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Sample records for program failure perform

  1. A combined aerobic and resistance exercise program improves physical functional performance in patients with heart failure: a pilot study.

    Science.gov (United States)

    Gary, Rebecca A; Cress, M Elaine; Higgins, Melinda K; Smith, Andrew L; Dunbar, Sandra B

    2012-01-01

    Recent guidelines for exercise in patients with heart failure (HF) recommended aerobic and resistance exercise as being safe and effective; however, the clinical and functional significance of these combined training modalities has not been established. In this pilot study, combined aerobic and resistance training was hypothesized to improve physical function, muscle strength, and health-related quality of life (HRQOL) compared with an attention control wait list (ACWL). The 10-item Continuous Scale Physical Functional Performance Test (CS-PFP10), which simulates common household chores; muscle strength (handgrip and knee extension); and HRQOL (Kansas City Cardiomyopathy Questionnaire) were evaluated at baseline (T1) and at 12 weeks (T2). The home-based moderate-intensity walking and resistance training program was performed 5 days a week. Twenty-four New York Heart Association class II to III HF patients (mean [SD] age, 60 [10] years; mean [SD] left ventricular ejection fraction, 25% [9%]) were randomized to a combined aerobic and resistance exercise program or to an ACWL group. Of the total group, 58% were New York Heart Association class III HF patients, 50% were white, and 50% were female. The CS-PFP10 total scores were significantly increased in the exercise group, from 45 (18) to 56 (16). The Kansas City Cardiomyopathy Questionnaire overall summary score was significantly improved (P exercise intervention group compared with the ACWL group. Participants provided the home-based, combined aerobic and resistance exercise program had significantly improved physical function, muscle strength, symptom severity, and HRQOL compared with the ACWL group. The findings of this study must be interpreted cautiously owing to the limitations of a small sample, data collection from a single center, and differences between control and interventions groups at baseline. A combined aerobic and resistance exercise approach may improve physical function in stable HF patients, but

  2. Failure Rates in Introductory Programming

    DEFF Research Database (Denmark)

    Bennedsen, Jens; Caspersen, Michael Edelgaard

    2007-01-01

    It is a common conception that CS1 is a very difficult course and that failure rates are high. However, until now there has only been anecdotal evidence for this claim. This article reports on a survey among institutions around the world regarding failure rates in introductory programming courses....... The article describes the design of the survey and the results. The number of institutions answering the call for data was unfortunately rather low, so it is difficult to make firm conclusions. It is our hope that this article can be the starting point for a systematic collection of data in order to find...

  3. Program Models Propagation Of Failures

    Science.gov (United States)

    Hackler, Donald B.; Bui, David T.; Becker, Fred J.

    1992-01-01

    FIRM is software tool for identification of failure and management of risk based on directed-graph ("digraph") approach. Three core algorithms optimized for processing singletons and doubletons and also handle tripletons. FIRM identifies loops in digraphs and displays direct failure paths between any two nodes. Solves for reachability for given node without computing reachability for entire digraph. Represents hybrid between schematic-diagram and fault-tree approaches. Written in C.

  4. Mnemonic anosognosia in Alzheimer's disease is caused by a failure to transfer online evaluations of performance: Evidence from memory training programs.

    Science.gov (United States)

    Silva, Ana Rita; Pinho, Maria Salomé; Macedo, Luís; Souchay, Céline; Moulin, Christopher

    2017-06-01

    There is a debate about the ability of patients with Alzheimer's disease to build an up-to-date representation of their memory function, which has been termed mnemonic anosognosia. This form of anosognosia is typified by accurate online evaluations of performance, but dysfunctional or outmoded representations of function more generally. We tested whether people with Alzheimer's disease could adapt or change their representations of memory performance across three different six-week memory training programs using global judgements of learning. We showed that whereas online assessments of performance were accurate, patients continued to make inaccurate overestimations of their memory performance. This was despite the fact that the magnitude of predictions shifted according to the memory training. That is, on some level patients showed an ability to change and retain a representation of performance over time, but it was a dysfunctional one. For the first time in the literature we were able to use an analysis using correlations to support this claim, based on a large heterogeneous sample of 51 patients with Alzheimer's disease. The results point not to a failure to retain online metamemory information, but rather that this information is never used or incorporated into longer term representations, supporting but refining the mnemonic anosognosia hypothesis.

  5. Failure analysis of high performance ballistic fibers

    OpenAIRE

    Spatola, Jennifer S

    2015-01-01

    High performance fibers have a high tensile strength and modulus, good wear resistance, and a low density, making them ideal for applications in ballistic impact resistance, such as body armor. However, the observed ballistic performance of these fibers is much lower than the predicted values. Since the predictions assume only tensile stress failure, it is safe to assume that the stress state is affecting fiber performance. The purpose of this research was to determine if there are failure mo...

  6. R high performance programming

    CERN Document Server

    Lim, Aloysius

    2015-01-01

    This book is for programmers and developers who want to improve the performance of their R programs by making them run faster with large data sets or who are trying to solve a pesky performance problem.

  7. Database principles programming performance

    CERN Document Server

    O'Neil, Patrick

    2014-01-01

    Database: Principles Programming Performance provides an introduction to the fundamental principles of database systems. This book focuses on database programming and the relationships between principles, programming, and performance.Organized into 10 chapters, this book begins with an overview of database design principles and presents a comprehensive introduction to the concepts used by a DBA. This text then provides grounding in many abstract concepts of the relational model. Other chapters introduce SQL, describing its capabilities and covering the statements and functions of the programmi

  8. Can Failure Succeed? Using Racial Subgroup Rules to Analyze the Effect of School Accountability Failure on Student Performance

    Science.gov (United States)

    Sims, David P.

    2013-01-01

    Many school accountability programs are built on the premise that the sanctions attached to failure will produce higher future student achievement. Furthermore, such programs often include subgroup achievement rules that attempt to hold schools accountable for the performance of all demographic classes of students. This paper looks at two issues:…

  9. Evaluations of Structural Failure Probabilities and Candidate Inservice Inspection Programs

    Energy Technology Data Exchange (ETDEWEB)

    Khaleel, Mohammad A.; Simonen, Fredric A.

    2009-05-01

    The work described in this report applies probabilistic structural mechanics models to predict the reliability of nuclear pressure boundary components. These same models are then applied to evaluate the effectiveness of alternative programs for inservice inspection to reduce these failure probabilities. Results of the calculations support the development and implementation of risk-informed inservice inspection of piping and vessels. Studies have specifically addressed the potential benefits of ultrasonic inspections to reduce failure probabilities associated with fatigue crack growth and stress-corrosion cracking. Parametric calculations were performed with the computer code pc-PRAISE to generate an extensive set of plots to cover a wide range of pipe wall thicknesses, cyclic operating stresses, and inspection strategies. The studies have also addressed critical inputs to fracture mechanics calculations such as the parameters that characterize the number and sizes of fabrication flaws in piping welds. Other calculations quantify uncertainties associated with the inputs calculations, the uncertainties in the fracture mechanics models, and the uncertainties in the resulting calculated failure probabilities. A final set of calculations address the effects of flaw sizing errors on the effectiveness of inservice inspection programs.

  10. Plant performance enhancement program

    Energy Technology Data Exchange (ETDEWEB)

    Munchausen, J.H. [EPRI Plant Support Engineering, Charlotte, NC (United States)

    1995-09-01

    The Plant Performance Enhancement Program (P{sup 2}EP), an initiative of the Electric Power Research Institute (EPRI), responds to strong industry incentives to improve nuclear plant thermal efficiency and electrical output. Launched by EPRI`s Nuclear Power Division, P{sup 2}EP operates within the purview of the Plant Support Engineering (PSE) Program, with day-to-day activities conducted out of the P{sup 2}EP office headquartered at EPRI`s facility in Charlotte, North Carolina. This alignment is consistent with EPFU`s strategic targets in support of industry goals, keeping P{sup 2}EP`s mission in clear focus: Helping utility thermal performance engineers improve the heat rate of nuclear power plants, thereby increasing unit average capacity and reducing plant operations and maintenance costs per kilowatt-hour.

  11. Python high performance programming

    CERN Document Server

    Lanaro, Gabriele

    2013-01-01

    An exciting, easy-to-follow guide illustrating the techniques to boost the performance of Python code, and their applications with plenty of hands-on examples.If you are a programmer who likes the power and simplicity of Python and would like to use this language for performance-critical applications, this book is ideal for you. All that is required is a basic knowledge of the Python programming language. The book will cover basic and advanced topics so will be great for you whether you are a new or a seasoned Python developer.

  12. Antibacterial drug development program successes and failures: a pharmacometric explanation.

    Science.gov (United States)

    Ambrose, Paul G

    2017-07-05

    My thesis is a simple one. We have not been doing a good enough job selecting dose regimens for serious infections during the drug development process. If we are to do a better job in the future, we need to revisit some uncomfortable places. That is, some notable program failures. To be clear, we are not revisiting program failures to make anyone uncomfortable or cast aspersions - but rather so that we sow the seeds for a better future. To that end, we will examine program failures and successes through a pharmacometric lens. Through this powerful lens, we will come to understand that many of our failures were not only predictable, but perhaps expected and entirely avoidable. The goal of this communication is to set forth the type of thinking and data that is necessary for rational dose selection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Statistical modeling of program performance

    Directory of Open Access Journals (Sweden)

    A. P. Karpenko

    2014-01-01

    Full Text Available A task of evaluation of program performance often occurs in the process of design of computer systems or during iterative compilation. A traditional way to solve this problem is emulation of program execution on the target system. A modern alternative approach to evaluation of program performance is based on statistical modeling of program performance on a computer under investigation. This statistical method of modeling program performance called Velocitas was introduced in this work. The method and its implementation in the Adaptor framework were presented. Investigation of the method's effectiveness showed high adequacy of program performance prediction.

  14. Predicting Subsequent Task Performance From Goal Motivation and Goal Failure

    Directory of Open Access Journals (Sweden)

    Laura Catherine Healy

    2015-07-01

    Full Text Available Recent research has demonstrated that the cognitive processes associated with goal pursuit can continue to interfere with unrelated tasks when a goal is unfulfilled. Drawing from the self-regulation and goal-striving literatures, the present study explored the impact of goal failure on subsequent cognitive and physical task performance. Furthermore, we examined if the autonomous or controlled motivation underpinning goal striving moderates the responses to goal failure. Athletes (75 male, 59 female, Mage = 19.90 years, SDage = 3.50 completed a cycling trial with the goal of covering a given distance in 8 minutes. Prior to the trial, their motivation was primed using a video. During the trial they were provided with manipulated performance feedback, thus creating conditions of goal success or failure. No differences emerged in the responses to goal failure between the primed motivation or performance feedback conditions. We make recommendations for future research into how individuals can deal with failure in goal striving.

  15. Predicting subsequent task performance from goal motivation and goal failure

    Science.gov (United States)

    Healy, Laura C.; Ntoumanis, Nikos; Stewart, Brandon D.; Duda, Joan L.

    2015-01-01

    Recent research has demonstrated that the cognitive processes associated with goal pursuit can continue to interfere with unrelated tasks when a goal is unfulfilled. Drawing from the self-regulation and goal-striving literatures, the present study explored the impact of goal failure on subsequent cognitive and physical task performance. Furthermore, we examined if the autonomous or controlled motivation underpinning goal striving moderates the responses to goal failure. Athletes (75 male, 59 female, Mage = 19.90 years, SDage = 3.50) completed a cycling trial with the goal of covering a given distance in 8 min. Prior to the trial, their motivation was primed using a video. During the trial they were provided with manipulated performance feedback, thus creating conditions of goal success or failure. No differences emerged in the responses to goal failure between the primed motivation or performance feedback conditions. We make recommendations for future research into how individuals can deal with failure in goal striving. PMID:26191029

  16. Performance of wireless sensor networks under random node failures

    Energy Technology Data Exchange (ETDEWEB)

    Bradonjic, Milan [Los Alamos National Laboratory; Hagberg, Aric [Los Alamos National Laboratory; Feng, Pan [Los Alamos National Laboratory

    2011-01-28

    Networks are essential to the function of a modern society and the consequence of damages to a network can be large. Assessing network performance of a damaged network is an important step in network recovery and network design. Connectivity, distance between nodes, and alternative routes are some of the key indicators to network performance. In this paper, random geometric graph (RGG) is used with two types of node failure, uniform failure and localized failure. Since the network performance are multi-facet and assessment can be time constrained, we introduce four measures, which can be computed in polynomial time, to estimate performance of damaged RGG. Simulation experiments are conducted to investigate the deterioration of networks through a period of time. With the empirical results, the performance measures are analyzed and compared to provide understanding of different failure scenarios in a RGG.

  17. ATR Performance Estimation Seed Program

    Science.gov (United States)

    2015-09-28

    19b. TELEPHONE NUMBER (Include area code) 09/28/2015 Research Performance Report July 2014 - June 2015 ATR Performance Estimation Seed Program Cook...Report: ATR Performance Estimation Seed Program Daniel A. Cook Georgia Tech Research Institute Sensors and Electromagnetic Applications Laboratory...term seed program to expand the Navy’s efforts in performance prediction for MCM. The team included individuals from ARL/PSU, APL-UW, GTRI, and NSWC

  18. Network Performance Improvement under Epidemic Failures in Optical Transport Networks

    DEFF Research Database (Denmark)

    Fagertun, Anna Manolova; Ruepp, Sarah Renée

    2013-01-01

    In this paper we investigate epidemic failure spreading in large- scale GMPLS-controlled transport networks. By evaluating the effect of the epidemic failure spreading on the network, we design several strategies for cost-effective network performance improvement via differentiated repair times....... First we identify the most vulnerable and the most strategic nodes in the network. Then, via extensive simulations we show that strategic placement of resources for improved failure recovery has better performance than randomly assigning lower repair times among the network nodes. Our OPNET simulation...

  19. The space shuttle program: a policy failure?

    Science.gov (United States)

    Logsdon, J M

    1986-05-30

    The 5 January 1972 announcement by President Richard Nixon that the United States would develop during the 1970's a new space transportation system-the space shuttle-has had fundamental impacts on the character of U.S. space activities. In retrospect, it can be argued that the shuttle design chosen was destined to fail to meet many of the policy objectives established for the system; the shuttle's problems in serving as the primary launch vehicle for the United States and in providing routine and cost-effective space transportation are in large part a result of the ways in which compromises were made in the 1971-72 period in order to gain White House and congressional approval to proceed with the program. The decision to develop a space shuttle is an example of a poor quality national commitment to a major technological undertaking.

  20. Clojure high performance programming

    CERN Document Server

    Kumar, Shantanu

    2013-01-01

    This is a short, practical guide that will teach you everything you need to know to start writing high performance Clojure code.This book is ideal for intermediate Clojure developers who are looking to get a good grip on how to achieve optimum performance. You should already have some experience with Clojure and it would help if you already know a little bit of Java. Knowledge of performance analysis and engineering is not required. For hands-on practice, you should have access to Clojure REPL with Leiningen.

  1. Elliptical Orbit Performance Computer Program

    Science.gov (United States)

    Myler, T.

    1984-01-01

    Elliptical Orbit Performance (ELOPE) computer program for analyzing orbital performance of space boosters uses orbit insertion data obtained from trajectory simulation to generate parametric data on apogee and perigee altitudes as function of payload data. Data used to generate presentation plots that display elliptical orbit performance capability of space booster.

  2. The failure of the 1976 swine influenza immunization program.

    Science.gov (United States)

    Begley, S L

    1977-01-01

    The program to immunize 210 million Americans against swine flu failed. It set back the Federal government's relations with state health agencies, private physicians, pharmaceutical manufacturers, and the insurance industry. It increased mistrust of immunization programs and of government health programs in general.The well-intentioned plan had far-reaching consequences because its scope and the speed with which it was implemented were overreactions to the threat. Its size magnified every one of its faults, legal, medical and political. Organizational and scientific capacity were less than expected. Local health agencies could not administer the program with the inadequate funds from HEW and pharmaceutical companies could not produce a safe, effective children's vaccine.Because of the urgency given the program, Congress neglected the opposition of consumer advocates and state health officials, and did not spend time trying to include immunization against childhood disease in the swine flu program.The failure illustrates the dangers of hasty decisions, of considering only direct medical costs and benefits and not social and political effects on health policy, of launching a public health program whose scientific basis is weak and whose administrative requirements are untested.

  3. [Outpatient management program of patients with chronic heart failure].

    Science.gov (United States)

    Cacciatore, G; Menichelli, M; Albi, F; De Lio, L; Boccanelli, A

    1998-10-01

    Hospitalization of patients with heart failure is often caused by poor adherence to drug therapy, by suboptimal utilization of ACE inhibitors and beta-blockers, and by the lack of systematic monitoring of patients after discharge. The aim of the study is to verify the impact of an outpatient management program on the hospitalization rate and functional status of patients with chronic heart failure. Over a five-year period, 435 patients entered our outpatient management program, which includes adjustment in medical therapy, patient education and visits timed according to the patient's status. Fifty-six percent of the patients were in New York Heart functional class I-II; 74% were male; mean age was 62 +/- 11 years. Heart failure was due to coronary heart disease in 42%, dilated cardiomyopathy in 35%, hypertensive heart disease in 13%, other etiologies in 10%. The following changes in medical therapy were made compared to the period before referral: ACE inhibitors in 88% of the patients vs 70% (p < 0.05), mean dose of enalapril and captopril respectively 18 +/- 6 mg vs 11 +/- 4 mg (p < 0.05) and 89 +/- 28 mg vs 61 +/- 34 mg (p < 0.05); digoxin in 71 vs 70% (NS); furosemide in 90 vs 87%; beta-blockers in 16 vs 6% (p < 0.05); amiodarone in 24 vs 16% (p < 0.05); oral anticoagulants in 22 vs 12% (p < 0.05); calcium channel blockers in 10 vs 16% (p < 0.05). During the follow-up period (35 +/- 11 months), there were 111 hospital admissions compared to 518 during the year before recruitment (p < 0.05). Seventy-two patients died (65 for cardiac causes) and four patients underwent cardiac transplantation. Functional status improved (301 patients in I-II functional class and 56 in III-IV after referral compared to 225 and 132 before referral, respectively). Our results were obtained through adjustment in pharmacological therapy, intensive patient education and therapeutic continuity made possible by our outpatient heart-failure clinic organization. It is likely that the

  4. Automatic failure in gynecologic cytology proficiency testing. Results from the College of American Pathologists proficiency testing program.

    Science.gov (United States)

    Moriarty, Ann T; Crothers, Barbara A; Bentz, Joel S; Souers, Rhona J; Fatheree, Lisa A; Wilbur, David C

    2009-11-01

    Automatic failure in gynecologic cytology proficiency testing occurs when a high-grade lesion or carcinoma (HSIL+, Category D) is misinterpreted as negative for intraepithelial lesion or malignancy (Category B). To document the automatic failure rate in 2006 and 2007 from the College of American Pathologists proficiency testing program (PAP PT) and compare them to projected values from 2004. Identify automatic failures from PAP PT in 2006 and 2007 and compare the rates of failure regarding participant and preparation type to validated slides in the College of American Pathologists Interlaboratory Comparison Program in 2004. There were 65 264 participant responses for HSIL+ slides included in this analysis from 2006 and 2007. Overall, 1% (666 of 65 264) of the HSIL+ responses were classified as negative, resulting in automatic failure for the participant. There were significantly fewer automatic failures in 2007 as compared with either 2006 or projected from 2004 data (P < .001). Conventional preparations had a lower automatic failure rate than liquid-based preparations but only for 2006. Both pathologists and cytotechnologists interpreting liquid-based preparations faired better than projected from 2004 data. The automatic failure rate in PAP PT is lower than expected based on 2004 data from the College of American Pathologists Interlaboratory Comparison Program. Automatic failures are a relatively small component (1% or less) of proficiency testing failures. The rate of automatic failure decreased from 2006 to 2007 and may be due to loss of poor performers in the testing pool, the test-taking environment, or removal of less robust slides from the program.

  5. Two Failures to Replicate High-Performance-Goal Priming Effects

    Science.gov (United States)

    Harris, Christine R.; Coburn, Noriko; Rohrer, Doug; Pashler, Harold

    2013-01-01

    Bargh et al. (2001) reported two experiments in which people were exposed to words related to achievement (e.g., strive, attain) or to neutral words, and then performed a demanding cognitive task. Performance on the task was enhanced after exposure to the achievement related words. Bargh and colleagues concluded that better performance was due to the achievement words having activated a "high-performance goal". Because the paper has been cited well over 1100 times, an attempt to replicate its findings would seem warranted. Two direct replication attempts were performed. Results from the first experiment (n = 98) found no effect of priming, and the means were in the opposite direction from those reported by Bargh and colleagues. The second experiment followed up on the observation by Bargh et al. (2001) that high-performance-goal priming was enhanced by a 5-minute delay between priming and test. Adding such a delay, we still found no evidence for high-performance-goal priming (n = 66). These failures to replicate, along with other recent results, suggest that the literature on goal priming requires some skeptical scrutiny. PMID:23977304

  6. Two failures to replicate high-performance-goal priming effects.

    Directory of Open Access Journals (Sweden)

    Christine R Harris

    Full Text Available Bargh et al. (2001 reported two experiments in which people were exposed to words related to achievement (e.g., strive, attain or to neutral words, and then performed a demanding cognitive task. Performance on the task was enhanced after exposure to the achievement related words. Bargh and colleagues concluded that better performance was due to the achievement words having activated a "high-performance goal". Because the paper has been cited well over 1100 times, an attempt to replicate its findings would seem warranted. Two direct replication attempts were performed. Results from the first experiment (n = 98 found no effect of priming, and the means were in the opposite direction from those reported by Bargh and colleagues. The second experiment followed up on the observation by Bargh et al. (2001 that high-performance-goal priming was enhanced by a 5-minute delay between priming and test. Adding such a delay, we still found no evidence for high-performance-goal priming (n = 66. These failures to replicate, along with other recent results, suggest that the literature on goal priming requires some skeptical scrutiny.

  7. A Heart Failure Management Program Using Shared Medical Appointments.

    Science.gov (United States)

    Carroll, Allison J; Howrey, Hillary L; Payvar, Susan; Deshida-Such, Kristen; Kansal, Mayank; Brar, Charanjit K

    2017-04-01

    Disease management programs for heart failure (HF) effectively reduce HF-related hospitalization rates and mortality. Shared medical appointments (SMAs) offer a cost-effective delivery method for HF disease management programs. However, few studies have evaluated this cost-effective delivery method of HF disease management among Veterans with acute HF. We hypothesized that Veterans who attended a multidisciplinary HF-SMA clinic promoting HF self-management, compared those who only received individual treatment through the HF specialty clinic, would have better 12-month hospitalization outcomes. We completed a retrospective review of the VA electronic health record for HF-SMA clinic appointments (1/1/2012 to 12/31/2013). The multidisciplinary HF-SMA program comprised 4 weekly sessions covering topics including HF disease, HF medications, diet adherence, physical activity, psychological well-being, and stress management. Patients who attended the HF-SMA clinic (n=54) were compared to patients who were scheduled for an HF-SMA appointment but never attended and were followed only in the HF clinic (n=37). Outcomes were 12-month HF-related and all-cause hospitalization rates, days in the hospital, and time to first hospitalization. Of 141 patients scheduled for an HF-SMA clinic appointment, 54 met criteria for the HF-SMA clinic group and 37 were included in the HF clinic group. The groups did not significantly differ on any sociodemographic variables. Furthermore, no significant differences were observed between the HF-SMA group and the HF clinic group on demographics or hospitalization outcomes, p>.05 for all comparisons. Our results did not support our hypothesis that offering multidisciplinary, HF-SMAs promoting HF self-management skills, above and beyond the individual disease management care provided in an HF specialty clinic, would improve hospitalization outcomes among Veterans with acute HF. Limitations of the present study and recommendations for HF self

  8. Performance-based planning and programming guidebook.

    Science.gov (United States)

    2013-09-01

    "Performance-based planning and programming (PBPP) refers to the application of performance management principles within the planning and programming processes of transportation agencies to achieve desired performance outcomes for the multimodal tran...

  9. Driven by fear: the effect of success and failure information on passionate individuals' performance.

    Science.gov (United States)

    Bélanger, Jocelyn J; Lafrenière, Marc-André K; Vallerand, Robert J; Kruglanski, Arie W

    2013-01-01

    Four studies investigated the impact of success and failure information on passionate individuals' performance. Obsessive passion, characterized by a rigid and defensive mode of functioning, predicted greater performance in domains both related and unrelated to the passionate activity in response to exposure to failure information. Conversely, harmonious passion, characterized by a flexible, nondefensive mode of functioning, was found to be unaffected by success or failure information. These performance effects were deeply ingrained, did not require conscious thought, and were automatically activated after unconscious exposure to failure-related words. In addition, the present research evinced that following failure information, obsessive passion predicted increases of performance through its effect on fear of failure. However, performance augmented only when the performance task was framed in such a way that failure would entail important negative consequences for the self and not when framed as inconsequential.

  10. Economic Modeling of Heart Failure Telehealth Programs: When Do They Become Cost Saving?

    Directory of Open Access Journals (Sweden)

    Sheena Xin Liu

    2016-01-01

    Full Text Available Telehealth programs for congestive heart failure have been shown to be clinically effective. This study assesses clinical and economic consequences of providing telehealth programs for CHF patients. A Markov model was developed and presented in the context of a home-based telehealth program on CHF. Incremental life expectancy, hospital admissions, and total healthcare costs were examined at periods ranging up to five years. One-way and two-way sensitivity analyses were also conducted on clinical performance parameters. The base case analysis yielded cost savings ranging from $2832 to $5499 and 0.03 to 0.04 life year gain per patient over a 1-year period. Applying telehealth solution to a low-risk cohort with no prior admission history would result in $2502 cost increase per person over the 1-year time frame with 0.01 life year gain. Sensitivity analyses demonstrated that the cost savings were most sensitive to patient risk, baseline cost of hospital admission, and the length-of-stay reduction ratio affected by the telehealth programs. In sum, telehealth programs can be cost saving for intermediate and high risk patients over a 1- to 5-year window. The results suggested the economic viability of telehealth programs for managing CHF patients and illustrated the importance of risk stratification in such programs.

  11. 19 CFR 143.6 - Failure to maintain performance standards.

    Science.gov (United States)

    2010-04-01

    ...; DEPARTMENT OF THE TREASURY (CONTINUED) SPECIAL ENTRY PROCEDURES Automated Broker Interface § 143.6 Failure to... Assistant Commissioner, Information and Technology, within 10 days following the date of the written notice...

  12. GAS TURBINE POWER PLANT PERFORMANCE EVALUATION UNDER KEY FAILURES

    Directory of Open Access Journals (Sweden)

    MANGEY RAM

    2017-07-01

    Full Text Available Compression and combustion are two important functions of a gas turbine power plant. It is generally used to drive generators and works as a combinatorial plant with conventional steam boilers. The most significant and valuable fact of the gas turbine power plant is that it requires air instead of water to generate electricity. The main components of gas turbine power plant are compressor, combustor, turbine and auxiliaries such as starting device, lubricant pump, fuel system, etc. In this paper, the authors have assumed the different types of component failure such as compressor, combustor, turbine, auxiliaries and human failure with some other auxiliary’s failures and determined the different reliability characteristics of gas turbine power plant by using supplementary variable techniques, Laplace transformation and Markov process. Some numerical examples on the basis of past research are also developed for the practical utility of the plant.

  13. Debugging a high performance computing program

    Science.gov (United States)

    Gooding, Thomas M.

    2013-08-20

    Methods, apparatus, and computer program products are disclosed for debugging a high performance computing program by gathering lists of addresses of calling instructions for a plurality of threads of execution of the program, assigning the threads to groups in dependence upon the addresses, and displaying the groups to identify defective threads.

  14. Performing success and failure in governance: Dutch planning experiences

    NARCIS (Netherlands)

    Assche, van K.A.M.; Beunen, R.; Duineveld, M.

    2012-01-01

    We present an analytical framework for analyzing the functions of failure and success ascriptions in public administration. The framework incorporates concepts and insights from Michel Foucault, Mieke Bal, and other discourse theorists, enriched with notions derived from Niklas Luhmann's theory of

  15. Structural performance and failure analysis of aluminium foams

    NARCIS (Netherlands)

    Amsterdam, Emiel

    2008-01-01

    The thesis is about the characterization of the microstructure of several aluminium foams and its relation to the failure behavior of these materials under monotonic tension and fatigue. Due to the production processes brittle inclusions are present in the microstructure of the foams investigated.

  16. Faults and Failures in SQL-based Data Manipulation Programming

    OpenAIRE

    Leitão Júnior, Plínio de Sá; Universidade Federal de Lavras; Vilela, Plínio Robert Souza; Universidade Metodista de Piracicaba; Jino, Mario; Unicamp

    2007-01-01

    Database applications, including SQL-based applications, have received little attention directed towards improving the knowledge of their possible faults. This paper deals with issues related to software faults and failures aiming at understanding what types of faults occur in SQL manipulation commands, and how they are propagated to the output of command execution. SQL manipulation commands are studied and their structure is organized into structural items, a step towards understanding and g...

  17. Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

    Science.gov (United States)

    Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

    2011-01-01

    In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.

  18. Cost-Effectiveness of Multidisciplinary Management Program and Exercise Training Program in Heart Failure.

    Science.gov (United States)

    Dang, Weixiong; Yi, Anji; Jhamnani, Sunny; Wang, Shi-Yi

    2017-10-15

    Heart failure causes significant health and financial burdens for patients and society. Multidisciplinary management program (MMP) and exercise training program (ETP) have been reported as cost-effective in improving health outcomes, yet no study has compared the 2 programs. We constructed a Markov model to simulate life year (LY) gained and total costs in usual care (UC), MMP, and ETP. The probability of transitions between states and healthcare costs were extracted from previous literature. We calculated the incremental cost-effectiveness ratio (ICER) over a 10-year horizon. Model robustness was assessed through 1-way and probabilistic sensitivity analyses. The expected LY for patients treated with UC, MMP, and ETP was 7.6, 8.2, and 8.4 years, respectively. From a societal perspective, the expected cost of MMP was $20,695, slightly higher than the cost of UC ($20,092). The cost of ETP was much higher ($48,378) because of its high implementation expense and the wage loss it incurred. The ICER of MMP versus UC was $976 per LY gained, and the ICER of ETP versus MMP was $165,702 per LY gained. The results indicated that, under current cost-effectiveness threshold, MMP is cost-effective compared with UC, and ETP is not cost-effective compared with MMP. However, ETP is cost-effective compared with MMP from a healthcare payer's perspective. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Failure detection in high-performance clusters and computers using chaotic map computations

    Science.gov (United States)

    Rao, Nageswara S.

    2015-09-01

    A programmable media includes a processing unit capable of independent operation in a machine that is capable of executing 10.sup.18 floating point operations per second. The processing unit is in communication with a memory element and an interconnect that couples computing nodes. The programmable media includes a logical unit configured to execute arithmetic functions, comparative functions, and/or logical functions. The processing unit is configured to detect computing component failures, memory element failures and/or interconnect failures by executing programming threads that generate one or more chaotic map trajectories. The central processing unit or graphical processing unit is configured to detect a computing component failure, memory element failure and/or an interconnect failure through an automated comparison of signal trajectories generated by the chaotic maps.

  20. Congestive heart failure disease management program: 1-Year population experience from a tertiary center heart failure registry in Saudi Arabia.

    Science.gov (United States)

    Salem, Khal; Fallata, Dania; ElSebaie, Maha; Montasser, Ahmad; ElGedamy, Khaled; ElKhateeb, Osama

    2017-04-01

    We aimed to evaluate congestive heart failure (CHF) multidisciplinary disease management program (DMProg) impact on mortality, readmission rates, length of stay (LOS), and gender health characteristics. This was a quasi-observational, pre- and post-trial with a parallel nonequivalent group. We enrolled 174 inpatients having CHF with reduced ejection fraction and New York Heart Association (NYHA) Class II-IV, and a total of 197 hospital admissions. A comparative follow-up was performed from 15 December 2014 to 15 December 2015. Among 197 consecutive hospital admissions, 76 (39%) were included in the preintervention or usual care group and 121 (61%) were assigned to the postintervention group. After 1 year, in comparison with the preintervention group, the postintervention group had shorter average LOS in days (7.6 days vs. 11.1 days, p < 0.002), lower 1-year readmission rate (36% vs. 57%, p < 0.003), and lower in-house mortality (1.6% vs. 7.8%, p = 0.03), but similar baseline mortality scores (38.2 vs. 38.6, p = 0.7), 30-day and 90-day readmission rates (15% vs. 18.3%, p = 0.62 and 27.6% vs. 30%, p = 0.65), and 30-day readmission risk score (24.9% vs. 26.2%, p = 0.09). By regression analysis, the DMProg intervention was an independent factor for 1-year readmission reduction (p = 0.001). Kaplan-Meier survival analysis favored the postintervention group (log-rank, p < 0.001). DMProg significantly decreased 1-year readmission rates, LOS, and in-house mortality.

  1. A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure.

    Science.gov (United States)

    Moss, Marc; Nordon-Craft, Amy; Malone, Dan; Van Pelt, David; Frankel, Stephen K; Warner, Mary Laird; Kriekels, Wendy; McNulty, Monica; Fairclough, Diane L; Schenkman, Margaret

    2016-05-15

    Early physical therapy (PT) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness. However, the optimal dosage of these interventions is currently unknown. To determine whether an intensive PT program significantly improves long-term physical functional performance compared with a standard-of-care PT program. Patients who required mechanical ventilation for at least 4 days were eligible. Enrolled patients were randomized to receive PT for up to 4 weeks delivered in an intensive or standard-of-care manner. Physical functional performance was assessed at 1, 3, and 6 months in survivors who were not currently in an acute or long-term care facility. The primary outcome was the Continuous Scale Physical Functional Performance Test short form (CS-PFP-10) score at 1 month. A total of 120 patients were enrolled from five hospitals. Patients in the intensive PT group received 12.4 ± 6.5 sessions for a total of 408 ± 261 minutes compared with only 6.1 ± 3.8 sessions for 86 ± 63 minutes in the standard-of-care group (P Physical function assessments were available for 86% of patients at 1 month, for 76% at 3 months, and for 60% at 6 months. In both groups, physical function was reduced yet significantly improved over time between 1, 3, and 6 months. When we compared the two interventions, we found no differences in the total CS-PFP-10 scores at all three time points (P = 0.73, 0.29, and 0.43, respectively) or in the total CS-PFP-10 score trajectory (P = 0.71). An intensive PT program did not improve long-term physical functional performance compared with a standard-of-care program. Clinical trial registered with www.clinicaltrials.gov (NCT01058421).

  2. High performance computing and communications program

    Science.gov (United States)

    Holcomb, Lee

    1992-01-01

    A review of the High Performance Computing and Communications (HPCC) program is provided in vugraph format. The goals and objectives of this federal program are as follows: extend U.S. leadership in high performance computing and computer communications; disseminate the technologies to speed innovation and to serve national goals; and spur gains in industrial competitiveness by making high performance computing integral to design and production.

  3. School Breakfast Program and School Performance.

    Science.gov (United States)

    Meyers, Alan; And Others

    Children who participate in the School Breakfast Program show significant improvement in academic performance and tardiness rates, and a trend toward improvement in absenteeism. The School Breakfast Program was created by Congress in 1966 to provide a breakfast on school days for low income children who would otherwise have none. Children…

  4. Provider Customer Service Program - Performance Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS is continuously analyzing performance and quality of the Provider Customer Service Programs (PCSPs) of the contractors and will be identifying trends and making...

  5. Effectiveness and cost of a transitional care program for heart failure: a prospective study with concurrent controls.

    Science.gov (United States)

    Stauffer, Brett D; Fullerton, Cliff; Fleming, Neil; Ogola, Gerald; Herrin, Jeph; Stafford, Pamala Martin; Ballard, David J

    2011-07-25

    Randomized controlled trials have demonstrated the efficacy of nurse-led transitional care programs to reduce readmission rates for patients with heart failure; the effectiveness of these programs in real-world health care systems is less well understood. We performed a prospective study with concurrent controls to test an advanced practice nurse-led transitional care program for patients with heart failure who were 65 years or older and were discharged from Baylor Medical Center Garland (BMCG) from August 24, 2009, through April 30, 2010. We compared the effect of the program on 30-day (from discharge) all-cause readmission rate, length of stay, and 60-day (from admission) direct cost for BMCG with that of other hospitals within the Baylor Health Care System. We also performed a budget impact analysis using costs and reimbursement experience from the intervention. The intervention significantly reduced adjusted 30-day readmission rates to BMCG by 48% during the postintervention period, which was better than the secular reductions seen at all other facilities in the system. The intervention had little effect on length of stay or total 60-day direct costs for BMCG. Under the current payment system, the intervention reduced the hospital financial contribution margin on average $227 for each Medicare patient with heart failure. Preliminary results suggest that transitional care programs reduce 30-day readmission rates for patients with heart failure. This underscores the potential of the intervention to be effective in a real-world setting, but payment reform may be required for the intervention to be financially sustainable by hospitals.

  6. Factors Contributing to SMEs Failure in Meeting Supplier Performance Standards

    National Research Council Canada - National Science Library

    Louise van Scheers

    2016-01-01

    ...) in meeting supplier performance standards. Suppliers are faced with the challenge of SMEs failing to meet supplier performance standards because they rely on these providers of products and services, mainly SMEs, for their operations...

  7. Failure mode and effects analysis based risk profile assessment for stereotactic radiosurgery programs at three cancer centers in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Teixeira, Flavia C., E-mail: flavitiz@gmail.com [CNEN—Comissao Nacional de Energia Nuclear, Rio de Janeiro, RJ 22290-901, Brazil and LCR/UERJ—Laboratorio de Ciencias Radiologicas/Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550-013 (Brazil); Almeida, Carlos E. de [LCR/UERJ—Laboratorio de Ciencias Radiologicas/Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ 20550-013 (Brazil); Saiful Huq, M. [Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC Cancer Center, Pittsburgh, Pennsylvania 15232 (United States)

    2016-01-15

    Purpose: The goal of this study was to evaluate the safety and quality management program for stereotactic radiosurgery (SRS) treatment processes at three radiotherapy centers in Brazil by using three industrial engineering tools (1) process mapping, (2) failure modes and effects analysis (FMEA), and (3) fault tree analysis. Methods: The recommendations of Task Group 100 of American Association of Physicists in Medicine were followed to apply the three tools described above to create a process tree for SRS procedure for each radiotherapy center and then FMEA was performed. Failure modes were identified for all process steps and values of risk priority number (RPN) were calculated from O, S, and D (RPN = O × S × D) values assigned by a professional team responsible for patient care. Results: The subprocess treatment planning was presented with the highest number of failure modes for all centers. The total number of failure modes were 135, 104, and 131 for centers I, II, and III, respectively. The highest RPN value for each center is as follows: center I (204), center II (372), and center III (370). Failure modes with RPN ≥ 100: center I (22), center II (115), and center III (110). Failure modes characterized by S ≥ 7, represented 68% of the failure modes for center III, 62% for center II, and 45% for center I. Failure modes with RPNs values ≥100 and S ≥ 7, D ≥ 5, and O ≥ 5 were considered as high priority in this study. Conclusions: The results of the present study show that the safety risk profiles for the same stereotactic radiotherapy process are different at three radiotherapy centers in Brazil. Although this is the same treatment process, this present study showed that the risk priority is different and it will lead to implementation of different safety interventions among the centers. Therefore, the current practice of applying universal device-centric QA is not adequate to address all possible failures in clinical processes at different

  8. Disease management 360 degrees: a scorecard approach to evaluating TRICARE's programs for asthma, congestive heart failure, and diabetes.

