a novel, integrated advanced airway management program across a large air medical company and explore the impact of the program on improvement in RSI success. The Helicopter Advanced Resuscitation Training (HeART) program was implemented across 160 bases in 2015. The HeART program includes a novel conceptual framework based on thorough understanding of physiology, critical thinking using a novel algorithm, difficult airway predictive tools, training in the optimal use of specific airway techniques and devices, and integrated performance improvement efforts to address opportunities for improvement. The C-MAC video/direct laryngoscope and high-fidelity human patient simulation laboratories were implemented during the study period. Chi-square test for trend was used to evaluate for improvements in airway management and RSI success (overall intubation success, first-attempt success, first-attempt success without desaturation) over the 25-month study period following HeART implementation. A total of 5,132 patients underwent RSI during the study period. Improvements in first-attempt intubation success (85% to 95%, p improving RSI intubation performance in a large air medical company.

  9. Effect of generic issues program on improving safety

    International Nuclear Information System (INIS)

    Fard, M. R.; Kauffman, J. V.

    2010-01-01

    The U.S. Nuclear Regulatory Commission (NRC) identifies (by its assessment of plant operation) certain issues involving public health and safety, the common defense and security, or the environment that could affect multiple entities under NRC jurisdiction. The Generic Issues Program (GIP) addresses the resolution of these Generic Issues (GIs). The resolution of these issues may involve new or revised rules, new or revised guidance, or revised interpretation of rules or guidance that affect nuclear power plant licensees, nuclear material certificate holders, or holders of other regulatory approvals. U.S. NRC provides information related to the past and ongoing GIP activities to the general public by the use of three main resources, namely NUREG-0933, 'Resolution of Generic Safety Issues, ' Generic Issues Management Control System (GIMCS), and GIP public web page. GIP information resources provide information such as historical information on resolved GIs, current status of the open GIs, policy documents, program procedures, GIP annual and quarterly reports and the process to contact GIP and propose a GI This paper provides an overview of the GIP and several examples of safety improvements resulting from the resolution of GIs. In addition, the paper provides a brief discussion of a few recent GIs to illustrate how the program functions to improve safety. (authors)

  10. Lesson learned from PSA in the design improvement program of KSNP+

    International Nuclear Information System (INIS)

    Kim, M.R.; Lim, H.K.; Kang, S.K.; Park, K.S.

    2001-01-01

    KOPEC (Korea Power Engineering Co.) in conjunction with the client KEPCO (Korea Electric Power Corp.) has been developing a highly competitive Improved Korean Standard Nuclear Power Plant named KSNP+. From the beginning of Design Improvement Program, PSA was carried out to assure that the safety level of KSNP+ is maintained or improved in comparison with that of KSNP, the Korean Standard NPP. To achieve the safety goal of KSNP+, PSA team reviewed all design changes that might affect the plant safety. Design vulnerabilities were identified from the PSA results and safety improvement items were recommended to the system designers. Through the Design Improvement Program, KSNP+ became more reliable, safer and economically competitive than KSNP. This was achieved by systematic approach for design optimization and effective use of PSA technology based on past experience and expertise of nuclear power plant. (author)

  11. The impact of middle manager affective commitment on perceived improvement program implementation success.

    Science.gov (United States)

    Fryer, Ashley-Kay; Tucker, Anita L; Singer, Sara J

    Recent literature suggests that middle manager affective commitment (emotional attachment, identification, and involvement) to an improvement program may influence implementation success. However, less is known about the interplay between middle manager affective commitment and frontline worker commitment, another important driver of implementation success. We contribute to this research by surveying middle managers who directly manage frontline workers on nursing units. We assess how middle manager affective commitment is related to their perceptions of implementation success and whether their perceptions of frontline worker support mediate this relationship. We also test whether a set of organizational support factors foster middle manager affective commitment. We adapt survey measures of manager affective commitment to our research context of hospitals. We surveyed 67 nurse managers from 19 U.S. hospitals. We use hierarchical linear regression to assess relationships among middle manager affective commitment to their units' falls reduction program and their perceptions of three constructs related to the program: frontline worker support, organizational support, and implementation success. Middle manager affective commitment to their unit's falls reduction program is positively associated with their perception of implementation success. This relationship is mediated by their perception of frontline worker support for the falls program. Moreover, middle managers' affective commitment to their unit's falls program mediates the relationship between perceived organizational support for the program and perceived implementation success. We, through this research, offer an important contribution by providing empirical support of factors that may influence successful implementation of an improvement program: middle manager affective commitment, frontline worker support, and organizational support for an improvement program. Increasing levels of middle manager affective

  12. Improvements Needed in Administration of the Guaranteed Student Loan Program.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report identifies improvements needed in administration of the guaranteed student loan program. Improvements needed are based on the fact that that lenders are not informed when student borrowers drop out of school. Alternatives for providing lenders with timely information on enrollment terminations are indicated. Additional administrative…

  13. Performance improvement of developed program by using multi-thread technique

    Directory of Open Access Journals (Sweden)

    Surasak Jabal

    2015-03-01

    Full Text Available This research presented how to use a multi-thread programming technique to improve the performance of a program written by Windows Presentation Foundation (WPF. The Computer Assisted Instruction (CAI software, named GAME24, was selected to use as a case study. This study composed of two main parts. The first part was about design and modification of the program structure upon the Object Oriented Programing (OOP approach. The second part was about coding the program using the multi-thread technique which the number of threads were based on the calculated Catalan number. The result showed that the multi-thread programming technique increased the performance of the program 44%-88% compared to the single-thread technique. In addition, it has been found that the number of cores in the CPU also increase the performance of multithreaded program proportionally.

  14. Inpo programs for improvement of nuclear power plant operations

    International Nuclear Information System (INIS)

    Edward Moore, C.

    1989-01-01

    The talk shows how key INPO programs help foster improved nuclear power operations. The talk focuses on the results being seen from six key efforts: evaluations, training and accreditation, assistance, events analysis and information exchange, human performance and maintenance. The talk stresses that all INPO programs are geared toward enhanced performance and that progress in key performance areas since 1980 shows that INPO and U.S. industry efforts are achieving desired results

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

    Science.gov (United States)

    Mark, Melvin M.; Pines, Edward

    1995-01-01

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

  16. The program of continuous improvements in factory in Juzbado

    International Nuclear Information System (INIS)

    Prieto, M.

    2015-01-01

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

  17. A Peer-to-Peer Mentoring Program for In-Center Hemodialysis: A Patient-Centered Quality Improvement Program.

    Science.gov (United States)

    St Clair Russell, Jennifer; Southerland, Shiree; Huff, Edwin D; Thomson, Maria; Meyer, Klemens B; Lynch, Janet R

    2017-01-01

    A patient-centered quality improvement program implemented in one Virginia hemodialysis facility sought to determine if peer-to-peer (P2P) programs can assist patients on in-center hemodialysis with self-management and improve outcomes. Using a single-arm, repeatedmeasurement, quasi-experimental design, 46 patients participated in a four-month P2P intervention. Outcomes include knowledge, self-management behaviors, and psychosocial health indicators: self-efficacy, perceived social support, hemodialysis social support, and healthrelated quality of life (HRQoL). Physiological health indicators included missed and shortened treatments, arteriovenous fistula placement, interdialytic weight gain, serum phosphorus, and hospitalizations. Mentees demonstrated increased knowledge, self-efficacy, perceived social support, hemodialysis social support, and HRQoL. Missed treatments decreased. Mentors experienced increases in knowledge, self-management, and social support. A P2P mentoring program for in-center hemodialysis can benefit both mentees and mentors. Copyright© by the American Nephrology Nurses Association.

  18. Improving MC and A Oversight in Russia by Implementing Measurement and Training Programs

    International Nuclear Information System (INIS)

    Bokov, Dmitry; Byers, Kenneth R.

    2004-01-01

    As the Russian State regulatory agency responsible for oversight of nuclear material control and accounting (MC and A), Gosatomnadzor of Russia (GAN) determines the status of the MC and A programs at Russian facilities. Last year, GAN developed and implemented their Nuclear Material Measurement Program Plan which documents current non-destructive assay (NDA) measurement capability in all regions of GAN; provides justification for upgrades to equipment, procedures and training; and defines the inspector-facility operator interface as it relates to NDA measurement equipment use. This Program Plan has helped to give the GAN inspection measurements more legal and official status as an oversight tool, and has also helped to improve other GAN MC and A oversight activities. These improvements include developing a tamper-indicating device program, conducting NDA workshops at specific Russian nuclear facilities to better train MC and A inspectors, and developing training evaluation programs. The Program is an important tool to address the GAN role in oversight of the Russian Federal Information System nuclear material database. This paper describes the feedback received from the GAN regional offices on the implementation of the Program Plan during its first year in operation and how the Program Plan has affected other GAN inspection activities to improve MC and A oversight.

  19. Research notes : are safety corridors really safe? Evaluation of the corridor safety improvement program.

    Science.gov (United States)

    1998-08-26

    High accident frequencies on Oregons highway corridors are of concern to the Oregon Department of Transportation (ODOT). : ODOT adopted the Corridor Safety Improvement Program as part of an overall program of safety improvements using federal and ...

  20. Campus Partnerships Improve Impact Documentation of Nutrition Programs

    Science.gov (United States)

    Brinkman, Patricia

    2015-01-01

    Partnerships with other campus college units can provide ways of improving Extension's impact documentation. Nutrition programs have relied upon knowledge gained and people's self report of behavior change. Partnering with the College of Nursing, student nurses provided blood screenings during the pre and 6 month follow-up of a pilot heart risk…

  1. Comprehensive yogic breathing program improves quality of life in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Viveka P Jyotsna

    2012-01-01

    Full Text Available Objective: To assess the effect of a comprehensive yogic breathing program on glycemic control and quality of life (QOL in patients with diabetes. Materials and Methods: This is a prospective randomized controlled intervention trial. Patients having HbA1c between 6 and 9% for at least 3 months with lifestyle modification and oral antidiabetic medication were included. They were followed-up and randomized at 6 months into two groups: one group receiving standard treatment of diabetes and the other group receiving standard treatment of diabetes and taught and told to regularly practice the comprehensive yogic breathing program (Sudarshan Kriya Yoga and Pranayam. Change in fasting and post-prandial blood sugars, glycated hemoglobin and QOL as assessed by the World Health Organization QOL WHOQOL BREF questionnaire were assessed. Results: There was a trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group following standard treatment alone, although this was not significant. There was significant improvement in physical, psychological and social domains and total QOL post-intervention in the group practicing the comprehensive yogic breathing program as compared with the group following standard treatment alone. Conclusion: There was significant improvement in the QOL and a non-significant trend toward improvement in glycemic control in the group practicing the comprehensive yogic breathing program compared with the group that was following standard treatment alone.

  2. Louisiana Airport System Plan Five-Year Capital Improvement Program.

    Science.gov (United States)

    1992-07-01

    The Louisiana Airport System Plan (LASP) Five-Year-Capital Improvement Program (CIP) is a development plan for all commercial service, reliever, and general aviation airports in Louisiana. It is a detailed listing of potential projects based on the a...

  3. Improve Problem Solving Skills through Adapting Programming Tools

    Science.gov (United States)

    Shaykhian, Linda H.; Shaykhian, Gholam Ali

    2007-01-01

    There are numerous ways for engineers and students to become better problem-solvers. The use of command line and visual programming tools can help to model a problem and formulate a solution through visualization. The analysis of problem attributes and constraints provide insight into the scope and complexity of the problem. The visualization aspect of the problem-solving approach tends to make students and engineers more systematic in their thought process and help them catch errors before proceeding too far in the wrong direction. The problem-solver identifies and defines important terms, variables, rules, and procedures required for solving a problem. Every step required to construct the problem solution can be defined in program commands that produce intermediate output. This paper advocates improved problem solving skills through using a programming tool. MatLab created by MathWorks, is an interactive numerical computing environment and programming language. It is a matrix-based system that easily lends itself to matrix manipulation, and plotting of functions and data. MatLab can be used as an interactive command line or a sequence of commands that can be saved in a file as a script or named functions. Prior programming experience is not required to use MatLab commands. The GNU Octave, part of the GNU project, a free computer program for performing numerical computations, is comparable to MatLab. MatLab visual and command programming are presented here.

  4. Using program impact pathways to understand and improve program delivery, utilization, and potential for impact of Helen Keller International's homestead food production program in Cambodia.

    Science.gov (United States)

    Olney, Deanna K; Vicheka, Sao; Kro, Meng; Chakriya, Chhom; Kroeun, Hou; Hoing, Ly Sok; Talukder, Aminzzaman; Quinn, Victoria; Iannotti, Lora; Becker, Elisabeth; Roopnaraine, Terry

    2013-06-01

    Evidence of the impact of homestead food production programs on nutrition outcomes such as anemia and growth is scant. In the absence of information on program impact pathways, it is difficult to understand why these programs, which have been successful in increasing intake of micronutrient-rich foods, have had such limited documented impact on nutrition outcomes. To conduct a process evaluation of Helen Keller International's (HKI's) homestead food production program in Cambodia to assess whether the program was operating as planned (in terms of design, delivery, and utilization) and to identify ways in which the program might need to be strengthened in order to increase its potential for impact. A program theory framework, which laid out the primary components along the hypothesized program impact pathways, was developed in collaboration with HKI and used to design the research. Semistructured interviews and focus group discussions with program beneficiaries (n = 36 and 12, respectively), nonbeneficiaries (n = 12), and program implementers (n = 17 and 2, respectively) and observations of key program delivery points, including health and nutrition training sessions (n = 6), village model farms (n = 6), and household gardens of beneficiaries (n = 36) and nonbeneficiaries (n = 12), were conducted to assess the delivery and utilization of the primary program components along the impact pathways. The majority of program components were being delivered and utilized as planned. However, challenges with some of the key components posited to improve outcomes such as anemia and growth were noted. Among these were a gap in the expected pathway from poultry production to increased intake of eggs and poultry meat, and some weaknesses in the delivery of the health and nutrition training sessions and related improvements in knowledge among the village health volunteers and beneficiaries. Although the program has been successful in delivering the majority of the program

  5. Applying national survey results for strategic planning and program improvement: the National Diabetes Education Program.

    Science.gov (United States)

    Griffey, Susan; Piccinino, Linda; Gallivan, Joanne; Lotenberg, Lynne Doner; Tuncer, Diane

    2015-02-01

    Since the 1970s, the federal government has spearheaded major national education programs to reduce the burden of chronic diseases in the United States. These prevention and disease management programs communicate critical information to the public, those affected by the disease, and health care providers. The National Diabetes Education Program (NDEP), the leading federal program on diabetes sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), uses primary and secondary quantitative data and qualitative audience research to guide program planning and evaluation. Since 2006, the NDEP has filled the gaps in existing quantitative data sources by conducting its own population-based survey, the NDEP National Diabetes Survey (NNDS). The NNDS is conducted every 2–3 years and tracks changes in knowledge, attitudes and practice indicators in key target audiences. This article describes how the NDEP has used the NNDS as a key component of its evaluation framework and how it applies the survey results for strategic planning and program improvement. The NDEP's use of the NNDS illustrates how a program evaluation framework that includes periodic population-based surveys can serve as an evaluation model for similar national health education programs.

  6. Does a voucher program improve reproductive health service delivery and access in Kenya?

    Science.gov (United States)

    Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

    2015-05-23

    Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

  7. Effectiveness of a quality-improvement program in improving management of primary care practices

    Science.gov (United States)

    Szecsenyi, Joachim; Campbell, Stephen; Broge, Bjoern; Laux, Gunter; Willms, Sara; Wensing, Michel; Goetz, Katja

    2011-01-01

    Background: The European Practice Assessment program provides feedback and outreach visits to primary care practices to facilitate quality improvement in five domains (infrastructure, people, information, finance, and quality and safety). We examined the effectiveness of this program in improving management in primary care practices in Germany, with a focus on the domain of quality and safety. Methods: In a before–after study, 102 primary care practices completed a practice assessment using the European Practice Assessment instrument at baseline and three years later (intervention group). A comparative group of 102 practices was included that completed their first assessment using this instrument at the time of the intervention group’s second assessment. Mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100. Results: We found significant improvements in all domains between the first and second assessments in the intervention group. In the domain of quality and safety, improvements in scores (mean scores were based on the proportion of indicators for which a positive response was achieved by all of the practices, on a scale of 0 to 100) were observed in the following dimensions: complaint management (from a mean score of 51.2 at first assessment to 80.7 at second assessment); analysis of critical incidents (from 79.1 to 89.6); and quality development, quality policy (from 40.7 to 55.6). Overall scores at the time of the second assessment were significantly higher in the intervention group than in the comparative group. Interpretation: Primary care practices that completed the European Practice Assessment instrument twice over a three-year period showed improvements in practice management. Our findings show the value of the quality-improvement cycle in the context of practice assessment and the use of established organizational standards for practice management with the

  8. Exercise program improved subjective dry eye symptoms for office workers.

    Science.gov (United States)

    Sano, Kokoro; Kawashima, Motoko; Takechi, Sayuri; Mimura, Masaru; Tsubota, Kazuo

    2018-01-01

    We investigated the benefits of a cognitive behavior therapy-based exercise program to reduce the dry eye symptoms of office workers. We recruited 11 office workers with dry eye symptoms, aged 31-64 years, who voluntarily participated in group health guidance at a manufacturing company. Participants learned about the role of physical activity and exercise in enhancing wellness and performed an exercise program at home 3 days per week for 10 weeks. We estimated the indexes of body composition, dry eye symptoms, and psychological distress using the Dry Eye-Related Quality of Life Score and the World Health Organization's Subjective Well-Being Inventory questionnaires pre- and postintervention. The 10-week exercise program and the questionnaires were completed by 48.1% (39 of 81) of the participants. Body composition did not change pre- and postintervention. However, the average of the Dry Eye-Related Quality of Life Score scores in participants with subjective dry eye significantly improved after the intervention. Moreover, the World Health Organization's Subjective Well-Being Inventory positive well-being score tended to increase after the intervention. In this study, we showed that a 10-week exercise program improved subjective dry eye symptoms of healthy office workers. Our study suggests that a cognitive behavior therapy-based exercise program can play an important role in the treatment of patients with dry eye disease.

  9. Image Quality Improvement after Implementation of a CT Accreditation Program

    International Nuclear Information System (INIS)

    Kim, You Sung; Jung, Seung Eun; Choi, Byung Gil; Shin, Yu Ri; Hwang, Seong Su; Ku, Young Mi; Lim, Yeon Soo; Lee, Jae Mun

    2010-01-01

    The purpose of this study was to evaluate any improvement in the quality of abdominal CTs after the utilization of the nationally based accreditation program. Approval was obtained from the Institutional Review Board, and informed consent was waived. We retrospectively analyzed 1,011 outside abdominal CTs, from 2003 to 2007. We evaluated images using a fill-up sheet form of the national accreditation program, and subjectively by grading for the overall CT image quality. CT scans were divided into two categories according to time periods; before and after the implementation of the accreditation program. We compared CT scans between two periods according to parameters pertaining to the evaluation of images. We determined whether there was a correlation between the results of a subjective assessment of the image quality and the evaluation scores of the clinical image. The following parameters were significantly different after the implementation of the accreditation program: identifying data, display parameters, scan length, spatial and contrast resolution, window width and level, optimal contrast enhancement, slice thickness, and total score. The remaining parameters were not significantly different between scans obtained from the two different periods: scan parameters, film quality, and artifacts. After performing the CT accreditation program, the quality of the outside abdominal CTs show marked improvement, especially for the parameters related to the scanning protocol

  10. Improving Reading Comprehension Skills through the SCRATCH Program

    Science.gov (United States)

    Papatga, Erdal; Ersoy, Ali

    2016-01-01

    The aim of this study was to reveal how reading comprehension skills of elementary fourth graders who have problems in reading comprehension can be improved by means of the SCRATCH program. The study was designed as a participant action research. It was carried out within a 15- week process at an elementary school with middle socio-economic level…

  11. A continuous quality improvement program to focus a college of pharmacy on programmatic advancement.

    Science.gov (United States)

    Hall, Philip D; Dipiro, Joseph T; Rowen, Randall C; McNair, David

    2013-08-12

    To enhance the achievement of a college of pharmacy's goals for education, research, and service missions by implementing an excellence program based on the Studer Group model for continuous quality improvement. The Studer model was combined with university strategic planning for a comprehensive quality-improvement program that was implemented over 5 years. The program included identifying and measuring key performance indicators, establishing specific "pillar" goals, aligning behaviors with goals and values, and training leaders. Assessment of key performance indicators over 5 years demonstrated progress toward achieving college goals for student and faculty satisfaction, research funding, numbers of students seeking formal postgraduate training, and private giving. Implementation of a continuous quality-improvement program based on the Studer program enabled the college to focus on and meet its yearly and strategic goals for all components of its mission.

  12. Improved Sorting-Based Procedure for Integer Programming

    DEFF Research Database (Denmark)

    Dantchev, Stefan

    2002-01-01

    Recently, Cornuéjols and Dawande have considered a special class of 0-1 programs that turns out to be hard for existing IP solvers. One of them is a sorting-based algorithm, based on an idea of Wolsey. In this paper, we show how to improve both the running time and the space requirements...... of this algorithm. The drastic reduction of space needed allows us to solve much larger instances than was possible before using this technique....

  13. School-based sleep education program improves sleep and academic performance of school-age children.

    Science.gov (United States)

    Gruber, Reut; Somerville, Gail; Bergmame, Lana; Fontil, Laura; Paquin, Soukaina

    2016-05-01

    The objective of this study was to develop and evaluate the effectiveness of a school-based sleep education program aimed at improving the sleep and academic performance of school-age children. Using a community-based participatory research approach, we created a school-based sleep education program, "Sleep for Success"™ (SFS), composed of four distinct modules that addressed the children, their family and community, the school staff, and decision makers within the school setting. Implementation was carried out in three elementary schools. Seventy-one students participated in the evaluation of the program. The effectiveness of the SFS program was evaluated using non-randomized controlled before-and-after study groups (intervention and control) assessed over two time points (pre- and post-program implementation). Before (baseline) and after implementation, sleep and academic performance were measured using actigraphy and report card marks, respectively. In the intervention group, true sleep was extended by 18.2 min per night, sleep efficiency improved by 2.3%, and sleep latency was shortened by 2.3 min, and report card grades in mathematics and English improved significantly. No changes were noted in the control group. Participation in the sleep education program was associated with significant improvements in children's sleep and academic performance. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. The impact of a quality improvement program on employee satisfaction in an academic microsystem.

    Science.gov (United States)

    Varkey, Prathibha; Karlapudi, Sudhakar P; Hensrud, Donald D

    2008-01-01

    Quality improvement is a potential method to enhance employee satisfaction. This study describes the impact of a program instituted to enhance employee satisfaction using the principles of high-performing microsystems. A shared leadership committee, participatory meetings, suggestion boxes, and quality improvement projects were implemented as part of the program. A follow-up survey 1 year after implementation of the program demonstrated an increase in employee perception of the division's desire to improve service (16%), opportunities to expand skills (17%), involvement in work decisions (25%), and the institution's interest in employee well-being (17%). Key drivers of discretionary effort (4 of 5), job satisfaction (2 of 6), and overall satisfaction (1 of 8) with the institution showed statistically significant improvement in the study division as compared with the other divisions in which no such program was implemented. Further research is needed to study systems changes that enhance employee satisfaction and their impact on patient and financial outcomes.

  15. Work engagement in employees at professional improvement programs in health

    Directory of Open Access Journals (Sweden)

    Elizangela Gianini Gonsalez

    2017-09-01

    Full Text Available Objective: This study evaluated the levels of engagement at work in enhancement programs and professionals training in health. Method: A cross-sectional study with 82 health professionals enhancement programs and improvement of a public institution in the State of São Paulo, using the Utrech Work Engagement Scale (UWES, a self-administered questionnaire composed of seventeen self-assessment items in three dimensions: vigor, dedication and absorption. The scores were calculated according to the statistical model proposed in the Preliminary Manual UWES. Results: Engagement levels were too high on the force, high dedication and dimension in general score, and medium in size to 71.61% absorption, 58.03%, 53.75% and 51.22% of workers, respectively. The professionals present positive relationship with the work; they are responsible, motivated and dedicated to the job and to the patients. Conclusion: Reinforces the importance of studies that evaluate positive aspects of the relationship between professionals and working environment, contributing to strengthen the programs of improvement, advancing the profile of professionals into the labour market.

  16. CM Process Improvement and the International Space Station Program (ISSP)

    Science.gov (United States)

    Stephenson, Ginny

    2007-01-01

    This viewgraph presentation reviews the Configuration Management (CM) process improvements planned and undertaken for the International Space Station Program (ISSP). It reviews the 2004 findings and recommendations and the progress towards their implementation.

  17. Design basis programs and improvements in plant operation

    International Nuclear Information System (INIS)

    Metcalf, M.F.

    1991-01-01

    Public Service Electric and Gas (PSE and G) Company operates three commercial nuclear power plants in southern New Jersey. The three plants are of different designs and vintages (two pressurized water reactors licensed in 1976 and 1980 and one boiling water reactor licensed in 1986). As the industry recognized the need to develop design basis programs, PSE and G also realized the need after a voluntary 52-day shutdown of one unit because of electrical design basis problems. In its drive to be a premier electric utility, PSE and G has been aggressively active in developing design basis documents (DBDs) with supporting projects and refined uses to obtain the expected value and see the return on investment. Progress on Salem is nearly 75% complete, while Hope Creek is 20% complete. To data, PSE and G has experienced success in the use of DBDs in areas such as development of plant modifications, development of the reliability-centered maintenance program, procedure upgrades, improved document retrieval, resolution of regulatory issues, and training. The paper examines the design basis development process, supporting projects, and expected improvements in plant operations as a result of these efforts

  18. Home visit program improves technique survival in peritoneal dialysis.

    Science.gov (United States)

    Martino, Francesca; Adıbelli, Z; Mason, G; Nayak, A; Ariyanon, W; Rettore, E; Crepaldi, Carlo; Rodighiero, Mariapia; Ronco, Claudio

    2014-01-01

    Peritoneal dialysis (PD) is a home therapy, and technique survival is related to the adherence to PD prescription at home. The presence of a home visit program could improve PD outcomes. We evaluated its effects on clinical outcome during 1 year of follow-up. This was a case-control study. The case group included all 96 patients who performed PD in our center on January 1, 2013, and who attended a home visit program; the control group included all 92 patients who performed PD on January 1, 2008. The home visit program consisted of several additional visits to reinforce patients' confidence in PD management in their own environment. Outcomes were defined as technique failure, peritonitis episode, and hospitalization. Clinical and dialysis features were evaluated for each patient. The case group was significantly older (p = 0.048), with a lower grade of autonomy (p = 0.033), but a better hemoglobin level (p = 0.02) than the control group. During the observational period, we had 11 episodes of technique failure. We found a significant reduction in the rate of technique failure in the case group (p = 0.004). Furthermore, survival analysis showed a significant extension of PD treatment in the patients supported by the home visit program (52 vs. 48.8 weeks, p = 0.018). We did not find any difference between the two groups in terms of peritonitis and hospitalization rate; however, trends toward a reduction of Gram-positive peritonitis rates as well as prevalence and duration of hospitalization related to PD problems were identified in the case group. The retrospective nature of the analysis was a limitation of this study. The home visit program improves the survival of PD patients and could reduce the rate of Gram-positive peritonitis and hospitalization. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi=365168.

  19. 42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

    ... projects, develop and implement an information technology system explicitly designed to improve patient... program that shows measurable improvement in indicators for which there is evidence that it will improve... learning throughout the hospital. (3) The hospital must take actions aimed at performance improvement and...

  20. Effectiveness of a Nutrition Education Program to Improve Children's Chewing Habits.

    Science.gov (United States)

    Sato, Nanae; Hayashi, Fumi; Yoshiike, Nobuo

    2016-01-01

    This quasi-experimental study determined whether the nutrition education program we developed to promote chewing food properly influenced children's chewing habits successfully. Four kindergarten classes in Japan (150 children, aged 5-6 years) were studied; one class received the educational program in the classroom and at home (Group A) and three classes received the program in the classroom only (Group B). The educational program was integrated into the classes' daily curriculum for five weeks. It included storytelling with large picture books, chewing consciously while eating lunch, singing a song with gestures, and greetings before and after meals (both groups). Group A also used a paper textbook and was provided information by the leaflet to encourage guardians to implement the program at home. Chewing habits before and after intervention were evaluated: (1) guardians completed seven questionnaire items related to chewing habits and chewing movement and (2) the number of chews and time spent eating the test meal were measured by a portable chewing sensor. Both approaches improved the children's chewing habits; however, no difference was found between the two groups. We concluded that this intervention could be used to improve chewing habits in young children even without active involvement of their guardians.

  1. Evolution of a Family Nurse Practitioner Program to Improve Primary Care Distribution

    Science.gov (United States)

    Andrus, Len Hughes; Fenley, Mary D.

    1976-01-01

    Describes a Family Nurse Practitioner Program that has effectively improved the distribution of primary health care manpower in rural areas. Program characteristics include selection of personnel from areas of need, decentralization of clinical and didactic training sites, competency-based portable curriculum, and circuit-riding institutionally…

  2. An improved instrument setpoint control program

    International Nuclear Information System (INIS)

    Cash, J.S. Jr.; George, R.T.; Kincaid, S.C.

    1991-01-01

    Instrument setpoints have a definite and often significant impact on plant safety, reliability, and availability. Although typically overshadowed by plant design, modification, and physical change activities, instrument setpoints can alter plant status and system operating characteristics just as significantly. Recognizing the need for a formal program that provides configuration control of instrument setpoints, provides a readily accessible and clearly documented basis for instrument setpoints, and integrates and coordinates operations, engineering, and maintenance activities that influence the basis for instrument setpoints, Philadelphia Electric Company (PECo) is developing an Improved Instrument Setpoint Control Program (IISCP) that incorporates current industry guidance and practices and state-of-the-art information systems technology. The IISCP was designed around PECo's then existing business processes for setpoint control, determination, and maintenance. A task force representing the various constituencies from both plants and the engineering and services organizations were formed to identify objectives and design features for the IISCP. Utilizing industry standards and guidance, regulatory documents, the experiences and good practices obtained from other utilities, and PECo's nuclear group strategies, objectives, and goals, specific objectives were identified to enhance the business processes

  3. Improvement program of state supervision system for radioactive and nuclear installations

    International Nuclear Information System (INIS)

    Cardenas, J.

    1993-01-01

    The current program begins as part of a policy to take care of the development of the cuban nuclear program and with the objective of improving the state supervision system of nuclear and radioactive facilities on the basis of the national experience, good skills internationally accepted and taking into account IAEA recommendations. The program develops the following topics: reorientation and restructure of state supervision, review of the current nuclear legislature, update of regulations of facility safety and qualification and training of state supervision personnel

  4. Using "Kaizen" to Improve Graduate Business School Degree Programs

    Science.gov (United States)

    Emiliani, M. L.

    2005-01-01

    Purpose: To illustrate the applicability of "kaizen" in higher education. Design/methodology/approach: "Kaizen" process was used for ten courses contained in a part-time executive MS degree program in management. Findings: "Kaizen" was found to be an effective process for improving graduate business school courses and the value proposition for…

  5. Peer Mentor Program for the General Chemistry Laboratory Designed to Improve Undergraduate STEM Retention

    Science.gov (United States)

    Damkaci, Fehmi; Braun, Timothy F.; Gublo, Kristin

    2017-01-01

    We describe the design and implementation of an undergraduate peer mentor program that can overlay an existing general chemistry laboratory and is designed to improve STEM student retention. For the first four freshman cohorts going through the program, year-to-year retention improved by a four-year average of 20% for students in peer-mentored…

  6. Reducing Channel Interaction Through Cochlear Implant Programming May Improve Speech Perception

    Directory of Open Access Journals (Sweden)

    Julie A. Bierer

    2016-06-01

    Full Text Available Speech perception among cochlear implant (CI listeners is highly variable. High degrees of channel interaction are associated with poorer speech understanding. Two methods for reducing channel interaction, focusing electrical fields, and deactivating subsets of channels were assessed by the change in vowel and consonant identification scores with different program settings. The main hypotheses were that (a focused stimulation will improve phoneme recognition and (b speech perception will improve when channels with high thresholds are deactivated. To select high-threshold channels for deactivation, subjects’ threshold profiles were processed to enhance the peaks and troughs, and then an exclusion or inclusion criterion based on the mean and standard deviation was used. Low-threshold channels were selected manually and matched in number and apex-to-base distribution. Nine ears in eight adult CI listeners with Advanced Bionics HiRes90k devices were tested with six experimental programs. Two, all-channel programs, (a 14-channel partial tripolar (pTP and (b 14-channel monopolar (MP, and four variable-channel programs, derived from these two base programs, (c pTP with high- and (d low-threshold channels deactivated, and (e MP with high- and (f low-threshold channels deactivated, were created. Across subjects, performance was similar with pTP and MP programs. However, poorer performing subjects (scoring  2. These same subjects showed slightly more benefit with the reduced channel MP programs (5 and 6. Subjective ratings were consistent with performance. These finding suggest that reducing channel interaction may benefit poorer performing CI listeners.

  7. A Community-based Healthy Living Promotion Program Improved Self-esteem Among Minority Children.

    Science.gov (United States)

    Wong, William W; Ortiz, Christina L; Stuff, Janice E; Mikhail, Carmen; Lathan, Debra; Moore, Louis A; Alejandro, Mercedes E; Butte, Nancy F; Smith, Elliot O'Brian

    2016-07-01

    Improving self-esteem, dietary habits, and physical activity is essential for long-term success in childhood obesity prevention. The aim is to evaluate the effects of a healthy living promotion program, Healthy Kids-Houston, on BMI, dietary habits, self-esteem, and physical activity among minority children. The after-school program was implemented at community centers in low-income neighborhoods with close proximity to public schools. The program consisted of 3 6-week sessions. Each week, children attended 2 2-hour sessions. Each 2-hour session in the intervention included 90 minutes of structured physical activities and 30 minutes of nutrition and healthy habit lessons. The control group received typical enrichment programs. Outcomes were measured before the intervention and at the end of each 6-week session. We enrolled 877 children (age 10.2 ± 0.1 years (mean ± SE); body mass index z score: 1.49 ± 0.1; 52.0% boys; 72.6% Hispanic) in the program with 524 children received the intervention at 14 community centers and 353 children served as control at 10 community centers. The intervention led to no improvements in BMI z score (P = 0.78) and dietary habits (P = 0.46). Significant improvements (P ≤ 0.02) were detected in the amount of exercise that a child perceived to be required to offset a large meal and in several key self-esteem scores. No improvements were detected in physical activities (P ≥ 0.21). The improvement in some key self-esteem scores and nutrition knowledge may act as a mediator to motivate these children to adopt a healthier lifestyle in the future.

  8. Improving bovine udder health: A national mastitis control program in the Netherlands

    NARCIS (Netherlands)

    Lam, T.J.G.M.; Borne, van den B.H.P.; Jansen, J.; Huijps, K.; Veersen, J.C.L.; Schaick, van G.; Hogeveen, H.

    2013-01-01

    Because of increasing bulk milk somatic cell counts and continuous clinical mastitis problems in a substantial number of herds, a national mastitis control program was started in 2005 to improve udder health in the Netherlands. The program started with founding the Dutch Udder Health Centre (UGCN),

  9. Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data

    Science.gov (United States)

    American Psychologist, 2009

    2009-01-01

    This document provides a set of criteria to be used by psychologists in evaluating quality improvement programs (QIPs) that have been promulgated by health care organizations, government agencies, professional associations, or other entities. These criteria also address the privacy and confidentiality issues evoked by the intended use of patient…

  10. Efficiency improvement opportunities in TVs: Implications for market transformation programs

    International Nuclear Information System (INIS)

    Park, Won Young; Phadke, Amol; Shah, Nihar; Letschert, Virginie

    2013-01-01

    Televisions (TVs) account for a significant portion of residential electricity consumption and global TV shipments are expected to continue to increase. We assess the market trends in the energy efficiency of TVs that are likely to occur without any additional policy intervention and estimate that TV efficiency will likely improve by over 60% by 2015 with savings potential of 45 terawatt-hours [TW h] per year in 2015, compared to today’s technology. We discuss various energy-efficiency improvement options and evaluate the cost effectiveness of three of them. At least one of these options improves efficiency by at least 20% cost effectively beyond ongoing market trends. We provide insights for policies and programs that can be used to accelerate the adoption of efficient technologies to further capture global energy savings potential from TVs which we estimate to be up to 23 TW h per year in 2015. - Highlights: • We analyze the impact of the recent TV market transition on TV energy consumption. • We review TV technology options that could be realized in the near future. • We assess the cost-effectiveness of selected energy-efficiency improvement options. • We estimate global electricity savings potential in selected scenarios. • We discuss possible directions of market transformation programs

  11. Networked Timetable Stability Improvement Based on a Bilevel Optimization Programming Model

    Directory of Open Access Journals (Sweden)

    Xuelei Meng

    2014-01-01

    Full Text Available Train timetable stability is the possibility to recover the status of the trains to serve as arranged according to the original timetable when the trains are disturbed. To improve the train timetable stability from the network perspective, the bilevel programming model is constructed, in which the upper level programming is to optimize the timetable stability on the network level and the lower is to improve the timetable stability on the dispatching railway segments. Timetable stability on the network level is defined with the variances of the utilization coefficients of the section capacity and station capacity. Weights of stations and sections are decided by the capacity index number and the degrees. The lower level programming focuses on the buffer time distribution plan of the trains operating on the sections and stations, taking the operating rules of the trains as constraints. A novel particle swarm algorithm is proposed and designed for the bilevel programming model. The computing case proves the feasibility of the model and the efficiency of the algorithm. The method outlined in this paper can be embedded in the networked train operation dispatching system.

  12. Improving Retention and Enrollment Forecasting in Part-Time Programs

    Science.gov (United States)

    Shapiro, Joel; Bray, Christopher

    2011-01-01

    This article describes a model that can be used to analyze student enrollment data and can give insights for improving retention of part-time students and refining institutional budgeting and planning efforts. Adult higher-education programs are often challenged in that part-time students take courses less reliably than full-time students. For…

  13. An Improved Particle Swarm Optimization for Solving Bilevel Multiobjective Programming Problem

    Directory of Open Access Journals (Sweden)

    Tao Zhang

    2012-01-01

    Full Text Available An improved particle swarm optimization (PSO algorithm is proposed for solving bilevel multiobjective programming problem (BLMPP. For such problems, the proposed algorithm directly simulates the decision process of bilevel programming, which is different from most traditional algorithms designed for specific versions or based on specific assumptions. The BLMPP is transformed to solve multiobjective optimization problems in the upper level and the lower level interactively by an improved PSO. And a set of approximate Pareto optimal solutions for BLMPP is obtained using the elite strategy. This interactive procedure is repeated until the accurate Pareto optimal solutions of the original problem are found. Finally, some numerical examples are given to illustrate the feasibility of the proposed algorithm.

  14. German diabetes management programs improve quality of care and curb costs.

    Science.gov (United States)

    Stock, Stephanie; Drabik, Anna; Büscher, Guido; Graf, Christian; Ullrich, Walter; Gerber, Andreas; Lauterbach, Karl W; Lüngen, Markus

    2010-12-01

    This paper reports the results of a large-scale analysis of a nationwide disease management program in Germany for patients with diabetes mellitus. The German program differs markedly from "classic" disease management in the United States. Although it combines important hallmarks of vendor-based disease management and the Chronic Care Model, the German program is based in primary care practices and carried out by physicians, and it draws on their personal relationships with patients to promote adherence to treatment goals and self-management. After four years of follow-up, overall mortality for patients and drug and hospital costs were all significantly lower for patients who participated in the program compared to other insured patients with similar health profiles who were not in the program. These results suggest that the German disease management program is a successful strategy for improving chronic illness care.

  15. Evaluating a brief prevention program for improving marital conflict in community families.

    Science.gov (United States)

    Cummings, E Mark; Faircloth, W Brad; Mitchell, Patricia M; Cummings, Jennifer S; Schermerhorn, Alice C

    2008-04-01

    Marital conflict is related to well-being in children and adults (E. M. Cummings & P. T. Davies, 2002). Marital conflict is likely most effectively ameliorated before it becomes clinically significant. However, families without significant problems may be unwilling to participate in couples therapies or other lengthy or intensive interventions. Responding to this gap, the authors developed a 4-session psychoeducational program about marital conflict for community families. Couples with children 4-8 years of age were randomly blocked into 1 of 3 groups: (1) a parent-only group (n = 24), (2) a parent-child group (n = 33), or (3) a self-study group (n = 33). Pre- and posttest and 6-month and 1-year assessments were conducted. This report evaluates (a) whether participation in a psychoeducational program for parents improved marital conflict, especially concerning ways of expressing disagreements, and (b) whether changes in marital conflict subsequently improved marital satisfaction, parenting, and child adjustment. Greater constructive and less destructive marital conflict was observed at all assessments for treatment groups, and these changes were linked with improvements in other family processes. The findings support the promise of brief, psychoeducational programs for improving marital conflict for community samples. (c) 2008 APA, all rights reserved.

  16. Survival prediction algorithms miss significant opportunities for improvement if used for case selection in trauma quality improvement programs.

    Science.gov (United States)

    Heim, Catherine; Cole, Elaine; West, Anita; Tai, Nigel; Brohi, Karim

    2016-09-01

    Quality improvement (QI) programs have shown to reduce preventable mortality in trauma care. Detailed review of all trauma deaths is a time and resource consuming process and calculated probability of survival (Ps) has been proposed as audit filter. Review is limited on deaths that were 'expected to survive'. However no Ps-based algorithm has been validated and no study has examined elements of preventability associated with deaths classified as 'expected'. The objective of this study was to examine whether trauma performance review can be streamlined using existing mortality prediction tools without missing important areas for improvement. We conducted a retrospective study of all trauma deaths reviewed by our trauma QI program. Deaths were classified into non-preventable, possibly preventable, probably preventable or preventable. Opportunities for improvement (OPIs) involve failure in the process of care and were classified into clinical and system deviations from standards of care. TRISS and PS were used for calculation of probability of survival. Peer-review charts were reviewed by a single investigator. Over 8 years, 626 patients were included. One third showed elements of preventability and 4% were preventable. Preventability occurred across the entire range of the calculated Ps band. Limiting review to unexpected deaths would have missed over 50% of all preventability issues and a third of preventable deaths. 37% of patients showed opportunities for improvement (OPIs). Neither TRISS nor PS allowed for reliable identification of OPIs and limiting peer-review to patients with unexpected deaths would have missed close to 60% of all issues in care. TRISS and PS fail to identify a significant proportion of avoidable deaths and miss important opportunities for process and system improvement. Based on this, all trauma deaths should be subjected to expert panel review in order to aim at a maximal output of performance improvement programs. Copyright © 2016 Elsevier

  17. Fee-for-service cancer rehabilitation programs improve health-related quality of life.

    Science.gov (United States)

    Kirkham, A A; Neil-Sztramko, S E; Morgan, J; Hodson, S; Weller, S; McRae, T; Campbell, K L

    2016-08-01

    Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (hrqol) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates. After enrolment and 17 ± 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (rand-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session. Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the rand-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629). Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in hrqol comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for

  18. Improvements in Spectrum's fit to program data tool.

    Science.gov (United States)

    Mahiane, Severin G; Marsh, Kimberly; Grantham, Kelsey; Crichlow, Shawna; Caceres, Karen; Stover, John

    2017-04-01

    The Joint United Nations Program on HIV/AIDS-supported Spectrum software package (Glastonbury, Connecticut, USA) is used by most countries worldwide to monitor the HIV epidemic. In Spectrum, HIV incidence trends among adults (aged 15-49 years) are derived by either fitting to seroprevalence surveillance and survey data or generating curves consistent with program and vital registration data, such as historical trends in the number of newly diagnosed infections or people living with HIV and AIDS related deaths. This article describes development and application of the fit to program data (FPD) tool in Joint United Nations Program on HIV/AIDS' 2016 estimates round. In the FPD tool, HIV incidence trends are described as a simple or double logistic function. Function parameters are estimated from historical program data on newly reported HIV cases, people living with HIV or AIDS-related deaths. Inputs can be adjusted for proportions undiagnosed or misclassified deaths. Maximum likelihood estimation or minimum chi-squared distance methods are used to identify the best fitting curve. Asymptotic properties of the estimators from these fits are used to estimate uncertainty. The FPD tool was used to fit incidence for 62 countries in 2016. Maximum likelihood and minimum chi-squared distance methods gave similar results. A double logistic curve adequately described observed trends in all but four countries where a simple logistic curve performed better. Robust HIV-related program and vital registration data are routinely available in many middle-income and high-income countries, whereas HIV seroprevalence surveillance and survey data may be scarce. In these countries, the FPD tool offers a simpler, improved approach to estimating HIV incidence trends.

  19. 34 CFR 403.204 - What are the State's responsibilities for program evaluation and improvement?

    Science.gov (United States)

    2010-07-01

    ... APPLIED TECHNOLOGY EDUCATION PROGRAM What Are the Administrative Responsibilities of a State Under the State Vocational and Applied Technology Education Program? § 403.204 What are the State's... description of vocational education strategies designed to improve the performance of the program as measured...

  20. Exercise program improved subjective dry eye symptoms for office workers

    Directory of Open Access Journals (Sweden)

    Sano K

    2018-02-01

    Full Text Available Kokoro Sano,1 Motoko Kawashima,1 Sayuri Takechi,2 Masaru Mimura,2 Kazuo Tsubota1 1Department of Ophthalmology, 2Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan Introduction: We investigated the benefits of a cognitive behavior therapy-based exercise program to reduce the dry eye symptoms of office workers. Materials and methods: We recruited 11 office workers with dry eye symptoms, aged 31–64 years, who voluntarily participated in group health guidance at a manufacturing company. Participants learned about the role of physical activity and exercise in enhancing wellness and performed an exercise program at home 3 days per week for 10 weeks. We estimated the indexes of body composition, dry eye symptoms, and psychological distress using the Dry Eye-Related Quality of Life Score and the World Health Organization’s Subjective Well-Being Inventory questionnaires pre- and postintervention. Results: The 10-week exercise program and the questionnaires were completed by 48.1% (39 of 81 of the participants. Body composition did not change pre- and postintervention. However, the average of the Dry Eye-Related Quality of Life Score scores in participants with subjective dry eye significantly improved after the intervention. Moreover, the World Health Organization’s Subjective Well-Being Inventory positive well-being score tended to increase after the intervention. Conclusion: In this study, we showed that a 10-week exercise program improved subjective dry eye symptoms of healthy office workers. Our study suggests that a cognitive behavior therapy-based exercise program can play an important role in the treatment of patients with dry eye disease. Keywords: dry eye, exercise, office workers, cognitive behavioral therapy

  1. 23 CFR 450.216 - Development and content of the statewide transportation improvement program (STIP).

    Science.gov (United States)

    2010-04-01

    ... Programming § 450.216 Development and content of the statewide transportation improvement program (STIP). (a... Equity Bonus funds; (5) Emergency relief projects (except those involving substantial functional...

  2. A training program to improve neuromuscular and performance indices in female high school basketball players.

    Science.gov (United States)

    Noyes, Frank R; Barber-Westin, Sue D; Smith, Stephanie T; Campbell, Thomas; Garrison, Tiina T

    2012-03-01

    The purpose of this study was to determine if a sports-specific training program could improve neuromuscular and performance indices in female high school basketball players. We combined components from a published anterior cruciate ligament injury prevention program for jump and strength training with other exercises and drills to improve speed, agility, overall strength, and aerobic conditioning. We hypothesized that this sports-specific training program would lead to significant improvements in neuromuscular and performance indices in high school female basketball players. Fifty-seven female athletes aged 14-17 years participated in the supervised 6-week program, 3 d·wk(-1) for approximately 90-120 minutes per session. The program was conducted on the basketball court and in weight room facilities in high schools. The athletes underwent a video drop-jump test, multistage fitness test, vertical jump test, and an 18-m sprint test before and upon completion of the training program. All the subjects attended at least 14 training sessions. After training, a significant increase was found in the mean estimated VO2max (p basketball players.