    Science.gov (United States)

    Yang, Wenya; Dall, Timothy M; Zhang, Yiduo; Hogan, Paul F; Arday, David R; Gantt, Cynthia J

    2010-08-01

    To assess the effect of TRICARE's asthma, congestive heart failure, and diabetes disease management programs using a scorecard approach. EVALUATION MEASURES: Patient healthcare utilization, financial, clinical, and humanistic outcomes. Absolute measures were translated into effect size and incorporated into a scorecard. Actual outcomes for program participants were compared with outcomes predicted in the absence of disease management. The predictive equations were established from regression models based on historical control groups (n = 39,217). Z scores were calculated for the humanistic measures obtained through a mailed survey. Administrative records containing medical claims, patient demographics and characteristics, and program participation status were linked using an encrypted patient identifier (n = 57,489). The study time frame is 1 year prior to program inception through 2 years afterward (October 2005-September 2008). A historical control group was identified with the baseline year starting October 2003 and a 1-year follow-up period starting October 2004. A survey was administered to a subset of participants 6 months after baseline assessment (39% response rate). Within the observation window--24 months for asthma and congestive heart failure, and 15 months for the diabetes program--we observed modest reductions in hospital days and healthcare cost for all 3 programs and reductions in emergency visits for 2 programs. Most clinical outcomes moved in the direction anticipated. The scorecard provided a useful tool to track performance of 3 regional contractors for each of 3 diseases and over time.

  9. Performance Evaluation of Three-Level Z-Source Inverters Under Semiconductor-Failure Conditions

    DEFF Research Database (Denmark)

    Gao, Feng; Loh, Poh Chiang; Blaabjerg, Frede

    2009-01-01

    This paper evaluates and proposes various compensation methods for three-level Z-source inverters under semiconductor-failure conditions. Unlike the fault-tolerant techniques used in traditional three-level inverters, where either an extra phase-leg or collective switching states are used...... under semiconductor-failure conditions. For verifying these described performance features, PLECS simulation and experimental testing were performed with some results captured and shown in a later section for visual confirmation....

  10. Effect of moderate or intensive disease management program on outcome in patients with heart failure : Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure (COACH)

    NARCIS (Netherlands)

    Jaarsma, T.; van der Wal, Martje H.L.; Lesman-Leegte, Ivonne; Luttik, Marie-Louise; Hogenhuis, Jochem; Veeger, Nic J.; Sanderman, Robbert; Hoes, A.W.; van Gilst, Wiek H.; Lok, D.J.; Dunselman, P.H.; Tijssen, J.G.; Hillege, Hans L.; van Veldhuisen, Dirk J.

    2008-01-01

    Background:: Heart failure (HF) disease management programs are widely implemented, but data about their effect on outcome have been inconsistent. Methods: The Coordinating Stud), Evaluating Out-comes of Advising and Counseling in Heart Failure (COACH) was a multicenter, randomized, controlled trial

  11. Management's performance justification and failure to meet earnings thresholds

    NARCIS (Netherlands)

    Zhang, S.; Aerts, Walter

    2015-01-01

    We examine the intensity of management's performance justification as a remedial narrative impression management device, by investigating the association between behavioural earnings thresholds and causal language intensity on earnings-related outcomes in annual management commentary reports. Not

  12. How failure to align climate and leadership style affects performance

    DEFF Research Database (Denmark)

    Håkonsson, Dorthe Døjbak; Burton, Richard; Obel, Børge

    2008-01-01

    The purpose of this paper is to investigate how misalignments between the organizational climate (measured as information-processing demand) and the leadership style (measured as information-processing capability) may result in negative performance consequences.......The purpose of this paper is to investigate how misalignments between the organizational climate (measured as information-processing demand) and the leadership style (measured as information-processing capability) may result in negative performance consequences....

  13. Root cause analysis underscores the importance of understanding, addressing, and communicating cold chain equipment failures to improve equipment performance.

    Science.gov (United States)

    Lennon, Pat; Atuhaire, Brian; Yavari, Shahrzad; Sampath, Vidya; Mvundura, Mercy; Ramanathan, Nithya; Robertson, Joanie

    2017-04-19

    Vaccine cold chain equipment (CCE) in developing countries is often exposed to harsh environmental conditions, such as extreme temperatures and humidity, and is subject to many additional challenges, including intermittent power supply, insufficient maintenance capacity, and a scarcity of replacement parts. Together, these challenges lead to high failure rates for refrigerators, potentially damaging vaccines and adversely affecting immunization coverage. Providing a sustainable solution for improving CCE performance requires an understanding of the root causes of failure. Project teams conducted small-scale studies to determine the root causes of CCE failure in selected locations in Uganda and Mozambique. The evaluations covered 59 failed refrigerators and freezers in Uganda and 27 refrigerators in Mozambique. In Uganda, the vast majority of failures were due to a cooling unit fault in one widely used refrigerator model. In Mozambique, 11 of the 27 problems were attributable to solar refrigerators with batteries that were unable to hold a charge, and another eight problems were associated with a need to adjust thermostat settings. The studies showed that tracking and evaluation of equipment performance and failure can yield important, actionable information for a range of stakeholders, including local CCE technicians, the ministry of health, equipment manufacturers, and international partners such as the United Nations Children's Fund, World Health Organization, and Gavi, the Vaccine Alliance. Collaborative efforts to systematically collect and communicate data on CCE performance and causes of failure will help to improve the efficiency and reach of immunization programs in low- and middle-income countries. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Financial performance evaluation and bankruptcy prediction (failure1

    Directory of Open Access Journals (Sweden)

    Talal A. Al-Kassar, Dr.

    2014-10-01

    The research also demonstrates the need to include measures of both financial and non-financial performance in the evaluation as they complement each other. Without both financial and non-financial, the evaluation process is incomplete and does not provide desired results or the correct image of the process. The research suggests including comprehensive measures of performance evaluation of projects by using indicators of adopted criteria. Thus, the application of both models leads to better results and assists users in maintaining greater objectivity while obtaining more accurate results than from analysis based on personal evaluation alone.

  15. [Failure to perform auto-test of anaesthesia machine at the opening of the operating room].

    Science.gov (United States)

    Suria, S; Puizillout, J-M; Baguenard, P; Bourgain, J-L

    2010-12-01

    controls performed at the opening of the operating room include the anesthesia machine auto-test. Omitting the preoperative checklist is unsafe for the patient and increases the risk of possible breakdowns. The purpose of this study was to evaluate the incidence and the situations in which the auto-test of the machine was not performed at the opening of the operative room. from a database including 55 195 cases between 1st January 2002 and 31st July 2009, a query identified cases in which the auto-test of the anaesthesia machine was omitted and the cases in which anaesthesia was made in spite of the failure of this test. Clinical circumstances were analyzed and anaesthetist and/or nurse anaesthetist were identified from the computerized anaesthesia record. one hundred and ninety cases (1.24%) were identified. Seventy-three percent of the omissions of the auto-test occurred while on duty whereas 85% of the failures of the auto-test took place at the beginning of the scheduled program. Individual factor was identified since three anaesthesiologists out of 22 were responsible for 49% of omissions on duty and one nurse anesthetist was responsible for 18% of the use of a failed machine and 30% of the omission of the auto-test. the auto-test of the anesthesia machine was correctly made in most cases but there are still situations where the checklist wasn't carried out. Therefore, the human factor seems important and justifies to be taken into account. 2010 Elsevier Masson SAS. All rights reserved.

  16. Performance and Dependability Evaluation: Successes, Failures and Challenges

    NARCIS (Netherlands)

    Haverkort, Boudewijn R.H.M.

    2008-01-01

    Over the last 40 years, the field of model-based performance and dependability evaluation has seen important developments, successes and scientific breakthroughs. However, the field has not matured into a key engineering discipline which is heavily called upon by computer system and software

  17. Failure to perform assisted deliveries is resulting in an increased ...

    African Journals Online (AJOL)

    The need to perform assisted vaginal delivery has been regarded as self-evident. Textbooks state: 'Assisted vaginal ... in the delivery room, but in a small proportion (2% to 5%), a trial of instrumental vaginal delivery is .... delivery[20] states that blood-borne viral infections of the mother are no contraindication to operative ...

  18. [Differences between German and Turkish-speaking participants in a chronic heart failure management program].

    Science.gov (United States)

    Ernstmann, N; Karbach, U

    2017-02-01

    German and Turkish-speaking patients were recruited for a chronic heart failure management program. So far little is known about the special needs and characteristics of Turkish-speaking patients with chronic heart failure; therefore, the aim of this study was to examine sociodemographic and illness-related differences between German and Turkish-speaking patients with chronic heart failure. German and Turkish-speaking patients suffering from chronic heart failure and insured with the AOK Rheinland/Hamburg or the BARMER GEK health insurance companies and living in Cologne, Germany, were enrolled. Recruitment took place in hospitals, private practices and at information events. Components of the program were coordination of a guideline-oriented medical care, telemonitoring (e.g., blood pressure, electrocardiogram, and weight), a 24-h information hotline, attendance by German and Turkish-speaking nurses and a patient education program. Data were collected by standardized interviews in German or Turkish language. Data were analyzed with descriptive measures and tested for significance differences using Pearson's χ(2)-test and the t‑test. A total of 465 patients (average age 71 years, 55 % male and 33 % Turkish-speaking) were enrolled in the care program during the study period. Significant differences between German and Turkish-speaking patients were found for age, education, employment status, comorbidities, risk perception, knowledge on heart failure and fear of loss of independence. The response rate could be achieved with the help of specific measures for patient enrollment by Turkish-speaking integration nurses. The differences between German and Turkish-speaking patients should in future be taken into account in the care of people with chronic heart failure.

  19. Performance incentives in the Massachusetts behavioral health program.

    Science.gov (United States)

    Lane, Nancy E

    2005-03-01

    Since 1996, the Massachusetts Behavioral Health Partnership (the Partnership/MBHP) has been the behavioral health carve-out vendor for the Commonwealth of Massachusetts Primary Care Clinician (PCC) Plan. Its use of performance standards and incentives has become one of the central organizing activities for both the Commonwealth and the vendor, and one of the program's hallmarks. Each year, the Commonwealth uses a participative process for generating suggestions for performance incentives, which are then negotiated with the Partnership. Success or failure of projects is judged in accordance with objective measures developed for each incentive project. From 1996 to 2004, 123 performance projects have been completed. Some projects have become contract requirements, and others have developed into programs or services. The performance incentive process blends features of more traditional performance standards with performance-based contracting approaches. This process gives both the Commonwealth and the Partnership the flexibility to reflect changing state policies and to develop a contract that meets the most current needs of members.

  20. Survival and Factors Associated with Failure of Pulpectomies Performed in Primary Teeth by Dental Students.

    Science.gov (United States)

    Brustolin, Juliane Priscila; Mariath, Adriela Azevedo Souza; Ardenghi, Thiago Machado; Casagrande, Luciano

    2017-01-01

    Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (ppulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (pTeeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.

  1. Indoor household residual spraying program performance in ...

    African Journals Online (AJOL)

    Introduction: Matabeleland South launched the malaria pre-elimination campaign in 2012 but provincial spraying coverage has failed to attain 95% target, with some districts still encountering malaria outbreaks. A study was conducted to evaluate program performance against achieving malaria pre-elimination. Methods: a ...

  2. Critical success factors for performance improvement programs.

    Science.gov (United States)

    Barron, William M; Krsek, Cathleen; Weber, Diane; Cerese, Julie

    2005-04-01

    Most health care organizations struggle with the design and implementation of effective, systemwide improvement programs. In 2000, the University HealthSystem Consortium initiated a benchmarking project to identify the organizational elements that predict a successful perfermance improvement (PI) program and that are best suited to support change initiatives. Forty-one organizations completed a survey about the presence of critical components, processes used to improve performance, and organizational PI structures. Follow-up site visits were conducted at three organizations. CRITICAL SUCCESS FACTORS FOR A PI PROGRAM: Eight organizational success factors for an effective performance improvement program were identified: (1) Strong Administrative Fxecutive and Performance Improvement Leadership, (2) Active Involvement of the Board of Trustees, (3) Effective Oversight Structure, (4) Expert Performance Improvement Staff, (5) Physician Involvement and Accountability, (6) Active Staff Involvement, (7) Effective Use of Information Resources-Data Used for Decision Making, and (8) Effective Communication Strategy. The approach offered is grounded in the belief that effective organizational structures and processes are prerequisites to improving health care delivery. Although some empirical support for the proposed model is provided, additional research will be required to determine the effectiveness of this approach.

  3. Greater prognostic value of peak VO2 after exercise training program completion in heart failure patients.

    Science.gov (United States)

    Tabet, Jean-Yves; Meurin, Philippe; Benzidi, Younes; Beauvais, Florence; Ben Driss, Ahmed; Weber, Hélène; Renaud, Nathalie; Dumaine, Raphaelle; Grosdemouge, Anne; Cohen Solal, Alain

    2013-10-09

    Exercise capacity, best reflected by peak exercise oxygen consumption (peak VO(2)), is a powerful prognostic factor in patients with chronic heart failure (CHF). However, the optimal time to assess exercise capacity for prognosis remains unclear and whether an exercise training program (ETP) to improve exercise capacity alters the prognostic value of cardiopulmonary exercise (CPX) testing variables in CHF is unknown. CHF patients who underwent an ETP in two cardiac rehabilitation centers between 2004 and 2009 were prospectively included, and CPX testing was performed before and after ETP completion. We included 285 consecutive patients who underwent an ETP (19.4 ± 8.7 training sessions in 4 to 10 weeks), including segmental gymnastics and cycling sessions. During follow-up (12 months), 14 patients died, 6 underwent cardiac transplantation and 15 were hospitalized for acute heart failure. Univariate analysis and receiver operating characteristic (ROC) curve analysis showed that CPX variables, especially peak oxygen consumption and circulatory power (product of peak VO(2) × peak systolic blood pressure) before and after ETP completion predicted prognosis. However, CPX data obtained after ETP completion had the best prognostic value (area under the ROC curve = 0.79 ± 0.03 for peak VO(2) after ETP completion vs 0.64 ± 0.04 before ETP completion, p < 0.0001). The results did not change even when considering only deaths. In patients with stable CHF who can exercise, the prognostic value of CPX data seems greater after versus before completion of a hospital-based ETP. Therefore, CPX capacity for prognostic purposes should at best be assessed after cardiac rehabilitation. © 2013.

  4. Failure at the top: How power undermines collaborative performance.

    Science.gov (United States)

    Hildreth, John Angus D; Anderson, Cameron

    2016-02-01

    All too commonly, we see groups of leaders fail to accomplish their stated goals when working together--legislators who cannot agree on a bill, heads of state who cannot draft meaningful environmental policy, or boards of trustees who make disastrous decisions for their school. The current research examines whether groups of leaders fail as often as they do in part because of the power each leader is accustomed to possessing among his or her constituents. In multiple studies we found that high power individuals, when working together in groups, performed worse than did other groups: individuals randomly assigned power in an initial task were less creative when they then worked together in groups on a subsequent task (Studies 1A and 4). Individuals with higher power who worked together in groups were also less likely to reach agreement on a difficult negotiation task, whether these groups comprised actual executives from an extant organization (Study 2) or participants randomly assigned power in the laboratory (Study 3). Mediation analyses suggest that groups of high power individuals performed worse because they fought over their relative status in the group, were less focused on the task, and shared information with each other less effectively. However, high power individuals were more effective when working on tasks that required less coordination: they were more creative (Studies 1B and 4) and persisted longer on a difficult task than other groups. Therefore, group processes are the key problem for groups of high power individuals when they work together. (c) 2016 APA, all rights reserved).

  5. Noninvasive detection of programmed cell loss with 99mTc-labeled annexin A5 in heart failure

    NARCIS (Netherlands)

    Kietselaer, Bas L J H; Reutelingsperger, Chris P M; Boersma, Hendrikus H; Heidendal, Guido A K; Liem, Ing Han; Crijns, Harry J G M; Narula, Jagat; Hofstra, Leo

    UNLABELLED: Apoptosis, or programmed cell death (PCD), contributes to the decline in ventricular function in heart failure. Because apoptosis comprises a programmed cascade of events, it is potentially reversible, and timely intervention should delay the development of cardiomyopathy.

  6. United we stand, divided we conquer: Pilot study of multidisciplinary General Medicine Heart Failure Care Program.

    Science.gov (United States)

    Wahbi Izzettin, Omar; Hopper, Ingrid; Ritchie, Edward; Nagalingam, Vathy; Aung, Ar Kar

    2017-10-11

    Heart failure care and education require a multifaceted approach to ensure appropriate transition from inpatient to outpatient care. To explore the feasibility of a multidisciplinary heart failure care model, General Medicine Heart Failure Care Program (GM-HFCP) within a General Medical Unit (GMU). Prospective non-randomised before-and-after observational quality improvement intervention over a 6-month period. All consecutive patients admitted to GMU at Alfred Hospital with diagnosis of acute decompensated heart failure were included. Main outcome measures included changes in rates of pharmacologic prescription, non-pharmacologic ward-based management, patient education and action plan provision after intervention. 108 patients were included [median age 84(IQR 80-89) years, 47(44%) females]. Significant improvements were noted in non-pharmacologic management for patient education regarding fluid restriction (12% to 30%, p = 0.04), weight monitoring (10% to 28%, p = 0.03), heart failure action plan on discharge (4% to 28%, p = 0.002) and salt restriction (6% to 32%, p = 0.002). The rates of prescription of heart failure medications remained similar between the pre- and post-implementation periods, particularly in patients with reduced ejection fraction by 'appropriateness of prescription' criteria. There were no differences in inpatient mortality or 30-day readmission rates in both groups. This prospective observational study demonstrated that it is possible to share the roles of a heart failure nurse amongst members of the multidisciplinary team, with similar rates of delivery of pharmacologic and non-pharmacologic management aspects. However, further innovative improvements are needed to address certain aspects of heart failure care. This article is protected by copyright. All rights reserved.

  7. Depression and the usefulness of a disease management program in heart failure : insights from the COACH (Coordinating study evaluating Outcomes of Advising and Counseling in Heart failure) study

    NARCIS (Netherlands)

    Jaarsma, Tiny; Lesman-Leegte, Ivonne; Hillege, Hans L.; Veeger, Nic J.; Sanderman, Robbert; van Veldhuisen, Dirk J.

    2010-01-01

    Objectives Our aim was to study the possible role of depressive symptoms in the effectiveness of a disease management program (DMP) in heart failure (HF) patients. Background Disease management programs are recommended in current HF guidelines, but certain patient groups, such as those with

  8. Relationships among grit, academic performance, perceived academic failure, and stress in associate degree students.

    Science.gov (United States)

    Lee, Wincy Wing Sze

    2017-10-01

    The present study examined the relationships among grit, academic performance, perceived academic failure, and stress levels of Hong Kong associate degree students using path analysis. Three hundred and forty-five students from a community college in Hong Kong voluntarily participated in the study. They completed a questionnaire that measured their grit (operationalized as interest and perseverance) and stress levels. The students also provided their actual academic performance and evaluated their perception of their academic performance as a success or a failure. The results of the path analysis showed that interest and perseverance were negatively associated with stress, and only perceived academic failure was positively associated with stress. These findings suggest that psychological appraisal and resources are more important antecedents of stress than objective negative events. Therefore, fostering students' psychological resilience may alleviate the stress experienced by associate degree students or college students in general. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. Use and predictors of heart failure disease management referral in patients hospitalized with heart failure: insights from the Get With the Guidelines Program.

    Science.gov (United States)

    Gharacholou, S Michael; Hellkamp, Anne S; Hernandez, Adrian F; Peterson, Eric D; Bhatt, Deepak L; Yancy, Clyde W; Fonarow, Gregg C

    2011-05-01

    Heart failure disease management (HFDM) may be beneficial in heart failure (HF) patients at risk for readmission or post-discharge mortality. However, characteristics of hospitalized HF patients referred to HFDM are not known. Get With the Guidelines (GWTG) program data was used to analyze 57,969 patients hospitalized with HF from January 2005 through January 2010 from 235 sites. Factors associated with referral to HFDM and rates of HF quality measures by referral status were studied. Mean age of patients was 69.7 ± 14.5 years, 52% were men, and 65% were white. HFDM referral occurred in 11,150 (19.2%) patients. The median rate of HFDM referral among all hospitals was 3.5% (25th-75th percentiles 0%-16.7%) and 8.7% (2.8%-27.7%) among hospitals with at least one previous HFDM referral. Quality and performance measures were higher in patients referred to HFDM. HFDM referral was associated with atrial fibrillation, implanted cardiac device, depression, and treatment at larger hospitals. Patients at higher 90-day mortality risk were paradoxically less likely to receive HFDM referral. HFDM referral occurred in less than one-fifth of hospitalized HF patients and was more frequently recommended to lower-risk patients. Increasing use and optimizing selection of patients for HFDM referral is a potential target for quality improvement. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Hospital cost effect of a heart failure disease management program: the Specialized Primary and Networked Care in Heart Failure (SPAN-CHF) trial.

    Science.gov (United States)

    Gregory, Douglas; Kimmelstiel, Carey; Perry, Kathleen; Parikh, Amay; Konstam, Varda; Konstam, Marvin A

    2006-05-01

    Determine the effect on hospitalization cost of a heart failure disease management (HFDM) program delivered within a diverse provider network as demonstrated in the SPAN-CHF randomized controlled trial. The SPAN-CHF trial was a prospective randomized assessment of the effectiveness of HFDM delivered for 90 days across a diverse provider network in a heterogeneous population of 200 patients. Baseline clinical and demographic data were obtained on each patient, mortality was monitored, and hospitalizations were tracked for 90 days. Cost estimates for each hospitalization were based on a subsample of patients seen at Tufts-New England Medical Center for whom hospitalization costs were calculated. Heart failure disease management program costs were estimated using a programmatic budget model. Hospital utilization and cost data were combined to estimate medical costs for intervention and control groups. Heart failure disease management had a favorable effect on heart failure hospitalization, which was partially offset by noncardiac hospitalizations. The relative odds of at least one all-cause hospitalization during the intervention period trended less for the intervention group compared with the control group (0.76 [95% CI 0.38-1.51]). The point estimate of the differential hospitalization cost between control and intervention groups was a reduction in cost of $375 per patient. The net effect including the costs of the program was an increase of $488 per patient for the intervention group compared with the control group. The program would have been cost saving if HFDM costs had been 24% lower. The HFDM intervention, administered over 90 days to patients hospitalized for heart failure, succeeded in reducing the rate of heart failure hospitalizations, although this effect was partially offset by an increase in non-heart failure hospitalizations. The resulting modest reduction in all-cause hospitalization costs was exceeded by the cost of the intervention. Thus, although

  11. Performance deficits following failure: learned helplessness or self-esteem protection?

    Science.gov (United States)

    Witkowski, T; Stiensmeier-Pelster, J

    1998-03-01

    We report two laboratory experiments which compare two competing explanations of performance deficits following failure: one based on Seligman's learned helplessness theory (LHT), and the other, on self-esteem protection theory (SEPT). In both studies, participants (Study 1: N = 40 pupils from secondary schools in Walbrzych, Poland; Study 2: N = 45 students from the University of Bielefeld, Germany) were confronted with either success or failure in a first phase of the experiment. Then, in the second phase of the experiment the participants had to work on a set of mathematical problems (Study 1) or a set of tasks taken from Raven's Progressive Matrices (Study 2) either privately or in public. In both studies failure in the first phase causes performance deficits in the second phase only if the participants had to solve the test tasks in public. These results were interpreted in line with SEPT and as incompatible with LHT.

  12. 2011 Annual Criticality Safety Program Performance Summary

    Energy Technology Data Exchange (ETDEWEB)

    Andrea Hoffman

    2011-12-01

    The 2011 review of the INL Criticality Safety Program has determined that the program is robust and effective. The review was prepared for, and fulfills Contract Data Requirements List (CDRL) item H.20, 'Annual Criticality Safety Program performance summary that includes the status of assessments, issues, corrective actions, infractions, requirements management, training, and programmatic support.' This performance summary addresses the status of these important elements of the INL Criticality Safety Program. Assessments - Assessments in 2011 were planned and scheduled. The scheduled assessments included a Criticality Safety Program Effectiveness Review, Criticality Control Area Inspections, a Protection of Controlled Unclassified Information Inspection, an Assessment of Criticality Safety SQA, and this management assessment of the Criticality Safety Program. All of the assessments were completed with the exception of the 'Effectiveness Review' for SSPSF, which was delayed due to emerging work. Although minor issues were identified in the assessments, no issues or combination of issues indicated that the INL Criticality Safety Program was ineffective. The identification of issues demonstrates the importance of an assessment program to the overall health and effectiveness of the INL Criticality Safety Program. Issues and Corrective Actions - There are relatively few criticality safety related issues in the Laboratory ICAMS system. Most were identified by Criticality Safety Program assessments. No issues indicate ineffectiveness in the INL Criticality Safety Program. All of the issues are being worked and there are no imminent criticality concerns. Infractions - There was one criticality safety related violation in 2011. On January 18, 2011, it was discovered that a fuel plate bundle in the Nuclear Materials Inspection and Storage (NMIS) facility exceeded the fissionable mass limit, resulting in a technical safety requirement (TSR) violation. The

  13. Assessing Hospital Readmission Risk Factors in Heart Failure Patients Enrolled in a Telemonitoring Program

    Directory of Open Access Journals (Sweden)

    Adrian H. Zai

    2013-01-01

    Full Text Available The purpose of this study was to validate a previously developed heart failure readmission predictive algorithm based on psychosocial factors, develop a new model based on patient-reported symptoms from a telemonitoring program, and assess the impact of weight fluctuations and other factors on hospital readmission. Clinical, demographic, and telemonitoring data was collected from 100 patients enrolled in the Partners Connected Cardiac Care Program between July 2008 and November 2011. 38% of study participants were readmitted to the hospital within 30 days. Ten different heart-failure-related symptoms were reported 17,389 times, with the top three contributing approximately 50% of the volume. The psychosocial readmission model yielded an AUC of 0.67, along with sensitivity 0.87, specificity 0.32, positive predictive value 0.44, and negative predictive value 0.8 at a cutoff value of 0.30. In summary, hospital readmission models based on psychosocial characteristics, standardized changes in weight, or patient-reported symptoms can be developed and validated in heart failure patients participating in an institutional telemonitoring program. However, more robust models will need to be developed that use a comprehensive set of factors in order to have a significant impact on population health.

  14. Electronic fetal monitoring as a public health screening program: the arithmetic of failure.

    Science.gov (United States)

    Grimes, David A; Peipert, Jeffrey F

    2010-12-01

    Electronic fetal monitoring has failed as a public health screening program. Nevertheless, most of the four million low-risk women giving birth in the United States each year continue to undergo this screening. The failure of this program should have been anticipated and thus avoided had the accepted principles of screening been considered before its introduction. All screening tests have poor positive predictive value when searching for rare conditions such as fetal death in labor or cerebral palsy. This problem is aggravated when the screening test does not have good validity as is the case with electronic fetal monitoring. Because of low-prevalence target conditions and mediocre validity, the positive predictive value of electronic fetal monitoring for fetal death in labor or cerebral palsy is near zero. Stated alternatively, almost every positive test result is wrong. To avoid such costly errors in the future, the prerequisites for any screening program must be fulfilled before the program is begun.

  15. DIPANALYST: A computer program for quantitative kinematic analysis of rock slope failures

    Science.gov (United States)

    Admassu, Yonathan; Shakoor, Abdul

    2013-04-01

    Kinematic analysis is used to analyze the potential for the various modes of structurally controlled rock slope failures (plane, wedge, and toppling failures) due to the presence of unfavorably oriented discontinuities. Traditionally kinematic analysis is performed after plotting discontinuity orientations, slope angle, slope azimuth and representative friction angle value on a stereonet. Due to large number of discontinuities, only representative orientation values (dip/dip direction) for identified cluster sets are considered. This stereonet-based analysis is qualitative in nature and requires the presence of tight data clusters for which a reasonable representative orientation value can be assigned. However, there are cases when a tight circular clustering of discontinuity orientations does not exist, making stereonet-based analysis unreliable. Also, variability of discontinuity data in cluster sets is not easy to consider using the stereonet-based method. To overcome these problems, an application software, DIPANALYST, has been developed by the first author to perform quantitative kinematic analysis based on not just representative discontinuity values, but all discontinuities and their possible intersections. The software calculates ratios of discontinuities or their possible intersections that can potentially cause failures (plane, wedge or toppling) to the total number of discontinuities or their possible intersections. The calculated ratios are known as failure indices, and the method is termed as the quantitative approach for kinematic analysis. DIPANALYST is also capable of performing the traditional stereonet-based method.

  16. Concepts for measuring maintenance performance and methods for analysing competing failure modes

    DEFF Research Database (Denmark)

    Cooke, R.; Paulsen, J.L.

    1997-01-01

    Measurement of maintenance performance is done on the basis of component history data in which service sojourns are distinguished according to whether they terminate in corrective or preventive maintenance. From the viewpoint of data analysis, corrective and preventive maintenance constitute...... competing failure modes. This article examines ways to assess maintenance performance without introducing statistical assumptions, then introduces a plausible statistical model for describing the interaction of preventive and corrective maintenance, and finally illustrates these with examples from...

  17. Performance in the WIPP nondestructive assay performance demonstration program

    Energy Technology Data Exchange (ETDEWEB)

    Marcinkiewicz, C.J. [Consolidated Technical Services, Inc., Frederick, MD (United States); Connolly, M.J.; Becker, G.K. [Lockheed Martin Idaho Technologies Company, Idaho Falls, ID (United States)

    1997-11-01

    Measurement facilities performing nondestructive assay (NDA) of wastes intended for disposal at the United States Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP) are required to demonstrate their ability to meet specific Quality Assurance Objectives (QAOs). This demonstration is performed, in part, by participation in the NDA Performance Demonstration Program (PDP). The PDP is funded and managed by the Carlsbad Area Office (CAO) of DOE and is conducted by the Idaho National Engineering Laboratory. It tests the characteristics of precision, system bias and/or total uncertainty through the measurement of variable, blind combinations of simulated waste drums and certified radioactive standards. Each facility must successfully participate in the PDP using each different type of measurement system planned for use in waste characterization. The first cycle of the PDP using each different type of measurement system planned for use in waste characterization. The first cycle of the PDP was completed in July 1996 and the second is scheduled for completion by December 1996. Seven sites reported data in cycle 1 for 11 different measurement systems. This paper describes the design and operation of the PDP and provides the performance data from cycle 1. It also describes the preliminary results from cycle 2 and updates the status and future plans for the NDA PDP. 4 refs., 9 figs., 11 tabs.

  18. Success, Failure, and Unfinished Business of Education, Prevention, Policy, and Intervention Programs on Substance Misuse in Brazilian Sport.

    Science.gov (United States)

    Santos, Azenildo M

    2015-01-01

    The current Brazilian situation is such that it is difficult to obtain a worldwide evaluation of failure in education, intervention, or prevention programs. How fragile Brazil's anti-doping system is, its appropriateness as well as its relevance, with needed policy infrastructures for achieving the selected goals, and how wide the gap is between education and prevention program effectiveness between high-performance athletes and recreational practitioners who just want to look good. An additional concern, and ever present flaw regarding Brazil's "common sportsman" in day-to-day society is their not receiving known and necessary "sports education," enabling the development of an "at-risk" population for self-harm. Reflections on public health policy are noted.

  19. Pilot program to identify valve failures which impact the safety and operation of light water nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Tsacoyeanes, J. C.; Raju, P. P.

    1980-04-01

    The pilot program described has been initiated under the Department of Energy Light Water Reactor Safety Research and Development Program and has the following specific objectives: to identify the principal types and causes of failures in valves, valve operators and their controls and associated hardware, which lead to, or could lead to plant trip; and to suggest possible remedies for the prevention of these failures and recommend future research and development programs which could lead to minimizing these valve failures or mitigating their effect on plant operation. The data surveyed cover incidents reported over the six-year period, beginning 1973 through the end of 1978. Three sources of information on valve failures have been consulted: failure data centers, participating organizations in the nuclear power industry, and technical documents.

  20. Do heart failure disease management programs make financial sense under a bundled payment system?

    Science.gov (United States)

    Eapen, Zubin J; Reed, Shelby D; Curtis, Lesley H; Hernandez, Adrian F; Peterson, Eric D

    2011-05-01

    Policy makers have proposed bundling payments for all heart failure (HF) care within 30 days of an HF hospitalization in an effort to reduce costs. Disease management (DM) programs can reduce costly HF readmissions but have not been economically attractive for caregivers under existing fee-for-service payment. Whether a bundled payment approach can address the negative financial impact of DM programs is unknown. Our study determined the cost-neutral point for the typical DM program and examined whether published HF DM programs can be cost saving under bundled payment programs. We used a decision analytic model using data from retrospective cohort studies, meta-analyses, 5 randomized trials evaluating DM programs, and inpatient claims for all Medicare beneficiaries discharged with an HF diagnosis from 2001 to 2004. We determined the costs of DM programs and inpatient care over 30 and 180 days. With a baseline readmission rate of 22.9%, the average cost for readmissions over 30 days was $2,272 per patient. Under base-case assumptions, a DM program that reduced readmissions by 21% would need to cost $477 per patient to be cost neutral. Among evaluated published DM programs, 2 of the 5 would increase provider costs (+$15 to $283 per patient), whereas 3 programs would be cost saving (-$241 to $347 per patient). If bundled payments were broadened to include care over 180 days, then program saving estimates would increase, ranging from $419 to $1,706 per patient. Proposed bundled payments for HF admissions provide hospitals with a potential financial incentive to implement DM programs that efficiently reduce readmissions. Copyright © 2011 Mosby, Inc. All rights reserved.

  1. Physician-directed heart failure transitional care program: a retrospective case review.

    Science.gov (United States)

    Ota, Ken S; Beutler, David S; Gerkin, Richard D; Weiss, Jessica L; Loli, Akil I

    2013-10-01

    Despite a variety of national efforts to improve transitions of care for patients at risk for rehospitalization, 30-day rehospitalization rates for patients with heart failure have remained largely unchanged. This is a retrospective review of 73 patients enrolled in our hospital-based, physican-directed Heart Failure Transitional Care Program (HFTCP). This study evaluated the 30- and 90- day readmission rates before and after enrollment in the program. The Transitionalist's services focused on bedside consultation prior to hospital discharge, follow-up home visits within 72 hours of discharge, frequent follow-up phone calls, disease-specific education, outpatient intravenous diuretic therapy, and around-the-clock telephone access to the Transitionalist. The pre-enrollment 30-day readmission rates for acute decompensated heart failure (ADHF) and all-cause readmission was 26.0% and 28.8%, respectively, while the post-enrollment rates for ADHF and all-cause readmission were 4.1% (P < 0.001) and 8.2% (P = 0.002), respectively. The pre-enrollment 90-day all-cause and ADHF readmission rates were 69.8%, and 58.9% respectively, while the post-enrollment rates for all-cause and ADHF were 27.3% (P < 0.001) and 16.4% (P < 0.001) respectively. Our physician-implemented HFTCP reduced rehospitalization risk for patients enrolled in the program. This program may serve as a model to assist other hospital systems to reduce readmission rates of patients with HF.

  2. Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Ørkild, Bodil

    2009-01-01

    Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning.......Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning....

  3. Using simulation to evaluate the performance of resilience strategies and process failures

    Energy Technology Data Exchange (ETDEWEB)

    Levy, Scott N.; Topp, Bryan Embry; Arnold, Dorian C; Ferreira, Kurt Brian; Widener, Patrick; Hoefler, Torsten

    2014-01-01

    Fault-tolerance has been identified as a major challenge for future extreme-scale systems. Current predictions suggest that, as systems grow in size, failures will occur more frequently. Because increases in failure frequency reduce the performance and scalability of these systems, significant effort has been devoted to developing and refining resilience mechanisms to mitigate the impact of failures. However, effective evaluation of these mechanisms has been challenging. Current systems are smaller and have significantly different architectural features (e.g., interconnect, persistent storage) than we expect to see in next-generation systems. To overcome these challenges, we propose the use of simulation. Simulation has been shown to be an effective tool for investigating performance characteristics of applications on future systems. In this work, we: identify the set of system characteristics that are necessary for accurate performance prediction of resilience mechanisms for HPC systems and applications; demonstrate how these system characteristics can be incorporated into an existing large-scale simulator; and evaluate the predictive performance of our modified simulator. We also describe how we were able to optimize the simulator for large temporal and spatial scales-allowing the simulator to run 4x faster and use over 100x less memory.

  4. 5 CFR 430.205 - Agency performance appraisal program(s).

    Science.gov (United States)

    2010-01-01

    ... REGULATIONS PERFORMANCE MANAGEMENT Performance Appraisal for General Schedule, Prevailing Rate, and Certain Other Employees § 430.205 Agency performance appraisal program(s). (a) Each agency shall establish at... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Agency performance appraisal program(s...

  5. Mortality benefit of a comprehensive heart failure disease management program in indigent patients.

    Science.gov (United States)

    Hebert, Kathy A; Horswell, Ronald L; Dy, Sydney; Key, Ira J; Butler, Michael K; Cerise, Frederick P; Arcement, Lee M

    2006-02-01

    Heart failure (HF) produces significant morbidity and mortality. Although HF disease management (HFDM) programs have been shown to decrease this morbidity, there is still a paucity of data on their effect on mortality. The objective of this study was to determine whether participation in an HFDM program would reduce mortality in an indigent population from rural Louisiana. Proportional hazards modeling was used to determine whether patients participating in the HFDM program had improved survival compared with patients receiving traditional outpatient care at the same institution. Inclusion criteria consisted of an index hospitalization with discharge occurring between July 1, 1997, and May 30, 2002, hospital discharge diagnosis of HF, left ventricular systolic dysfunction documented during hospitalization, and at least 1 subsequent outpatient visit. Data from patients having participated in the HFDM program before their index hospitalization were excluded. Compared with patients who were given traditional care (n = 100), HFDM patients (n = 156) were younger (56.7 vs 60 years, P = .031), more likely to be African American (48.7% vs 33.0%, P = .014), more likely to be uninsured (47.4% vs 27%, P = .001), and more likely to have an ejection fraction of HFDM program was associated with a significant reduction in mortality compared with traditional care (adjusted hazard ratio .33, P HFDM program was associated with decreased mortality compared with traditional follow-up care.

  6. Program evaluation of remote heart failure monitoring: healthcare utilization analysis in a rural regional medical center.

    Science.gov (United States)

    Riley, William T; Keberlein, Pamela; Sorenson, Gigi; Mohler, Sailor; Tye, Blake; Ramirez, A Susana; Carroll, Mark

    2015-03-01

    Remote monitoring for heart failure (HF) has had mixed and heterogeneous effects across studies, necessitating further evaluation of remote monitoring systems within specific healthcare systems and their patient populations. "Care Beyond Walls and Wires," a wireless remote monitoring program to facilitate patient and care team co-management of HF patients, served by a rural regional medical center, provided the opportunity to evaluate the effects of this program on healthcare utilization. Fifty HF patients admitted to Flagstaff Medical Center (Flagstaff, AZ) participated in the project. Many of these patients lived in underserved and rural communities, including Native American reservations. Enrolled patients received mobile, broadband-enabled remote monitoring devices. A matched cohort was identified for comparison. HF patients enrolled in this program showed substantial and statistically significant reductions in healthcare utilization during the 6 months following enrollment, and these reductions were significantly greater compared with those who declined to participate but not when compared with a matched cohort. The findings from this project indicate that a remote HF monitoring program can be successfully implemented in a rural, underserved area. Reductions in healthcare utilization were observed among program participants, but reductions were also observed among a matched cohort, illustrating the need for rigorous assessment of the effects of HF remote monitoring programs in healthcare systems.

  7. Aquatic Exercise Training is Effective in Maintaining Exercise Performance in Trained Heart Failure Patients: A Randomised Crossover Pilot Trial.

    Science.gov (United States)

    Adsett, Julie; Morris, Norman; Kuys, Suzanne; Hwang, Rita; Mullins, Robert; Khatun, Mohsina; Paratz, Jennifer; Mudge, Alison

    2017-06-01

    Providing flexible models and a variety of exercise options are fundamental to supporting long-term exercise participation for patients with heart failure (HF). The aim of this pilot study was to determine the feasibility and efficacy of aquatic exercise training during a maintenance phase for a clinical heart failure population. In this 2 x 2 crossover design trial, individuals who had previously completed HF rehabilitation were randomised into either a land-based or aquatic training program once per week for six weeks, after which time they changed to the alternate exercise training protocol for an additional six weeks. Six-minute walk test (6MWT), grip strength, walk speed, and measures of balance were compared for the two training protocols. Fifty-one participants (43 males, mean age 69.2 yrs) contributed data for the analysis. Both groups maintained function during the follow-up period, however improvements in 6MWT were greater in the land-based training group (95% CI: 0.7, 22.5; p=0.038), by a mean difference of 10.8 metres. No significant difference was observed for other parameters when the two training protocols were compared. Attending an aquatic exercise program once per week is feasible for patients with stable HF and may provide a suitable option to maintain functional performance in select patients. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  8. Association of the Hospital Readmissions Reduction Program Implementation With Readmission and Mortality Outcomes in Heart Failure.

    Science.gov (United States)

    Gupta, Ankur; Allen, Larry A; Bhatt, Deepak L; Cox, Margueritte; DeVore, Adam D; Heidenreich, Paul A; Hernandez, Adrian F; Peterson, Eric D; Matsouaka, Roland A; Yancy, Clyde W; Fonarow, Gregg C

    2018-01-01

    Public reporting of hospitals' 30-day risk-standardized readmission rates following heart failure hospitalization and the financial penalization of hospitals with higher rates have been associated with a reduction in 30-day readmissions but have raised concerns regarding the potential for unintended consequences. To examine the association of the Hospital Readmissions Reduction Program (HRRP) with readmission and mortality outcomes among patients hospitalized with heart failure within a prospective clinical registry that allows for detailed risk adjustment. Interrupted time-series and survival analyses of index heart failure hospitalizations were conducted from January 1, 2006, to December 31, 2014. This study included 115 245 fee-for-service Medicare beneficiaries across 416 US hospital sites participating in the American Heart Association Get With The Guidelines-Heart Failure registry. Data analysis took place from January 1, 2017, to June 8, 2017. Time intervals related to the HRRP were before the HRRP implementation (January 1, 2006, to March 31, 2010), during the HRRP implementation (April 1, 2010, to September 30, 2012), and after the HRRP penalties went into effect (October 1, 2012, to December 31, 2014). Risk-adjusted 30-day and 1-year all-cause readmission and mortality rates. The mean (SD) age of the study population (n = 115 245) was 80.5 (8.4) years, 62 927 (54.6%) were women, and 91 996 (81.3%) were white and 11 037 (9.7%) were black. The 30-day risk-adjusted readmission rate declined from 20.0% before the HRRP implementation to 18.4% in the HRRP penalties phase (hazard ratio (HR) after vs before the HRRP implementation, 0.91; 95% CI, 0.87-0.95; P service Medicare beneficiaries discharged after heart failure hospitalizations, implementation of the HRRP was temporally associated with a reduction in 30-day and 1-year readmissions but an increase in 30-day and 1-year mortality. If confirmed, this finding may require reconsideration of the HRRP in

  9. Virologic failure of protease inhibitor-based second-line antiretroviral therapy without resistance in a large HIV treatment program in South Africa.

    Directory of Open Access Journals (Sweden)

    Julie H Levison

    Full Text Available We investigated the prevalence of wild-type virus (no major drug resistance and drug resistance mutations at second-line antiretroviral treatment (ART failure in a large HIV treatment program in South Africa.HIV-infected patients ≥ 15 years of age who had failed protease inhibitor (PI-based second-line ART (2 consecutive HIV RNA tests >1000 copies/ml on lopinavir/ritonavir, didanosine, and zidovudine were identified retrospectively. Patients with virologic failure were continued on second-line ART. Genotypic testing for drug resistance was performed on frozen plasma samples obtained closest to and after the date of laboratory confirmed second-line ART failure. Of 322 HIV-infected patients on second-line ART, 43 were adults with confirmed virologic failure, and 33 had available plasma for viral sequencing. HIV-1 RNA subtype C predominated (n = 32, 97%. Mean duration on ART (SD prior to initiation of second-line ART was 23 (17 months, and time from second-line ART initiation to failure was 10 (9 months. Plasma samples were obtained 7(9 months from confirmed failure. At second-line failure, 22 patients (67% had wild-type virus. There was no major resistance to PIs found. Eleven of 33 patients had a second plasma sample taken 8 (5.5 months after the first. Median HIV-1 RNA and the genotypic resistance profile were unchanged.Most patients who failed second-line ART had wild-type virus. We did not observe evolution of resistance despite continuation of PI-based ART after failure. Interventions that successfully improve adherence could allow patients to continue to benefit from second-line ART therapy even after initial failure.

  10. Direct Telephonic Communication in a Heart Failure Transitional Care Program: An observational study.

    Science.gov (United States)

    Ota, Ken S; Beutler, David S; Sheikh, Hassam; Weiss, Jessica L; Parkinson, Dallin; Nguyen, Peter; Gerkin, Richard D; Loli, Akil I

    2013-10-01

    This study investigated the trend of phone calls in the Banner Good Samaritan Medical Center (BGSMC) Heart Failure Transitional Care Program (HFTCP). The primary goal of the HFTCP is to reduce 30-Day readmissions for heart failure patients by using a multi-pronged approach. This study included 104 patients in the HFTCP discharged over a 51-week period who had around-the-clock telephone access to the Transitionalist. Cellular phone records were reviewed. This study evaluated the length and timing of calls. A total of 4398 telephone calls were recorded of which 39% were inbound and 61% were outbound. This averaged to 86 calls per week. During the "Weekday Daytime" period, Eighty-five percent of the totals calls were made. There were 229 calls during the "Weekday Nights" period with 1.5 inbound calls per week. The "Total Weekend" calls were 10.2% of the total calls which equated to a weekly average of 8.8. Our experience is that direct, physician-patient telephone contact is feasible with a panel of around 100 HF patients for one provider. If the proper financial reimbursements are provided, physicians may be apt to participate in similar transitional care programs. Likewise, third party payers will benefit from the reduction in unnecessary emergency room visits and hospitalizations.

  11. Early Implant Failures Related to Individual Surgeons: An Analysis Covering 11,074 Operations Performed during 28 Years.

    Science.gov (United States)

    Jemt, Torsten; Olsson, Malin; Renouard, Franck; Stenport, Victoria; Friberg, Bertil

    2016-10-01

    Compared with knowledge on patient and implant component factors, little knowledge is available on surgeons' role in early implant failures. To report incidence of early implant failures related to total number of operations performed by individual surgeons. Early implant failures (≤1 year of implant prosthesis function) were reported after a total of 11,074 implant operations at one specialist clinic during 28 years of surgery. Altogether, 8,808 individual patients were treated by 23 different dentists, of whom 21 surgeons were specialists in oral surgery or periodontology. Recorded failures were related to total numbers of performed operations per surgeon, followed by statistical comparisons (χ(2) ) between surgeons with regard to type of treated jaw and implant surface. Altogether, 616 operations were recorded with early implant failures (5.6%), most often observed in edentulous upper jaws after placing implants with a turned surface (p failures are complex, multifactorial problems associated with many aspects in the surgical procedure. A stochastic variation of failures for individual surgeons could be observed over the years. Different levels of failure rate could be observed between the surgeons, occasionally reaching significant levels as a total or for different jaw situations (p failure rates when using implants with moderately rough surfaces (p failure rate between the surgeons was maintained. © 2015 Wiley Periodicals, Inc.

  12. Application of a Healthcare Failure Modes and Effects Analysis to Identify and Mitigate Potential Risks in the Implementation of a National Prehospital Pediatric Rapid Sequence Intubation Program.

    Science.gov (United States)

    Howard, Ian; Castle, Nicholas; Al Shaikh, Loua Asad

    2017-12-15

    Rapid sequence intubation (RSI) has become the de facto airway method of choice in the emergency airway management of adult and pediatric patients. There is significant controversy regarding pediatric RSI in the prehospital setting, given not only the complexities inherent in both the procedure and patient population, but in variations in emergency medical service models, prehospital qualifications, scope of practice, and patient exposure too. A Healthcare Failure Mode and Effects Analysis was conducted to identify and mitigate potential hazards in the national implementation of a prehospital pediatric RSI program. A process map and potential failure points were developed and identified. Probabilities, severity, and hazards scores were calculated for each failure point, and actions items developed to address these. One hundred four potential failure points were identified among 44 subprocesses, divided between nine major processes. In terms of severity, most were classified as either major (n = 39 [37.5%]) or catastrophic (n = 35 [33.7%]) with just more than half falling within the uncommon category (n = 56 [53.9%]) in terms of probability. Five strategic actions items were identified to mitigate against the failure points meeting criteria for action. To monitor the success of these, 11 quality and performance indicators were developed for concurrent implementation. The Healthcare Failure Mode and Effects Analysis represents a simple yet comprehensive first step toward risk analysis of complex procedures within the prehospital emergency care setting. Application of the methodology provided guidance for the consensus identification of hazards associated with prehospital pediatric RSI and appropriate actions to mitigate them.

  13. Measuring Poverty Reduction and Targeting Performance Under Multiple Government Programs

    OpenAIRE

    Paul Makdissi; Quentin Wodon

    2001-01-01

    The evaluation of the poverty impact and targeting performance of a given social program may depend on how other programs are treated in the analysis.Using well-known results from cooperative game theory, this paper proposes an empirically simple yet theoretically sound method for allocating between various programs the overall poverty reduction obtained from a set of programs, and for assessing the targeting performance of each program

  14. Heart failure severity, inappropriate ICD therapy, and novel ICD programming: a MADIT-RIT substudy.

    Science.gov (United States)

    Daimee, Usama A; Vermilye, Katherine; Rosero, Spencer; Schuger, Claudio D; Daubert, James P; Zareba, Wojciech; McNitt, Scott; Polonsky, Bronislava; Moss, Arthur J; Kutyifa, Valentina

    2017-12-01

    The effects of heart failure (HF) severity on risk of inappropriate implantable cardioverter-defibrillator (ICD) therapy have not been thoroughly investigated. We aimed to study the association between HF severity and inappropriate ICD therapy in MADIT-RIT. MADIT-RIT randomized 1,500 patients to three ICD programming arms: conventional (Arm A), high-rate cut-off (Arm B: ≥200 beats/min), and delayed therapy (Arm C: 60-second delay for ≥170 beats/min). We evaluated the association between New York Heart Association (NYHA) class III (n = 256) versus class I-II (n = 251) and inappropriate ICD therapy in Arm A patients with ICD-only and cardiac resynchronization therapy with defibrillator (CRT-D). We additionally assessed benefit of novel ICD programming in Arms B and C versus Arm A by NYHA classification. In Arm A, the risk of inappropriate therapy was significantly higher in those with NYHA III versus NYHA I-II for both ICD (hazard ratio [HR] = 2.55, confidence interval [CI]: 1.51-4.30, P programming significantly reduced inappropriate therapy in patients with both NYHA III (Arm B vs Arm A: HR = 0.08, P programming with high-rate cut-off or delayed detection reduces inappropriate ICD therapies in both mild and moderate HF. © 2017 Wiley Periodicals, Inc.

  15. Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

    Science.gov (United States)

    Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C

    2015-11-01

    Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Performance Contracts -- Success or Failure. Contract Learning Projects, Grand Rapids Public Schools, 1970-72.

    Science.gov (United States)

    Webster, Joan M.

    This report evaluates the Grand Rapids Public School (GRPS) experience with performance contracting. The report describes the first two years of the GRPS performance contracting experience, assesses the accomplishments of those two years, and describes the third year (1972-73) program. The author concludes that the contracts were successful and…

  17. A Framework for Performing Multiscale Stochastic Progressive Failure Analysis of Composite Structures

    Science.gov (United States)

    Bednarcyk, Brett A.; Arnold, Steven M.

    2007-01-01

    A framework is presented that enables coupled multiscale analysis of composite structures. The recently developed, free, Finite Element Analysis-Micromechanics Analysis Code (FEAMAC) software couples the Micromechanics Analysis Code with Generalized Method of Cells (MAC/GMC) with ABAQUS to perform micromechanics based FEA such that the nonlinear composite material response at each integration point is modeled at each increment by MAC/GMC. As a result, the stochastic nature of fiber breakage in composites can be simulated through incorporation of an appropriate damage and failure model that operates within MAC/GMC on the level of the fiber. Results are presented for the progressive failure analysis of a titanium matrix composite tensile specimen that illustrate the power and utility of the framework and address the techniques needed to model the statistical nature of the problem properly. In particular, it is shown that incorporating fiber strength randomness on multiple scales improves the quality of the simulation by enabling failure at locations other than those associated with structural level stress risers.

  18. Failure Analysis of a Modern High Performance Diesel Engine Cylinder Head

    Directory of Open Access Journals (Sweden)

    Bingbin Guo

    2014-05-01

    Full Text Available This paper presents a failure analysis on a modern high performance diesel engine cylinder head made of gray cast iron. Cracks appeared intensively at the intersection of two exhaust passages in the cylinder head. The metallurgical examination was conducted in the crack origin zone and other zones. Meanwhile, the load state of the failure part of the cylinder head was determined through the Finite Element Analysis. The results showed that both the point of the maximum temperature and the point of the maximum thermal-mechanical coupling stress were not in the crack position. The excessive load was not the main cause of the failure. The large cooling rate in the casting process created an abnormal graphite zone that existed below the surface of the exhaust passage (about 1.1 mm depth, which led to the fracture of the cylinder head. In the fractured area, there were a large number of casting defects (dip sand, voids, etc. and inferior graphite structure (type D, type E which caused stress concentration. Moreover, high temperature gas entered the cracks, which caused material corrosion, material oxidization, and crack propagation. Finally, premature fracture of the cylinder head took place.

  19. The Skills Enhancement Training Program. Performance Report.

    Science.gov (United States)

    Food and Beverage Workers Union, Local 32, Washington, DC.

    This report describes a joint labor-management workplace literacy program called SET (Skills Enhancement Training) that targeted the more than 2,000 unionized employees of food service contractors at U.S. government institutions in Washington, D.C. Nineteen classes were offered and a total of 191 people self-selected themselves into the program.…

  20. Investigation of stainless steel clad fuel rod failures and fuel performance in the Connecticut Yankee Reactor. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Pasupathi, V.; Klingensmith, R. W.

    1981-11-01

    Significant levels of fuel rod failures were observed in the batch 8 fuel assemblies of the Connecticut Yankee reactor. Failure of 304 stainless steel cladding in a PWR environment was not expected. Therefore a detailed poolside and hot cell examination program was conducted to determine the cause of failure and identify differences between batch 8 fuel and previous batches which had operated without failures. Hot cell work conducted consisted of detailed nondestructive and destructive examination of fuel rods from batches 7 and 8. The results indicate that the batch 8 failure mechanism was stress corrosion cracking initiating on the clad outer surface. The sources of cladding stresses are believed to be (a) fuel pellet chips wedged in the cladding gap, (b) swelling of highly nondensifying batch 8 fuel and (c) potentially harmful effects of a power change event that occurred near the end of the second cycle of irradiation for batch 8.

  1. Reliability and Availability Analysis of Some Systems with Common-Cause Failures Using SPICE Circuit Simulation Program

    Directory of Open Access Journals (Sweden)

    Muhammad Taher Abuelma'atti

    1999-01-01

    Full Text Available The effectiveness of SPICE circuit simulation program in calculating probabilities, reliability, steady-state availability and mean-time to failure of repairable systems described by Markov models is demonstrated. Two examples are presented. The first example is a warm standby system with common-cause failures and human errors. The second example is a non-identical unit parallel system with common-cause failures. In both cases recourse to numerical solution is inevitable to obtain the Laplace transforms of the probabilities. Results obtained using SPICE are compared with previously published results obtained using the Laplace transform method. Full SPICE listings are included.

  2. Fusion magnet safety studies program: superconducting magnet protection system and failure. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Allinger, J.; Danby, G.; Hsieh, S.Y.; Keane, J.; Powell, J.; Prodell, A.

    1975-11-01

    This report includes the first two quarters study of available information on schemes for protecting superconducting magnets. These schemes can be divided into two different categories. The first category deals with the detection of faulty regions (or normal regions) in the magnet. The second category relates to the protection of the magnet when a fault is detected, and the derived signal which can be used to activate a safety system (or energy removal system). The general detection and protection methods are first described briefly and then followed by a survey of the protection systems used by different laboratories for various magnets. A survey of the cause of the magnet difficulties or failures is also included. A preliminary discussion of these protection schemes and the experimental development of this program is given.

  3. Heart failure remote monitoring: evidence from the retrospective evaluation of a real-world remote monitoring program.

    Science.gov (United States)

    Agboola, Stephen; Jethwani, Kamal; Khateeb, Kholoud; Moore, Stephanie; Kvedar, Joseph

    2015-04-22

    Given the magnitude of increasing heart failure mortality, multidisciplinary approaches, in the form of disease management programs and other integrative models of care, are recommended to optimize treatment outcomes. Remote monitoring, either as structured telephone support or telemonitoring or a combination of both, is fast becoming an integral part of many disease management programs. However, studies reporting on the evaluation of real-world heart failure remote monitoring programs are scarce. This study aims to evaluate the effect of a heart failure telemonitoring program, Connected Cardiac Care Program (CCCP), on hospitalization and mortality in a retrospective database review of medical records of patients with heart failure receiving care at the Massachusetts General Hospital. Patients enrolled in the CCCP heart failure monitoring program at the Massachusetts General Hospital were matched 1:1 with usual care patients. Control patients received care from similar clinical settings as CCCP patients and were identified from a large clinical data registry. The primary endpoint was all-cause mortality and hospitalizations assessed during the 4-month program duration. Secondary outcomes included hospitalization and mortality rates (obtained by following up on patients over an additional 8 months after program completion for a total duration of 1 year), risk for multiple hospitalizations and length of stay. The Cox proportional hazard model, stratified on the matched pairs, was used to assess primary outcomes. A total of 348 patients were included in the time-to-event analyses. The baseline rates of hospitalizations prior to program enrollment did not differ significantly by group. Compared with controls, hospitalization rates decreased within the first 30 days of program enrollment: hazard ratio (HR)=0.52, 95% CI 0.31-0.86, P=.01). The differential effect on hospitalization rates remained consistent until the end of the 4-month program (HR=0.74, 95% CI 0

  4. School Breakfast Program and School Performance

    OpenAIRE

    J Gordon Millichap

    1989-01-01

    The effects of participation in the school breakfast program by low income children on academic achievement and rates of absence and tardiness are reported from the Department of Pediatrics, Boston City Hospital, Boston, MA.

  5. Effects of multidisciplinary Internet-based program on management of heart failure

    Directory of Open Access Journals (Sweden)

    Machiko R Tomita

    2008-12-01

    Full Text Available Machiko R Tomita1, Bin-Min Tsai2, Nadine M Fisher1, Neeraj A Kumar1, Greg Wilding3, Kathy Stanton1, Bruce J Naughton41Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA; 2Department of Occupational Therapy, I-Shou University, Taiwan; 3Department of Biostatistics, University at Buffalo, Buffalo, New York, USA; 4Department of Medicine, University at Buffalo, Buffalo, New York, USAObjectives: To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF.Methods: The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant’s record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics.Results: The treatment group had a high (85% adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001, amount of exercise (p = 0.001, and quality of life (p = 0.001, and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001, blood pressure (systolic, p = 0.002; diastolic, p < 0.001, frequency of emergency room visit, and length of hospital stay (both p = 0.001.Conclusions: An effective program to change one’s behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient’s daily record, which can be accomplished through Internet use.Keywords: e-health, self-management, Internet, heart failure, older adults, exercise

  6. Resveratrol improves exercise performance and skeletal muscle oxidative capacity in heart failure.

    Science.gov (United States)

    Sung, Miranda M; Byrne, Nikole J; Robertson, Ian M; Kim, Ty T; Samokhvalov, Victor; Levasseur, Jody; Soltys, Carrie-Lynn; Fung, David; Tyreman, Neil; Denou, Emmanuel; Jones, Kelvin E; Seubert, John M; Schertzer, Jonathan D; Dyck, Jason R B

    2017-04-01

    We investigated whether treatment of mice with established pressure overload-induced heart failure (HF) with the naturally occurring polyphenol resveratrol could improve functional symptoms of clinical HF such as fatigue and exercise intolerance. C57Bl/6N mice were subjected to either sham or transverse aortic constriction surgery to induce HF. Three weeks postsurgery, a cohort of mice with established HF (%ejection fraction resveratrol (~450 mg·kg-1·day-1) or vehicle for 2 wk. Although the percent ejection fraction was similar between both groups of HF mice, those mice treated with resveratrol had increased total physical activity levels and exercise capacity. Resveratrol treatment was associated with altered gut microbiota composition, increased skeletal muscle insulin sensitivity, a switch toward greater whole body glucose utilization, and increased basal metabolic rates. Although muscle mass and strength were not different between groups, mice with HF had significant declines in basal and ADP-stimulated O2 consumption in isolated skeletal muscle fibers compared with sham mice, which was completely normalized by resveratrol treatment. Overall, resveratrol treatment of mice with established HF enhances exercise performance, which is associated with alterations in whole body and skeletal muscle energy metabolism. Thus, our preclinical data suggest that resveratrol supplementation may effectively improve fatigue and exercise intolerance in HF patients.NEW & NOTEWORTHY Resveratrol treatment of mice with heart failure leads to enhanced exercise performance that is associated with altered gut microbiota composition, increased whole body glucose utilization, and enhanced skeletal muscle metabolism and function. Together, these preclinical data suggest that resveratrol supplementation may effectively improve fatigue and exercise intolerance in heart failure via these mechanisms. Copyright © 2017 the American Physiological Society.

  7. Mechanical, Hormonal and Psychological Effects of a Non-Failure Short-Term Strength Training Program in Young Tennis Players

    Directory of Open Access Journals (Sweden)

    Sarabia Jose Manuel

    2015-03-01

    Full Text Available This study examined the effects of a 6-week non-failure strength training program in youth tennis players. Twenty tennis players (age: 15.0 ± 1 years, body height: 170.9 ± 5.1 cm, body mass: 63.3 ± 9.1 kg were divided into experimental and control groups. Pre and post-tests included half squats, bench press, squat jumps, countermovementjumps and side-ball throws. Salivary cortisol samples were collected, and the Profile of Mood States questionnaire was used weekly during an anatomical adaptation period, a main training period and after a tapering week. The results showed that, after the main training period, the experimental group significantly improved (p<0.05 in mean and peak power output and in the total number of repetitions during the half-squat endurance test; mean force, power and velocity in the half-squat power output test; Profile of Mood States (in total mood disturbance between the last week of the mean training period and the tapering week; and in squat-jump and countermovement-jump height. Moreover, significant differences were found between the groups at the post-tests in the total number of repetitions, mean and peak power during the half-squat endurance test, mean velocity in the half-squat power output test, salivary cortisol concentration (baselines, first and third week of the mean training period and in the Profile of Mood States (in fatigue subscale: first and third week of the mean training period. In conclusion, a non-failure strength training protocol improved lower-limb performance levels and produced a moderate psychophysiological impact in youth elite tennis players, suggesting that it is a suitable program to improve strength. Such training protocols do not increase the total training load of tennis players and may be recommended to improve strength.

  8. Effect of Educational Program on Quality of Life of Patients with Heart Failure: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mohammad Khajegodary

    2013-02-01

    Full Text Available Introduction: Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. Methods: This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22 received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22 received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. Results: The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Conclusion: Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

  9. NASA High Performance Computing and Communications program

    Science.gov (United States)

    Holcomb, Lee; Smith, Paul; Hunter, Paul

    1994-01-01

    The National Aeronautics and Space Administration's HPCC program is part of a new Presidential initiative aimed at producing a 1000-fold increase in supercomputing speed and a 1(X)-fold improvement in available communications capability by 1997. As more advanced technologies are developed under the HPCC program, they will be used to solve NASA's 'Grand Challenge' problems, which include improving the design and simulation of advanced aerospace vehicles, allowing people at remote locations to communicate more effectively and share information, increasing scientists' abilities to model the Earth's climate and forecast global environmental trends, and improving the development of advanced spacecraft. NASA's HPCC program is organized into three projects which are unique to the agency's mission: the Computational Aerosciences (CAS) project, the Earth and Space Sciences (ESS) project, and the Remote Exploration and Experimentation (REE) project. An additional project, the Basic Research and Human Resources (BRHR) project, exists to promote long term research in computer science and engineering and to increase the pool of trained personnel in a variety of scientific disciplines. This document presents an overview of the objectives and organization of these projects, as well as summaries of early accomplishments and the significance, status, and plans for individual research and development programs within each project. Areas of emphasis include benchmarking, testbeds, software and simulation methods.

  10. 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.

  11. Level of Automation and Failure Frequency Effects on Simulated Lunar Lander Performance

    Science.gov (United States)

    Marquez, Jessica J.; Ramirez, Margarita

    2014-01-01

    A human-in-the-loop experiment was conducted at the NASA Ames Research Center Vertical Motion Simulator, where instrument-rated pilots completed a simulated terminal descent phase of a lunar landing. Ten pilots participated in a 2 x 2 mixed design experiment, with level of automation as the within-subjects factor and failure frequency as the between subjects factor. The two evaluated levels of automation were high (fully automated landing) and low (manual controlled landing). During test trials, participants were exposed to either a high number of failures (75% failure frequency) or low number of failures (25% failure frequency). In order to investigate the pilots' sensitivity to changes in levels of automation and failure frequency, the dependent measure selected for this experiment was accuracy of failure diagnosis, from which D Prime and Decision Criterion were derived. For each of the dependent measures, no significant difference was found for level of automation and no significant interaction was detected between level of automation and failure frequency. A significant effect was identified for failure frequency suggesting failure frequency has a significant effect on pilots' sensitivity to failure detection and diagnosis. Participants were more likely to correctly identify and diagnose failures if they experienced the higher levels of failures, regardless of level of automation

  12. Intestinal Graft Failure: Should We Perform the Allograft Enterectomy Before or With Retransplantation?

    Science.gov (United States)

    Nagai, Shunji; Mangus, Richard S; Anderson, Eve; Ekser, Burcin; Kubal, Chandrashekhar A; Fridell, Jonathan A; Tector, A Joseph

    2017-02-01

    Intestinal graft dysfunction is sometimes irreversible and requires allograft enterectomy with or without retransplantation. There is no comprehensive assessment of allograft enterectomy regarding indications and outcomes. The aim of this study was to evaluate management of patients with intestinal graft failure with special reference to indications and outcomes of allograft enterectomy and the procedure's validity as a bridge to retransplantation. Graft and patient survivals, reason for graft failure, and rejection episodes were evaluated in 221 intestinal recipients (primary transplantation [n = 201], retransplantation [n = 20]). Indications, surgical factors, and outcomes of allograft enterectomy were investigated. Reasons for isolated enterectomy included systemic infection in 11, gastrointestinal bleeding in 1, and severe electrolyte imbalance in 1, all of which were associated with rejection. One isolated intestinal transplantation patient underwent isolated enterectomy due to cytomegalovirus enteritis. One multivisceral transplantation patient underwent isolated allograft enterectomy due to bowel necrosis. Of these 15 patients, 3 died from persistent infection postoperatively, whereas 8 underwent retransplantation with median interval of 74 days (42-252 days). Allosensitization occurred between isolated enterectomy and retransplantation in 2, one of whom lost the second graft due to rejection. Simultaneous allograft enterectomy and retransplantation was performed in 3 isolated intestinal transplantation and 9 multivisceral transplantation patients. Patient survival after retransplantation was similar between patients who underwent isolated allograft enterectomy and those who did simultaneous enterectomy with retransplantation (P = 0.82). In cases of irreversible intestinal graft dysfunction, isolated allograft enterectomy successfully provides recovery from comorbidities as a lifesaving procedure and does not compromise outcomes of retransplantation.

  13. A Self Directed Adherence Management Program for Patients' with Heart Failure Completing Combined Aerobic and Resistance Exercise Training

    OpenAIRE

    Duncan, Kathleen; Pozehl, Bunny; Norman, Joseph F.; Hertzog, Melody

    2009-01-01

    This study measured the impact of the Exercise Adherence Management Program (EAMP) provided to 20 patients with heart failure (HF) who participated in a combined resistance and aerobic exercise training program during two, 12 week phases. The EAMP included strategies designed to support exercise self-efficacy and adherence. Results indicate an improvement in exercise self-efficacy occurred during the study period while exercise adherence declined during the unsupervised phase. The highest rat...

  14. Costs and benefits of personalized healthcare for patients with chronic heart failure in the care and education program "Telemedicine for the Heart".

    Science.gov (United States)

    Sohn, Stefan; Helms, Thomas M; Pelleter, Jörg T; Müller, Axel; Kröttinger, Annett I; Schöffski, Oliver

    2012-04-01

    A health economic analysis was conducted to evaluate the program "Telemedicine for the Heart," which the German Foundation for the Chronically Ill organizes for the Techniker Krankenkasse, one of the biggest German statutory health insurance funds. The program consists of nurse-calls to motivate patients to perform regular self-measurements (blood pressure, pulse, weight) with either their own or telemedical measuring devices provided by the program. In the case of measured values outside of set limits, calls to treating physicians were placed to allow for the initiation of therapy adjustments where applicable. To evaluate the program, a retrospective matched-pairs analysis was performed. Program participants (n=281) and regularly insured patients (n=843) were matched for demographics and morbidity status and compared according to their use of resources. Significant cost differences in favor of the study group of up to 25% in relation to total costs could be detected, particularly in the group of New York Heart Association (NYHA) classification II patients (persons with mild symptoms and slight limitation according to the NYHA classification for the extent of heart failure). In the more severe NYHA stages III and IV the cost relation differed and showed a slight cost disadvantage for the program group. Mortality was 35.1% lower in the program group than in the control group. Quality of life measures were almost constant over the observation time, compatible with a positive impact of the program on the highly impaired patient group. The findings suggest that, besides a reduction of costs, by participating in "Telemedicine for the Heart" patients with chronic heart failure experienced a reduced number of hospital stays, optimized medical therapy, better quality of life, and reduced mortality.

  15. Why GPA Isn't Predictive: Student Perceptions of Success or Failure in an Associate Degree Nursing Program

    Science.gov (United States)

    Sall, James

    2009-01-01

    The purpose of this research was to identify the factors that students attending a Midwestern community college perceived contributed to their academic success or failure in an Associate Degree nursing program. A review of student academic records revealed that many students with weak academic records were successful while students with strong…

  16. Solving Component Structural Dynamic Failures Due to Extremely High Frequency Structural Response on the Space Shuttle Program

    Science.gov (United States)

    Frady, Greg; Nesman, Thomas; Zoladz, Thomas; Szabo, Roland

    2010-01-01

    For many years, the capabilities to determine the root-cause failure of component failures have been limited to the analytical tools and the state of the art data acquisition systems. With this limited capability, many anomalies have been resolved by adding material to the design to increase robustness without the ability to determine if the design solution was satisfactory until after a series of expensive test programs were complete. The risk of failure and multiple design, test, and redesign cycles were high. During the Space Shuttle Program, many crack investigations in high energy density turbomachines, like the SSME turbopumps and high energy flows in the main propulsion system, have led to the discovery of numerous root-cause failures and anomalies due to the coexistences of acoustic forcing functions, structural natural modes, and a high energy excitation, such as an edge tone or shedding flow, leading the technical community to understand many of the primary contributors to extremely high frequency high cycle fatique fluid-structure interaction anomalies. These contributors have been identified using advanced analysis tools and verified using component and system tests during component ground tests, systems tests, and flight. The structural dynamics and fluid dynamics communities have developed a special sensitivity to the fluid-structure interaction problems and have been able to adjust and solve these problems in a time effective manner to meet budget and schedule deadlines of operational vehicle programs, such as the Space Shuttle Program over the years.

  17. The Performance Enhancement Group Program: Integrating Sport Psychology and Rehabilitation

    OpenAIRE

    Granito, Vincent J.; Hogan, Jeffery B.; Varnum, Lisa K.

    1995-01-01

    In an effort to improve the psychological health of the athlete who has sustained an injury, the Performance Enhancement Group program for injured athletes was created. This paper will offer a model for the Performance Enhancement Group program as a way to: 1) support the athlete, both mentally and physically; 2) deal with the demands of rehabilitation; and 3) facilitate the adjustments the athlete has to make while being out of the competitive arena. The program consists of responsibilities ...

  18. Report for the ASC CSSE L2 Milestone (4873) - Demonstration of Local Failure Local Recovery Resilient Programming Model.

    Energy Technology Data Exchange (ETDEWEB)

    Heroux, Michael Allen; Teranishi, Keita

    2014-06-01

    Recovery from process loss during the execution of a distributed memory parallel application is presently achieved by restarting the program, typically from a checkpoint file. Future computer system trends indicate that the size of data to checkpoint, the lack of improvement in parallel file system performance and the increase in process failure rates will lead to situations where checkpoint restart becomes infeasible. In this report we describe and prototype the use of a new application level resilient computing model that manages persistent storage of local state for each process such that, if a process fails, recovery can be performed locally without requiring access to a global checkpoint file. LFLR provides application developers with an ability to recover locally and continue application execution when a process is lost. This report discusses what features are required from the hardware, OS and runtime layers, and what approaches application developers might use in the design of future codes, including a demonstration of LFLR-enabled MiniFE code from the Matenvo mini-application suite.

  19. A Performance Assessment of NASA's Heliophysics Program

    Science.gov (United States)

    2009-01-01

    Recognizing the importance of distributed observations of all elements of the Sun-to-Earth system and the synergies between observation and theory and between basic and targeted research, the National Research Council's 2003 solar and space physics decadal survey laid out an integrated research strategy that sought to extend and augment what has now become the Heliophysics Great Observatory as well as to enhance NASA, NOAA, NSF, and DOD's other solar and space physics research activities. The Integrated Research Strategy provided a prioritized list of flight missions and theory and modeling programs that would advance the relevant physical theories, incorporate those theories in models that describe a system of interactions between the Sun and the space environment, obtain data on the system, and analyze and test the adequacy of the theories and models. As directed by Congress in the NASA Authorization Act of 2005, the purpose of this report is to assess the progress of NASA's Heliophysics Division at the 5-year mark against the NASA goals and priorities laid out in the decadal survey. In addition to the Integrated Research Strategy, the decadal survey also considered non-mission-specific initiatives to foster a robust solar and space physics program. The decadal survey set forth driving science challenges as well as recommendations devoted to the need for technology development, collaborations and cooperation with other disciplines, understanding the effects of the space environment on technology and society, education and public outreach, and steps that could strengthen and enhance the research enterprise. Unfortunately, very little of the recommended NASA program priorities from the decadal survey s Integrated Research Strategy will be realized during the period (2004-2013) covered by the survey. Mission cost growth, reordering of survey mission priorities, and unrealized budget assumptions have delayed or deferred nearly all of the NASA spacecraft missions

  20. The effects of self-report cognitive failures and cognitive load on antisaccade performance

    Directory of Open Access Journals (Sweden)

    Nick eBerggren

    2011-10-01

    Full Text Available Individuals reporting high levels of distractibility in everyday life show impaired performance in standard laboratory tasks measuring selective attention and inhibitory processes. Similarly, increasing cognitive load leads to more errors/distraction in a variety of cognitive tasks. How these two factors interact is currently unclear; highly distractible individuals may be affected more when their cognitive resources are taxed, or load may linearly affect performance for all individuals. We investigated the relationship between self-reported levels of cognitive failuresin daily life and performance in the antisaccade task, a widely used tool examining attentional control. Levels of concurrent cognitive demand were manipulated using a secondary auditory discrimination task. We found that both levels of self-reported cognitive failures and task load increased antisaccade latencies while having no effect on prosaccade eye-movements. However individuals rating themselves as suffering few daily life distractions showed a comparable load cost to those who experience many. These findings suggest that the likelihood of distraction is governed by the addition of both internal susceptibility and the external current load placed on working memory.

  1. The effects of self-report cognitive failures and cognitive load on antisaccade performance.

    Science.gov (United States)

    Berggren, Nick; Hutton, Samuel B; Derakshan, Nazanin

    2011-01-01

    Individuals reporting high levels of distractibility in everyday life show impaired performance in standard laboratory tasks measuring selective attention and inhibitory processes. Similarly, increasing cognitive load leads to more errors/distraction in a variety of cognitive tasks. How these two factors interact is currently unclear; highly distractible individuals may be affected more when their cognitive resources are taxed, or load may linearly affect performance for all individuals. We investigated the relationship between self-reported levels of cognitive failures (CF) in daily life and performance in the antisaccade task, a widely used tool examining attentional control. Levels of concurrent cognitive demand were manipulated using a secondary auditory discrimination task. We found that both levels of self-reported CF and task load increased antisaccade latencies while having no effect on prosaccade eye-movements. However individuals rating themselves as suffering few daily life distractions showed a comparable load cost to those who experience many. These findings suggest that the likelihood of distraction is governed by the addition of both internal susceptibility and the external current load placed on working memory.

  2. Economic Evaluation of Exercise-Based Cardiac Rehabilitation Programs for Chronic Heart Failure Patients in Colombia.

    Science.gov (United States)

    Rincón, Mónica; Rojas, Maria Ximena; Rodriguez Romero, Viviana Alejandra; Tamayo, Diana Carolina; Franco, Camilo; Castro, Hector; Brophy, James; Dennis, Rodolfo

    2016-01-01

    Cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) has met with resistance from third-party payers in low- and middle-income countries because of lack of evidence regarding its cost-effectiveness. We aimed to provide information to help better inform this decision-making process. Costs associated with a 12-week exercise-based rehabilitation program in Colombia for patients with CHF were estimated. We collected data on all medical resources used in ambulatory care and data on hospital costs incurred for treating patients with uncompensated CHF. A literature search to establish the hospitalization rates because of uncompensated CHF, death because of CHF, and potential decreases in these data because of the utilization of CR was conducted. We modeled incremental costs and effectiveness over a period of 5 years from the perspective of the third-party payer. All costs were converted from Colombian pesos to US dollars. For an exercise-based CR program of 12-week duration (36 sessions), costs ranged from US$265 to US$369 per patient. Monthly costs associated with ambulatory care of CHF averaged US$128 ± US$321 per patient, and hospitalization costs were US$3621 ± US$5 444 per event. Yearly hospitalization incidence rates with and without CR were 0.154 and 0.216, respectively. The incremental cost of CR would be US$998 per additional quality-adjusted life-year. Sensitivity analysis did not significantly change these results. Cardiac rehabilitation in patients with CHF in settings such as Colombia can be a cost-effective strategy, with minimal incremental costs and better quality of life, mainly because of decreased rates of hospitalization.