  3. Atrial electrogram interpretation improves after an innovative education program.

    Science.gov (United States)

    Preston, Julie L; Currey, Judy; Considine, Julie

    2015-01-01

    To avoid adverse patient outcomes from inappropriate treatment, it is recommended that an atrial electrogram (AEG) be recorded whenever atrial arrhythmias develop in patients after cardiac surgery. However, AEGs are not commonly performed because nurses lack knowledge about differentiating atrial rhythms on AEGs. To investigate whether completing a novel online evidence-based education program on interpreting AEGs would improve critical care nurses' AEG interpretation. Specialized critical care nurses were taught about obtaining and interpreting atrial rhythms on AEGs using a 42-minute online mini-movie. AEG interpretation was assessed pre and two and eight weeks post-intervention. AEG interpretation increased two weeks post intervention and was retained at eight weeks. Some participants used this newly acquired knowledge to interpret arrhythmias that were not taught during the education program. Accurate interpretation of AEGs is an easy skill for specialized critical care nurses to learn via an online education program.

  4. Program to improve the effectiveness of education and professional activities of college students

    Directory of Open Access Journals (Sweden)

    I.V. Vlaskina

    2013-04-01

    Full Text Available We describe a training program on “Psychology of effective professional activity”, realized on the basis of the Ural College of the Beauty Industry. The purpose of this discipline is to improve the effectiveness of education and professional activities of college students acquiring professions of “Human-Human” type. To improve effectiveness of education and professional activities, this program provides formation of professionally important qualities of students. The results of the program can be: students’ acquisition of knowledge required for the effective performance of professional activities (ways to prevent burnout, increase self-confidence, etc.; mastery of professional skills (planning, simulation, etc.; formation of professionally important qualities (stress, tolerance, etc.; increasing the efficiency of their professional activities.

  5. Impact of a process improvement program in a production software environment: Are we any better?

    Science.gov (United States)

    Heller, Gerard H.; Page, Gerald T.

    1990-01-01

    For the past 15 years, Computer Sciences Corporation (CSC) has participated in a process improvement program as a member of the Software Engineering Laboratory (SEL), which is sponsored by GSFC. The benefits CSC has derived from involvement in this program are analyzed. In the environment studied, it shows that improvements were indeed achieved, as evidenced by a decrease in error rates and costs over a period in which both the size and the complexity of the developed systems increased substantially. The principles and mechanics of the process improvement program, the lessons CSC has learned, and how CSC has capitalized on these lessons are also discussed.

  6. Streamlined library programming how to improve services and cut costs

    CERN Document Server

    Porter-Reynolds, Daisy

    2014-01-01

    In their roles as community centers, public libraries offer many innovative and appealing programs; but under current budget cuts, library resources are stretched thin. With slashed budgets and limited staff hours, what can libraries do to best serve their publics? This how-to guide provides strategies for streamlining library programming in public libraries while simultaneously maintaining-or even improving-quality delivery. The wide variety of principles and techniques described can be applied on a selective basis to libraries of all sizes. Based upon the author's own extensive experience as

  7. Meeting the Pepsi Challenge: Preparing Evaluation Programs for Scholastic Improvement.

    Science.gov (United States)

    Hopkins, Mona S.

    This document provides guidelines for preparing evaluation programs for scholastic improvement. The philosophy underlying assessment and accountability is discussed, with specific reference to the positive and negative aspects of assessment. The design of a curriculum evaluation model is presented, including goal identification, data gathering,…

  8. LWR-PV Surveillance Dosimetry Improvement Program review graphics

    International Nuclear Information System (INIS)

    McElroy, W.N.; Gold, R.; Gutherie, G.L.

    1979-10-01

    A primary objective of the multilaboratory program is to prepare an updated and improved set of dosimetry, damage correlation, and the associated reactor analysis ASTM standards for LWR-PV irradiation surveillance programs. Supporting this objective are a series of analytical and experimental validation and calibration studies in Benchmark Neutron Fields, reactor Test Regions, and operating power reactor Surveillance Positions. These studies will establish and certify the precision and accuracy of the measurement and predictive methods which are recommended for use in these standards. Consistent and accurate measurement and data analysis techniques and methods, therefore, will have been developed and validated along with guidelines for required neutron field calculations that are used to (1) correlate changes in material properties with the characteristics of the neutron radiation field and (2) predict pressure vessel steel toughness and embrittlement from power reactor surveillance data

  9. Improving patients' home cooking - A case series of participation in a remote culinary coaching program.

    Science.gov (United States)

    Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

    2017-08-01

    This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.

  10. Joint program for the improvement of bimetallic weld inspection

    International Nuclear Information System (INIS)

    Serre, M.; Rattoni, B.; Coquillay; Samman; Billet; Bodson; Olivera

    1985-02-01

    The aim of this program is to improve the in-service monitoring of austenitic and bimetallic welds in PWR Main Coolant Systems. This paper presents the work performed on the bimetallic weld connecting the safe end to the reactor vessel nozzle: suitability of ultrasonic testing for determining the size and location of defects, automation and calibration, gamma-ray examination in three different planes

  11. Disallowing Same-program Co-schedules to Improve Efficiency in Quad-core Servers

    OpenAIRE

    de Blanche, Andreas; Lundqvist, Thomas

    2017-01-01

    Programs running on different cores in a multicore server are often forced to share resources like off-chip memory, caches, I/O devices, etc. This resource sharing often leads to degraded performance, a slowdown, for the programs that share the resources. A job scheduler can improve performance by co-scheduling programs that use different resources on the same server. The most common approach to solve this co-scheduling problem has been to make job-schedulers resource aware, finding ways to c...

  12. Statewide Transportation Improvement Program 2010-2013 : sorted by MPO and RPA.

    Science.gov (United States)

    2006-01-01

    Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC. The : STIP is generated to provide the Federal Highway Administration (FHWA) and : Federal Transit Administrati...

  13. Fuel performance improvement program. Quarterly/annual progress report, October 1977--September 1978

    International Nuclear Information System (INIS)

    Crouthamel, C.E.

    1978-10-01

    This quarterly/annual report reviews and summarizes the activities performed in support of the Fuel Performance Improvement Program (FPIP) during Fiscal Year 1978 with emphasis on those activities that transpired during the quarter ending September 30, 1978. Significant progress has been made in achieving the primary objectives of the program, i.e., to demonstrate commercially viable fuel concepts with improved fuel - cladding interaction (FCI) behavior. This includes out-of-reactor experiments to support the fuel concepts being evaluated, initiation of instrumented test rod experiments in the Halden Boiling Water Reactor (HBWR), and fabrication of the first series of demonstration rods for irradiation in the Big Rock Point Reactor

  14. Recommended Resources for Planning to Evaluate Program Improvement Efforts (Including the SSIP)

    Science.gov (United States)

    National Center for Systemic Improvement at WestEd, 2015

    2015-01-01

    This document provides a list of recommended existing resources for state Part C and Part B 619 staff and technical assistance (TA) providers to utilize to support evaluation planning for program improvement efforts (including the State Systemic Improvement Plan, SSIP). There are many resources available related to evaluation and evaluation…

  15. Organizational Wellness Program Implementation and Evaluation: A Holistic Approach to Improve the Wellbeing of Middle Managers.

    Science.gov (United States)

    Medina, Maria Del Consuelo; Calderon, Angelica; Blunk, Dan I; Mills, Brandy W; Leiner, Marie

    2018-06-01

    : Employee wellness programs can provide benefits to institutions as well as employees and their families. Despite the attempts of some organizations to implement programs that take a holistic approach to improve physical, mental, and social wellness, the most common programs are exclusively comprised of physical and nutritional components. In this study, we implemented a wellness program intervention, including training using a holistic approach to improve the wellbeing of middle managers in several multinational organizations. We included control and experimental groups to measure wellness and teamwork with two repeated measures. Our results indicated that employees receiving the intervention had improved measures of wellness and teamwork. A positive relationship was found between wellness and teamwork in the experimental group when compared with the control group. Taken together, the data suggest that implementation of these programs would provide valuable outcomes for both employees and organizations.

  16. 25 CFR 170.808 - Can BIA Road Maintenance Program funds be used to improve IRR transportation facilities?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Can BIA Road Maintenance Program funds be used to improve... THE INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.808 Can BIA Road Maintenance Program funds be used to improve IRR transportation facilities? No. BIA Road...

  17. Adaptive Programming Improves Outcomes in Drug Court: An Experimental Trial.

    Science.gov (United States)

    Marlowe, Douglas B; Festinger, David S; Dugosh, Karen L; Benasutti, Kathleen M; Fox, Gloria; Croft, Jason R

    2012-04-01

    Prior studies in Drug Courts reported improved outcomes when participants were matched to schedules of judicial status hearings based on their criminological risk level. The current experiment determined whether incremental efficacy could be gained by periodically adjusting the schedule of status hearings and clinical case-management sessions in response to participants' ensuing performance in the program. The adjustments were made pursuant to a priori criteria specified in an adaptive algorithm. Results confirmed that participants in the full adaptive condition (n = 62) were more than twice as likely as those assigned to baseline-matching only (n = 63) to be drug-abstinent during the first 18 weeks of the program; however, graduation rates and the average time to case resolution were not significantly different. The positive effects of the adaptive program appear to have stemmed from holding noncompliant participants more accountable for meeting their attendance obligations in the program. Directions for future research and practice implications are discussed.

  18. The Effects of International Operations on the Relationship Between Manufacturing Improvement Programs and Operational Performance

    DEFF Research Database (Denmark)

    Matyusz, Zsolt; Demeter, Krisztina; Boer, Harry

    The link between manufacturing programs and operational performance, and the effects of company internal and external factors on that relationship, are well studied in the literature, both theoretically and empirically. However, previous studies rarely took into account how the scope of operations...... of the business unit affects the relationship between manufacturing programs and performances. We investigate the scope of operations from the manufacturing perspective (i.e. companies that manufacture in only one country have narrow scope of operations, while companies that manufacture in more than one country...... have broad scope of operations). We apply structural equation modelling (SEM) using PLS path modelling to investigate the effect of scope of operations on the relationship between manufacturing improvement programs and operational performance. Manufacturing improvement programs are programs like...

  19. Exercise training programs to improve hand rim wheelchair propulsion capacity: a systematic review.

    NARCIS (Netherlands)

    Zwinkels, M.; Verschuren, O.; Janssen, T.W.J.; Ketelaar, M.; Takken, T.

    2014-01-01

    Objective: An adequate wheelchair propulsion capacity is required to perform daily life activities. Exercise training may be effective to gain or improve wheelchair propulsion capacity. This review investigates whether different types of exercise training programs are effective in improving

  20. Exercise training programs to improve hand rim wheelchair propulsion capacity: a systematic review

    NARCIS (Netherlands)

    Zwinkels, M.G.J.; Verschuren, O.W.; Janssen, T.; Ketelaar, M.; Takken, T.; Backx, F.J.G.; Groot, J.F. de; Smits, D.W.; Volman, MJM

    2014-01-01

    Objective: An adequate wheelchair propulsion capacity is required to perform daily life activities. Exercise training may be effective to gain or improve wheelchair propulsion capacity. This review investigates whether different types of exercise training programs are effective in improving

  1. Economic Impact of a Peritoneal Dialysis Continuous Quality Improvement Program in Colombia.

    Science.gov (United States)

    Makhija, Dilip U; Walton, Surrey M; Mora, Juan P; Sanabria, Rafael M

    2017-01-01

    ♦ BACKGROUND: There is little information regarding the financial burden of peritonitis and the economic impact of continuous quality improvement (CQI) programs in peritoneal dialysis (PD) patients. The objectives of this study were to measure the costs of peritonitis, and determine the net savings of a PD CQI program in Colombia. ♦ METHODS: The Renal Therapy Services (RTS) network in Colombia, along with Coomeva EPS, provided healthcare resource utilization data for PD patients with and without peritonitis between January 2012 and December 2013. Propensity score matching and regression analysis were performed to estimate the incremental cost of peritonitis. Patient months at risk, episodes of peritonitis pre- and post-CQI, and costs of CQI were obtained. Annual net savings of the CQI program were estimated based on the number of peritonitis events prevented. ♦ RESULTS: The incremental cost of a peritonitis episode was $250. In an 8-year period, peritonitis decreased from 1,837 episodes per 38,596 patient-months in 2006 to 841 episodes per 50,910 patient-months in 2014. Overall, the CQI program prevented an estimated 10,409 episodes of peritonitis. The cost of implementing the CQI program was $147,000 in the first year and $119,000 annually thereafter. Using a five percent discount rate, the net present value of the program was $1,346,431, with an average annual net savings of $207,027. The return on investment (i.e. total savings-program cost/program cost) of CQI was 169%. ♦ CONCLUSION: Continuous quality improvement initiatives designed to reduce rates of peritonitis have a strong potential to generate cost savings. Copyright © 2017 International Society for Peritoneal Dialysis.

  2. A Program to Improve Student Engagement at Research-Focused Universities

    Science.gov (United States)

    Whillans, Ashley V.; Hope, Sally E.; Wylie, Lauren J.; Zhao, Bob; Souza, Michael J.

    2018-01-01

    Promoting undergraduate engagement is an important and challenging obstacle at large research-focused universities. Thus, the current study evaluated whether a peer-led program of student-geared events could improve engagement among a diverse group of psychology students early on in their degrees. We randomly assigned interested second-year…

  3. Feedback to providers improves evidence-based implantable cardioverter-defibrillator programming and reduces shocks.

    Science.gov (United States)

    Silver, Marc T; Sterns, Laurence D; Piccini, Jonathan P; Joung, Boyoung; Ching, Chi-Keong; Pickett, Robert A; Rabinovich, Rafael; Liu, Shufeng; Peterson, Brett J; Lexcen, Daniel R

    2015-03-01

    Implantable cardioverter-defibrillator (ICD) shocks are associated with increased anxiety, health care utilization, and potentially mortality. The purpose of the Shock-Less Study was to determine if providing feedback reports to physicians on their adherence to evidence-based shock reduction programming could improve their programming behavior and reduce shocks. Shock-Less enrolled primary prevention (PP) and secondary prevention (SP) ICD patients between 2009 and 2012 at 118 study centers worldwide and followed patients longitudinally after their ICD implant. Center-specific therapy programming reports (TPRs) were delivered to each center 9 to 12 months after their first enrollment. The reports detailed adherence to evidence-based programming targets: number of intervals to detect ventricular fibrillation (VF NID), longest treatment interval (LTI), supraventricular tachycardia (SVT) discriminators (Wavelet, PR Logic), SVT limit, Lead Integrity Alert (LIA), and antitachycardia pacing (ATP). Clinicians programmed ICDs at their discretion. The primary outcome measure was the change in utilization of evidence-based shock reduction programming before (phase I, n = 2694 patients) and after initiation of the TPR (phase II, n = 1438 patients). Patients implanted after feedback reports (phase II) were up to 20% more likely to have their ICDs programmed in line with evidence-based shock reduction programming (eg, VF NID in PP patients 30/40 in 33.5% vs 18.6%, P programming feedback reports improves adherence to evidence-based shock reduction programming and is associated with lower risk of ICD shocks. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  4. Statewide Transportation Improvement program 2011-2014 : sorted by MPO and RPA.

    Science.gov (United States)

    2010-01-01

    Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC and 49 : USC. The STIP is generated to provide the Federal Highway Administration : (FHWA) and Federal Transit A...

  5. Statewide Transportation Improvement Program 2012-2015 : sorted by MPO and RPA.

    Science.gov (United States)

    2011-01-01

    Iowas Statewide Transportation Improvement Program (STIP) has been : developed in conformance with the guidelines prescribed by 23 USC and 49 : USC. The STIP is generated to provide the Federal Highway Administration : (FHWA) and Federal Transit A...

  6. Improving reading comprehension skills through the SCRATCH program

    Directory of Open Access Journals (Sweden)

    Erdal Papatga

    2016-09-01

    Full Text Available The aim of this study was to reveal how reading comprehension skills of elementary fourth graders who have problems in reading comprehension can be improved by means of the SCRATCH program. The study was designed as a participant action research. It was carried out within a 15-week process at an elementary school with middle socio-economic level in the Eskisehir province in the fall term of the 2015-2016 school year. The participants of the study were eight fourth graders who had problems in reading comprehension and were selected based on the criterion sampling method. Different data gathering tools were employed in different stages of the study. These were the Informal Reading Inventory, readability assessment rubric, participant selection form and identification forms for developmental level in reading comprehension for the quantitative data, and observation notes, a researcher diary, video recordings, teacher and student observation notes, and the projects the students prepared using the SCRATCH program for the qualitative data. In the study, the analysis of the quantitative data was done with correlation analysis, and Kendall W Test that shows inter-rater reliability. In addition, the identification forms for developmental level in reading comprehension were used to reveal the improvement in reading comprehension skills, and the Informal Reading Inventory was employed to score these forms. On the other hand, the qualitative data were analysed through the thematic analysis method, and MAXQDA was used for the analysis. As a result of the analyses, it was found that the reading level of the eight students who had problems in reading comprehension went up from the anxiety level to the instructional level in some forms, and even to the independent reading level in other forms; in other words, there was an improvement in the reading comprehension skills of all eight students.

  7. 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

  8. 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

  9. [Preparation and effect of a behavioral science-based education program for sleep improvement among medical students].

    Science.gov (United States)

    Ueda, Masumi; Adachi, Yoshiko; Hayama, Junko; Yamagami, Toshiko

    2008-01-01

    The present study aimed to investigate a simple education program that is effective for sleep improvement among medical students who will be medical doctors in the future. The education program applied in the present study was developed for sleep improvement based on behavioral science and changes in knowledge and sleeping habits were observed. Subjects were 6th-year medical students of 2002 and 2003. Students of 2002 attended a program including a 90-minute lecture and a 2-week practice learning session, and students of 2003 attended only the lecture. In the lecture, behavior therapy for chronic insomnia was explained using a booklet. In the practice learning session, students set a target behavior for improvement and conducted self-monitoring of their sleep and the targeted behavior. Changes in knowledge about sleep, attitude toward the therapy, sleep, and sleep-related habits were observed and compared between the 2 groups of subjects immediately and 2-weeks after the lecture. It was found that after both programs subjects had more knowledge about sleep than before. In the program including practice learning session, subjects' attitude for managing patients changed from before the lecture to after the lecture, and after the practice learning session. It was found that more than half of the students thought that they could provide sleep guidance based on the behavior therapy. Regarding the subjects' sleep, significant improvements were observed for "having nightmares upon falling asleep," "sleepiness during daytime," "sense of getting a sound sleep," and "mood upon waking up." Regarding sleep-related habits, significant improvements were observed for "taking a nap," "dozing off," and "eating breakfast." On the other hand, only the lecture subjects improved irregularity of bedtime and sleeping time. Although an increase in knowledge and improvement of sleep were observed among students who attended only the lecture, a further increase in knowledge and improvement

  10. Embedding research to improve program implementation in Latin America and the Caribbean.

    Science.gov (United States)

    Tran, Nhan; Langlois, Etienne V; Reveiz, Ludovic; Varallyay, Ilona; Elias, Vanessa; Mancuso, Arielle; Becerra-Posada, Francisco; Ghaffar, Abdul

    2017-06-08

    In the last 10 years, implementation research has come to play a critical role in improving the implementation of already-proven health interventions by promoting the systematic uptake of research findings and other evidence-based strategies into routine practice. The Alliance for Health Policy and Systems Research and the Pan American Health Organization implemented a program of embedded implementation research to support health programs in Latin America and the Caribbean (LAC) in 2014-2015. A total of 234 applications were received from 28 countries in the Americas. The Improving Program Implementation through Embedded Research (iPIER) scheme supported 12 implementation research projects led by health program implementers from nine LAC countries: Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, Panama, Peru, and Saint Lucia. Through this experience, we learned that the "insider" perspective, which implementers bring to the research proposal, is particularly important in identifying research questions that focus on the systems failures that often manifest in barriers to implementation. This paper documents the experience of and highlights key conclusions about the conduct of embedded implementation research. The iPIER experience has shown great promise for embedded research models that place implementers at the helm of implementation research initiatives.

  11. 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 ...

  12. The association between event learning and continuous quality improvement programs and culture of patient safety.

    Science.gov (United States)

    Mazur, Lukasz; Chera, Bhishamjit; Mosaly, Prithima; Taylor, Kinley; Tracton, Gregg; Johnson, Kendra; Comitz, Elizabeth; Adams, Robert; Pooya, Pegah; Ivy, Julie; Rockwell, John; Marks, Lawrence B

    2015-01-01

    To present our approach and results from our quality and safety program and to report their possible impact on our culture of patient safety. We created an event learning system (termed a "good catch" program) and encouraged staff to report any quality or safety concerns in real time. Events were analyzed to assess the utility of safety barriers. A formal continuous quality improvement program was created to address these reported events and make improvements. Data on perceptions of the culture of patient safety were collected using the Agency for Health Care Research and Quality survey administered before, during, and after the initiatives. Of 560 good catches reported, 367 could be ascribed to a specific step on our process map. The calculated utility of safety barriers was highest for those embedded into the pretreatment quality assurance checks performed by physicists and dosimetrists (utility score 0.53; 93 of 174) and routine checks done by therapists on the initial day of therapy. Therapists and physicists reported the highest number of good catches (24% each). Sixty-four percent of events were caused by performance issues (eg, not following standardized processes, including suboptimal communications). Of 31 initiated formal improvement events, 26 were successfully implemented and sustained, 4 were discontinued, and 1 was not implemented. Most of the continuous quality improvement program was conducted by nurses (14) and therapists (7). Percentages of positive responses in the patient safety culture survey appear to have increased on all dimensions (p continuous quality improvement programs can be successfully implemented and that there are contemporaneous improvements in the culture of safety. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  13. West Virginia peer exchange : streamlining highway safety improvement program project delivery.

    Science.gov (United States)

    2015-01-01

    The West Virginia Division of Highways (WV DOH) hosted a Peer Exchange to share information and experiences : for streamlining Highway Safety Improvement Program (HSIP) project delivery. The event was held September : 22 to 23, 2014 in Charleston, We...

  14. Quality Improvement in Otolaryngology Residency: Survey of Program Directors.

    Science.gov (United States)

    Bowe, Sarah N

    2016-02-01

    The Clinical Learning Environment Review focuses on the responsibility of the sponsoring institution for quality and patient safety. Very little information is known regarding the status of quality improvement (QI) education during otolaryngology training. The purpose of this survey is to evaluate the extent of resident and faculty participation in QI and identify opportunities for both resident curriculum and faculty development. Cross-sectional survey A 15-item survey was distributed to all 106 otolaryngology program directors. The survey was developed after an informal review of the literature regarding education in QI and patient safety. Questions were directed at the format and content of the QI curriculum, as well as barriers to implementation. There was a 39% response rate. Ninety percent of responding program directors considered education in QI important or very important to a resident's future success. Only 23% of responding programs contained an educational curriculum in QI, and only 33% monitored residents' individual outcome measures. Barriers to implementation of a QI program included inadequate number of faculty with expertise in QI (75%) and competing resident educational demands (90%). Every program director considered morbidity and mortality conferences as an integral component in QI education. Program directors recognize the importance of QI in otolaryngology practice. Unfortunately, this survey identifies a distinct lack of resources in support of these educational goals. The results highlight the need to generate a comprehensive and stepwise approach to QI for faculty development and resident instruction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  15. Survey of Programs Designed to Improve Employee Morale in Seven Major American Shipyards

    National Research Council Canada - National Science Library

    1992-01-01

    ... and therefore his productivity. This study is purposely limited to those employee morale improvement programs which were designed to improve productivity and which in the opinion of management did, in fact, cause an increase in productivity whether or not that increase in productivity is quantifiable.

  16. Process Evaluation for Improving K12 Program Effectiveness: Case Study of a National Institutes of Health Building Interdisciplinary Research Careers in Women's Health Research Career Development Program.

    Science.gov (United States)

    Raymond, Nancy C; Wyman, Jean F; Dighe, Satlaj; Harwood, Eileen M; Hang, Mikow

    2018-06-01

    Process evaluation is an important tool in quality improvement efforts. This article illustrates how a systematic and continuous evaluation process can be used to improve the quality of faculty career development programs by using the University of Minnesota's Building Interdisciplinary Research Careers in Women's Health (BIRCWH) K12 program as an exemplar. Data from a rigorous process evaluation incorporating quantitative and qualitative measurements were analyzed and reviewed by the BIRCWH program leadership on a regular basis. Examples are provided of how this evaluation model and processes were used to improve many aspects of the program, thereby improving scholar, mentor, and advisory committee members' satisfaction and scholar outcomes. A rigorous evaluation plan can increase the effectiveness and impact of a research career development plan.

  17. Effects of a Program to Improve Mental Health Literacy for Married Immigrant Women in Korea.

    Science.gov (United States)

    Choi, Yun-Jung

    2017-08-01

    This study aimed to develop and evaluate a mental health improvement program for the acculturative stress and mental health literacy of married immigrant women using bilingual gatekeepers. Bilingual gatekeepers were recruited from multicultural centers and trained to provide 8-week structured mental health improvement services to the women in the experimental group using a mental health improvement guidebook developed by the authors in 8 different languages. The program was effective in improving mental health and mental health literacy scores as well as reducing the degree of acculturative stress. This study offers a model of effective mental healthcare for multicultural communities. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. [Evaluation of nutritional status of school-age children after implementation of "Nutrition Improvement Program" in rural area in Hunan, China].

    Science.gov (United States)

    Deng, Zhu-Juan; Mao, Guang-Xu; Wang, Yu-Jun; Liu, Li; Chen, Yan

    2016-09-01

    To investigate the nutritional status of school-age children in rural area in Hunan, China from 2012 to 2015 and to evaluate the effectiveness of the "Nutrition Improvement Program for Compulsory Education Students in Rural Area" (hereinafter referred to as "Nutrition Improvement Program"). The nutritional status of school-age children aged 6-14 years was evaluated after the implementation of the "Nutrition Improvement Program" and the changing trend of the children's nutritional status was analyzed. The statistical analysis was performed on the monitoring data of the school-age children aged 6-14 years in rural area in Hunan, China from 2012 to 2015, which came from "The Nutrition and Health Status Monitoring and Evaluation System of Nutrition Improvement Program for Compulsory Education Students in Rural Area". In 2015, female students aged 6-7 years in rural area in Hunan, China had a significantly greater body length than the rural average in China (PNutrition Improvement Program", the prevalence rate of growth retardation decreased (PNutrition Improvement Program" has achieved some success, but the nutritional status of school-age children has not improved significantly. Overweight/obesity and malnutrition are still present. Therefore, to promote the nutritional status of school-age children it is recommended to improve the measures for the "Nutrition Improvement Program".

  19. A 30-Minute Physical Education Program Improves Students' Executive Attention

    Science.gov (United States)

    Kubesch, Sabine; Walk, Laura; Spitzer, Manfred; Kammer, Thomas; Lainburg, Alyona; Heim, Rudiger; Hille, Katrin

    2009-01-01

    Physical activity is not only beneficial to physical health but also to cognitive functions. In particular, executive functions that are closely related to learning achievement can be improved by acute and recurring physical activity. We examined the effects of a single 30-min physical education program in contrast to a 5-min movement break on…

  20. 75 FR 72830 - Medicare Program; Quality Improvement Organization (QIO) Contracts: Solicitation of Proposals...

    Science.gov (United States)

    2010-11-26

    ...] Medicare Program; Quality Improvement Organization (QIO) Contracts: Solicitation of Proposals From In-State... the Social Security Act (the Act) to provide at least 6 months' advance notice of the expiration dates of contracts with out- of-State Quality Improvement Organizations (QIOs) before renewing any of those...

  1. Online Programs as Tools to Improve Parenting: A meta-analytic review

    NARCIS (Netherlands)

    Prof. Dr. Jo J.M.A Hermanns; Prof. Dr. Ruben R.G. Fukkink; dr. Christa C.C. Nieuwboer

    2013-01-01

    Background. A number of parenting programs, aimed at improving parenting competencies,have recently been adapted or designed with the use of online technologies. Although webbased services have been claimed to hold promise for parent support, a meta-analytic review of online parenting interventions

  2. Online programs as tools to improve parenting: A meta-analytic review

    NARCIS (Netherlands)

    Nieuwboer, C.C.; Fukkink, R.G.; Hermanns, J.M.A.

    2013-01-01

    Background: A number of parenting programs, aimed at improving parenting competencies, have recently been adapted or designed with the use of online technologies. Although web-based services have been claimed to hold promise for parent support, a meta-analytic review of online parenting

  3. Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

    Science.gov (United States)

    Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

    2017-01-01

    Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  4. DOE program for improvement practices for shallow burial of radioactive waste

    International Nuclear Information System (INIS)

    Dieckhoner, J.E.

    1978-01-01

    The practice of burying solid radioactive waste in relatively shallow pits or trenches at government nuclear sites dates back to the Manhattan Project. In some cases, where local conditions were considered unfavorable, intersite shipment of waste has been required. This general concept was later used at commercially-operated sites under Federal or state regulation. The purpose, scope, and results of a DOE program begun several years ago for improvements of burial ground disposal methods are reviewed. The program includes the re-evaluation of the original siting and of operating practices at existing burial grounds (including monitoring for migration of activity); the development of improved criteria for siting of new grounds that might be required as the defense site operations continue; and development of corrective measures such as diking and better draining for possible unsatisfactory conditions that might be detected. The possible applications of these findings to commercial burial grounds is discussed

  5. Closing the gap-cardiovascular risk and primary prevention: results from the American College of Physicians quality improvement program.

    Science.gov (United States)

    Snow, Vincenza; Reynolds, Cara Egan; Bennett, Lia; Weiss, Kevin B; Snooks, Qianna; Qaseem, Amir

    2010-01-01

    The objective was to study the impact of a practice-based quality improvement program on practice teams' care for patients who have increased risk of cardiovascular disease. A total of 54 team members from 18 internal medicine practices participated in an educational program that used a pre-post intervention study design and focused on measures related to cardiovascular risk factors. The program involved live instruction, faculty-led conference calls, practice data collection, and progress reports detailing practices' improvement strategies. Data on 817 patients were reported. Practices showed significant improvement in counseling for diet (70% to 78%), exercise (67% to 74%), and weight loss (64% to 72%). Use of aspirin (53% to 64%) and statins (83% to 89%) also showed significant improvement. Administration of flu vaccine increased significantly from 51% to 54%. Improvements in patient counseling and medication management, if sustained, should lead to fewer cardiovascular events. However, program duration did not allow the capture of outcomes measures improvement.

  6. Quality improvement program reduces perioperative dental injuries – A review of 64,718 anesthetic patients

    OpenAIRE

    Kuo, Yi-Wei; Lu, I-Cheng; Yang, Hui-Ying; Chiu, Shun-Li; Hsu, Hung-Te; Cheng, Kuang-I

    2016-01-01

    Background: Perioperative dental injury (PDI) is a common adverse event associated with anesthesia that can easily lead to medicolegal litigation. A quality improvement program was conducted with the electronic, standardized dental chart to document dentition before anesthesia and dentist consultation when necessary. This study aimed to reduce PDIs through execution of a quality improvement program. Methods: We reviewed the 42-month interval anesthetic records of 64,718 patients who underw...

  7. Development of a Positive Youth Development Program: Helping Parents to Improve Their Parenting Skills

    Directory of Open Access Journals (Sweden)

    Daniel T.L. Shek

    2006-01-01

    Full Text Available The Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programs is a positive youth development program that attempts to promote holistic development in adolescents in Hong Kong. In the Tier 2 Program of this project, social workers are expected to develop positive youth development programs for adolescents having greater psychosocial needs. They are required to submit proposals that will be evaluated in terms of whether the proposals are evidence based, and appropriate evaluation mechanisms are included. With reference to the literature on parental control processes that Chinese parents may be loose in their behavioral control and they tend to overemphasize academic excellence, it is argued that improvement of the parenting skills of parents of Chinese adolescents is an important area to be addressed. To facilitate social workers to prepare the related proposals, a sample proposal on how to improve the parenting skills of Chinese parents is described, including its conceptual framework, proposed program, and evaluation plan. It is argued that this supportive approach (i.e., preparation of a sample proposal can help social workers to develop quality proposals on positive youth development programs in Hong Kong.

  8. Embedding research to improve program implementation in Latin America and the Caribbean

    Directory of Open Access Journals (Sweden)

    Nhan Tran

    2017-06-01

    Full Text Available ABSTRACT In the last 10 years, implementation research has come to play a critical role in improving the implementation of already-proven health interventions by promoting the systematic uptake of research findings and other evidence-based strategies into routine practice. The Alliance for Health Policy and Systems Research and the Pan American Health Organization implemented a program of embedded implementation research to support health programs in Latin America and the Caribbean (LAC in 2014–2015. A total of 234 applications were received from 28 countries in the Americas. The Improving Program Implementation through Embedded Research (iPIER scheme supported 12 implementation research projects led by health program implementers from nine LAC countries: Argentina, Bolivia, Brazil, Chile, Colombia, Mexico, Panama, Peru, and Saint Lucia. Through this experience, we learned that the “insider” perspective, which implementers bring to the research proposal, is particularly important in identifying research questions that focus on the systems failures that often manifest in barriers to implementation. This paper documents the experience of and highlights key conclusions about the conduct of embedded implementation research. The iPIER experience has shown great promise for embedded research models that place implementers at the helm of implementation research initiatives.

  9. Effects of a Program for Improving Biomechanical Characteristics During Walking and Running in Children Who Are Obese.

    Science.gov (United States)

    Steinberg, Nili; Rubinstein, Meron; Nemet, Dan; Ayalon, Moshe; Zeev, Aviva; Pantanowitz, Michal; Brosh, Tamar; Eliakim, Alon

    2017-10-01

    To investigate the influence of a weight-reduction program with locomotion-emphasis on improving biomechanical characteristics of children who are obese (OW). Ten children who are OW participated in a 6-month multidisciplinary childhood obesity management program (GRP1); another 10 children who are OW participated in the same multidisciplinary childhood obesity management program with additional locomotion-emphasis exercises for improving biomechanical characteristics (GRP2); and 10 control children who are OW with no intervention program. Outcomes were anthropometric measurements and temporal and foot pressure parameters. GRP2 had significantly improved foot pressure in the different walking/running speeds compared with GRP1. In the temporal parameters, pretests by speed by group interactions were significantly improved for GRP2 compared with GRP1. We found evidence to support beneficial effects of combined dietary and physical activity/locomotion-emphasis exercises on the movement characteristics of children who are OW.

  10. Improving student understanding in web programming material through multimedia adventure games

    Science.gov (United States)

    Fitriasari, N. S.; Ashiddiqi, M. F.; Nurdin, E. A.

    2018-05-01

    This study aims to make multimedia adventure games and find out the improvement of learners’ understanding after being given treatment of using multimedia adventure game in learning Web Programming. Participants of this study are students of class X (ten) in one of the Vocational Schools (SMK) in Indonesia. The material of web programming is a material that difficult enough to be understood by the participant therefore needed tools to facilitate the participants to understand the material. Solutions offered in this study is by using multimedia adventures game. Multimedia has been created using Construct2 and measured understood with method Non-equivalent Control Group Design. Pre-test and post-test has given to learners who received treatment using the multimedia adventure showed increase in understanding web programming material.

  11. Remodularizing Java Programs for Improved Locality of Feature Implementations in Source Code

    DEFF Research Database (Denmark)

    Olszak, Andrzej; Jørgensen, Bo Nørregaard

    2011-01-01

    Explicit traceability between features and source code is known to help programmers to understand and modify programs during maintenance tasks. However, the complex relations between features and their implementations are not evident from the source code of object-oriented Java programs....... Consequently, the implementations of individual features are difficult to locate, comprehend, and modify in isolation. In this paper, we present a novel remodularization approach that improves the representation of features in the source code of Java programs. Both forward- and reverse restructurings...... are supported through on-demand bidirectional restructuring between feature-oriented and object-oriented decompositions. The approach includes a feature location phase based of tracing program execution, a feature representation phase that reallocates classes into a new package structure based on single...

  12. Availability Improvement Program for Louisiana Power and Light's Waterford 3 Nuclear Power Plant

    International Nuclear Information System (INIS)

    Simoneaux, G.E.

    1985-01-01

    The Middle South Utilities System (MSUS) began an Availability Improvement Program (AIP) in the late nineteen-seventies for the benefit of all the operating units making up the System. This paper describes the methodology that is being employed in implementing a formal Avalability Improvement Program for a new nuclear unit known as Waterford 3. The tasks needed to install and maintain the AIP at Waterford 3 are discussed in terms of Analytical Methodology, Avalability Data System, and Plant Imvolvement. In particular, the AIP will provide: Management reporting; External reporting; A self-sufficient core of trained avalability personnel; Procedures and methodologies to monitor plant availability and to analyze availability problems

  13. Change in Adverse Events After Enrollment in the National Surgical Quality Improvement Program: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Joshua Montroy

    Full Text Available The American College of Surgeons' National Surgical Quality Improvement Program (NSQIP is the first nationally validated, risk-adjusted, outcomes-based program to measure and compare the quality of surgical care across North America. Participation in this program may provide an opportunity to reduce the incidence of adverse events related to surgery.A systematic review of the literature was performed. MedLine, EMBASE and PubMed were searched for studies relevant to NSQIP. Patient characteristics, intervention, and primary outcome measures were abstracted. The intervention was participation in NSQIP and monitoring of Individual Site Summary Reports with or without implementation of a quality improvement program. The outcomes of interest were change in peri-operative adverse events and mortality represented by pooled risk ratios (pRR and 95% confidence intervals (CI.Eleven articles reporting on 35 health care institutions were included. Nine (82% of the eleven studies implemented a quality improvement program. Minimal improvements in superficial (pRR 0.81; 95% CI 0.72-0.91, deep (pRR 0.82; 95% CI0.64-1.05 and organ space (pRR 1.15; 95% CI 0.96-1.37 infections were observed at centers that did not institute a quality improvement program. However, centers that reported formal interventions for the prevention and treatment of infections observed substantial improvements (superficial pRR 0.55, 95% CI 0.39-0.77; deep pRR 0.61, 95% CI 0.50-0.75, and organ space pRR 0.60, 95% CI 0.50-0.71. Studies evaluating other adverse events noted decreased incidence following NSQIP participation and implementation of a formal quality improvement program.These data suggest that NSQIP is effective in reducing surgical morbidity. Improvement in surgical quality appears to be more marked at centers that implemented a formal quality improvement program directed at the reduction of specific morbidities.

  14. An after-school exercise program improves fitness, and body composition in elementary school children.

    Science.gov (United States)

    Carrel, Aaron L; Logue, Julie; Deininger, Heidi; Clark, R Randall; Curtis, Vanessa; Montague, Paul; Baldwin, Sharon

    2011-07-01

    Reduced cardiovascular fitness (CVF) is a risk factor for obesity and cardiovascular disease. It has previously shown that a school-based fitness curriculum can improve CVF, and other health indicators in middle school aged children. Whether an afterschool program improves CVF and other health markers in elementary-school children is unresolved. The objective of this study was therefore to determine whether an on-site afterschool-based fitness program improves body composition, cardiovascular fitness level, in elementary school children. 80 elementary school children were evaluated in a "fitness-oriented" afterschool program managed by the local YMCA. Children underwent evaluation of cardiovascular fitness by maximal VO 2 treadmill testing and body composition by dual x-ray absorptiometry (DXA), at baseline (prior to the school-year) and again at end of the school year. Findings revealed that, at baseline, children had a mean age of 8.8 years, BMI of 18.7± 3, with a maximal VO 2 of 40.03 ± 7.6 ml/kg/min, and percent body fat of 28.7 ± 7%. After a 9-month intervention, children maximal VO 2 increased to 44.8 ± 7.5 ml/kg/min (p=0.04) and percent body fat decreased to 25.8 ± 6.2% (p=0.033). The study concluded that on-site afterschool programming focusing on fitness improved body composition and cardiovascular fitness, in elementary school children. Combined with prior studies, these data demonstrate that afterschool-based fitness curricula can benefit both obese and non-obese children. It was therefore recommended that, partnerships with schools to promote fitness even outside of school time should be a part of a school approach to improving children's health.

  15. Effectiveness of an oral health program in improving the knowledge and competencies of head start staff.

    Science.gov (United States)

    Chinn, Courtney Hugh

    2011-01-01

    Head Start and Early Head Start (HS/EHS) programs have partnered with the American Academy of Pediatric Dentistry to promote oral health and increase access to dental homes. Preparing HS/EHS staff for issues related to pediatric oral health promises to improve effectiveness of this collaboration. This paper's purpose was to describe the Columbia Head Start Oral Health Program (C-HSOHP) and changes in HS/EHS staff pediatric oral health knowledge and competencies after participating in C-HSOHP. Four HS/EHS grantees in New York City engaged in the 2008-09 C-HSOHP. A convenience sample of 61 staff completed pre- and postself assessments of knowledge and competencies. Significant paired mean improvements were found for staff-reported level of preparation to explain dental issues during pregnancy, the tooth decay process, and preparing parents for their child's first dental visit. Significant improvements were found in staff confidence in teaching parents about children's oral health issues, referring for pediatric dental services, and talking to a dentist about a concern. The Columbia Head Start Oral Health Program was effective in improving Head Start/Early Head Start staff self-confidence and self-perceived preparedness in teaching parents about oral health, applying oral health knowledge to HS/EHS programs, communicating with dental professionals, and improving access to pediatric dental services.

  16. An overview of the US Department of Energy Plant Lifetime Improvement Program

    International Nuclear Information System (INIS)

    Moonka, A.K.; Harrison, D.L.

    1995-01-01

    This paper provides a brief summary of the U.S. Department of Energy's (USDOE's) cooperative effort with the nuclear industry to develop technology to manage the effects of material degradation in systems, structures and components (SSCs) that impact plant safety or can significantly improve plant performance/economics and to establish and demonstrate the license renewal process. Also included are efforts to reduce decontamination/decommission costs, and reduce the uncertainty in long-term service-life decision making. During 1995, the Plant Lifetime Improvement (PLIM) Program was renamed the Commercial Operating Light Water Reactor (COLWR) Program activities are focused on sustaining the LWR option for domestic electricity generation by supporting operation of existing LWRs as long as they are safe, efficient, and economical. The status of the key projects is discussed in this paper

  17. Effects of Self-esteem Improvement Program on Self-esteem and Peer Attachment in Elementary School Children with Observed Problematic Behaviors

    Directory of Open Access Journals (Sweden)

    Kyung Min Park, PhD, RN

    2015-03-01

    Conclusions: The self-esteem improvement program in this study improved the self-esteem and peer attachment in elementary school children. The self-esteem program helped acknowledge the peer's name and increased their connections. The program needs to be considered as a formal and consistent program.

  18. Recent improvements in program packages SHUFFLE and FAR

    International Nuclear Information System (INIS)

    Slavic, S.; Kromar, M.; Zefran, B.

    1996-01-01

    Program packages SHUFFLE and FAR were developed at 'Jozef Stefan' Institute to monitor all changes of fuel assemblies during a nuclear power plant operation. Both packages were written in the Clipper language which is suitable for data base applications and allows straightforward communications with other available data bases. Packages currently run on PC machines under DOS operating system. Both packages are in routine use at a nuclear power plant Krsko, but they can be applied to any PWR power plant without significant modification. Experiences obtained from the utility in past few years triggered several improvements and new features. (author)

  19. Evaluation of a guided continuous quality improvement program in community pharmacies.

    Science.gov (United States)

    Chinthammit, Chanadda; Rupp, Michael T; Armstrong, Edward P; Modisett, Tara; Snead, Rebecca P; Warholak, Terri L

    2017-01-01

    The importance of creating and sustaining a strong culture of patient safety has been recognized as a critical component of safe medication use. This study aims to assess changes in attitudes toward patient safety culture and frequency of quality-related event (QRE) reporting after guided implementation of a continuous quality improvement (CQI) program in a panel of community pharmacies in the United States (U.S.). Twenty-one community pharmacies volunteered to participate in the project and were randomly assigned to intervention or control groups. Pharmacy staff in the intervention group received guided training to ensure full implementation of a CQI program while those in the control group partially implemented the program. Pharmacy staff in both groups completed retrospective pre-post safety culture questionnaires and reported medication errors and near misses that occurred in their practices. Rasch analysis was applied to assess questionnaire validity and reliability and to confirm if the ordinal level data approximated interval level measures. Paired t-tests and repeated measure analysis of covariance tests were subsequently used to compare observed changes in the attitudes of subjects and frequency of QREs reporting in intervention and control groups. Sixty-nine employees completed the questionnaire, a 43.9% response rate. Improvement in attitudes toward patient safety was statistically significant in the intervention group in six domains: staff, training, and skill ( p  = 0.017); patient counseling ( p  = 0.043); communication about mistakes ( p  continuous improvement ( p  < 0.001); and overall patient safety perceptions ( p  = 0.033). No significant differences were observed in QRE reporting rates between intervention and control groups. However, differences were observed in the types of QREs reported (e.g., incorrect safety cap) and the point in the prescription processing workflow where a QRE was detected (e.g., partner check station, and drug

  20. An improved multiple linear regression and data analysis computer program package

    Science.gov (United States)

    Sidik, S. M.

    1972-01-01

    NEWRAP, an improved version of a previous multiple linear regression program called RAPIER, CREDUC, and CRSPLT, allows for a complete regression analysis including cross plots of the independent and dependent variables, correlation coefficients, regression coefficients, analysis of variance tables, t-statistics and their probability levels, rejection of independent variables, plots of residuals against the independent and dependent variables, and a canonical reduction of quadratic response functions useful in optimum seeking experimentation. A major improvement over RAPIER is that all regression calculations are done in double precision arithmetic.

  1. Quality in-training initiative--a solution to the need for education in quality improvement: results from a survey of program directors.

    Science.gov (United States)

    Kelz, Rachel R; Sellers, Morgan M; Reinke, Caroline E; Medbery, Rachel L; Morris, Jon; Ko, Clifford

    2013-12-01

    The Next Accreditation System and the Clinical Learning Environment Review Program will emphasize practice-based learning and improvement and systems-based practice. We present the results of a survey of general surgery program directors to characterize the current state of quality improvement in graduate surgical education and introduce the Quality In-Training Initiative (QITI). In 2012, a 20-item survey was distributed to 118 surgical residency program directors from ACS NSQIP-affiliated hospitals. The survey content was developed in collaboration with the QITI to identify program director opinions regarding education in practice-based learning and improvement and systems-based practice, to investigate the status of quality improvement education in their respective programs, and to quantify the extent of resident participation in quality improvement. There was a 57% response rate. Eighty-five percent of program directors (n = 57) reported that education in quality improvement is essential to future professional work in the field of surgery. Only 28% (n = 18) of programs reported that at least 50% of their residents track and analyze their patient outcomes, compare them with norms/benchmarks/published standards, and identify opportunities to make practice improvements. Program directors recognize the importance of quality improvement efforts in surgical practice. Subpar participation in basic practice-based learning and improvement activities at the resident level reflects the need for support of these educational goals. The QITI will facilitate programmatic compliance with goals for quality improvement education. Copyright © 2013 American College of Surgeons. All rights reserved.