  3. 42 CFR 57.314 - Repayment of loans made after November 17, 1971, for failure to complete a program of study. 2

    Science.gov (United States)

    2010-10-01

    ..., for failure to complete a program of study. 2 57.314 Section 57.314 Public Health PUBLIC HEALTH... made after November 17, 1971, for failure to complete a program of study. 2 2 Effective November 26... in nursing for which an eligible education loan was made upon certification by a school of nursing...

  4. 42 CFR 57.214 - Repayment of loans made after November 17, 1971, for failure to complete a program of study.

    Science.gov (United States)

    2010-10-01

    ..., for failure to complete a program of study. 57.214 Section 57.214 Public Health PUBLIC HEALTH SERVICE... after November 17, 1971, for failure to complete a program of study. In the event that the Secretary... eligible education loan was made upon certification by a health professions school that the individual...

  5. A self-directed adherence management program for patients with heart failure completing combined aerobic and resistance exercise training.

    Science.gov (United States)

    Duncan, Kathleen; Pozehl, Bunny; Norman, Joseph F; Hertzog, Melody

    2011-11-01

    This study measured the impact of the Exercise Adherence Management Program (EAMP) provided to 20 patients with heart failure (HF) who participated in a combined resistance and aerobic exercise training program during two 12-week phases. The EAMP included strategies designed to support exercise self-efficacy and adherence. Results indicate that an improvement in exercise self-efficacy occurred during the study period, whereas exercise adherence declined during the unsupervised phase. The highest rated adherence strategy for helpfulness and self-efficacy was group sessions. The study supports the use of adherence strategies based on self-efficacy in exercise programs for patients with HF. Published by Elsevier Inc.

  6. TEAM-HF Cost-Effectiveness Model: A Web-Based Program Designed to Evaluate the Cost-Effectiveness of Disease Management Programs in Heart Failure

    Science.gov (United States)

    Reed, Shelby D.; Neilson, Matthew P.; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H.; Polsky, Daniel E.; Graham, Felicia L.; Bowers, Margaret T.; Paul, Sara C.; Granger, Bradi B.; Schulman, Kevin A.; Whellan, David J.; Riegel, Barbara; Levy, Wayne C.

    2015-01-01

    Background Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. Methods We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics, use of evidence-based medications, and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model (SHFM). Projections of resource use and quality of life are modeled using relationships with time-varying SHFM scores. The model can be used to evaluate parallel-group and single-cohort designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. Results The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. Conclusion The TEAM-HF Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. PMID:26542504

  7. Evaluation of a Community Health Service Center-Based Intervention Program for Managing Chronic Heart Failure.

    Science.gov (United States)

    Gu, Moli; Ma, Yanlan; Zhou, Ti; Xia, Yunfeng

    2016-01-01

    Although the role of primary care for the management of patients with chronic heart failure (CHF) has been highly recommended, structural involvement of primary care in heart failure (HF) management programs is extremely limited. To examine the feasibility and applicability of two most recommended forms of care delivery mode, home visit and telephone support, for CHF management in the setting of community health service center (CHSC). Prospective study. This study was conducted in two CHSCs in Beijing, China. Care delivery was led by trained general practitioners or community nurses via home visits in one CHSC and telephone support in the other. Data regarding the change in mortality and hospitalization rate during 12 months and self-care level at 6 months were prospectively collected and compared across the intervention groups. A total of 329 patients were included, with 142 in the home visit group and 187 in the telephone support group. Patients in both groups had frequent visits to CHSC (8.1±5.9 in the home visit and 7.7±4.1 in the telephone support group, p=0.45) during the follow-up period. Compared to the telephone support group, patients in the home visit group showed a reduction in all-cause mortality (14.1% versus 20.3%, p=0.14), one or more hospitalizations due to any cause (33.8% versus 44.2%, p=0.12) and one or more hospitalizations due to cardiac cause (17.6% versus 24.6%, p=0.13) in the home visit group. The absolute differences were 6.2% (95% CI: 1.9%, 14.3%), 8.4% (95% CI: 2.1%, 18.9%) and 7.3% (95% CI: 1.5%, 16.1%), respectively, although the results were not statistically significant. After 6 months of intervention, patients in both groups achieved marked improvement in self-care with reference to their own baseline values. Although no statistical difference was observed between the two care delivery approaches regarding the clinical outcomes of interest, given the high participation rates, the acceptable rate of adverse events, frequent CHSC

  8. The Performance of Short-Term Heart Rate Variability in the Detection of Congestive Heart Failure.

    Science.gov (United States)

    Lucena, Fausto; Barros, Allan Kardec; Ohnishi, Noboru

    2016-01-01

    Congestive heart failure (CHF) is a cardiac disease associated with the decreasing capacity of the cardiac output. It has been shown that the CHF is the main cause of the cardiac death around the world. Some works proposed to discriminate CHF subjects from healthy subjects using either electrocardiogram (ECG) or heart rate variability (HRV) from long-term recordings. In this work, we propose an alternative framework to discriminate CHF from healthy subjects by using HRV short-term intervals based on 256 RR continuous samples. Our framework uses a matching pursuit algorithm based on Gabor functions. From the selected Gabor functions, we derived a set of features that are inputted into a hybrid framework which uses a genetic algorithm and k-nearest neighbour classifier to select a subset of features that has the best classification performance. The performance of the framework is analyzed using both Fantasia and CHF database from Physionet archives which are, respectively, composed of 40 healthy volunteers and 29 subjects. From a set of nonstandard 16 features, the proposed framework reaches an overall accuracy of 100% with five features. Our results suggest that the application of hybrid frameworks whose classifier algorithms are based on genetic algorithms has outperformed well-known classifier methods.

  9. The Performance of Short-Term Heart Rate Variability in the Detection of Congestive Heart Failure

    Directory of Open Access Journals (Sweden)

    Fausto Lucena

    2016-01-01

    Full Text Available Congestive heart failure (CHF is a cardiac disease associated with the decreasing capacity of the cardiac output. It has been shown that the CHF is the main cause of the cardiac death around the world. Some works proposed to discriminate CHF subjects from healthy subjects using either electrocardiogram (ECG or heart rate variability (HRV from long-term recordings. In this work, we propose an alternative framework to discriminate CHF from healthy subjects by using HRV short-term intervals based on 256 RR continuous samples. Our framework uses a matching pursuit algorithm based on Gabor functions. From the selected Gabor functions, we derived a set of features that are inputted into a hybrid framework which uses a genetic algorithm and k-nearest neighbour classifier to select a subset of features that has the best classification performance. The performance of the framework is analyzed using both Fantasia and CHF database from Physionet archives which are, respectively, composed of 40 healthy volunteers and 29 subjects. From a set of nonstandard 16 features, the proposed framework reaches an overall accuracy of 100% with five features. Our results suggest that the application of hybrid frameworks whose classifier algorithms are based on genetic algorithms has outperformed well-known classifier methods.

  10. Cardiac resynchronization therapy improves psycho-cognitive performance in patients with heart failure.

    Science.gov (United States)

    Duncker, David; Friedel, Katrin; König, Thorben; Schreyer, Hendrik; Lüsebrink, Ulrich; Duncker, Mareke; Oswald, Hanno; Klein, Gunnar; Gardiwal, Ajmal

    2015-09-01

    Reduced cognitive performance and high prevalence of depression have been reported in patients with congestive heart failure (CHF) and severe left ventricular dysfunction. However, effects of contemporary device therapy on cognitive performance and depression symptoms have not been studied thoroughly. Seventy-four consecutive CHF patients-45 receiving a biventricular defibrillator (CRT-D) and 29 receiving an implantable single or dual-chamber defibrillator (ICD) as a control group-were enrolled in this investigator-initiated, prospective, controlled, and investigator-blinded study. A set of neuropsychological tests (mini-mental state examination, DemTect, age-concentration test, and Beck depression inventory) was performed before, at 3 and at 6 months after device implantation. DemTect-score improved significantly (F = 7.8; P = 0.007) after CRT-D-implantation compared with ICD. Age-concentration test revealed better concentration ability after CRT-D-implantation (F = 8.3; P = 0.005) compared with ICD. Under CRT-D mini-mental state examination showed a significant improvement (F = 4.2; P = 0.043). CRT with defibrillator therapy also improved depression revealed by beck depression inventory (F = 14.7; P< 0.001) compared with ICD. This prospective study is the first to demonstrate psycho-cognitive improvement by resynchronization therapy in CHF patients with severe left ventricular dysfunction. In contrast to ICD therapy, the beneficial effect of CRT-D on psycho-cognitive performance might be attributed to improved cardiac function and haemodynamics. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  11. Camp Verde Adult Reading Program. Final Performance Report.

    Science.gov (United States)

    Maynard, David A.

    This document begins with a four-page performance report describing how the Camp Verde Adult Reading Program site was relocated to the Community Center Complex, and the Town Council contracted directly with the Friends of the Camp Verde Library to provide for the requirements of the program. The U.S. Department of Education grant allowed the…

  12. Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study.

    Science.gov (United States)

    Oh, Heung-Kwon; Ihn, Myong Hun; Son, Il Tae; Park, Jin Taek; Lee, Jaebong; Kim, Duck-Woo; Kang, Sung-Bum

    2016-03-01

    Although enhanced recovery programs (ERPs) have been proven to be beneficial after laparoscopic colon surgery, they may result in adverse clinical outcomes following failure. This study analyzed risk factors associated with ERP failure after laparoscopic colon cancer surgery. We analyzed the outcomes of 208 patients who underwent ERPs following laparoscopic colon cancer surgery between June 2007 and April 2013. The ERP included early oral feeding, early ambulation, and regular laxative administration. ERP failure was defined as postoperative hospital stay of more than 5 days related to postoperative complications, unplanned readmission within 30 days of surgery, or death. Surgical procedures included anterior resection (n = 101), right hemicolectomy (n = 90), and left hemicolectomy (n = 17). The mean postoperative hospital stay was 6.5 ± 2.3 days (range 3-24 days). ERP failure occurred in 36 patients (17.3%), with no mortality; reasons included ileus (n = 14), wound infection (n = 4), chylous drainage (n = 3), anastomotic bleeding (n = 3), pneumonia (n = 1), or readmission (n = 11) owing to delayed complications. Univariable analysis showed that ERP failure was associated with proximal colon cancer, side-to-side anastomosis, longer operation time, increased blood loss, and longer resected specimen length. Multivariable analysis showed that side-to-side anastomosis [odds ratio (OR) 4.534; 95% confidence interval (CI) 1.902-10.811; P = 0.001] and increased blood loss (OR 1.004; 95% CI 1.001-1.008; P = 0.041) were independent risk factors for ERP failure. We showed that increased blood loss and side-to-side anastomosis in comparison with end-to-end anastomosis were independent risk factors associated with ERP failure after laparoscopic colon cancer surgery. This suggests that intraoperative elements may be important determinants to obtain successful postoperative recovery in the era of ERP.

  13. Quality of life predicts outcome in a heart failure disease management program.

    LENUS (Irish Health Repository)

    O'Loughlin, Christina

    2012-02-01

    BACKGROUND: Chronic heart failure (HF) is associated with a poor Health Related Quality of Life (HRQoL). HRQoL has been shown to be a predictor of HF outcomes however, variability in the study designs make it difficult to apply these findings to a clinical setting. The aim of this study was to establish if HRQoL is a predictor of long-term mortality and morbidity in HF patients followed-up in a disease management program (DMP) and if a HRQoL instrument could be applied to aid in identifying high-risk patients within a clinical context. METHODS: This is a retrospective analysis of HF patients attending a DMP with 18+\\/-9 months follow-up. Clinical and biochemical parameters were recorded on discharge from index HF admission and HRQoL measures were recorded at 2 weeks post index admission. RESULTS: 225 patients were enrolled into the study (mean age=69+\\/-12 years, male=61%, and 78%=systolic HF). In multivariable analysis, all dimensions of HRQoL (measured by the Minnesota Living with HF Questionnaire) were independent predictors of both mortality and readmissions particularly in patients <80 years. A significant interaction between HRQoL and age (Total((HRQoL))age: p<0.001) indicated that the association of HRQoL with outcomes diminished as age increased. CONCLUSIONS: These data demonstrate that HRQoL is a predictor of outcome in HF patients managed in a DMP. Younger patients (<65 years) with a Total HRQoL score of > or =50 are at high risk of an adverse outcome. In older patients > or =80 years HRQoL is not useful in predicting outcome.

  14. Architecture and Programming Models for High Performance Intensive Computation

    Science.gov (United States)

    2016-06-29

    AFRL-AFOSR-VA-TR-2016-0230 Architecture and Programming Models for High Performance Intensive Computation XiaoMing Li UNIVERSITY OF DELAWARE Final...TITLE AND SUBTITLE Architecture and Programming Models for High Performance Intensive Computation 5a. CONTRACT NUMBER 5b. GRANT NUMBER FA9550-13-1-0213...developing an efficient system architecture and software tools for building and running Dynamic Data Driven Application Systems (DDDAS). The foremost

  15. Effectiveness of Human Research Protection Program Performance Measurements.

    Science.gov (United States)

    Tsan, Min-Fu; Nguyen, Yen

    2017-10-01

    We analyzed human research protection program performance metric data of all Department of Veterans Affairs research facilities obtained from 2010 to 2016. Among a total of 25 performance metrics, 21 (84%) showed improvement, four (16%) remained unchanged, and none deteriorated during the study period. The overall improvement from these 21 performance metrics was 81.1% ± 18.7% (mean ± SD), with a range of 30% to 100%. The four performance metrics that did not show improvement all had initial noncompliance/incidence rates of performance metrics that showed improvement ranged from 0.05% to 60%. However, of the 21 performance metrics that showed improvement, 10 had initial noncompliance/incidence rates of performance measurement is an effective tool in improving the performance of human research protection programs.

  16. Sequential File Programming Patterns and Performance with .NET

    OpenAIRE

    Kukol, Peter; Gray, Jim

    2005-01-01

    Programming patterns for sequential file access in the .NET Framework are described and the performance is measured. The default behavior provides excellent performance on a single disk - 50 MBps both reading and writing. Using large request sizes and doing file pre-allocation when possible have quantifiable benefits. When one considers disk arrays, .NET unbuffered IO delivers 800 MBps on a 16-disk array, but buffered IO delivers about 12% of that performance. Consequently, high-performance f...

  17. Sarcopenia, cachexia, and muscle performance in heart failure: Review update 2016.

    Science.gov (United States)

    Saitoh, Masakazu; Ishida, Junichi; Doehner, Wolfram; von Haehling, Stephan; Anker, Markus S; Coats, Andrew J S; Anker, Stefan D; Springer, Jochen

    2017-07-01

    Cachexia in the context of heart failure (HF) has been termed cardiac cachexia, and represents a progressive involuntary weight loss. Cachexia is mainly the result of an imbalance in the homeostasis of muscle protein synthesis and degradation due to a lower activity of protein synthesis pathways and an over-activation of protein degradation. In addition, muscle wasting leads to of impaired functional capacity, even after adjusting for clinical relevant variables in patients with HF. However, there is no sufficient therapeutic strategy in muscle wasting in HF patients and very few studies in animal models. Exercise training represents a promising intervention that can prevent or even reverse the process of muscle wasting, and worsening the muscle function and performance in HF with muscle wasting and cachexia. The pathological mechanisms and effective therapeutic approach of cardiac cachexia remain uncertain, because of the difficulty to establish animal cardiac cachexia models, thus novel animal models are warranted. Furthermore, the use of improved animal models will lead to a better understanding of the pathways that modulate muscle wasting and therapeutics of muscle wasting of cardiac cachexia. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Reliability modeling technology for CNC PCB performance degradation based on competing failure

    Directory of Open Access Journals (Sweden)

    Chuanning XIE

    2017-04-01

    Full Text Available To comprehensively, objectively, and accurately predict the reliability of CNC PCB under the action of the external environment stress and the internal circuit, and verify whether the reliability design of CNC system could meet the requirement and the system could reliably work, the CNC PCB is investigated. Starting from crucial and key problems of the reliability ana-lysis and evaluation, on the basis of review of the failure mechanism and degradation failure analysis, the typical accelerated model of CNC PCB is proposed in consideration of the multiple failure mechanism competing, which provides a new method to accurately analyze and evaluate the reliability of CNC PCB. Then in consideration of the failure mechanism and relation among multiple failure modes, a thought on building the typical accelerated model of CNC PCB is advanced. Finally, through analyzing the correlation and quantifying the proportions of all failure mechanisms based on test data, the accelerated model of CNC PCB is proposed on competing failure. It provides a new method to analyze and evaluate the reliability of CNC PCB accurately.

  19. A disease management program for heart failure: collaboration between a home care agency and a care management organization.

    Science.gov (United States)

    Gorski, Lisa A; Johnson, Kathy

    2003-01-01

    This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described.

  20. Availability of energetic substrates and exercise performance in heart failure with or without diabetes.

    Science.gov (United States)

    Melenovsky, Vojtech; Kotrc, Martin; Polak, Jan; Pelikanova, Terezie; Bendlova, Bela; Cahova, Monika; Malek, Ivan; Jarolim, Petr; Kazdova, Ludmila; Kautzner, Josef

    2012-07-01

    The goal of the study was to examine whether resting or post-exercise metabolic substrate levels are associated with differential exercise performance and long-term outcome in control subjects or heart failure (HF) patients with or without type 2 diabetes mellitus (DM). Twenty five healthy controls matched with 97 patients with stable advanced HF were prospectively enrolled. Exercise capacity, age, gender, and HF aetiology were balanced between HFDM- and HFDM+ groups. Subjects underwent maximal bicycle spiroergometry with blood sampling to measure metabolites and neurohormones before and immediately after the exercise. HFDM+ patients had increased free fatty acids, glucose, and β-hydroxybutyrate compared with controls. HFDM+ patients had higher baseline copeptin (24 ± 16 vs. 17 ± 13 pmol/L, P HFDM- patients. Peak oxygen consumption (VO(2)) was unrelated to post-exercise free fatty acids, glucose, lactate, or glycerol, but strongly correlated with post-exercise pyruvate (in all: r = 0.62, P < 0.001). During the next 17 ± 10 months, 36% of HF patients experienced an adverse event (death, urgent transplantation, or assist device insertion). From metabolic factors, only post-exercise glucose [hazard ratio (HR) 1.28, P = 0.04), total body fat (HR 0.58, P < 0.001), and the presence of DM (HR 1.98, P = 0.04) were predictive of the outcome. With the exception of pyruvate, acute changes of metabolic substrates are not related to cardiac performance in HF, regardless of diabetic status. Inhibition of body fat depletion, attenuation of stress-related hyperglycaemia, or increasing dynamics of plasma pyruvate may represent therapeutic targets in advanced HF.

  1. A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure

    OpenAIRE

    Moss, Marc; Nordon-Craft, Amy; Malone, Dan; Van Pelt, David; Frankel, Stephen K.; Warner, Mary Laird; Kriekels, Wendy; McNulty, Monica; Fairclough, Diane L.; Schenkman, Margaret

    2016-01-01

    Rationale: Early physical therapy (PT) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness. However, the optimal dosage of these interventions is currently unknown.

  2. Assessing Preservice Teachers' Mathematics Cognitive Failures as Related to Mathematics Anxiety and Performance in Undergraduate Calculus

    Science.gov (United States)

    Awofala, Adeneye O. A.; Odogwu, Helen N.

    2017-01-01

    The study investigated mathematics cognitive failures as related to mathematics anxiety, gender and performance in calculus among 450 preservice teachers from four public universities in the South West geo-political zone of Nigeria using the quantitative research method within the blueprint of the descriptive survey design. Data collected were…

  3. A concept for performance management for Federal science programs

    Science.gov (United States)

    Whalen, Kevin G.

    2017-11-06

    The demonstration of clear linkages between planning, funding, outcomes, and performance management has created unique challenges for U.S. Federal science programs. An approach is presented here that characterizes science program strategic objectives by one of five “activity types”: (1) knowledge discovery, (2) knowledge development and delivery, (3) science support, (4) inventory and monitoring, and (5) knowledge synthesis and assessment. The activity types relate to performance measurement tools for tracking outcomes of research funded under the objective. The result is a multi-time scale, integrated performance measure that tracks individual performance metrics synthetically while also measuring progress toward long-term outcomes. Tracking performance on individual metrics provides explicit linkages to root causes of potentially suboptimal performance and captures both internal and external program drivers, such as customer relations and science support for managers. Functionally connecting strategic planning objectives with performance measurement tools is a practical approach for publicly funded science agencies that links planning, outcomes, and performance management—an enterprise that has created unique challenges for public-sector research and development programs.

  4. Accelerating Matlab performance 1001 tips to speed up Matlab programs

    CERN Document Server

    Altman, Yair M

    2014-01-01

    … a very interesting new book on MATLAB® performance … covering basic tools and an appropriate range of specific programming techniques. The book seems to take a whole-system approach … helping readers understand the big picture of how to get better performance.-Michelle Hirsch, Ph.D., Head of MATLAB® Product Management, The MathWorks Inc..

  5. Designing PV Incentive Programs to Promote System Performance: AReview of Current Practice

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2006-11-12

    Some stakeholders continue to voice concerns about the performance of customer-sited photovoltaic (PV) systems, particularly because these systems typically receive financial support through ratepayer- or publicly-funded programs. Although much remains to be understood about the extent and specific causes of poor PV system performance, several studies of the larger programs and markets have shed some light on the issue. An evaluation of the California Energy Commission (CEC)'s Emerging Renewables Program, for example, found that 7% of systems, in a sample of 95, had lower-than-expected power output due to shading or soiling (KEMA 2005). About 3% of a larger sample of 140 systems were not operating at all or were operating well below expected output, due to failed equipment, faulty installation workmanship, and/or a lack of basic maintenance. In a recent evaluation of the other statewide PV incentive program in California, the Self-Generation Incentive Program, 9 of 52 projects sampled were found to have annual capacity factors less than 14.5%, although reasons for these low capacity factors generally were not identified (Itron 2005). Studies of PV systems in Germany and Japan, the two largest PV markets worldwide, have also revealed some performance problems associated with issues such as shading, equipment and installation defects, inverter failure, and deviations from module manufacturers' specifications (Otani et al. 2004, Jahn & Nasse 2004). Although owners of PV systems have an inherent incentive to ensure that their systems perform well, many homeowners and building operators may lack the necessary information and expertise to carry out this task effectively. Given this barrier, and the responsibility of PV incentive programs to ensure that public funds are prudently spent, these programs should (and often do) play a critical role in promoting PV system performance. Performance-based incentives (PBIs), which are based on actual energy production

  6. Usefulness of frailty profile for targeting older heart failure patients in disease management programs: a cost-effectiveness, pilot study.

    Science.gov (United States)

    Pulignano, Giovanni; Del Sindaco, Donatella; Di Lenarda, Andrea; Tarantini, Luigi; Cioffi, Giovanni; Gregori, Dario; Tinti, Maria Denitza; Monzo, Luca; Minardi, Giovanni

    2010-10-01

    Disease management programs (DMP) improve outcomes in patients with heart failure. Because older heart failure patients represent a heterogeneous population, the aim of this study was to determine which patients benefit mostly from a DMP, by means of their frailty profile. Heart failure outpatient clinic. Consecutive (n = 173) patients aged more than 70 years were randomized to a multidisciplinary DMP (n = 86) or usual care (n = 87). A modified frailty score (range 1-6) was used as an index of global functional impairment. Mild to moderate frailty (frailty score = 2-3) was associated with significant improvements in outcomes (death and/or heart failure admission, heart failure admissions and all-cause admissions) in DMP patients vs. usual care. Even in more frail patients (frailty score = 4-6) a significant reduction in heart failure admissions was observed. By contrast, nonfrail patients (frailty score = 1) did not derive significant benefit. In the cost-effectiveness analysis, the mean savings per patient, stratified according to their frailty score, were -1003.31 euro for frailty score 1 (95% confidence interval -3717.00-1709.00), 1104.72 euro for frailty score 2 (-280.6-2491.00), 2635.42 euro for frailty score 3 (352.60-4917.00, P = 0.025) and 419.53 euro for frailty score 4-6 (-1909.00-2749.00). Intervention was therefore significantly cost saving in moderately frail, but not in nonfrail or severely frail patients. Thus, DMP was dominant (i.e. both less costly and more effective than usual care) in moderately frail patients. At sensitivity analysis, DMP remained dominant even to changes in cost of intervention and hospitalizations. This suggests that an intensive, hospital-based DMP appears to be more effective in older patients with mild-to-moderate levels of frailty. Thus, a multidimensional assessment of frailty seems to be a useful tool for appropriate selection of model of care.

  7. Hemodynamic-guided heart-failure management using a wireless implantable sensor: Infrastructure, methods, and results in a community heart failure disease-management program.

    Science.gov (United States)

    Jermyn, Rita; Alam, Amit; Kvasic, Jessica; Saeed, Omar; Jorde, Ulrich

    2017-03-01

    The real-world impact of remote pulmonary artery pressure (PAP) monitoring on New York Heart Association (NYHA) class improvement and heart failure (HF) hospitalization rate is presented here from a single center. METHODS: Seventy-seven previously hospitalized outpatients with NYHA class III HF were offered PAP monitoring via device implantation in a multidisciplinary HF-management program. Prospective effectiveness analyses compared outcomes in 34 hemodynamically monitored patients to a group of similar patients (n = 32) who did not undergo device implantation but received usual care. NYHA class and 6-minute walk testing were assessed at baseline and 90 days. All hospitalizations were collected after 6 months of the implantation date (average follow-up, 15 months) and compared with the number of hospitalizations experienced prior to hemodynamic monitoring. Patients in both groups had similar distributions of age, sex, and ejection fraction. After 90 days, 61.8% of the monitored patients had NYHA class improvement of ≥1, compared with 12.5% in the controls (P management leads to significant improvements in NYHA class and HF hospitalization rate in a real-world setting compared with usual care delivered in a comprehensive disease-management program. © 2016 Wiley Periodicals, Inc.

  8. Human placenta-derived adherent cells improve cardiac performance in mice with chronic heart failure.

    Science.gov (United States)

    Chen, Hong-Jung; Chen, Chien-Hsi; Chang, Ming-Yao; Tsai, Da-Ching; Baum, Ellen Z; Hariri, Robert; Herzberg, Uri; Hsieh, Patrick C H

    2015-03-01

    Human placenta-derived adherent cells (PDACs) are a culture-expanded, undifferentiated mesenchymal-like population derived from full-term placental tissue, with immunomodulatory, anti-inflammatory, angiogenic, and neuroprotective properties. PDA-001 (cenplacel-L), an intravenous formulation of PDAC cells, is in clinical development for the treatment of autoimmune and inflammatory diseases. We tested the therapeutic effects of PDA-001 in mice with chronic heart failure (CHF). Three weeks after transaortic constriction surgery to induce CHF, the mice underwent direct intramyocardial (IM) or i.v. injection of PDA-001 at a high (0.5 × 10(6) cells per mouse), medium (0.5 × 10(5) cells per mouse), or low (0.5 × 10(4) cells per mouse) dose. The mice were sacrificed 4 weeks after treatment. Echocardiography and ventricular catheterization showed that IM injection of PDA-001 significantly improved left ventricular systolic and diastolic function compared with injection of vehicle or i.v. injection of PDA-001. IM injection of PDA-001 also decreased cardiac fibrosis, shown by trichrome staining in the vicinity of the injection sites. Low-dose treatment showed the best improvement in cardiac performance compared with the medium- and high-dose groups. In another independent study to determine the mechanism of action with bromodeoxyuridine labeling, the proliferation rates of endothelial cells and cardiomyocytes were significantly increased by low or medium IM dose PDA-001. However, no surviving PDA-001 cells were detected in the heart 1 month after injection. In vivo real-time imaging consistently revealed that the PDA-001 cells were detectable only within 2 days after IM injection of luciferase-expressing PDA-001. Together, these results have demonstrated the cardiac therapeutic potential of PDA-001, likely through a paracrine effect. ©AlphaMed Press.

  9. Novel insights on effect of atrioventricular programming of biventricular pacemaker in heart failure – a case series

    Directory of Open Access Journals (Sweden)

    Rafique Asim M

    2006-10-01

    Full Text Available Abstract Background Echocardiography plays an integral role in the diagnosis of congestive heart failure including measurement of left heart pressure as well as mechanical dyssynchrony. Methods In this report we describe novel therapeutic uses of echo pulsed wave Doppler in atrioventricular pacemaker optimization in patients who had either not derived significant symptomatic benefit post biventricular pacemaker implantation or deteriorated after deriving initial benefit. In these patients atrioventricular optimization showed novel findings and improved cardiac output and symptoms. Results In 3 patients with Cheyne Stokes pattern of respiration echo Doppler showed worsening of mitral regurgitation during hyperpneac phase in one patient, marked E and A fusion in another patient and exaggerated ventricular interdependence in a third patient thus highlighting mechanisms of adverse effects of Cheyne Stokes respiration in patients with heart failure. All 3 patients required a very short atrioventricular delay programming for best cardiac output. In one patient with recurrent congestive heart failure post cardiac resynchronization, mitral inflow pulse wave Doppler showed no A wave until a sensed atrioventricular delay of 190 ms was reached and showed progressive improvement in mitral inflow pattern until an atrioventricular delay of 290 ms. In 2 patients atrioventricular delay as short as 50 ms was required to allow E and A separation and prevent diastolic mitral regurgitation. All patients developed marked improvement in congestive heart failure symptoms post echo-guided biv pacemaker optimization. Conclusion These findings highlight the value of echo-guided pacemaker optimization in symptomatic patients post cardiac resynchronization treatment.

  10. Smaller Brain Volume is Associated with Poorer Instrumental ADL Performance in Heart Failure

    Science.gov (United States)

    Alosco, Michael L.; Brickman, Adam M.; Spitznagel, Mary Beth; Narkhede, Atul; Griffith, Erica Y; Cohen, Ronald; Sweet, Lawrence H.; Josephson, Richard; Hughes, Joel; Gunstad, John

    2014-01-01

    Background Heart failure patients require assistance with instrumental activities of daily living in part due to the high rates of cognitive impairment in this population. Structural brain insult (e.g., reduced gray matter volume) is theorized to underlie cognitive dysfunction in heart failure, although no study has examined the association among gray matter, cognition, and instrumental activities of daily living in heart failure. Objectives To investigate the associations among gray matter volume, cognitive function, and functional ability in heart failure. Methods 81 heart failure patients completed a cognitive test battery and the Lawton-Brody self-report questionnaire to assess instrumental activities of daily living. Participants underwent magnetic resonance imaging to quantify total gray matter and subcortical gray matter volume. Results Impairments in instrumental activities of daily living were common in this sample of HF patients. Regression analyses controlling for demographic and medical confounders showed smaller total gray matter volume predicted decreased scores on the instrumental activities of daily living composite, with specific associations noted for medication management and independence in driving. Interaction analyses showed that reduced total gray matter volume interacted with worse attention/executive function and memory to negatively impact instrumental activities of daily living. Conclusions Smaller gray matter volume is associated with greater impairment in instrumental activities of daily living in persons with heart failure, possibly via cognitive dysfunction. Prospective studies are needed to clarify the utility of clinical correlates of gray matter volume (e.g., cognitive dysfunction) in identifying heart failure patients at risk for functional decline and determine whether interventions that target improved brain and cognitive function can preserve functional independence in this high risk population. PMID:25419946

  11. High Performance Object-Oriented Scientific Programming in Fortran 90

    Science.gov (United States)

    Norton, Charles D.; Decyk, Viktor K.; Szymanski, Boleslaw K.

    1997-01-01

    We illustrate how Fortran 90 supports object-oriented concepts by example of plasma particle computations on the IBM SP. Our experience shows that Fortran 90 and object-oriented methodology give high performance while providing a bridge from Fortran 77 legacy codes to modern programming principles. All of our object-oriented Fortran 90 codes execute more quickly thatn the equeivalent C++ versions, yet the abstraction modelling capabilities used for scentific programming are comparably powereful.

  12. Integrated population-development program performance: the Malaysian Felda experience.

    Science.gov (United States)

    Fong, C O

    1985-01-01

    Program performance of the Malaysian Felda program, an integrated population development program, is examined in this report. It also evaluates the relationship of the performance of this program with its organizational, integrational, and community support factors. Starting in 1956, Felda had, by the end of 1981, developed 308 land schemes covering an area of 1.4 million acres planted predominantly with oil palm (59.4%) and rubber (31.6%). The land schemes have settled a total of 70,600 families or over 400,000 people. The integrated programs existing in the Felda schmes are the focus of analysis for this study. Out of the universe of 308 Felda schemes, 26 schemes were randomly selected for the study. In each scheme, 2 surveys were conducted: first, the staff surveys to gather information on the organizational factors and extent of integration in existence in the scheme and then household surveys to gather information on the extent of community support for the integrated program and the performance of the program. In the case of the performance variables, the information gathered from the household survey was supplemented by the records from the Felda scheme office. In the sample of 26 schemes, a total of 1641 settler households were selected for the household survey and 363 staff were selected for the staff survey. The surveys were conducted in the 1st quarter of 1982. The results indicate that the Felda mode of delivering population and community development services has been very effective. Over 55.2% of the eligible women were found to be practicing family planning (compared to about 35.5% for the national rural average), while over 78.9% of the eligible women utilized postnatal health care facilities. About 1 in 3 of the eligible children in Felda schemes attend kindergarten classes, while over 46.9% of the Felda households are involved in some form of extramural income generating activities. The more integrated the program in a particular community, the more

  13. Enhancing network performance under single link failure with AS-disjoint BGP extension

    DEFF Research Database (Denmark)

    Manolova, Anna Vasileva; Romeral, S.; Ruepp, Sarah Renée

    2009-01-01

    In this paper we propose an enhancement of the BGP protocol for obtaining AS-disjoint paths in GMPLS multi-domain networks. We evaluate the benefits of having AS-disjoint paths under single inter-domain link failure for two main applications: routing of future connection requests during routing...... protocol re-convergence and applying multi-domain restoration as survivability mechanism in case of a single link failure. The proposed BGP modification is a simple and effective solution for disjoint path selection in connection-oriented multi-domain networks. Our results show that applying the proper...... failure notification method combined with our proposal reduces the blocking of new connection requests under protocol re-convergence. Furthermore. we show that our proposal is a valuable complementary process for increasing the network resilience....

  14. Evaluation of failure or deficient performance factors of approved research projects by TUMS research council

    Directory of Open Access Journals (Sweden)

    Zarinara A.

    2002-08-01

    Full Text Available The major activity for vice chancellor for research at Tehran University of Medical Sciences (TUMS is to monitor research projects undertaken by the academic staff. Sometimes projects have been failed in meeting their objectives. The aim of this project was the evaluation of the failure of the research projects at TUMS from the establishment date to 1379. A case-control survey was designed and 70 failed projects with 71 successfully completed projects were considered and compared. Results showed that type of study, location of administration, methodology, qualification of executive and duration of project were the factors of failure of the projects. Number of executives, experienced in research projects and executive position were not the effective factors. The most important reason for failure was unsustainably of executive. So, university research council (URC should pay attention on forecast of time and budget of projects and realization of mentioned matters, besides of attention to methodology of project.

  15. Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program.

    Science.gov (United States)

    Shah, Nikhil; Reintjes, Frances; Courtney, Mark; Klarenbach, Scott W; Ye, Feng; Schick-Makaroff, Kara; Jindal, Kailash; Pauly, Robert P

    2017-07-24

    Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance. Records were reviewed for the 6 months before exit, and vital statistics were assessed up to 90 days postexit. Ninety-four patients completed training; 25 (27%) received a transplant, 11 (12%) died, and 23 (25%) were transferred to in-center hemodialysis. Compared with the positive disposition group, patients in the negative disposition group had a longer mean dialysis vintage (3.15 [SD=4.98] versus 1.06 [SD=1.16] years; P=0.003) and were performing conventional versus a more intensive hemodialysis prescription (23 of 34 versus 23 of 60; Pday mortality among patients undergoing modality conversion was 26%. Over a 6-year period, approximately one third of patients exited the program due to death or modality conversion. Patients who die or transfer to another modality have significantly higher health care resource utilization (e.g., hospitalization, respite treatments, nursing time, etc.). Copyright © 2017 by the American Society of Nephrology.

  16. HerzMobil Tirol network: rationale for and design of a collaborative heart failure disease management program in Austria.

    Science.gov (United States)

    Von der Heidt, Andreas; Ammenwerth, Elske; Bauer, Karl; Fetz, Bettina; Fluckinger, Thomas; Gassner, Andrea; Grander, Willhelm; Gritsch, Walter; Haffner, Immaculata; Henle-Talirz, Gudrun; Hoschek, Stefan; Huter, Stephan; Kastner, Peter; Krestan, Susanne; Kufner, Peter; Modre-Osprian, Robert; Noebl, Josef; Radi, Momen; Raffeiner, Clemens; Welte, Stefan; Wiseman, Andreas; Poelzl, Gerhard

    2014-11-01

    Heart failure (HF) is approaching epidemic proportions worldwide and is the leading cause of hospitalization in the elderly population. High rates of readmission contribute substantially to excessive health care costs and highlight the fragmented nature of care available to HF patients. Disease management programs (DMPs) have been implemented to improve health outcomes, patient satisfaction, and quality of life, and to reduce health care costs. Telemonitoring systems appear to be effective in the vulnerable phase after discharge from hospital to prevent early readmissions. DMPs that emphasize comprehensive patient education and guideline-adjusted therapy have shown great promise to result in beneficial long-term effects. It can be speculated that combining core elements of the aforementioned programs may substantially improve long-term cost-effectiveness of patient management.We introduce a collaborative post-discharge HF disease management program (HerzMobil Tirol network) that incorporates physician-controlled telemonitoring and nurse-led care in a multidisciplinary network approach.

  17. Toward resilient high performance applications through real time reliability metric generaion and autonomous failure correction

    Energy Technology Data Exchange (ETDEWEB)

    Debardeleben, Nathan [Los Alamos National Laboratory; Chandler, Clayton [Los Alamos National Laboratory; Leangsuksun, Chokchai [LOUISIANA TECH UNIV

    2009-01-01

    One predominant barrier encountered in furthering research and development efforts aimed at facilitating resilient HPC applications is a substantial lack of existing reliability and performance data originating from extreme-scale computing distributions. In order to develop an understanding of how and why highly scaled HPC applications are encountering increasingly frequent performance interruptions, one must conduct extensive trending and analysis on contemporary machines and their associated programs. However, existing HPC application log files are labyrinthine documents that, even with the assistance of intelligent data mining algorithms, translate poorly to human discern. In addition, conventional log filtering, processes are limited to execution within a post-mortem, reactive time period, as the enormous size of these documents prevents efficient real time interaction. Thus, there exists a strong need within the HPC field for the provision of accurate-yet-concise real time application information. Moreover, the means of reporting this data must be sufficiently lightweight and non-intrusive, as to successfully-yet-discretely attach itself to the multiple processes running on multiple cores within tens (or in some cases, hundreds) of thousands of compute nodes. Furthermore, this information should in turn be used to facilitate the autonomous correction of application-threatening faults, suspensions, and interruptions. This paper describes a dynamic application instrumentation module (utilizing a combination of Open/SpeedShop software and custom scripting) aimed at successfully achieving these goals.