  2. Effect of Exercise Program Speed, Agility, and Quickness (SAQ) in Improving Speed, Agility, and Acceleration

    Science.gov (United States)

    Azmi, K.; Kusnanik, N. W.

    2018-01-01

    This study aimed to analyze the effect of speed, agility and quickness training program to increase in speed, agility and acceleration. This study was conducted at 26 soccer players and divided into 2 groups with 13 players each group. Group 1 was given SAQ training program, and Group 2 conventional training program for 8 weeks. This study used a quantitative approach with quasi-experimental method. The design of this study used a matching-only design. Data was collected by testing 30-meter sprint (speed), agility t-test (agility), and run 10 meters (acceleration) during the pretest and posttest. Furthermore, the data was analyzed using paired sample t-test and independent t-test. The results showed: that there was a significant effect of speed, agility and quickness training program in improving in speed, agility and acceleration. In summary, it can be concluded that the speed, agility and quickness training program can improve the speed, agility and acceleration of the soccer players.

  3. Effectiveness of an Intervention Program for Improving School Atmosphere: Some Results

    Science.gov (United States)

    Sanchez, A. M.; Rivas, M. T.; Trianes, M. V.

    2006-01-01

    This work describes the results of the "Programa de Desarrollo Social y Afectivo" [Social and Affective Development Program] (Trianes & Munoz, 1994; Trianes, 1996), under way during four years at a public school in a disadvantaged area Malaga, earmarked for special educational resources. The intervention is meant to improve classroom…

  4. Orion Heat Shield Manufacturing Producibility Improvements for the EM-1 Flight Test Program

    Science.gov (United States)

    Koenig, William J.; Stewart, Michael; Harris, Richard F.

    2018-01-01

    This paper describes how the ORION program is incorporating improvements in the heat shield design and manufacturing processes reducing programmatic risk and ensuring crew safety in support of NASA's Exploration missions. The approach for the EFT-1 heat shield utilized a low risk Apollo heritage design and manufacturing process using an Avcoat TPS ablator with a honeycomb substrate to provide a one piece heat shield to meet the mission re-entry heating environments. The EM-1 mission will have additional flight systems installed to fly to the moon and return to Earth. Heat shield design and producibility improvements have been incorporated in the EM-1 vehicle to meet deep space mission requirements. The design continues to use the Avcoat material, but in a block configuration to enable improvements in consistant and repeatable application processes using tile bonding experience developed on the Space Shuttle Transportation System Program.

  5. Uranium Mill Tailings Remedial Action Project: Cost Reduction and Productivity Improvement Program Project Plan

    International Nuclear Information System (INIS)

    1991-11-01

    The purpose of the Cost Reduction/Productivity Improvement Program Plan is to formalize and improve upon existing efforts to control costs which have been underway since project inception. This program plan has been coordinated with the Department of Energy (DOE) Office of Environmental Management (EM) and the DOE Field Office, Albuquerque (AL). It incorporates prior Uranium Mill Tallings Remedial Action (UMTRA) Project Office guidance issued on the subject. The opportunities for reducing cosh and improving productivity are endless. The CR/PIP has these primary objectives: Improve productivity and quality; heighten the general cost consciousness of project participants, at all levels of their organizations; identify and implement specific innovative employee ideas that extend beyond what is required through existing processes and procedures; emphasize efforts that create additional value for the money spent by maintaining the project Total Estimated Cost (TEC) at the lowest possible level

  6. Land Acquisition and Relocation Assistance for Airport Improvement Program (AIP) Assisted Projects

    Science.gov (United States)

    2017-07-10

    This advisory circular (AC) provides guidance to sponsors of airport projects developed under the Airport Improvement Program (AIP) to meet the requirements of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (Pl 9...

  7. 75 FR 13735 - Fund for the Improvement of Postsecondary Education (FIPSE)-Special Focus Competition: Program...

    Science.gov (United States)

    2010-03-23

    ... DEPARTMENT OF EDUCATION Fund for the Improvement of Postsecondary Education (FIPSE)-- Special Focus Competition: Program for North American Mobility in Higher Education ACTION: Extension; Notice... of Postsecondary Education (FIPSE)--Special Focus Competition: Program for North American Mobility in...

  8. A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors

    NARCIS (Netherlands)

    Warner, G.; Packer, T.L.; Villeneuve, M.; Audulv, A.; Versnel, J.

    2015-01-01

    PURPOSE: A systematic review of stroke self-management programs was conducted to: (i) identify how many and what self-management support strategies were included in stroke self-management interventions and (ii) describe whether self-management programs effectively improved outcomes, focusing

  9. 78 FR 40625 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

    Science.gov (United States)

    2013-07-08

    ... National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the Healthy... Continuous Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010'' on February 22, 2013... performance benchmarks and to develop and implement continuous improvement plans if they fail to do so. The...

  10. COMPARISON OF CRM PROGRAMS BASING ON IMPROVING CUSTOMER PROFITABILITY: USING THE AHP METHOD

    Directory of Open Access Journals (Sweden)

    Dong-Fei Xue

    2014-04-01

    Full Text Available In this paper, we generalize the cause-related marketing (CRM methods that used by most current enterprises. And then, we probe into the difference of the effects of different types of CRM programs aiming at improving customer profitability by analytic hierarchy process (AHP. Consequently, we find out the sequencing results and provide some reference to the enterprises while performing CRM programs.

  11. Incentive Design and Quality Improvements: Evidence from State Medicaid Nursing Home Pay-for-Performance Programs.

    Science.gov (United States)

    Konetzka, R Tamara; Skira, Meghan M; Werner, Rachel M

    2018-01-01

    Pay-for-performance (P4P) programs have become a popular policy tool aimed at improving health care quality. We analyze how incentive design affects quality improvements in the nursing home setting, where several state Medicaid agencies have implemented P4P programs that vary in incentive structure. Using the Minimum Data Set and the Online Survey, Certification, and Reporting data from 2001 to 2009, we examine how the weights put on various performance measures that are tied to P4P bonuses, such as clinical outcomes, inspection deficiencies, and staffing levels, affect improvements in those measures. We find larger weights on clinical outcomes often lead to larger improvements, but small weights can lead to no improvement or worsening of some clinical outcomes. We find a qualifier for P4P eligibility based on having few or no severe inspection deficiencies is more effective at decreasing inspection deficiencies than using weights, suggesting simple rules for participation may incent larger improvement.

  12. 34 CFR 637.1 - What is the Minority Science and Engineering Improvement Program (MSEIP)?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What is the Minority Science and Engineering... Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.1 What is the Minority Science and Engineering Improvement...

  13. Fit Families Program Improves Self-Perception in Children.

    Science.gov (United States)

    Archuleta, Martha; VanLeeuwen, Dawn; Turner, Carol

    2016-06-01

    To determine the impact of the Fit Families youth weight management program on self-perception of participants. Fit Families was delivered through Cooperative Extension and provided education to overweight and obese children and their families on healthful eating and physical activity along with building self-esteem and social competence. At the beginning and end of the 7-week program, a convenience sample of 46 youth completed the Self-Perception Profile for Children questionnaire to evaluate changes in self-perception. Youth had improved self-perception in the areas of athletic competence (P = .04) and physical appearance (P = .007) after participating in Fit Families. Fit Families provides a holistic approach to weight management that promotes positive self-perception, which may decrease the burden of depression, anxiety, and low self-esteem obese youth face. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  14. Rating the strength of scientific evidence: relevance for quality improvement programs.

    Science.gov (United States)

    Lohr, Kathleen N

    2004-02-01

    To summarize an extensive review of systems for grading the quality of research articles and rating the strength of bodies of evidence, and to highlight for health professionals and decision-makers concerned with quality measurement and improvement the available "best practices" tools by which these steps can be accomplished. Drawing on an extensive review of checklists, questionnaires, and other tools in the field of evidence-based practice, this paper discusses clinical, management, and policy rationales for rating strength of evidence in a quality improvement context, and documents best practices methods for these tasks. After review of 121 systems for grading the quality of articles, 19 systems, mostly specific, met a priori scientific standards for grading systematic reviews, randomized controlled trials, observational studies, and diagnostic tests; eight systems (of 40 reviewed) met similar standards for rating the overall strength of evidence. All can be used as is or adapted for particular types of evidence reports or systematic reviews. Formally grading study quality and rating overall strength of evidence, using sound instruments and procedures, can produce reasonable levels of confidence about the science base for parts of quality improvement programs. With such information, health care professionals and administrators concerned with quality improvement can understand better the level of science (versus only clinical consensus or opinion) that supports practice guidelines, review criteria, and assessments that feed into quality assurance and improvement programs. New systems are appearing and research is needed to confirm the conceptual and practical underpinnings of these grading and rating systems, but the need for those developing systematic reviews, practice guidelines, and quality or audit criteria to understand and undertake these steps is becoming increasingly clear.

  15. Understanding the "How" of Quality Improvement: Lessons from the Rhode Island Program Quality Intervention

    Science.gov (United States)

    Devaney, Elizabeth; Smith, Charles; Wong, Kenneth

    2012-01-01

    Over the past 10 years, afterschool and youth development programming has moved from providing childcare for working parents to being an integral component of the learning day, supporting the academic, social, and emotional development of young people. An important part of that transition has been a growing emphasis on improving program quality.…

  16. An energy management for series hybrid electric vehicle using improved dynamic programming

    Science.gov (United States)

    Peng, Hao; Yang, Yaoquan; Liu, Chunyu

    2018-02-01

    With the increasing numbers of hybrid electric vehicle (HEV), management for two energy sources, engine and battery, is more and more important to achieve the minimum fuel consumption. This paper introduces several working modes of series hybrid electric vehicle (SHEV) firstly and then describes the mathematical model of main relative components in SHEV. On the foundation of this model, dynamic programming is applied to distribute energy of engine and battery on the platform of matlab and acquires less fuel consumption compared with traditional control strategy. Besides, control rule recovering energy in brake profiles is added into dynamic programming, so shorter computing time is realized by improved dynamic programming and optimization on algorithm.

  17. Improving the School Program through the Effective Use of Federal Funds.

    Science.gov (United States)

    McFarland, Dan

    This pamphlet shows school personnel how to apply successfully for Federal grants to finance improvements in educational programs. Advice is given on the importance of evaluating needs, objectives, and procedures as a prerequisite to writing a proposal. Next, suggestions for writing a good proposal are made, including references to the need for…

  18. Using systematic aging assessments to improve effectiveness of plant maintenance programs

    International Nuclear Information System (INIS)

    Watson, P.; Yang, J.X.; Dam, R.F.; Nickerson, J.H.

    2003-01-01

    Nuclear plant equipment aging assessment studies provided by AECL include life assessments, condition assessments or systematic assessments of maintenance. AECL has developed several tools to apply the results of aging assessment studies to improve the effectiveness of actual plant maintenance programs. The Systematic Assessment of Maintenance and the SYSTMS tool generate maintenance tasks for a system. The System Maintenance Datastore tool assesses the maintenance resources on a system basis, and can thus quantify the savings realized by optimizing the maintenance program. Long term trends in condition-based maintenance due to component aging can be predicted, and resource savings due to optimum timing of component replacement or general plant refurbishment can be quantified. The System based Adaptive Maintenance Process ensures the maintenance program is continually updated to reflect the latest plant equipment condition and maintenance strategy information. (author)

  19. A care improvement program acting as a powerful learning environment to support nursing students learning facilitation competencies.

    Science.gov (United States)

    Jukema, Jan S; Harps-Timmerman, Annelies; Stoopendaal, Annemiek; Smits, Carolien H M

    2015-11-01

    Change management is an important area of training in undergraduate nursing education. Successful change management in healthcare aimed at improving practices requires facilitation skills that support teams in attaining the desired change. Developing facilitation skills in nursing students requires formal educational support. A Dutch Regional Care Improvement Program based on a nationwide format of change management in healthcare was designed to act as a Powerful Learning Environment for nursing students developing competencies in facilitating change. This article has two aims: to provide comprehensive insight into the program components and to describe students' learning experiences in developing their facilitation skills. This Dutch Regional Care Improvement Program considers three aspects of a Powerful Learning Environment: self-regulated learning; problem-based learning; and complex, realistic and challenging learning tasks. These three aspects were operationalised in five distinct areas of facilitation: increasing awareness of the need for change; leadership and project management; relationship building and communication; importance of the local context; and ongoing monitoring and evaluation. Over a period of 18 months, 42 nursing students, supported by trained lecturer-coaches, took part in nine improvement teams in our Regional Care Improvement Program, executing activities in all five areas of facilitation. Based on the students' experiences, we propose refinements to various components of this program, aimed at strengthenin the learning environment. There is a need for further detailed empirical research to study the impact this kind of learning environment has on students developing facilitation competencies in healthcare improvement. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Improvement in PWR flexibility the french program 1975-1995

    International Nuclear Information System (INIS)

    Gautier, A.; Miossec, C.

    1985-12-01

    Between 1975 and 1985, a substantial effort was launched in France to greatly improve PWR's flexibility, resulting in the current situation where both frequency control and load follow are now routinely performed on most plants in operation. Based on rapidly accumulating operational experience and on all expertise acquired in the past decade, a second-generation core control strategy is now being finalized for application on all future 1400 MW plants (with commercial operation scheduled in 1992 for first unit). This 20-year program is discussed

  1. Meeting the imperative to improve physician well-being: assessment of an innovative program.

    Science.gov (United States)

    Dunn, Patrick M; Arnetz, Bengt B; Christensen, John F; Homer, Louis

    2007-11-01

    Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative. To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being. From 2000 to 2005, 22-32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning. Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey. Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study. A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk.

  2. Feed-pump hydraulic performance and design improvement, Phase I: research program design. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Brown, W.H.; Gopalakrishnan, S.; Fehlau, R.; Thompson, W.E.; Wilson, D.G.

    1982-03-01

    As a result of prior EPRI-sponsored studies, it was concluded that a research program should be designed and implemented to provide an improved basis for the design, procurement, testing, and operation of large feed pumps with increased reliability and stability over the full range of operating conditions. This two-volume report contains a research plan which is based on a review of the present state of the art and which defines the necessary R and D program and estimates the benefits and costs of the program. The recommended research program consists of 30 interrelated tasks. It is designed to perform the needed research; to verify the results; to develop improved components; and to publish computer-aided design methods, pump specification guidelines, and a troubleshooting manual. Most of the technology proposed in the research plan is applicable to nuclear power plants as well as to fossil-fired plants. This volume discusses the design, performance and failures of feed pumps, and recommendations for research on pump dynamics, design, and specifications.

  3. An improvement of the child acute respiratory infection treatment program

    OpenAIRE

    E. N. Simovan'yan; E. E. Badalyants; L. P. Sizyakina; A. A. Lebedenko; V. B. Denisenko; M. A. Kim

    2013-01-01

    High morbidity rate, frequent development of severe complication forms, unfavorable remote effects for children’s health, insufficient efficacy of the used acute respiratory infection therapy schemes necessitate a treatment program improvement for this group of diseases. A complex clinical-laboratory examination of 72 3-6-year-old children with acute nasopharyngites and bronchites was conducted. Dependence of the disease’s clinical form and course peculiarities from the premorbid setting stat...

  4. Evaluation of a Junior High School Program Designed to Improve Reading, Self-Concept, and Classroom Behavior.

    Science.gov (United States)

    Miller, Margery Staman

    Two groups of seventh-grade students participated in a comparison of the effects of an experimental remedial reading program emphasizing positive self-concept and improved behavior and a control program. A total of 57 students participated in the thirty-week program. Results from the Coopersmith Self-Esteem Inventory, the Stanford Diagnostic…

  5. 75 FR 13740 - Office of Innovation and Improvement; Overview Information; Charter Schools Program (CSP) Grants...

    Science.gov (United States)

    2010-03-23

    ... DEPARTMENT OF EDUCATION Office of Innovation and Improvement; Overview Information; Charter Schools Program (CSP) Grants for National Leadership Activities; Notice Inviting Applications for New... of public schools have been identified for improvement, corrective action, or restructuring under...

  6. Effectiveness of the Spirometry 360 Quality Improvement Program for Improving Asthma Care: A Cluster Randomized Trial.

    Science.gov (United States)

    Mangione-Smith, Rita; Zhou, Chuan; Corwin, Michael J; Taylor, James A; Rice, Fiona; Stout, James W

    To determine the effectiveness of the Spirometry 360 distance learning quality improvement (QI) program for enhancing the processes and outcomes of care for children with asthma. Cluster randomized controlled trial involving 25 matched pairs of pediatric primary care practices. Practices were recruited from 2 practice-based research networks: the Slone Center Office-based Research Network at Boston University, Boston, Mass, and the Puget Sound Pediatric Research Network, Seattle, Wash. Study participants included providers from one of the 50 enrolled pediatric practices and 626 of their patients with asthma. Process measures assessed included spirometry test quality and appropriate prescription of asthma controller medications. Outcome measures included asthma-specific health-related quality of life, and outpatient, emergency department, and inpatient utilization for asthma. At baseline, 25.4% of spirometry tests performed in control practices and 50.4% of tests performed in intervention practices were of high quality. During the 6-month postintervention period, 28.7% of spirometry tests performed in control practices and 49.9% of tests performed in intervention practices were of high quality. The adjusted difference-of-differences analysis revealed no intervention effect on spirometry test quality. Adjusted differences-of-differences analysis also revealed no intervention effect on appropriate use of controller medications or any of the parent- or patient-reported outcomes examined. In this study, the Spirometry 360 distance learning QI program was ineffective in improving spirometry test quality or parent- or patient-reported outcomes. QI programs like the one assessed here may need to focus on practices with lower baseline performance levels or may need to be tailored for those with higher baseline performance. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  7. 78 FR 67442 - Congestion Mitigation and Air Quality Improvement Program Interim Guidance

    Science.gov (United States)

    2013-11-12

    ...] Congestion Mitigation and Air Quality Improvement Program Interim Guidance AGENCY: Federal Highway... Comment. SUMMARY: The FHWA is issuing Interim Guidance on the Congestion Mitigation and Air Quality.../environment/air_quality/cmaq/policy_and_guidance/2008_guidance/ guidance/. DATES: This Interim Guidance is...

  8. Quality improvement program reduces perioperative dental injuries - A review of 64,718 anesthetic patients.

    Science.gov (United States)

    Kuo, Yi-Wei; Lu, I-Cheng; Yang, Hui-Ying; Chiu, Shun-Li; Hsu, Hung-Te; Cheng, Kuang-I

    2016-12-01

    Perioperative dental injury (PDI) is a common adverse event associated with anesthesia that can easily lead to medicolegal litigation. A quality improvement program was conducted with the electronic, standardized dental chart to document dentition before anesthesia and dentist consultation when necessary. This study aimed to reduce PDIs through execution of a quality improvement program. We reviewed the 42-month interval anesthetic records of 64,718 patients who underwent anesthesia. A standardized electronic dental chart was designed to identify any dental prosthetics, fixed and removable dentures, and degree of loose teeth. The incidence of dental injuries associated with anesthesia was separated into three time periods: baseline, initiative (Phase I), and execution (Phase II). Primary outcome measurement was the incidence of PDIs related to anesthesia. The overall incidence of dental injury related to anesthesia was 0.059% (38/64,718 patients). During the baseline period, the dental injury rate was 0.108% (26/24,137 patients), and it decreased from 0.051% in the initiative period (10/19,711 patients) to 0.009% in the execution period (2/20,870 patients) during implementation of the quality improvement program. Most dental injuries were associated with laryngeal mask airway (42.1%) and laryngoscopy (28.9%). The most commonly involved teeth were the upper incisors. Dental injury incidence was significantly reduced and remained at low levels after implementation of the quality improvement program. We suggest the implementation of a standardized dental examination into the preoperative evaluation system adding pathologic teeth fixed or protected devices to minimize dental injury associated with anesthesia. Copyright © 2016. Published by Elsevier Taiwan LLC.

  9. Sustainable Monitoring and Surveillance Systems to Improve HIV Programs: Review.

    Science.gov (United States)

    Low-Beer, Daniel; Mahy, Mary; Renaud, Francoise; Calleja, Txema

    2018-04-24

    HIV programs have provided a major impetus for investments in surveillance data, with 5-10% of HIV program budgets recommended to support data. However there are questions concerning the sustainability of these investments. The Sustainable Development Goals have consolidated health into one goal and communicable diseases into one target (Target 3.3). Sustainable Development Goals now introduce targets focused specifically on data (Targets 17.18 and 17.19). Data are seen as one of the three systemic issues (in Goal 17) for implementing Sustainable Development Goals, alongside policies and partnerships. This paper reviews the surveillance priorities in the context of the Sustainable Development Goals and highlights the shift from periodic measurement towards sustainable disaggregated, real-time, case, and patient data, which are used routinely to improve programs. Finally, the key directions in developing person-centered monitoring systems are assessed with country examples. The directions contribute to the Sustainable Development Goal focus on people-centered development applied to data. ©Daniel Low-Beer, Mary Mahy, Francoise Renaud, Txema Calleja. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 24.04.2018.

  10. Video training and certification program improves reliability of postischemic neurologic deficit measurement in the rat.

    Science.gov (United States)

    Taninishi, Hideki; Pearlstein, Molly; Sheng, Huaxin; Izutsu, Miwa; Chaparro, Rafael E; Goldstein, Larry B; Warner, David S

    2016-12-01

    Scoring systems are used to measure behavioral deficits in stroke research. Video-assisted training is used to standardize stroke-related neurologic deficit scoring in humans. We hypothesized that a video-assisted training and certification program can improve inter-rater reliability in assessing neurologic function after middle cerebral artery occlusion in rats. Three expert raters scored neurologic deficits in post-middle cerebral artery occlusion rats using three published systems having different complexity levels (3, 18, or 48 points). The system having the highest point estimate for the correlation between neurologic score and infarct size was selected to create a video-assisted training and certification program. Eight trainee raters completed the video-assisted training and certification program. Inter-rater agreement ( Κ: score) and agreement with expert consensus scores were measured before and after video-assisted training and certification program completion. The 48-point system correlated best with infarct size. Video-assisted training and certification improved agreement with expert consensus scores (pretraining = 65 ± 10, posttraining = 87 ± 14, 112 possible scores, P  0.4 (pretraining = 4, posttraining = 9), and number of categories with an improvement in the Κ: score from pretraining to posttraining (n = 6). Video-assisted training and certification improved trainee inter-rater reliability and agreement with expert consensus behavioral scores in rats after middle cerebral artery occlusion. Video-assisted training and certification may be useful in multilaboratory preclinical studies. © The Author(s) 2015.

  11. Improving Emotional Intelligence through Personality Development: The Effect of the Smart Phone Application based Dharma Life Program on Emotional Intelligence.

    Science.gov (United States)

    Poonamallee, Latha; Harrington, Alex M; Nagpal, Manisha; Musial, Alec

    2018-01-01

    Emotional intelligence is established to predict success in leadership effectiveness in various contexts and has been linked to personality factors. This paper introduces Dharma Life Program, a novel approach to improving emotional intelligence by targeting maladaptive personality traits and triggering neuroplasticity through the use of a smart-phone application and mentoring. The program uses neuroplasticity to enable users to create a more adaptive application of their maladaptive traits, thus improving their emotional intelligence. In this study 26 participants underwent the Dharma Life Program in a leadership development setting. We assessed their emotional and social intelligence before and after the Dharma Life Program intervention using the Emotional and Social Competency Inventory (ESCI). The study found a significant improvement in the lowest three competencies and a significant improvement in almost all domains for the entire sample. Our findings suggest that the completion of the Dharma Life Program has a significant positive effect on Emotional and Social Competency scores and offers a new avenue for improving emotional intelligence competencies.

  12. Algorithm improvement program nuclide identification algorithm scoring criteria and scoring application.

    Energy Technology Data Exchange (ETDEWEB)

    Enghauser, Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-02-01

    The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

  13. Using Balanced Scorecard (BSC) approach to improve ergonomics programs.

    Science.gov (United States)

    Fernandes, Marcelo Vicente Forestieri

    2012-01-01

    The purpose of this paper is to propose foundations for a theory of using the Balanced Scorecard (BSC) methodology to improve the strategic view of ergonomics inside the organizations. This approach may help to promote a better understanding of investing on an ergonomic program to obtain good results in quality and production, as well as health maintenance. It is explained the basics of balanced scorecard, and how ergonomists could use this to work with strategic enterprises demand. Implications of this viewpoint for the development of a new methodology for ergonomics strategy views are offered.

  14. Understanding Effective Program Improvement Schools through a Distributed Leadership Task Context Model

    Science.gov (United States)

    Gipson, Frances Marie

    2012-01-01

    Federal, state, and local agencies face challenges organizing resources that create the conditions necessary to create, sustain, and replicate effective high performing schools. Knowing that leadership does impact achievement outcomes and that school districts tackle growing numbers of sanctioned Program Improvement schools, a distributed…

  15. Medication Adherence Improvements in Employees Participating in a Pharmacist-Run Risk Reduction Program

    Directory of Open Access Journals (Sweden)

    Mallory C. McKenzie

    2012-01-01

    Full Text Available Objective: To evaluate the medication adherence of individuals participating in a pharmacist-run employee health Cardiovascular and Diabetes Risk Reduction Program. Design: Retrospective analysis of medication adherence using pharmacy refill data. Setting: A medium sized university located in the Midwest United States and the organization's outpatient pharmacy. Participants: 38 participants ≥ 18 years of age, employed and receiving their health insurance through the organization, and have a diagnosis of hypertension, hyperlipidemia, diabetes mellitus, or a combination thereof. Intervention: Participation in the risk reduction program that emphasizes medication therapy management (MTM, lifestyle medicine and care coordination. Main Outcome Measures: The Proportion of Days Covered (PDC and the Medication Possession Ratio (MPR. Results: PDC and MPR analysis showed a statistically significant improvement in medication adherence for 180 days and 360 days post enrollment versus the 180 days prior to enrollment (P<0.01. The PDC analysis demonstrated a statistically significant improvement in the number of medications that achieved a PDC ≥ 80% (high adherence for the 180 days post enrollment versus the 180 days prior to enrollment (+30%, P<0.01. The MPR analysis showed a non-statistically significant improvement in the number of medications that achieved an MPR ≥ 80% (high adherence pre enrollment versus post enrollment (+10%, P=0.086. The percentage of participants in the program that reached a PDC and MPR adherence rate ≥ 80% at 180 days post enrollment was 78.9% and 94.4%, respectively which exceeds that of a matched cohort that reached a PDC and MPR adherence rate ≥ 80% of 66.4% and 82.8%, respectively. Conclusion: Pharmacists can improve medication adherence as measured by PDC and MPR when working with employees enrolled in a novel pharmacist-run employee health risk reduction program. Medication adherence was shown to be sustainable for

  16. La Hague Continuous Improvement Program: Enhancement of the Vitrification Throughput

    International Nuclear Information System (INIS)

    Petitjean, V.; De Vera, R.; Hollebecque, J.F.; Tronche, E.; Flament, T.; Pereira Mendes, F.; Prod'homme, A.

    2006-01-01

    The vitrification of high-level liquid waste produced from nuclear fuel reprocessing has been carried out industrially for over 25 years by AREVA/COGEMA, with two main objectives: containment of the long lived fission products and reduction of the final volume of waste. At the 'La Hague' plant, in the 'R7' and 'T7' facilities, vitrified waste is obtained by first evaporating and calcining the nitric acid feed solution-containing fission products in calciners. The product-named calcinate- is then fed together with glass frit into induction-heated metallic melters to produce the so-called R7/T7 glass, well known for its excellent containment properties. Both facilities are equipped with three processing lines. In the near future the increase of the fuel burn-up will influence the amount of fission product solutions to be processed at R7/T7. As a consequence, in order to prepare these changes, it is necessary to feed the calciner at higher flow-rates. Consistent and medium-term R and D programs led by CEA (French Atomic Energy Commission, the AREVA/COGEMA's R and D and R and T provider), AREVA/COGEMA (Industrial Operator) and AREVA/SGN (AREVA/COGEMA's Engineering), and associated to the industrial feed back of AREVA/COGEMA operations, have allowed continuous improvement of the process since 1998: - The efficiency and limitation of the equipment have been studied and solutions for technological improvements have been proposed whenever necessary, - The increase of the feeding flow-rate has been implemented on the improved CEA test rig (so called PEV, Evolutional Prototype of Vitrification) and adapted by AREVA/SGN for the La Hague plant using their modeling studies; the results obtained during this test confirmed the technological and industrial feasibility of the improvements achieved, - After all necessary improved equipments have been implemented in R7/T7 facilities, and a specific campaign has been performed on the R7 facility by AREVA/COGEMA. The flow-rate to the

  17. Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India.

    Science.gov (United States)

    Masters, William A; Rosettie, Katherine L; Kranz, Sarah; Danaei, Goodarz; Webb, Patrick; Mozaffarian, Dariush

    2018-05-01

    Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource

  18. The Denver region traffic signal system improvement program : planning for management and operations

    Science.gov (United States)

    2009-04-01

    The Denver Regional Council of Governments (DRCOG) works with over 30 local jurisdictions on the Traffic Signal System Improvement Program (TSSIP), a combination of management and operations strategies designed to time and coordinate traffic signals ...

  19. Impact of a quality improvement program on care and outcomes for children with asthma.

    Science.gov (United States)

    Homer, Charles J; Forbes, Peter; Horvitz, Lisa; Peterson, Laura E; Wypij, David; Heinrich, Patricia

    2005-05-01

    To test a quality improvement intervention, a learning collaborative based on the Institute for Healthcare Improvement's Breakthrough Series methodology, specifically intended to improve care and outcomes for patients with childhood asthma. Randomized trial in primary care practices. Practices in greater Boston, Mass, and greater Detroit, Mich. Forty-three practices, with 13 878 pediatric patients with asthma, randomized to intervention and control groups. Intervention Participation in a learning collaborative project based on the Breakthrough Series methodology of continuous quality improvement. Change from baseline in the proportion of children with persistent asthma who received appropriate medication therapy for asthma, and in the proportion of children whose parent received a written management plan for their child's asthma, as determined by telephone interviews with parents of 631 children. After adjusting for state, practice size, child age, sex, and within-practice clustering, no overall effect of the intervention was found. This methodologically rigorous assessment of a widely used quality improvement technique did not demonstrate a significant effect on processes or outcomes of care for children with asthma. Potential deficiencies in program implementation, project duration, sample selection, and data sources preclude making the general inference that this type of improvement program is ineffective. Additional rigorous studies should be undertaken under more optimal settings to assess the efficacy of this method for improving care.

  20. Meeting the Imperative to Improve Physician Well-being: Assessment of an Innovative Program

    Science.gov (United States)

    Arnetz, Bengt B.; Christensen, John F.; Homer, Louis

    2007-01-01

    BACKGROUND Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative. OBJECTIVE To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being. DESIGN AND PARTICIPANTS From 2000 to 2005, 22–32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning. MEASUREMENTS Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey. RESULTS Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study. CONCLUSIONS A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk. PMID:17891503

  1. The improvement program of radwaste treatment at Chinshan nuclear power station

    International Nuclear Information System (INIS)

    Lin, M.M.H.; Huang, C.Y.

    1986-01-01

    Chinshan-1 and 2, the twin 636-megawatt boiling water reactors with independent radwaste treatment facilities, located at northern Taiwan, started power generation in 1977 and 1978, respectively. Initial years of operation of CSNPS indicated a need for improvement of the radwaste scheme originally provided. The major betterment programs for radwaste system include: (1) addition of auxiliary demineralization system and addition resin storage tank/demineralizer, (2) addition of dry laundry and miscellant drain system, (3) addition of off-gas charcoal delay system, (4) tie connection of the liquid waste system of unit 1 and 2, (5) solid waste system retrofit study, (6) volume reduction study. The administration and water quality controls have also been much improved and the discharge of radioactivity is considerably lower after the improvement has been implemented

  2. Breastfeeding Support in a Community Pharmacy: Improving Access through the Well Babies at Walgreens Program.

    Science.gov (United States)

    Lenell, Amy; Friesen, Carol A; Hormuth, Laura

    2015-11-01

    Well Babies at Walgreens is a unique community-based corporate partnership program that offers breastfeeding support by a lactation professional in a private room at the pharmacy. Walgreens is a community pharmacy chain with more than 8000 locations in the United States, Puerto Rico, and the US Virgin Islands. The primary goal of Well Babies is to support breastfeeding women using a model that is expandable to other Walgreens pharmacy sites. The Well Babies program offers drop-in services, with a professional consultation by a lactation consultant and baby weight check, if desired. Well Babies creators are developing a business plan for Walgreens and a toolkit that would help other stores implement the program. An additional goal is to improve continuity of care for breastfeeding by engaging pharmacists as vital members of the health care team. Offering breastfeeding support at a pharmacy improves access and encourages support persons to attend while simultaneously allowing the family to complete other errands. This initiative included education for pharmacists to improve the recommendations they make for breastfeeding mothers and to improve awareness among pharmacists of the benefits associated with breastfeeding and the need to preserve the breastfeeding relationship. The first drop-in location opened in April 2012. Grant funding from the US Centers for Disease Control and Prevention, awarded to the Indiana State Department of Health, made it possible to open a second drop-in location in June 2013. Future plans include developing an employee lactation program and expanding Well Babies at Walgreens at other store locations. © The Author(s) 2015.

  3. Improving Emotional Intelligence through Personality Development: The Effect of the Smart Phone Application based Dharma Life Program on Emotional Intelligence

    Directory of Open Access Journals (Sweden)

    Latha Poonamallee

    2018-02-01

    Full Text Available Emotional intelligence is established to predict success in leadership effectiveness in various contexts and has been linked to personality factors. This paper introduces Dharma Life Program, a novel approach to improving emotional intelligence by targeting maladaptive personality traits and triggering neuroplasticity through the use of a smart-phone application and mentoring. The program uses neuroplasticity to enable users to create a more adaptive application of their maladaptive traits, thus improving their emotional intelligence. In this study 26 participants underwent the Dharma Life Program in a leadership development setting. We assessed their emotional and social intelligence before and after the Dharma Life Program intervention using the Emotional and Social Competency Inventory (ESCI. The study found a significant improvement in the lowest three competencies and a significant improvement in almost all domains for the entire sample. Our findings suggest that the completion of the Dharma Life Program has a significant positive effect on Emotional and Social Competency scores and offers a new avenue for improving emotional intelligence competencies.

  4. Improving Emotional Intelligence through Personality Development: The Effect of the Smart Phone Application based Dharma Life Program on Emotional Intelligence

    Science.gov (United States)

    Poonamallee, Latha; Harrington, Alex M.; Nagpal, Manisha; Musial, Alec

    2018-01-01

    Emotional intelligence is established to predict success in leadership effectiveness in various contexts and has been linked to personality factors. This paper introduces Dharma Life Program, a novel approach to improving emotional intelligence by targeting maladaptive personality traits and triggering neuroplasticity through the use of a smart-phone application and mentoring. The program uses neuroplasticity to enable users to create a more adaptive application of their maladaptive traits, thus improving their emotional intelligence. In this study 26 participants underwent the Dharma Life Program in a leadership development setting. We assessed their emotional and social intelligence before and after the Dharma Life Program intervention using the Emotional and Social Competency Inventory (ESCI). The study found a significant improvement in the lowest three competencies and a significant improvement in almost all domains for the entire sample. Our findings suggest that the completion of the Dharma Life Program has a significant positive effect on Emotional and Social Competency scores and offers a new avenue for improving emotional intelligence competencies. PMID:29527182

  5. 78 FR 45231 - Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality...

    Science.gov (United States)

    2013-07-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-3280-FN] Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality's (CIHQ's) Hospital Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS. ACTION: Final...

  6. Program planning for future improvement in managing ORNL's radioactive wastes

    International Nuclear Information System (INIS)

    1982-01-01

    This report is intended to serve as a reference document and guide in developing the long-term improvements section of ORNL's radioactive waste management plan. The report reviews ORNL's operations and future program needs in terms of currently applicable DOE regulations and also in terms of regulations and accepted practices of the commerical sector of the nuclear power industry so that the impact of potential future adoption of these regulations and standards on ORNL's operations can be fully evaluated. The principal conclusion reached after reviewing ORNL's waste management operations is that these operations are currently being conducted in a manner that does not endanger the health or safety of workers or the general public and that does not have an adverse effect on the environment. Although nineteen specific problem areas have been identified all of these problems can be attributed to one of the following: a) the legacy of past practices; b) gradual deterioration of systems which have reached (or are near to reaching) the end of their reasonable design lives; and c) potential changes in regulations applicable to ORNL. All of the programs designed to improve or correct these problem areas could be accomplished within a four year period. However, given current limitations on manpower and capital, these programs would more likely be spread out over a five to ten year period of time if they were all to be undertaken. The cost of undertaking all of these projects concurrently is estimated to be between 60 and 100 million dollars. Due to the many unknowns and uncertainties associated with the problem areas, actual total costs for specific projects could vary from those presented in this report by as much as 300 percent

  7. Evaluation of a multicomponent workplace health promotion program conducted in Japan for improving employees' cardiovascular disease risk factors.

    Science.gov (United States)

    Muto, T; Yamauchi, K

    2001-12-01

    The long-term effectiveness of multicomponent worksite health promotion programs targeting cardiovascular disease risk factors remains unclear in Japan. This study was conducted to evaluate the effectiveness of such a health promotion program consisting of a main program provided over 4 days and a follow-up program provided over 1 year. The subjects of this randomized controlled trial were male employees working for a building maintenance company in Japan. The intervention group (n = 152) and the control group (n = 150) consisted of employees having abnormal findings in at least one of the following items at baseline health examination: body mass index (BMI), systolic (SBP) or diastolic blood pressure, total cholesterol, HDL cholesterol, triglycerides, and fasting blood glucose. Evaluation was conducted at 18 months after the main program. BMI, SBP, total cholesterol, and triglycerides improved significantly in the intervention group compared with the control group (P < 0.05). When comparisons were limited to those who showed abnormality at baseline, BMI, total cholesterol, and triglycerides improved significantly in the intervention group (P < 0.05). The multicomponent health promotion program provided to employees was shown to be effective in improving obesity, high blood pressure, and hyperlipidemia when evaluated 18 months after the main intervention program. Copyright 2001 American Health Foundation and Elsevier Science.

  8. Aging mitigation and improved programs for nuclear service diesel generators

    International Nuclear Information System (INIS)

    Hoopingarner, K.R.; Zaloudek, F.R.

    1989-12-01

    Recent NRC sponsored aging research work on nuclear service diesel generators has resulted in a recommendation that an improved engine management program should be adopted for aging mitigation and reliability improvement. The center of attention should be to ensure diesel-generator operational readiness. This report emphasizes a ''healthy engine concept'' and recommends parameters to be monitored to determine engine condition. The proposed program and approach recommended in this report represent balanced management where diesel generator testing, inspections, monitoring, trending, training, and maintenance all have appropriate importance. Fast-starting and fast-loading test of nuclear service diesels causes very rapid wear of certain engine components. This report documents this aging and wear mechanism and recommends ways to largely eliminate this unique aging stressor. Current periodic intrusive maintenance and engine overhaul practice have been found to be less favorable for safety assurance than engine overhauls based on monitoring and trending results or on a need to correct specific engine defects. This report recommends that the periodic overhaul requirements be re-evaluated. Diesel generator research on aging and wear is sponsored by the US Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research. The research reported in this report was conducted by Pacific Northwest Laboratory (PNL), which is operated for the Department of Energy by Battelle Memorial Institute. 23 refs., 3 figs., 8 tabs

  9. Improving Leadership Preparation Programs through a School, University, and Professional Organization Partnership.

    Science.gov (United States)

    Peel, Henry A.; Wallace, Corinna

    Beginning educational administrators often find that they are unprepared to deal with the realities of school administration. This paper describes how the Halifax County, North Carolina, school system worked with a national organization and an area university to develop a plan to improve its administrator-preparation program. In 1992 the school…

  10. Program of participation and improvement of management in N.P. Cofrentes (Spain)

    International Nuclear Information System (INIS)

    Almoguera, R.; Garcia Fernandez, N.

    1995-01-01

    The generation sector of Iberdrola began in 1992 the Participation program and management improvement management in the Nuclear Power Plant of Cofrentes (Spain) to set up a model for the Total Quality management. The model used was develop by Florida Power and Light and the enterprise Sistecal was selected as consulting

  11. Cameco engineered tailings program: linking applied research with industrial processes for improved tailings performance

    International Nuclear Information System (INIS)

    Kotzer, T.G.

    2010-01-01

    'Full text:' Mine tailings at Cameco's operations are by-products of milling uranium ore having variable concentrations of uranium, metals, oxyanions and trace elements or elements of concern (EOC). Cameco has undertaken an Engineered Tailings (ET) program to optimize tailings performance and minimize environmental EOC impacts, regardless of the milled ore source. Applied geochemical and geotechnical tailings research is key within the ET program. In-situ drilling and experimental programs are used to understand long-term tailings behaviour and help validate source term predictions. Within this, the ET program proactively aids in the development of mill-based processes for production of tailings having improved long-term stability. (author)

  12. A hospital-randomized controlled trial of a formal quality improvement educational program in rural and small community Texas hospitals: one year results.

    Science.gov (United States)

    Filardo, Giovanni; Nicewander, David; Herrin, Jeph; Edwards, Janine; Galimbertti, Percy; Tietze, Mari; McBride, Susan; Gunderson, Julie; Collinsworth, Ashley; Haydar, Ziad; Williams, Josie; Ballard, David J

    2009-08-01

    To investigate the effectiveness of a quality improvement educational program in rural hospitals. Hospital-randomized controlled trial. A total of 47 rural and small community hospitals in Texas that had previously received a web-based benchmarking and case-review tool. The 47 hospitals were randomized either to receive formal quality improvement educational program or to a control group. The educational program consisted of two 2-day didactic sessions on continuous quality improvement techniques, followed by the design, implementation and reporting of a local quality improvement project, with monthly coaching conference calls and annual follow-up conclaves. Performance on core measures for community-acquired pneumonia and congestive heart failure were compared between study groups to evaluate the impact of the educational program. No significant differences were observed between the study groups on any measures. Of the 23 hospitals in the intervention group, only 16 completed the didactic program and 6 the full training program. Similar results were obtained when these groups were compared with the control group. While the observed results suggest no incremental benefit of the quality improvement educational program following implementation of a web-based benchmarking and case-review tool in rural hospitals, given the small number of hospitals that completed the program, it is not conclusive that such programs are ineffective. Further research incorporating supporting infrastructure, such as physician champions, financial incentives and greater involvement of senior leadership, is needed to assess the value of quality improvement educational programs in rural hospitals.

  13. A short executive function training program improves preschoolers’ working memory

    Directory of Open Access Journals (Sweden)

    Emma eBlakey

    2015-11-01

    Full Text Available Cognitive training has been shown to improve executive functions in middle childhood and adulthood. However, fewer studies have targeted the preschool years – a time when executive functions undergo rapid development. The present study tested the effects of a short four session executive function training program in 54 four-year-olds. The training group significantly improved their working memory from pre-training relative to an active control group. Notably, this effect extended to a task sharing few surface features with the trained tasks, and continued to be apparent three months later. In addition, the benefits of training extended to a measure of mathematical reasoning three months later, indicating that training executive functions during the preschool years has the potential to convey benefits that are both long-lasting and wide-ranging.

  14. Improved physical fitness among older female participants in a nationally disseminated, community-based exercise program.

    Science.gov (United States)

    Seguin, Rebecca A; Heidkamp-Young, Eleanor; Kuder, Julia; Nelson, Miriam E

    2012-04-01

    Strength training (ST) is an important health behavior for aging women; it helps maintain strength and function and reduces risk for chronic diseases. This study assessed change in physical fitness following participation in a ST program implemented and evaluated by community leaders. The StrongWomen Program is a nationally disseminated, research-based, community ST program active in 40 states. The Senior Fitness Test is used to assess upper and lower body strength, upper and lower body flexibility, aerobic fitness, and agility; data are collected prior to and following program participation. For these analyses, five states provided deidentified data for 367 female participants, mean age 63 (±11) years. Attendance in approximately 10 weeks of twice-weekly classes was 69.4%. Paired t tests were used to analyze pre-post change. Significant improvements were observed (p age-group and compared with published, age-based norms. This study demonstrates that it is feasible for community leaders to conduct pre-post physical fitness evaluations with participants and that participants experienced improvements across several important domains of physical fitness.

  15. Post-disaster psychosocial support and quality improvement: A conceptual framework for understanding and improving the quality of psychosocial support programs

    NARCIS (Netherlands)

    Dückers, Michel L. A.; Thormar, Sigridur B.

    2015-01-01

    This article is original in that it addresses post-disaster psychosocial support programs from a quality-improvement perspective, not from the traditional viewpoint of mental health services. Based on a combination of renowned quality models, a framework is sketched that offers chances to better

  16. Education in Quality Improvement for Pediatric Practice: an online program to teach clinicians QI.

    Science.gov (United States)

    Bundy, David G; Morawski, Lori F; Lazorick, Suzanne; Bradbury, Scott; Kamachi, Karen; Suresh, Gautham K

    2014-01-01

    Education in Quality Improvement for Pediatric Practice (EQIPP) is an online program designed to improve evidence-based care delivery by teaching front-line clinicians quality improvement (QI) skills. Our objective was to evaluate EQIPP data to characterize 1) participant enrollment, use patterns, and demographics; 2) changes in performance in clinical QI measures from baseline to follow-up measurement; and 3) participant experience. We conducted an observational study of EQIPP participants utilizing 1 of 3 modules (asthma, immunizations, gastroesophageal reflux disease) from 2009 to 2013. Enrollment and use, demographic, and quality measure data were extracted directly from the EQIPP system; participant experience was assessed via an optional online survey. Study participants (n = 3501) were diverse in their gender, age, and race; most were board certified. Significant quality gaps were observed across many of the quality measures at baseline; sizable improvements were observed across most quality measures at follow-up. Participants were generally satisfied with their experience. The most influential module elements were collecting and analyzing data, creating and implementing aim statements and improvement plans, and completing "QI Basics." Online educational programs, such as EQIPP, hold promise for front-line clinicians to learn QI. The sustainability of the observed improvements in care processes and their linkage to improvements in health outcomes are unknown and are an essential topic for future study. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. 76 FR 78343 - HOME Investment Partnerships Program: Improving Performance and Accountability; and Updating...

    Science.gov (United States)

    2011-12-16

    ... CFR Parts 91 and 92 HOME Investment Partnerships Program: Improving Performance and Accountability... Performance and Accountability; and Updating Property Standards AGENCY: Office of the Assistant Secretary for... regulatory requirements and establish new requirements designed to enhance accountability by States and units...

  18. Mixed-Methods Assessment of Trauma and Acute Care Surgical Quality Improvement Programs in Peru.

    Science.gov (United States)

    LaGrone, Lacey N; Fuhs, Amy K; Egoavil, Eduardo Huaman; Rodriguez Castro, Manuel J A; Valderrama, Roberto; Isquith-Dicker, Leah N; Herrera-Matta, Jaime; Mock, Charles N

    2017-04-01

    Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru. Key areas identified for improvement in morbidity and mortality (M&M) conferences were the standardization of case selection, incorporation of evidence from the medical literature into case presentation and discussion, case documentation, and the development of a clear plan for case follow-up. The key barriers to QI program implementation were a lack of prioritization of QI, lack of sufficient human and administrative resources, lack of political support, and lack of education on QI practices. A national program that makes QI a required part of all health providers' professional training and responsibilities would effectively address a majority of identified barriers to QI programs in Peru. Specifically, the presence of basic QI elements, such as M&M conferences, should be required at hospitals that train pre-graduate physicians. Alternatively, short of this national-level organization, efforts that capitalize on local examples through apprenticeships between institutions or integration of QI into continuing medical education would be expected to build on the facilitators for QI programs that exist in Peru.

  19. Is Children's Programming Improving?

    Science.gov (United States)

    Potter, Rosemary Lee

    1979-01-01

    Susan Futterman, a former teacher and early childhood specialist for Action for Children's Television, comments on changing formats for children's programs, as well as on the role of educators in using television as a learning vehicle. (Editor/KC)

  20. Substation design improvement with a probabilistic reliability approach using the TOPASE program

    Energy Technology Data Exchange (ETDEWEB)

    Bulot, M.; Heroin, G.; Bergerot, J-L.; Le Du, M. [Electricite de France (France)

    1997-12-31

    TOPASE, (the French acronym for Probabilistic Tools and Data Processing for the Analysis of Electric Systems), developed by Electricite de France (EDF) to perform reliability studies on transmission substations, was described. TOPASE serves a dual objective of assisting in the automation of HV substation studies, as well as enabling electrical systems experts who are not necessarily specialists in reliability studies to perform such studies. The program is capable of quantifying the occurrence rate of undesirable events and of identifying critical equipment and the main incident scenarios. The program can be used to improve an existing substation, to choose an HV structure during the design stage, or to choose a system of protective devices. Data collected during 1996 and 1997 will be analyzed to identify useful experiences and to validate the basic concepts of the program. 4 figs.

  1. Establishing a Nurse Mentor Program to Improve Nurse Satisfaction and Intent to Stay.

    Science.gov (United States)

    Jones, Sara Jane

    Mentoring is an intervention to foster development and socialization of new registered nurses to an organization or unit. A nurse mentor program was developed and implemented with the purpose to improve new registered nurse satisfaction and intent to stay. A pre- and postintervention design was used in a rural emergency department to evaluate nurse job satisfaction and intent to stay in the job. Intent to stay in the job mean scores increased, and the registered nurse participants reported program satisfaction through verbal and written feedback.

  2. Evaluating the Implementation of a Training Program for Improving Quality Service: An Action Research Study

    Science.gov (United States)

    Pierre, Ketly Dieudonne

    2014-01-01

    There is a need to implement a comprehensive training program to build employees' knowledge, skills, and attitudes in order to improve quality service at ABC Restaurant because of a surge in customer complaints. The purpose of this study was to develop a training program that included an employee handbook as a training tool, a handbook designed…

  3. Short-term high intensity plyometric training program improves strength, power and agility in male soccer players.

    Science.gov (United States)

    Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

    2013-03-01

    The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 - 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer.

  4. Short-Term High Intensity Plyometric Training Program Improves Strength, Power and Agility in Male Soccer Players

    Science.gov (United States)

    Váczi, Márk; Tollár, József; Meszler, Balázs; Juhász, Ivett; Karsai, István

    2013-01-01

    The aim of the present study was to investigate the effects of a short-term in-season plyometric training program on power, agility and knee extensor strength. Male soccer players from a third league team were assigned into an experimental and a control group. The experimental group, beside its regular soccer training sessions, performed a periodized plyometric training program for six weeks. The program included two training sessions per week, and maximal intensity unilateral and bilateral plyometric exercises (total of 40 – 100 foot contacts/session) were executed. Controls participated only in the same soccer training routine, and did not perform plyometrics. Depth vertical jump height, agility (Illinois Agility Test, T Agility Test) and maximal voluntary isometric torque in knee extensors using Multicont II dynamometer were evaluated before and after the experiment. In the experimental group small but significant improvements were found in both agility tests, while depth jump height and isometric torque increments were greater. The control group did not improve in any of the measures. Results of the study indicate that plyometric training consisting of high impact unilateral and bilateral exercises induced remarkable improvements in lower extremity power and maximal knee extensor strength, and smaller improvements in soccer-specific agility. Therefore, it is concluded that short-term plyometric training should be incorporated in the in-season preparation of lower level players to improve specific performance in soccer. PMID:23717351

  5. Online Student Evaluation Improves Course Experience Questionnaire Results in a Physiotherapy Program

    Science.gov (United States)

    Tucker, Beatrice; Jones, Sue; Straker, Leon

    2008-01-01

    This paper reports the use of an online student evaluation system, Course Experience on the Web (CEW), in a physiotherapy program to improve their Course Experience Questionnaire (CEQ) results. CEW comprises a course survey instrument modeled on the CEQ and a tailored unit survey instrument. Closure of the feedback loop is integral in the CEW…

  6. Development of a Virtual Crew Resource Management Training Program to Improve Communication.

    Science.gov (United States)

    Tschannen, Dana

    2017-11-01

    Crew Resource Management (CRM), a method focused on the management of human error and risk reduction, has shown promise in reducing communication failure in health care. The purpose of this project was to develop a virtual training program in CRM principles of effective leadership and followership, and evaluate the applicability to nurses working in the hospital setting. The intervention included the development of a virtual CRM training program consisting of a self-learning module and virtual simulation. Beta testing of the module was conducted by six nurses, followed by an evaluation of the training program by nurses (n = 5) in a general medicine department. Nurses reported the overall program to be worthwhile (X̄= 5; SD = 0.5), with great applicability to nursing care (X̄= 4.5, SD = 0.5). Nurses completing the simulation activity reported strong agreement to CRM applicability and training effectiveness. The CRM training module proved to be applicable to nursing care and is ready for widespread use to improve patient care and communication. J Contin Educ Nurs. 2017;48(11):525-532. Copyright 2017, SLACK Incorporated.

  7. Reducing Anxiety and Improving Academic Performance Through a Biofeedback Relaxation Training Program.

    Science.gov (United States)

    Aritzeta, Aitor; Soroa, Goretti; Balluerka, Nekane; Muela, Alexander; Gorostiaga, Arantxa; Aliri, Jone

    2017-09-01

    The aim of this study was to analyze the influence of a biofeedback relaxation training program on anxiety and academic performance. The program consisted of five biofeedback sessions coupled with three training activities focused on deep breathing, guided imagery, and muscle relaxation. The participants were second-year psychology undergraduates from the University of the Basque Country (UPV/EHU, northern Spain). The experimental group comprised 152 students (M age  = 19.6, SD = 0.74; 74% women) and the control group 81 students (M age   = 19.4, SD = 0.92; 71% women). Results showed that after participating in the program, students in the experimental group had lower levels of anxiety and increased academic performance. Furthermore, they scored lower on anxiety and higher on academic performance in comparison with the control subjects. This suggests that the inclusion of biofeedback training programs in educational contexts could be a way of reducing anxiety and improving academic performance. It may also deepen our understanding of the dynamic interplay between psychophysiological, cognitive, and emotional processes.

  8. Assessment of current NRC/IE professional training program and recommendations for improvement

    International Nuclear Information System (INIS)

    Bartley, H.J.; Hagerup, J.E.; Harrison, O.J.; Heyer, F.H.K.; Kaas, I.W.; Schwartz, E.G.

    1978-05-01

    This document is the General Research Corporation (GRC) report on Task III: to assess the current NRC/IE professional training program and to provide recommendations for improvement. The major objectives of this task were to determine the overall effectiveness of the NRC/IE training program and to provide recommendations for improvements where appropriate. The research involved a review of course manuals and of student critiques, observation in the classroom and person to person interviews; it also included an evaluation of the assignment of instructors to the Career Management Branch. Findings addressed refresher training, retread training and initial training--with emphasis on the last of these. Conclusions are that: (1) The curriculum provides, in general, types and levels of training needed; (2) the mix of training methods used is correct; and (3) the training management is effective. However, the training facilities do not reflect a commitment to quality instruction nor is assignment as instructor to the Career Management Branch attractive to inspectors. Recommendations presented in the report are based upon the findings; all lie within the implementing authority of Headquarters NRC/IE

  9. Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self-Assessment Evaluations - Redacted

    Science.gov (United States)

    2016-12-20

    from mandatory disclosure under the Freedom of Information Act. Defense Logistics Agency Disposition Services Needs to Improve Demilitarization...Project No. D2016-D000RD-0057.000) │ i Results in Brief Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self...Assessment Evaluations Visit us at www.dodig.mil December 20, 2016 Objective Our audit objective was to determine whether the Defense Logistics Agency

  10. An Improved Method for Solving Multiobjective Integer Linear Fractional Programming Problem

    Directory of Open Access Journals (Sweden)

    Meriem Ait Mehdi

    2014-01-01

    Full Text Available We describe an improvement of Chergui and Moulaï’s method (2008 that generates the whole efficient set of a multiobjective integer linear fractional program based on the branch and cut concept. The general step of this method consists in optimizing (maximizing without loss of generality one of the fractional objective functions over a subset of the original continuous feasible set; then if necessary, a branching process is carried out until obtaining an integer feasible solution. At this stage, an efficient cut is built from the criteria’s growth directions in order to discard a part of the feasible domain containing only nonefficient solutions. Our contribution concerns firstly the optimization process where a linear program that we define later will be solved at each step rather than a fractional linear program. Secondly, local ideal and nadir points will be used as bounds to prune some branches leading to nonefficient solutions. The computational experiments show that the new method outperforms the old one in all the treated instances.

  11. Introduction of a quality improvement program in a children's hospital in Tehran: design, implementation, evaluation and lessons learned.

    Science.gov (United States)

    Mohammadi, S Mehrdad; Mohammadi, S Farzad; Hedges, Jerris R; Zohrabi, Morteza; Ameli, Omid

    2007-08-01

    Reports addressing continuous quality improvement (CQI) methods in developing countries are scant and there are questions about the applicability of quality improvement methods in such settings. The structure and output of a formal quality improvement program implemented in a teaching hospital affiliated with the Tehran University of Medical Sciences is presented. OBJECTIVE METHOD: During a nine-month period, a multi-stage quality improvement program was implemented. It comprised: (i) training workshops; (ii) a steering committee; (iii) weekly consultation and facilitation of improvement projects; and (iv) a day-long demonstration and recognition meeting. Four cycles of workshops were held in which 132 employees were trained in the basics of CQI. Thirty improvement projects were initiated. Twenty-five of the projects were completed. In an evaluation survey more than 70% of respondents assessed a 'positive impact' on organizational culture, work efficiency and quality of services. More than 90% believed that the changes were sustained, and more than 60% reported that they have implemented additional improvement projects. Our quality improvement package supported rapid implementation of multiple projects. The underlying 'change structure' comprised the improvement teams, top management and the university's quality improvement office; it integrated project management, support and facilitation functions by the respective participant. Organization-wide change was more limited than anticipated. To institutionalize the program and ensure sustainability, a local structure for change should be organized, management coaching should be sustained, local facilitators should be developed, incentives should be established and physician involvement should be emphasized.

  12. IMPROVING THE AESTHETIC LOOK OF GARMENTS, USING COMPUTERIZED GRAPHICS PROGRAMS

    Directory of Open Access Journals (Sweden)

    ŞUTEU Marius

    2016-05-01

    Full Text Available The present paper explains the stages of clothing style improvement by using computer graphics programs. Ovidiu Stan, a student in the Department of Textiles and Leatherworking and Industrial Management, under our guidance, did research at the Ethnographic Museum of Transylvania in Cluj Napoca, where he selected a folk pattern specific to Transylvania area, reinterpreted it and digitized it in the vector graphics program CorelDRAW. This program allows the shape and size of drawings to be modified, and offers a vast chromatic palette which allows us to style the drawings. The pattern was printed on the T-shirt with an Azon Tex Pro printer, which can replace screen-printing or thermal transfer. The printing system is high-speed and very high quality, and the printed patterns can be unique, highly resistent to wear and washing. After the digitization stage, the next stage was to embroider the pattern on the T-shirt with the Happy embroidery machine. The embroidered pattern was designed by using the BERNINA Embroidery Software Designer Plus software. This embroidery software offers the freedom to design and edit elegant monograms, and complete freedom of creative design. All the projects completed with this software can bear their own distinct, individual mark, as an original work of art.

  13. Compression planning for continuous improvement in quality programs

    International Nuclear Information System (INIS)

    Willis, Y.A.; Hood, F.C.

    1992-01-01

    This paper describes Compression Planning, an innovative approach for planning in groups. This participative and structured approach is especially suitable for technical and highly regulated organizations. Compression Planning was applied to the first organization-wide effort at training integration for regulatory compliance, at Battelle Pacific Northwest Laboratory (PNL), a multi-program national laboratory. The planning process was judged as measurably superior to PNL's customary planning. Within 10 days a training policy was issued and an action plan drafted. The participants produced a report identifying and prioritizing 33 key training issues; began to data gather and solicit input from personnel Lab-wide, producing a 2-volume training inventory; and formulated 14 recommendations for implementation. Two years later the plan is still evolving, as PNL training continues to develop, consistent with Continuous Improvement Process objectives

  14. An Improved Evolutionary Programming with Voting and Elitist Dispersal Scheme

    Science.gov (United States)

    Maity, Sayan; Gunjan, Kumar; Das, Swagatam

    Although initially conceived for evolving finite state machines, Evolutionary Programming (EP), in its present form, is largely used as a powerful real parameter optimizer. For function optimization, EP mainly relies on its mutation operators. Over past few years several mutation operators have been proposed to improve the performance of EP on a wide variety of numerical benchmarks. However, unlike real-coded GAs, there has been no fitness-induced bias in parent selection for mutation in EP. That means the i-th population member is selected deterministically for mutation and creation of the i-th offspring in each generation. In this article we present an improved EP variant called Evolutionary Programming with Voting and Elitist Dispersal (EPVE). The scheme encompasses a voting process which not only gives importance to best solutions but also consider those solutions which are converging fast. By introducing Elitist Dispersal Scheme we maintain the elitism by keeping the potential solutions intact and other solutions are perturbed accordingly, so that those come out of the local minima. By applying these two techniques we can be able to explore those regions which have not been explored so far that may contain optima. Comparison with the recent and best-known versions of EP over 25 benchmark functions from the CEC (Congress on Evolutionary Computation) 2005 test-suite for real parameter optimization reflects the superiority of the new scheme in terms of final accuracy, speed, and robustness.

  15. AISI/DOE Advanced Process Control Program Vol. 3 of 6: Improved Liquid Steel Feeding for Slab Casters; FINAL

    International Nuclear Information System (INIS)

    Brent Isaacson; Mike Slepian; Thomas Richter

    1999-01-01

    This report describes the development, construction and testing of the Electromagnetic Valve System (EVS), conducted as a project entitled ''Improved Liquid Steel Feeding System for Slab Casters''. This program ran from November 1992 to January 1995. Many of the technical issues in bringing the EVS to the steel industry were identified and resolved during the course of the program. During this time, significant hardware improvements in Westinghouse's electromagnetic valve were made to easily integrate it with existing continuous casting processes,. An improved refractory nozzle was developed and tested which had superior thermal shock and anti-cracking performance. In addition, several trials were conducted with molten steel to verify the proof-of-principle of the electromagnetic valve and its auxiliary equipment. However, improvements in other conventional pouring technologies have greatly diminished the potential value of this project to the steel industry. A such, the program w as canceled by the American Iron and Steel Institute after the conclusion of Phase I

  16. A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly.

    Science.gov (United States)

    Weerdesteyn, Vivian; Rijken, Hennie; Geurts, Alexander C H; Smits-Engelsman, Bouwien C M; Mulder, Theo; Duysens, Jacques

    2006-01-01

    Falls in the elderly are a major health problem. Although exercise programs have been shown to reduce the risk of falls, the optimal exercise components, as well as the working mechanisms that underlie the effectiveness of these programs, have not yet been established. To test whether the Nijmegen Falls Prevention Program was effective in reducing falls and improving standing balance, balance confidence, and obstacle avoidance performance in community-dwelling elderly people. A total of 113 elderly with a history of falls participated in this study (exercise group, n = 79; control group, n = 28; dropouts before randomization, n = 6). Exercise sessions were held twice weekly for 5 weeks. Pre- and post-intervention fall monitoring and quantitative motor control assessments were performed. The outcome measures were the number of falls, standing balance and obstacle avoidance performance, and balance confidence scores. The number of falls in the exercise group decreased by 46% (incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.36-0.79) compared to the number of falls during the baseline period and by 46% (IRR 0.54, 95% CI 0.34-0.86) compared to the control group. Obstacle avoidance success rates improved significantly more in the exercise group (on average 12%) compared to the control group (on average 6%). Quiet stance and weight-shifting measures did not show significant effects of exercise. The exercise group also had a 6% increase of balance confidence scores. The Nijmegen Falls Prevention Program was effective in reducing the incidence of falls in otherwise healthy elderly. There was no evidence of improved control of posture as a mechanism underlying this result. In contrast, an obstacle avoidance task indicated that subjects improved their performance. Laboratory obstacle avoidance tests may therefore be better instruments to evaluate future fall prevention studies than posturographic balance assessments. Copyright (c) 2006 S. Karger AG, Basel.

  17. Improving health-related quality of life through an evidence-based obesity reduction program: the Healthy Weights Initiative

    Directory of Open Access Journals (Sweden)

    Lemstra ME

    2016-03-01

    Full Text Available Mark E Lemstra,1 Marla R Rogers,21Alliance Health, Moose Jaw, 2Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada Abstract: When evaluating any health intervention, it is critical to include the impact of the intervention on health-related quality of life (HRQL. Among those who are obese, HRQL is often lower than the general population and even more when considering obesity-related comorbidities and bodily pain. The objectives of this paper were to determine the impact of a multidisciplinary, community-based obesity reduction program on HRQL and to determine the independent risk factors for lack of improvement from baseline to follow-up. HRQL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36 at baseline and follow-up (24 weeks. To date, 84.5% of those who completed the program had improvements in their overall SF-36 score. Significant increases in the mean scores on eight dimensions of health were also observed. Lack of improvement was independently affected by smoking status (odds ratio 3.75; 95% confidence interval 1.44–9.78; P=0.007 and not having a buddy to attend the program (odds ratio 3.70; 95% confidence interval 1.28–10.68; P=0.015. Obesity reduction programs that target increasing exercise, improving diet, and cognitive behavioral therapy can positively impact HRQL in obese adults. Social support has a strong role to play in improving outcomes. Keywords: obesity, health-related quality of life, social- support, SF-36, Canada

  18. A community-based healthy living promotion program improved self-esteem among minority children

    Science.gov (United States)

    Improving self-esteem, dietary habits, and physical activity is essential for long-term success in childhood obesity prevention. The aim is to evaluate the effects of a healthy living promotion program, Healthy Kids-Houston, on BMI, dietary habits, self-esteem, and physical activity among minority c...

  19. Peer tutoring pilot program for the improvement of oral health behavior in underprivileged and immigrant children.

    Science.gov (United States)

    Reinhardt, Claus H; Löpker, Nadine; Noack, Michael J; Klein, Klaus; Rosen, Evelyne

    2009-01-01

    Caries prevalence in underprivileged children is particularly high and, even though many efforts have been made, adherence to dental preventive programs is low. The purpose of this study was to evaluate whether a tutoring program can improve oral health behavior in underprivileged and/or immigrant children. Thirty fourth-grade children (mean age = 9.6), over 50 percent of immigrant background, participated in this longitudinal pilot study. The fourth graders were invited to develop on oral health program for their first-grade peers. For this purpose, the fourth graders learned oral health practices and developed the peer tutoring program. Prior to the intervention and after having instructed their first-grade peers, all fourth graders were interviewed about their oral health habits and their tooth-brushing was recorded on video. Toothbrushing time, performance of circular tooth-brushing movements, and systematic cleaning of all dental surfaces were analyzed before and after the intervention. After peer teaching, there was a significant increase concerning tooth-brushing time (P = .004), performance of circular tooth-brushing movements (P tutoring program yielded a significant improvement in relevant oral care behavior. This approach provided an environment which, in contrast to traditional approaches, facilitates empowerment.

  20. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    International Nuclear Information System (INIS)

    Cohen, Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-01-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O ampersand M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O ampersand M Improvement Program. O ampersand M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O ampersand M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O ampersand M costs was achieved. Based on the lessons learned, an optimum solar- field O ampersand M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O ampersand M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts

  1. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Cohen Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-06-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O&M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O&M Improvement Program. O&M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O&M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O&M costs was achieved. Based on the lessons learned, an optimum solar- field O&M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O&M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts.

  2. Improving the management of diabetes in hospitalized patients: the results of a computer-based house staff training program.

    Science.gov (United States)

    Vaidya, Anand; Hurwitz, Shelley; Yialamas, Maria; Min, Le; Garg, Rajesh

    2012-07-01

    Poorly controlled diabetes in hospitalized patients is associated with poor clinical outcomes. We hypothesized that computer-based diabetes training could improve house staff knowledge and comfort for the management of diabetes in a large tertiary-care hospital. We implemented a computer-based training program on inpatient diabetes for internal medicine house staff at the Brigham and Women's Hospital (Boston, MA) in September 2009. House staff were required to complete the program and answer a set of questions, before and after the program, to evaluate their level of comfort and knowledge of inpatient diabetes. Chart reviews of all non-critically ill patients with diabetes managed by house staff in August 2009 (before the program) and December 2009 (after the program) were performed. Chart reviews were also performed for August 2008 and December 2008 to compare house staff management practices when the computer-based educational program was not available. A significant increase in comfort levels and knowledge in the management of inpatient diabetes was seen among house staff at all levels of training (Pstaff compared with junior house staff. Nonsignificant trends suggesting increased use of basal-bolus insulin (P=0.06) and decreased use of sliding-scale insulin (P=0.10) were seen following the educational intervention in 2009, whereas no such change was seen in 2008 (P>0.90). Overall, house staff evaluated the training program as "very relevant" and the technology interface as "good." A computer-based diabetes training program can improve the comfort and knowledge of house staff and potentially improve their insulin administration practices at large academic centers.

  3. Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice

    International Nuclear Information System (INIS)

    Leong, Cheng Nang; Shakespeare, Thomas Philip; Mukherjee, Rahul K.; Back, Michael F.; Lee, Khai Mun; Lu, Jiade Jay; Wynne, Christopher J.; Lim, Keith; Tang, Johann; Zhang Xiaojian

    2006-01-01

    Purpose: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. Methods and Materials: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. Results: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. Conclusion: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence

  4. Use of wetlands for water quality improvement under the USEPA Region V Clean Lakes Program

    Science.gov (United States)

    Landers, Judith C.; Knuth, Barbara A.

    1991-03-01

    The United States Environmental Protection Agency (USEPA) Region V Clean Lakes Program employs artificial and modified natural wetlands in an effort to improve the water quality of selected lakes. We examined use of wetlands at seven lake sites and evaluated the physical and institutional means by which wetland projects are implemented and managed, relative to USEPA program goals and expert recommendations on the use of wetlands for water quality improvement. Management practices recommended by wetlands experts addressed water level and retention, sheet flow, nutrient removal, chemical treatment, ecological and effectiveness monitoring, and resource enhancement. Institutional characteristics recommended included local monitoring, regulation, and enforcement and shared responsibilities among jurisdictions. Institutional and ecological objectives of the National Clean Lakes Program were met to some degree at every site. Social objectives were achieved to a lesser extent. Wetland protection mechanisms and appropriate institutional decentralization were present at all sites. Optimal management techniques were employed to varying degrees at each site, but most projects lack adequate monitoring to determine adverse ecological impacts and effectiveness of pollutant removal and do not extensively address needs for recreation and wildlife habitat. There is evidence that the wetland projects are contributing to improved lake water quality; however, more emphasis needs to be placed on wetland protection and long-term project evaluation.

  5. Taking Care of You: Body, Mind, Spirit--A Unique Stress Management Program That Improves Lifestyle Behaviors

    Science.gov (United States)

    Vetter-Smith, Molly; Massey, Vera; Rellergert, Linda; Wissmann, Mary

    2014-01-01

    Taking Care of You: Body, Mind, Spirit is a multi-session group program developed by University of Missouri Extension that provides a unique and practical approach to helping adults better managing their stress and bounce back from life's challenges while improving lifestyle behaviors. The program combines mindfulness and a variety of other…

  6. Randomized Trial of the Availability, Responsiveness and Continuity (ARC) Organizational Intervention for Improving Youth Outcomes in Community Mental Health Programs

    Science.gov (United States)

    Glisson, Charles; Hemmelgarn, Anthony; Green, Philip; Williams, Nathaniel J.

    2013-01-01

    Objectives: The primary objective of the study was to assess whether the Availability, Responsiveness and Continuity (ARC) organizational intervention improved youth outcomes in community based mental health programs. The second objective was to assess whether programs with more improved organizational social contexts following the 18-month ARC…

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

    International Nuclear Information System (INIS)

    Vine, Edward

    2008-01-01

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

  8. Music enrichment programs improve the neural encoding of speech in at-risk children.

    Science.gov (United States)

    Kraus, Nina; Slater, Jessica; Thompson, Elaine C; Hornickel, Jane; Strait, Dana L; Nicol, Trent; White-Schwoch, Travis

    2014-09-03

    Musicians are often reported to have enhanced neurophysiological functions, especially in the auditory system. Musical training is thought to improve nervous system function by focusing attention on meaningful acoustic cues, and these improvements in auditory processing cascade to language and cognitive skills. Correlational studies have reported musician enhancements in a variety of populations across the life span. In light of these reports, educators are considering the potential for co-curricular music programs to provide auditory-cognitive enrichment to children during critical developmental years. To date, however, no studies have evaluated biological changes following participation in existing, successful music education programs. We used a randomized control design to investigate whether community music participation induces a tangible change in auditory processing. The community music training was a longstanding and successful program that provides free music instruction to children from underserved backgrounds who stand at high risk for learning and social problems. Children who completed 2 years of music training had a stronger neurophysiological distinction of stop consonants, a neural mechanism linked to reading and language skills. One year of training was insufficient to elicit changes in nervous system function; beyond 1 year, however, greater amounts of instrumental music training were associated with larger gains in neural processing. We therefore provide the first direct evidence that community music programs enhance the neural processing of speech in at-risk children, suggesting that active and repeated engagement with sound changes neural function. Copyright © 2014 the authors 0270-6474/14/3411913-06$15.00/0.

  9. Difficult airway response team: a novel quality improvement program for managing hospital-wide airway emergencies.

    Science.gov (United States)

    Mark, Lynette J; Herzer, Kurt R; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I; Berkow, Lauren C; Haut, Elliott R; Hillel, Alexander T; Miller, Christina R; Feller-Kopman, David J; Schiavi, Adam J; Xie, Yanjun J; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W; Mirski, Marek A

    2015-07-01

    Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. We developed a quality improvement program-the Difficult Airway Response Team (DART)-to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had 3 core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a Web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index >40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty

  10. Exercise training programs to improve hand rim wheelchair propulsion capacity: a systematic review.

    Science.gov (United States)

    Zwinkels, Maremka; Verschuren, Olaf; Janssen, Thomas Wj; Ketelaar, Marjolijn; Takken, Tim

    2014-09-01

    An adequate wheelchair propulsion capacity is required to perform daily life activities. Exercise training may be effective to gain or improve wheelchair propulsion capacity. This review investigates whether different types of exercise training programs are effective in improving wheelchair propulsion capacity. PubMed and EMBASE databases were searched from their respective inceptions in October 2013. Exercise training studies with at least one outcome measure regarding wheelchair propulsion capacity were included. In this study wheelchair propulsion capacity includes four parameters to reflect functional wheelchair propulsion: cardio-respiratory fitness (aerobic capacity), anaerobic capacity, muscular fitness and mechanical efficiency. Articles were not selected on diagnosis, training type or mode. Studies were divided into four training types: interval, endurance, strength, and mixed training. Methodological quality was rated with the PEDro scale, and the level of evidence was determined. The 21 included studies represented 249 individuals with spinal-cord injury (50%), various diagnoses like spina bifida (4%), cerebral palsy (2%), traumatic injury, (3%) and able-bodied participants (38%). All interval training studies found a significant improvement of 18-64% in wheelchair propulsion capacity. Three out of five endurance training studies reported significant effectiveness. Methodological quality was generally poor and there were only two randomised controlled trials. Exercise training programs seem to be effective in improving wheelchair propulsion capacity. However, there is remarkably little research, particularly for individuals who do not have spinal-cord injury. © The Author(s) 2014.

  11. Improving completion rates of students in biomedical PhD programs: an interventional study.

    Science.gov (United States)

    Viđak, Marin; Tokalić, Ružica; Marušić, Matko; Puljak, Livia; Sapunar, Damir

    2017-08-25

    Analysis of graduation success at the University of Split School of Medicine PhD programs conducted in 2011 revealed that only 11% of students who enrolled and completed their graduate coursework between 1999 and 2011 earned a doctoral degree. In this prospective cohort study we evaluated and compared three PhD programs within the same medical school, where the newest program, called Translational Research in Biomedicine (TRIBE), established in the academic year 2010/11, aimed to increase the graduation rate through an innovative approach. The intervention in the new program was related to three domains: redefined recruitment strategy, strict study regulations, and changes to the curriculum. We compared performance of PhD students between the new and existing programs and analyzed their current status, time to obtain a degree (from enrolment to doctorate), age at doctorate, number of publications on which the thesis was based and the impact factor of journals in which these were published. These improvement strategies were associated with higher thesis completion rate and reduced time to degree for students enrolled in the TRIBE program. There was no change in the impact factor or number of publications that were the basis for the doctoral theses. Our study describes good practices which proved useful in the design or reform of the PhD training program.

  12. Improving employee productivity through improved health.

    Science.gov (United States)

    Mitchell, Rebecca J; Ozminkowski, Ronald J; Serxner, Seth

    2013-10-01

    The objective of this study was to estimate productivity-related savings associated with employee participation in health promotion programs. Propensity score weighting and multiple regression techniques were used to estimate savings. These techniques were adjusted for demographic and health status differences between participants who engaged in one or more telephonic health management programs and nonparticipants who were eligible for but did not engage in these programs. Employees who participated in a program and successfully improved their health care or lifestyle showed significant improvements in lost work time. These employees saved an average of $353 per person per year. This reflects about 10.3 hours in additional productive time annually, compared with similar, but nonparticipating employees. Participating in health promotion programs can help improve productivity levels among employees and save money for their employers.

  13. Measuring Performance Excellence: Key Performance Indicators for Institutions Accepted into the Academic Quality Improvement Program (AQIP)

    Science.gov (United States)

    Ballard, Paul J.

    2013-01-01

    Given growing interest in accountability and outcomes, the North Central Association's Higher Learning Commission developed a new path for accreditation, the Academic Quality Improvement Program (AQIP). The goal is to infuse continuous improvement and quality in the culture of higher education, and to blend traditional accreditation with the…

  14. Improving Deficient Listening Skills in the Language Arts Program at the Middle Grades.

    Science.gov (United States)

    Alonso, Laura

    A project developed a program for improving deficient student-to-student listening skills. The targeted population consisted of 18 seventh-grade middle school students in a culturally diverse, lower middle class community in a near-western suburb of Chicago. The problem of deficient listening skills was evident through teacher observation and…

  15. 78 FR 7476 - Airport Improvement Program

    Science.gov (United States)

    2013-02-01

    ... Airports, Airport Planning and Programming, Routing Symbol APP-501, 800 Independence Avenue SW., Room 619... Programming, Routing Symbol APP-501, 800 Independence Avenue SW., Room 619, Washington, DC 20591; between 9 a... recognition of the interest of all segments of the airport community in the AIP. The agency will consider all...

  16. A Pharmaceutical Care Program to Improve Adherence to Statin Therapy : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Eussen, Simone R. B. M.; van der Elst, Menno E.; Klungel, Olaf H.; Rompelberg, Cathy J. M.; Garssen, Johan; Oosterveld, Marco H.; de Boer, Anthonius; de Gier, Johan J.; Bouvy, Marcel L.

    2010-01-01

    BACKGROUND: Despite the well-known beneficial effects of statins, many patients do not adhere to chronic medication regimens. OBJECTIVE: To implement and assess the effectiveness of a community pharmacy based pharmaceutical care program developed to improve patients' adherence to statin therapy.

  17. Improving Phonological Awareness in Parents of Children at Risk of Literacy Difficulties: A Preliminary Evaluation of the Boost Program

    Directory of Open Access Journals (Sweden)

    Mark E. Boyes

    2017-09-01

    Full Text Available BackgroundPhonological awareness is an important skill underpinning the development of early literacy. Given the central role of parents in supporting the development of children’s early literacy skills, and that poor parental phonological awareness is associated with poorer child literacy outcomes, it is possible that improving parent phonological awareness may aid literacy development for at-risk children. This study is a preliminary evaluation of a program aiming to improve phonological awareness skills of parents in low socioeconomic status communities, and also provide these parents with strategies to support their child’s literacy development.MethodsAfter completing the program, participants were asked if it had helped them learn about how to assist their child’s reading and spelling, whether they planned on using the resources provided, and if they would be likely to attend a future workshop building on the Boost program. Phonological awareness measures (rhyme, syllable, and phoneme level, and measures of overall confidence in performance on the phonological awareness tasks, were administered both before and after attending the program.ResultsAlmost all parents indicated that the program helped with learning how to assist their child’s reading and spelling, that they would use the resources provided, and would likely attend a future workshop. Significant increases in pre- to post-program phonological awareness scores were obtained at the rhyme and phoneme level.ConclusionThe program and associated resources appear acceptable to parents in communities with high rates of literacy problems and improved parents’ phonological awareness skills. However, findings are preliminary and further evaluation using more rigorous methodologies and testing whether improvements in parents’ phonological awareness translate into better literacy outcomes for children is needed.

  18. Using Evaluability Assessment to Improve Program Evaluation for the Blue-Throated Macaw Environmental Education Project in Bolivia

    Science.gov (United States)

    Salvatierra da Silva, Daniela; Jacobson, Susan K.; Monroe, Martha C.; Israel, Glenn D.

    2016-01-01

    An evaluability assessment of a program to save a critically endangered bird helped prepare the Blue-throated Macaw Environmental Education Project for evaluation and program improvement. The evaluability assessment facilitated agreement among key stakeholders on evaluation criteria and intended uses of evaluation information in order to maximize…

  19. Increasing patient mobility through an individualized goal-centered hospital mobility program: A quasi-experimental quality improvement project.

    Science.gov (United States)

    Klein, Lisa M; Young, Daniel; Feng, Du; Lavezza, Annette; Hiser, Stephanie; Daley, Kelly N; Hoyer, Erik H

    2018-02-27

    Hospital-acquired functional decline due to decreased mobility has negative impacts on patient outcomes. Current nurse-directed mobility programs lack a standardized approach to set achievable mobility goals. We aimed to describe implementation and outcomes from a nurse-directed patient mobility program. The quality improvement mobility program on the project unit was compared to a similar control unit providing usual care. The Johns Hopkins Mobility Goal Calculator was created to guide a daily patient mobility goal based on the level of mobility impairment. On the project unit, patient mobility increased from 5.2 to 5.8 on the Johns Hopkins Highest Level of Mobility score, mobility goal attainment went from 54.2% to 64.2%, and patients exceeding the goal went from 23.3% to 33.5%. All results were significantly higher than the control unit. An individualized, nurse-directed, patient mobility program using daily mobility goals is a successful strategy to improve daily patient mobility in the hospital. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program.

    Science.gov (United States)

    Perry, Cary

    2008-07-23

    This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH) and will be published article-by-article over the next few weeks. The third article presents a successful application in Mozambique of a leadership development program created by Management Sciences for Health (MSH). Through this program, managers from 40 countries have learned to work in teams to identify their priority challenges and act to implement effective responses. From 2003 to 2004, 11 health units in Nampula Province, participated in a leadership and management development program called the Challenges Program. This was following an assessment which found that the quality of health services was poor, and senior officials determined that the underlying cause was the lack of human resource capacity in leadership and management in a rapidly decentralizing health care system. The program was funded by the US Agency for International Development (USAID) and implemented in partnership between the Mozambican Ministry of Health (MOH) Provincial Directorate in Nampula and Management Sciences for Health (MSH). The Challenges Program used simple management and leadership tools to assist the health units and their communities to address health service challenges. An evaluation of the program in 2005 showed that 10 of 11 health centers improved health services over the year of the program. The Challenges Program used several strategies that contributed to successful outcomes. It integrated leadership strengthening into the day-to-day challenges that staff were facing in the health units. The second success factor in the Challenges Program was the creation of participatory teams. After the program, people no longer waited passively to be trained but instead proactively requested training in needed areas. MOH workers in Nampula reported

  1. Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program

    Directory of Open Access Journals (Sweden)

    Perry Cary

    2008-07-01

    Full Text Available Abstract This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH and will be published article-by-article over the next few weeks. The third article presents a successful application in Mozambique of a leadership development program created by Management Sciences for Health (MSH. Through this program, managers from 40 countries have learned to work in teams to identify their priority challenges and act to implement effective responses. From 2003 to 2004, 11 health units in Nampula Province, participated in a leadership and management development program called the Challenges Program. This was following an assessment which found that the quality of health services was poor, and senior officials determined that the underlying cause was the lack of human resource capacity in leadership and management in a rapidly decentralizing health care system. The program was funded by the US Agency for International Development (USAID and implemented in partnership between the Mozambican Ministry of Health (MOH Provincial Directorate in Nampula and Management Sciences for Health (MSH. The Challenges Program used simple management and leadership tools to assist the health units and their communities to address health service challenges. An evaluation of the program in 2005 showed that 10 of 11 health centers improved health services over the year of the program. The Challenges Program used several strategies that contributed to successful outcomes. It integrated leadership strengthening into the day-to-day challenges that staff were facing in the health units. The second success factor in the Challenges Program was the creation of participatory teams. After the program, people no longer waited passively to be trained but instead proactively requested training in needed areas. MOH workers

  2. Improving Attendance and Retention in Out-of-School Time Programs. Research-to-Results Practitioner Insights. Publication # 2007-17

    Science.gov (United States)

    Kennedy, Elena; Wilson, Brooke; Valladares, Sherylls; Bronte-Tinkew, Jacinta

    2007-01-01

    Regular participation in out-of-school time activities is associated with benefits for children. However, children cannot reap the benefits of program participation if they do not attend programs in the first place. This brief focuses on ways in which out-of-school time programs can improve the attendance and retention of children and youth in…

  3. A program of physical activity improves gait impairment in people with Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Diego Orcioli-Silva

    2018-03-01

    Full Text Available Abstract AIM This study aimed to identify the effects of aging and Alzheimer’s disease (AD on gait parameters after a four-month period and to investigate the effects of a four-month program of physical activity, with emphasis on the cognitive components of gait during single and dual task, in people with AD. METHODS Twenty-three people with AD, divided into the Training Group (TG; n=12; aged 79.17±7.62 years and the Control Group (CG; n=11; aged 77.00±5.57 years, and eleven healthy older adults (Healthy Group - HG; aged 75.82±4.83 years were included in this study. TG participated in a physical activity program for four months. The CG and HG were instructed not to participate in any kind of regular physical activity in this period. The physical activity program includes motor activities and cognitive tasks simultaneously. The participants attended a 1-h session three times a week. The kinematic parameters of gait were analyzed under two conditions, before and after a physical activity program: single and dual task. Deltas for all dependent variables between pre and post training were calculated. The deltas were compared using two-way ANOVAs with group (TG x CG and CG x HG and task (single x dual task as factors, with repeated measures for task. RESULTS After the training period, the TG improved stride length, duration, velocity and cadence compared to the CG. CONCLUSION Physical activity with emphasis on cognitive components promotes better reallocation of attention while walking in people with AD, improving attentional focus on the gait and thus resulting in a safer locomotive pattern.

  4. Improvement of gross motor and cognitive abilities by an exercise training program: three case reports

    Directory of Open Access Journals (Sweden)

    Alesi M

    2014-03-01

    Full Text Available Marianna Alesi,1 Giuseppe Battaglia,2 Michele Roccella,1 Davide Testa,1 Antonio Palma,2 Annamaria Pepi1 1Department of Psychology, 2Department of Law, Social and Sport Science, University of Palermo, Palermo, Italy Background: This work examined the efficacy of an integrated exercise training program (coach and family in three children with Down syndrome to improve their motor and cognitive abilities, in particular reaction time and working memory. Methods: The integrated exercise training program was used in three children with Down syndrome, comprising two boys (M1, with a chronological age of 10.3 years and a mental age of 4.7 years; M2, with a chronological age of 14.6 years and a mental age of less than 4 years and one girl (F1, chronological age 14.0 years and a mental age of less than 4 years. Results: Improvements in gross motor ability scores were seen after the training period. Greater improvements in task reaction time were noted for both evaluation parameters, ie, time and omissions. Conclusion: There is a close interrelationship between motor and cognitive domains in individuals with atypical development. There is a need to plan intervention programs based on the simultaneous involvement of child and parents and aimed at promoting an active lifestyle in individuals with Down syndrome. Keywords: disability, Down syndrome, gross motor abilities, cognitive abilities, physical activity

  5. Effectiveness of blood pressure educational and evaluation program for the improvement of measurement accuracy among nurses.

    Science.gov (United States)

    Rabbia, Franco; Testa, Elisa; Rabbia, Silvia; Praticò, Santina; Colasanto, Claudia; Montersino, Federica; Berra, Elena; Covella, Michele; Fulcheri, Chiara; Di Monaco, Silvia; Buffolo, Fabrizio; Totaro, Silvia; Veglio, Franco

    2013-06-01

    To assess the procedure for measuring blood pressure (BP) among hospital nurses and to assess if a training program would improve technique and accuracy. 160 nurses from Molinette Hospital were included in the study. The program was based upon theoretical and practical lessons. It was one day long and it was held by trained nurses and physicians who have practice in the Hypertension Unit. An evaluation of nurses' measuring technique and accuracy was performed before and after the program, by using a 9-item checklist. Moreover we calculated the differences between measured and effective BP values before and after the training program. At baseline evaluation, we observed inadequate performance on some points of clinical BP measurement technique, specifically: only 10% of nurses inspected the arm diameter before placing the cuff, 4% measured BP in both arms, 80% placed the head of the stethoscope under the cuff, 43% did not remove all clothing that covered the location of cuff placement, did not have the patient seat comfortably with his legs uncrossed and with his back and arms supported. After the training we found a significant improvement in the technique for all items. We didn't observe any significant difference of measurement knowledge between nurses working in different settings such as medical or surgical departments. Periodical education in BP measurement may be required, and this may significantly improve the technique and consequently the accuracy.

  6. Cost-benefit comparisons of investments in improved water supply and cholera vaccination programs.

    Science.gov (United States)

    Jeuland, Marc; Whittington, Dale

    2009-05-18

    This paper presents the first cost-benefit comparison of improved water supply investments and cholera vaccination programs. Specifically, we compare two water supply interventions -- deep wells with public hand pumps and biosand filters (an in-house, point-of-use water treatment technology) -- with two types of cholera immunization programs with new-generation vaccines -- general community-based and targeted and school-based programs. In addition to these four stand-alone investments, we also analyze five combinations of water and vaccine interventions: (1) borehole+hand pump and community-based cholera vaccination, (2) borehole+hand pump and school-based cholera vaccination, (3) biosand filter and community-based cholera vaccination, (4) biosand filter and school-based cholera vaccination, and (5) biosand filter and borehole+hand pump. Using recent data applicable to developing country locations for parameters such as disease incidence, the effectiveness of vaccine and water supply interventions against diarrheal diseases, and the value of a statistical life, we construct cost-benefit models for evaluating these interventions. We then employ probabilistic sensitivity analysis to estimate a frequency distribution of benefit-cost ratios for all four interventions, given a wide variety of possible parameter combinations. Our results demonstrate that there are many plausible conditions in developing countries under which these interventions will be attractive, but that the two improved water supply interventions and the targeted cholera vaccination program are much more likely to yield attractive cost-benefit outcomes than a community-based vaccination program. We show that implementing community-based cholera vaccination programs after borehole+hand pump or biosand filters have already been installed will rarely be justified. This is especially true when the biosand filters are already in place, because these achieve substantial cholera risk reductions on their own

  7. Initial results from the Auto/Oil Air Quality Improvement Research Program

    International Nuclear Information System (INIS)

    McCabe, L.J.

    1993-01-01

    The Auto/Air Quality Improvement Research Program (AQIRP), a cooperative effort by the three major US auto companies and fourteen oil companies, is the most comprehensive research effort ever undertaken to develop data on the air quality effects of the use of various motor fuels in various automotive systems and the relative cost-effectiveness of various fuel/vehicle combinations. Phase 1 of the Program, at a cost of about $15 million, is examining emissions and air quality impacts from current and older vehicles using reformulated gasolines with widely different values of aromatics content, olefin content, oxygenate content and type, sulfur content, vapor pressure (RVP) and 90% distillation temperature. Emissions from Flexible and Variable Fuel vehicles using methanol/gasoline mixtures are also being examined. A second phase with a $25 million budget over three years has also been approved. Initial findings for the Phase 1 study and Phase 2 plans are presented

  8. Estimating Typhoon Rainfall over Sea from SSM/I Satellite Data Using an Improved Genetic Programming

    Science.gov (United States)

    Yeh, K.; Wei, H.; Chen, L.; Liu, G.

    2010-12-01

    Estimating Typhoon Rainfall over Sea from SSM/I Satellite Data Using an Improved Genetic Programming Keh-Chia Yeha, Hsiao-Ping Weia,d, Li Chenb, and Gin-Rong Liuc a Department of Civil Engineering, National Chiao Tung University, Hsinchu, Taiwan, 300, R.O.C. b Department of Civil Engineering and Engineering Informatics, Chung Hua University, Hsinchu, Taiwan, 300, R.O.C. c Center for Space and Remote Sensing Research, National Central University, Tao-Yuan, Taiwan, 320, R.O.C. d National Science and Technology Center for Disaster Reduction, Taipei County, Taiwan, 231, R.O.C. Abstract This paper proposes an improved multi-run genetic programming (GP) and applies it to predict the rainfall using meteorological satellite data. GP is a well-known evolutionary programming and data mining method, used to automatically discover the complex relationships among nonlinear systems. The main advantage of GP is to optimize appropriate types of function and their associated coefficients simultaneously. This study makes an improvement to enhance escape ability from local optimums during the optimization procedure. The GP continuously runs several times by replacing the terminal nodes at the next run with the best solution at the current run. The current novel model improves GP, obtaining a highly nonlinear mathematical equation to estimate the rainfall. In the case study, this improved GP described above combining with SSM/I satellite data is employed to establish a suitable method for estimating rainfall at sea surface during typhoon periods. These estimated rainfalls are then verified with the data from four rainfall stations located at Peng-Jia-Yu, Don-Gji-Dao, Lan-Yu, and Green Island, which are four small islands around Taiwan. From the results, the improved GP can generate sophisticated and accurate nonlinear mathematical equation through two-run learning procedures which outperforms the traditional multiple linear regression, empirical equations and back-propagated network

  9. Cardiac autonomic function in patients with diabetes improves with practice of comprehensive yogic breathing program

    Directory of Open Access Journals (Sweden)

    Viveka P Jyotsna

    2013-01-01

    Full Text Available Background: The aim of this study was to observe the effect comprehensive yogic breathing (Sudarshan Kriya Yoga [SKY] and Pranayam had on cardiac autonomic functions in patients with diabetes. Materials and Methods: This is a prospective randomized controlled intervention trial. Cardiac autonomic functions were assessed in 64 diabetics. Patients were randomized into two groups, one group receiving standard therapy for diabetes and the other group receiving standard therapy for diabetes and comprehensive yogic breathing program. Standard therapy included dietary advice, brisk walking for 45 min daily, and administration of oral antidiabetic drugs. Comprehensive yogic breathing program was introduced to the participants through a course of 12 h spread over 3 days. It was an interactive session in which SKY, a rhythmic cyclical breathing, preceded by Pranayam is taught under the guidance of a certified teacher. Cardiac autonomic function tests were done before and after 6 months of intervention. Results: In the intervention group, after practicing the breathing techniques for 6 months, the improvement in sympathetic functions was statistically significant (P 0.04. The change in sympathetic functions in the standard therapy group was not significant (P 0.75.Parasympathetic functions did not show any significant change in either group. When both parasympathetic and sympathetic cardiac autonomic functions were considered, there was a trend toward improvement in patients following comprehensive yogic breathing program (P 0.06. In the standard therapy group, no change in cardiac autonomic functions was noted (P 0.99. Conclusion: Cardiac autonomic functions improved in patients with diabetes on standard treatment who followed the comprehensive yogic breathing program compared to patients who were on standard therapy alone.