  18. Financial implications of a model heart failure disease management program for providers, hospital, healthcare systems, and payer perspectives.

    Science.gov (United States)

    Whellan, David J; Reed, Shelby D; Liao, Lawrence; Gould, Stuart D; O'connor, Christopher M; Schulman, Kevin A

    2007-01-15

    Although heart failure disease management (HFDM) programs improve patient outcomes, the implementation of these programs has been limited because of financial barriers. We undertook the present study to understand the economic incentives and disincentives for adoption of disease management strategies from the perspectives of a physician (group), a hospital, an integrated health system, and a third-party payer. Using the combined results of a group of randomized controlled trials and a set of financial assumptions from a single academic medical center, a financial model was developed to compute the expected costs before and after the implementation of a HFDM program by 3 provider types (physicians, hospitals, and health systems), as well as the costs incurred from a payer perspective. The base-case model showed that implementation of HFDM results in a net financial loss to all potential providers of HFDM. Implementation of HFDM as described in our base-case analysis would create a net loss of US dollars 179,549 in the first year for a physician practice, US dollars 464,132 for an integrated health system, and US dollars 652,643 in the first year for a hospital. Third-party payers would be able to save US dollars 713,661 annually for the care of 350 patients with heart failure in a HFDM program. In conclusion, although HFDM programs may provide patients with improved clinical outcomes and decreased hospitalizations that save third-party payers money, limited financial incentives are currently in place for healthcare providers and hospitals to initiate these programs.

  19. [Successes and failures of the Polonoroeste Integrated Development Program in Brazil].

    Science.gov (United States)

    Frelastre, G

    1985-01-01

    Despite the fact that by 1980 Brazil's external debt approached US$100 billion and the effects of economic crisis were strongly felt, the government attempted to continue with previously launched integrated regional development projects including the "Polonoroeste" program. 3 phases were foreseen for the project, in Rondonia, Mato Grosso, and in new colonization zones. The goals of the Rondonia and Mato Grosso phases were to establish agriculture in the Amazon basin zone covered by the Polonoroeste, where the soils were reported to be of good or average quality although extremely heterogeneous over small areas. To avoid danger of rapid and complete deforestation, each colonist was to receive 100 hectares, 5 of which would be cleared and planted each year, allowing the forest to regenerate over 20 years. Colonists were expected to preserve 50 hectares of forest in their 100 hectare lots, but with increasing numbers of colonists the tendency has been to cut back the forest. Colonists were to receive credits and low interest loans repayable beginning 5 years after settlement over a period of 15 years. Since loans were not indexed, the amounts due would be a very small proportion of their initial worth in Brazil's inflationary economy. Boundary disputes sometimes resulting in armed conflict or murder have occurred in both Rondonia and especially in Mato Grosso between legal settlers and squatters, and between different categories of settlers. More serious has been the settlers' resentment and contesting of the large reserves set aside for the indigenous population, which has declined precipitously in recent years, probably as the result of massacres. In Mato Grosso, inequality in land holdings is demonstrated by the control over 55% of the land exercised by 1% of landholders. The demographic response to the colonization schemes was overwhelming. The populations of Rondonia and Mato Grosso respectively were estimated at 36,935 and 522,044 in 1950, 69,792 and 889,539 in

  20. Failure analysis and performance evaluation of NASA inertial reference unit (DRIRU 2) after 50 months of orbital operation

    Science.gov (United States)

    Green, K. N.; Ritter, J. W.; Skinner, D.; Vanalstine, R. L.

    1985-01-01

    The first production DRIRU 2 (NASA standard high performance inertial reference unit) system was launched as a subsystem of the Modular Attitude Control System for the Solar Maximum Mission (SMM) spacecraft in February 1980. This hardware was retrieved during the repair of the SMM during Shuttle Flight 41-C in April 1984 and returned to Teledyne Systems Company (manufacturer) for investigation and performance measurements as directed by Goddard Space Flight Center. A failure of one of the three gyro channels occurred approximately 6.5 months after launch. The built in redundancy functioned properly, the DRIRU 2 continued to provide the required attitude control function without performance degradation. Subsequent failure of other attitude control subsystems made the SMM a candidate for the first demonstration of the shuttle in-orbit repair capabilty. The in-orbit DRIRU 2 II failure scenario and the results of the analyses/tests conducted after retrieval are discussed. Comparison of this data with similar data prior to launch demonstates the excellent stability of performance parameters achieveable with DRIRU 2.

  1. Performance Evaluation of Three-Level Z-Source Inverters Under Semiconductor Failure Conditions

    DEFF Research Database (Denmark)

    Gao, Feng; Loh, P.C.; Vilathgamuwa, D.M.

    2007-01-01

    This paper proposes various compensation methods for three-level Z-source inverters under semiconductor failure conditions. Unlike the traditional fault tolerant techniques in three-level inverter by using either an additional phase-leg or collective switching states, the proposed methods simply ...

  2. Key issues in the design of pay for performance programs.

    Science.gov (United States)

    Eijkenaar, Frank

    2013-02-01

    Pay for performance (P4P) is increasingly being used to stimulate healthcare providers to improve their performance. However, evidence on P4P effectiveness remains inconclusive. Flaws in program design may have contributed to this limited success. Based on a synthesis of relevant theoretical and empirical literature, this paper discusses key issues in P4P-program design. The analysis reveals that designing a fair and effective program is a complex undertaking. The following tentative conclusions are made: (1) performance is ideally defined broadly, provided that the set of measures remains comprehensible, (2) concerns that P4P encourages "selection" and "teaching to the test" should not be dismissed, (3) sophisticated risk adjustment is important, especially in outcome and resource use measures, (4) involving providers in program design is vital, (5) on balance, group incentives are preferred over individual incentives, (6) whether to use rewards or penalties is context-dependent, (7) payouts should be frequent and low-powered, (8) absolute targets are generally preferred over relative targets, (9) multiple targets are preferred over single targets, and (10) P4P should be a permanent component of provider compensation and is ideally "decoupled" form base payments. However, the design of P4P programs should be tailored to the specific setting of implementation, and empirical research is needed to confirm the conclusions.

  3. The Work Disability Prevention CIHR Strategic Training Program: program performance after 5 years of implementation.

    Science.gov (United States)

    Loisel, Patrick; Hong, Quan Nha; Imbeau, Daniel; Lippel, Katherine; Guzman, Jaime; Maceachen, Ellen; Corbière, Marc; Santos, Brenda R; Anema, Johannes R

    2009-03-01

    The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) Strategic Training Program was developed in 2001 and is a unique program in the world. The main objective of this program is to help future researchers develop transdisciplinary knowledge, skills and attitudes regarding WDP. The purpose of this paper is to present a descriptive portrait of the program's performance over the past 5 years, as well as the trainees' and alumni's perspectives on the WDP CIHR Training Program. Data on the program's performance were collected from documents in the program records. The trainees' opinions on the WDP training program were obtained through focus groups and telephone interviews. The data collected were compiled and divided into themes to summarize the qualitative findings pertaining to each question. From 2003 to 2007, five successive summer sessions have been offered, involving 44 high-caliber applicants from nine countries, 34 mentors and collaborators, 29 guest speakers and 15 stakeholders. Overall, trainees appreciated the networking, the opportunity to interact with people from different disciplines and countries, the openness, and the international perspective and uniqueness of the program. The least appreciated aspects concerned mainly the e-learning course, evaluations and information on optional courses. The coordination and logistics were judged appropriate and several topics were suggested to improve the program quality. In general, the program implementation went well, with good participation from mentors, speakers and stakeholders; the program was appreciated by the trainees and alumni. This paper underscores the importance of the international perspective, the transdisciplinarity and the scientific networking established through the program.

  4. Measuring and Improving Student Performance in an Introductory Programming Course

    Science.gov (United States)

    Alturki, Raad A.

    2016-01-01

    Students' performances in introductory programming courses show large variation across students. There may be many reasons for these variations, such as methods of teaching, teacher competence in the subject, students' coding backgrounds and abilities, students' self-discipline, the teaching environment, and the resources available to students,…

  5. The US Acid Rain Program: design, performance, and assessment

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard

    1998-01-01

    The US Acid Rain Program (ARP) from 1990 allows 1,000 major electric utilities all over the US to trade SO2 permits. Historical emission rights have been grandfathered and the target level is 50% SO2 reduction. Market performance has been successfull with much trade activity and unexpectedly low...

  6. Counselor Competence, Performance Assessment, and Program Evaluation: Using Psychometric Instruments

    Science.gov (United States)

    Tate, Kevin A.; Bloom, Margaret L.; Tassara, Marcel H.; Caperton, William

    2014-01-01

    Psychometric instruments have been underutilized by counselor educators in performance assessment and program evaluation efforts. As such, we conducted a review of the literature that revealed 41 instruments fit for such efforts. We described and critiqued these instruments along four dimensions--"Target Domain," "Format,"…

  7. Immediate Effects of Different Trunk Exercise Programs on Jump Performance.

    Science.gov (United States)

    Imai, A; Kaneoka, K; Okubo, Y; Shiraki, H

    2016-03-01

    The aim of this study was to investigate the immediate effects of trunk stabilization exercise (SE) and conventional trunk exercise (CE) programs on jump performance. 13 adolescent male soccer players performed 2 kinds of jump testing before and immediate after 3 experimental conditions: SE, CE, and non-exercise (NE). The SE program consisted of the elbow-toe, hand-knee, and back bridge, and the CE program consisted of the sit-up, sit-up with trunk rotation and back extension. Testing of a countermovement jump (CMJ) and rebound jump (RJ) were performed to assess jump performance. Jump height of the CMJ and RJ-index, contact time, and jump height of the RJ were analyzed. The RJ index was improved significantly only after SE (p=0.017). However, contact time and jump height did not improve significantly in the SE condition. Moreover, no significant interaction or main effects of time or group were observed in the CMJ. Consequently, this study showed the different immediate effect on the RJ between the SE and CE, and suggested the possibility that the SE used in this study is useful as a warm-up program to improve the explosive movements. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure.

    Science.gov (United States)

    Wong, Frances Kam Yuet; So, Ching; Ng, Alina Yee Man; Lam, Po-Tin; Ng, Jeffrey Sheung Ching; Ng, Nancy Hiu Yim; Chau, June; Sham, Michael Mau Kwong

    2018-02-01

    Studies have shown positive clinical outcomes of specialist palliative care for end-stage heart failure patients, but cost-effectiveness evaluation is lacking. To examine the cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure patients as compared to the customary palliative care service. A cost-effectiveness analysis was conducted alongside a randomized controlled trial (Trial number: NCT02086305). The costs included pre-program training, intervention, and hospital use. Quality of life was measured using SF-6D. The study took place in three hospitals in Hong Kong. The inclusion criteria were meeting clinical indicators for end-stage heart failure patients including clinician-judged last year of life, discharged to home within the service area, and palliative care referral accepted. A total of 84 subjects (study = 43, control = 41) were recruited. When the study group was compared to the control group, the net incremental quality-adjusted life years gain was 0.0012 (28 days)/0.0077 (84 days) and the net incremental costs per case was -HK$7935 (28 days)/-HK$26,084 (84 days). The probability of being cost-effective was 85% (28 days)/100% (84 days) based on the cost-effectiveness thresholds recommended both by National Institute for Health and Clinical Excellence (£20,000/quality-adjusted life years) and World Health Organization (Hong Kong gross domestic product/capita in 2015, HK$328117). Results suggest that a transitional home-based palliative care program is more cost-effective than customary palliative care service. Limitations of the study include small sample size, study confined to one city, clinic consultation costs, and societal costs including patient costs and unpaid care-giving costs were not included.

  9. 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.

  10. Design and Usage of the HeartCycle Education and Coaching Program for Patients With Heart Failure.

    Science.gov (United States)

    Stut, Wim; Deighan, Carolyn; Armitage, Wendy; Clark, Michelle; Cleland, John G; Jaarsma, Tiny

    2014-12-11

    Heart failure (HF) is common, and it is associated with high rates of hospital readmission and mortality. It is generally assumed that appropriate self-care can improve outcomes in patients with HF, but patient adherence to many self-care behaviors is poor. The objective of our study was to develop and test an intervention to increase self-care in patients with HF using a novel, online, automated education and coaching program. The online automated program was developed using a well-established, face-to-face, home-based cardiac rehabilitation approach. Education is tailored to the behaviors and knowledge of the individual patient, and the system supports patients in adopting self-care behaviors. Patients are guided through a goal-setting process that they conduct at their own pace through the support of the system, and they record their progress in an electronic diary such that the system can provide appropriate feedback. Only in challenging situations do HF nurses intervene to offer help. The program was evaluated in the HeartCycle study, a multicenter, observational trial with randomized components in which researchers investigated the ability of a third-generation telehealth system to enhance the management of patients with HF who had a recent (Heart Association (NYHA) functional class III/IV symptoms despite treatment with diuretic agents. The patients were enrolled from January 2012 through February 2013 at 3 hospital sites within the United Kingdom, Germany, and Spain. Of 123 patients enrolled (mean age 66 years (SD 12), 66% NYHA III, 79% men), 50 patients (41%) reported that they were not physically active, 56 patients (46%) did not follow a low-salt diet, 6 patients (5%) did not restrict their fluid intake, and 6 patients (5%) did not take their medication as prescribed. About 80% of the patients who started the coaching program for physical activity and low-salt diet became adherent by achieving their personal goals for 2 consecutive weeks. After becoming

  11. Fully coupled multiscale modeling of cohesive failure in heterogeneous interfaces using high performance computing

    OpenAIRE

    Mosby, Matthew; Matous, Karel

    2014-01-01

    Multiscale interfaces are prevalent throughout engineering design and application, often in the form of layered composites and adhesive joints. Most modern adhesives are highly heterogeneous, containing a wide range of sizes, shapes, and material properties of reinforcing constituents. Predicting how the size, shape, orientation, and distribution of the reinforcing particles change the failure response of the bonded structure is important for design and safety assessment. Using Direct Numeric...

  12. Using Failure Mode and Effect Analysis (FMEA for Performing Good Ploughing with Mouldboard

    Directory of Open Access Journals (Sweden)

    M Namdari

    2011-03-01

    Full Text Available Farm management needs creative methods to success. FMEA (Failure Modes and Effects Analysis is a new method to analyze potential reliability problems in the development cycle of the project, making it easier to take actions to overcome such issues, thus enhancing the reliability through design or process. Anticipating these failure modes, being the central step in the analysis, needs to be carried on extensively, in order to prepare a list of maximum potential failure modes. Risk is measured in terms of Risk Priority Number (RPN that is a product of occurrence, severity, and detection difficulty. This study attempted to improve clod mean weight diameter and soil inversion as indicators of tillage quality by FMEA methodology. The results showed that low soil moisture, slow speed of ploughing and great depth of ploughing is the most important factors that increase clod MWD with 900, 630 and 560 RPN, respectively. Also for soil inversion the slow speed of ploughing, not using coulter, low soil moisture and great depth of ploughing are important factors with 720, 648, 490 and 420 RPN. Using a split - split factorial experiment with 16 treatments and three replications also acknowledged the results of this method. After reforming the conditions and re-testing the experiment, results showed that clod MWD was reduced 20% and soil inversion increased 2% approximately. This study proposes the use of this technique in agricultural management.

  13. "Health system approach" for improving immunization program performance

    Directory of Open Access Journals (Sweden)

    Chandrakant Lahariya

    2015-01-01

    Full Text Available Immunization programs are one of the most well-recognized and successful public health programs across the world. The immunization programs have achieved significant successes in a number of countries; however, the coverage with available vaccines remains sub-optimal in many low- and middle-income countries (LMICs. This article, based upon extensive review of literature and using universal immunization program (UIP in India as a case study, summarizes the latest developments and initiatives in the area of vaccination and immunization in the last few years. The article analyzes initiatives under UIP in India from the "health system approach" and argues that it is possible to increase coverage with available vaccines and overall program performance by focused attention on various functions of health systems. It also discusses the emerging evidence that health systems could be strengthened prior to the introduction of new interventions (vaccines included and the introduction of new interventions (including vaccines could be planned in a way to strengthen the health systems. It concludes that immunization programs could be one of the entry points for strengthening health systems in the countries and lessons from vaccine introduction could pave pathway for scaling up other health interventions and therefore, could contribute to advancing Universal Health Coverage (UHC.

  14. Multi-Language Programming Environments for High Performance Java Computing

    Directory of Open Access Journals (Sweden)

    Vladimir Getov

    1999-01-01

    Full Text Available Recent developments in processor capabilities, software tools, programming languages and programming paradigms have brought about new approaches to high performance computing. A steadfast component of this dynamic evolution has been the scientific community’s reliance on established scientific packages. As a consequence, programmers of high‐performance applications are reluctant to embrace evolving languages such as Java. This paper describes the Java‐to‐C Interface (JCI tool which provides application programmers wishing to use Java with immediate accessibility to existing scientific packages. The JCI tool also facilitates rapid development and reuse of existing code. These benefits are provided at minimal cost to the programmer. While beneficial to the programmer, the additional advantages of mixed‐language programming in terms of application performance and portability are addressed in detail within the context of this paper. In addition, we discuss how the JCI tool is complementing other ongoing projects such as IBM’s High‐Performance Compiler for Java (HPCJ and IceT’s metacomputing environment.

  15. Development of an Automated Remedy Performance Evaluation Program - 13622

    Energy Technology Data Exchange (ETDEWEB)

    Tonkin, Matthew J.; Kennel, Jonathan [S.S. Papadopulos and Assoc., Inc., 7944 Wisconsin Avenue, Bethesda, MD (United States); Biebesheimer, Frederick; Dooley, David [CH2M Hill Plateau Remediation Company, Richland, WA (United States)

    2013-07-01

    Performance monitoring is a vital element of groundwater remediation. Unfortunately, the enormous efforts and costs that are expended procuring, managing, processing and storing monitoring data are often not subject to correspondingly rigorous evaluation. This is despite the fact that many steps in the process are predictable and are repeated many times over the remedy life cycle. At the Department of Energy (DOE) Hanford Site, a program is underway to automate many of these steps - processing, formatting any analyzing large volumes of heterogeneous data associated with the operation of several groundwater pump-and-treat (P and T) and in-situ remedies. The Automated Remedy Performance Evaluation Program (ARPEP) was developed from a work-flow process designed to deliver (a) monthly data summaries and preliminary analysis, (b) quarterly performance assessments, and (c) annual roll-up analyses that detect changes in long-term monitoring datasets and support remedy optimization. The intent of the ARPEP is to provide detailed, systematic and traceable data summaries, depictions and analyses that can be used by project scientists to complete their evaluation of remedy performance. The ARPEP work-flow was formalized following extensive review of applicable guidance, regulation and industry standards. The ARPEP incorporates disparate data types collected over different frequencies, such as water levels and pumping rates recorded every minute, and groundwater sample results obtained on quarterly, annual or irregular intervals. The data are processed, reduced to frequencies suitable for assessment, and combined in various ways leading to performance indicators such as (a) pumped well capacities and system downtime that reflect operational performance; (b) hydraulic gradients and areas of hydraulic containment that reflect hydraulic performance; and (c) time-series (longitudinal) and geo-statistical (spatial) trend analyses that reflect progress toward attainment of Remedial

  16. How to Use Linear Programming for Information System Performances Optimization

    Directory of Open Access Journals (Sweden)

    Hell Marko

    2014-09-01

    Full Text Available Background: Organisations nowadays operate in a very dynamic environment, and therefore, their ability of continuously adjusting the strategic plan to the new conditions is a must for achieving their strategic objectives. BSC is a well-known methodology for measuring performances enabling organizations to learn how well they are doing. In this paper, “BSC for IS” will be proposed in order to measure the IS impact on the achievement of organizations’ business goals. Objectives: The objective of this paper is to present the original procedure which is used to enhance the BSC methodology in planning the optimal targets of IS performances value in order to maximize the organization's effectiveness. Methods/Approach: The method used in this paper is the quantitative methodology - linear programming. In the case study, linear programming is used for optimizing organization’s strategic performance. Results: Results are shown on the example of a case study national park. An optimal performance value for the strategic objective has been calculated, as well as an optimal performance value for each DO (derived objective. Results are calculated in Excel, using Solver Add-in. Conclusions: The presentation of methodology through the case study of a national park shows that this methodology, though it requires a high level of formalisation, provides a very transparent performance calculation.

  17. Reliability of one-repetition maximum performance in people with chronic heart failure.

    Science.gov (United States)

    Ellis, Rachel; Holland, Anne E; Dodd, Karen; Shields, Nora

    2018-02-24

    Evaluate intra-rater and inter-rater reliability of the one-repetition maximum strength test in people with chronic heart failure. Intra-rater and inter-rater reliability study. A public tertiary hospital in northern metropolitan Melbourne. Twenty-four participants (nine female, mean age 71.8 ± 13.1 years) with mild to moderate heart failure of any aetiology. Lower limb strength was assessed by determining the maximum weight that could be lifted using a leg press. Intra-rater reliability was tested by one assessor on two separate occasions . Inter-rater reliability was tested by two assessors in random order. Intra-class correlation coefficients and 95% confidence intervals were calculated. Bland and Altman analyses were also conducted, including calculation of mean differences between measures ([Formula: see text]) and limits of agreement . Ten intra-rater and 21 inter-rater assessments were completed. Excellent intra-rater (intra-class correlation coefficient 2,1 0.96) and inter-rater (intra-class correlation coefficient 2,1 0.93) reliability was found. Intra-rater assessment showed less variability (mean difference 4.5 kg, limits of agreement -8.11 to 17.11 kg) than inter-rater agreement (mean difference -3.81 kg, limits of agreement -23.39 to 15.77 kg). One-repetition maximum determined using a leg press is a reliable measure in people with heart failure. Given its smaller limits of agreement, intra-rater testing is recommended. Implications for Rehabilitation Using a leg press to determine a one-repetition maximum we were able to demonstrate excellent inter-rater and intra-rater reliability using an intra-class correlation coefficient. The Bland and Altman levels of agreement were wide for inter-rater reliability and so we recommend using one assessor if measuring change in strength within an individual over time.

  18. Test Program for the Performance Analysis of DNS64 Servers

    Directory of Open Access Journals (Sweden)

    Gábor Lencse

    2015-09-01

    Full Text Available In our earlier research papers, bash shell scripts using the host Linux command were applied for testing the performance and stability of different DNS64 server imple­mentations. Because of their inefficiency, a small multi-threaded C/C++ program (named dns64perf was written which can directly send DNS AAAA record queries. After the introduction to the essential theoretical background about the structure of DNS messages and TCP/IP socket interface programming, the design decisions and implementation details of our DNS64 performance test program are disclosed. The efficiency of dns64perf is compared to that of the old method using bash shell scripts. The result is convincing: dns64perf can send at least 95 times more DNS AAAA record queries per second. The source code of dns64perf is published under the GNU GPLv3 license to support the work of other researchers in the field of testing the performance of DNS64 servers.

  19. Assessing the Effects of the "Rocket Math" Program with a Primary Elementary School Student at Risk for School Failure: A Case Study

    Science.gov (United States)

    Smith, Christina R.; Marchand-Martella, Nancy E.; Martella, Ronald C.

    2011-01-01

    This study assessed the effects of the "Rocket Math" program on the math fluency skills of a first grade student at risk for school failure. The student received instruction in the "Rocket Math" program over 6 months. He was assessed using a pre- and posttest curriculum-based measurement (CBM) and individualized fluency checkouts within the…

  20. Applying Fuzzy Multiple Criteria Decision-Making Method and Service Failure Index to Evaluate Restaurants¡¯ Performance

    OpenAIRE

    Hsi-Tien Chen

    2014-01-01

    When a severe service failure occurs, loss to the firm is generally inevitable, but little research has been conducted on how to control the frequency of severe service failure. The purpose of this study is to propose a service failure control process and model by assessing whether the failure frequency in various service failure categories meets minimum tolerance levels. An initial restaurant-related service failure classification model was constructed based on literature review and expert s...

  1. Microcomputer programs for particulate control: section failure; baghouse; plume opacity prediction; and in-stack opacity calculator. Software

    Energy Technology Data Exchange (ETDEWEB)

    Sparks, L.E.

    1985-09-01

    IBM-PC usable versions of several computer models useful in particulate control are provided. The models were originally written for the TRS-80 Model I-III series of microcomputers and have been translated to run on the IBM-PC. The documentation for the TRS-80 versions applies to the IBM-PC versions. The programs are written in FORTRAN and are provided in both source (FORTRAN) and executable form. Some small machine language routines are used to format the screen for data entry. These routines limit the programs to IBM-PC and close clones. The minimum hardware requirements are 256K IBM-PC or close clone, a monochrome monitor, and a disk drive. A printer is useful but not required. The following computer programs are provided in the four-disk package: (1) ESP section failure model, (2) GCA/EPA baghouse model, (3) Plume opacity prediction model, and (4) In-stack opacity calculator. All the models are documented in EPA report Microcomputer Programs for Particulate Control, EPA-600/8-85-025a (PB86-146529). The models provide useful tools for those involved in particulate control.

  2. Expression of the irisin precursor FNDC5 in skeletal muscle correlates with aerobic exercise performance in patients with heart failure.

    Science.gov (United States)

    Lecker, Stewart H; Zavin, Alexandra; Cao, Peirang; Arena, Ross; Allsup, Kelly; Daniels, Karla M; Joseph, Jacob; Schulze, P Christian; Forman, Daniel E

    2012-11-01

    Exercise-induced increase in peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α) expression has been shown to increase the expression of the fibronectin type III domain containing 5 (FNDC5) gene and thereby its product, irisin, in mice. Given that exercise intolerance is a hallmark characteristic of heart failure (HF), and because PGC-1α and irisin promote exercise benefits in animals, we hypothesized that expression of these genes relates to aerobic performance in patients with HF. Systolic HF (left ventricular ejection fraction ≤40%) patients underwent cardiopulmonary exercise testing to evaluate aerobic performance. High versus low aerobic performance was assessed using oxygen consumption (peak Vo(2) [>14 versus ≤14 mL O(2)·kg(-1)·min(-1)]) and ventilatory efficiency (VE/Vco(2) slope [aerobic performance in HF patients.

  3. ECG-triggered skeletal muscle stimulation improves hemodynamics and physical performance of heart failure patients.

    Science.gov (United States)

    Lapanashvili, L; Buziashvili, Y I; Matskeplishvili, S T; Lobjanidze, T G; Bockeria, L A; Huber, P P; Hess, O M; Walpoth, B H

    2008-03-01

    Muscular counterpulsation (MCP) was developed for circulatory assistance by stimulation of peripheral skeletal muscles. We report on a clinical MCP study in patients with and without chronic heart failure (CHF). MCP treatment was applied (30 patients treated, 25 controls, all under optimal therapy) for 30 minutes during eight days by an ECG-triggered, battery-powered, portable pulse generator with skin electrodes inducing light contractions of calf and thigh muscles, sequentially stimulated at early diastole. Hemodynamic parameters (ECG, blood pressure and echocardiography) were measured one day before and one day after the treatment period in two groups: Group 1 (9 MCP, 11 no MCP) with ejection fraction (EF) above 40% and Group 2 (21 MCP, 14 no MCP) below 40%. In Group 2 (all patients suffering from CHF) mean EF increased by 21% (pCHF.

  4. Direct Observations of Children at Risk for Academic Failure: Benefits of an Intergenerational Visiting Program

    Science.gov (United States)

    Marcia, S. Marx; Alicia, R. Pannell; Parpura-Gill, Aleksandra; Cohen-Mansfield, Jiska

    2004-01-01

    Ten elementary school students in need of a positive self-image and/or a sense of appropriate social conduct took part in a monthly intergenerational visiting program at an assisted living facility. In comparison to systematic observations obtained in their classrooms, the children were observed to be significantly less anxious, more interested,…

  5. Method and system for detecting a failure or performance degradation in a dynamic system such as a flight vehicle

    Science.gov (United States)

    Miller, Robert H. (Inventor); Ribbens, William B. (Inventor)

    2003-01-01

    A method and system for detecting a failure or performance degradation in a dynamic system having sensors for measuring state variables and providing corresponding output signals in response to one or more system input signals are provided. The method includes calculating estimated gains of a filter and selecting an appropriate linear model for processing the output signals based on the input signals. The step of calculating utilizes one or more models of the dynamic system to obtain estimated signals. The method further includes calculating output error residuals based on the output signals and the estimated signals. The method also includes detecting one or more hypothesized failures or performance degradations of a component or subsystem of the dynamic system based on the error residuals. The step of calculating the estimated values is performed optimally with respect to one or more of: noise, uncertainty of parameters of the models and un-modeled dynamics of the dynamic system which may be a flight vehicle or financial market or modeled financial system.

  6. The Health Benefits of a 12-Week Home-Based Interval Training Cardiac Rehabilitation Program in Patients With Heart Failure.

    Science.gov (United States)

    Safiyari-Hafizi, Hedieh; Taunton, Jack; Ignaszewski, Andrew; Warburton, Darren E R

    2016-04-01

    Recently, high-intensity interval training has been advocated for the rehabilitation of persons living with heart failure (HF). Home-based training is more convenient for many patients and could augment compliance. However, the safety and efficacy of home-based interval training remains unclear. We evaluated the safety and efficacy of a supervised home-based exercise program involving a combination of interval and resistance training. Measures of aerobic power, endurance capacity, ventilatory threshold, and quality of life in 40 patients with HF, were taken at baseline and after 12 weeks. Patients were matched and randomized to either control (CTL; n = 20) or experimental (EXP; n = 20) conditions. The EXP group underwent a 12-week high-intensity interval and resistance training program while the CTL group maintained their usual activities of daily living. In the EXP group, we found a significant improvement in aerobic power, endurance capacity, ventilatory threshold, and quality of life. There were no significant changes in the CTL group. We have shown that a home-based cardiac rehabilitation program involving interval and resistance training is associated with improved aerobic capacity and quality of life in patients with HF. This research has important implications for the treatment of HF. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  7. Programas de continuidad de cuidados: éxitos, fracasos y retos futuros Case management programs: successes, failures and future challenges

    Directory of Open Access Journals (Sweden)

    Ana González Rodríguez

    2011-12-01

    Full Text Available Los programas de continuidad de cuidados surgen a finales de los años 70 en EEUU, en respuesta a los problemas detectados durante del proceso de desintitucionalización de los hospitales psiquiátricos. Desde entonces, se han extendido por todo el mundo, con variaciones y peculiaridades según las regiones, convirtiéndose en piedra angular de la atención a las personas con enfermedad mental grave y persistente. En este artículo se revisa el origen de estos programas, su desarrollo a lo largo de más de treinta años, la filosofía que los ha guiado en su devenir, así como los éxitos y fracasos en su desarrollo.The case management programs arise in the late 70's in the U.S., in response to problems identified during the process of deinstitutionalization of psychiatric hospitals. Since then, the case management and the assertive community treatment programs have spread throughout the world, with variations and particularities in different regions, becoming the cornerstone of the community care for people with severe and persistent mental illness. This article reviews the origins of these programs in U.S., their development for over thirty years around the world, the philosophy and objectives that have guided its evolution, as well as successes and failures in their development.

  8. Performance Demonstration Program Plan for Analysis of Simulated Headspace Gases

    Energy Technology Data Exchange (ETDEWEB)

    Carlsbad Field Office

    2006-04-01

    The Performance Demonstration Program (PDP) for headspace gases distributes sample gases of volatile organic compounds (VOCs) for analysis. Participating measurement facilities (i.e., fixed laboratories, mobile analysis systems, and on-line analytical systems) are located across the United States. Each sample distribution is termed a PDP cycle. These evaluation cycles provide an objective measure of the reliability of measurements performed for transuranic (TRU) waste characterization. The primary documents governing the conduct of the PDP are the Quality Assurance Program Document (QAPD) (DOE/CBFO-94-1012) and the Waste Isolation Pilot Plant (WIPP) Waste Analysis Plan (WAP) contained in the Hazardous Waste Facility Permit (NM4890139088-TSDF) issued by the New Mexico Environment Department (NMED). The WAP requires participation in the PDP; the PDP must comply with the QAPD and the WAP. This plan implements the general requirements of the QAPD and the applicable requirements of the WAP for the Headspace Gas (HSG) PDP. Participating measurement facilities analyze blind audit samples of simulated TRU waste package headspace gases according to the criteria set by this PDP Plan. Blind audit samples (hereafter referred to as PDP samples) are used as an independent means to assess each measurement facility’s compliance with the WAP quality assurance objectives (QAOs). To the extent possible, the concentrations of VOC analytes in the PDP samples encompass the range of concentrations anticipated in actual TRU waste package headspace gas samples. Analyses of headspace gases are required by the WIPP to demonstrate compliance with regulatory requirements. These analyses must be performed by measurement facilities that have demonstrated acceptable performance in this PDP. These analyses are referred to as WIPP analyses and the TRU waste package headspace gas samples on which they are performed are referred to as WIPP samples in this document. Participating measurement

  9. Performance Demonstration Program Plan for Analysis of Simulated Headspace Gases

    Energy Technology Data Exchange (ETDEWEB)

    Carlsbad Field Office

    2007-11-13

    The Performance Demonstration Program (PDP) for headspace gases distributes blind audit samples in a gas matrix for analysis of volatile organic compounds (VOCs). Participating measurement facilities (i.e., fixed laboratories, mobile analysis systems, and on-line analytical systems) are located across the United States. Each sample distribution is termed a PDP cycle. These evaluation cycles provide an objective measure of the reliability of measurements performed for transuranic (TRU) waste characterization. The primary documents governing the conduct of the PDP are the Quality Assurance Program Document (QAPD) (DOE/CBFO-94-1012) and the Waste Isolation Pilot Plant (WIPP) Waste Analysis Plan (WAP) contained in the Hazardous Waste Facility Permit (NM4890139088-TSDF) issued by the New Mexico Environment Department (NMED). The WAP requires participation in the PDP; the PDP must comply with the QAPD and the WAP. This plan implements the general requirements of the QAPD and the applicable requirements of the WAP for the Headspace Gas (HSG) PDP. Participating measurement facilities analyze blind audit samples of simulated TRU waste package headspace gases according to the criteria set by this PDP Plan. Blind audit samples (hereafter referred to as PDP samples) are used as an independent means to assess each measurement facility’s compliance with the WAP quality assurance objectives (QAOs). To the extent possible, the concentrations of VOC analytes in the PDP samples encompass the range of concentrations anticipated in actual TRU waste package headspace gas samples. Analyses of headspace gases are required by the WIPP to demonstrate compliance with regulatory requirements. These analyses must be performed by measurement facilities that have demonstrated acceptable performance in this PDP. These analyses are referred to as WIPP analyses and the TRU waste package headspace gas samples on which they are performed are referred to as WIPP samples in this document

  10. Performance Demonstration Program Plan for Analysis of Simulated Headspace Gases

    Energy Technology Data Exchange (ETDEWEB)

    Carlsbad Field Office

    2007-11-19

    The Performance Demonstration Program (PDP) for headspace gases distributes blind audit samples in a gas matrix for analysis of volatile organic compounds (VOCs). Participating measurement facilities (i.e., fixed laboratories, mobile analysis systems, and on-line analytical systems) are located across the United States. Each sample distribution is termed a PDP cycle. These evaluation cycles provide an objective measure of the reliability of measurements performed for transuranic (TRU) waste characterization. The primary documents governing the conduct of the PDP are the Quality Assurance Program Document (QAPD) (DOE/CBFO-94-1012) and the Waste Isolation Pilot Plant (WIPP) Waste Analysis Plan (WAP) contained in the Hazardous Waste Facility Permit (NM4890139088-TSDF) issued by the New Mexico Environment Department (NMED). The WAP requires participation in the PDP; the PDP must comply with the QAPD and the WAP. This plan implements the general requirements of the QAPD and the applicable requirements of the WAP for the Headspace Gas (HSG) PDP. Participating measurement facilities analyze blind audit samples of simulated TRU waste package headspace gases according to the criteria set by this PDP Plan. Blind audit samples (hereafter referred to as PDP samples) are used as an independent means to assess each measurement facility’s compliance with the WAP quality assurance objectives (QAOs). To the extent possible, the concentrations of VOC analytes in the PDP samples encompass the range of concentrations anticipated in actual TRU waste package headspace gas samples. Analyses of headspace gases are required by the WIPP to demonstrate compliance with regulatory requirements. These analyses must be performed by measurement facilities that have demonstrated acceptable performance in this PDP. These analyses are referred to as WIPP analyses and the TRU waste package headspace gas samples on which they are performed are referred to as WIPP samples in this document

  11. Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

    OpenAIRE

    Vanessa Blanco; Paul Rohde; Fernando L. Vázquez; Patricia Otero

    2014-01-01

    The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were ...

  12. A randomized controlled trial to assess effectiveness of a nurse-led home-based heart failure management program

    Directory of Open Access Journals (Sweden)

    Mamata Rai

    2017-01-01

    Full Text Available Introduction: The burden of cardiovascular disease is increasing in India. It is a chronic condition, and poor management can increase the risk and frequency of acute episodes resulting in poor quality of life (QOL, frequent hospital admissions, and mortality. Disease management programs can improve medication adherence and patient's QOL. Objective: The aim of this study is to assess the effectiveness of nurse-led home-based heart failure management program (HOME-N. Materials and Methods: This randomized controlled trial was conducted among fifty outpatient heart failure (HF patients visiting a tertiary care hospital. The control group received usual routine care, whereas the experimental group received HOME-N, which included formal health teaching, a HF checklist (Hriday card, telemonitoring of vital parameters (blood pressure, heart rate, and weight weekly through a mobile application named as “Dhadkan” and telephonic follow-up for 3 months. Kansas City Cardiomyopathy Questionnaire (KCCQ and adherence to refills and medications scale were used to assess QOL and drug adherence, respectively, in the study patients. The outcome measures were the QOL, drug compliance, hospitalization, and mortality rate. Results: At baseline, the demographic and morbidity profile, and QOL and drug compliance scores of both groups were comparable. After intervention, the QOL domain score of KCCQ as well as drug compliance improved significantly both within the experimental group (P = 0.001, P = 0.001 and as compared to control group (P = 0.001, P = 0.004, respectively. Conclusion: The HOME-N was significantly effective in improving QOL and drug compliance in HF patients.

  13. Impact of a Telehealth Program With Voice Recognition Technology in Patients With Chronic Heart Failure: Feasibility Study.

    Science.gov (United States)

    Lee, Heesun; Park, Jun-Bean; Choi, Sae Won; Yoon, Yeonyee E; Park, Hyo Eun; Lee, Sang Eun; Lee, Seung-Pyo; Kim, Hyung-Kwan; Cho, Hyun-Jai; Choi, Su-Yeon; Lee, Hae-Young; Choi, Jonghyuk; Lee, Young-Joon; Kim, Yong-Jin; Cho, Goo-Yeong; Choi, Jinwook; Sohn, Dae-Won

    2017-10-02

    Despite the advances in the diagnosis and treatment of heart failure (HF), the current hospital-oriented framework for HF management does not appear to be sufficient to maintain the stability of HF patients in the long term. The importance of self-care management is increasingly being emphasized as a promising long-term treatment strategy for patients with chronic HF. The objective of this study was to evaluate whether a new information communication technology (ICT)-based telehealth program with voice recognition technology could improve clinical or laboratory outcomes in HF patients. In this prospective single-arm pilot study, we recruited 31 consecutive patients with chronic HF who were referred to our institute. An ICT-based telehealth program with voice recognition technology was developed and used by patients with HF for 12 weeks. Patients were educated on the use of this program via mobile phone, landline, or the Internet for the purpose of improving communication and data collection. Using these systems, we collected comprehensive data elements related to the risk of HF self-care management such as weight, diet, exercise, medication adherence, overall symptom change, and home blood pressure. The study endpoints were the changes observed in urine sodium concentration (uNa), Minnesota Living with Heart Failure (MLHFQ) scores, 6-min walk test, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as surrogate markers for appropriate HF management. Among the 31 enrolled patients, 27 (87%) patients completed the study, and 10 (10/27, 37%) showed good adherence to ICT-based telehealth program with voice recognition technology, which was defined as the use of the program for 100 times or more during the study period. Nearly three-fourths of the patients had been hospitalized at least once because of HF before the enrollment (20/27, 74%); 14 patients had 1, 2 patients had 2, and 4 patients had 3 or more previous HF hospitalizations. In the total study

  14. WINDOW 4. 0: Program description. A PC program for analyzing the thermal performance of fenestration products

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    WINDOW 4.0 is a publicly available IBM PC compatible computer program developed by the Windows and Daylighting Group at Lawrence Berkeley Laboratory for calculating total window thermal performance indices (e.g. U-values, solar heat gain coefficients, shading coefficients, and visible transmittances). WINDOW 4.0 provides a versatile heat transfer analysis method consistent with the rating procedure developed by the National Fenestration Rating Council (NFRC). The program can be used to design and develop new products, to rate and compare performance characteristics of all types of window products, to assist educators in teaching heat transfer through windows, and to help public officials in developing building energy codes. WINDOW 4.0 is a major revision to WINDOW 3.1 and we strongly urge all users to read this manual before using the program. Users who need professional assistance with the WINDOW 4.0 program or other window performance simulation issues are encouraged to contact one or more of the NFRC-accredited Simulation Laboratories. A list of these accredited simulation professionals is available from the NFRC.

  15. Enhancing Functional Performance using Sensorimotor Adaptability Training Programs

    Science.gov (United States)

    Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Brady, R.; Audas, C.; Ruttley, T. M.; Cohen, H. S.

    2009-01-01

    During the acute phase of adaptation to novel gravitational environments, sensorimotor disturbances have the potential to disrupt the ability of astronauts to perform functional tasks. The goal of this project is to develop a sensorimotor adaptability (SA) training program designed to facilitate recovery of functional capabilities when astronauts transition to different gravitational environments. The project conducted a series of studies that investigated the efficacy of treadmill training combined with a variety of sensory challenges designed to increase adaptability including alterations in visual flow, body loading, and support surface stability.

  16. Success, Failure and Emotions: Examining the Relationship between Performance Feedback and Emotions in Diagnostic Reasoning

    Science.gov (United States)

    Jarrell, Amanda; Harley, Jason M.; Lajoie, Susanne; Naismith, Laura

    2017-01-01

    Students experience a variety of emotions following achievement outcomes which stand to influence how they learn and perform in academic settings. However, little is known about the link between student outcome emotions and dimensions of performance feedback in computer-based learning environments (CBLEs). Understanding the dynamics of this…

  17. A Tool for Performance Modeling of Parallel Programs

    Directory of Open Access Journals (Sweden)

    J.A. González

    2003-01-01

    Full Text Available Current performance prediction analytical models try to characterize the performance behavior of actual machines through a small set of parameters. In practice, substantial deviations are observed. These differences are due to factors as memory hierarchies or network latency. A natural approach is to associate a different proportionality constant with each basic block, and analogously, to associate different latencies and bandwidths with each "communication block". Unfortunately, to use this approach implies that the evaluation of parameters must be done for each algorithm. This is a heavy task, implying experiment design, timing, statistics, pattern recognition and multi-parameter fitting algorithms. Software support is required. We present a compiler that takes as source a C program annotated with complexity formulas and produces as output an instrumented code. The trace files obtained from the execution of the resulting code are analyzed with an interactive interpreter, giving us, among other information, the values of those parameters.

  18. Evaluation of Early Enlistment Failures under the U.S. Army Trainee Discharge Program

    Science.gov (United States)

    1975-11-01

    should rnmain in their training unit and continue normal training activities once they receive a second negativo evalu- ation at the company levol. 1...comprellondiveellss of the c m1.tinupon% which the Pro~ gram is based, Th i t’raiiiing cadro we intorviewed Coutid m~any parts of tho TILADOC Circular 6~35 -1...Scouting pro- (S8 7%) (41.3%) (00%) grams , 4-H Club, youth clubs, school programs) I participated in or. 43 20 0 gatnised team sports (68. 3%) (31.70

  19. Reduced Physical Fitness in Patients With Heart Failure as a Possible Risk Factor for Impaired Driving Performance.

    Science.gov (United States)

    Alosco, Michael L; Penn, Marc S; Spitznagel, Mary Beth; Cleveland, Mary Jo; Ott, Brian R; Gunstad, John

    2015-01-01

    Reduced physical fitness secondary to heart failure (HF) may contribute to poor driving; reduced physical fitness is a known correlate of cognitive impairment and has been associated with decreased independence in driving. No study has examined the associations among physical fitness, cognition, and driving performance in people with HF. Eighteen people with HF completed a physical fitness assessment, a cognitive test battery, and a validated driving simulator scenario. Partial correlations showed that poorer physical fitness was correlated with more collisions and stop signs missed and lower scores on a composite score of attention, executive function, and psychomotor speed. Cognitive dysfunction predicted reduced driving simulation performance. Reduced physical fitness in participants with HF was associated with worse simulated driving, possibly because of cognitive dysfunction. Larger studies using on-road testing are needed to confirm our findings and identify clinical interventions to maximize safe driving. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  20. Pecan Street Grid Demonstration Program. Final technology performance report

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2015-02-10

    This document represents the final Regional Demonstration Project Technical Performance Report (TPR) for Pecan Street Inc.’s (Pecan Street) Smart Grid Demonstration Program, DE-OE-0000219. Pecan Street is a 501(c)(3) smart grid/clean energy research and development organization headquartered at The University of Texas at Austin (UT). Pecan Street worked in collaboration with Austin Energy, UT, Environmental Defense Fund (EDF), the City of Austin, the Austin Chamber of Commerce and selected consultants, contractors, and vendors to take a more detailed look at the energy load of residential and small commercial properties while the power industry is undergoing modernization. The Pecan Street Smart Grid Demonstration Program signed-up over 1,000 participants who are sharing their home or businesses’s electricity consumption data with the project via green button protocols, smart meters, and/or a home energy monitoring system (HEMS). Pecan Street completed the installation of HEMS in 750 homes and 25 commercial properties. The program provided incentives to increase the installed base of roof-top solar photovoltaic (PV) systems, plug-in electric vehicles with Level 2 charging, and smart appliances. Over 200 participants within a one square mile area took advantage of Austin Energy and Pecan Street’s joint PV incentive program and installed roof-top PV as part of this project. Of these homes, 69 purchased or leased an electric vehicle through Pecan Street’s PV rebate program and received a Level 2 charger from Pecan Street. Pecan Street studied the impacts of these technologies along with a variety of consumer behavior interventions, including pricing models, real-time feedback on energy use, incentive programs, and messaging, as well as the corresponding impacts on Austin Energy’s distribution assets.The primary demonstration site was the Mueller community in Austin, Texas. The Mueller development, located less than three miles from the Texas State Capitol

  1. Performance Demonstration Program Plan for Nondestructive Assay of Boxed Wastes for the TRU Waste Characterization Program

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2009-10-01

    Each testing and analytical facility performing waste characterization activities for the Waste Isolation Pilot Plant (WIPP) participates in the Performance Demonstration Program (PDP) to comply with the Transuranic Waste Acceptance Criteria for the Waste Isolation Pilot Plant (WAC) (DOE/WIPP-02-3122) and the Quality Assurance Program Document (QAPD) (CBFO-94-1012). The PDP serves as a quality control check for data generated in the characterization of waste destined for WIPP. Single-blind audit samples are prepared and distributed to each of the facilities participating in the PDP. Different PDPs evaluate the analyses of simulated headspace gases (HSGs), constituents of the Resource Conservation and Recovery Act (RCRA), and transuranic (TRU) radionuclides using nondestructive assay (NDA) techniques.

  2. Performance Demonstration Program Plan for Nondestructive Assay of Drummed Wastes for the TRU Waste Characterization Program

    Energy Technology Data Exchange (ETDEWEB)

    N/A

    2009-04-01

    Each testing and analytical facility performing waste characterization activities for the Waste Isolation Pilot Plant (WIPP) participates in the Performance Demonstration Program (PDP) to comply with the Transuranic Waste Acceptance Criteria for the Waste Isolation Pilot Plant (WAC) (DOE/WIPP-02-3122) and the Quality Assurance Program Document (QAPD) (CBFO-94-1012). The PDP serves as a quality control check for data generated in the characterization of waste destined for WIPP. Single blind audit samples are prepared and distributed to each of the facilities participating in the PDP. The PDP evaluates analyses of simulated headspace gases, constituents of the Resource Conservation and Recovery Act (RCRA), and transuranic (TRU) radionuclides using nondestructive assay (NDA) techniques.

  3. Failures (with some successes) of assisted reproduction and gamete donation programs.

    Science.gov (United States)

    2013-01-01

    Although the possibilities for the treatment of infertility have been improved tremendously, not every couple will be treated successfully. Crude overall pregnancy rates of 50-65% per patient can be achieved nowadays, irrespective of the type of profertility treatment applied first. IVF only accounts for about 20% of the pregnancies achieved. Dropout is an important reason for not reaching the estimated pregnancy rate. Even after failed IVF, spontaneous pregnancies do occur. Sperm and oocyte donation (OD) offer additional chances to subfertile couples. Severity of the male factor (in sperm donation) and young donor age (in OD) are important determinants of success. Analysis of assisted reproduction technology outcomes would benefit from more universally accepted definitions and deserves better statistical analysis. Long-term cumulative live birth rates of 80% may be expected if dropout can be limited. Milder stimulation, a patient-friendlier approach and better counseling may help to keep more patients in the program.

  4. Development of Motivate4Change Using the Intervention Mapping Protocol: An Interactive Technology Physical Activity and Medication Adherence Promotion Program for Hospitalized Heart Failure Patients.

    Science.gov (United States)

    Oosterom-Calo, Rony; Te Velde, Saskia J; Stut, Wim; Brug, Johannes

    2015-07-20

    It is important that heart failure (HF) patients adhere to their medication regimen and engage in physical activity. Evidence shows that adherence to these HF self-management behaviors can be improved with appropriate interventions. To further promote medication adherence and physical activity among HF patients, we developed an intervention for hospitalized HF patients. The intervention mapping protocol was applied in the development of the intervention. This entailed performing a needs assessment, defining change objectives, selecting determinants and strategies, and developing the materials. The resulting intervention, Motivate4Change, makes use of interactive technology and provides HF patients with personalized feedback and advice. Specific change objectives were defined. The relevant behavioral determinants for the physical activity program were practical knowledge on physical activity performance and self-efficacy for, and perceived benefits of, physical activity. For medication-taking, the selected determinants were practical knowledge on medication-taking, perceived barriers to medication-taking, beliefs about the necessity and harm regarding the medication prescribed, and beliefs about overprescribing and harm of medication in general. The change objectives and behavior change determinants were translated in feedback and advice strategies in an interactive technology program that included tailored feedback and advice, and role models in videos in which the behaviors and overcoming barriers were demonstrated. Relevant stakeholders were involved in the interventions development process. The intervention was pretested among HF patients and adjustments were made accordingly. The interactive technology physical activity and medication adherence promotion program for hospitalized HF patients was systematically developed using the intervention mapping protocol and was based on the available theory and evidence regarding HF self-management behavior change. The

  5. Levosimendan improves exercise performance in patients with advanced chronic heart failure.

    Science.gov (United States)

    Mushtaq, Saima; Andreini, Daniele; Farina, Stefania; Salvioni, Elisabetta; Pontone, Gianluca; Sciomer, Susanna; Volpato, Valentina; Agostoni, Piergiuseppe

    2015-09-01

    Cardiopulmonary exercise test (CPET) provides parameters such as peak VO2 and ventilation/CO2 production (VE/VCO2) slope, which are strong prognostic predictors in patients with stable advanced chronic heart failure (ADHF). The study aim was to evaluate the effects of the inodilator levosimendan on CPET in patients with ADHF under stable clinical conditions. We enrolled patients with ADHF (peak VO2 < 12 mL/min/kg) in a double-blind, placebo-controlled protocol. Patients were randomly assigned to i.v. infusion of placebo (500 mL 5% glucose; n = 19) or levosimendan (in 500 mL 5% glucose; n = 23). Before and 24 h after the end of the infusion, patients underwent determination of New York Heart Association class, B-type natriuretic peptide (BNP), haemoglobin, serum creatinine, and blood urea nitrogen levels, as well as CPET, standard spirometry, and alveolar capillary gas diffusion. BNP showed no change with placebo (1042 ± 811 to 1043 ± 867 pg/mL), but it was decreased with levosimendan (1163 ± 897 to 509 ± 543 pg/mL, P < 0.001). No changes were observed for haemoglobin, creatinine, and blood urea nitrogen in either group. With levosimendan, a minor improvement was observed in spirometry measurements, but not in alveolar capillary gas diffusion. Peak VO2 showed a small, non-significant increase with placebo (9.5 ± 1.7 to 10.0 ± 2.1 mL/kg/min, P = 0.12), and a greater increase with levosimendan (9.8 ± 1.7 to 11.0 ± 1.9 mL/kg/min, P < 0.005). The VE/VCO2 slope showed no change (44.0 ± 11 vs. 43.4 ± 10.3, P = 0.44), and a decrease (41.9 ± 10 vs. 36.6 ± 6.4, P < 0.001) in the placebo and in the levosimendan group, respectively. Levosimendan treatment significantly improves peak VO2 and reduces VE/VCO2 slope and BNP in patients with ADHF.

  6. Structural performance of light-frame roof assemblies. I, Truss assemblies designed for high variability and wood failure

    Science.gov (United States)

    R.W. Wolfe; Monica McCarthy

    1989-01-01

    The first report of a three-part series that covers results of a full-scale roof assemblies research program. The focus of this report is the structural performance of truss assemblies comprising trusses with abnormally high stiffness variability and critical joint strength. Results discussed include properties of truss members and connections. individual truss...

  7. A FRAMEWORK FOR PERFORMANCE EVALUATION AND MONITORING OF PUBLIC HEALTH PROGRAM USING COMPOSITE PERFORMANCE INDEX

    Directory of Open Access Journals (Sweden)

    Susanta Kumar Gauri

    2017-12-01

    Full Text Available A public health program (PHP taken up by the government of a country refers to all organized measures to prevent disease and promote health among the population, by providing different planned cares/services to the people. Usually, the target population for different PHP are different. The basic requirement for success of a PHP is to ensure that all the planned cares/services are reached to each member of the target population. Therefore, the important performance measures for a PHP are the implementation status of all the planned cares/services under the PHP. However, management and monitoring of a PHP become quite difficult by interpreting separately the information contained in a large number of performance measures. Therefore, usually a metric, called composite performance index (CPI, is evaluated to understand the overall performance of a PHP. However, due a scaling operation involved in the CPI computation procedure, the CPI value does not reveal the true overall implementation status of a PHP and consequently, it is effective for management of a PHP. This paper presents a new approach for CPI computation, in which scaling/normalization of the performance variables is not required and therefore, it can be used for monitoring the true overall implementation status of a PHP in a region. A systematic approach for monitoring a PHP using the CPI values is proposed and applied for monitoring the maternal and child healthcare (MCH program. The results are found effective towards continuous improvement of implementation status.

  8. Impact of distracting activities and drivers' cognitive failures on driving performance

    NARCIS (Netherlands)

    Farah, H.; Zatmeh, S.; Toledo, T.

    2015-01-01

    The rapid increase in the availability of smart phones and other infotainment devices, and their widespread use while driving, contributes significantly to car crash rates. This is since the human brain has limited capacity and cannot perform two tasks at the same time, but rather switches from one

  9. Predictors of prevention failure in college students participating in two indicated depression prevention programs.

    Science.gov (United States)

    Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L; Otero, Patricia

    2014-04-04

    The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force.

  10. Predictors of Prevention Failure in College Students Participating in Two Indicated Depression Prevention Programs

    Science.gov (United States)

    Blanco, Vanessa; Rohde, Paul; Vázquez, Fernando L.; Otero, Patricia

    2014-01-01

    The purpose of this study was to identify subgroups of university students with the highest likelihood of remaining at elevated levels of depressive symptoms six months following the receipt of a depressive prevention intervention on the basis of known risk factors and participation in one of two depression prevention programs. Data from a randomized controlled trial evaluating depression prevention among 133 college students with elevated depressive symptoms were analyzed. Participants were randomized to a cognitive-behavioral or relaxation training group preventive intervention. Classification tree analysis showed that older age was the strongest risk factor for persistently elevated depression. Additional risk factors were: (1) for younger students, fewer daily pleasant activities; (2) for those with higher level of pleasant activities, higher level of stressful events; and (3) for those with higher level of stressful events, lower assertiveness. Results offer directions for prevention foci, identify specific subgroups of college students to target for depression prevention efforts, and suggest that research aim to help older, non-traditional students or graduating students manage the transition from college to the work force. PMID:24714056

  11. High Performance Computing - Power Application Programming Interface Specification.

    Energy Technology Data Exchange (ETDEWEB)

    Laros, James H.,; Kelly, Suzanne M.; Pedretti, Kevin; Grant, Ryan; Olivier, Stephen Lecler; Levenhagen, Michael J.; DeBonis, David

    2014-08-01

    Measuring and controlling the power and energy consumption of high performance computing systems by various components in the software stack is an active research area [13, 3, 5, 10, 4, 21, 19, 16, 7, 17, 20, 18, 11, 1, 6, 14, 12]. Implementations in lower level software layers are beginning to emerge in some production systems, which is very welcome. To be most effective, a portable interface to measurement and control features would significantly facilitate participation by all levels of the software stack. We present a proposal for a standard power Application Programming Interface (API) that endeavors to cover the entire software space, from generic hardware interfaces to the input from the computer facility manager.

  12. Performance Demonstration Program Plan for Nondestructive Assay of Drummed Wastes for the TRU Waste Characterization Program

    Energy Technology Data Exchange (ETDEWEB)

    Carlsbad Field Office

    2005-08-03

    The Performance Demonstration Program (PDP) for Nondestructive Assay (NDA) is a test program designed to yield data on measurement system capability to characterize drummed transuranic (TRU) waste generated throughout the Department of Energy (DOE) complex. The tests are conducted periodically and provide a mechanism for the independent and objective assessment of NDA system performance and capability relative to the radiological characterization objectives and criteria of the Office of Characterization and Transportation (OCT). The primary documents requiring an NDA PDP are the Waste Acceptance Criteria for the Waste Isolation Pilot Plant (WAC), which requires annual characterization facility participation in the PDP, and the Quality Assurance Program Document (QAPD). This NDA PDP implements the general requirements of the QAPD and applicable requirements of the WAC. Measurement facilities must demonstrate acceptable radiological characterization performance through measurement of test samples comprised of pre-specified PDP matrix drum/radioactive source configurations. Measurement facilities are required to analyze the NDA PDP drum samples using the same procedures approved and implemented for routine operational waste characterization activities. The test samples provide an independent means to assess NDA measurement system performance and compliance per criteria delineated in the NDA PDP Plan. General inter-comparison of NDA measurement system performance among DOE measurement facilities and commercial NDA services can also be evaluated using measurement results on similar NDA PDP test samples. A PDP test sample consists of a 55-gallon matrix drum containing a waste matrix type representative of a particular category of the DOE waste inventory and nuclear material standards of known radionuclide and isotopic composition typical of DOE radioactive material. The PDP sample components are made available to participating measurement facilities as designated by the

  13. Comparative performance of modern digital mammography systems in a large breast screening program

    Energy Technology Data Exchange (ETDEWEB)

    Yaffe, Martin J., E-mail: martin.yaffe@sri.utoronto.ca; Bloomquist, Aili K.; Hunter, David M.; Mawdsley, Gordon E. [Physical Sciences Division, Sunnybrook Research Institute, Departments of Medical Biophysics and Medical Imaging, University of Toronto, Ontario M4N 3M5 (Canada); Chiarelli, Anna M. [Prevention and Cancer Control, Cancer Care Ontario, Dalla Lana School of Public Health, University of Toronto, Ontario M4N 3M5, Canada and Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Muradali, Derek [Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Ontario M5G 1X3 (Canada); Mainprize, James G. [Physical Sciences Division, Sunnybrook Research Institute, Toronto, Ontario M4N 3M5 (Canada)

    2013-12-15

    Purpose: To compare physical measures pertaining to image quality among digital mammography systems utilized in a large breast screening program. To examine qualitatively differences in these measures and differences in clinical cancer detection rates between CR and DR among sites within that program. Methods: As part of the routine quality assurance program for screening, field measurements are made of several variables considered to correlate with the diagnostic quality of medical images including: modulation transfer function, noise equivalent quanta, d′ (an index of lesion detectability) and air kerma to allow estimation of mean glandular dose. In addition, images of the mammography accreditation phantom are evaluated. Results: It was found that overall there were marked differences between the performance measures of DR and CR mammography systems. In particular, the modulation transfer functions obtained with the DR systems were found to be higher, even for larger detector element sizes. Similarly, the noise equivalent quanta, d′, and the phantom scores were higher, while the failure rates associated with low signal-to-noise ratio and high dose were lower with DR. These results were consistent with previous findings in the authors’ program that the breast cancer detection rates at sites employing CR technology were, on average, 30.6% lower than those that used DR mammography. Conclusions: While the clinical study was not large enough to allow a statistically powered system-by-system assessment of cancer detection accuracy, the physical measures expressing spatial resolution, and signal-to-noise ratio are consistent with the published finding that sites employing CR systems had lower cancer detection rates than those using DR systems for screening mammography.

  14. Learning to drive: learners' self-reported cognitive failure level predicts driving instructor's observation rating of driving performance.

    Science.gov (United States)

    Elfering, Achim; Ruppen, Veronique; Grebner, Simone

    2013-01-01

    Evidence increases that cognitive failure may be used to screen for drivers at risk. Until now, most studies have relied on driving learners. This exploratory pilot study examines self-report of cognitive failure in driving beginners and error during real driving as observed by driving instructors. Forty-two driving learners of 14 driving instructors filled out a work-related cognitive failure questionnaire. Driving instructors observed driving errors during the next driving lesson. In multiple linear regression analysis, driving errors were regressed on cognitive failure with the number of driving lessons as an estimator of driving experience controlled. Higher cognitive failure predicted more driving errors (p < .01) when age, gender and driving experience were controlled in analysis. Cognitive failure was significantly associated with observed driving errors. Systematic research on cognitive failure in driving beginners is recommended.

  15. 76 FR 78343 - HOME Investment Partnerships Program: Improving Performance and Accountability; and Updating...

    Science.gov (United States)

    2011-12-16

    ... Investment Partnerships Program: Improving Performance and Accountability; and Updating Property Standards... Program: Improving Performance and Accountability; and Updating Property Standards AGENCY: Office of the... certain existing regulatory requirements and establish new requirements designed to enhance accountability...

  16. Tuberculosis control program in the municipal context: performance evaluation.

    Science.gov (United States)

    Arakawa, Tiemi; Magnabosco, Gabriela Tavares; Andrade, Rubia Laine de Paula; Brunello, Maria Eugenia Firmino; Monroe, Aline Aparecida; Ruffino-Netto, Antonio; Scatena, Lucia Marina; Villa, Tereza Cristina Scatena

    2017-03-30

    The objective of this study is to evaluate the performance of the Tuberculosis Control Program in municipalities of the State of São Paulo. This is a program evaluation research, with ecological design, which uses three non-hierarchical groups of the municipalities of the State of São Paulo according to their performance in relation to operational indicators. We have selected 195 municipalities with at least five new cases of tuberculosis notified in the Notification System of the State of São Paulo and with 20,000 inhabitants or more in 2010. The multiple correspondence analysis was used to identify the association between the groups of different performances, the epidemiological and demographic characteristics, and the characteristics of the health systems of the municipalities. The group with the worst performance showed the highest rates of abandonment (average [avg] = 10.4, standard deviation [sd] = 9.4) and the lowest rates of supervision of Directly Observed Treatment (avg = 6.1, sd = 12.9), and it was associated with low incidence of tuberculosis, high tuberculosis and HIV, small population, high coverage of the Family Health Strategy/Program of Community Health Agents, and being located on the countryside. The group with the best performance presented the highest cure rate (avg = 83.7, sd = 10.5) and the highest rate of cases in Directly Observed Treatment (avg = 83.0, sd = 12.7); the group of regular performance showed regular results for outcome (avg cure = 79.8, sd = 13.2; abandonment avg = 9.5, sd = 8.3) and supervision of the Directly Observed Treatment (avg = 42.8, sd = 18.8). Large population, low coverage of the Family Health Strategy/Program of Community Health Agents, high incidence of tuberculosis and AIDS, and being located on the coast and in metropolitan areas were associated with these groups. The findings highlight the importance of the Directly Observed Treatment in relation to the outcome for treatment and raise reflections on the

  17. Hospital Value-Based Purchasing (HVBP) – Heart Failure Scores

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals participating in the Hospital VBP Program and their performance rates and scores for the Clinical Process of Care Heart Failure measures.

  18. Prediction of hospital acute myocardial infarction and heart failure 30-day mortality rates using publicly reported performance measures.

    Science.gov (United States)

    Aaronson, David S; Bardach, Naomi S; Lin, Grace A; Chattopadhyay, Arpita; Goldman, L Elizabeth; Dudley, R Adams

    2013-01-01

    To identify an approach to summarizing publicly reported hospital performance data for acute myocardial infarction (AMI) or heart failure (HF) that best predicts current year hospital mortality rates. A total of 1,868 U.S. hospitals reporting process and outcome measures for AMI and HF to the Centers for Medicare and Medicaid Services (CMS) from July 2005 to June 2006 (Year 0) and July 2006 to June 2007 (Year 1). Observational cohort study measuring the percentage variation in Year 1 hospital 30-day risk-adjusted mortality rate explained by denominator-based weighted composite scores summarizing hospital Year 0 performance. Data were prospectively collected from hospitalcompare.gov. Percentage variation in Year 1 mortality was best explained by mortality rate alone in Year 0 over other composites including process performance. If only Year 0 mortality rates were reported, and consumers using hospitals in the highest decile of mortality instead chose hospitals in the lowest decile of mortality rate, the number of deaths at 30 days that potentially could have been avoided was 1.31 per 100 patients for AMI and 2.12 for HF (p < .001). Public reports focused on 30-day risk-adjusted mortality rate may more directly address policymakers' goals of facilitating consumer identification of hospitals with better outcomes. © 2011 National Association for Healthcare Quality.

  19. Influence of the Expression of Inflammatory Markers on Kidney after Fetal Programming in an Experimental Model of Renal Failure

    Directory of Open Access Journals (Sweden)

    Carlos Donizete Pereira Júnior

    2016-01-01

    Full Text Available Objective. To evaluate the expression of inflammatory markers in experimental renal failure after fetal programming. Methods. The offspring aged two and five months were divided into four groups: CC (control dams, control offspring; DC (diabetic dams, control offspring; CFA (control dams, folic acid offspring, 250 mg/Kg; and DFA (diabetic dams, folic acid offspring. Gene expression of inflammatory markers MCP-1, IL-1, NOS3, TGF-β, TNF-α, and VEGF was evaluated by RT-PCR. Results. MCP-1 was increased in the CFA and DFA groups at two and five months of age, as well as in DC5 when compared to CC5. There was a higher expression of IL-1 in the CFA2, DFA2, and DC2 groups. There was a decrease in NOS3 and an increase in TNF-α in DFA5 in relation to CFA5. The gene expression of TGF-β increased in cases that had received folic acid at two and five months, and VEGF decreased in the CFA5 and DFA5 groups. DC5 showed increased VEGF expression in comparison with CC5. Conclusions. Gestational diabetes mellitus and folic acid both change the expression of inflammatory markers, thus demonstrating that the exposure to harmful agents in adulthood has a more severe impact in cases which underwent fetal reprogramming.

  20. Deficiency in Lipoteichoic Acid Synthesis Causes a Failure in Executing the Colony Developmental Program in Bacillus subtilis

    Directory of Open Access Journals (Sweden)

    Gideon Mamou

    2017-10-01

    Full Text Available Colonies are an abundant form of bacterial multicellularity; however, relatively little is known about the initial stages of their construction. We have previously described that colony development of the soil bacterium Bacillus subtilis is a highly ordered process, typically initiating with the formation of extending cell chains arranged in a Y shape structure. Furthermore, we demonstrated that Y arm extension is a key for defining the size of the future colony. Here we conducted a genetic screen surveying for mutants deficient in these early developmental stages, and revealed LtaS, the major lipoteichoic acid (LTA synthase, to be crucial for execution of these events. We found that the ltaS mutant fails to produce proper Y shape structures, forming extremely elongated chains of cells with no evidence of chain breakage, necessary for Y shape formation. Furthermore, we show that frequent cell death at the tips of the cell chains is a major cause in limiting arm extension. Collectively, these perturbations lead to the production of a small sized colony by the mutant. Thus, deficiency in LTA synthesis causes a mechanical failure in executing the colony developmental program.

  1. School-Based Performance Award Programs, Teacher Motivation, and School Performance: Findings from a Study of Three Programs. CPRE Research Report Series.

    Science.gov (United States)

    Kelley, Carolyn; Heneman, Herbert, III; Milanowski, Anthony

    This report provides an overview of the findings of 3 studies conducted between 1995 and 1998 on school-based performance award (SBPA) programs. Such programs provide teachers, and often other school staff, with pay bonuses when their school as a whole achieves specific educational objectives. The studies focused on programs in the state of…

  2. PCOM: A Microcomputer Program that Performs a Principal Components Analysis.

    Science.gov (United States)

    Powers, Stephen

    1984-01-01

    This paper describes a microcomputer program that extracts principal components from a correlation matrix and rotates them to a varimax solution. Eigenvalues, variances associated with each component, unrotated component loadings, and varimax rotated loadings are output by the program. (Author)

  3. A CFD model for analysis of performance, water and thermal distribution, and mechanical related failure in PEM fuel cells

    Directory of Open Access Journals (Sweden)

    Maher A.R. Sadiq Al-Baghdadi

    2016-07-01

    Full Text Available This paper presents a comprehensive three–dimensional, multi–phase, non-isothermal model of a Proton Exchange Membrane (PEM fuel cell that incorporates significant physical processes and key parameters affecting the fuel cell performance. The model construction involves equations derivation, boundary conditions setting, and solution algorithm flow chart. Equations in gas flow channels, gas diffusion layers (GDLs, catalyst layers (CLs, and membrane as well as equations governing cell potential and hygro-thermal stresses are described. The algorithm flow chart starts from input of the desired cell current density, initialization, iteration of the equations solution, and finalizations by calculating the cell potential. In order to analyze performance, water and thermal distribution, and mechanical related failure in the cell, the equations are solved using a computational fluid dynamic (CFD code. Performance analysis includes a performance curve which plots the cell potential (Volt against nominal current density (A/cm2 as well as losses. Velocity vectors of gas and liquid water, liquid water saturation, and water content profile are calculated. Thermal distribution is then calculated together with hygro-thermal stresses and deformation. The CFD model was executed under boundary conditions of 20°C room temperature, 35% relative humidity, and 1 MPA pressure on the lower surface. Parameters values of membrane electrode assembly (MEA and other base conditions are selected. A cell with dimension of 1 mm x 1 mm x 50 mm is used as the object of analysis. The nominal current density of 1.4 A/cm2 is given as the input of the CFD calculation. The results show that the model represents well the performance curve obtained through experiment. Moreover, it can be concluded that the model can help in understanding complex process in the cell which is hard to be studied experimentally, and also provides computer aided tool for design and optimization of PEM

  4. A Mixed Methods Analysis of the Effect of Google Docs Environment on EFL Learners' Writing Performance and Causal Attributions for Success and Failure

    Science.gov (United States)

    Seyyedrezaie, Zari Sadat; Ghonsooly, Behzad; Shahriari, Hesamoddin; Fatemi, Hazar Hosseini

    2016-01-01

    This study investigated the effect of writing process in Google Docs environment on Iranian EFL learners' writing performance. It also examined students' perceptions towards the effects of Google Docs and their perceived causes of success or failure in writing performance. In this regard, 48 EFL students were chosen based on their IELTs writing…

  5. Designing and Evaluating Library Leadership Programs: Improving Performance and Effectiveness

    Science.gov (United States)

    Romaniuk, Mary-Jo; Haycock, Ken

    2011-01-01

    It has become accepted wisdom that there is a shortage of leaders in the library profession. A number of leader and leadership development programs have emerged in Australia, Canada and the United States that attract interested participants, yet what is the core purpose of these programs? Do they work? Review of leadership programs reveals that…

  6. TankSIM: A Cryogenic Tank Performance Prediction Program

    Science.gov (United States)

    Bolshinskiy, L. G.; Hedayat, A.; Hastings, L. J.; Moder, J. P.; Schnell, A. R.; Sutherlin, S. G.

    2015-01-01

    Accurate prediction of the thermodynamic state of the cryogenic propellants in launch vehicle tanks is necessary for mission planning and successful execution. Cryogenic propellant storage and transfer in space environments requires that tank pressure be controlled. The pressure rise rate is determined by the complex interaction of external heat leak, fluid temperature stratification, and interfacial heat and mass transfer. If the required storage duration of a space mission is longer than the period in which the tank pressure reaches its allowable maximum, an appropriate pressure control method must be applied. Therefore, predictions of the pressurization rate and performance of pressure control techniques in cryogenic tanks are required for development of cryogenic fluid long-duration storage technology and planning of future space exploration missions. This paper describes an analytical tool, Tank System Integrated Model (TankSIM), which can be used for modeling pressure control and predicting the behavior of cryogenic propellant for long-term storage for future space missions. It is written in the FORTRAN 90 language and can be compiled with any Visual FORTRAN compiler. A thermodynamic vent system (TVS) is used to achieve tank pressure control. Utilizing TankSIM, the following processes can be modeled: tank self-pressurization, boiloff, ullage venting, and mixing. Details of the TankSIM program and comparisons of its predictions with test data for liquid hydrogen and liquid methane will be presented in the final paper.

  7. Critical pathway for the management of acute heart failure at the Veterans Affairs San Diego Healthcare System: transforming performance measures into cardiac care.

    Science.gov (United States)

    Gardetto, Nancy J; Greaney, Karen; Arai, Lisa; Brenner, April; Carroll, Karen C; Howerton, Nancy M; Lee, Melinda; Pada, Laureen; Tseng, Marilynne; Maisel, Alan S

    2008-09-01

    Acute decompensated heart failure (ADHF) is a major public health problem and leading cause for hospitalization in people 65 years and older. Admission rates for ADHF, accounted for more than 1 million heart failure (HF) hospitalizations in 2004, and more than 6.5 million inpatient hospital days. Despite significant advances in HF management, including pharmacotherapy and devices; and extensive collaborative efforts of the American College of Cardiology, and American Heart Association to disseminate evidence-based practice guidelines for management of chronic HF in adults; 3 patients continue to present to the emergency departments in ADHF. The hospital treatment of HF frequently does not follow published guidelines, potentially contributing to the high morbidity, mortality, and economic cost of this disorder. This highlights an ongoing need for development of quality improvement programs that focus on delivering reliable, evidence-based care for patients with ADHF. Consequently, the development of clinical pathways has the potential to reduce the current variability in care, enhance guideline adherence, and improve outcomes for patients. The Veterans Affairs San Diego Healthcare System (VASDHCS) formed a multidisciplinary HF performance improvement team. The team set forth on the task of developing standard order sets for patients with ADHF. After analyzing local care processes, reviewing evidence of best care practices, and defining appropriate goals to satisfy the multidimensional needs of HF patient; the team developed a computerized pathway in a user-friendly format that is simple, yet comprehensive; and focuses on early stages of HF evaluation and treatment for patients presenting to the emergency department. Successful strategies to improve care for HF patients need to assist health care providers with rapid recognition and early aggressive treatment, while creating a reliable process that ensures continuity of care. This critical pathway for management of

  8. Degradation and Failure Characteristics of NPP Containment Protective Coating Systems

    Energy Technology Data Exchange (ETDEWEB)

    Sindelar, R.L.

    2000-12-01

    A research program to investigate the performance and potential for failure of Service Level I coating systems used in nuclear power plant containment is in progress. The research activities are aligned to address phenomena important to cause failure as identified by the industry coatings expert panel.

  9. Financial, performance, and organizational outcomes of a nurse extern program.

    Science.gov (United States)

    Oja, Kenneth John

    2013-01-01

    Nurse externships help prepare nursing students for practice, but the organizational costs are high. To decrease costs, nurse educators collaborated to revise their existing nurse extern program. Nursing professional development educators who want to implement a nurse extern program within an organization will benefit by learning about the planning, implementation, and evaluation of a nurse extern program designed to decrease costs while producing well-prepared new graduate nurses.

  10. Gynecologic cytology proficiency testing failures: what have we learned?: observations from the college of american pathologists gynecologic cytology proficiency testing program.

    Science.gov (United States)

    Ducatman, Barbara S; Bentz, Joel S; Fatheree, Lisa A; Souers, Rhona; Ostrowski, Saula; Moriarty, Ann T; Henry, Michael; Laucirica, Rodolfo; Booth, Christine N; Wilbur, David C

    2011-11-01

    In 2006, the first gynecologic cytology proficiency tests were offered by the College of American Pathologists. Four years of data are now available using field-validated slides, including conventional and liquid-based Papanicolaou tests. To characterize the pattern of error types that resulted in initial proficiency-test failure for cytotechnologists, primary screening pathologists, and secondary pathologists (those whose slides are prescreened by cytotechnologists). The results of 37 029 initial College of American Pathologists Papanicolaou proficiency tests were reviewed from 4 slide-set modules: conventional, ThinPrep, SurePath, or a module containing all 3 slide types. During this 4-year period, cytotechnologists were least likely to fail the initial test (3.4%; 614 of 18 264), followed by secondary pathologists (ie, those reviewing slides already screened by a cytotechnologist) with a failure rate of 4.2% (728 of 17 346), and primary pathologists (ie, those screening their own slides) having the highest level of failure (13.7%; 194 of 1419). Failure rates have fallen for all 3 groups over time. Pathologists are graded more stringently on proficiency tests, and more primary pathologists would have passed if they had been graded as cytotechnologists. There were no significant differences among performances using different types of slide sets. False-positive errors were common for both primary (63.9%; 124 of 194 errors) and secondary (55.6%; 405 of 728 errors) pathologists, whereas automatic failures were most common for cytotechnologists (75.7%; 465 of 614 errors). The failure rate is decreasing for all participants. The failures for primary pathologist screeners are due to false-positive responses. Primary screening cytotechnologists and secondary pathologists have automatic failures more often than do primary screening pathologists.

  11. Improving Math Performance through a Peer Tutoring Program.

    Science.gov (United States)

    Greenfield, Susan D.; McNeil, Mary E.