  10. The Educational Toolbox: Kick Start Your Educational Program in Quality Improvement.

    Science.gov (United States)

    Hoffman, Rebecca L; Medbery, Rachel L; Vandermeer, Thomas J; Morris, Jon B; Kelz, Rachel R

    2015-01-01

    To disseminate materials and learning from the proceedings of the Association of Program Directors 2014 Annual Meeting workshop on the integration of quality improvement (QI) education into the existing educational infrastructure. Modern surgical practice demands an understanding of QI methodology. Yet, today׳s surgeons are not formally educated in QI methodology. Therefore, it is hard to follow the historical mantra of "see one, do one, teach one" in the quality realm. Participants were given a brief introduction to QI approaches. A number of concrete examples of how to incorporate QI education into training programs were presented, followed by a small group session focused on the identification of barriers to incorporation. Participants were provided with a worksheet to help navigate the initial incorporation of QI education in 3 steps. Participants were representative of all types of training programs, with differing levels of existing QI integration. Barriers to QI education included lack of resident interest/buy-in, concerns over the availability of educational resources (i.e., limited time to devote to QI), and a limited QI knowledge among surgical educators. The 3 steps to kick starting the educational process included (1) choosing a specific method of QI education, (2) incorporation via barrier, infrastructure, and stakeholder identification, and (3) implementation and ongoing assessment. Recent changes in the delivery of surgical care along with the new accreditation system have necessitated the development of QI education programs for use in surgical education. To continue to make surgery safer and ensure optimal patient outcomes, surgical educators must teach each resident to adopt quality science methodology in a meaningful way. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. EFFECT OF A TRAINING PROGRAM ON THE IMPROVEMENT OF BASKETBALL PLAYERS' DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Francisco Alarc\\u00F3n

    2009-01-01

    Full Text Available The aim of this study was to analyse whether a tactical training program based on a constructivist model can improve decision making related to keeping control of the ball for a men's senior basketball team composed of ten players. The dependent variables were: player distribution around the ball, and achieving support on both sides of the ball at an effective passing distance. Data collection was made through observational analysis utilizing a previously validated tool. A pretest-posttest design without a control group was used. Results demonstrated an improvement in decision making after the posttest for both the number of support players near the player with the ball, as it increased from 85% in the pretest to 100% in the posttest, and the number of collective or team actions around the player with the ball (from 5% to 76.5% with highly significant differences. The primary conclusion is that a training program for teaching team tactics based on a constructivist model has a positive influence on players' capability to facilitate the pass to their teammates.

  12. Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system

    Directory of Open Access Journals (Sweden)

    Yano Elizabeth M

    2009-11-01

    Full Text Available Abstract Background Implementing quality improvement programs that require behavior change on the part of health care professionals and patients has proven difficult in routine care. Significant randomized trial evidence supports creating fall prevention programs for community-dwelling older adults, but adoption in routine care has been limited. Nationally-collected data indicated that our local facility could improve its performance on fall prevention in community-dwelling older people. We sought to develop a sustainable local fall prevention program, using theory to guide program development. Methods We planned program development to include important stakeholders within our organization. The theory-derived plan consisted of 1 an initial leadership meeting to agree on whether creating a fall prevention program was a priority for the organization, 2 focus groups with patients and health care professionals to develop ideas for the program, 3 monthly workgroup meetings with representatives from key departments to develop a blueprint for the program, 4 a second leadership meeting to confirm that the blueprint developed by the workgroup was satisfactory, and also to solicit feedback on ideas for program refinement. Results The leadership and workgroup meetings occurred as planned and led to the development of a functional program. The focus groups did not occur as planned, mainly due to the complexity of obtaining research approval for focus groups. The fall prevention program uses an existing telephonic nurse advice line to 1 place outgoing calls to patients at high fall risk, 2 assess these patients' risk factors for falls, and 3 triage these patients to the appropriate services. The workgroup continues to meet monthly to monitor the progress of the program and improve it. Conclusion A theory-driven program development process has resulted in the successful initial implementation of a fall prevention program.

  13. Structural Aging Program approach to providing an improved basis for aging management of safety-related concrete structures

    International Nuclear Information System (INIS)

    Naus, D.J.; Oland, C.B.; Ellingwood, B.

    1993-01-01

    The Structural Aging (SAG) Program is being conducted at the Oak Ridge National Laboratory (ORNL) for the United States Nuclear Regulatory Commission (USNRC). The SAG Program is addressing the aging management of safety-related concrete structures in nuclear power plants for the purpose of providing improved technical bases for their continued service. The program is organized into four tasks: Program Management, Materials Property Data Base, Structural Component Assessment/Repair Technologies, and Quantitative Methodology for Continued Service Determinations. Objectives and a summary of recent accomplishments under each of these tasks are presented

  14. Does a competitive voucher program for adolescents improve the quality of reproductive health care? A simulated patient study in Nicaragua

    Directory of Open Access Journals (Sweden)

    Gorter Anna C

    2006-08-01

    Full Text Available Abstract Background Little is known about how sexual and reproductive (SRH health can be made accessible and appropriate to adolescents. This study evaluates the impact and sustainability of a competitive voucher program on the quality of SRH care for poor and underserved female adolescents and the usefulness of the simulated patient (SP method for such evaluation. Methods 28,711 vouchers were distributed to adolescents in disadvantaged areas of Managua that gave free-of-charge access to SRH care in 4 public, 10 non-governmental and 5 private clinics. Providers received training and guidelines, treatment protocols, and financial incentives for each adolescent attended. All clinics were visited by female adolescent SPs requesting contraception. SPs were sent one week before, during (with voucher and one month after the intervention. After each consultation they were interviewed with a standardized questionnaire. Twenty-one criteria were scored and grouped into four categories. Clinics' scores were compared using non-parametric statistical methods (paired design: before-during and before-after. Also the influence of doctors' characteristics was tested using non-parametric statistical methods. Results Some aspects of service quality improved during the voucher program. Before the program started 8 of the 16 SPs returned 'empty handed', although all were eligible contraceptive users. During the program 16/17 left with a contraceptive method (p = 0.01. Furthermore, more SPs were involved in the contraceptive method choice (13/17 vs.5/16, p = 0.02. Shared decision-making on contraceptive method as well as condom promotion had significantly increased after the program ended. Female doctors had best scores before- during and after the intervention. The improvements were more pronounced among male doctors and doctors older than 40, though these improvements did not sustain after the program ended. Conclusion This study illustrates provider

  15. CMAQ and NPS : exploring the applicability of the Congestion Mitigation and Air Quality Improvement program to NPS transit

    Science.gov (United States)

    2014-03-06

    The Congestion Mitigation and Air Quality Improvement (CMAQ) Program is a funding program that was most recently : re-authorized in Moving Ahead for Progress in the 21st Century. CMAQ offers a potential funding opportunity for NPS park units : with e...

  16. Healthcare team training programs aimed at improving depression management in primary care: A systematic review.

    Science.gov (United States)

    Vöhringer, Paul A; Castro, Ariel; Martínez, Pablo; Tala, Álvaro; Medina, Simón; Rojas, Graciela

    2016-08-01

    Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement.

    Science.gov (United States)

    Block, Lauren; Flynn, Sarah J; Cooper, Lisa A; Lentz, Caroline; Hull, Tammie; Dietz, Katherine B; Boonyasai, Romsai T

    2018-01-10

    The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners' knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression. All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm. We designed, implemented, and evaluated a web-based educational program to improve knowledge, skills, and attitudes in blood pressure measurement and use of an automated device among nurses and medical assistants in ambulatory care. The program reinforced knowledge related to recommended blood pressure measurement technique

  18. A case study in R and D productivity: Helping the program manager cope with job stress and improve communication effectiveness

    Science.gov (United States)

    Bodensteiner, W. D.; Gerloff, E. A.

    1985-01-01

    Certain structural changes in the Naval Material Command which resulted from a comparison of its operations to those of selected large-scale private sector companies are described. Central to the change was a reduction in the number of formal reports from systems commands to headquarters, and the provision of Program Management Assistance Teams (at the request of the program manager) to help resolve project problems. It is believed that these changes improved communication and information-processing, reduced program manager stress, and resulted in improved productivity.

  19. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

    Directory of Open Access Journals (Sweden)

    Candida Graham

    2014-01-01

    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  20. A virtual reality-integrated program for improving social skills in patients with schizophrenia: a pilot study.

    Science.gov (United States)

    Rus-Calafell, Mar; Gutiérrez-Maldonado, José; Ribas-Sabaté, Joan

    2014-03-01

    Social skills training (SST) intervention has shown its efficacy to improve social dysfunction in patients with psychosis; however the implementation of new skills into patients' everyday functioning is difficult to achieve. In this study, we report results from the application of a virtual reality (VR) integrated program as an adjunct technique to a brief social skills intervention for patients with schizophrenia. It was predicted that the intervention would improve social cognition and performance of patients as well as generalisation of the learned responses into patient's daily life. Twelve patients with schizophrenia or schizoaffective disorder completed the study. They attended sixteen individual one-hour sessions, and outcome assessments were conducted at pre-treatment, post-treatment and four-month follow-up. The results of a series of repeated measures ANOVA revealed significant improvement in negative symptoms, psychopathology, social anxiety and discomfort, avoidance and social functioning. Objective scores obtained through the use of the VR program showed a pattern of learning in emotion perception, assertive behaviours and time spent in a conversation. Most of these gains were maintained at four-month follow-up. The reported results are based on a small, uncontrolled pilot study. Although there was an independent rater for the self-reported and informant questionnaires, assessments were not blinded. The results showed that the intervention may be effective for improving social dysfunction. The use of the VR program contributed to the generalisation of new skills into the patient's everyday functioning. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Improving energy efficiency and smart grid program analysis with agent-based end-use forecasting models

    International Nuclear Information System (INIS)

    Jackson, Jerry

    2010-01-01

    Electric utilities and regulators face difficult challenges evaluating new energy efficiency and smart grid programs prompted, in large part, by recent state and federal mandates and financial incentives. It is increasingly difficult to separate electricity use impacts of individual utility programs from the impacts of increasingly stringent appliance and building efficiency standards, increasing electricity prices, appliance manufacturer efficiency improvements, energy program interactions and other factors. This study reviews traditional approaches used to evaluate electric utility energy efficiency and smart-grid programs and presents an agent-based end-use modeling approach that resolves many of the shortcomings of traditional approaches. Data for a representative sample of utility customers in a Midwestern US utility are used to evaluate energy efficiency and smart grid program targets over a fifteen-year horizon. Model analysis indicates that a combination of the two least stringent efficiency and smart grid program scenarios provides peak hour reductions one-third greater than the most stringent smart grid program suggesting that reductions in peak demand requirements are more feasible when both efficiency and smart grid programs are considered together. Suggestions on transitioning from traditional end-use models to agent-based end-use models are provided.

  2. IESIP - AN IMPROVED EXPLORATORY SEARCH TECHNIQUE FOR PURE INTEGER LINEAR PROGRAMMING PROBLEMS

    Science.gov (United States)

    Fogle, F. R.

    1994-01-01

    IESIP, an Improved Exploratory Search Technique for Pure Integer Linear Programming Problems, addresses the problem of optimizing an objective function of one or more variables subject to a set of confining functions or constraints by a method called discrete optimization or integer programming. Integer programming is based on a specific form of the general linear programming problem in which all variables in the objective function and all variables in the constraints are integers. While more difficult, integer programming is required for accuracy when modeling systems with small numbers of components such as the distribution of goods, machine scheduling, and production scheduling. IESIP establishes a new methodology for solving pure integer programming problems by utilizing a modified version of the univariate exploratory move developed by Robert Hooke and T.A. Jeeves. IESIP also takes some of its technique from the greedy procedure and the idea of unit neighborhoods. A rounding scheme uses the continuous solution found by traditional methods (simplex or other suitable technique) and creates a feasible integer starting point. The Hook and Jeeves exploratory search is modified to accommodate integers and constraints and is then employed to determine an optimal integer solution from the feasible starting solution. The user-friendly IESIP allows for rapid solution of problems up to 10 variables in size (limited by DOS allocation). Sample problems compare IESIP solutions with the traditional branch-and-bound approach. IESIP is written in Borland's TURBO Pascal for IBM PC series computers and compatibles running DOS. Source code and an executable are provided. The main memory requirement for execution is 25K. This program is available on a 5.25 inch 360K MS DOS format diskette. IESIP was developed in 1990. IBM is a trademark of International Business Machines. TURBO Pascal is registered by Borland International.

  3. Pediatric Diabetes Telemedicine Program Improves Access to Care for Rural Families: Role of APRNs.

    Science.gov (United States)

    Smith, Nancy Marie; Satyshur, Rosemarie DiMauro

    2016-01-01

    Type 1 diabetes mellitus has increased in children by 23% from 2001 to 2009. Rural communities additionally have increased disparities related to access barriers and a large minority population with poorer overall health. Research evidence supports telemedicine as an effective alternative to bring preventive diabetes care to remote areas. This article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program at a rural pediatric outpatient specialty clinic in partnership with a tertiary center telemedicine network. The telemedicine program quality improvement (QI) project explored caregiver satisfaction with a convenience sample of caregivers (N = 14) using a nine-item Telemedicine Diabetes Caregiver Satisfaction Survey (TDCSS), with responses ranging from 1 = strongly disagree to 5 = strongly agree. Findings indicate caregivers were highly satisfied with communication/ privacy (M = 4.8), access to care (M = 4.1), and quality of services (M = 5.0). The multidisciplinary collaborative teamwork, continuous QI, and dependable technology were integral to the quality of the telemedicine clinical initiative. APRNs provided technology expertise, interdisciplinary collaboration leadership, care coordination, and advocacy for policy changes. Results demonstrate that telemedicine and APRN leadership can help implement innovative programs into rural communities to improve access to care, healthcare cost, and outcomes.

  4. Use of a Behavioral Art Program to Improve Social Skills of Two Children with Autism Spectrum Disorders

    Science.gov (United States)

    Chou, Wan-Chi; Lee, Gabrielle T.; Feng, Hua

    2016-01-01

    The purpose of this study was to investigate the effectiveness of a behavioral art program in improving social skills for two children with autism in group settings. A multiple probe design across behaviors was used. The results indicated that for both children, the program increased the percentages of spontaneous verbal communications,…

  5. Clinical improvements are not explained by changes in tendon structure on UTC following an exercise program for patellar tendinopathy.

    Science.gov (United States)

    van Ark, Mathijs; Rio, Ebonie; Cook, Jill; van den Akker-Scheek, Inge; Gaida, James E; Zwerver, Johannes; Docking, Sean

    2018-04-11

    The aim of this study was to investigate the effects of a 4-week in-season exercise program of isometric or isotonic exercises on tendon structure and dimensions as quantified by Ultrasound Tissue Characterization (UTC). Randomized clinical trial. Volleyball and basketball players (16-31 years, n=29) with clinically diagnosed patellar tendinopathy were randomized to a 4-week isometric or isotonic exercise program. The programs were designed to decrease patellar tendon pain. A baseline and 4-week UTC scan was used to evaluate change in tendon structure. No significant change in tendon structure or dimensions on UTC was detected after the exercise program, despite patellar tendinopathy symptoms improving. The percentage and mean cross-sectional area (mCSA) of aligned fibrillar structure (echo-types I+II) (Z=-0.414,p=0.679) as well as disorganized structure (echo-types III + IV) (Z=-0.370,p=0.711) did not change over the 4-week exercise program. Change in tendon structure and dimensions on UTC did not differ significantly between the groups. Structural properties and dimensions of the patellar tendon on UTC did not change after a 4-week isometric or isotonic exercise program for athletes with patellar tendinopathy in-season, despite an improvement of symptoms. It seems that structural improvements are not required for a positive clinical outcome.

  6. Quality and productivity improvement program (PPKP) from alumni perspective

    Science.gov (United States)

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

    Defining the quality of the university education system is not easy. Institutions of higher education, through curriculum are hoped to provide the knowledge, wisdom and personality of students. It is questionable of how far Quality and Productivity Improvement Program (PPKP) are capable to ensure the courses offered relevant and effective in preparing the students for job market. The effectiveness of a university to undertake responsibilities and the impact given to students even after they graduate can be a measure of education quality at university. So, the quality of education can be enhanced and improved from time to time. In general, this study is aims to determine the effectiveness of PPKP's education system from the perspective of their alumni as well as their satisfaction and the importance level based on how PPKP be able to meet their needs. In overall, summary of open-ended questions from the questionnaire, Importance-Performance analysis and correlation analysis were conducted for this study. Based on result, it appears that there are still some deficiencies that can be improve, particularly in terms of teaching skills and PPKP's relationships with external organizations to enable knowledge be channel effectively. Importance-Performance analysis highlights some topics or courses that should be offered by PPKP based on their importance in industrial practice. Summary of the results of correlation analysis was found that women are more positive and not too demanding compared to men. In addition, it is found that the responsibilities and workload of the older generations, higher income and a high level of experience demands them to use and practice what they have learned during their studies at PPKP. Results of this study are hoped could be used to improve the quality of education system at PPKP.

  7. Reduced stress and improved physical functional ability in elderly with mental health problems following a horticultural therapy program.

    Science.gov (United States)

    Han, Ah-Reum; Park, Sin-Ae; Ahn, Byung-Eun

    2018-06-01

    This study aimed to determine the effects of a plant cultivation-based horticultural therapy program for elderly people with mental health problems. Pre- and post-test design with experimental and control groups. Twenty-eight elderly Korean people with mental health problems participated from April to June 2017 at a farm located in Suwon, South Korea. The participants were randomly assigned to either the control (n = 14) or horticultural therapy group (n = 14); the latter participated in once-weekly sessions of a previously designed 10-session horticultural therapy program. The pre-test occurred 1 week before starting the horticultural therapy program. The post-test was completed within 1 week after finishing the final program session. Cortisol levels were measured in saliva samples collected from both groups. The Senior Fitness Test was used to assess physical functional ability in both groups. In the horticultural therapy group, the cortisol levels decreased significantly from before to after the horticultural therapy program, and the post-test scores for six subtests of the Senior Fitness Test improved significantly. No significant improvements were seen in either measure in the control group. This study demonstrates the potential ability of horticultural therapy to improve the stress levels and physical functional abilities of elderly people with mental health problems. In future studies, it would be interesting to verify the long-term effects of this horticultural therapy program and to compare its effects with regard to sex, age, and various mental symptoms. Copyright © 2018 Elsevier Ltd. All rights reserved.

  8. Understanding an improved cookstove program in rural Mexico: An analysis from the implementers' perspective

    International Nuclear Information System (INIS)

    Troncoso, Karin; Castillo, Alicia; Merino, Leticia; Lazos, Elena; Masera, Omar R.

    2011-01-01

    The adoption of innovations in rural areas depends, among many different factors, on the way development workers approach a community. Through a qualitative research methodology this study documented the adoption of a new technology, by following an improved cookstove implementation program carried out by a Mexican NGO. This technology reduces fuel consumption and addresses health impacts of indoor air pollution caused by the widespread use of traditional biomass fuels in open fires in developing countries. Different demographic and socio-economic factors have been analyzed to explain the low success rates implementation projects have faced worldwide, but there are almost no studies that examine the problem from the perspective of implementers. The aim of this study was to understand how the different visions of the individuals involved in an implementation program affect its outcome. Findings showed that the NGO work was constrained by the need to meet the commitment with sponsors. The adoption rates did not change between the first and the second stage of the project, even though the approach towards users was very different. A lack of a shared vision among the work team towards the project was found and the existence of two main perspectives among program workers—broadly described as people-centered and technology-centered—, gave place to differences in attitudes towards the program. - Highlights: ► This study assesses a Mexican NGO ICS implementation program that followed three distinct approaches. ► The first two had similar adoption rates despite their different approaches towards the users. ► An improvement in the technology proved to be more important in raising the adoption rates. ► Two visions were observed among stakeholders: people-centered and technology-centered. ► The NGO work was constrained by the need to meet the commitments with sponsors.

  9. Focus groups for developing a peer mentoring program to improve self-management in pediatric inflammatory bowel disease.

    Science.gov (United States)

    Mackner, Laura M; Ruff, Jessica M; Vannatta, Kathryn

    2014-10-01

    Inflammatory bowel disease (IBD) presents challenges for self-management in many areas. A peer mentoring program may offer advantages over other forms of self-management interventions because youth may be more receptive to learning self-management skills from a peer than from a parent or professional. The purpose of the present study was to identify themes from focus groups to inform development of a peer mentoring program for improving self-management in pediatric IBD. Focus groups were conducted for youth ages 12 to 17, stratified by age (3 groups; n = 14), young adults ages 18 to 20 (1 group; n = 5), and parents of the youth (3 groups; n = 17). Broad questions covered program goals, general program characteristics, mentor/mentee characteristics, and family involvement, and transcriptions were analyzed via directed content analysis, with the a priori codes specified as the broad questions above. Participants identified the primary goals of a program as support, role model, information/education, and fun. They described a program that would include a year-long, 1-on-1 mentor relationship with a peer who has had IBD for at least a year, educational group activities, fun activities that are not focused on IBD, expectations for in-person contact 1 to 2 times per month, and mentor-to-mentor and parent support. Many of the suggestions from the focus groups correspond with research findings associated with successful mentoring programs. Using participants' suggestions and empirically based best practices for mentoring may result in an effective peer mentoring program for improving self-management in youth with IBD.

  10. Application of Two Intervention Programs in Order to Optimize Motivation and to Improve Eating Habits in Adult and Elderly Women.

    Science.gov (United States)

    Leyton, Marta; Batista, Marco; Lobato, Susana; Aspano, Mª Isabel; Jiménez, Ruth

    2017-10-01

    The objective of this study was to analyse the effectiveness of two intervention programs: a physical exercise program with strategies to support the three basic psychological needs (autonomy, competence and relatedness); and a physical exercise program with nutritional education in order to improve the lifestyles of adult and elderly women who practiced functional maintenance. The Self-Determination Theory was applied as the theoretical framework. A sample of 135 women aged between 40 and 88 years (59.66 ± 10.76) who enrolled in a 12-week functional maintenance program and attended 24 exercise classes took part in the study. A quasi-experimental study was performed where strategies to support the three basic psychological needs were applied to one group and strategies for the improvement of eating habits were applied to the other group. No strategy was applied to the control group. The main results showed an improvement in experimental groups I and II when compared to the control group regarding the variables of autonomy, competence, intrinsic regulation, identified regulation, introjected regulation, external regulation and eating habits, after the application of the intervention programs. The conclusion is that both intervention programs were successful with this project's participants and that it is crucial to promote such intervention programs in functional maintenance classes, as they foster healthy lifestyles among participants.

  11. Application of Two Intervention Programs in Order to Optimize Motivation and to Improve Eating Habits in Adult and Elderly Women

    Directory of Open Access Journals (Sweden)

    Leyton Marta

    2017-10-01

    Full Text Available The objective of this study was to analyse the effectiveness of two intervention programs: a physical exercise program with strategies to support the three basic psychological needs (autonomy, competence and relatedness; and a physical exercise program with nutritional education in order to improve the lifestyles of adult and elderly women who practiced functional maintenance. The Self-Determination Theory was applied as the theoretical framework. A sample of 135 women aged between 40 and 88 years (59.66 ± 10.76 who enrolled in a 12-week functional maintenance program and attended 24 exercise classes took part in the study. A quasi-experimental study was performed where strategies to support the three basic psychological needs were applied to one group and strategies for the improvement of eating habits were applied to the other group. No strategy was applied to the control group. The main results showed an improvement in experimental groups I and II when compared to the control group regarding the variables of autonomy, competence, intrinsic regulation, identified regulation, introjected regulation, external regulation and eating habits, after the application of the intervention programs. The conclusion is that both intervention programs were successful with this project’s participants and that it is crucial to promote such intervention programs in functional maintenance classes, as they foster healthy lifestyles among participants.

  12. Efficacy of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP) Primary Version

    Science.gov (United States)

    DiPerna, James Clyde; Lei, Puiwa; Bellinger, Jillian; Cheng, Weiyi

    2015-01-01

    A multisite cluster randomized trial was conducted to examine the effects of the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007) on students' classroom social behavior. The final sample included 432 students across 38 second grade classrooms. Social skills and problem behaviors were measured…

  13. 25 CFR 256.14 - What are the steps that must be taken to process my application for the Housing Improvement Program?

    Science.gov (United States)

    2010-04-01

    ... to process my application for the Housing Improvement Program? (a) The servicing housing office must... 25 Indians 1 2010-04-01 2010-04-01 false What are the steps that must be taken to process my application for the Housing Improvement Program? 256.14 Section 256.14 Indians BUREAU OF INDIAN AFFAIRS...

  14. Michigan's fee-for-value physician incentive program reduces spending and improves quality in primary care.

    Science.gov (United States)

    Lemak, Christy Harris; Nahra, Tammie A; Cohen, Genna R; Erb, Natalie D; Paustian, Michael L; Share, David; Hirth, Richard A

    2015-04-01

    As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians. We analyzed the program's impact on quality and spending from 2008 to 2011 for over three million beneficiaries in over 11,000 physician practices. Participation in the incentive program was associated with approximately 1.1 percent lower total spending for adults (5.1 percent lower for children) and the same or improved performance on eleven of fourteen quality measures over time. Our findings contribute to the growing body of evidence about the potential effectiveness of models that align payment with cost and quality performance, and they demonstrate that it is possible to transform reimbursement within a fee-for-service framework to encourage and incentivize physicians to provide high-quality care, while also reducing costs. Project HOPE—The People-to-People Health Foundation, Inc.

  15. A Multicenter Performance Improvement Program Uses Rural Trauma Filters for Benchmarking: An Evaluation of the Findings.

    Science.gov (United States)

    Coniglio, Ray; McGraw, Constance; Archuleta, Mike; Bentler, Heather; Keiter, Leigh; Ramstetter, Julie; Reis, Elizabeth; Romans, Cristi; Schell, Rachael; Ross, Kelli; Smith, Rachel; Townsend, Jodi; Orlando, Alessandro; Mains, Charles W

    Colorado requires Level III and IV trauma centers to conduct a formal performance improvement program (PI), but provides limited support for program development. Trauma program managers and coordinators in rural facilities rarely have experience in the development or management of a PI program. As a result, rural trauma centers often face challenges in evaluating trauma outcomes adequately. Through a multidisciplinary outreach program, our Trauma System worked with a group of rural trauma centers to identify and define seven specific PI filters based on key program elements of rural trauma centers. This retrospective observational project sought to develop and examine these PI filters so as to enhance the review and evaluation of patient care. The project included 924 trauma patients from eight Level IV and one Level III trauma centers. Seven PI filters were retrospectively collected and analyzed by quarter in 2016: prehospital managed airway for patients with a Glasgow Coma Scale (GCS) score of less than 9; adherence to trauma team activation criteria; evidence of physician team leader presence within 20 min of activation; patient with a GCS score less than 9 in the emergency department (ED): intubated in less than 20 min; ED length of stay (LOS) less than 4 hr from patient arrival to transfer; adherence to admission criteria; documentation of GCS on arrival, discharge, or with change of status. There was a significantly increasing compliance trend toward appropriate documentation of GCS (p trend used to develop compliance thresholds, to identify areas for improvement, and create corrective action plans as necessary.

  16. West Virginia Peer Exchange : Streamlining Highway Safety Improvement Program Project Delivery - An RSPCB Peer Exchange

    Science.gov (United States)

    2014-09-01

    The West Virginia Division of Highways (WV DOH) hosted a Peer Exchange to share information and experiences for streamlining Highway Safety Improvement Program (HSIP) project delivery. The event was held September 23 to 24, 2014 in Charleston, West V...

  17. Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation.

    Science.gov (United States)

    Philippon, Donald J; Montesanti, Stephanie; Stafinski, Tania

    2018-03-01

    This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

  18. A social marketing theory-based diet-education program for women ages 54 to 83 years improved dietary status.

    Science.gov (United States)

    Francis, Sarah L; Taylor, Martha L

    2009-12-01

    Social Marketing Theory is a comprehensive approach of program development encompassing the needs and preferences of the intended audience. It was hypothesized a Social Marketing Theory-based, registered dietitian-led, in-home, cardiovascular disease-targeted diet-education program would improve the dietary status of community-residing older women. Using a randomized control group design, this 90-day program in two North Carolina counties included 58 women (30 control; 28 intervention) ages 54 to 83 years. Data were collected using the Mini Nutritional Assessment, three 3-day food records, and program evaluations. The intervention group received two individual registered dietitian-led in-home education sessions and the control group received education material mailings (Visits 2 and 3). Pretested education materials were used. Visits/mailings were scheduled 28 to 30 days apart. Variables measured included cardiovascular disease-related dietary practices and dietary status (Mini Nutritional Assessment). Data were analyzed using descriptive statistics, paired sample t tests, multivariant analyses, and independent t tests. Intervention and control Mini Nutritional Assessment scores improved (P=0.0001). Intervention subjects consumed more fiber than control (P=0.013) and reduced sodium intake (P=0.02). Controls reduced energy (P=0.01) and cholesterol intakes (P=0.029), likely because of the decreased food intake. The majority (n=51, 87.9%) rated the program as good to excellent and almost all (n=55, 94.8%) would recommend the program to a friend. The most popular features of the program were the individualized sessions (n=20, 34.5%) and diet analyses (n=11, 19%). These results suggest that cardiovascular disease diet-education materials utilizing Social Marketing Theory principles can lead to improved dietary status among community-residing older women.

  19. Difficult Airway Response Team: A Novel Quality Improvement Program for Managing Hospital-Wide Airway Emergencies

    Science.gov (United States)

    Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.

    2015-01-01

    Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous

  20. Minnesota 4-H Youth Program Quality Improvement Model

    Science.gov (United States)

    Herman, Margo; Grant, Samantha

    2015-01-01

    The University of Minnesota Extension Center for Youth Development made an organizational decision in 2011 to invest in a system-wide approach to implement youth program quality into the 4-H program using the Youth Program Quality Assessment (YPQA) tool. This article describes the four key components to the Minnesota Youth Program Quality…

  1. An overview of the United States Department of Energy Plant Lifetime Improvement Program

    International Nuclear Information System (INIS)

    Rosinski, S.T.; Clauss, J.M.; Harrison, D.L.

    2004-01-01

    Since 1985, the U.S. Department of Energy (DOE) has been working with the nuclear industry and the U.S. Nuclear Regulatory Commission (NRC) to establish and demonstrate the option to extend the life of nuclear power plants through the renewal of operating licenses. This paper focuses primarily on DOE'S Plant Lifetime Improvement (PLIM) Program efforts to develop the technical criteria and bases for effective aging management and lifetime improvement for continued operation of nuclear power plants. This paper describes current projects to resolve generic technical issues, including degradation of long-lived components, reactor pressure vessel (RPV) embrittlement management approaches, and analytical methodologies to characterize RPV integrity. (author)

  2. A pragmatic comparison of two diabetes education programs in improving type 2 diabetes mellitus outcomes.

    Science.gov (United States)

    Dorland, Katherine; Liddy, Clare

    2014-03-28

    Although it is clear that education programs constitute key elements of improved diabetes management, uncertainty exists regarding the optimal method of delivering that education. In addition to the lack of consensus regarding the most appropriate delivery methods for these programs, there is a paucity of research which evaluates these methods in terms of specific clinical outcomes. This pragmatic study compares the effectiveness of two distinct diabetes education programs in improving clinical outcomes in patients with type 2 diabetes mellitus in a primary care setting. The two diabetes education classes (n = 80 enrolled) retrospectively evaluated were 'the ABC's of Diabetes' (one 2-hour didactic teaching session) and 'Conversation Maps' (3 highly interactive weekly classes, 6 hours in total). Eligible participants (n = 32) had their charts reviewed and outcome measures (i.e., glycosylated hemoglobin levels (HbA1c), low density lipoprotein (LDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), and weight) recorded 1 year prior to and 6 months following the class. Pre- and post-class outcome measures were compared. A trend towards lower HbA1c was observed after completion of both classes, with an average reduction of 0.2%, and 0.6% after 6 months in the 'ABC's of Diabetes' class and 'Conversation Maps' class respectively. A significant decrease in weight was observed 6 months after the 'ABC's of Diabetes' class (p = 0.028), and in LDL after the 'Conversation Maps' class (p = 0.049). Patients with HbA1c ≥ 8% showed a drop of 1.1% in HbA1c 3 months after either class (p = 0.004). No significant difference in outcomes was found between the two diabetes education classes assessed. There was a trend towards improved glycemic control after both classes, and patients with high HbA1c levels demonstrated statistically significant improvements. This indicates that shorter sessions using didactic teaching methods may be equally

  3. Information Needs Perceived as Important by Leaders in Advanced Technological Education: Alignment with Community College Program Improvement Initiatives

    Science.gov (United States)

    Badway, Norena Norton; Somerville, Jerry

    2011-01-01

    The purpose of this study was to analyze what leaders of Advanced Technological Education (ATE) programs funded by the National Science Foundation believe are their most important needs for research information. Data was collected through a Delphi process, and results were analyzed through frameworks associated with program improvement initiatives…

  4. APhA 2011 REMS white paper: Summary of the REMS stakeholder meeting on improving program design and implementation.

    Science.gov (United States)

    American Pharmacists Association; Bough, Marcie

    2011-01-01

    To develop an improved risk evaluation and mitigation strategies (REMS) system for maximizing effective and safe patient medication use while minimizing burden on the health care delivery system. 34 stakeholders gathered October 6-7, 2010, in Arlington, VA, for the REMS Stakeholder Meeting, convened by the American Pharmacists Association (APhA). Participants included national health care provider associations, including representatives for physicians, physician assistants, nurses, nurse practitioners, and pharmacists, as well as representatives for patient advocates, drug distributors, community pharmacists (chain and independent), drug manufacturer associations (brand, generic, and biologic organizations), and health information technology, standards, and safety organizations. Staff from the Food and Drug Administration (FDA) Center for Drug Evaluation and Research participated as observers. The meeting built on themes from the APhA's 2009 REMS white paper. The current REMS environment presents many challenges for health care providers due to the growing number of REMS programs and the lack of standardization or similarities among various REMS programs. A standardized REMS process that focuses on maximizing patient safety and minimizing impacts on patient access and provider implementation could offset these challenges. A new process that includes effective provider interventions and standardized tools and systems for implementing REMS programs may improve patient care and overcome some of the communication issues providers and patients currently face. Metrics could be put in place to evaluate the effectiveness of REMS elements. By incorporating REMS program components into existing technologies and data infrastructures, achieving REMS implementation that is workflow neutral and minimizes administrative burden may be possible. An appropriate compensation model could ensure providers have adequate resources for patient care and REMS implementation. Overall

  5. [An oral function improvement program utilizing health behavior theories ameliorates oral functions and oral hygienic conditions of pre-frail elderly persons].

    Science.gov (United States)

    Sakaguchi, Hideo

    2014-06-01

    Oral function improvement programs utilizing health behavior theories are considered to be effective in preventing the need for long-term social care. In the present study, an oral function improvement program based upon health behavior theories was designed, and its utility was assessed in 102 pre-frail elderly persons (33 males, 69 females, mean age: 76.9 +/- 5.7) considered to be in potential need of long-term social care and attending a long-term care prevention class in Sayama City, Saitama Prefecture, Japan. The degree of improvement in oral functions (7 items) and oral hygienic conditions (3 items) was assessed by comparing oral health before and after participation in the program. The results showed statistically significant improvements in the following oral functions: (1) lip functions (oral diadochokinesis, measured by the regularity of the repetition of the syllable "Pa"), (2) tongue functions, (3) tongue root motor skills (oral diadochokinesis, measured by the regularity of the repetition of the syllables "Ta" and "Ka"), (4) tongue extension/retraction, (5) side-to-side tongue movement functions, (6) cheek motor skills, and (7) repetitive saliva swallowing test (RSST). The following measures of oral hygiene also showed a statistically significant improvement: (1) debris on dentures or teeth, (2) coated tongue, and (3) frequency of oral cleaning. These findings demonstrated that an improvement program informed by health behavior theories is useful in improving oral functions and oral hygiene conditions.

  6. A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

    Directory of Open Access Journals (Sweden)

    Rosa Ortiz-Gutiérrez

    2013-10-01

    Full Text Available Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25 received physiotherapy treatment twice a week (40 min per session. Experimental group (n = 25 received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session.The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available.

  7. A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

    Science.gov (United States)

    Ortiz-Gutiérrez, Rosa; Cano-de-la-Cuerda, Roberto; Galán-del-Río, Fernando; Alguacil-Diego, Isabel María; Palacios-Ceña, Domingo; Miangolarra-Page, Juan Carlos

    2013-01-01

    Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available. PMID:24185843

  8. Program planning for future improvement in managing ORNL's radioactive wastes

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    This report is intended to serve as a reference document and guide in developing the long-term improvements section of ORNL's radioactive waste management plan. The report reviews ORNL's operations and future program needs in terms of currently applicable DOE regulations and also in terms of regulations and accepted practices of the commerical sector of the nuclear power industry so that the impact of potential future adoption of these regulations and standards on ORNL's operations can be fully evaluated. The principal conclusion reached after reviewing ORNL's waste management operations is that these operations are currently being conducted in a manner that does not endanger the health or safety of workers or the general public and that does not have an adverse effect on the environment. Although nineteen specific problem areas have been identified all of these problems can be attributed to one of the following: a) the legacy of past practices; b) gradual deterioration of systems which have reached (or are near to reaching) the end of their reasonable design lives; and c) potential changes in regulations applicable to ORNL. All of the programs designed to improve or correct these problem areas could be accomplished within a four year period. However, given current limitations on manpower and capital, these programs would more likely be spread out over a five to ten year period of time if they were all to be undertaken. The cost of undertaking all of these projects concurrently is estimated to be between 60 and 100 million dollars. Due to the many unknowns and uncertainties associated with the problem areas, actual total costs for specific projects could vary from those presented in this report by as much as 300 percent. (DMC)

  9. An integrated approach for improving occupational health and safety management: the voluntary protection program in Taiwan.

    Science.gov (United States)

    Su, Teh-Sheng; Tsai, Way-Yi; Yu, Yi-Chun

    2005-05-01

    A voluntary compliance program for occupational health and safety management, Voluntary Protection Programs (VPP), was implemented with a strategy of cooperation and encouragement in Taiwan. Due to limitations on increasing the human forces of inspection, a regulatory-based guideline addressing the essence of Occupational Health and Safety Management Systems (OHSMS) was promulgated, which combined the resources of third parties and insurance providers to accredit a self-improving worksite with the benefits of waived general inspection and a merit contributing to insurance premium payment reduction. A designated institute accepts enterprise's applications, performs document review and organizes the onsite inspection. A final review committee of Council of Labor Affairs (CLA) confers a two-year certificate on an approved site. After ten years, the efforts have shown a dramatic reduction of occupational injuries and illness in the total number of 724 worksites granted certification. VPP worksites, in comparison with all industries, had 49% lower frequency rate in the past three years. The severity rate reduction was 80% in the same period. The characteristics of Taiwan VPP program and international occupational safety and health management programs are provided. A Plan-Do-Check-Act management cycle was employed for pursuing continual improvements to the culture fostered. The use of a quantitative measurement for assessing the performance of enterprises' occupational safety and health management showed the efficiency of the rating. The results demonstrate that an employer voluntary protection program is a promising strategy for a developing country.

  10. Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

    Science.gov (United States)

    Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

    2018-04-01

    The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

  11. Balance improvements in female high school basketball players after a 6-week neuromuscular-training program.

    Science.gov (United States)

    McLeod, Tamara C Valovich; Armstrong, Travis; Miller, Mathew; Sauers, Jamie L

    2009-11-01

    Poor balance has been associated with increased injury risk among athletes. Neuromuscular-training programs have been advocated as a means of injury prevention, but little is known about the benefits of these programs on balance in high school athletes. To determine whether there are balance gains after participation in a neuromuscular-training program in high school athletes. Nonrandomized controlled trial. All data were collected at each participating high school before and after a 6-wk intervention or control period. 62 female high school basketball players recruited from the local high school community and assigned to a training (n = 37) or control (n = 25) group. Training-group subjects participated in a 6-wk neuromuscular-training program that included plyometric, functional-strengthening, balance, and stability-ball exercises. Data were collected for the Balance Error Scoring System (BESS) and Star Excursion Balance Test (SEBT) before and after the 6-wk intervention or control period. The authors found a significant decrease in total BESS errors in the trained group at the posttest compared with their pretest and the control group (P = .003). Trained subjects also scored significantly fewer BESS errors on the single-foam and tandem-foam conditions at the posttest than the control group and demonstrated improvements on the single-foam compared with their pretest (P = .033). The authors found improvements in reach in the lateral, anteromedial, medial, and posterior directions in the trained group at the posttest compared with the control group (P training program can increase the balance and proprioceptive capabilities of female high school basketball players and that clinical balance measures are sensitive to detect these differences.

  12. Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

    Science.gov (United States)

    McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

    2012-10-01

    To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management

  13. A Cluster Randomized Trial of the Social Skills Improvement System-Classwide Intervention Program (SSIS-CIP) in First Grade

    Science.gov (United States)

    DiPerna, James Clyde; Lei, Puiwa; Cheng, Weiyi; Hart, Susan Crandall; Bellinger, Jillian

    2018-01-01

    The purpose of this study was to evaluate the efficacy of a universal social skills program, the Social Skills Improvement System Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007), for students in first grade. Classrooms from 6 elementary schools were randomly assigned to treatment or business-as-usual control conditions.…

  14. Beyond quality improvement: exploring why primary care teams engage in a voluntary audit and feedback program.

    Science.gov (United States)

    Wagner, Daniel J; Durbin, Janet; Barnsley, Jan; Ivers, Noah M

    2017-12-02

    Despite its popularity, the effectiveness of audit and feedback in support quality improvement efforts is mixed. While audit and feedback-related research efforts have investigated issues relating to feedback design and delivery, little attention has been directed towards factors which motivate interest and engagement with feedback interventions. This study explored the motivating factors that drove primary care teams to participate in a voluntary audit and feedback initiative. Interviews were conducted with leaders of primary care teams who had participated in at least one iteration of the audit and feedback program. This intervention was developed by an organization which advocates for high-quality, team-based primary care in Ontario, Canada. Interview transcripts were coded using the Consolidated Framework for Implementation Research and the resulting framework was analyzed inductively to generate key themes. Interviews were completed with 25 individuals from 18 primary care teams across Ontario. The majority were Executive Directors (14), Physician leaders (3) and support staff for Quality Improvement (4). A range of motivations for participating in the audit and feedback program beyond quality improvement were emphasized. Primarily, informants believed that the program would eventually become a best-in-class audit and feedback initiative. This reflected concerns regarding existing initiatives in terms of the intervention components and intentions as well as the perception that an initiative by primary care, for primary care would better reflect their own goals and better support desired patient outcomes. Key enablers included perceived obligations to engage and provision of support for the work involved. No teams cited an evidence base for A&F as a motivating factor for participation. A range of motivating factors, beyond quality improvement, contributed to participation in the audit and feedback program. Findings from this study highlight that efforts to

  15. Program management plan for the conduct of a research, development, and demonstration program for improving the safety of nuclear powerplants

    International Nuclear Information System (INIS)

    1981-12-01

    Congress passed Public Law 96-567, Nuclear Safety Research, Development, and Demonstration Act of 1980, (hereafter referred to as the Act) to provide for an accelerated and coordinated program of light water reactor safety research, development, and demonstration to be carried out by the Department of Energy. In order to assure that this program would be compatible with the needs of Nuclear Regulatory Commission (NRC) and industry, the Department of Energy (DOE) initiated its response to Section 4 of the Act by conducting individual information gathering meetings with NRC and a wide cross section of the nuclear industry. The Department received recommendations on needs of what type of activities would and would not be appropriate for the Department to assist in satisfying these needs. Based on the evaluation of these inputs, it is concluded that the Department's ongoing Light Water Reactor (LWR) safety program is responsive to the Act. Specifically, the Department's ongoing program includes tasks in the areas of regulatory assessment, risk assessment, fission product source term, and emergency preparedness as well as providing technical assistance to the Institute of Nuclear Power Operations (INPO) to improve training of nuclear power personnel. These were among the very high priority efforts that were identified as necessary and appropriate for support by the Department

  16. A crew resource management program tailored to trauma resuscitation improves team behavior and communication.

    Science.gov (United States)

    Hughes, K Michael; Benenson, Ronald S; Krichten, Amy E; Clancy, Keith D; Ryan, James Patrick; Hammond, Christopher

    2014-09-01

    Crew Resource Management (CRM) is a team-building communication process first implemented in the aviation industry to improve safety. It has been used in health care, particularly in surgical and intensive care settings, to improve team dynamics and reduce errors. We adapted a CRM process for implementation in the trauma resuscitation area. An interdisciplinary steering committee developed our CRM process to include a didactic classroom program based on a preimplementation survey of our trauma team members. Implementation with new cultural and process expectations followed. The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tool were used to design, evaluate, and validate our CRM program. The initial trauma communication survey was completed by 160 team members (49% response). Twenty-five trauma resuscitations were observed and scored using Communication and Teamwork Skills. Areas of concern were identified and 324 staff completed our 3-hour CRM course during a 3-month period. After CRM training, 132 communication surveys and 38 Communication and Teamwork Skills observations were completed. In the post-CRM survey, respondents indicated improvement in accuracy of field to medical command information (p = 0.029); accuracy of emergency department medical command information to the resuscitation area (p = 0.002); and team leader identity, communication of plan, and role assignment (p = 0.001). After CRM training, staff were more likely to speak up when patient safety was a concern (p = 0.002). Crew Resource Management in the trauma resuscitation area enhances team dynamics, communication, and, ostensibly, patient safety. Philosophy and culture of CRM should be compulsory components of trauma programs and in resuscitation of injured patients. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Participation in a National Lifestyle Change Program is associated with improved diabetes Control outcomes.

    Science.gov (United States)

    Jackson, Sandra L; Staimez, Lisa R; Safo, Sandra; Long, Qi; Rhee, Mary K; Cunningham, Solveig A; Olson, Darin E; Tomolo, Anne M; Ramakrishnan, Usha; Narayan, Venkat K M; Phillips, Lawrence S

    2017-09-01

    Clinical trials show lifestyle change programs are beneficial, yet large-scale, successful translation of these programs is scarce. We investigated the association between participation in the largest U.S. lifestyle change program, MOVE!, and diabetes control outcomes. This longitudinal, retrospective cohort study used Veterans Health Administration databases of patients with diabetes who participated in MOVE! between 2005 and 2012, or met eligibility criteria (BMI ≥25kg/m 2 ) but did not participate. Main outcomes were diabetic eye disease, renal disease, and medication intensification. There were 400,170 eligible patients with diabetes, including 87,366 (22%) MOVE! Included patients were 96% male, 77% white, with mean age 58years and BMI 34kg/m 2 . Controlling for baseline measurements and age, race, sex, BMI, and antidiabetes medications, MOVE! participants had lower body weight (-0.6kg), random plasma glucose (-2.8mg/dL), and HbA1c (-0.1%) at 12months compared to nonparticipants (each plifestyle change programs in U.S. health systems may improve health among the growing patient population with diabetes. Published by Elsevier Inc.