    Whole-class peer tutoring programs have been found by some to be an effective way of providing students with a one-to-one instructional setting. This document reports on a study in which a peer tutoring program on mathematics fact acquisition was assessed using a second grade classroom consisting of 21 learners who possessed below average…

  12. An automated competency-based student performance assessment program for advanced pharmacy practice experiential programs.

    Science.gov (United States)

    Ried, L Douglas; Nemire, Ruth; Doty, Randell; Brickler, Mildred P; Anderson, Holly H; Frenzel-Shepherd, Elizabeth; Larose-Pierre, Margareth; Dugan, Dee

    2007-12-15

    To describe the development and preliminary outcomes of the System of Universal Clinical Competency Evaluation in the Sunshine State (SUCCESS) for preceptors to assess students' clinical performance in advanced pharmacy practice experiences (APPEs). An Internet-based APPE assessment tool was developed by faculty members from colleges of pharmacy in Florida and implemented. Numeric scores and grades derived from the SUCCESS algorithm were similar to preceptors' comparison grades. The average SUCCESS GPA was slightly higher compared to preceptors' scores (0.02 grade points). The SUCCESS program met its goals, including establishing a common set of forms, standardized assessment criteria, an objective document that is accessible on the Internet, and standardized grading, and reducing pressure on preceptors from students concerning their grades.

  13. Rationale and design of PICNIC study: nutritional intervention program in hospitalized patients with heart failure who are malnourished.

    Science.gov (United States)

    Gámez-López, Antonio L; Bonilla-Palomas, Juan L; Anguita-Sánchez, Manuel; Moreno-Conde, Mirian; López-Ibáñez, Cristina; Alhambra-Expósito, Rosa; Castillo-Domínguez, Juan C; Villar-Ráez, Antonia; Suárez de Lezo, José

    2014-04-01

    Hospitalized patients with heart failure who are malnourished present a worse prognosis than those with an adequate nutritional status. It is unknown whether a nutritional intervention can modify the prognosis of these patients. The aim of this study is to assess the efficacy of a nutritional intervention on morbidity and mortality in hospitalized patients with heart failure who are malnourished. PICNIC is a multicentre, randomized, controlled trial in which hospitalized patients with heart failure and malnutrition, as defined by the Mini Nutritional Assessment, are randomly assigned to conventional management of heart failure or conventional management of heart failure and an individualized nutritional intervention consisting of 3 points: optimization of diet, specific recommendations, and prescription, if deemed necessary, of nutritional supplements. A sample size of 182 patients for a maximum follow-up of 12 months has been estimated. The primary endpoint is time to death from any cause or rehospitalization because of heart failure. Analysis is by intention to treat. PICNIC study will determine the prognostic impact of a nutritional intervention in hospitalized patients with heart failure who are malnourished. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  14. Federal High Performance Computing and Communications Program. The Department of Energy Component.

    Science.gov (United States)

    Department of Energy, Washington, DC. Office of Energy Research.

    This report, profusely illustrated with color photographs and other graphics, elaborates on the Department of Energy (DOE) research program in High Performance Computing and Communications (HPCC). The DOE is one of seven agency programs within the Federal Research and Development Program working on HPCC. The DOE HPCC program emphasizes research in…

  15. A MIXED METHODS ANALYSIS OF THE EFFECT OF GOOGLE DOCS ENVIRONMENT ON EFL LEARNERS’ WRITING PERFORMANCE AND CAUSAL ATTRIBUTIONS FOR SUCCESS AND FAILURE

    Directory of Open Access Journals (Sweden)

    Zari Sadat SEYYEDREZAIE

    2016-07-01

    Full Text Available This study investigated the effect of writing process in Google Docs environment on Iranian EFL learners’ writing performance. It also examined students’ perceptions towards the effects of Google Docs and their perceived causes of success or failure in writing performance. In this regard, 48 EFL students were chosen based on their IELTs writing test scores. During the treatment, the students were taught how to write a formal five-paragraph essay in the class, but they were supposed to practice writing process and give feedback to their peers’ essays through Google Docs. At the end of the treatment phase, the participants received another sample of IELTs writing test (posttest. Moreover, 20 participants were interviewed for their perceptions regarding the causes for their success and failure and the influence of Google Docs on their writing performance. The analysis of a Paired-Sample t-test revealed that Google Docs played an effective role in improving students’ writing performance. In addition, the analysis of interview revealed that the students perceived both internal and external causes for their success and failure; but in case of failure, internal factors were cited more often than external ones. Also, it was revealed that students generally showed positive attitude towards the implication of Google Docs as a factor leading to success in their writing performance.

  16. Short Term Survival after Admission for Heart Failure in Sweden: Applying Multilevel Analyses of Discriminatory Accuracy to Evaluate Institutional Performance.

    Directory of Open Access Journals (Sweden)

    Nermin Ghith

    Full Text Available Hospital performance is frequently evaluated by analyzing differences between hospital averages in some quality indicators. The results are often expressed as quality charts of hospital variance (e.g., league tables, funnel plots. However, those analyses seldom consider patients heterogeneity around averages, which is of fundamental relevance for a correct evaluation. Therefore, we apply an innovative methodology based on measures of components of variance and discriminatory accuracy to analyze 30-day mortality after hospital discharge with a diagnosis of Heart Failure (HF in Sweden.We analyzed 36,943 patients aged 45-80 treated in 565 wards at 71 hospitals during 2007-2009. We applied single and multilevel logistic regression analyses to calculate the odds ratios and the area under the receiver-operating characteristic (AUC. We evaluated general hospital and ward effects by quantifying the intra-class correlation coefficient (ICC and the increment in the AUC obtained by adding random effects in a multilevel regression analysis (MLRA. Finally, the Odds Ratios (ORs for specific ward and hospital characteristics were interpreted jointly with the proportional change in variance (PCV and the proportion of ORs in the opposite direction (POOR.Overall, the average 30-day mortality was 9%. Using only patient information on age and previous hospitalizations for different diseases we obtained an AUC = 0.727. This value was almost unchanged when adding sex, country of birth as well as hospitals and wards levels. Average mortality was higher in small wards and municipal hospitals but the POOR values were 15% and 16% respectively.Swedish wards and hospitals in general performed homogeneously well, resulting in a low 30-day mortality rate after HF. In our study, knowledge on a patient's previous hospitalizations was the best predictor of 30-day mortality, and this information did not improve by knowing the sex and country of birth of the patient or where the

  17. On mechanics and material length scales of failure in heterogeneous interfaces using a finite strain high performance solver

    Science.gov (United States)

    Mosby, Matthew; Matouš, Karel

    2015-12-01

    Three-dimensional simulations capable of resolving the large range of spatial scales, from the failure-zone thickness up to the size of the representative unit cell, in damage mechanics problems of particle reinforced adhesives are presented. We show that resolving this wide range of scales in complex three-dimensional heterogeneous morphologies is essential in order to apprehend fracture characteristics, such as strength, fracture toughness and shape of the softening profile. Moreover, we show that computations that resolve essential physical length scales capture the particle size-effect in fracture toughness, for example. In the vein of image-based computational materials science, we construct statistically optimal unit cells containing hundreds to thousands of particles. We show that these statistically representative unit cells are capable of capturing the first- and second-order probability functions of a given data-source with better accuracy than traditional inclusion packing techniques. In order to accomplish these large computations, we use a parallel multiscale cohesive formulation and extend it to finite strains including damage mechanics. The high-performance parallel computational framework is executed on up to 1024 processing cores. A mesh convergence and a representative unit cell study are performed. Quantifying the complex damage patterns in simulations consisting of tens of millions of computational cells and millions of highly nonlinear equations requires data-mining the parallel simulations, and we propose two damage metrics to quantify the damage patterns. A detailed study of volume fraction and filler size on the macroscopic traction-separation response of heterogeneous adhesives is presented.

  18. Effects of anticoccidial and antibiotic growth promoter programs on broiler performance and immune status

    Science.gov (United States)

    This study investigated the effects of various coccidiosis control programs in combination with antibiotic growth promoters (AGPs) on growth performance and host immune responses in broiler chickens. The coccidiosis programs that were investigated include in ovo coccidiosis vaccination (CVAC) with ...

  19. Designing PV Incentive Programs to Promote Performance: A Reviewof Current Practice

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2007-06-01

    Increasing levels of financial support for customer-sited photovoltaic (PV) systems, provided through publicly-funded incentive programs, has heightened concerns about the long-term performance of these systems. Given the barriers that customers face to ensuring that their PV systems perform well, and the responsibility that PV incentive programs bear to ensure that public funds are prudently spent, these programs should, and often do, play a critical role in ensuring that PV systems receiving incentives perform well. To provide a point of reference for assessing the current state of the art, and to inform program design efforts going forward, we examine the approaches to encouraging PV system performance used by 32 prominent PV incentive programs in the U.S. We identify eight general strategies or groups of related strategies that these programs have used to address performance issues, and highlight important differences in the implementation of these strategies among programs.

  20. Effectiveness and Factors Determining the Success of Management Programs for Patients With Heart Failure: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Oyanguren, Juana; Latorre García, Pedro María; Torcal Laguna, Jesús; Lekuona Goya, Iñaki; Rubio Martín, Susana; Maull Lafuente, Elena; Grandes, Gonzalo

    2016-10-01

    Heart failure management programs reduce hospitalizations. Some studies also show reduced mortality. The determinants of program success are unknown. The aim of the present study was to update our understanding of the reductions in mortality and readmissions produced by these programs, elucidate their components, and identify the factors determining program success. Systematic literature review (1990-2014; PubMed, EMBASE, CINAHL, Cochrane Library) and manual search of relevant journals. The studies were selected by 3 independent reviewers. Methodological quality was evaluated in a blinded manner by an external researcher (Jadad scale). These results were pooled using random effects models. Heterogeneity was evaluated with the I 2 statistic, and its explanatory factors were determined using metaregression analysis. Of the 3914 studies identified, 66 randomized controlled clinical trials were selected (18 countries, 13 535 patients). We determined the relative risks to be 0.88 for death (95% confidence interval [95%CI], 0.81-0.96; P < .002; I 2 , 6.1%), 0.92 for all-cause readmissions (95%CI, 0.86-0.98; P < .011; I 2 , 58.7%), and 0.80 for heart failure readmissions (95%CI, 0.71-0.90; P < .0001; I 2 , 52.7%). Factors associated with program success were implementation after 2001, program location outside the United States, greater baseline use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, a higher number of intervention team members and components, specialized heart failure cardiologists and nurses, protocol-driven education and its assessment, self-monitoring of signs and symptoms, detection of deterioration, flexible diuretic regimen, early care-seeking among patients and prompt health care response, psychosocial intervention, professional coordination, and program duration. We confirm the reductions in mortality and readmissions with heart failure management programs. Their success is associated with various structural and

  1. 28 CFR 66.40 - Monitoring and reporting program performance.

    Science.gov (United States)

    2010-07-01

    ... performance. 66.40 Section 66.40 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) UNIFORM... submit annual performance reports unless the awarding agency requires quarterly or semi-annual reports. However, performance reports will not be required more frequently than quarterly. Annual reports shall be...

  2. Virological failure and HIV-1 drug resistance mutations among naive and antiretroviral pre-treated patients entering the ESTHER program of Calmette Hospital in Cambodia.

    Directory of Open Access Journals (Sweden)

    Hubert Barennes

    Full Text Available INTRODUCTION: In resource limited settings, patients entering an antiretroviral therapy (ART program comprise ART naive and ART pre-treated patients who may show differential virological outcomes. METHODS: This retrospective study, conducted in 2010-2012 in the HIV clinic of Calmette Hospital located in Phnom Penh (Cambodia assessed virological failure (VF rates and patterns of drug resistance of naive and pre-treated patients. Naive and ART pre-treated patients were included when a Viral Load (VL was performed during the first year of ART for naive subjects or at the first consultation for pre-treated individuals. Patients showing Virological failure (VF (>1,000 copies/ml underwent HIV DR genotyping testing. Interpretation of drug resistance mutations was done according to 2013 version 23 ANRS algorithms. RESULTS: On a total of 209 patients, 164 (78.4% were naive and 45 (21.5% were ART pre-treated. Their median initial CD4 counts were 74 cells/mm3 (IQR: 30-194 and 279 cells/mm3 (IQR: 103-455 (p<0.001, respectively. Twenty seven patients (12.9% exhibited VF (95% CI: 8.6-18.2%, including 10 naive (10/164, 6.0% and 17 pre-treated (17/45, 37.8% patients (p<0.001. Among these viremic patients, twenty-two (81.4% were sequenced in reverse transcriptase and protease coding regions. Overall, 19 (86.3% harbored ≥1 drug resistance mutations (DRMs whereas 3 (all belonging to pre-treated patients harbored wild-types viruses. The most frequent DRMs were M184V (86.3%, K103N (45.5% and thymidine analog mutations (TAMs (40.9%. Two (13.3% pre-treated patients harbored viruses that showed a multi-nucleos(tide resistance including Q151M, K65R, E33A/D, E44A/D mutations. CONCLUSION: In Cambodia, VF rates were low for naive patients but the emergence of DRMs to NNRTI and 3TC occurred relatively quickly in this subgroup. In pre-treated patients, VF rates were much higher and TAMs were relatively common. HIV genotypic assays before ART initiation and for ART pre

  3. Individual plant examination program: Perspectives on reactor safety and plant performance. Part 1: Final summary report; Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    This report provides perspectives gained by reviewing 75 Individual Plant Examination (IPE) submittals pertaining to 108 nuclear power plant units. IPEs are probabilistic analyses that estimate the core damage frequency (CDF) and containment performance for accidents initiated by internal events. The US Nuclear Regulatory Commission (NRC) reviewed the IPE submittals with the objective of gaining perspectives in three major areas: (1) improvements made to individual plants as a result of their IPEs and the collective results of the IPE program, (2) plant-specific design and operational features and modeling assumptions that significantly affect the estimates of CDF and containment performance, and (3) strengths and weaknesses of the models and methods used in the IPEs. These perspectives are gained by assessing the core damage and containment performance results, including overall CDF, accident sequences, dominant contributions to component failure and human error, and containment failure modes. Methods, data, boundary conditions, and assumptions used in the IPEs are considered in understanding the differences and similarities observed among the various types of plants. This report is divided into three volumes containing six parts. Part 1 is a summary report of the key perspectives gained in each of the areas identified above, with a discussion of the NRC`s overall conclusions and observations. Part 2 discusses key perspectives regarding the impact of the IPE Program on reactor safety. Part 3 discusses perspectives gained from the IPE results regarding CDF, containment performance, and human actions. Part 4 discusses perspectives regarding the IPE models and methods. Part 5 discusses additional IPE perspectives. Part 6 contains Appendices A, B and C which provide the references of the information from the IPEs, updated PRA results, and public comments on draft NUREG-1560 respectively.

  4. Individual plant examination program: Perspectives on reactor safety and plant performance. Parts 2--5: Final report; Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    This report provides perspectives gained by reviewing 75 Individual Plant Examination (IPE) submittals pertaining to 108 nuclear power plant units. IPEs are probabilistic analyses that estimate the core damage frequency (CDF) and containment performance for accidents initiated by internal events. The US Nuclear Regulatory Commission (NRC) reviewed the IPE submittals with the objective of gaining perspectives in three major areas: (1) improvements made to individual plants as a result of their IPEs and the collective results of the IPE program, (2) plant-specific design and operational features and modeling assumptions that significantly affect the estimates of CDF and containment performance, and (3) strengths and weaknesses of the models and methods used in the IPEs. These perspectives are gained by assessing the core damage and containment performance results, including overall CDF, accident sequences, dominant contributions to component failure and human error, and containment failure modes. Methods, data, boundary conditions, and assumptions used in the IPEs are considered in understanding the differences and similarities observed among the various types of plants. This report is divided into three volumes containing six parts. Part 1 is a summary report of the key perspectives gained in each of the areas identified above, with a discussion of the NRC`s overall conclusions and observations. Part 2 discusses key perspectives regarding the impact of the IPE Program on reactor safety. Part 3 discusses perspectives gained from the IPE results regarding CDF, containment performance, and human actions. Part 4 discusses perspectives regarding the IPE models and methods. Part 5 discusses additional IPE perspectives. Part 6 contains Appendices A, B and C which provide the references of the information from the IPEs, updated PRA results, and public comments on draft NUREG-1560 respectively.

  5. The Work Disability Prevention CIHR Strategic Training Program: Program Performance After 5 Years of Implementation

    NARCIS (Netherlands)

    Loisel, P.; Hong, Q.N.; Imbeau, D.; Lippel, K.; Guzman, J.; MacEachen, E.; Corbiere, M.; Santos, B.R.; Anema, J.R.

    2009-01-01

    Introduction The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) Strategic Training Program was developed in 2001 and is a unique program in the world. The main objective of this program is to help future researchers develop transdisciplinary knowledge, skills and

  6. Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Haja Mydin H

    2013-03-01

    Full Text Available Helmy Haja Mydin, Stephen Murphy, Howell Clague, Kishore Sridharan, Ian K TaylorDepartment of Respiratory Medicine, Sunderland Royal Infirmary, Sunderland, United KingdomBackground: In patients with acute hypercapnic respiratory failure (AHRF during exacerbations of COPD, mortality can be high despite noninvasive ventilation (NIV. For some, AHRF is terminal and NIV is inappropriate. However there is no definitive method of identifying patients who are unlikely to survive. The aim of this study was to identify factors associated with inpatient mortality from AHRF with respiratory acidosis due to COPD.Methods: COPD patients presenting with AHRF and who were treated with NIV were studied prospectively. The forced expiratory volume in 1 second (FEV1, World Health Organization performance status (WHO-PS, clinical observations, a composite physiological score (Early Warning Score, routine hematology and biochemistry, and arterial blood gases prior to commencing NIV, were recorded.Results: In total, 65 patients were included for study, 29 males and 36 females, with a mean age of 71 ± 10.5 years. Inpatient mortality in the group was 33.8%. Mortality at 30 days and 12 months after admission were 38.5% and 58.5%, respectively. On univariate analysis, the variables associated with inpatient death were: WHO-PS ≥ 3, long-term oxygen therapy, anemia, diastolic blood pressure < 70 mmHg, Early Warning Score ≥ 3, severe acidosis (pH < 7.20, and serum albumin < 35 g/L. On multivariate analysis, only anemia and WHO-PS ≥ 3 were significant. The presence of both predicted 68% of inpatient deaths, with a specificity of 98%.Conclusion: WHO-PS ≥ 3 and anemia are prognostic factors in AHRF with respiratory acidosis due to COPD. A combination of the two provides a simple method of identifying patients unlikely to benefit from NIV.Keywords: acute exacerbations of COPD, noninvasive ventilation, emphysema, prognostic markers

  7. 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.

  8. Reduced Gray Matter Volume Is Associated With Poorer Instrumental Activities of Daily Living Performance in Heart Failure.

    Science.gov (United States)

    Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth; Narkhede, Atul; Griffith, Erica Y; Cohen, Ronald; Sweet, Lawrence H; Josephson, Richard; Hughes, Joel; Gunstad, John

    2016-01-01

    Heart failure patients require assistance with instrumental activities of daily living in part because of the high rates of cognitive impairment in this population. Structural brain insult (eg, reduced gray matter volume) is theorized to underlie cognitive dysfunction in heart failure, although no study has examined the association among gray matter, cognition, and instrumental activities of daily living in heart failure. The aim of this study was to investigate the associations among gray matter volume, cognitive function, and functional ability in heart failure. A total of 81 heart failure patients completed a cognitive test battery and the Lawton-Brody self-report questionnaire to assess instrumental activities of daily living. Participants underwent magnetic resonance imaging to quantify total gray matter and subcortical gray matter volume. Impairments in instrumental activities of daily living were common in this sample of HF patients. Regression analyses controlling for demographic and medical confounders showed that smaller total gray matter volume predicted decreased scores on the instrumental activities of daily living composite, with specific associations noted for medication management and independence in driving. Interaction analyses showed that reduced total gray matter volume interacted with worse attention/executive function and memory to negatively impact instrumental activities of daily living. Smaller gray matter volume is associated with greater impairment in instrumental activities of daily living in persons with heart failure, possibly via cognitive dysfunction. Prospective studies are needed to clarify the utility of clinical correlates of gray matter volume (eg, cognitive dysfunction) in identifying heart failure patients at risk for functional decline and determine whether interventions that target improved brain and cognitive function can preserve functional independence in this high-risk population.

  9. A retrospective study on 1592 consecutively performed operations in one private referral clinic. Part II: Peri-implantitis and implant failures.

    Science.gov (United States)

    Jemt, Torsten; Karouni, Michel; Abitbol, Jérémy; Zouiten, Ons; Antoun, Hadi

    2017-06-01

    Few large-scale follow-up studies are reported on routine implant treatment. To report retrospective data on peri-implantitis and overall implant failures at one private referral clinic (effectiveness study). A total of 1017 patients were consecutively provided with 3082 implants with an anodized surface during 1592 operations between 2000 and 2011. All patients with any of four events of problems were identified; "peri-implantitis," "surgery related to peri-implantitis," "overall implant failure," and "late implant failures." A logistic multivariate analysis was performed to identify possible factors with association to the four events. "Lower jaw surgery" (HR = 3.03) and "immediate gingival grafting" at implant surgery (HR = 3.34) were factors with the highest risk associated to the two peri-implantitis events, respectively. Risk of peri-implantitis increased by year of inclusion from year 2000 (HR = 1.28). "Overall implant failures" were associated to "smoking" (HR = 2.11), "surgical technique" (highest for direct placement; HR = 1.67), and "type of implant" (NobelActive CC; HR = 2.48). NobelActive CC was more used in upper jaws, using immediate or one-stage surgery with bone and mucosa grafting procedures than other implants (P failures were shown to be associated to earlier inflammatory problems, smoking habits, surgical technique, and treatment in the posterior lower jaw. © 2017 Wiley Periodicals, Inc.

  10. The Cafeteria Workers' Skills Enhancement Training Program. Performance Report.

    Science.gov (United States)

    Burt, Miriam

    A program was conducted by the Food and Beverage Workers Union in Washington, D.C., to provide workplace literacy classes for food service workers in the city's government agencies, universities, and museums. A curriculum for workplace literacy skills was developed, sites were selected, and students were recruited. From a target audience of…

  11. Starlite Workplace Literacy Program. Final Closeout Performance Report.

    Science.gov (United States)

    Reyes, Lolita C.

    The Star Team Acquiring Rewards in Literacy and Insights Through Education (STARLITE) program was implemented to improve the job proficiency of employees at the Pacific Star Hotel, Guam. Its goal was to provide employees with both workplace literacy skills and employability skills. An audit was completed in each department of the hotel. Modules…

  12. Impact of the Occlusion Duration on the Performance of J-CTO Score in Predicting Failure of Percutaneous Coronary Intervention for Chronic Total Occlusion.

    Science.gov (United States)

    de Castro-Filho, Antonio; Lamas, Edgar Stroppa; Meneguz-Moreno, Rafael A; Staico, Rodolfo; Siqueira, Dimytri; Costa, Ricardo A; Braga, Sergio N; Costa, J Ribamar; Chamié, Daniel; Abizaid, Alexandre

    2017-06-01

    The present study examined the association between Multicenter CTO Registry in Japan (J-CTO) score in predicting failure of percutaneous coronary intervention (PCI) correlating with the estimated duration of chronic total occlusion (CTO). The J-CTO score does not incorporate estimated duration of the occlusion. This was an observational retrospective study that involved all consecutive procedures performed at a single tertiary-care cardiology center between January 2009 and December 2014. A total of 174 patients, median age 59.5 years (interquartile range [IQR], 53-65 years), undergoing CTO-PCI were included. The median estimated occlusion duration was 7.5 months (IQR, 4.0-12.0 months). The lesions were classified as easy (score = 0), intermediate (score = 1), difficult (score = 2), and very difficult (score ≥3) in 51.1%, 33.9%, 9.2%, and 5.7% of the patients, respectively. Failure rate significantly increased with higher J-CTO score (7.9%, 20.3%, 50.0%, and 70.0% in groups with J-CTO scores of 0, 1, 2, and ≥3, respectively; PJ-CTO score predicted failure of CTO-PCI independently of the estimated occlusion duration (P=.24). Areas under receiver-operating characteristic curves were computed and it was observed that for each occlusion time period, the discriminatory capacity of the J-CTO score in predicting CTO-PCI failure was good, with a C-statistic >0.70. The estimated duration of occlusion had no influence on the J-CTO score performance in predicting failure of PCI in CTO lesions. The probability of failure was mainly determined by grade of lesion complexity.

  13. Rationale and design of a randomised controlled trial evaluating the effectiveness of an exercise program to improve the quality of life of patients with heart failure in primary care: The EFICAR study protocol

    Directory of Open Access Journals (Sweden)

    de la Torre Maria M

    2010-01-01

    Full Text Available Abstract Background Quality of life (QoL decreases as heart failure worsens, which is one of the greatest worries of these patients. Physical exercise has been shown to be safe for people with heart failure. Previous studies have tested heterogeneous exercise programs using different QoL instruments and reported inconsistent effects on QoL. The aim of this study is to evaluate the effectiveness of a new exercise program for people with heart failure (EFICAR, additional to the recommended optimal treatment in primary care, to improve QoL, functional capacity and control of cardiovascular risk factors. Methods/Design Multicenter clinical trial in which 600 patients with heart failure in NYHA class II-IV will be randomized to two parallel groups: EFICAR and control. After being recruited, through the reference cardiology services, in six health centres from the Spanish Primary Care Prevention and Health Promotion Research Network (redIAPP, patients are followed for 1 year after the beginning of the intervention. Both groups receive the optimized treatment according to the European Society of Cardiology guidelines. In addition, the EFICAR group performs a 3 month supervised progressive exercise program with an aerobic (high-intensity intervals and a strength component; and the programme continues linked with community resources for 9 months. The main outcome measure is the change in health-related QoL measured by the SF-36 and the Minnesota Living with Heart Failure Questionnaires at baseline, 3, 6 and 12 months. Secondary outcomes considered are changes in functional capacity measured by the 6-Minute Walking Test, cardiac structure (B-type natriuretic peptides, muscle strength and body composition. Both groups will be compared on an intention to treat basis, using multi-level longitudinal mixed models. Sex, age, social class, co-morbidity and cardiovascular risk factors will be considered as potential confounding and predictor variables. Discussion

  14. Application of Transformational Leadership Principles in the Development and Integration of Palliative Care Within an Advanced Heart Failure Program.

    Science.gov (United States)

    George, Susan; Leasure, A Renee

    2016-01-01

    Heart failure (HF) is a major health problem in United States, and it has reached epidemic proportions. Heart failure is associated with significant morbidity, mortality, and cost. Although the prognosis of HF is worse than many forms of cancer, many patients, families, and clinicians are unaware of the dire prognosis. As the disease progress to advanced HF, patients are faced with many challenges, such as poor quality of life due to worsening symptoms and frequent hospitalizations. Heart failure management adds significant financial burden to the health care system. Palliative care can be integrated into HF care to improve quality of life and symptom management and to address physical, spiritual, and psychosocial needs of patients and families. Palliative care can be used concurrently with or independent of curative or life-prolonging HF therapies. Transformational leadership principles were used to guide the development of a plan to enhance integration of palliative care within traditional advanced HF care.

  15. Half-molar sodium lactate infusion improves cardiac performance in acute heart failure: a pilot randomised controlled clinical trial.

    Science.gov (United States)

    Nalos, Marek; Leverve, Xavier; Huang, Stephen; Weisbrodt, Leonie; Parkin, Ray; Seppelt, Ian; Ting, Iris; Mclean, Anthony

    2014-03-25

    Acute heart failure (AHF) is characterized by inadequate cardiac output (CO), congestive symptoms, poor peripheral perfusion and end-organ dysfunction. Treatment often includes a combination of diuretics, oxygen, positive pressure ventilation, inotropes and vasodilators or vasopressors. Lactate is a marker of illness severity but is also an important metabolic substrate for the myocardium at rest and during stress. We tested the effects of half-molar sodium lactate infusion on cardiac performance in AHF. We conducted a prospective, randomised, controlled, open-label, pilot clinical trial in 40 patients fulfilling two of the following three criteria for AHF: (1) left ventricular ejection fraction Hartmann's solution without continuous infusion. The primary outcome was CO assessed by transthoracic echocardiography 24 hours after randomisation. Secondary outcomes included a measure of right ventricular systolic function (tricuspid annular plane systolic excursion (TAPSE)), acid-base balance, electrolyte and organ function parameters, along with length of stay and mortality. The infusion of half-molar sodium lactate increased (mean ± SD) CO from 4.05 ± 1.37 L/min to 5.49 ± 1.9 L/min (P < 0.01) and TAPSE from 14.7 ± 5.5 mm to 18.3 ± 7 mm (P = 0.02). Plasma sodium and pH increased (136 ± 4 to 146 ± 6 and 7.40 ± 0.06 to 7.53 ± 0.03, respectively; both P < 0.01), but potassium, chloride and phosphate levels decreased. There were no significant differences in the need for vasoactive therapy, respiratory support, renal or liver function tests, duration of ICU and hospital stay or 28- and 90-day mortality. Infusion of half-molar sodium lactate improved cardiac performance and led to metabolic alkalosis in AHF patients without any detrimental effects on organ function. Clinicaltrials.gov NCT01981655. Registered 13 August 2013.

  16. Performance and Reliability Analysis of Water Distribution Systems under Cascading Failures and the Identification of Crucial Pipes

    Science.gov (United States)

    Shuang, Qing; Zhang, Mingyuan; Yuan, Yongbo

    2014-01-01

    As a mean of supplying water, Water distribution system (WDS) is one of the most important complex infrastructures. The stability and reliability are critical for urban activities. WDSs can be characterized by networks of multiple nodes (e.g. reservoirs and junctions) and interconnected by physical links (e.g. pipes). Instead of analyzing highest failure rate or highest betweenness, reliability of WDS is evaluated by introducing hydraulic analysis and cascading failures (conductive failure pattern) from complex network. The crucial pipes are identified eventually. The proposed methodology is illustrated by an example. The results show that the demand multiplier has a great influence on the peak of reliability and the persistent time of the cascading failures in its propagation in WDS. The time period when the system has the highest reliability is when the demand multiplier is less than 1. There is a threshold of tolerance parameter exists. When the tolerance parameter is less than the threshold, the time period with the highest system reliability does not meet minimum value of demand multiplier. The results indicate that the system reliability should be evaluated with the properties of WDS and the characteristics of cascading failures, so as to improve its ability of resisting disasters. PMID:24551102

  17. A meta-review of evidence on heart failure disease management programs: the challenges of describing and synthesizing evidence on complex interventions

    Directory of Open Access Journals (Sweden)

    Thompson David R

    2011-08-01

    Full Text Available Abstract Background Despite favourable results from past meta-analyses, some recent large trials have not found Heart Failure (HF disease management programs to be beneficial. To explore reasons for this, we evaluated evidence from existing meta-analyses. Methods Systematic review incorporating meta-review was used. We selected meta-analyses of randomized controlled trials published after 1995 in English that examined the effects of HF disease management programs on key outcomes. Databases searched: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR, DARE, NHS EED, NHS HTA, Ageline, AMED, Scopus, Web of Science and CINAHL; cited references, experts and existing reviews were also searched. Results 15 meta-analyses were identified containing a mean of 18.5 randomized trials of HF interventions +/- 10.1 (range: 6 to 36. Overall quality of the meta-analyses was very mixed (Mean AMSTAR Score = 6.4 +/- 1.9; range 2-9. Reporting inadequacies were widespread around populations, intervention components, settings and characteristics, comparison, and comparator groups. Heterogeneity (statistical, clinical, and methodological was not taken into account sufficiently when drawing conclusions from pooled analyses. Conclusions Meta-analyses of heart failure disease management programs have promising findings but often fail to report key characteristics of populations, interventions, and comparisons. Existing reviews are of mixed quality and do not adequately take account of program complexity and heterogeneity.

  18. Job Performance Appraisal System Training Program. Final Report.

    Science.gov (United States)

    Glasgow, Zita; Simkins, Mary Lou

    The Civil Service Reform Act of 1978 requires each government agency to develop a performance-based employee appraisal system. The purpose of this study was to determine how to train effectively more than 200,000 Air Force civilian employees to use the Job Performance Appraisal System (JPAS) designed by the Air Force. Experimental comparisons were…

  19. International Acquisition Programs: Variables Beyond Cost, Schedule and Performance

    Science.gov (United States)

    2015-02-17

    US defense budget and often run on a different budgeting timeline.25 For example, the Norwegian defense budget is approximately 1 percent of the US...Defense Acquisition System, 5. 12 Wood , International Military Aerospace Collaboration Case Studies in Domestic and Intergovernmental Politics, 3. 13...Financial Impacts on Foreign Suppliers, 8. 35 Ibid., 55. 36 Hoff, “The F-16 Coproduction Program – An Analysis,” 21. 37 Ibid., 15. 38 Wood

  20. [Electronic fetal monitoring and management of adverse outcomes: how to perform and improve a training program for clinicians?].

    Science.gov (United States)

    Secourgeon, J-F

    2012-10-01

    Electronic fetal monitoring during labor is the most commonly used method to evaluate the fetal status, but it remains exposed to some criticism. By comparison with intermittent auscultation and in the light of the results of the great studies in the last 30 years, it may be accused its failure to improve the neonatal outcome and its responsibility in the increase on operative deliveries. Actually, the electronic fetal monitoring is a tool whose effectiveness is linked to the accuracy of the analysis developed by the clinician. Studies on assessment of the tracing interpretation indicate that there is always a lack of quality, which may be improved through training programs. It also reveals the benefit of the fetal blood sampling to reduce operative deliveries and the generalization of this method, in addition to electronic fetal monitoring, is recommended by referral agencies. More generally, the continuous monitoring is only a part of the patient safety strategy in the labour ward and we are currently observing, in some European countries and in the United States, the development of training programs concerning the management of the adverse outcomes in obstetrics. The good performances related to the quality of care are demonstrated by the findings of the studies performed in the centers that have implemented an active training policy. In France, the professionals directly involved in the field of the perinatology should benefit from such educational programs that could be organized within the care networks under the authority of referral agencies. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  1. Terminal Performance Objectives for a Phased Shorthand Program in Business Education.

    Science.gov (United States)

    San Mateo Union High School District, CA.

    This phased Shorthand Program is designed to allow each student to move as rapidly toward achieving the goal of vocational competence as his motivation, ability, and time permit. Successful completion of the program is based upon the student's ability to meet the minimum Terminal Performance Objectives. Students completing this program are…

  2. A Pilot Study of Cooperative Programming Learning Behavior and Its Relationship with Students' Learning Performance

    Science.gov (United States)

    Hwang, Wu-Yuin; Shadiev, Rustam; Wang, Chin-Yu; Huang, Zhi-Hua

    2012-01-01

    In this study we proposed a web-based programming assisted system for cooperation (WPASC) and we also designed one learning activity for facilitating students' cooperative programming learning. The aim of this study was to investigate cooperative programming learning behavior of students and its relationship with learning performance. Students'…

  3. 75 FR 59605 - National Veterinary Accreditation Program; Currently Accredited Veterinarians Performing...

    Science.gov (United States)

    2010-09-28

    ... Health Inspection Service 9 CFR Part 161 RIN 0579-AC04 National Veterinary Accreditation Program... National Veterinary Accreditation Program (NVAP) may continue to perform accredited duties and to elect to.... Todd Behre, National Veterinary Accreditation Program, VS, APHIS, 4700 River Road Unit 200, Riverdale...

  4. The DOE Program in HPCC: High-Performance Computing and Communications.

    Science.gov (United States)

    Department of Energy, Washington, DC. Office of Energy Research.

    This document reports to Congress on the progress that the Department of Energy has made in 1992 toward achieving the goals of the High Performance Computing and Communications (HPCC) program. Its second purpose is to provide a picture of the many programs administered by the Office of Scientific Computing under the auspices of the HPCC program.…

  5. 75 FR 9544 - Inmate Work and Performance Pay Program

    Science.gov (United States)

    2010-03-03

    ... inmate's poor performance or adverse behavior. Sec. 545.28 Achievement awards. Inmates may receive... Psychology Services Department, each inmate who is making satisfactory progress or completes a residential...

  6. The cost and performance of utility commercial lighting programs. A report from the Database on Energy Efficiency Programs (DEEP) project

    Energy Technology Data Exchange (ETDEWEB)

    Eto, J.; Vine, E.; Shown, L.; Sonnenblick, R.; Payne, C. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.

    1994-05-01

    The objective of the Database on Energy Efficiency Programs (DEEP) is to document the measured cost and performance of utility-sponsored, energy-efficiency, demand-side management (DSM) programs. Consistent documentation of DSM programs is a challenging goal because of problems with data consistency, evaluation methodologies, and data reporting formats that continue to limit the usefulness and comparability of individual program results. This first DEEP report investigates the results of 20 recent commercial lighting DSM programs. The report, unlike previous reports of its kind, compares the DSM definitions and methodologies that each utility uses to compute costs and energy savings and then makes adjustments to standardize reported program results. All 20 programs were judged cost-effective when compared to avoided costs in their local areas. At an average cost of 3.9{cents}/kWh, however, utility-sponsored energy efficiency programs are not ``too cheap to meter.`` While it is generally agreed upon that utilities must take active measures to minimize the costs and rate impacts of DSM programs, the authors believe that these activities will be facilitated by industry adoption of standard definitions and reporting formats, so that the best program designs can be readily identified and adopted.

  7. Assessing Medicare's hospital pay-for-performance programs and whether they are achieving their goals.

    Science.gov (United States)

    Kahn, Charles N; Ault, Thomas; Potetz, Lisa; Walke, Thomas; Chambers, Jayne Hart; Burch, Samantha

    2015-08-01

    Three separate pay-for-performance programs affect the amount of Medicare payment for inpatient services to about 3,400 US hospitals. These payments are based on hospital performance on specified measures of quality of care. A growing share of Medicare hospital payments (6 percent by 2017) are dependent upon how hospitals perform under the Hospital Readmissions Reduction Program, the Value-Based Purchasing Program, and the Hospital-Acquired Condition Reduction Program. In 2015 four of five hospitals subject to these programs will be penalized under one or more of them, and more than one in three major teaching hospitals will be penalized under all three. Interactions among these programs should be considered going forward, including overlap among measures and differences in scoring performance. Project HOPE—The People-to-People Health Foundation, Inc.

  8. 42 CFR 460.134 - Minimum requirements for quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

    ... well being. (ii) Functional status. (iii) Cognitive ability. (iv) Social/behavioral functioning. (v...) Minimum program requirements. A PACE organization's quality assessment and performance improvement program... applicable to the care of PACE participants. (c) Minimum levels of performance. The PACE organization must...

  9. A Modified Importance-Performance Framework for Evaluating Recreation-Based Experiential Learning Programs

    Science.gov (United States)

    Pitas, Nicholas; Murray, Alison; Olsen, Max; Graefe, Alan

    2017-01-01

    This article describes a modified importance-performance framework for use in evaluation of recreation-based experiential learning programs. Importance-performance analysis (IPA) provides an effective and readily applicable means of evaluating many programs, but the near universal satisfaction associated with recreation inhibits the use of IPA in…

  10. 10 CFR 600.341 - Monitoring and reporting program and financial performance.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Monitoring and reporting program and financial performance. 600.341 Section 600.341 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL... Organizations Post-Award Requirements § 600.341 Monitoring and reporting program and financial performance. (a...

  11. Development of an instrument for a primary airway provider's performance with an ICU multidisciplinary team in pediatric respiratory failure using simulation.