  18. Comparison the Impact of Spark Motor Program and Basketball Techniques on Improving Gross Motor Skills in Educable Intellectually Disabled Boys

    Directory of Open Access Journals (Sweden)

    Hashem Faal Moghanlo

    2014-09-01

    Full Text Available Background & objectives : Different types of practises are known for improving motor skills in intellectually disabled boys. The purpose of this study was to compar e the impact of spark motor program and basketball on improving of gross motor skills in this people.   Methods: In this semi-experimental study , from 98 educable intellectually disabled students who studied in special school in Urmia, 30 children ( age range of 9 to 13 years and IQ mean 64.4 were selected objectively and divided in three groups (2 experimental and 1 control based on pre - test. BOTMP was used as a measurement of motor ability. Selected motor program (Spark motor program including strengthening training, games, sports and basketball techniques was performed for 24 sessions. T-tests (dependent and co-variance were used to comparison of results.   Results: In Spark group after 24 sessions, there were significant effects on balance (p= 0.000, bilateral coordination (p=0.000 and strength (p=0.001. There was no significant effect in agility and speed (p= 0.343 in basketball techniques group after 24 sessions, there were significant effects in agility and speed (p= 0.001, balance (p= 0.000, bilateral coordination (p= 0.013 and strength (p= 0.007.   Conclusion: Based on the results of this study, it can be claimed that the Spark program and basketball techniques improve gross motor skills in educable intellectually disabled students. We also found a significant difference between the Spark program and basketball techniques efficacy on the improved skills. Furthermore, the efficacy of Spark program was significantly higher than basketball techniques (p<0.05.

  19. Nuclear power plant life time improvement and management program in Korea

    International Nuclear Information System (INIS)

    Sung Yull Hong; Ill Seok Jeong; Taek Ho Song

    1995-01-01

    Korea Electric Power Research Institute (KEPRI) of Korea Electric Power Corporation (KEPCO) has performed a lifetime management of nuclear power plant program (LMNPP), ''Nuclear Power Plant Lifetime Management (PLIM) (I)'', since November 1993, which is a feasibility study of the Kori Unit 1 lifetime management including aging evaluation of the thirteen major components. The results of the PLIM(I) will provide information which is necessary for decision making of the Kori Unit 1 lifetime improvement. A plan of the work scope and schedule for the next phase, PLIM(II), will also be provided by this project. This paper introduced KEPRI's basic strategy of LMNPP, PLIM organization, current status, some interim results of the PLIM(I), and other related programs in Korea. So far, we have done field data survey, systems/structures screening, components prioritization, lifetime evaluation methodology study, and fracture mechanics tests of the Kori Unit 1 reactor pressure vessel surveillance coupons. Currently life assessment of the major components and PLIM economic evaluation of Kori Unit 1 are under way. (author)

  20. Improving Insider Threat Training Awareness and Mitigation Programs at Nuclear Facilities.

    Energy Technology Data Exchange (ETDEWEB)

    Abbott, Shannon [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-06-01

    In recent years, insider threat programs have become an important aspect of nuclear security, and nuclear security training courses. However, many nuclear security insider threat programs fail to address the insider threat attack and monitoring potential that exists on information technology (IT) systems. This failure is critical because of the importance of information technology and networks in today’s world. IT systems offer an opportunity to perpetrate dangerous insider attacks, but they also present an opportunity to monitor for them and prevent them. This paper suggests a number of best practices for monitoring and preventing insider attacks on IT systems, and proposes the development of a new IT insider threat tabletop that can be used to help train nuclear security practitioners on how best to implement IT insider threat prevention best practices. The development of IT insider threat best practices and a practical tabletop exercise will allow nuclear security practitioners to improve nuclear security trainings as it integrates a critical part of insider threat prevention into the broader nuclear security system.

  1. [Profile, competencies and digital fluency of nurses in the Professional Improvement Program].

    Science.gov (United States)

    Tanabe, Lyvia Pini; Kobayashi, Rika Miyahara

    2013-08-01

    A descriptive exploratory study conducted in the city of São Paulo, which aimed to identify the profile, competencies and digital fluency of nurses in the Professional Improvement Program in handling technology at work. The population, composed by 60 nurses in the program, answered a questionnaire with data about profile, digital fluency and professional competencies. The participants were found to be: 95.0% female, 61.7% between 23 and 25 years old, 75.0% from public schools, 58.3% enrolled in cardiovascular nursing, 98.3% had contact with computing resources during graduation, 100.0% had a computer at home, 86.7% accessed the internet daily, 96.7% used Messenger and 58.3% had an intermediate level of knowledge and skill in computing. Professional competencies required for technology management referred to knowing how to be innovative, creative, and updated to identify and manage software and to use technological resources.

  2. A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability

    Science.gov (United States)

    Hakim, Renée M.; Ross, Michael D.; Runco, Wendy; Kane, Michael T.

    2017-01-01

    The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants’ measures of physical performance prior to and following the 8-week aquatic exercise program, improvements were seen in all measures, but the change in scores for the 6-min walk test, 30-sec chair stand test, and the static plank test achieved statistical significance (P<0.05). An 8-week group aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility. PMID:28349039

  3. Heat stress management program improving worker health and operational effectiveness: a case study.

    Science.gov (United States)

    Huss, Rosalyn G; Skelton, Scott B; Alvis, Kimberly L; Shane, Leigh A

    2013-03-01

    Heat stress monitoring is a vital component of an effective health and safety program when employees work in exceptionally warm environments. Workers at hazardous waste sites often wear personal protective equipment (PPE), which increases the body heat stress load. No specific Occupational Safety and Health Administration (OSHA) regulations address heat stress; however, OSHA does provide several guidance documents to assist employers in addressing this serious workplace health hazard. This article describes a heat stress and surveillance plan implemented at a hazardous waste site as part of the overall health and safety program. The PPE requirement for work at this site, coupled with extreme environmental temperatures, made heat stress a significant concern. Occupational health nurses and industrial hygienists developed a monitoring program for heat stress designed to prevent the occurrence of significant heat-related illness in site workers. The program included worker education on the signs of heat-related illness and continuous physiologic monitoring to detect early signs of heat-related health problems. Biological monitoring data were collected before workers entered the exclusion zone and on exiting the zone following decontamination. Sixty-six site workers were monitored throughout site remediation. More than 1,700 biological monitoring data points were recorded. Outcomes included improved worker health and safety, and increased operational effectiveness. Copyright 2013, SLACK Incorporated.

  4. Improving CERN's Presence on Wikipedia - Project Report, Summer Student Lecture Program 2017

    CERN Document Server

    Storehaug, Ida

    2017-01-01

    Dissemination of information on high energy physics and related technologies is at the core of CERN’s mission, making research done at CERN available, both to the public and other researchers. Wikipedia, being the most used social media site for researchers and a popular source of science information for the public, is an obvious platform for CERN to be present on. Between 19 June and 25 August 2017, as part of the CERN Summer Student Program, a project to improve CERN’s presence on Wikipedia was carried out in the department of Scientific Information Service at CERN. In the following the use of references in the collection of CERN-related Wikipedia articles is discussed, and the topics of plagiarism and licenses are raised. Furthermore, methods to benefit from the CERN community and archives are described, followed by a summary of how to get a Wikipedia article accepted by the Wikipedia community. Lists of Wikipedia articles created or improved and of Wikipedia articles in need of improvement are given.

  5. Quality improvement program reduces perioperative dental injuries – A review of 64,718 anesthetic patients

    Directory of Open Access Journals (Sweden)

    Yi-Wei Kuo

    2016-12-01

    Conclusion: Dental injury incidence was significantly reduced and remained at low levels after implementation of the quality improvement program. We suggest the implementation of a standardized dental examination into the preoperative evaluation system adding pathologic teeth fixed or protected devices to minimize dental injury associated with anesthesia.

  6. Use of protoplast, cell, and shoot tip culture in an elm germ plasm improvement program

    Science.gov (United States)

    R. Daniel Lineberger; M.B. Sticklen; P.M. Pijut; Mark A. Kroggel; C.V.M. Fink; S.C. Domir

    1990-01-01

    An elm germplasm improvement program was established using three distinct approaches: (1) development of protoplast regeneration protocols with the goal of attempting somatic hybridization between Ulmus americana and disease resistant hybrids; (2) evaluation of the extent of somaclonal variation in plants regenerated from protoplasts; and (3)...

  7. 34 CFR 637.4 - What definitions apply to the Minority Science and Engineering Improvement Program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What definitions apply to the Minority Science and... Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.4 What definitions apply to the Minority Science and Engineering...

  8. 34 CFR 637.3 - What regulations apply to the Minority Science and Engineering Improvement Program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What regulations apply to the Minority Science and... Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION MINORITY SCIENCE AND ENGINEERING IMPROVEMENT PROGRAM General § 637.3 What regulations apply to the Minority Science and Engineering...

  9. Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program

    Science.gov (United States)

    Hafström, Anna; Malmström, Eva-Maj; Terdèn, Josefine; Fransson, Per-Anders; Magnusson, Måns

    2016-01-01

    Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP) designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO), 206% with eyes closed (EC) on solid surface, and 54% EO on compliant surface (p balance improvements when perturbed on solid and compliant surfaces with EO and EC (p ≤ .033). Walking, step stool, and Timed Up and Go speeds increased (p ≤ .001), as did scores in Berg Balance and balance confidence scales (p ≤ .018). Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly. PMID:28138495

  10. Improving the care of people with traumatic brain injury through the Neurotrauma Evidence Translation (NET program: protocol for a program of research

    Directory of Open Access Journals (Sweden)

    Green Sally E

    2012-08-01

    Full Text Available Abstract The Neurotrauma Evidence Translation (NET program was funded in 2009 to increase the uptake of research evidence in the clinical care of patients who have sustained traumatic brain injury. This paper reports the rationale and plan for this five-year knowledge translation research program. The overarching aims of the program are threefold: to improve outcomes for people with traumatic brain injury; to create a network of neurotrauma clinicians and researchers with expertise in knowledge translation and evidence-based practice; and to contribute knowledge to the field of knowledge translation research. The program comprises a series of interlinked projects spanning varying clinical environments and disciplines relevant to neurotrauma, anchored within four themes representing core knowledge translation activities: reviewing research evidence; understanding practice; developing and testing interventions for practice change; and building capacity for knowledge translation in neurotrauma. The program uses a range of different methods and study designs, including: an evidence fellowship program; conduct of and training in systematic reviews; mixed method study designs to describe and understand factors that influence current practices (e.g., semi-structured interviews and surveys; theory-based methods to develop targeted interventions aiming to change practice; a cluster randomised trial to test the effectiveness of a targeted theory-informed intervention; stakeholder involvement activities; and knowledge translation events such as consensus conferences.

  11. Multimedia Exercise Training Program Improves Distance Walked, Heart Rate Recovery, and Self-efficacy in Cardiac Surgery Patients.

    Science.gov (United States)

    Wang, Li-Wei; Ou, Shu-Hua; Tsai, Chien-Sung; Chang, Yue-Cune; Kao, Chi-Wen

    2016-01-01

    Patient education has been shown to be more effective when delivered using multimedia than written materials. However, the effects of using multimedia to assist patients in cardiac rehabilitation have not been investigated. The purpose of this study is to examine the effect of an inpatient multimedia exercise training program on distance walked in the 6-minute walking test (6MWT), heart rate recovery, and walking self-efficacy of patients who had undergone heart surgery. For this longitudinal quasi-experimental study, 60 consecutive patients were assigned to an experimental (n = 20; inpatient multimedia exercise training program) or control (n = 40; routine care) group. Data were collected at 3 times (before surgery, 1 to 2 days before hospital discharge, and 1 month after hospital discharge) and analyzed with the generalized estimating equation approach. Most subjects were men (66.7%), had a mean age of 61.32 ± 13.4 years and left ventricular ejection fraction of 56.96% ± 13.28%, and underwent coronary artery bypass graft surgery (n = 34, 56.7%). Subjects receiving the exercise training program showed significantly greater improvement than those in the control group in the 6MWT walking distance (P self-efficacy (P = .002) at hospital discharge. Furthermore, the intervention effects on 6MWT distance (P self-efficacy (P exercise training program safely improved distance walked in the 6MWT, heart rate recovery, and self-efficacy at hospital discharge in patients after heart surgery and maintained their improvement in 6MWT and self-efficacy 1 month later.

  12. Nuclear security. DOE actions to improve the personnel clearance program

    International Nuclear Information System (INIS)

    Fultz, Keith O.; Bannerman, Carl J.; Daniel, Beverly A.

    1988-11-01

    The status of the Department of Energy's (DOE) implementation of recommendations in our two reports on DOE's personnel security clearance program was determined. The recommendations were aimed at improving the timeliness, accuracy, and efficiency of personnel security clearance decisions. Specifically, the objective was to determine and report on steps DOE is taking to implement these recommendations. In summary, it was found that DOE has either initiated action or is studying ways to address all the recommendations, but none of the recommendations have been completely implemented. The effectiveness of the DOE actions will depend, in part, on the adequacy of its internal control system for overseeing and evaluating program operations. DOE's personnel security clearance program is intended to provide reasonable assurance that personnel with access to classified information and materials are trustworthy. The Department requests that the Office of Personnel Management or the Federal Bureau of Investigation collect personal data on each person who requires such access to do his or her job. Based on these background investigations, DOE officials authorize individuals whose personal histories indicate that they are trustworthy to have access to classified information, secured facilities, and controlled materials as needed to perform their jobs. DOE has five types of these authorizations or personnel security clearances and must update information on personnel holding each type at 5-year intervals to confirm their continuing reliability. The five types are based on the types of security interests to which the person needs access, e.g., persons needing nuclear weapons-related data must have a Q clearance, and persons with a top secret clearance can have access to national security data classified as top secret

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

    Science.gov (United States)

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

    2009-12-01

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

  14. Co-creating a Peer Education program to improve skin health in older people from diverse communities: An innovation in health promotion.

    Science.gov (United States)

    Ogrin, Rajna; Brasher, Kathleen; Occleston, Jessica; Byrne, Jennifer

    2017-06-01

    Chronic wounds, debilitating and costly to manage, are more common in older people. Prevention is possible through improving skin health. We developed, implemented and evaluated an innovative health promotion program to improve skin health of older adults. A one-hour, peer education program was co-created and delivered to culturally diverse community-dwelling older people. A mixed-methods evaluation approach comprised objective measures of skin health and barrier function at commencement and six weeks posteducation, and focus groups posteducation. Seventy-three participants participated in the study (mean age 74.38 ± 11.80 years). Hydration significantly improved at follow-up for English speaking participants (t(27) = -2.90, P = 0.007). The majority of participants reported the education to be informative and useful in supporting behaviour changes. The peer education program improved skin hydration in older English speaking individuals. Peer education may effectively deliver health promotion information in some groups. © 2017 AJA Inc.

  15. Can reproductive health voucher programs improve quality of postnatal care? A quasi-experimental evaluation of Kenya's safe motherhood voucher scheme.

    Directory of Open Access Journals (Sweden)

    Claire Watt

    Full Text Available This study tests the group-level causal relationship between the expansion of Kenya's Safe Motherhood voucher program and changes in quality of postnatal care (PNC provided at voucher-contracted facilities. We compare facilities accredited since program inception in 2006 (phase I and facilities accredited since 2010-2011 (phase II relative to comparable non-voucher facilities. PNC quality is assessed using observed clinical content processes, as well as client-reported outcome measures. Two-tailed unpaired t-tests are used to identify differences in mean process quality scores and client-reported outcome measures, comparing changes between intervention and comparison groups at the 2010 and 2012 data collection periods. Difference-in-differences analysis is used to estimate the reproductive health (RH voucher program's causal effect on quality of care by exploiting group-level differences between voucher-accredited and non-accredited facilities in 2010 and 2012. Participation in the voucher scheme since 2006 significantly improves overall quality of postnatal care by 39% (p=0.02, where quality is defined as the observable processes or components of service provision that occur during a PNC consultation. Program participation since phase I is estimated to improve the quality of observed maternal postnatal care by 86% (p=0.02, with the largest quality improvements in counseling on family planning methods (IRR 5.0; p=0.01 and return to fertility (IRR 2.6; p=0.01. Despite improvements in maternal aspects of PNC, we find a high proportion of mothers who seek PNC are not being checked by any provider after delivery. Additional strategies will be necessary to standardize provision of packaged postnatal interventions to both mother and newborn. This study addresses an important gap in the existing RH literature by using a strong evaluation design to assess RH voucher program effectiveness on quality improvement.

  16. Improving Transfer of Learning: An Innovative Comentoring Program to Enhance Workplace Implementation After an Occupational Therapy Course on Autism Spectrum Disorders.

    Science.gov (United States)

    Ashburner, Jill; Ziviani, Jenny; Rodger, Sylvia; Hinder, Elizabeth A; Cartmill, Linda; White, Jessica; Vickerstaff, Sandy

    2015-01-01

    Research suggests that learning gained through training is infrequently implemented in the workplace. A short-term postcourse comentoring program was developed with the aim of facilitating workplace implementation of learning after a 3-day course for occupational therapists. The program was evaluated for usefulness, successes, challenges, recommended improvements, and associations with changes in self-rated knowledge and confidence. Two months after the course, 42 participants completed an evaluation of the comentoring program with closed- and open-ended questions addressing usefulness, successes, challenges, pairing preferences, and recommendations. They also completed a record on whether or not they had worked on goals nominated in their comentoring contract. Before and 2 months after the course, they completed a self-rated questionnaire on knowledge and confidence. The comentoring program was recommended by 80% of participants. Benefits included opportunities for information and resource sharing, debriefing, problem solving, reassurance, and implementation of ideas. Ninety-five percent of participants worked on some or all their comentoring goals. Although there were significant improvements in knowledge (P < 0.001) and confidence (P < 0.001), the total comentoring evaluation score was not significantly associated with these changes. It is therefore possible that these improvements related to the course itself rather than the comentoring program. Challenges related to time, scheduling, distance, and pairing of comentors. Reported benefits of the program included enhanced psychosocial support and prompting to trial newly learned strategies. Effectiveness may be improved by setting aside time for comentoring in the workplace and better matching of comentors.

  17. Sepsis in general surgery: the 2005-2007 national surgical quality improvement program perspective.

    Science.gov (United States)

    Moore, Laura J; Moore, Frederick A; Todd, S Rob; Jones, Stephen L; Turner, Krista L; Bass, Barbara L

    2010-07-01

    To document the incidence, mortality rate, and risk factors for sepsis and septic shock compared with pulmonary embolism and myocardial infarction in the general-surgery population. Retrospective review. American College of Surgeons National Surgical Quality Improvement Program institutions. General-surgery patients in the 2005-2007 National Surgical Quality Improvement Program data set. Incidence, mortality rate, and risk factors for sepsis and septic shock. Of 363 897 general-surgery patients, sepsis occurred in 8350 (2.3%), septic shock in 5977 (1.6%), pulmonary embolism in 1078 (0.3%), and myocardial infarction in 615 (0.2%). Thirty-day mortality rates for each of the groups were as follows: 5.4% for sepsis, 33.7% for septic shock, 9.1% for pulmonary embolism, and 32.0% for myocardial infarction. The septic-shock group had a greater percentage of patients older than 60 years (no sepsis, 40.2%; sepsis, 51.7%; and septic shock, 70.3%; P surgery resulted in more cases of sepsis (4.5%) and septic shock (4.9%) than did elective surgery (sepsis, 2.0%; septic shock, 1.2%) (P surgery, and the presence of any comorbidity. This study emphasizes the need for early recognition of patients at risk via aggressive screening and the rapid implementation of evidence-based guidelines.

  18. Efficiency improvement opportunities for personal computer monitors. Implications for market transformation programs

    Energy Technology Data Exchange (ETDEWEB)

    Park, Won Young; Phadke, Amol; Shah, Nihar [Environmental Energy Technologies Division, Lawrence Berkeley National Laboratory, Berkeley, CA (United States)

    2013-08-15

    Displays account for a significant portion of electricity consumed in personal computer (PC) use, and global PC monitor shipments are expected to continue to increase. We assess the market trends in the energy efficiency of PC monitors that are likely to occur without any additional policy intervention and estimate that PC monitor efficiency will likely improve by over 40 % by 2015 with saving potential of 4.5 TWh per year in 2015, compared to today's technology. We discuss various energy-efficiency improvement options and evaluate the cost-effectiveness of three of them, at least one of which improves efficiency by at least 20 % cost effectively beyond the ongoing market trends. We assess the potential for further improving efficiency taking into account the recent development of universal serial bus-powered liquid crystal display monitors and find that the current technology available and deployed in them has the potential to deeply and cost effectively reduce energy consumption by as much as 50 %. We provide insights for policies and programs that can be used to accelerate the adoption of efficient technologies to further capture global energy saving potential from PC monitors which we estimate to be 9.2 TWh per year in 2015.

  19. Improving Empathy and Communication Skills of Visually Impaired Early Adolescents through a Psycho-Education Program

    Science.gov (United States)

    Yildiz, Mehmet Ali; Duy, Baki

    2013-01-01

    The purpose of this study was to investigate the effectiveness of an interpersonal communication skills psycho-education program to improve empathy and communication skills of visually impaired adolescents. Participants of the study were sixteen early adolescents schooling in an elementary school for visually impaired youth in Diyarbakir. The…

  20. RC2S: a cognitive remediation program to improve social cognition in schizophrenia and related disorders

    Directory of Open Access Journals (Sweden)

    Elodie ePEYROUX

    2014-06-01

    Full Text Available In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind, attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (Cognitive Remediation of Social Cognition in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients’ functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual-reality techniques. In the RC2S program, the patient’s goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters’ mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with

  1. RC2S: A Cognitive Remediation Program to Improve Social Cognition in Schizophrenia and Related Disorders.

    Science.gov (United States)

    Peyroux, Elodie; Franck, Nicolas

    2014-01-01

    In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind (ToM), attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (cognitive remediation of social cognition) in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients' functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual reality techniques. In the RC2S program, the patient's goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters' mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with psychiatric disorders.

  2. RC2S: A Cognitive Remediation Program to Improve Social Cognition in Schizophrenia and Related Disorders

    Science.gov (United States)

    Peyroux, Elodie; Franck, Nicolas

    2014-01-01

    In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind (ToM), attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (cognitive remediation of social cognition) in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients’ functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual reality techniques. In the RC2S program, the patient’s goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters’ mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with psychiatric disorders

  3. A year-long caregiver training program to improve neurocognition in preschool Ugandan HIV-exposed children.

    Science.gov (United States)

    Boivin, Michael J; Bangirana, Paul; Nakasujja, Noeline; Page, Connie F; Shohet, Cilly; Givon, Deborah; Bass, Judith K; Opoka, Robert O; Klein, Pnina S

    2013-05-01

    Mediational intervention for sensitizing caregivers (MISC) is a structured program enabling caregivers to enhance their child's cognitive and emotional development through daily interactions. The principal aim was to evaluate if a year-long MISC caregiver training program produced greater improvement in child cognitive and emotional development compared with a control program. One hundred and nineteen uninfected HIV-exposed preschool children and their caregivers were randomly assigned to 1 of 2 treatment arms: biweekly MISC training alternating between home and clinic for 1 year or a health and nutrition curriculum. All children were evaluated at baseline, 6 months, and 1 year with the Mullen Early Learning Scales, Color-Object Association Test for memory, and Achenbach Child Behavior Checklist for psychiatric symptoms. Caregivers were evaluated on the same schedule with the Hopkins Symptoms Checklist-25 for depression and anxiety. The treatment arms were compared using repeated-measures analysis of covariance with child age, gender, weight, socioeconomic status, caregiving quality, caregiver anxiety, and caregiver education as covariates. The MISC children had significantly greater gains compared to controls on the Mullen Receptive and Expressive Language development, and on the Mullen composite score of cognitive ability. Color-Object Association Test total memory for MISC children was marginally better than controls. No Achenbach Child Behavior Checklist differences between the groups were noted. Caldwell Home Observation for Measurement of the Environment scores and observed mediational interaction scores from videotapes measuring caregiving quality also improved significantly more for the MISC group. The MISC enhanced cognitive performance, especially in language development. These benefits were possibly mediated by improved caregiving and positive emotional benefit to the caregiver.

  4. SEL's Software Process-Improvement Program

    Science.gov (United States)

    Basili, Victor; Zelkowitz, Marvin; McGarry, Frank; Page, Jerry; Waligora, Sharon; Pajerski, Rose

    1995-01-01

    The goals and operations of the Software Engineering Laboratory (SEL) is reviewed. For nearly 20 years the SEL has worked to understand, assess, and improve software and the development process within the production environment of the Flight Dynamics Division (FDD) of NASA's Goddard Space Flight Center. The SEL was established in 1976 with the goals of reducing: (1) the defect rate of delivered software, (2) the cost of software to support flight projects, and (3) the average time to produce mission-support software. After studying over 125 projects of FDD, the results have guided the standards, management practices, technologies, and the training within the division. The results of the studies have been a 75 percent reduction in defects, a 50 percent reduction in cost, and a 25 percent reduction in development time. Over time the goals of SEL have been clarified. The goals are now stated as: (1) Understand baseline processes and product characteristics, (2) Assess improvements that have been incorporated into the development projects, (3) Package and infuse improvements into the standard SEL process. The SEL improvement goal is to demonstrate continual improvement of the software process by carrying out analysis, measurement and feedback to projects with in the FDD environment. The SEL supports the understanding of the process by study of several processes including, the effort distribution, and error detection rates. The SEL assesses and refines the processes. Once the assessment and refinement of a process is completed, the SEL packages the process by capturing the process in standards, tools and training.

  5. A Case Study of Culturally Relevant School-Based Programming for First Nations Youth: Improved Relationships, Confidence and Leadership, and School Success

    Science.gov (United States)

    Crooks, Claire V.; Burleigh, Dawn; Snowshoe, Angela; Lapp, Andrea; Hughes, Ray; Sisco, Ashley

    2015-01-01

    Schools are expected to promote social and emotional learning skills among youth; however, there is a lack of culturally-relevant programming available. The Fourth R: Uniting Our Nations programs for Aboriginal youth include strengths-based programs designed to promote healthy relationships and cultural connectedness, and improve school success…

  6. Effects of self-esteem improvement program on self-esteem and peer attachment in elementary school children with observed problematic behaviors.

    Science.gov (United States)

    Park, Kyung Min; Park, Heeok

    2015-03-01

    The purpose of this study was to investigate the effects of a self-esteem improvement program on self-esteem and peer attachment in elementary school children with observed problematic behaviors. This study is a quasi-experimental study with a nonequivalent control group pretest-post-test design. A total of 47 fourth grade elementary school students participated in this study. The program was provided for 45 minutes once a week; a total of 12 sessions were completed with a group in the classroom for the experimental group. Child Problem-Behavior Screening Questionnaire was used to measure problematic behavior. Self-esteem was measured using the Rosenberg's Self-esteem Questionnaire, and peer attachment was measured using the Inventory of Parent and Attachment. Measuring was performed right after the program was done (post 1) and 1 month after the program was finished (post 2). To compare the differences in self-esteem and peer attachment between groups, repeated measures analysis of variance was used. Most participants in the experimental group were 10 years old (62.5%, range 10-11), male (52.0%) and with middle grade point average (64.0%). The self-esteem scores in the experimental group were significantly higher than those of the control group (F = 26.64, p < .001). The peer attachment scores in the experimental group were significantly higher than those of the control group (F = 6.48, p = .014). The self-esteem improvement program in this study improved the self-esteem and peer attachment in elementary school children. The self-esteem program helped acknowledge the peer's name and increased their connections. The program needs to be considered as a formal and consistent program. Copyright © 2015. Published by Elsevier B.V.

  7. Program improvement and applications

    International Nuclear Information System (INIS)

    Hink, M.; Imke, U.; Pfrang, W.; Porscha, B.; Struwe, D.; Zimmerer, W.; Allan, P.

    1995-01-01

    An account is given about further improvements of the SAS4A-Ref. 94.R0 version of the HCDA code. They concern in particular the DEFORM fuel rod deformation module. For a validation of the new code version, various CABRI experiments have been calculated, especially tests with high burnup fuel rods. Progress was shown to be achieved, but the precise timing and location of the observed fuel failures is still hard to calculate. The work was performed in close cooperation with partners in France, Britain, and Japan. An important application concerns the CAPRA project of a reactor for actinide burning. Its behavior under ULOF conditions was analyzed using the improved SAS4A Ref. 94 R0 code. The core design turned out to tend toward a long-term coolable configuration even more so than the EFR core design would do in an ULOF. (orig.)

  8. College and University Environmental Programs as a Policy Problem (Part 2): Strategies for Improvement

    Science.gov (United States)

    Clark, Susan G.; Rutherford, Murray B.; Auer, Matthew R.; Cherney, David N.; Wallace, Richard L.; Mattson, David J.; Clark, Douglas A.; Foote, Lee; Krogman, Naomi; Wilshusen, Peter; Steelman, Toddi

    2011-05-01

    Environmental studies and environmental sciences programs in American and Canadian colleges and universities seek to ameliorate environmental problems through empirical enquiry and analytic judgment. In a companion article (Part 1) we describe the environmental program movement (EPM) and discuss factors that have hindered its performance. Here, we complete our analysis by proposing strategies for improvement. We recommend that environmental programs re-organize around three principles. First, adopt as an overriding goal the concept of human dignity—defined as freedom and social justice in healthy, sustainable environments. This clear higher-order goal captures the human and environmental aspirations of the EPM and would provide a more coherent direction for the efforts of diverse participants. Second, employ an explicit, genuinely interdisciplinary analytical framework that facilitates the use of multiple methods to investigate and address environmental and social problems in context. Third, develop educational programs and applied experiences that provide students with the technical knowledge, powers of observation, critical thinking skills and management acumen required for them to become effective professionals and leaders. Organizing around these three principles would build unity in the EPM while at the same time capitalizing on the strengths of the many disciplines and diverse local conditions involved.

  9. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence.

    Science.gov (United States)

    Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson

    2015-01-01

    US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants - sexual activity, number of sexual partners, condom use, and other contraceptive use - among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent-youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent-youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts, rigorously evaluate programs that appear promising, and

  10. A training program to improve gait while dual tasking in patients with Parkinson's disease: a pilot study.

    Science.gov (United States)

    Yogev-Seligmann, Galit; Giladi, Nir; Brozgol, Marina; Hausdorff, Jeffrey M

    2012-01-01

    Impairments in the ability to perform another task while walking (ie, dual tasking [DT]) are associated with an increased risk of falling. Here we describe a program we developed specifically to improve DT performance while walking based on motor learning principles and task-specific training. We examined feasibility, potential efficacy, retention, and transfer to the performance of untrained tasks in a pilot study among 7 patients with Parkinson's disease (PD). Seven patients (Hoehn and Yahr stage, 2.1±0.2) were evaluated before, after, and 1 month after 4 weeks of DT training. Gait speed and gait variability were measured during usual walking and during 4 DT conditions. The 4-week program of one-on-one training included walking while performing several distinct cognitive tasks. Gait speed and gait variability during DT significantly improved. Improvements were also seen in the DT conditions that were not specifically trained and were retained 1 month after training. These initial findings support the feasibility of applying a task-specific DT gait training program for patients with PD and suggest that it positively affects DT gait, even in untrained tasks. The present results are also consistent with the possibility that DT gait training enhances divided attention abilities during walking. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  11. A Community-Based Sensory Training Program Leads to Improved Experience at a Local Zoo for Children with Sensory Challenges

    Directory of Open Access Journals (Sweden)

    Michele Kong

    2017-09-01

    Full Text Available Sensory processing difficulties are common among many special needs children, especially those with autism spectrum disorder (ASD. The sensory sensitivities often result in interference of daily functioning and can lead to social isolation for both the individual and family unit. A quality improvement (QI project was undertaken within a local zoo to systematically implement a sensory training program targeted at helping special needs individuals with sensory challenges, including those with ASD, Down’s syndrome, attention-deficit/hyperactivity disorder, and speech delay. We piloted the program over a 2-year period. The program consisted of staff training, provision of sensory bags and specific social stories, as well as creation of quiet zones. Two hundred family units were surveyed before and after implementation of the sensory training program. In this pilot QI study, families reported increased visitation to the zoo, improved interactions with staff members, and the overall quality of their experience. In conclusion, we are able to demonstrate that a sensory training program within the community zoo is feasible, impactful, and has the potential to decrease social isolation for special needs individuals and their families.

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ... Enrollment Webinars ACS NSQIP ACS National Surgical Quality Improvement Program ACS National Surgical Quality Improvement Program About ...

  13. 75 FR 56858 - Improvements to the Supplemental Security Income Program-Heroes Earnings Assistance and Relief...

    Science.gov (United States)

    2010-09-17

    ... number, 1-800-772-1213, or TTY 1-800-325-0778, or visit our Internet site, Social Security Online, at... SOCIAL SECURITY ADMINISTRATION 20 CFR Part 416 [Docket No. SSA-2009-0017] RIN 0960-AH00 Improvements to the Supplemental Security Income Program--Heroes Earnings Assistance and Relief Tax Act of 2008...

  14. Improving the quality control program for patient dose calibrator according to IEC 60580

    International Nuclear Information System (INIS)

    Costa, Nathalia Almeida; Potiens, Maria da Penha Albuquerque

    2013-01-01

    The objective of this work was to improve the program quality control of this equipment based on the International Standard IEC 60580 - Medical electrical equipment - Dose area product meters . The initial program was established following the recommendations of IEC 61674 quoting dosimeters with ionization chambers and / or semiconductor detectors used in diagnostic X-ray image, however, the IEC 60580 is referred specifically to gauges and KAP (kerma-area product) presents additional tests. Tests included: intrinsic relative error, repeatability, scanning resolution, settling time, restarting, float values, response time and spatial uniformity of response. As a rule, all measurements are within the range characteristic of equipment performance. Thus, the PDC (Patient Dose Calibrator) again shows a device with excellent functionality and reliability in characterization tests carried out to quality control as( for the test in clinical PKA meters

  15. Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

    Science.gov (United States)

    Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

    2017-08-01

    We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

  16. Improving Defense Health Program Medical Research Processes

    Science.gov (United States)

    2017-08-08

    research , including a Business Cell; 87 Research Development, 88 Research Oversight, 89 and Research Compliance offices;90 and the Center...needed for DHP medical research , such as the Army’s Clinical and Translational Research Program Office, 38 the Navy’s Research Methods Training Program... research stated, “key infrastructure for a learning health system will encompass three core elements: data networks, methods , and workforce.” 221

  17. The disconnected values model improves mental well-being and fitness in an employee wellness program.

    Science.gov (United States)

    Anshel, Mark H; Brinthaupt, Thomas M; Kang, Minsoo

    2010-01-01

    This study examined the effect of a 10-week wellness program on changes in physical fitness and mental well-being. The conceptual framework for this study was the Disconnected Values Model (DVM). According to the DVM, detecting the inconsistencies between negative habits and values (e.g., health, family, faith, character) and concluding that these "disconnects" are unacceptable promotes the need for health behavior change. Participants were 164 full-time employees at a university in the southeastern U.S. The program included fitness coaching and a 90-minute orientation based on the DVM. Multivariate Mixed Model analyses indicated significantly improved scores from pre- to post-intervention on selected measures of physical fitness and mental well-being. The results suggest that the Disconnected Values Model provides an effective cognitive-behavioral approach to generating health behavior change in a 10-week workplace wellness program.

  18. Development and Operation of the nuclear technology program for improving the public acceptance by providing the right information

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Juwoon; Kang, Mincheol; Min, Sangky; Yi, Jongmin; Yi, Yunyoung

    2013-11-15

    This detailed assignment conducted to improve the communication efficiency through the operation of differentiated programs to accomplish 'Establishment of knowledge diffusion system for improvement of Nuclear understanding', which is the purpose of the general assignment. We developed the programs on each social opinion leader groups by providing the right information on nuclear(radiation) technology, and had a forum for providing the right information on each social groups. Also, Consisted the consultant group, which participates humanities and social sciences, civic group, science teachers, the press, national assembly workers. Technology PR was performed 4 times, which is 1 time more than the original plan of 4 times. In the theme of affection of radiation, we broadened the vision of various fields which enabled to approach in general for the PR program. We Induced a positive reaction from the participants in political areas which coexistent of uncertain expectation and difficult vision of nuclear and radiation, by sharing the development possibility in relation with potential values of radiation industry and other industries and delivering accurate information, not a fragmentary knowledge, but in general. We hope that this results will contribute to establishing the effective nuclear knowledge diffusion program system.

  19. Development and Operation of the nuclear technology program for improving the public acceptance by providing the right information

    International Nuclear Information System (INIS)

    Lee, Juwoon; Kang, Mincheol; Min, Sangky; Yi, Jongmin; Yi, Yunyoung

    2013-11-01

    This detailed assignment conducted to improve the communication efficiency through the operation of differentiated programs to accomplish 'Establishment of knowledge diffusion system for improvement of Nuclear understanding', which is the purpose of the general assignment. We developed the programs on each social opinion leader groups by providing the right information on nuclear(radiation) technology, and had a forum for providing the right information on each social groups. Also, Consisted the consultant group, which participates humanities and social sciences, civic group, science teachers, the press, national assembly workers. Technology PR was performed 4 times, which is 1 time more than the original plan of 4 times. In the theme of affection of radiation, we broadened the vision of various fields which enabled to approach in general for the PR program. We Induced a positive reaction from the participants in political areas which coexistent of uncertain expectation and difficult vision of nuclear and radiation, by sharing the development possibility in relation with potential values of radiation industry and other industries and delivering accurate information, not a fragmentary knowledge, but in general. We hope that this results will contribute to establishing the effective nuclear knowledge diffusion program system

  20. A hybrid health service accreditation program model incorporating mandated standards and continuous improvement: interview study of multiple stakeholders in Australian health care.

    Science.gov (United States)

    Greenfield, David; Hinchcliff, Reece; Hogden, Anne; Mumford, Virginia; Debono, Deborah; Pawsey, Marjorie; Westbrook, Johanna; Braithwaite, Jeffrey

    2016-07-01

    The study aim was to investigate the understandings and concerns of stakeholders regarding the evolution of health service accreditation programs in Australia. Stakeholder representatives from programs in the primary, acute and aged care sectors participated in semi-structured interviews. Across 2011-12 there were 47 group and individual interviews involving 258 participants. Interviews lasted, on average, 1 h, and were digitally recorded and transcribed. Transcriptions were analysed using textual referencing software. Four significant issues were considered to have directed the evolution of accreditation programs: altering underlying program philosophies; shifting of program content focus and details; different surveying expectations and experiences and the influence of external contextual factors upon accreditation programs. Three accreditation program models were noted by participants: regulatory compliance; continuous quality improvement and a hybrid model, incorporating elements of these two. Respondents noted the compatibility or incommensurability of the first two models. Participation in a program was reportedly experienced as ranging on a survey continuum from "malicious compliance" to "performance audits" to "quality improvement journeys". Wider contextual factors, in particular, political and community expectations, and associated media reporting, were considered significant influences on the operation and evolution of programs. A hybrid accreditation model was noted to have evolved. The hybrid model promotes minimum standards and continuous quality improvement, through examining the structure and processes of organisations and the outcomes of care. The hybrid model appears to be directing organisational and professional attention to enhance their safety cultures. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Quality and Safety Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program ... ISCR Enrollment Webinars ACS NSQIP ACS National Surgical Quality Improvement Program ACS National Surgical Quality Improvement Program About ...

  2. Improved Balance Confidence and Stability for Elderly After 6 Weeks of a Multimodal Self-Administered Balance-Enhancing Exercise Program

    Directory of Open Access Journals (Sweden)

    Anna Hafström MD, PhD

    2016-04-01

    Full Text Available Objective: To develop and assess the efficacy of a multimodal balance-enhancing exercise program (BEEP designed to be regularly self-administered by community-dwelling elderly. The program aims to promote sensory reweighting, facilitate motor control, improve gaze stabilization, and stimulate continuous improvement by being constantly challenging. Method: Forty participants aged 60 to 80 years performed 6 weeks of BEEP training, on average for 16 min four times weekly, in a randomized one-arm crossover design. Results: One-leg standing time improved 32% with eyes open (EO, 206% with eyes closed (EC on solid surface, and 54% EO on compliant surface ( p < .001. Posturography confirmed balance improvements when perturbed on solid and compliant surfaces with EO and EC ( p  ≤ .033. Walking, step stool, and Timed Up and Go speeds increased ( p  ≤ .001, as did scores in Berg Balance and balance confidence scales ( p  ≤ .018. Discussion: Multimodal balance exercises offer an efficient, cost-effective way to improve balance control and confidence in elderly.

  3. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

    Directory of Open Access Journals (Sweden)

    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  4. Efficiency Improvement Opportunities for Personal Computer Monitors. Implications for Market Transformation Programs

    Energy Technology Data Exchange (ETDEWEB)

    Park, Won Young [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Phadke, Amol [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Shah, Nihar [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-06-29

    Displays account for a significant portion of electricity consumed in personal computer (PC) use, and global PC monitor shipments are expected to continue to increase. We assess the market trends in the energy efficiency of PC monitors that are likely to occur without any additional policy intervention and estimate that display efficiency will likely improve by over 40% by 2015 compared to today’s technology. We evaluate the cost effectiveness of a key technology which further improves efficiency beyond this level by at least 20% and find that its adoption is cost effective. We assess the potential for further improving efficiency taking into account the recent development of universal serial bus (USB) powered liquid crystal display (LCD) monitors and find that the current technology available and deployed in USB powered monitors has the potential to deeply reduce energy consumption by as much as 50%. We provide insights for policies and programs that can be used to accelerate the adoption of efficient technologies to capture global energy saving potential from PC monitors which we estimate to be 9.2 terawatt-hours [TWh] per year in 2015.

  5. Results of ENHANCED Implantable Cardioverter Defibrillator Programming to Reduce Therapies and Improve Quality of Life (from the ENHANCED-ICD Study)

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H.; Pedersen, Susanne S.; van der Tweel, Ingeborg

    2016-01-01

    -reported outcomes. The "ENHANCED Implantable Cardioverter Defibrillator programming to reduce therapies and improve quality of life" study (ENHANCED-ICD study) was a prospective, safety-monitoring study enrolling 60 primary and secondary prevention patients at the University Medical Center Utrecht. Patients...... programming strategy, unnecessary ICD therapy was prevented in 10% of ENHANCED-ICD patients during a median follow-up period of 1.3 years. With respect to patient-reported outcomes, levels of distress were highest and perceived health status lowest at the time of implantation, which both gradually improved...... during follow-up. In conclusion, the ENHANCED-ICD study demonstrates that programming a NID 60/80 for VT/VF detection is safe for ICD patients and does not negatively impact their quality of life....

  6. Assessment of existing local houses condition as analysis tools for shore housing improvement program in Weriagar district, Bintuni Bay

    Science.gov (United States)

    Firmansyah, F.; Fernando, A.; Allo, I. P. R.

    2018-01-01

    The housing assessment is a part of the pre-feasibility study inThe Shore Housing Improvement Program in Weriagar District, West Papua. The housing assessment was conducted to identify the physical condition of existing houses. The parameters of assessment formulated from local references, practices and also national building regulation that covers each building system components, such as building structure/frame, building floor, building cover, and building roof. This study aims to explains lessons from local practices and references, used as the formula to generate assessment parameter, elaborate with Indonesia building regulation. The result of housing assessment were used as a basis to develop the house improvement strategy, the design alternative for housing improvement and further planning recommendations. The local knowledges involved in housing improvement program expected that the local-based approach could respect to the local build culture, respect the local environment, and the most important can offer best suitable solutions for functional utility and livability.

  7. Improving Undergraduate Research Experiences With An Intentional Mentoring Program: Lessons Learned Through Assessment of Keck Geology Consortium Programs

    Science.gov (United States)

    Wirth, K. R.; Garver, J. I.; Greer, L.; Pollock, M.; Varga, R. J.; Davidson, C. M.; Frey, H. M.; Hubbard, D. K.; Peck, W. H.; Wobus, R. A.

    2015-12-01

    The Keck Geology Consortium, with support from the National Science Foundation (REU Program) and ExxonMobil, is a collaborative effort by 18 colleges to improve geoscience education through high-quality research experiences. Since its inception in 1987 more than 1350 undergraduate students and 145 faculty have been involved in 189 yearlong research projects. This non-traditional REU model offers exceptional opportunities for students to address research questions at a deep level, to learn and utilize sophisticated analytical methods, and to engage in authentic collaborative research that culminates in an undergraduate research symposium and published abstracts volume. The large numbers of student and faculty participants in Keck projects also affords a unique opportunity to study the impacts of program design on undergraduate research experiences in the geosciences. Students who participate in Keck projects generally report significant gains in personal and professional dimensions, as well as in clarification of educational and career goals. Survey data from student participants, project directors, and campus advisors identify mentoring as one of the most critical and challenging elements of successful undergraduate research experiences. Additional challenges arise from the distributed nature of Keck projects (i.e., participants, project directors, advisors, and other collaborators are at different institutions) and across the span of yearlong projects. In an endeavor to improve student learning about the nature and process of science, and to make mentoring practices more intentional, the Consortium has developed workshops and materials to support both project directors and campus research advisors (e.g., best practices for mentoring, teaching ethical professional conduct, benchmarks for progress, activities to support students during research process). The Consortium continues to evolve its practices to better support students from underrepresented groups.

  8. Adherence to Cancer Screening Guidelines and Predictors of Improvement Among Participants in the Kansas State Employee Wellness Program

    OpenAIRE

    Hui, Siu-kuen Azor; Engelman, Kimberly K.; Shireman, Theresa I.; Ellerbeck, Edward F.

    2013-01-01

    Introduction Employee wellness programs (EWPs) have been used to implement worksite-based cancer prevention and control interventions. However, little is known about whether these programs result in improved adherence to cancer screening guidelines or how participants’ characteristics affect subsequent screening. This study was conducted to describe cancer screening behaviors among participants in a state EWP and identify factors associated with screening adherence among those who were initia...

  9. A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students.

    Science.gov (United States)

    Moir, Fiona; Henning, Marcus; Hassed, Craig; Moyes, Simon A; Elley, C Raina

    2016-01-01

    There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services. Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided support to students in the intervention group, as well as offering teaching in mindfulness meditation. An exploratory study was conducted with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources, intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores. Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline and 6 months. Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference between the intervention and nonintervention groups did not reach statistical significance. Although

  10. From Dignity to Employment - Newly arrived immigrants and refugees’ interpretations of opportunities to improve labor market participation through the Introduction Program

    OpenAIRE

    Ediassen, Tora

    2016-01-01

    Master i International Social Welfare and Health Policy The aim of this thesis is to explore how newly arrived immigrants and refugees interpret their opportunities to improve labor market participation through the Introduction Program. The thesis is based on qualitative interviews with six former participants of the program situated in Oslo, Norway. The Introduction Program is an activation program designed to qualify newly arrived immigrants and refugees for economic indep...

  11. Improved dynamic-programming-based algorithms for segmentation of masses in mammograms

    International Nuclear Information System (INIS)

    Dominguez, Alfonso Rojas; Nandi, Asoke K.

    2007-01-01

    In this paper, two new boundary tracing algorithms for segmentation of breast masses are presented. These new algorithms are based on the dynamic programming-based boundary tracing (DPBT) algorithm proposed in Timp and Karssemeijer, [S. Timp and N. Karssemeijer, Med. Phys. 31, 958-971 (2004)] The DPBT algorithm contains two main steps: (1) construction of a local cost function, and (2) application of dynamic programming to the selection of the optimal boundary based on the local cost function. The validity of some assumptions used in the design of the DPBT algorithm is tested in this paper using a set of 349 mammographic images. Based on the results of the tests, modifications to the computation of the local cost function have been designed and have resulted in the Improved-DPBT (IDPBT) algorithm. A procedure for the dynamic selection of the strength of the components of the local cost function is presented that makes these parameters independent of the image dataset. Incorporation of this dynamic selection procedure has produced another new algorithm which we have called ID 2 PBT. Methods for the determination of some other parameters of the DPBT algorithm that were not covered in the original paper are presented as well. The merits of the new IDPBT and ID 2 PBT algorithms are demonstrated experimentally by comparison against the DPBT algorithm. The segmentation results are evaluated with base on the area overlap measure and other segmentation metrics. Both of the new algorithms outperform the original DPBT; the improvements in the algorithms performance are more noticeable around the values of the segmentation metrics corresponding to the highest segmentation accuracy, i.e., the new algorithms produce more optimally segmented regions, rather than a pronounced increase in the average quality of all the segmented regions

  12. Improving nuclear safety at international research reactors: The Integrated Research Reactor Safety Enhancement Program (IRRSEP)

    International Nuclear Information System (INIS)

    Huizenga, David; Newton, Douglas; Connery, Joyce

    2002-01-01

    Nuclear energy continues to play a major role in the world's energy economy. Research and test reactors are an important component of a nation's nuclear power infrastructure as they provide training, experiments and operating experience vital to developing and sustaining the industry. Indeed, nations with aspirations for nuclear power development usually begin their programs with a research reactor program. Research reactors also are vital to international science and technology development. It is important to keep them safe from both accident and sabotage, not only because of our obligation to prevent human and environmental consequence but also to prevent corresponding damage to science and industry. For example, an incident at a research reactor could cause a political and public backlash that would do irreparable harm to national nuclear programs. Following the accidents at Three Mile Island and Chernobyl, considerable efforts and resources were committed to improving the safety posture of the world's nuclear power plants. Unsafe operation of research reactors will have an amplifying effect throughout a country or region's entire nuclear programs due to political, economic and nuclear infrastructure consequences. (author)

  13. Multiple educational programs improves glycemic control, quality of life with diminishing the impact of diabetes in poorly controlled type 1 diabetics.

    Science.gov (United States)

    Vyas, Chintan; Dalal, Lopa; Talaviya, Praful; Saboo, Banshi

    2017-12-01

    The aim of present study was to assess the outcomes of multiple educational programs on glycemic control, quality of life and impact of diabetes in poorly controlled Type 1 Diabetic patients. A 12 months diabetes education programs were conducted every week for first one month then followed by every 3 months with follow up on improvement of HbA1c and QOL in T1D patients (n=54). Clinical characteristics were recorded at baseline visit. The QOL was evaluated by 15 set DQOL questionnaires in 40 consecutive patients at baseline, 3, 6 and 12 months after education programs. The HbA1c level (%) was evaluated at same time point. Decrease in DQOL score was reported as improvement in QOL. The rate of patients response to educational programs was noted 74.07% (n=40) at end of the study (12 months). The prevalence of T1D was reported higher in men than in women. The overall DQOL score and HbA1c% level was significantly (Peducational programs. Patients exhibited greater satisfaction and diminished impact of diabetes after educational programs was observed after 3 months and it was continue up to end of study. The frequencies of self-monitoring of blood glucose were increased. Numbers of hypoglycemic and DKA events were decreased after educational programs when compared to baseline. Results of study revealed that the appropriate education and counseling diminish impact of diabetes, improve QOL and help to achieve desired glycemic (HbA1c) level in poorly control T1D patients. Copyright © 2017. Published by Elsevier Ltd.

  14. Improving Nurses' Peripheral Intravenous Catheter Insertion Knowledge, Confidence, and Skills Using a Simulation-Based Blended Learning Program

    Science.gov (United States)

    Keleekai, Nowai L.; Schuster, Catherine A.; Murray, Connie L.; King, Mary Anne; Stahl, Brian R.; Labrozzi, Laura J.; Gallucci, Susan; LeClair, Matthew W.; Glover, Kevin R.

    2016-01-01

    Introduction Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. Methods The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. Results At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%. Conclusions Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored. PMID:27504890

  15. Effectiveness of different memory training programs on improving hyperphagic behaviors of residents with dementia: a longitudinal single-blind study.

    Science.gov (United States)

    Kao, Chieh-Chun; Lin, Li-Chan; Wu, Shiao-Chi; Lin, Ker-Neng; Liu, Ching-Kuan

    2016-01-01

    Hyperphagia increases eating-associated risks for people with dementia and distress for caregivers. The purpose of this study was to compare the long-term effectiveness of spaced retrieval (SR) training and SR training combined with Montessori activities (SR + M) for improving hyperphagic behaviors of special care unit residents with dementia. The study enrolled patients with dementia suffering from hyperphagia resident in eight institutions and used a cluster-randomized single-blind design, with 46 participants in the SR group, 49 in the SR + M group, and 45 participants in the control group. For these three groups, trained research assistants collected baseline data on hyperphagic behavior, pica, changes in eating habits, short meal frequency, and distress to caregivers. The SR and SR + M groups underwent memory training over a 6-week training period (30 sessions), and a generalized estimating equation was used to compare data of all the three groups of subjects obtained immediately after the training period and at follow-ups 1 month, 3 months, and 6 months later. Results showed that the hyperphagic and pica behaviors of both the SR and SR + M groups were significantly improved (P<0.001) and that the effect lasted for 3 months after training. The improvement of fast eating was significantly superior in the SR + M group than in the SR group. The improvement in distress to caregivers in both intervention groups lasted only until the posttest. Improvement in changes in eating habits of the two groups was not significantly different from that of the control group. SR and SR + M training programs can improve hyperphagic behavior of patients with dementia. The SR + M training program is particularly beneficial for the improvement of rapid eating. Caregivers can choose a suitable memory training program according to the eating problems of their residents.

  16. Determining the Effectiveness of a Modulated Parenting Skills Program on Reducing Autistic Symptoms in Children and Improvement of Parental Adjustment

    Directory of Open Access Journals (Sweden)

    Homa Rezaee

    2018-03-01

    Discussion: The compiled parenting program is recommended to improve parental empowerment for the families of autistic children, because it is capable of reducing autistic symptoms in social interaction and relationships as well as improving marital adjustment in such families.

  17. People's Republic of Bangladesh - Revenue Mobilization Program for Results : VAT Improvement Program

    OpenAIRE

    World Bank

    2014-01-01

    In accordance with the Bank s OP/BP 9.0 an Integrated Fiduciary Systems Assessment (IFSA) was carried out to determine whether the fiduciary systems pertaining to the Program provide reasonable assurances that the Program funds will be used for their intended purpose. The IFSA comprised an assessment of the fiduciary risks relating to: (a) procurement; (b) financial management; and (c) gov...

  18. [Development and Evaluation of a Motivational Interviewing Program for Exercise Improvement in Persons with Physical Disabilities].

    Science.gov (United States)

    Jeong, Jeong Hee; Jeong, Ihn Sook

    2017-06-01

    The aims of this study were to develop a motivational interviewing program for exercise improvement in persons with physical disabilities and to examine the effect of this motivational interviewing intervention. The study employed a nonequivalent control group pretest and posttest design. A total of 62 persons with physical disabilities (30 in the experimental group, 32 in the control group) were recruited from 2 community rehabilitation centers. The experimental group received 8 sessions of a group motivational interviewing program, scheduled once a week, with each session lasting 60 minutes. Test measures were completed before the intervention, immediately after the end of the intervention, 2 weeks later, and 6 weeks after the end of the intervention. Measures included self-efficacy for exercise, decisional balance for exercise, stage of change for exercise, regularity of exercise, exercise maintenance, and independent living ability. Data were analyzed using the χ²-test, Fisher's exact test, Independent samples t-test, and repeated measures ANOVA, conducted using IBM SPSS Statistics version 18. The experimental group showed a significant increase in self-efficacy for exercise (F=50.98, pmotivational interviewing program has the potential to improve exercise levels in persons with physical disabilities. © 2017 Korean Society of Nursing Science

  19. Too little but not too late: results of a literature review to improve routine immunization programs in developing countries.

    Science.gov (United States)

    Ryman, Tove K; Dietz, Vance; Cairns, K Lisa

    2008-06-21

    Globally, immunization services have been the center of renewed interest with increased funding to improve services, acceleration of the introduction of new vaccines, and the development of a health systems approach to improve vaccine delivery. Much of the credit for the increased attention is due to the work of the GAVI Alliance and to new funding streams. If routine immunization programs are to take full advantage of the newly available resources, managers need to understand the range of proven strategies and approaches to deliver vaccines to reduce the incidence of diseases. In this paper, we present strategies that may be used at the sub-national level to improve routine immunization programs. We conducted a systematic review of studies and projects reported in the published and gray literature. Each paper that met our inclusion criteria was rated based on methodological rigor and data were systematically abstracted. Routine-immunization - specific papers with a methodological rigor rating of greater than 60% and with conclusive results were reported. Greater than 11,000 papers were identified, of which 60 met our inclusion criteria and 25 papers were reported. Papers were grouped into four strategy approaches: bringing immunizations closer to communities (n = 11), using information dissemination to increase demand for vaccination (n = 3), changing practices in fixed sites (n = 4), and using innovative management practices (n = 7). Immunization programs are at a historical crossroads in terms of developing new funding streams, introducing new vaccines, and responding to the global interest in the health systems approach to improving immunization delivery. However, to complement this, actual service delivery needs to be strengthened and program managers must be aware of proven strategies. Much was learned from the 25 papers, such as the use of non-health workers to provide numerous services at the community level. However it was startling to see how few papers

  20. The Effectiveness of an Additional Stretching Exercise Program in Improving Flexibility Level among Preschool Boys

    Science.gov (United States)

    Lee, Wee Akina Sia Seng; Rengasamy, Shabeshan A/L; Raju, Subramaniam A/L

    2014-01-01

    This study was conducted to examine the effectiveness of a two minutes' additional stretching exercise program in a 30 minutes games teaching lesson in improving the flexibility level of 6 year old preschool boys (M = 5.92, SD = 0.27) in a preschool in Malaysia. Fifty (50) preschool boys were selected for the study based on the intact sampling…

  1. Improving Emotion Regulation and Sibling Relationship Quality: The More Fun with Sisters and Brothers Program

    Science.gov (United States)

    Kennedy, Denise E.; Kramer, Laurie

    2008-01-01

    We examined the role of emotion regulation (ER) in improving sibling relationship quality (SRQ) by evaluating the More Fun With Sisters and Brothers Program where 4- to 8-year-old siblings from 95 families were taught emotional and social competencies. Parents reported on SRQ and ER, and sibling interactions were observed in homes. SRQ and ER…

  2. Physical activity stimulation program for children with cerebral palsy did not improve physical activity: a randomised trial

    NARCIS (Netherlands)

    van Wely, L.; Balemans, A.C.J.; Becher, J.G.; Dallmeijer, A.J.

    2014-01-01

    Question: In children with cerebral palsy, does a 6-month physical activity stimulation program improve physical activity, mobility capacity, fitness, fatigue and attitude towards sports more than usual paediatric physiotherapy? Design: Multicentre randomised controlled trial with concealed

  3. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Manlove J

    2015-04-01

    Full Text Available Jennifer Manlove, Heather Fish, Kristin Anderson Moore Child Trends, Bethesda, MD, USA Background: US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs, highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods: This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results: Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome. We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use. Conclusion: Future efforts should

  4. Epstein-Barr Virus Infection in Children: Improving the Diagnosis and Treatment Program

    Directory of Open Access Journals (Sweden)

    E. N. Simovanyan

    2016-01-01

    Full Text Available Widespread, severe course, frequent development of chronic forms, adverse effects of the Epstein-Barr virus infection to the health of children, the difficulties of diagnosis and therapy dictate the need to improve the diagnostic and treatment programs in this disease. A total of 286 patients with acute and chronic Epstein-Barr virus infection. It was established, that for the timely diagnosis of the disease requires a comprehensive analysis of anamnesis, clinical symptoms, including symptoms of acute and chronic mononucleosis syndrome in combination with multiorgan pathology, and the results of laboratory examination (enzyme immunoassay, polymerase chain reaction, immune status.

  5. College and university environmental programs as a policy problem (Part 2): Strategies for improvement

    Science.gov (United States)

    Clark, S.G.; Rutherford, M.B.; Auer, M.R.; Cherney, D.N.; Wallace, R.L.; Mattson, D.J.; Clark, D.A.; Foote, L.; Krogman, N.; Wilshusen, P.; Steelman, T.

    2011-01-01

    Environmental studies and environmental sciences programs in American and Canadian colleges and universities seek to ameliorate environmental problems through empirical enquiry and analytic judgment. In a companion article (Part 1) we describe the environmental program movement (EPM) and discuss factors that have hindered its performance. Here, we complete our analysis by proposing strategies for improvement. We recommend that environmental programs re-organize around three principles. First, adopt as an overriding goal the concept of human dignity-defined as freedom and social justice in healthy, sustainable environments. This clear higher-order goal captures the human and environmental aspirations of the EPM and would provide a more coherent direction for the efforts of diverse participants. Second, employ an explicit, genuinely interdisciplinary analytical framework that facilitates the use of multiple methods to investigate and address environmental and social problems in context. Third, develop educational programs and applied experiences that provide students with the technical knowledge, powers of observation, critical thinking skills and management acumen required for them to become effective professionals and leaders. Organizing around these three principles would build unity in the EPM while at the same time capitalizing on the strengths of the many disciplines and diverse local conditions involved. ?? 2011 Springer Science+Business Media, LLC.

  6. Barriers and facilitators to implementing continuous quality improvement programs in colonoscopy services: a mixed methods systematic review.

    Science.gov (United States)

    Candas, Bernard; Jobin, Gilles; Dubé, Catherine; Tousignant, Mario; Abdeljelil, Anis Ben; Grenier, Sonya; Gagnon, Marie-Pierre

    2016-02-01

    Continuous quality improvement (CQI) programs may result in quality of care and outcome improvement. However, the implementation of such programs has proven to be very challenging. This mixed methods systematic review identifies barriers and facilitators pertaining to the implementation of CQI programs in colonoscopy services and how they relate to endoscopists, nurses, managers, and patients. We developed a search strategy adapted to 15 databases. Studies had to report on the implementation of a CQI intervention and identified barriers or facilitators relating to any of the four groups of actors directly concerned by the provision of colonoscopies. The quality of the selected studies was assessed and findings were extracted, categorized, and synthesized using a generic extraction grid customized through an iterative process. We extracted 99 findings from the 15 selected publications. Although involving all actors is the most cited factor, the literature mainly focuses on the facilitators and barriers associated with the endoscopists' perspective. The most reported facilitators to CQI implementation are perception of feasibility, adoption of a formative approach, training and education, confidentiality, and assessing a limited number of quality indicators. Receptive attitudes, a sense of ownership and perceptions of positive impacts also facilitate the implementation. Finally, an organizational environment conducive to quality improvement has to be inclusive of all user groups, explicitly supportive, and provide appropriate resources. Our findings corroborate the current models of adoption of innovations. However, a significant knowledge gap remains with respect to barriers and facilitators pertaining to nurses, patients, and managers.

  7. Improved Birth Weight for Black Infants: Outcomes of a Healthy Start Program

    Science.gov (United States)

    Zielinski, Ruth; James, Arthur; Charoth, Remitha M.; del Carmen Sweezy, Luz

    2014-01-01

    Objectives. We determined whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women. Methods. We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan state- and Kalamazoo County–level birth certificate records for 2008 to 2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model. Results. Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than did Black nonparticipants (P = .05). White HBHS participants had significantly more prenatal care than did White nonparticipants, but they had similar birth outcomes (P = .7 for birth weight; P = .55 for gestation). Conclusions. HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women. PMID:24354844

  8. A contemporary analysis of Fournier gangrene using the National Surgical Quality Improvement Program.

    Science.gov (United States)

    Kim, Stanley Y; Dupree, James M; Le, Brian V; Kim, Dae Y; Zhao, Lee C; Kundu, Shilajit D

    2015-05-01

    To determine a nationwide contemporary description of surgical Fournier gangrene (FG) and necrotizing fasciitis of the genitalia (NFG) outcomes because historically reported mortality rates for FG and NFG are based on small single-institution studies from the 1980s and the 1990s. The National Surgical Quality Improvement Program is a risk-adjusted surgical database used by nearly 400 hospitals nationwide, which tracks preoperative, intraoperative, and 30-day postoperative clinical variables. Data are extracted from patient charts by an independent surgical clinical reviewer at each hospital. Using the National Surgical Quality Improvement Program data from 2005 to 2009, we calculated 30-day mortality rates and identified preoperative factors associated with increased mortality. A total of 650 patients were identified with surgery for FG or NFG. Fourteen patients with do not resuscitate orders placed preoperatively were excluded from analyses. For the remaining 636 patients, the overall 30-day mortality was 10.1% (64 of 636). Fifty-seven percent of patients (360 of 636) were men, 70% (446 of 636) were white, and 13% (81 of 636) were African American. Multivariate logistic regression indicated that increased age (odds ratio [OR], 1.041; P = .004), body mass index (OR, 1.045; P <.001), and preoperative white blood cell count (OR, 1.061; P = .001), and decreased platelet count (OR, 0.993; P <.001) were all associated with increased risk of death. We determined a surgical mortality rate for FG-NFG of 10.1%. This rate is about half of historically published estimates and similar to recent studies. The lower rate may indicate improvements in therapy. Increased age, body mass index, and white blood cell count, and decreased platelet count were all associated with an increased risk of 30-day mortality. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Development of a nursing education program for improving Chinese undergraduates' self-directed learning: A mixed-method study.

    Science.gov (United States)

    Tao, Ying; Li, Liping; Xu, Qunyan; Jiang, Anli

    2015-11-01

    This paper demonstrates the establishment of an extra-curricular education program in Chinese context and evaluates its effectiveness on undergraduate nursing students' self-directed learning. Zimmerman's self-directed learning model was used as the theoretical framework for the development of an education program. Mixed-method was applied in this research study. 165 undergraduate students from a nursing college were divided into experimental group (n=32) and control group (n=133). Pre- and post-tests were implemented to evaluate the effectiveness of this education program using the self-directed learning scale of nursing undergraduates. Qualitative interview was undertaken within participants from the experimental group to obtain their insights into the influence of this program. Both quantitative and qualitative analyses showed that the program contributed to nursing students' self-directed learning ability. In the experimental group, the post-test score showed an increase compared with pretest score (plearning activities and influence on learning environment. It can be found in the qualitative analysis that learners benefited from this program. The education program contributes to the improvement of nursing undergraduates' self-directed learning. Various pedagogic methods could be applied for self-directed learning. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Does the Animal Fun program improve motor performance in children aged 4-6 years?

    Science.gov (United States)

    Piek, J P; McLaren, S; Kane, R; Jensen, L; Dender, A; Roberts, C; Rooney, R; Packer, T; Straker, L

    2013-10-01

    The Animal Fun program was designed to enhance the motor ability of young children by imitating the movements of animals in a fun, inclusive setting. The efficacy of this program was investigated through a randomized controlled trial using a multivariate nested cohort design. Pre-intervention scores were recorded for 511 children aged 4.83 years to 6.17 years (M=5.42 years, SD=3.58 months). Six control and six intervention schools were compared 6 months later following the intervention, and then again at 18 months after the initial testing when the children were in their first school year. Changes in motor performance were examined using the Bruininks-Oseretsky Test of Motor Proficiency short form. Data were analyzed using multi-level-mixed effects linear regression. A significant Condition×Time interaction was found, F(2,1219)=3.35, p=.035, demonstrating that only the intervention group showed an improvement in motor ability. A significant Sex×Time interaction was also found, F(2,1219)=3.84, p=.022, with boys improving over time, but not girls. These findings have important implications for the efficacy of early intervention of motor skills and understanding the differences in motor performance between boys and girls. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Improving Adherence to Mediterranean-Style Diet With a Community Culinary Coaching Program: Methodology Development and Process Evaluation.

    Science.gov (United States)

    Polak, Rani; Pober, David; Morris, Avigail; Arieli, Rakefet; Moore, Margaret; Berry, Elliot; Ziv, Mati

    The Community Culinary Coaching Program is a community-based participatory program aimed at improving communal settlement residents' nutrition. The residents, central kitchens, preschools, and communal dining rooms were identified as areas for intervention. Evaluation included goals accomplishment assessed by food purchases by the central kitchens, and residents' feedback through focus groups. Purchasing included more vegetables (mean (standard error) percent change), (+7% (4); P = .32), fish (+115% (11); P < .001), whole grains, and legumes (+77% (9); P < .001); and less soup powders (-40% (9); P < .05), processed beef (-55% (8); P < .001), and margarine (-100% (4); P < .001). Residents recommended continuing the program beyond the project duration. This model might be useful in organizations with communal dining facilities.

  12. Epigenetic marks: regulators of livestock phenotypes and conceivable sources of missing variation in livestock improvement programs

    Directory of Open Access Journals (Sweden)

    Eveline M Ibeagha-Awemu

    2015-09-01

    Full Text Available Improvement in animal productivity has been achieved over the years through careful breeding and selection programs. Today, variations in the genome are gaining increasing importance in livestock improvement strategies. Genomic information alone however explains only a part of the phenotypic variance in traits. It is likely that a portion of the unaccounted variance is embedded in the epigenome. The epigenome encompasses epigenetic marks such as DNA methylation, histone tail modifications, chromatin remodeling and other molecules that can transmit epigenetic information such as non-coding RNA species. Epigenetic factors respond to external or internal environmental cues such as nutrition, pathogens and climate, and have the ability to change gene expression leading to emergence of specific phenotypes. Accumulating evidence shows that epigenetic marks influence gene expression and phenotypic outcome in livestock species. This review examines available evidence of the influence of epigenetic marks on livestock (cattle, sheep, goat and pig traits and discusses the potential for consideration of epigenetic markers in livestock improvement programs. However, epigenetic research activities on farm animal species are currently limited partly due to lack of recognition, funding and a global network of researchers. Therefore, considerable less attention has been given to epigenetic research in livestock species in comparison to extensive work in humans and model organisms. Elucidating therefore the epigenetic determinants of animal diseases and complex traits may represent one of the principal challenges to use epigenetic markers for further improvement of animal productivity.

  13. Do Farmers' Markets Improve Diet of Participants Using Federal Nutrition Assistance Programs? A Literature Review

    Science.gov (United States)

    Byker, Carmen J.; Misyak, Sarah; Shanks, Justin; Serrano, Elena L.

    2013-01-01

    Farmers' markets have emerged as one health strategy to improve the access and availability of fresh foods for limited-resource audiences using federal nutrition assistance programs, although their effectiveness on dietary intake is not well understood. The review reported here evaluates the strengths and weaknesses of existing research about…

  14. An intervention to improve program implementation: findings from a two-year cluster randomized trial of Assets-Getting To Outcomes

    Science.gov (United States)

    2013-01-01

    Background Studies have shown that communities have not always been able to implement evidence-based prevention programs with quality and achieve outcomes demonstrated by prevention science. Implementation support interventions are needed to bridge this gap between science and practice. The purpose of this article is to present two-year outcomes from an evaluation of the Assets Getting To Outcomes (AGTO) intervention in 12 Maine communities engaged in promoting Developmental Assets, a positive youth development approach to prevention. AGTO is an implementation support intervention that consists of: a manual of text and tools; face-to-face training, and onsite technical assistance, focused on activities shown to be associated with obtaining positive results across any prevention program. Methods This study uses a nested and cross-sectional, cluster randomized controlled design. Participants were coalition members and program staff from 12 communities in Maine. Each coalition nominated up to five prevention programs to participate. At random, six coalitions and their respective 30 programs received the two-year AGTO intervention and the other six maintained routine operations. The study assessed prevention practitioner capacity (efficacy and behaviors), practitioner exposure to and use of AGTO, practitioner perceptions of AGTO, and prevention program performance. Capacity of coalition members and performance of their programs were compared between the two groups across the baseline, one-, and two-year time points. Results We found no significant differences between AGTO and control group’s prevention capacity. However, within the AGTO group, significant differences were found between those with greater exposure to and use of AGTO. Programs that received the highest number of technical assistance hours showed the most program improvement. Conclusions This study is the first of its kind to show that use of an implementation support intervention-AGTO -yielded

  15. Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

    Science.gov (United States)

    Verweij, Lisanne Marlieke; Wehrens, Rik; Oldenhof, Lieke; Bal, Roland; Francke, Anneke L

    2018-05-02

    The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program for care for older people was implemented (2008-2016) in the Netherlands. Questionnaire data were used from 385 nursing professionals (response rate 51%) that were part of the Nursing Staff Panel, a nationwide representative group of nursing staff, and working in home care, hospitals or general practices. Additionally, questionnaire data were used from 73 older adults (response rate 81%) who were involved in regional networks to discuss project proposals and to represent the voice of older adults in the nationwide improvement program. Participants were asked to evaluate care for older people with regard to collaboration between healthcare organizations and with regard to the tailored service, accessibility, and quality of care within their organizations and in the region in which they lived. A majority of older adults (54%) and nursing professionals (61%) felt that collaboration with others had improved over the last few years. Approximately one third of the older adults stated that care for older people was tailored to fit individual needs and was accessible most of the time or always, as opposed to approximately two thirds of the professionals. Moreover, 17% older adults thought that the quality of care was good, compared with 54% of the nursing professionals. 77% of the nursing professionals and 94% of the older adults thought that improvements were still needed in care for older people, for example better integration of the different aspects of care and a more patient-centered approach. Older adults who were involved in networks of the improvement program generally gave a less positive evaluation of aspects of care for older people and its development than nursing professionals

  16. Using management action plans to integrate program improvement efforts

    Energy Technology Data Exchange (ETDEWEB)

    Meador, S.W.; Kidwell, R.J.; Shangraw, W.R.; Cardamone, E.N. [Project Performance Corporation, Sterling, VA (United States)

    1994-12-31

    The Department of Energy`s (DOE`s) Environmental Management Program is the country`s largest and most sophisticated environmental program to date. The rapid expansion of the DOE`s environmental restoration efforts has led to increased scrutiny of its management processes and systems. As the program continues to grow and mature, maintaining adequate accountability for resources and clearly communicating progress will be essential to sustaining public confidence. The Office of Environmental Management must ensure that adequate processes and systems are in place at Headquarters, Operation Offices, and contractor organizations. These systems must provide the basis for sound management, cost control, and reporting. To meet this challenge, the Office of Environmental Restoration introduced the Management Action Plan process. This process was designed to serve three primary functions: (1) define the program`s management capabilities at Headquarters and Operations Offices; (2) describe how management initiatives address identified program deficiencies; and (3) identify any duplication of efforts or program deficiencies. The Environmental Restoration Management Action Plan is a tracking, reporting, and statusing tool, used primarily at the Headquarters level, for assessing performance in key areas of project management and control. BY DOE to communicate to oversight agencies and stakeholders a clearer picture of the current status of the environmental restoration project management system. This paper will discuss how Management Action Plans are used to provide a program-wide assessment of management capabilities.

  17. DANCE, BALANCE AND CORE MUSCLE PERFORMANCE MEASURES ARE IMPROVED FOLLOWING A 9-WEEK CORE STABILIZATION TRAINING PROGRAM AMONG COMPETITIVE COLLEGIATE Dancers.

    Science.gov (United States)

    Watson, Todd; Graning, Jessica; McPherson, Sue; Carter, Elizabeth; Edwards, Joshuah; Melcher, Isaac; Burgess, Taylor

    2017-02-01

    Dance performance requires not only lower extremity muscle strength and endurance, but also sufficient core stabilization during dynamic dance movements. While previous studies have identified a link between core muscle performance and lower extremity injury risk, what has not been determined is if an extended core stabilization training program will improve specific measures of dance performance. This study examined the impact of a nine-week core stabilization program on indices of dance performance, balance measures, and core muscle performance in competitive collegiate dancers. Within-subject repeated measures design. A convenience sample of 24 female collegiate dance team members (age = 19.7 ± 1.1 years, height = 164.3 ± 5.3 cm, weight 60.3 ± 6.2 kg, BMI = 22.5 ± 3.0) participated. The intervention consisted of a supervised and non-supervised core (trunk musculature) exercise training program designed specifically for dance team participants performed three days/week for nine weeks in addition to routine dance practice. Prior to the program implementation and following initial testing, transversus abdominis (TrA) activation training was completed using the abdominal draw-in maneuver (ADIM) including ultrasound imaging (USI) verification and instructor feedback. Paired t tests were conducted regarding the nine-week core stabilization program on dance performance and balance measures (pirouettes, single leg balance in passe' releve position, and star excursion balance test [SEBT]) and on tests of muscle performance. A repeated measures (RM) ANOVA examined four TrA instruction conditions of activation: resting baseline, self-selected activation, immediately following ADIM training and four days after completion of the core stabilization training program. Alpha was set at 0.05 for all analysis. Statistically significant improvements were seen on single leg balance in passe' releve and bilateral anterior reach for the SEBT (both p ≤ 0

  18. Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money.

    Science.gov (United States)

    Davis, Jennifer J J

    2008-09-01

    Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, "Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense." This promising approach to improving health and reducing healthcare costs could potentially be applied to other employer groups.

  19. Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money

    Science.gov (United States)

    Davis, Jennifer “J. J.”

    2008-01-01

    Background Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. Objectives As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. Methods The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. Results In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Conclusions Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, “Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense.” This promising approach to improving health and reducing healthcare costs could potentially be applied to other

  20. Darlington refurbishment - performance improvement programs goals and experience

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, N. [Ontario Power Generation, Toronto, ON (Canada)

    2015-07-01

    This paper discusses the refurbishment program at the Darlington site. The program focuses on safety, integrity, excellence and personnel. Worker safety and public safety are of the highest priority. Success resulted from collaborative engineering interface, collaborative front end planning, highly competent people and respectful relationship with partners and regulators.

  1. Genetic diversity analysis in Malaysian giant prawns using expressed sequence tag microsatellite markers for stock improvement program.

    Science.gov (United States)

    Atin, K H; Christianus, A; Fatin, N; Lutas, A C; Shabanimofrad, M; Subha, B

    2017-08-17

    The Malaysian giant prawn is among the most commonly cultured species of the genus Macrobrachium. Stocks of giant prawns from four rivers in Peninsular Malaysia have been used for aquaculture over the past 25 years, which has led to repeated harvesting, restocking, and transplantation between rivers. Consequently, a stock improvement program is now important to avoid the depletion of wild stocks and the loss of genetic diversity. However, the success of such an improvement program depends on our knowledge of the genetic variation of these base populations. The aim of the current study was to estimate genetic variation and differentiation of these riverine sources using novel expressed sequence tag-microsatellite (EST-SSR) markers, which not only are informative on genetic diversity but also provide information on immune and metabolic traits. Our findings indicated that the tested stocks have inbreeding depression due to a significant deficiency in heterozygotes, and F IS was estimated as 0.15538 to 0.31938. An F-statistics analysis suggested that the stocks are composed of one large panmictic population. Among the four locations, stocks from Johor, in the southern region of the peninsular, showed higher allelic and genetic diversity than the other stocks. To overcome inbreeding problems, the Johor population could be used as a base population in a stock improvement program by crossing to the other populations. The study demonstrated that EST-SSR markers can be incorporated in future marker assisted breeding to aid the proper management of the stocks by breeders and stakeholders in Malaysia.

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Strategic Improvements to TSA Spot Program

    Science.gov (United States)

    2015-03-01

    supporting me in this program, and specifically, Assistant Administrators Robin Kane, John Sanders, and Chris McLaughlin for their sponsorship. I hope...analysis. Edited by Michael Borenstein, Larry V. Hedges, Julian P. T. Higgins , and Hannah R. Rothstein, 377–387. Chichester, UK: John Wiley & Sons, 2009

  4. Effect of a brief training program based on cognitive behavioral therapy in improving work performance: A randomized controlled trial.

    Science.gov (United States)

    Kimura, Risa; Mori, Makiko; Tajima, Miyuki; Somemura, Hironori; Sasaki, Norio; Yamamoto, Megumi; Nakamura, Saki; Okanoya, June; Ito, Yukio; Otsubo, Tempei; Tanaka, Katsutoshi

    2015-01-01

    Efforts to improve performance in the workplace with respect to positive mental health have increased, and cognitive behavioral therapy (CBT) has recently attracted attention as an intervention measure to this end. Here, we conducted a randomized controlled trial to evaluate the effectiveness of a brief training program on CBT for improving work performance of employees. The participants were employees of an electric company in Japan. The intervention consisted of 1 group session of CBT (120 min) and web-based CBT homework for 1 month. We evaluated employees in both the intervention and control groups at baseline and follow-up after three months. The main outcome was work performance, which was evaluated by a subjective score from 1 to 10. The secondary outcome was self-evaluation of cognitive flexibility. Analyses were conducted based on ITT. In the intervention group, 84 participants attended the group session, with 79 subsequently completing at least 1 instance of online homework. ITT analysis showed that the subjective performance of the intervention group was significantly improved compared with that of the control group (1.47 vs. 0.69, mean difference 0.78 [95% confidence interval {CI}, 0.05 to 1.51], Cohen's d=0.31). The ability to recognize dysfunctional thinking patterns and change them to positive ones significantly improved in the intervention group compared to the control group (0.71 vs. 0.26, mean difference 0.45 [95% CI 0.06 to 0.83], d=0.33). However, after adjustment for baseline scores, no significant difference was observed. The ability to view a situation from multiple perspectives and expand one's repertoire of thought patterns in the intervention group also significantly improved (0.83 vs. 0.35, mean difference 0.48 [95% CI 0.35 to 0.95], d=0.29), but here again, significance was lost after adjusting for baseline scores. Our results suggest that a brief training program that combines a group CBT session with web-based CBT homework improved

  5. Does the Animal Fun program improve social-emotional and behavioural outcomes in children aged 4-6 years?

    NARCIS (Netherlands)

    Piek, J.P.; Kane, R.; Rigoli, D.; McLaren, S.; Roberts, C.M.; Rooney, R.; Jensen, L.; Dender, A.; Packer, T.L.; Straker, L.

    2015-01-01

    Animal Fun was designed to enhance motor and social development in young children. Its efficacy in improving motor skills was presented previously using a randomised controlled trial and a multivariate nested cohort design. Based on the Environmental Stress Hypothesis, it was argued that the program

  6. In situ pediatric trauma simulation: assessing the impact and feasibility of an interdisciplinary pediatric in situ trauma care quality improvement simulation program.

    Science.gov (United States)

    Auerbach, Marc; Roney, Linda; Aysseh, April; Gawel, Marcie; Koziel, Jeannette; Barre, Kimberly; Caty, Michael G; Santucci, Karen

    2014-12-01

    This study aimed to evaluate the feasibility and measure the impact of an in situ interdisciplinary pediatric trauma quality improvement simulation program. Twenty-two monthly simulations were conducted in a tertiary care pediatric emergency department with the aim of improving the quality of pediatric trauma (February 2010 to November 2012). Each session included 20 minutes of simulated patient care, followed by 30 minutes of debriefing that focused on teamwork, communication, and the identification of gaps in care. A single rater scored the performance of the team in real time using a validated assessment instrument for 6 subcomponents of care (teamwork, airway, intubation, breathing, circulation, and disability). Participants completed a survey and written feedback forms. A trend analysis of the 22 simulations found statistically significant positive trends for overall performance, teamwork, and intubation subcomponents; the strength of the upward trend was the strongest for the teamwork (τ = 0.512), followed by overall performance (τ = 0.488) and intubation (τ = 0.433). Two hundred fifty-one of 398 participants completed the participant feedback form (response rate, 63%), reporting that debriefing was the most valuable aspect of the simulation. An in situ interdisciplinary pediatric trauma simulation quality improvement program resulted in improved validated trauma simulation assessment scores for overall performance, teamwork, and intubation. Participants reported high levels of satisfaction with the program, and debriefing was reported as the most valuable component of the program.

  7. Improvement of computer programs 'BAMBOO' and 'ASFRE-IV' for coupling analysis of deformation and thermal-hydraulics in a high burn-up fuel subassembly of fast reactor

    International Nuclear Information System (INIS)

    Uwaba, Tomoyuki; Ohshima, Hiroyuki; Imai, Yasutomo

    2003-04-01

    A simulation system of a deformed fuel subassembly is being developed for the structure integrity of high burn-up wire-spacer-type fuel subassemblies of sodium-cooled fast breeder reactors. This report describes a computer program improvement work for coupling analyses of deformation and thermal-hydraulics in a fuel subassembly as part of the simulation system development. In this work, a function of data conversion as an interface between a bundle deformation analysis program BAMBOO and a thermal hydraulic analysis program ASFRE-IV was incorporated to each program. BAMBOO was improved to accept the coolant temperature data from ASFRE-IV and to offer bundle deformation data to ASFRE-IV. ASFRE-IV was also improved to offer the coolant temperature data to BAMBOO and to obtain the bundle deformation data from BAMBOO. Improved BAMBOO and ASFRE-IV were applied to an analysis of 169-pin bundle for the program verification. It was confirmed that the coupling analysis gave the physically reasonable results on both deformation and thermal hydraulic behaviors in the fuel subassembly. (author)

  8. Improved uranium-utilization program, Phase I. First semiannual report, September 1979-March 1980

    International Nuclear Information System (INIS)

    Hopkins, G.C.

    1980-11-01

    The Improved Uranium Utilization Program includes a Phase I evaluation of BWR design alternatives which have potential to reduce uranium ore requirements in once-through fuel cycles. The Phase I project is evaluating the alternatives in detail, including considerations of reliability, performance, manufacturing, safety and economics; is establishing implementation development requirements, costs and schedules; is selecting the most promising alternatives; and is developing detailed plans for Phase II projects for implementation. Emphasis is being placed on developing practical alternatives which can be demonstrated at the earliest possible date in existing operating BWR nuclear power stations. Priority is being given to alternatives which have the maximum payoff, measured by reduction of the nation's uranium resource requirements, on the shortest schedule. Alternatives included in current evaluations are: improved refueling and control rod pattern optimization, spectral shift, extended burnup, reduction in gadolinia residual, axial blanket optimization, reconstitution, and combinations of these alternatives

  9. A field test of a web-based workplace health promotion program to improve dietary practices, reduce stress, and increase physical activity: randomized controlled trial.

    Science.gov (United States)

    Cook, Royer F; Billings, Douglas W; Hersch, Rebekah K; Back, Anita S; Hendrickson, April

    2007-06-19

    Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet. The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity. Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests. Retention rates were good for both groups-85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F(1,415) = 7.104, P = .008) and Dietary Stage of Change (F(1,408) = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F(2,203) = 5.270, P = .003), Attitudes Toward a Healthful Diet (F(2,204) = 2.585, P = .045), and Dietary Stage of Change (F(2,200) = 4.627, P = .005). No significant differences were found between the two groups on measures of stress or physical

  10. Skill improvement among coalition members in the California Healthy Cities and Communities Program.

    Science.gov (United States)

    Kegler, Michelle C; Norton, Barbara L; Aronson, Robert

    2007-06-01

    Community-driven, collaborative approaches to health promotion have the potential to enhance skills among community members and, in turn, increase community capacity. This study uses data from an evaluation of the California Healthy Cities and Communities (CHCC) Program to examine whether, and how, community problem-solving and collaboration skills are improved among coalition members and local coordinators in 20 participating communities. Methods include semi-structured interviews with coordinators and mailed surveys with coalition members (n=330 in planning phase and n=243 in implementation phase). The largest number of coordinators reported skill improvement in defining health broadly and assessing needs and assets. Similarly, coalition members reported greatest skill improvement for defining health broadly, assessing needs and assets and setting priorities and developing action plans. Modest correlations were observed between number of roles played in the local healthy cities and communities project and each skill area assessed. Time committed to the local CHCC coalition and its activities was not meaningfully correlated with any of the skills. Types of skill-building opportunities may be more important than number of hours devoted to meetings and activities in strengthening community problem-solving and collaboration skills among coalition members.

  11. The effectiveness of a community health program in improving diabetes knowledge in the Hispanic population: Salud y Bienestar (Health and Wellness).

    Science.gov (United States)

    Cruz, Yanira; Hernandez-Lane, Maria-Eugenia; Cohello, Janet I; Bautista, Christian T

    2013-12-01

    We evaluated the effectiveness of the Salud y Bienestar program to deliver diabetes education in the Hispanic population in the United States. This program uses a community outreach model where community health promoters are trained and then they deliver education to other community members regarding diabetes disease, risk factors, and ways to prevent and control disease. This intervention applies a one-group pre- and post-test design to improve diabetes knowledge. The intervention carried out in the states of California, Texas, and Washington DC. A total of 1,413 participants were enrolled. Of these, 73% were females, 46% were 65 years or older, 59% were Mexican, 64% had at least elementary education, 56% had lived in the US for more than 20 years, and 38% participants were self-reported diabetic. Among diabetic participants, a significant improvement was observed on diabetes knowledge when comparing pre- and post-test scores (13.7 vs. 18.6, P Salud y Bienestar program conducted by community health workers was effective approach to improving diabetes knowledge in the Hispanic population.

  12. Long-term effectiveness of a quality improvement program for patients with type 2 diabetes in general practice.

    NARCIS (Netherlands)

    Renders, C.M.; Valk, G.D.; Franse, L.V.; Schellevis, F.; Eijk, J.T.M. van; Wal, G. van der

    2001-01-01

    OBJECTIVE— To assess the long-term effectiveness of a quality improvement program on care provided and patient outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS— A nonrandomized trial was performed with 312 patients with type 2 diabetes in the intervention group and 77 patients with

  13. Improving Program Design and Assessment with Broadening Participation Resources

    Science.gov (United States)

    Siegfried, D.; Johnson, A.; Thomas, S. H.; Fauver, A.; Detrick, L.

    2012-12-01

    Many theoretical and research-based approaches suggest how to best use mentoring to enhance an undergraduate research program. The Institute for Broadening Participation's Pathways to Engineering and Pathways to Ocean Sciences projects synthesized a set of mentoring studies, theoretical sources, and other texts pertinent to undergraduate research program design into a suite of practical tools that includes an online mentoring manual, an online reference library of mentoring and diversity literature, and practical guides such as Using Social Media to Build Diversity in Your REU. The overall goal is to provide easy-to-access resources that can assist faculty and program directors in implementing or honing the mentoring elements in their research programs for undergraduates. IBP's Online Mentoring Manual addresses common themes, such as modeling, student self-efficacy, career development, retention and evaluation. The Online Diversity Reference Library provides a comprehensive, annotated selection of key policy documents, research studies, intervention studies, and other texts on broadening participation in science, technology, engineering and mathematics. IBP's suite of tools provides the theoretical underpinnings and research findings that can help leaders in education integrate site-appropriate mentoring elements into their educational programs. Program directors and faculty from a variety of program types and disciplines have benefitted from using the Manual and other resources. IBP continues the work of translating and synthesizing theory to practice and welcomes your participation and partnership in that effort.

  14. Using management action plans to integrate program improvement efforts

    International Nuclear Information System (INIS)

    Meador, S.W.; Kidwell, R.J.; Shangraw, W.R.; Cardamone, E.N.

    1994-01-01

    The Department of Energy's (DOE's) Environmental Management Program is the country's largest and most sophisticated environmental program to date. The rapid expansion of the DOE's environmental restoration efforts has led to increased scrutiny of its management processes and systems. As the program continues to grow and mature, maintaining adequate accountability for resources and clearly communicating progress will be essential to sustaining public confidence. The Office of Environmental Management must ensure that adequate processes and systems are in place at Headquarters, Operation Offices, and contractor organizations. These systems must provide the basis for sound management, cost control, and reporting. To meet this challenge, the Office of Environmental Restoration introduced the Management Action Plan process. This process was designed to serve three primary functions: (1) define the program's management capabilities at Headquarters and Operations Offices; (2) describe how management initiatives address identified program deficiencies; and (3) identify any duplication of efforts or program deficiencies. The Environmental Restoration Management Action Plan is a tracking, reporting, and statusing tool, used primarily at the Headquarters level, for assessing performance in key areas of project management and control. BY DOE to communicate to oversight agencies and stakeholders a clearer picture of the current status of the environmental restoration project management system. This paper will discuss how Management Action Plans are used to provide a program-wide assessment of management capabilities

  15. Uranium Holdup Survey Program (UHSP) Lean Improvement Project

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Jeff [Y-12 National Security Complex, Oak Ridge, TN (United States); Univ. of Tennessee, Knoxville, TN (United States)

    2017-10-13

    This report discusses the UHSP monitoring program, a radioactive material accounting process and its purpose. The systematic approach to implementing Lean principles, determining key requirements, root causes of variation and disruption that interfere with program efficiency and effectiveness. Preexisting issues within the UHSP are modeled to illustrate the impact that they have on the large and extensive systems.

  16. Cognitive Training Program to Improve Working Memory in Older Adults with MCI.

    Science.gov (United States)

    Hyer, Lee; Scott, Ciera; Atkinson, Mary Michael; Mullen, Christine M; Lee, Anna; Johnson, Aaron; Mckenzie, Laura C

    2016-01-01

    Deficits in working memory (WM) are associated with age-related decline. We report findings from a clinical trial that examined the effectiveness of Cogmed, a computerized program that trains WM. We compare this program to a Sham condition in older adults with Mild Cognitive Impairment (MCI). Older adults (N = 68) living in the community were assessed. Participants reported memory impairment and met criteria for MCI, either by poor delayed memory or poor performance in other cognitive areas. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Delayed Memory Index) and the Clinical Dementia Rating scale (CDR) were utilized. All presented with normal Mini Mental State Exams (MMSE) and activities of daily living (ADLs). Participants were randomized to Cogmed or a Sham computer program. Twenty-five sessions were completed over five to seven weeks. Pre, post, and follow-up measures included a battery of cognitive measures (three WM tests), a subjective memory scale, and a functional measure. Both intervention groups improved over time. Cogmed significantly outperformed Sham on Span Board and exceeded in subjective memory reports at follow-up as assessed by the Cognitive Failures Questionnaire (CFQ). The Cogmed group demonstrated better performance on the Functional Activities Questionnaire (FAQ), a measure of adjustment and far transfer, at follow-up. Both groups, especially Cogmed, enjoyed the intervention. Results suggest that WM was enhanced in both groups of older adults with MCI. Cogmed was better on one core WM measure and had higher ratings of satisfaction. The Sham condition declined on adjustment.

  17. Identification of Barriers Towards Change and Proposal to Institutionalize Continuous Improvement Programs in Manufacturing Operations

    Directory of Open Access Journals (Sweden)

    Alvair Silveira Torres Jr.

    2011-06-01

    Full Text Available A multi case research unfolded into a study in a sample of Brazilian manufacturing companies concerning their Continuous Improvement (CI program in manufacturing operations. Stakeholders interviews and performance analyses were conducted. The study aims to analyze the existence or absence of the institutionalization of a CI culture in manufacturing operations, identify barriers and difficulties within the process and propose a model for change. As a result of the research, it was observed that despite the considerable motivation of staff, rapid gains of the company and superior results during the early phases of the CI program, time and again such results were either not upheld or faded out over time, delivering no significant mid-term or long term results, due to poor management of changes. This happened mainly as a result of lack of strategic alignment at all levels of the organization, translated in measureable activities and projects, coached and mentored by the middle and upper management throughout the implementation and maintenance of the program. The selected cases showed a declining in performance after two years of CI program start up. Learning, union and process ownership among participants by means of interactions, are necessary to absorb and incorporate changes, instead of merely "smart words" .

  18. Improved Gout Outcomes in Primary Care Using a Novel Disease Management Program: A Pilot Study.

    Science.gov (United States)

    Bulbin, David; Denio, Alfred E; Berger, Andrea; Brown, Jason; Maynard, Carson; Sharma, Tarun; Kirchner, H Lester; Ayoub, William T

    2018-02-13

    To pilot a primary care gout management improvement intervention. Two large primary care sites were selected: one underwent the intervention, the other, a control, underwent no intervention. The intervention consisted of: engagement of intervention site staff, surveys of provider performance improvement preferences, and onsite live and enduring online education. Electronic Health Record reminders were constructed. Both the intervention and control sites had 3 quality measures assessed monthly: percent of gout patients treated with urate lowering therapy, percent of treated patients monitored with serum urate, and percent of treated patients at target serum urate ≤ 6.0 mg/dl. The intervention site providers received monthly reports comparing their measures against their peers. By 6 months, the intervention site significantly improved all 3 gout performance measures. Percentage treated increased from 54.4 to 61.1%, OR 1.19 (95% CI 1.08, 1.31 and p-value management program can significantly improve primary care gout management performance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. A school-based health education program can improve cholesterol values for middle school students.

    Science.gov (United States)

    Cotts, T B; Goldberg, C S; Palma Davis, L M; Durussel-Weston, J E; Aaronson, S M; Lin, K; Eagle, K A

    2008-09-01

    This prospective study aimed to measure the impact of a school-based multidisciplinary education program on risk factors for atherosclerosis in sixth-grade students. A prospective study was performed in which patients served as their own controls. Healthy sixth-grade students from three middle schools in a city of approximately 100,000 were exposed to an educational program promoting healthful habits through behavioral and environmental change. Risk factors including body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), cholesterol panel, and random blood glucose were measured before program initiation, then 5 months afterward. Of 711 sixth-graders at three middle schools, 287 (47% boys; mean age, 11.5 +/- 0.37 years) consented to participate in the study. The mean total cholesterol value decreased from 169 +/- 26 to 154 +/- 26 mg/dl (p value decreased from 86 +/- 25 to 84 +/- 23 mg/dl (p = 0.01), and the high-density lipoprotein (HDL) cholesterol value decreased from 56 +/- 13 to 50 +/- 13 mg/dl (p value decreased from 96 +/- 13 to 93 +/- 15 mm/dl (p = 0.01). The mean SBP did not change, showing 109 +/- 12.5 mmHg before the program and 108 +/- 11.5 mmHg afterward. The DBP decreased from 63.6 +/- 8.6 to 62.3 +/- 7.8 mmHg (p = 0.01). The Project Healthy Schools program is feasible and appears to be effective. The results showed significant improvement in risk factors for early atherosclerosis among sixth-grade students including total cholesterol, LDL cholesterol, random glucose levels, and diastolic blood pressure. Further study with a larger group and a longer follow-up period would be valuable.

  20. Healthy and productive workers:using intervention mapping to design a workplace health promotion and wellness program to improve presenteeism

    OpenAIRE

    Ammendolia, Carlo; Côté, Pierre; Cancelliere, Carol; Cassidy, J David; Hartvigsen, Jan; Boyle, Eleanor; Soklaridis, Sophie; Stern, Paula; Amick, Benjamin

    2016-01-01

    Background Presenteeism is a growing problem in developed countries mostly due to an aging workforce. The economic costs related to presenteeism exceed those of absenteeism and employer health costs. Employers are implementing workplace health promotion and wellness programs to improve health among workers and reduce presenteeism. How best to design, integrate and deliver these programs are unknown. The main purpose of this study was to use an intervention mapping approach to develop a workpl...

  1. Health education programs may be as effective as exercise intervention on improving health-related quality of life among Japanese people over 65 years.

    Science.gov (United States)

    Tamari, Kotaro; Kawamura, Kenji; Sato, Mitsuya; Harada, Kazuhiro

    2012-09-01

    The current study was aimed to examine the short-term effects of a 3-month health education program on health-related quality of life using the Short-Form 36. Twenty-five Japanese older people aged 65 and older in the health education program were compared with two historical control groups (n = 25 each) undertaking group and resistance exercise interventions and matched by age, sex and body mass index. A series of split-design two-way analyses of variance were conducted for data analysis. Significant improvements were observed in general health and vitality subscales of the Short-Form 36 in the educational program group. Multivariate analyses, adjusted for several confounding factors, revealed that the effects of the three programs were comparable. The findings suggest that a structured 3-month educational program may be as effective as exercise interventions in improving general health and vitality in a community-dwelling Japanese older population. © 2011 The Authors. Australasian Journal on Ageing © 2011 ACOTA.

  2. Inexact nonlinear improved fuzzy chance-constrained programming model for irrigation water management under uncertainty

    Science.gov (United States)

    Zhang, Chenglong; Zhang, Fan; Guo, Shanshan; Liu, Xiao; Guo, Ping

    2018-01-01

    An inexact nonlinear mλ-measure fuzzy chance-constrained programming (INMFCCP) model is developed for irrigation water allocation under uncertainty. Techniques of inexact quadratic programming (IQP), mλ-measure, and fuzzy chance-constrained programming (FCCP) are integrated into a general optimization framework. The INMFCCP model can deal with not only nonlinearities in the objective function, but also uncertainties presented as discrete intervals in the objective function, variables and left-hand side constraints and fuzziness in the right-hand side constraints. Moreover, this model improves upon the conventional fuzzy chance-constrained programming by introducing a linear combination of possibility measure and necessity measure with varying preference parameters. To demonstrate its applicability, the model is then applied to a case study in the middle reaches of Heihe River Basin, northwest China. An interval regression analysis method is used to obtain interval crop water production functions in the whole growth period under uncertainty. Therefore, more flexible solutions can be generated for optimal irrigation water allocation. The variation of results can be examined by giving different confidence levels and preference parameters. Besides, it can reflect interrelationships among system benefits, preference parameters, confidence levels and the corresponding risk levels. Comparison between interval crop water production functions and deterministic ones based on the developed INMFCCP model indicates that the former is capable of reflecting more complexities and uncertainties in practical application. These results can provide more reliable scientific basis for supporting irrigation water management in arid areas.

  3. Effectiveness of a knowledge-contact program in improving nursing students' attitudes and emotional competence in serving people living with HIV/AIDS.

    Science.gov (United States)

    Yiu, Jessie W; Mak, Winnie W S; Ho, Winnie S; Chui, Ying Yu

    2010-07-01

    This study compared the effectiveness of an AIDS knowledge-only program (knowledge) with a combined program of AIDS knowledge and contact with people having HIV/AIDS (PHA) (knowledge-contact) in reducing nursing students' stigma and discrimination towards PHA and in enhancing their emotional competence to serve PHA. Eighty-nine nursing students from two universities in Hong Kong were randomly assigned to either the knowledge or the knowledge-contact condition. All participants completed measures of AIDS knowledge, stigmatizing attitudes, fear of contagion, willingness to treat, positive affect, and negative affect at pre-test, post-test, and six-week follow-up. Findings showed that in both groups, significant improvement in AIDS knowledge, stigmatizing attitudes, fear of contagion, willingness to treat, and negative affect were found at post-test. The effects on AIDS knowledge, fear of contagion, willingness to treat, and negative affect were sustained at follow-up for both groups. Intergroup comparisons at post-test showed that the effectiveness of knowledge-contact program was significantly greater than knowledge program in improving stigmatizing attitudes. No significant difference between the two groups was found at follow-up. Findings showed the short-term effect of contact in improving nursing students' attitudes and emotional competence in serving PHA. Implications for research and training of nursing staff were discussed. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  4. Atmospheric radiation measurement: A program for improving radiative forcing and feedback in general circulation models

    International Nuclear Information System (INIS)

    Patrinos, A.A.; Renne, D.S.; Stokes, G.M.; Ellingson, R.G.

    1991-01-01

    The Atmospheric Radiation Measurement (ARM) Program is a key element of the Department of Energy's (DOE's) global change research strategy. ARM represents a long-term commitment to conduct comprehensive studies of the spectral atmospheric radiative energy balance profile for a wide range of cloud conditions and surface types, and to develop the knowledge necessary to improve parameterizations of radiative processes under various cloud regimes for use in general circulation models (GCMs) and related models. The importance of the ARM program is a apparent from the results of model assessments of the impact on global climate change. Recent studies suggest that radiatively active trace gas emissions caused by human activity can lead to a global warming of 1.5 to 4.5 degrees Celsius and to important changes in water availability during the next century (Cess, et al. 1989). These broad-scale changes can be even more significant at regional levels, where large shifts in temperature and precipitation patterns are shown to occur. However, these analyses also indicate that considerable uncertainty exists in these estimates, with the manner in which cloud radiative processes are parameterized among the most significant uncertainty. Thus, although the findings have significant policy implications in assessment of global and regional climate change, their uncertainties greatly influence the policy debate. ARM's highly focused observational and analytical research is intended to accelerate improvements and reduce key uncertainties associated with the way in which GCMs treat cloud cover and cloud characteristics and the resulting radiative forcing. This paper summarizes the scientific context for ARM, ARM's experimental approach, and recent activities within the ARM program

  5. Community-Based Multidisciplinary Computed Tomography Screening Program Improves Lung Cancer Survival.

    Science.gov (United States)

    Miller, Daniel L; Mayfield, William R; Luu, Theresa D; Helms, Gerald A; Muster, Alan R; Beckler, Vickie J; Cann, Aaron

    2016-05-01

    cancer specific survival was 71% in the screened patients, whereas nonscreened lung cancer patients during that time in WHS had an overall survival of only 19% (p < 0.001). A community-based multidisciplinary lung cancer screening program can improve survival of patients with lung cancer outside of a large multicenter study. This survival advantage was caused by a significant stage shift to earlier disease. Lung cancer CT screening may also benefit patients not meeting the National Lung Screening Trial criteria who are at moderate or high risk for lung cancer. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Clean Coal Technology Programs: Program Update 2009

    Energy Technology Data Exchange (ETDEWEB)

    None

    2009-10-01

    The purpose of the Clean Coal Technology Programs: Program Update 2009 is to provide an updated status of the U.S. Department of Energy (DOE) commercial-scale demonstrations of clean coal technologies (CCT). These demonstrations have been performed under the Clean Coal Technology Demonstration Program (CCTDP), the Power Plant Improvement Initiative (PPII), and the Clean Coal Power Initiative (CCPI). Program Update 2009 provides: (1) a discussion of the role of clean coal technology demonstrations in improving the nation’s energy security and reliability, while protecting the environment using the nation’s most abundant energy resource—coal; (2) a summary of the funding and costs of the demonstrations; and (3) an overview of the technologies being demonstrated, along with fact sheets for projects that are active, recently completed, or recently discontinued.

  7. Clean Coal Technology Demonstration Program: Program Update 2001

    Energy Technology Data Exchange (ETDEWEB)

    Assistant Secretary for Fossil Energy

    2002-07-30

    Annual report on the Clean Coal Technology Demonstration Program (CCT Program). The report address the role of the CCT Program, implementation, funding and costs, accomplishments, project descriptions, legislative history, program history, environmental aspects, and project contacts. The project descriptions describe the technology and provides a brief summary of the demonstration results. Also includes Power Plant Improvement Initiative Projects.

  8. Process Improvement Essentials

    CERN Document Server

    Persse, James R

    2006-01-01

    Process Improvement Essentials combines the foundation needed to understand process improvement theory with the best practices to help individuals implement process improvement initiatives in their organization. The three leading programs: ISO 9001:2000, CMMI, and Six Sigma--amidst the buzz and hype--tend to get lumped together under a common label. This book delivers a combined guide to all three programs, compares their applicability, and then sets the foundation for further exploration.

  9. Biophotonics-based strategies for improving Alzheimer’s and Parkinson’s disease diagnosis and monitoring: two innovative approaches by the Van ‘t Hoff program

    NARCIS (Netherlands)

    Amelink, A.; Westerlaken, A.C.; Boer, B.M. de

    2015-01-01

    The Van ‘t Hoff program is a new collaborative research and innovation program, initiated by TNO, in the field of biomedical optics. The Van ‘t Hoff program aims to improve medical diagnosis and therapy through development of innovative medical devices based on photonics and biomedical technologies.

  10. An Electronic Wellness Program to Improve Diet and Exercise in College Students: A Pilot Study

    OpenAIRE

    Schweitzer, Amy L; Ross, Jamisha T; Klein, Catherine J; Lei, Kai Y; Mackey, Eleanor R

    2016-01-01

    Background In transitioning from adolescence to adulthood, college students are faced with significant challenges to their health habits. Independence, stress, and perceived lack of time by college students have been known to result in poor eating and exercise habits, which can lead to increased disease risk. Objective To assess the feasibility and to determine preliminary efficacy of an electronic wellness program in improving diet and physical activity in college students. Methods A 24-week...

  11. Improved atmospheric dispersion modelling in the new program system UFOMOD for accident consequence assessments

    International Nuclear Information System (INIS)

    Panitz, H.J.

    1988-01-01

    An essential aim of the improvements of the new program system UFOMOD for Accident Consequence Assessments (ACAs) was to substitute the straightline Gaussian plume model conventionally used in ACA models by more realistic atmospheric dispersion models. To identify improved models which can be applied in ACA codes and to quantify the implications of different concepts of dispersion modelling on the results of an ACA, probabilistic comparative calculations with different atmospheric dispersion models have been carried out. The study showed that there are trajectory models available which can be applied in ACAs and that these trajectory models provide more realistic results of ACAs than straight-line Gaussian models. This led to a completly novel concept of atmospheric dispersion modelling which distinguish between two different distance ranges of validity: the near range ( 50 km). The two ranges are assigned to respective trajectory models

  12. INTEGRATED PRACTICE LEARNING MODEL TO IMPROVE WAITER/S’ COMPETENCY ON HOSPITALITY STUDY PROGRAM, POLITEKNIK NEGERI BALI

    Directory of Open Access Journals (Sweden)

    I Made Darma Oka

    2017-12-01

    Full Text Available Hospitality Study Program, Politeknik Negeri Bali (PNB, hadn’t implemented integrated learning practice optimally. The aim of this research was improving the learning process method as an integrated practice learning model involving three courses (Food Production, FB Service, English for Restaurant in the same topic. This study was conducted on the forth semester of Hotel Study Program as the sample used in this research. After the random sampling was selected two classes as research samples, those were IVA class as an experiment group and IVB class as a control. Thus the samples could be determined according to the number of students in each class as many as 26 people. The application of integrated practice learning had an effect on the achievement of student competency in waiter/s occupation at Hotel Studies Program. The result of statistical test showed that there was a significant difference of competency achievement between integrated learning practices with partial practice learning students groups. It’s suggested to the management Hospitality Study Program to encourage and to facilitate the lecturers especially of core subjects to apply integrated learning practices in order to achieve the competency.

  13. End-Stage Renal Disease Outcomes among the Kaiser Permanente Southern California Creatinine Safety Program (Creatinine SureNet): Opportunities to Reflect and Improve.

    Science.gov (United States)

    Sim, John J; Batech, Michael; Danforth, Kim N; Rutkowski, Mark P; Jacobsen, Steven J; Kanter, Michael H

    2017-01-01

    The Kaiser Permanente Southern California (KPSC) creatinine safety program (Creatinine SureNet) identifies and outreaches to thousands of people annually who may have had a missed diagnosis for chronic kidney disease (CKD). We sought to determine the value of this outpatient program and evaluate opportunities for improvement. Longitudinal cohort study (February 2010 through December 2015) of KPSC members captured into the creatinine safety program who were characterized using demographics, laboratory results, and different estimations of glomerular filtration rate. Age- and sex-adjusted rates of end-stage renal disease (ESRD) were compared with those in the overall KPSC population. Among 12,394 individuals, 83 (0.7%) reached ESRD. The age- and sex-adjusted relative risk of ESRD was 2.7 times higher compared with the KPSC general population during the same period (94.7 vs 35.4 per 100,000 person-years; p creatinine measurements, only 13% had a urine study performed (32% among patients with confirmed CKD). Our study found a higher incidence of ESRD among individuals captured into the KPSC creatinine safety program. If the Chronic Kidney Disease Epidemiology Collaboration equation were used, fewer people would have been captured while improving the accuracy for diagnosing CKD. Urine testing was low even among patients with confirmed CKD. Our findings demonstrate the importance of a creatinine safety net program in an integrated health system but also suggest opportunities to improve CKD care and screening.

  14. Assisting People with Multiple Disabilities by Improving Their Computer Pointing Efficiency with an Automatic Target Acquisition Program

    Science.gov (United States)

    Shih, Ching-Hsiang; Shih, Ching-Tien; Peng, Chin-Ling

    2011-01-01

    This study evaluated whether two people with multiple disabilities would be able to improve their pointing performance through an Automatic Target Acquisition Program (ATAP) and a newly developed mouse driver (i.e. a new mouse driver replaces standard mouse driver, and is able to monitor mouse movement and intercept click action). Initially, both…

  15. A comprehensive medical student career development program improves medical student satisfaction with career planning.

    Science.gov (United States)

    Zink, Brian J; Hammoud, Maya M; Middleton, Eric; Moroney, Donney; Schigelone, Amy

    2007-01-01

    In 1999, the University of Michigan Medical School (UMMS) initiated a new career development program (CDP). The CDP incorporates the 4-phase career development model described by the Association of American Medical Colleges (AAMC) Careers in Medicine (CiM). The CDP offers self-assessment exercises with guidance from trained counselors for 1st- and 2nd-year medical students. Career exploration experiences include Career Seminar Series luncheons, shadow experiences with faculty, and a shadow program with second-year (M2) and fourth-year (M4) medical students. During the decision-making phase, students work with trained faculty career advisors (FCA). Mandatory sessions are held on career selection, preparing the residency application, interviewing, and program evaluation. During the implementation phase, students meet with deans or counselors to discuss residency application and matching. An "at-risk plan" assists students who may have difficulty matching. The CiM Web site is extensively used during the 4 stages. Data from the AAMC and UMMS Graduation Questionnaires (GQ) show significant improvements for UMMS students in overall satisfaction with career planning services and with faculty mentoring, career assessment activities, career information, and personnel availability. By 2003, UMMS students had significantly higher satisfaction in all measured areas of career planning services when compared with all other U.S. medical students.

  16. Improved remote HEPA filtration development program

    International Nuclear Information System (INIS)

    Wilson, C.E. III.

    1987-03-01

    This paper presents a summary of the prototype development and hot cell mock-up testing program undertaken to adapt a commercial remote HEPA filter housing for use in the Process Facility Modification Project (PFMP). This program was initiated in response to the project design criteria and documentation that required the air from the hot cell environment to be exhausted through three stages of HEPA filtration. Due to the anticipated quantity of radioactive contamination captured by the first stage of filters, it was determined that the first stage would need to be located in a remotely operated and maintained shielded cell adjoining the primary hot cell areas. Commercially available remote filtration equipment was evaluated and candidate unit was identified, which could be developed into a suitable filter housing. A candidate unit was obtained from Flanders Filters, Inc. and a series of hot cell mock-up tests were identified in the 305 facility at the Hanford site. The results of these tests, and further interaction with the vendor, led to a prototype remote filter housing which satisfied most PFMP criteria and proved to be significantly superior to existing commercial units for remote operation/maintenance

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

    Energy Technology Data Exchange (ETDEWEB)

    Prieto, M.

    2015-07-01

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

  18. Improving Phonological Awareness in Parents of Children at Risk of Literacy Difficulties: A Preliminary Evaluation of the Boost Program

    OpenAIRE

    Boyes, Mark E.; Leitão, Suze; Claessen, Mary; Dzidic, Peta; Boyle, Gemma; Perry, Alison; Nayton, Mandy

    2017-01-01

    Background Phonological awareness is an important skill underpinning the development of early literacy. Given the central role of parents in supporting the development of children’s early literacy skills, and that poor parental phonological awareness is associated with poorer child literacy outcomes, it is possible that improving parent phonological awareness may aid literacy development for at-risk children. This study is a preliminary evaluation of a program aiming to improve phonologica...

  19. A multistate quality improvement program to decrease elective deliveries before 39 weeks of gestation.

    Science.gov (United States)

    Oshiro, Bryan T; Kowalewski, Leslie; Sappenfield, William; Alter, Caroline C; Bettegowda, Vani R; Russell, Rebecca; Curran, John; Reeves, Lori; Kacica, Marilyn; Andino, Nelson; Mason-Marti, Peyton; Crouse, Dennis; Knight, Susan; Littlejohn, Karen; Malatok, Sharyn; Dudley, Donald J; Berns, Scott D

    2013-05-01

    Nonmedically indicated (elective) deliveries before 39 weeks of gestation result in unnecessary neonatal morbidity. We sought to determine whether implementation of a process improvement program will decrease the rate of elective scheduled singleton early-term deliveries (37 0/7-38 6/7 weeks of gestation) in a group of diverse community and academic hospitals. Policies and procedures for scheduling inductions and cesarean deliveries were implemented and patient and health care provider education was provided. Outcomes for scheduled singleton deliveries at 34 weeks of gestation or higher were submitted through a web-based data entry system. The rate of scheduled singleton elective early-term deliveries as well as the rates of early-term medically indicated and unscheduled deliveries, neonatal intensive care unit admissions, and singleton term fetal mortality rate were evaluated. A total of 29,030 scheduled singletons at 34 weeks of gestation or higher were delivered in 26 participating hospitals between January 2011 and December 2011. Elective scheduled early-term deliveries decreased from 27.8% in the first month to 4.8% in the 12th month (Pscheduled singleton early-term inductions (72%, P=.029) and cesarean deliveries (84%; Pscheduled early-term singletons decreased nonsignificantly from 1.5% to 1.2% (P=.24). There was no increase in the term fetal mortality rate. A rapid-cycle process improvement program substantially decreased elective scheduled early-term deliveries to less than 5% in a group of diverse hospitals across multiple states. III.

  20. Report: EPA’s National Security Information Program Could Be Improved

    Science.gov (United States)

    Report #12-P-0543, June 18, 2012. Under its classified NSI program, EPA has assigned responsibilities and provided guidance, training, and oversight. EPA program offices provide secure equipment and space, following NSI program specifications.

  1. 76 FR 41246 - Pesticide Program Dialogue Committee, Pesticide Registration Improvement Act Process Improvement...

    Science.gov (United States)

    2011-07-13

    ... Committee, Pesticide Registration Improvement Act Process Improvement Workgroup; Notice of Public Meeting...) Process Improvement Work Group. EPA plans to meet its ESA consultation obligations through the pesticide... a pesticide during the registration review process. This meeting of the PRIA Process Improvement...

  2. Improved Adherence Rates and Clinical Outcomes of an Integrated, Closed-Loop, Pharmacist-Led Oral Chemotherapy Management Program.

    Science.gov (United States)

    Muluneh, Benyam; Schneider, Molly; Faso, Aimee; Amerine, Lindsey; Daniels, Rowell; Crisp, Brett; Valgus, John; Savage, Scott

    2018-06-01

    To address the growing use of oral anticancer therapy, an integrated, closed-loop, pharmacist-led oral chemotherapy management program was created within an academic medical center. An integrated, closed-loop, pharmacy-led oral chemotherapy management program was established. From September 2014 until June 2015, demographic information, rates of adherence, patient understanding of treatment, pharmacist interventions, patient and provider satisfaction, and molecular response rates in patients with chronic myeloid leukemia (CML) were collected. After full implementation, 107 patients were enrolled in our oral chemotherapy management program from September 2014 until June 2015. All patients were educated before starting oral chemotherapy, and using pre- and postassessment tests, comprehension of oral chemotherapy treatment increased from 43% to 95%. Patient-reported adherence was 86% and 94.7% for the GI/breast and malignant hematology patient populations, respectively, and these were validated with medication possession ratio, revealing adherence rates of 85% and 93.9% for the GI/breast and malignant hematology patient populations, respectively. A total of 350 encounters with a clinical pharmacist and 318 adverse effects were reported, which led to 235 interventions. This program led to a higher major molecular response rate (83%) in our CML population compared with published clinical trials (average major molecular response rates, 40% and 60% with 1- and 2-year follow-up, respectively). An innovative model was developed and resulted in improved patient knowledge regarding oral chemotherapy, improved adherence rates that exceeded nationally established thresholds, and superior major molecular response outcomes for patients with CML compared with published literature. As a result, this model has produced the gold standard in managing patients receiving oral chemotherapy.

  3. A New Visual Stimulation Program for Improving Visual Acuity in Children with Visual Impairment: A Pilot Study

    Science.gov (United States)

    Tsai, Li-Ting; Hsu, Jung-Lung; Wu, Chien-Te; Chen, Chia-Ching; Su, Yu-Chin

    2016-01-01

    The purpose of this study was to investigate the effectiveness of visual rehabilitation of a computer-based visual stimulation (VS) program combining checkerboard pattern reversal (passive stimulation) with oddball stimuli (attentional modulation) for improving the visual acuity (VA) of visually impaired (VI) children and children with amblyopia and additional developmental problems. Six children (three females, three males; mean age = 3.9 ± 2.3 years) with impaired VA caused by deficits along the anterior and/or posterior visual pathways were recruited. Participants received eight rounds of VS training (two rounds per week) of at least eight sessions per round. Each session consisted of stimulation with 200 or 300 pattern reversals. Assessments of VA (assessed with the Lea symbol VA test or Teller VA cards), visual evoked potential (VEP), and functional vision (assessed with the Chinese-version Functional Vision Questionnaire, FVQ) were carried out before and after the VS program. Significant gains in VA were found after the VS training [VA = 1.05 logMAR ± 0.80 to 0.61 logMAR ± 0.53, Z = –2.20, asymptotic significance (2-tailed) = 0.028]. No significant changes were observed in the FVQ assessment [92.8 ± 12.6 to 100.8 ±SD = 15.4, Z = –1.46, asymptotic significance (2-tailed) = 0.144]. VEP measurement showed improvement in P100 latency and amplitude or integration of the waveform in two participants. Our results indicate that a computer-based VS program with passive checkerboard stimulation, oddball stimulus design, and interesting auditory feedback could be considered as a potential intervention option to improve the VA of a wide age range of VI children and children with impaired VA combined with other neurological disorders. PMID:27148014

  4. A New Visual Stimulation Program for Improving Visual Acuity in Children with Visual Impairment: A Pilot Study.

    Science.gov (United States)

    Tsai, Li-Ting; Hsu, Jung-Lung; Wu, Chien-Te; Chen, Chia-Ching; Su, Yu-Chin

    2016-01-01

    The purpose of this study was to investigate the effectiveness of visual rehabilitation of a computer-based visual stimulation (VS) program combining checkerboard pattern reversal (passive stimulation) with oddball stimuli (attentional modulation) for improving the visual acuity (VA) of visually impaired (VI) children and children with amblyopia and additional developmental problems. Six children (three females, three males; mean age = 3.9 ± 2.3 years) with impaired VA caused by deficits along the anterior and/or posterior visual pathways were recruited. Participants received eight rounds of VS training (two rounds per week) of at least eight sessions per round. Each session consisted of stimulation with 200 or 300 pattern reversals. Assessments of VA (assessed with the Lea symbol VA test or Teller VA cards), visual evoked potential (VEP), and functional vision (assessed with the Chinese-version Functional Vision Questionnaire, FVQ) were carried out before and after the VS program. Significant gains in VA were found after the VS training [VA = 1.05 logMAR ± 0.80 to 0.61 logMAR ± 0.53, Z = -2.20, asymptotic significance (2-tailed) = 0.028]. No significant changes were observed in the FVQ assessment [92.8 ± 12.6 to 100.8 ±SD = 15.4, Z = -1.46, asymptotic significance (2-tailed) = 0.144]. VEP measurement showed improvement in P100 latency and amplitude or integration of the waveform in two participants. Our results indicate that a computer-based VS program with passive checkerboard stimulation, oddball stimulus design, and interesting auditory feedback could be considered as a potential intervention option to improve the VA of a wide age range of VI children and children with impaired VA combined with other neurological disorders.

  5. A new visual stimulation program for improving visual acuity in children with visual impairment: a pilot study

    Directory of Open Access Journals (Sweden)

    Li-Ting eTsai

    2016-04-01

    Full Text Available The purpose of this study was to investigate the effectiveness of visual rehabilitation of a computer-based visual stimulation (VS program combining checkerboard pattern reversal (passive stimulation with oddball stimuli (attentional modulation for improving the visual acuity (VA of visually impaired (VI children and children with amblyopia and additional developmental problems. Six children (3 females, 3 males; mean age = 3.9 ± 2.3 years with impaired VA caused by deficits along the anterior and/or posterior visual pathways were recruited. Participants received eight rounds of VS training (two rounds per week of at least 8 sessions per round. Each session consisted of stimulation with 200 or 300 pattern reversals. Assessments of VA (assessed with the Lea symbol VA test or Teller VA cards, visual evoked potential (VEP, and functional vision (assessed with the Chinese-version Functional Vision Questionnaire, FVQ were carried out before and after the VS program. Significant gains in VA were found after the VS training (VA=1.05 logMAR ± 0.80 to 0.61 logMAR ± 0.53, Z=-2.20, asymptotic significance (2-tailed =0.028. No significant changes were observed in the FVQ assessment (92.8 ± 12.6 to 100.8 ± SD=15.4, Z=-1.46, asymptotic significance (2-tailed = 0.144. VEP measurement showed improvement in P100 latency and amplitude or integration of the waveform in two participants. Our results indicate that a computer-based VS program with passive checkerboard stimulation, oddball stimulus design, and interesting auditory feedback could be considered as a potential intervention option to improve the VA of a wide age range of VI children and children with impaired VA combined with other neurological disorders.

  6. Alaska: Improving Referrals of Victims of Maltreatment to the IDEA Part C Program. State Spotlight: Data Sharing

    Science.gov (United States)

    Derrington, Taletha; Peters, Mary Louise; Mauzy, Denise; Ruggiero, Robert

    2015-01-01

    This 2015 state spotlight document describes how Alaska Part C improved the referral of children from Child Welfare to the Individuals with Disabilities Education Act (IDEA) Part C Program by an automated transfer of data from Child Welfare to Part C for substantiated cases of child maltreatment (i.e., child abuse and/or neglect).

  7. Social Validity of the Social Skills Improvement System--Classwide Intervention Program (SSIS-CIP) in the Primary Grades

    Science.gov (United States)

    Wollersheim Shervey, Sarah; Sandilos, Lia E.; DiPerna, James C.; Lei, Pui-Wa

    2017-01-01

    The purpose of this study was to examine the social validity of the Social Skills Improvement System--Classwide Intervention Program (SSIS-CIP) for teachers in the primary grades. Participants included 45 first and second grade teachers who completed a 16-item social validity questionnaire during each year of the SSIS-CIP efficacy trial. Findings…

  8. Innovation in diabetes care: improving consumption of healthy food through a "chef coaching" program: a case report.

    Science.gov (United States)

    Polak, Rani; Dill, Diana; Abrahamson, Martin J; Pojednic, Rachele M; Phillips, Edward M

    2014-11-01

    Nutrition therapy as part of lifestyle care is recommended for people with type 2 diabetes. However, most people with diabetes do not follow this guideline. Changing eating habits involves obtaining knowledge and building practical skills such as shopping, meal preparation, and food storage. Just as fitness coaches use their specific knowledge base in fitness to enhance the effectiveness of their coaching, credentialed chefs trained as health coaches might combine their culinary expertise with coaching in order to improve clients' food choices and lifestyles. This report documents the case of a 55-year-old white male physician, single and living alone, who was recently diagnosed with type 2 diabetes and reported chronic stress, sedentary behavior, and unhealthy eating habits. He participated in a chef coaching program of 8 weekly one-on-one 30-minute coaching sessions via Skype delivered by a chef trained as a health coach. During the first five meetings, the patient's goals were primarily culinary; however, with his success in accomplishing these goals, the patient progressed and expanded his goals to include other lifestyle domains, specifically exercise and work-life balance. At the end of the program, the patient had improved both his nutritional and exercise habits, his confidence in further self-care improvement, and his health parameters such as HgA1c (8.8% to 6.7%; normal implement them so that they eat better and, further, has the potential to help them improve their overall self-care. We intend to further develop chef coaching and assess its potential as we learn from its implementation.

  9. [Effectiveness of an educational program for respiratory rehabilitation of Chronic Obstructive Pulmonary Disease patients in Primary Care in improving the quality of life, symptoms, and clinical risk].

    Science.gov (United States)

    Blánquez Moreno, Cristina; Colungo Francia, Cristina; Alvira Balada, M Carme; Kostov, Belchin; González-de Paz, Luis; Sisó-Almirall, Antoni

    2017-10-04

    To determine the impact of an educational program to improve the management of chronic obstructive pulmonary disease (COPD) that contributes to an increase of the quality of life, exercise capacity, level of dyspnoea, and clinical risk. Intervention study without controls. Primary Healthcare Centre. 193 patients with COPD were invited, 73 accepted and 55 participated in the educational program. Respiratory rehabilitation educational program with basic concepts of pulmonary and respiratory pathophysiology, respiratory physiotherapy exercises, practical workshop on the use of the most frequent inhalation devices, understanding of chronic disease and self-care measures in case of exacerbation. The quality of life (the COPD assessment test), exercise tolerance (the Six-Minute Walk Test), rating of perceived exertion (Borg Dyspnoea Score) and clinical risk (BODE index) were assessed by means of validated questionnaires in Spanish. A total of 43 (78.2%) participants completed the program. An improvement in the quality of life by a mean of 3.3 points was observed (95%CI; 1.76-4.84). Just over half (53.5%) of the participants obtained a clinically relevant improvement. Participants also improved their physical exercise capacity at post-intervention by increasing the distance that they walked in 6min by a mean of 20.76m (95%CI; 2.57-38.95). Improvements in the level of dyspnoea and clinical risk were also observed. The educational program shows a statistically significant and clinically relevant improvement in the quality of life, fatigue, symptomatology, exercise capacity, level of dyspnoea, and clinical risk. The program is adaptable to the health care routine of healthcare centres. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. Improving Nurses' Peripheral Intravenous Catheter Insertion Knowledge, Confidence, and Skills Using a Simulation-Based Blended Learning Program: A Randomized Trial.

    Science.gov (United States)

    Keleekai, Nowai L; Schuster, Catherine A; Murray, Connie L; King, Mary Anne; Stahl, Brian R; Labrozzi, Laura J; Gallucci, Susan; LeClair, Matthew W; Glover, Kevin R

    2016-12-01

    Peripheral intravenous catheter (PIVC) insertion is one of the most common invasive procedures performed in a hospital, but most nurses receive little formal training in this area. Blended PIVC insertion training programs that incorporate deliberate simulated practice have the potential to improve clinical practice and patient care. The study was a randomized, wait-list control group with crossover using nurses on three medical/surgical units. Baseline PIVC knowledge, confidence, and skills assessments were completed for both groups. The intervention group then received a 2-hour PIVC online course, followed by an 8-hour live training course using a synergistic mix of three simulation tools. Both groups were then reassessed. After crossover, the wait-list group received the same intervention and both groups were reassessed. At baseline, both groups were similar for knowledge, confidence, and skills. Compared with the wait-list group, the intervention group had significantly higher scores for knowledge, confidence, and skills upon completing the training program. After crossover, the wait-list group had similarly higher scores for knowledge, confidence, and skills than the intervention group. Between the immediate preintervention and postintervention periods, the intervention group improved scores for knowledge by 31%, skills by 24%, and decreased confidence by 0.5%, whereas the wait-list group improved scores for knowledge by 28%, confidence by 16%, and skills by 15%. Results demonstrate significant improvements in nurses' knowledge, confidence, and skills with the use of a simulation-based blended learning program for PIVC insertion. Transferability of these findings from a simulated environment into clinical practice should be further explored.

  11. Does the Animal Fun program improve social-emotional and behavioural outcomes in children aged 4-6 years?

    Science.gov (United States)

    Piek, Jan P; Kane, Robert; Rigoli, Daniela; McLaren, Sue; Roberts, Clare M; Rooney, Rosanna; Jensen, Lynn; Dender, Alma; Packer, Tanya; Straker, Leon

    2015-10-01

    Animal Fun was designed to enhance motor and social development in young children. Its efficacy in improving motor skills was presented previously using a randomised controlled trial and a multivariate nested cohort design. Based on the Environmental Stress Hypothesis, it was argued that the program would also result in positive mental health outcomes, investigated in the current study. Pre-intervention scores were recorded for 511 children aged 4.83-6.17 years (M=5.42, SD=.30). Intervention and control groups were compared 6 months following intervention, and again in their first school year. Changes in teacher-rated prosocial behaviour and total difficulties were assessed using the Strengths and Difficulties Questionnaire, and data analysed using Generalised Linear Mixed Models. There was a significant improvement in prosocial behaviour of children in the intervention group six months after initial testing, which remained at 18-month follow-up. Total difficulties decreased at 6 months for the intervention group, with no change at 18 months. This effect was present only for the hyperactivity/inattention subscale. The only significant change for the control group was an increase in hyperactivity/inattention scores from pre-intervention to 18-month follow-up. The Animal Fun program appears to be effective in improving social and behavioural outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Performance improvement program: goals and experience

    International Nuclear Information System (INIS)

    Guglielmi, F.

    2015-01-01

    Following long 54 month refurbishment outage at Point Lepreau Generating Station, operational performance had fallen below industry standards in a number of areas. Leadership development and succession planning had stalled. Operational focus was low primarily due to the construction focus during refurbishment. Condition of balance of plant was poor including several long standing deficiencies. In order to improve performance, the site implemented a framework based on INPO 12-011: Focus on Improving Behaviours; Set common goals and demonstrate results; Align and engage the organization; Drive to achieve high levels of performance and sustain performance.

  13. Performance improvement program: goals and experience

    Energy Technology Data Exchange (ETDEWEB)

    Guglielmi, F. [Point Lepreau Generating Station, Maces Bay, New Brunswick (Canada)

    2015-07-01

    Following long 54 month refurbishment outage at Point Lepreau Generating Station, operational performance had fallen below industry standards in a number of areas. Leadership development and succession planning had stalled. Operational focus was low primarily due to the construction focus during refurbishment. Condition of balance of plant was poor including several long standing deficiencies. In order to improve performance, the site implemented a framework based on INPO 12-011: Focus on Improving Behaviours; Set common goals and demonstrate results; Align and engage the organization; Drive to achieve high levels of performance and sustain performance.

  14. Sustained Improvements in Dynamic Balance and Landing Mechanics After a 6-Week Neuromuscular Training Program in College Women's Basketball Players.

    Science.gov (United States)

    Pfile, Kate R; Gribble, Phillip A; Buskirk, Gretchen E; Meserth, Sara M; Pietrosimone, Brian G

    2016-08-01

    Epidemiological data demonstrate the need for lower-extremity injury-prevention training. Neuromuscular-control (NMC) programs are immediately effective at minimizing lower-extremity injury risk and improving sport-related performance measures. Research investigating lasting effects after an injury-prevention program is limited. To determine whether dynamic balance, landing mechanics, and hamstring and quadriceps strength could be improved after a 6-wk NMC intervention and maintained for a season. Prospective case series. Controlled laboratory. 11 Division I women's basketball players (age 19.40 ± 1.35 y, height 178.05 ± 7.52 cm, mass 72.86 ± 10.70 kg). Subjects underwent testing 3 times, completing the Star Excursion Balance Test (SEBT), Landing Error Scoring System (LESS), and isometric strength testing for the hamstrings and quadriceps muscles. Pretest and posttest 1 occurred immediately before and after the intervention, respectively, and posttest 2 at the end of the competitive season, 9 mo after posttest 1. Subjects participated in eighteen 30-min plyometric and NMC-training sessions over a 6-wk period. The normalized SEBT composite score, normalized peak isometric hamstrings:quadriceps (H:Q) ratio, and the LESS total score. The mean composite reach significantly improved over time (F2,10 = 6.96, P = .005) where both posttest scores were significantly higher than pretest (70.41% ± 4.08%) (posttest 1 73.48% ± 4.19%, t10 = -3.11, P = .011) and posttest 2 (74.2% ± 4.77%, t10 = -3.78, P = .004). LESS scores significantly improved over time (F2,10 = 6.29, P = .009). The pretest LESS score (7.30 ± 3.40) was higher than posttest 1 (4.9 ± 1.20, t10 = 2.71, P = .024) and posttest 2 (5.44 ± 1.83, t10 = 2.58, P = .030). There were no statistically significant differences (P > .05) over time for the H:Q ratio when averaging both legs (F2,10 = 0.83, P = .45). A 6-wk NMC program improved landing mechanics and dynamic balance over a 9-mo period in women

  15. Genomic mutational analysis of the impact of the classical strain improvement program on β-lactam producing Penicillium chrysogenum

    NARCIS (Netherlands)

    Salo, Oleksandr V; Ries, Marco; Medema, Marnix H; Lankhorst, Peter P; Vreeken, Rob J; Bovenberg, Roel A L; Driessen, Arnold J M

    2015-01-01

    BACKGROUND: Penicillium chrysogenum is a filamentous fungus that is employed as an industrial producer of β-lactams. The high β-lactam titers of current strains is the result of a classical strain improvement program (CSI) starting with a wild-type like strain more than six decades ago. This

  16. Designing and Assessing the Validity and Reliability of the Hospital Readiness Assessment Tools to Conducting Quality Improvement Program

    Directory of Open Access Journals (Sweden)

    Kamal Gholipoor

    2016-09-01

    Full Text Available Background and objectives : Identifying the readiness of hospital and its strengths and weaknesses can be useful in developing appropriate planning and situation analyses and management to getting effective in clinical audit programs. The aim of this study was to design and assess the validity of the Hospital Readiness Assessment Tools to conduct quality improvement and clinical audit programs. Material and Methods: In this study, based on the results of a systematic review of literature, an initial questionnaire with 77 items was designed. Questionnaire content validity was reviewed by experts in the field of hospital management and quality improvement in Tabriz University of Medical Sciences. For this purpose, 20 questionnaires were sent to experts. Finally, 15 participants returned completed questionnaire. Questionnaire validity was reviewed and confirmed based on Content Validity Index and Content Validity Ratio. Questionnaire reliability was confirmed based on Cronbach's alpha index (α = 0.96 in a pilot study by participation of 30 hospital managers. Results: The results showed that the final questionnaire contains 54 questions as nine category as: data and information (9 items, teamwork (12 questions, resources (5 questions, patient and education (5, intervention design and implementation (5 questions, clinical audit management (4 questions, human resources (6 questions, evidence and standard (4 items and evaluation and feedback (4 items. The final questionnaire content validity index was 0.91 and final questionnaire Cronbach's alpha coefficient was 0.96. Conclusion: Considering the relative good validity and reliability of the designed tool in this study, it appears that the questionnaire can be used to identify and assess the readiness of hospitals for quality improvement and clinical audit program implementation

  17. Teachers' participation in research programs improves their students' achievement in science.

    Science.gov (United States)

    Silverstein, Samuel C; Dubner, Jay; Miller, Jon; Glied, Sherry; Loike, John D

    2009-10-16

    Research experience programs engage teachers in the hands-on practice of science. Program advocates assert that program participation enhances teachers' skills in communicating science to students. We measured the impact of New York City public high-school science teachers' participation in Columbia University's Summer Research Program on their students' academic performance in science. In the year before program entry, students of participating and nonparticipating teachers passed a New York State Regents science examination at the same rate. In years three and four after program entry, participating teachers' students passed Regents science exams at a rate that was 10.1% higher (P = 0.049) than that of nonparticipating teachers' students. Other program benefits include decreased teacher attrition from classroom teaching and school cost savings of U.S. $1.14 per $1 invested in the program.

  18. Accreditation of Medical Education Programs: Moving From Student Outcomes to Continuous Quality Improvement Measures.

    Science.gov (United States)

    Blouin, Danielle; Tekian, Ara

    2018-03-01

    Accreditation of undergraduate medical education programs aims to ensure the quality of medical education and promote quality improvement, with the ultimate goal of providing optimal patient care. Direct linkages between accreditation and education quality are, however, difficult to establish. The literature examining the impact of accreditation predominantly focuses on student outcomes, such as performances on national examinations. However, student outcomes present challenges with regard to data availability, comparability, and contamination.The true impact of accreditation may well rest in its ability to promote continuous quality improvement (CQI) within medical education programs. The conceptual model grounding this paper suggests accreditation leads medical schools to commit resources to and engage in self-assessment activities that represent best practices of CQI, leading to the development within schools of a culture of CQI. In line with this model, measures of the impact of accreditation on medical schools need to include CQI-related markers. The CQI orientation of organizations can be measured using validated instruments from the business and management fields. Repeated determinations of medical schools' CQI orientation at various points throughout their accreditation cycles could provide additional evidence of the impact of accreditation on medical education. Strong CQI orientation should lead to high-quality medical education and would serve as a proxy marker for the quality of graduates and possibly for the quality of care they provide.It is time to move away from a focus on student outcomes as measures of the impact of accreditation and embrace additional markers, such as indicators of organizational CQI orientation.

  19. A statewide model program to improve emergency department readiness for pediatric care.

    Science.gov (United States)

    Cichon, Mark E; Fuchs, Susan; Lyons, Evelyn; Leonard, Daniel

    2009-08-01

    Pediatric emergency patients have unique needs, requiring specialized personnel, training, equipment, supplies, and medications. Deficiencies in these areas have resulted in historically poorer outcomes for pediatric patients versus adults. Since 1985, federally funded Emergency Medical Services for Children (EMSC) programs in each state have been working to improve the quality of pediatric emergency care. The Health Resources and Services Administration now requires that all EMSC grantees report on specific performance measures. This includes implementation of a standardized system recognizing hospitals that are able to stabilize or manage pediatric medical emergencies and trauma cases. We describe the steps involved in implementing Illinois' 3-level facility recognition process to illustrate a model that other states might use to provide appropriate pediatric care and comply with new Health Resources and Services Administration performance measures.

  20. Improving maintenance of lost weight following a commercial liquid meal replacement program: a preliminary study.

    Science.gov (United States)

    Ames, Gretchen E; Patel, Roshni H; McMullen, Jillian S; Thomas, Colleen S; Crook, Julia E; Lynch, Scott A; Lutes, Lesley D

    2014-01-01

    Clinic-based liquid meal replacement (800kcals/day) programs produce substantial weight loss. Nevertheless, long-term maintenance remains a challenge. A limitation of maintenance programs is that they continue to promote large behavior changes that are initially required to induce weight loss which may be unsustainable long-term. The study aims were to conduct a preliminary assessment of the feasibility, acceptability, and effectiveness of a small changes maintenance intervention (SCM) for 30 patients who completed liquid meal replacement program (LMR). The 20-session SCM delivered over 52 weeks offered no preset goals for maintenance behaviors and all changes in behavior were self-selected. Participants had a median BMI of 40.9 kg/m(2) and weight of 111 kg at the start of LMR. At LMR completion, they lost 18% (21 kg) of body weight. The SCM was completed by 22 patients (73%); 19 completers (86%) attended ≥ 17 of 20 sessions with a median satisfaction rating of 9 (on a scale of 1 to 9). Completers were asked to record self-selected maintenance behaviors daily (median 351 days recorded). The most commonly reported daily behaviors were self-weighing, use of meal replacements and step counting. Median percent regain at week 52 was 14% (2.8 kg) of lost weight (range, -42 to 74%), significantly less than a median of 56% (11 kg) percent regain of lost weight (range, -78 to 110%) in a demographically similar historical control group with no maintenance intervention after LMR completion (P<0.001). Thus, SCM holds promise for improving weight maintenance. Future research should compare SCM to standard maintenance programs that promote large program-directed changes. © 2013.