    Science.gov (United States)

    Nishisaki, Akira; Donoghue, Aaron J; Colborn, Shawn; Watson, Christine; Meyer, Andrew; Niles, Dana; Bishnoi, Ram; Hales, Roberta; Hutchins, Larissa; Helfaer, Mark A; Brown, Calvin A; Walls, Ron M; Nadkarni, Vinay M; Boulet, John R

    2012-07-01

    To develop a scoring system that can assess the multidisciplinary management of respiratory failure in a pediatric ICU. In a single tertiary pediatric ICU we conducted a simulation-based evaluation in a patient care area auxiliary to the ICU. The subjects were pediatric and emergency medicine residents, nurses, and respiratory therapists who work in the pediatric ICU. A multidisciplinary focus group with experienced providers in pediatric ICU airway management and patient safety specialists was formed. A task-based scoring instrument was developed to evaluate a primary airway provider's performance through Healthcare Failure Mode and Effect Analysis. Reliability and validity of the instrument were evaluated using multidisciplinary simulation-based airway management training sessions. Each session was evaluated by 3 independent expert raters. A global assessment of the team performance and the previous experience in training were used to evaluate the validity of the instrument. The Just-in-Time Pediatric Airway Provider Performance Scale (JIT-PAPPS) version 3, with 34 task-based items (14 technical, 20 behavioral), was developed. Eighty-five teams led by resident airway providers were evaluated by 3 raters. The intraclass correlation coefficient for raters was 0.64. The JIT-PAPPS score correlated well with the global rating scale (r = 0.71, P primary airway provider's performance with a multidisciplinary pediatric ICU team on simulated pediatric respiratory failure was developed. Reliability and validity evaluation supports the developed scale.

  12. Clinical guidelines performance in patients with chronic heart failure: the data of 2015 registry in Ivanovo region

    Directory of Open Access Journals (Sweden)

    Shutemova E.A.

    2016-03-01

    Full Text Available The article presents the results of assessment of guidelines implementation in 2358 patients with chronic heart failure who applied for medical care to primary care units of Ivanovo region in 2015. The data and quality indicators of multicenter national registry were used.

  13. Comparison of the predictive performance of eGFR formulae for mortality and graft failure in renal transplant recipients.

    LENUS (Irish Health Repository)

    He, Xiang

    2009-02-15

    To date, efforts have focused on assessing estimated glomerular filtration rate (eGFR) formulae against measured GFR. However, a more appropriate clinical gold standard is one conveying a defined clinical disadvantage. In renal transplantation, these measures are mortality and graft failure.

  14. A Five-Tier System for Improving the Categorization of Transplant Program Performance.

    Science.gov (United States)

    Wey, Andrew; Salkowski, Nicholas; Kasiske, Bertram L; Israni, Ajay K; Snyder, Jon J

    2017-06-13

    To better inform health care consumers by better identifying differences in transplant program performance. Adult kidney transplants performed in the United States, January 1, 2012-June 30, 2014. In December 2016, the Scientific Registry of Transplant Recipients instituted a five-tier system for reporting transplant program performance. We compare the differentiation of program performance and the simulated misclassification rate of the five-tier system with the previous three-tier system based on the 95 percent credible interval. Scientific Registry of Transplant Recipients database. The five-tier system improved differentiation and maintained a low misclassification rate of less than 22 percent for programs differing by two tiers. The five-tier system will better inform health care consumers of transplant program performance. © Health Research and Educational Trust.

  15. Causal Analysis for Performance Modeling of Computer Programs

    Directory of Open Access Journals (Sweden)

    Jan Lemeire

    2007-01-01

    Full Text Available Causal modeling and the accompanying learning algorithms provide useful extensions for in-depth statistical investigation and automation of performance modeling. We enlarged the scope of existing causal structure learning algorithms by using the form-free information-theoretic concept of mutual information and by introducing the complexity criterion for selecting direct relations among equivalent relations. The underlying probability distribution of experimental data is estimated by kernel density estimation. We then reported on the benefits of a dependency analysis and the decompositional capacities of causal models. Useful qualitative models, providing insight into the role of every performance factor, were inferred from experimental data. This paper reports on the results for a LU decomposition algorithm and on the study of the parameter sensitivity of the Kakadu implementation of the JPEG-2000 standard. Next, the analysis was used to search for generic performance characteristics of the applications.

  16. 42 CFR 438.240 - Quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assessment and performance improvement... Performance Improvement Measurement and Improvement Standards § 438.240 Quality assessment and performance... PIHP have an ongoing quality assessment and performance improvement program for the services it...

  17. The influence of critical thinking skills on performance and progression in a pre-registration nursing program.

    Science.gov (United States)

    Pitt, Victoria; Powis, David; Levett-Jones, Tracy; Hunter, Sharyn

    2015-01-01

    The importance of developing critical thinking skills in preregistration nursing students is recognized worldwide. Yet, there has been limited exploration of how students' critical thinking skill scores on entry to pre-registration nursing education influence their academic and clinical performance and progression. The aim of this study was to: i) describe entry and exit critical thinking scores of nursing students enrolled in a three year bachelor of nursing program in Australia in comparison to norm scores; ii) explore entry critical thinking scores in relation to demographic characteristics, students' performance and progression. This longitudinal correlational study used the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills in a sample (n=134) of students, at entry and exit (three years later). A one sample t-test was used to determine if differences existed between matched student critical thinking scores between entry and exit points. Academic performance, clinical performance and progression data were collected and correlations with entry critical thinking scores were examined. There was a significant relationship between critical thinking scores, academic performance and students' risk of failing, especially in the first semester of study. Critical thinking scores were predictive of program completion within three years. The increase in critical thinking scores from entry to exit was significant for the 28 students measured. In comparison to norm scores, entry level critical thinking scores were significantly lower, but exit scores were comparable. Critical thinking scores had no significant relationship to clinical performance. Entry critical thinking scores significantly correlate to academic performance and predict students risk of course failure and ability to complete a nursing degree in three years. Students' critical thinking scores are an important determinant of their success and as such can inform curriculum development and

  18. A Performance Support Tool for Cisco Training Program Managers

    Science.gov (United States)

    Benson, Angela D.; Bothra, Jashoda; Sharma, Priya

    2004-01-01

    Performance support systems can play an important role in corporations by managing and allowing distribution of information more easily. These systems run the gamut from simple paper job aids to sophisticated computer- and web-based software applications that support the entire corporate supply chain. According to Gery (1991), a performance…

  19. High Performance Computing Modernization Program Kerberos Throughput Test Report

    Science.gov (United States)

    2017-10-26

    ORGANIZATION REPORT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 10. SPONSOR / MONITOR’S ACRONYM(S)9. SPONSORING / MONITORING AGENCY...the high computing power of the main supercomputer. Each supercomputer is different in node architecture as well as hardware specifications. 2

  20. Characteristics, quality of care, and in-hospital outcomes of Asian-American heart failure patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program.

    Science.gov (United States)

    Qian, Feng; Fonarow, Gregg C; Krim, Selim R; Vivo, Rey P; Cox, Margueritte; Hannan, Edward L; Shaw, Benjamin A; Hernandez, Adrian F; Eapen, Zubin J; Yancy, Clyde W; Bhatt, Deepak L

    2015-01-01

    Because little was previously known about Asian-American patients with heart failure (HF), we compared clinical profiles, quality of care, and outcomes between Asian-American and non-Hispanic white HF patients using data from the American Heart Association Get With The Guidelines-Heart Failure (GWTG-HF) program. We analyzed 153,023 HF patients (149,249 whites, 97.5%; 3774 Asian-Americans, 2.5%) from 356 U.S. centers participating in the GWTG-HF program (2005-2012). Baseline characteristics, quality of care metrics, in-hospital mortality, discharge to home, and length of stay were examined. Relative to white patients, Asian-American HF patients were younger, more likely to be male, uninsured or covered by Medicaid, and recruited in the western region. They had higher prevalence of diabetes, hypertension, and renal insufficiency, but similar ejection fraction. Overall, Asian-American HF patients had comparable quality of care except that they were less likely to receive aldosterone antagonists at discharge (relative risk , 0.88; 95% confidence interval , 0.78-0.99), and anticoagulation for atrial fibrillation (RR, 0.91; 95% CI, 0.85-0.97) even after risk adjustment. Compared with white patients, Asian-American patients had comparable risk adjusted in-hospital mortality (RR, 1.11; 95% CI, 0.91-1.35), length of stay>4 days (RR, 1.01; 95% CI, 0.95-1.08), and were more likely to be discharged to home (RR, 1.08; 95% CI, 1.06-1.11). Despite some differences in clinical profiles, Asian-American patients hospitalized with HF receive very similar quality of care and have comparable health outcomes to their white counterparts. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Effect of a multidisciplinary supportive program for family caregivers of patients with heart failure on caregiver burden, quality of life, and depression: A randomized controlled study.

    Science.gov (United States)

    Hu, Xiaolin; Dolansky, Mary A; Su, Yonglin; Hu, Xiuying; Qu, Moying; Zhou, Lingjuan

    2016-10-01

    Caregivers of patients with heart failure experience burden and negative health outcomes. Adequate support for family caregivers improves their well-being and the quality of care provided to the patients. However, little is known about the benefits of interventions for caregivers of patients with heart failure in China. To test the effects of a multidisciplinary supportive program for family caregivers on caregiver burden, quality of life, and depression. A randomized controlled design with repeated measures was used in this study. A total of 118 participants were randomized into experimental (n=59) and control groups (n=59) from May to December 2014 in one hospital in Chengdu, People's Republic of China. Participants in the experimental group received a 3-month multidisciplinary supportive program, consisting of three 60-min sessions of group classes, three 30-min peer support groups, and regular telephone follow-ups and consultations, while participants in the control group received usual care only. Outcomes were caregiver burden, quality of life, and depression. Data were collected at baseline, post-test (3 months after discharge), and 3 months after post-test (6 months after discharge). The repeated measures analysis of variance was used to examine the effects of groups, changes over time, and time-group interaction on outcome variables. There were significant improvements in caregiver burden, mental health, and depression after post-test and 3 months after post-test in the experimental group. However, there was no significant improvement in caregivers' physical health at either 3 or 6 months following discharge. A multidisciplinary supportive program for caregivers of heart failure patients had positive effects and provides a unique perspective of an intervention considering Chinese culture and customs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Computer-Based Reading Programs: A Preliminary Investigation of Two Parent Implemented Programs with Students At-Risk for Reading Failure

    Science.gov (United States)

    Pindiprolu, Sekhar S.; Forbush, David

    2009-01-01

    In 2000, National Reading Panelists (NRP) reported that computer delivered reading instruction has potential for promoting the reading skills of students at-risk for reading failure. However, panelists also noted a scarcity of data present in the literature on the effects of computer-based reading instruction. This preliminary investigation…

  3. Performance of recommended measures on risk factors control in patients with hypertension, coronary artery disease and chronic heart failure: the data from 2014 Russian registry

    Directory of Open Access Journals (Sweden)

    Posnenkova O.M.

    2015-03-01

    Full Text Available A report presents the results of evaluation of recommended measures on risk factors control in patients with hypertension, stable coronary artery disease (CAD and chronic heart failure (CHF. The performance of recommended measures was assessed with the help of specially developed system of clinical indicators on the basis of data of the year 2014 from patients enrolled in multicenter Russian registry of hypertension, CAD and CHF.

  4. Small Business Administration (SBA) Loan Program Performance- Post-Charge Off Recovery Rates by Program

    Data.gov (United States)

    Small Business Administration — Reflects total post-charge off recovery rates, as a percent of the amounts charged off by charge off year, for the major loan programs and aggregate totals by charge...

  5. Fe-Substitution for Ni in Misch Metal-Based Superlattice Hydrogen Absorbing Alloys—Part 2. Ni/MH Battery Performance and Failure Mechanisms

    Directory of Open Access Journals (Sweden)

    Tiejun Meng

    2017-09-01

    Full Text Available The electrochemical performance and failure mechanisms of Ni/MH batteries made with a series of the Fe-substituted A2B7 superlattice alloys as the negative electrodes were investigated. The incorporation of Fe does not lead to improved cell capacity or cycle life at either room or low temperature, although Fe promotes the formation of a favorable Ce2Ni7 phase. Fe-substitution was found to inhibit leaching of Al from the metal hydride negative electrode and promote leaching of Co, which could potentially extend the cycle life of the positive electrode. The failure mechanisms of the cycled cells with the Fe-substituted superlattice hydrogen absorbing alloys were analyzed by scanning electron microscopy, energy dispersive spectroscopy and inductively coupled plasma analysis. The failure of cells with Fe-free and low Fe-content alloys is mainly attributed to the pulverization of the metal hydride alloy. Meanwhile, severe oxidation/corrosion of the negative electrode is observed for cells with high Fe-content alloys, resulting in increased internal cell resistance, formation of micro-shortages in the separator and eventual cell failure.

  6. Student stress and academic performance: home hospital program.

    Science.gov (United States)

    Yucha, Carolyn B; Kowalski, Susan; Cross, Chad

    2009-11-01

    The purpose of this study was to evaluate whether nursing students assigned to a home hospital experience less stress and improved academic performance. Students were assigned to a home hospital clinical placement (n = 78) or a control clinical placement (n = 79). Stress was measured using the Student Nurse Stress Index (SNSI) and Spielberger's State Anxiety Inventory. Academic performance included score on the RN CAT, a standardized mock NCLEX-RN(®)-type test; nursing grade point average; and first attempt pass-fail on the NCLEX-RN. There were no statistically significant differences between the two groups for age, gender, marital status, ethnicity, or score on the nurse entrance examination. There were significant changes in SNSI over time but not between groups. Academic load and state anxiety showed an interaction of time by group, with the home hospital group showing reductions over time, compared with the control group. Copyright 2009, SLACK Incorporated.

  7. NASA Human Research Program Behavioral Health and Performance Element (BHP)

    Science.gov (United States)

    Whitmire, Sandra; Faulk, Jeremy; Leveton, Lauren

    2010-01-01

    The goal of NASA BHP is to identify, characterize, and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. The NASA Behavioral Health and Performance Operations Group (BHP Ops) supports astronauts and their families before, during, and after a long-duration mission (LDM) on the ISS. BHP Ops provides ISS crews with services such as preflight training (e.g., psychological factors of LDM, psychological support, cross-cultural); preflight, in-flight, and postflight support services, including counseling for astronauts and their families; and psychological support such as regular care packages and a voice-over IP phone system between crew members and their families to facilitate real-time one-on-one communication.

  8. From Procedural to Object-Oriented Programming (OOP- Performance in OOP: An empirical study

    Directory of Open Access Journals (Sweden)

    Irene Govender

    2011-02-01

    Full Text Available This exploratory study of introductory pre- and in-service teachers’ performance in object-oriented programming (OOP assessments reveals important issues with regard to learning and teaching OOP, using java. The study is set against the backdrop of the country’s transition of its national IT curriculum from a procedural to an object-oriented programming language. The effect of prior programming experience and performances in different types of questions are examined. A combination of quantitative and qualitative methods is used to analyse the data. The effect of prior programming experience of a procedural kind and the type of assessments given is shown to have a marked influence on the performance in programming assessments and teaching of OOP. Many introductory OOP courses are in effect taught procedurally as courses in the small. Therefore educating teachers how to teach programming is a significant educational challenge. Some implications for teaching are therefore suggested

  9. Academic difficulty and program-level variables predict performance on the National Physical Therapy Examination for licensure: a population-based cohort study.

    Science.gov (United States)

    Riddle, Daniel L; Utzman, Ralph R; Jewell, Dianne V; Pearson, Stephanie; Kong, Xiangrong

    2009-11-01

    Several factors have been shown to influence first-time pass rates on the National Physical Therapy Examination (NPTE). It is unclear to what extent academic difficulty experienced by students in a physical therapist education program may affect NPTE pass rates. The effects of institutional status (public or private) and Carnegie Classification on NPTE pass rates also are unknown. The aim of this study was to quantify the odds of failure on the NPTE for students experiencing academic difficulty and for institutional status and Carnegie Classification. This investigation was a retrospective population-based cohort study. Quota sampling was used to recruit a random sample of 20 professional physical therapist education programs across the United States. Individual student demographic, preadmission, and academic performance data were collected, as were data on program-level variables and data indicating pass/fail performance on the NPTE. A generalized linear mixed-effects logistic regression model was used to adjust for confounding factors and to describe relationships among the key predictor variables-academic difficulty, institutional status, and Carnegie Classification-and the dependent variable, NPTE performance. Academic difficulty during a student's professional training was an independent predictor for NPTE failure. The odds of students who had academic difficulty (relative to students who did not experience academic difficulty) failing the NPTE were 5.89 (95% confidence interval=4.06-8.93). The odds of NPTE failure also varied depending on institutional status and Carnegie Classification. The findings related to Carnegie Classification and institutional status should be considered preliminary. Student performance on the NPTE was influenced by multiple factors, but the most important, potentially modifiable risk factor for poor NPTE performance likely is academic difficulty during professional training.

  10. Thinking processes used by high-performing students in a computer programming task

    Directory of Open Access Journals (Sweden)

    Marietjie Havenga

    2011-07-01

    Full Text Available Computer programmers must be able to understand programming source code and write programs that execute complex tasks to solve real-world problems. This article is a trans- disciplinary study at the intersection of computer programming, education and psychology. It outlines the role of mental processes in the process of programming and indicates how successful thinking processes can support computer science students in writing correct and well-defined programs. A mixed methods approach was used to better understand the thinking activities and programming processes of participating students. Data collection involved both computer programs and students’ reflective thinking processes recorded in their journals. This enabled analysis of psychological dimensions of participants’ thinking processes and their problem-solving activities as they considered a programming problem. Findings indicate that the cognitive, reflective and psychological processes used by high-performing programmers contributed to their success in solving a complex programming problem. Based on the thinking processes of high performers, we propose a model of integrated thinking processes, which can support computer programming students. Keywords: Computer programming, education, mixed methods research, thinking processes.  Disciplines: Computer programming, education, psychology

  11. FREQFIT: Computer program which performs numerical regression and statistical chi-squared goodness of fit analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hofland, G.S.; Barton, C.C.

    1990-10-01

    The computer program FREQFIT is designed to perform regression and statistical chi-squared goodness of fit analysis on one-dimensional or two-dimensional data. The program features an interactive user dialogue, numerous help messages, an option for screen or line printer output, and the flexibility to use practically any commercially available graphics package to create plots of the program`s results. FREQFIT is written in Microsoft QuickBASIC, for IBM-PC compatible computers. A listing of the QuickBASIC source code for the FREQFIT program, a user manual, and sample input data, output, and plots are included. 6 refs., 1 fig.

  12. Efficiency of Pay for Performance Programs in Romanian Companies and the Mediating Role of Organizational Justice

    Directory of Open Access Journals (Sweden)

    Uriesi Sebastian

    2017-03-01

    Full Text Available The present research examined the influences of pay for performance programs on employee performance in the Romanian context, by comparing a sample of employees in companies in which such programs are implemented to a sample of employees in organizations in which performance is not used as a criterion in deciding financial rewards. Results show that the work performances of the former, as evaluated by the direct supervisors of each employee, are significantly higher than those of the latter, and that this effect of performance pay is partly mediated by its positive effects on employee perceptions of distributive and procedural justice. Furthermore, results indicate that the individual – level financial incentive systems are more efficient in fostering work performance than the team – level performance pay programs in the Romanian employee sample, and that they also have stronger effects on the two dimensions of organizational justice.

  13. Effects of a 14-month low-cost maintenance training program in patients with chronic systolic heart failure: a randomized study

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming

    2009-01-01

    BACKGROUND: Exercise training is known to be beneficial in chronic heart failure (CHF) patients but there is a lack of studies following patient groups for longer duration with maintenance training programs to defer deconditioning. METHODS: Study base consisted of all patients diagnosed with CHF...... in a 3-year period. Sixty-six patients with systolic CHF (ejection fraction Heart Association II-III) were randomized to 12 months of either usual care orhome-based maintenance exercise with group training sessions every 2 weeks after an initial 8-week training program. The primary endpoint...... was maximum workload; secondary endpoints were 6-min walk test, incremental shuttle walk test, sit-to-stand test, quality of life, and serological markers. RESULTS: Six patients died and 43 completed the study. The initial 8-week training was associated with small but significant improvement in all...

  14. Success of Old Order Amish Children in a Strategy-Oriented Program for Children at Risk of Failure in Reading.

    Science.gov (United States)

    Yukish, Joseph F.; Fraas, John W.

    Evaluating the effectiveness of the Reading Recovery program pioneered in New Zealand by Marie Clay (daily supplemental lessons, for students with reading difficulties, which develop a strategy-oriented, self-improving reading system), a study examined the success of the program in an Old Order Amish population of first-grade students from Ohio.…

  15. [Individualization of exercise load control for inpatient cardiac rehabilitation. Development and evaluation of a HRV-based intervention program for patients with ischemic heart failure].

    Science.gov (United States)

    Behrens, K; Hottenrott, K; Weippert, M; Montanus, H; Kreuzfeld, S; Rieger, A; Lübke, J; Werdan, K; Stoll, R

    2015-03-01

    The effective use of rehabilitation programs is of primary importance in order to improve the physical performance of cardiac disease patients. A modular program has been developed which is intended to structure and individualize conventional, exercise-based rehabilitation programs according to the individual needs and physical condition of each patient. The individualization of the program is based on detailed diagnostics before patients enter the program and daily measurements of heart rate variability (HRV) during cardiac rehabilitation. A total of 30 patients with ischemic heart disease were randomly assigned either to the intervention group (IG), completing the modular individualized rehabilitation program [n=15, mean age 54.4±4.2 years and mean left ventricular ejection fraction (LVEF) 28.53±6.25%) or to the control group (CG) taking part in the conventional rehabilitation program (n=15, mean age 56.4±4.4 years and mean LVEF 27.63±5.62). Before and after the intervention, cardiorespiratory fitness was assessed by measurement of maximal oxygen consumption (relative VO2max) during bicycle ergometry and the 6-minute walk test (6-MWT). Pre-post comparisons of cardiorespiratory fitness indicators were used to evaluate the effectiveness of the rehabilitation program. In addition to the results of the basic clinical investigations and the cardiorespiratory testing, results of standardized HRV measurements of 10 min at morning rest served as criteria for program individualization. The relative VO2max increased significantly (pmaximum power output during bicycle ergometry (pmaximum performance matrix in cardiac rehabilitation. Individualization should be based on clinical and performance diagnostics before and accompanying assessments of training condition, e.g. by HRV measurements, during rehabilitation programs. Each patient should only perform those intervention programs which match the results of the basic clinical investigation and additional analyses during

  16. Students at risk of educational exclusion in secondary education. Perceptions of teachers involved in special programs about prevention of school failure

    Directory of Open Access Journals (Sweden)

    Francisco Javier AMORES FERNÁNDEZ

    2016-06-01

    Full Text Available School failure in Secondary Education is one of the most serious problems that carries the Spanish educational system today. Initial vocational qualification programs (pcpi were designed to offer a second chance to failed students (or at risk of educational exclusion in this educational stage. This study, for which has been used a mixed or hybrid method research, has provided a number of results that offer a more complete vision on the usefulness of these «Educational reclosing» programs (now Vocational Basic Training, in the centers of the province of Granada, showing viewpoints as interesting as the teachers and students involved in the study. Here the perception of teachers is summarized on these students at risk who, due to several reasons, have been excluded from the mainstream educational system, and doomed to failure. Students that fail not only for learning difficulties or personal problems related to their family, also crash into an educational system that has not been able to provide adequate answers to their needs. 

  17. Respiratory Failure

    Science.gov (United States)

    Respiratory failure happens when not enough oxygen passes from your lungs into your blood. Your body's organs, ... brain, need oxygen-rich blood to work well. Respiratory failure also can happen if your lungs can' ...

  18. Heart Failure

    Science.gov (United States)

    ... heart failure due to systolic dysfunction. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ... patient with heart failure or cardiomyopathy. http://www.uptodate.com/home. Accessed Sept. 26, 2014. Colucci WS. ...

  19. Designing PV Incentive Programs to Promote Performance: A Reviewof Current Practice in the U.S.

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Wiser, Ryan; Bolinger, Mark

    2006-10-06

    In the U.S., the increasing financial support for customer-sited photovoltaic (PV) systems provided through publicly-funded incentive programs has heightened concerns about the long-term performance of these systems. Given the barriers that customers face to ensuring that their PV systems perform well, and the responsibility that PV incentive programs bear to ensure that public funds are prudently spent, these programs should, and often do, play a critical role in addressing PV system performance. To provide a point of reference for assessing the current state of the art, and to inform program design efforts going forward, we examine the approaches to encouraging PV system performance used by 32 prominent PV incentive programs in the U.S. We identify eight general strategies or groups of related strategies that these programs have used to address factors that affect performance, and describe key implementation details. Based on this review, we then offer recommendations for how PV incentive programs can be effectively designed to mitigate potential performance issues.

  20. Do it right this time: the role of employee service recovery performance in customer-perceived justice and customer loyalty after service failures.

    Science.gov (United States)

    Liao, Hui

    2007-03-01

    Integrating justice and customer service literatures, this research examines the role of customer service employees' behaviors of handling customer complaints, or service recovery performance (SRP), in conveying a just image of service organizations and achieving desirable customer outcomes. Results from a field study and a laboratory study demonstrate that the dimensions of SRP--making an apology, problem solving, being courteous, and prompt handling--positively influenced customer satisfaction and then customer repurchase intent through the mediation of customer-perceived justice. In addition, service failure severity and repeated failures reduced the positive impact of some dimensions of SRP on customer satisfaction, and customer-perceived justice again mediated these moderated effects. (c) 2007 APA, all rights reserved.

  1. HORSE SPECIES SYMPOSIUM: Nutritional programming and the impact on mare and foal performance.

    Science.gov (United States)

    Coverdale, J A; Hammer, C J; Walter, K W

    2015-07-01

    Many environmental factors can alter the phenotype of offspring when applied during critical periods of early development. In most domestic species, maternal nutrition influences fetal development and the fetus is sensitive to the nutrition of the dam during pregnancy. Many experimental models have been explored including both under- and overnutrition of the dam. Both nutritional strategies have yielded potential consequences including altered glucose tolerance, pancreatic endocrine function, insulin sensitivity, body composition, and colostrum quality. Although the impact of maternal nutrition on fetal development in the equine has not been thoroughly investigated, overnutrition is a common occurrence in the industry. Work in our laboratory has focused on effects of maternal overnutrition on mare and foal performance, mare DMI, foaling parameters, colostrum quality and passive transfer of immunity, and glucose and insulin dynamics. Over several trials, mares were fed either 100 or 140% of NRC requirements for DE, and supplemental Se and arginine were added to diets in an attempt to mitigate potential intrauterine growth retardation resulting from dams overfed during the last third of pregnancy. As expected, when mares were overfed, BW, BCS, and rump fat values increased. Foal growth over 150 d was also not influenced. Maternal nutrition did not alter colostrum volume but influenced colostrum quality. Maternal overnutrition resulted in lower colostrum IgG concentrations but did not cause failure of passive transfer in foals. Supplemental Se and arginine were unable to mitigate this reduction in colostrum IgG. Additionally, mare and foal glucose and insulin dynamics were influenced by maternal nutrition. Mare glucose and insulin area under the curve (AUC) increased with increased concentrate supplementation. Foal insulin AUC and peak insulin concentrations were increased when mares were fed concentrate and, in a later trial, foal peak glucose values were reduced

  2. Heart Failure

    DEFF Research Database (Denmark)

    Jorsal, Anders; Wiggers, Henrik; McMurray, John J V

    2018-01-01

    This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint.......This article briefly discusses the epidemiology of heart failure and diabetes and summarizes the key findings from the recent cardiovascular outcome trials in patients with type 2 diabetes, with a focus on heart failure as an endpoint....

  3. On Failure

    Science.gov (United States)

    2009-06-01

    assigned to the Acquisition Chief Process Office at SAF/AQ. He holds degrees in electrical engineering, engineering management , and systems engineering...failure. Failure Types Exposure to Loss Opportunity to Learn Optimal Low High Negative High Low Acquisition project leaders would obviously prefer to...of failure a major defense acquisi- Acquisition project leaders would obviously prefer to succeed but should remember that failure is inevitable

  4. Design of benign matrix drums for the non-destructive assay performance demonstration program for the National TRU Program

    Energy Technology Data Exchange (ETDEWEB)

    Becker, G.K.

    1996-09-01

    Regulatory compliance programs associated with the Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP) Transuranic (TRU) Waste Characterization Program (the Program) require the collection of waste characterization data of known quality to support repository performance assessment, permitting, and associated activities. Blind audit samples, referred to as PDP (performance demonstration program) samples, are devices used in the NDA PDP program to acquire waste NDA system performance data per defined measurement routines. As defined under the current NDA PDP Program Plan, a PDP sample consists of a DOT 17C 55-gallon PDP matrix drum configured with insertable radioactive standards, working reference materials (WRMs). The particular manner in which the matrix drum and PDP standard(s) are combined is a function of the waste NDA system performance test objectives of a given cycle. The scope of this document is confined to the design of the PDP drum radioactive standard internal support structure, the matrix type and the as installed configuration. The term benign is used to designate a matrix possessing properties which are nominally non-interfering to waste NDA measurement techniques. Measurement interference sources are technique specific but include attributes such as: high matrix density, heterogeneous matrix distributions, matrix compositions containing high moderator/high Z element concentrations, etc. To the extent practicable the matrix drum design should not unduly bias one NDA modality over another due to the manner in which the matrix drum configuration manifests itself to the measurement system. To this end the PDP matrix drum configuration and composition detailed below is driven primarily by the intent to minimize the incorporation of matrix attributes known to interfere with fundamental waste NDA modalities, i.e. neutron and gamma based techniques.

  5. Heart Failure

    Science.gov (United States)

    Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that your heart has stopped ... and shortness of breath Common causes of heart failure are coronary artery disease, high blood pressure and ...

  6. Performance Data Report: Space Medicine Division, Human Research Program, Behavioural Health and Performance Research Element

    Science.gov (United States)

    Shea, Camille; Keeton, Kathryn E.; Schmidt, Lacey L.; Slack, Kelley J.; Patterson, Holly N.; Leveton, Lauren B.; Holland, Albert W.

    2012-01-01

    This report is the result of a collaborative effort between NASA?s Behavioral Health & Performance (BHP) Research and Operations Group to investigate and determine the availability of data pertaining to behavioral performance (and other pertinent variables) that have been collected by the laboratories at NASA?s Johnson Space Center. BHP?s Operations and Research groups collaborated to systematically identify what types of performance data are needed in relevant BHP performance domains and also to conduct structured interviews with NASA personnel to identify which data do or do not exist currently (and for instances where such data exist, to evaluate the type, quality, accessibility, and confidentiality of those data). The authors defined outcome categories of performance that encapsulate BHP performance domains, mapped BHP Research Risks and Gaps onto those performance outcome categories, and identified and prioritized indicators for each outcome category. The team identified key points of contact (subject matter experts [SMEs]) as potential interviewees, created a template for structured interview questions about sources and accessibility of performance data, and coordinated and conducted structured interviews with the SMEs. The methodology, results, and implications of this effort, as well as forward work needed, are discussed in this report.

  7. Do In-School Feeding Programs Have an Impact on Academic Performance?

    Science.gov (United States)

    Adrogue, Cecilia; Orlicki, Maria Eugenia

    2013-01-01

    As Argentina presents problems of malnutrition, the federal in-school feeding program has become a key policy because it provides an important nutritional intervention during a relevant growth period. This paper estimates the effect of the program on academic performance--measured by standardized test scores--with a difference in difference model,…

  8. Predictive Modeling of Student Performances for Retention and Academic Support in a Diagnostic Medical Sonography Program

    Science.gov (United States)

    Borghese, Peter; Lacey, Sandi

    2014-01-01

    As part of a retention and academic support program, data was collected to develop a predictive model of student performances in core classes in a Diagnostic Medical Sonography (DMS) program. The research goal was to identify students likely to have difficulty with coursework and provide supplemental tutorial support. The focus was on the…

  9. Schools behind Bars: Windham School System and Other Prison Education Programs. A Performance Review.

    Science.gov (United States)

    MGT of America, Inc., Tallahassee, FL.

    This report presents results of a performance review undertaken to develop recommendations for improving the effectiveness of the Windham School System (WSS) and educational programs in the four privately operated prison units in Texas. (WSS provides educational programs for inmates who do not possess a high school diploma.) Chapter 1 is an…

  10. 20 CFR 658.604 - Assessment and evaluation of program performance data.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Assessment and evaluation of program..., DEPARTMENT OF LABOR ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Review and Assessment of State Agency Compliance With Job Service Regulations § 658.604 Assessment and evaluation of program performance...

  11. The role of supply chain action programs in achieving operational performance excellence

    DEFF Research Database (Denmark)

    Farooq, Sami; Dukovska-Popovska, Iskra; Boer, Harry

    2009-01-01

    This paper investigates the effects of five individual supply chain action programs on cost and speed aspects of procurement and manufacturing performance. The study is based on the IMSS-IV database. As should be expected, supply chain action programs have stronger effects on externally oriented ...

  12. The Relationships among Group Size, Participation, and Performance of Programming Language Learning Supported with Online Forums

    Science.gov (United States)

    Shaw, Ruey-Shiang

    2013-01-01

    This study examined the relationships among group size, participation, and learning performance factors when learning a programming language in a computer-supported collaborative learning (CSCL) context. An online forum was used as the CSCL environment for learning the Microsoft ASP.NET programming language. The collaborative-learning experiment…

  13. Workshop on programming languages for high performance computing (HPCWPL): final report.

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Richard C.

    2007-05-01

    This report summarizes the deliberations and conclusions of the Workshop on Programming Languages for High Performance Computing (HPCWPL) held at the Sandia CSRI facility in Albuquerque, NM on December 12-13, 2006.

  14. An assessment of BWR (boiling water reactor) Mark-II containment challenges, failure modes, and potential improvements in performance

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, D.L.; Jones, K.R.; Dallman, R.J. (EG and G Idaho, Inc., Idaho Falls, ID (USA)); Wagner, K.C. (Science Applications International Corp., Albuquerque, NM (USA))

    1990-07-01

    This report assesses challenges to BWR Mark II containment integrity that could potentially arise from severe accidents. Also assessed are some potential improvements that could prevent core damage or containment failure, or could mitigate the consequences of such failure by reducing the release of fission products to the environment. These challenges and improvements are analyzed via a limited quantitative risk/benefit analysis of a generic BWR/4 reactor with Mark II containment. Point estimate frequencies of the dominant core damage sequences are obtained and simple containment event trees are constructed to evaluate the response of the containment to these severe accident sequences. The resulting containment release modes are then binned into source term release categories, which provide inputs to the consequence analysis. The output of the consequences analysis is used to construct an overall base case risk profile. Potential improvements and sensitivities are evaluated by modifying the event tree spilt fractions, thus generating a revised risk profile. Several important sensitivity cases are examined to evaluate the impact of phenomenological uncertainties on the final results. 75 refs., 25 figs., 65 tabs.

  15. Empirical study of self-configuring genetic programming algorithm performance and behaviour

    Science.gov (United States)

    Semenkin, E.; Semenkina, M.

    2015-01-01

    The behaviour of the self-configuring genetic programming algorithm with a modified uniform crossover operator that implements a selective pressure on the recombination stage, is studied over symbolic programming problems. The operator's probabilistic rates interplay is studied and the role of operator variants on algorithm performance is investigated. Algorithm modifications based on the results of investigations are suggested. The performance improvement of the algorithm is demonstrated by the comparative analysis of suggested algorithms on the benchmark and real world problems.

  16. CRITICAL SUCCESS FACTORS THAT INFLUENCING SAFETY PROGRAM PERFORMANCE IN MALAYSIAN CONSTRUCTION PROJECTS: CASE STUDIES

    OpenAIRE

    ABDELNASER OMRAN; ABDELWAHAB OMRAN; ABDUL HAMID PAKIR KADIR

    2010-01-01

    The construction industry is characterized as one with a poor safety culture globally. To achieve better site safety performance, emphasis has been placed on implementing effective safety programs. The main aim of this paper is to identify the Critical Success Factors that influencing safety program performance in Malaysian construction projects. In order to accomplish the aim of this study, the following objective was taken into consideration which is to study the factors contributing to the...

  17. Development and implementation of an in-house healthcare program for university-level performing artists.

    Science.gov (United States)

    Ambegaonkar, Jatin P; Caswell, Shane V

    2011-01-01

    Performing Arts Medicine (PAM) specializes in providing healthcare to performing artists. Participation in the performing arts can cause injury and impair performing artists' art and livelihood. While healthcare is often available for professionals, university-level students remain underserved. Therefore, our objective was to describe the successful development and implementation of the George Mason University university-level PAM program as a possible template for other institutions. Collaborations among the Athletic Training Education Program, the Department of Dance, and the University Central Administration. An athletic trainer provided free healthcare services that included preventive care, acute emergency and non-emergency injury care, assessment and referral, and rehabilitation to the students. Nearly 100 different injuries and 300 assessment and treatment healthcare sessions were provided in the first year of the program. Program benefits included improved healthcare for dancers, increased learning opportunities for students, research opportunities, and enhanced university recognition. The PAM program offers primary injury prevention by implementing performing artists specific interventions and secondary prevention to improve their health outcomes. Overall, we hope the program's success encourages other institutions to provide in-house healthcare to their students, eventually helping improve healthcare status of all university-level performing artists.

  18. Evaluation of a self-management patient education program for patients with chronic heart failure undergoing inpatient cardiac rehabilitation: study protocol of a cluster randomized controlled trial.

    Science.gov (United States)

    Meng, Karin; Musekamp, Gunda; Seekatz, Bettina; Glatz, Johannes; Karger, Gabriele; Kiwus, Ulrich; Knoglinger, Ernst; Schubmann, Rainer; Westphal, Ronja; Faller, Hermann

    2013-08-23

    Chronic heart failure requires a complex treatment regimen on a life-long basis. Therefore, self-care/self-management is an essential part of successful treatment and comprehensive patient education is warranted. However, specific information on program features and educational strategies enhancing treatment success is lacking. This trial aims to evaluate a patient-oriented and theory-based self-management educational group program as compared to usual care education during inpatient cardiac rehabilitation in Germany. The study is a multicenter cluster randomized controlled trial in four cardiac rehabilitation clinics. Clusters are patient education groups that comprise HF patients recruited within 2 weeks after commencement of inpatient cardiac rehabilitation. Cluster randomization was chosen for pragmatic reasons, i.e. to ensure a sufficient number of eligible patients to build large-enough educational groups and to prevent contamination by interaction of patients from different treatment allocations during rehabilitation. Rehabilitants with chronic systolic heart failure (n = 540) will be consecutively recruited for the study at the beginning of inpatient rehabilitation. Data will be assessed at admission, at discharge and after 6 and 12 months using patient questionnaires. In the intervention condition, patients receive the new patient-oriented self-management educational program, whereas in the control condition, patients receive a short lecture-based educational program (usual care). The primary outcome is patients' self-reported self-management competence. Secondary outcomes include behavioral determinants and self-management health behavior (symptom monitoring, physical activity, medication adherence), health-related quality of life, and treatment satisfaction. Treatment effects will be evaluated separately for each follow-up time point using multilevel regression analysis, and adjusting for baseline values. This study evaluates the effectiveness of a

  19. WINDOW 4.0: Program description. A PC program for analyzing the thermal performance of fenestration products

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    WINDOW 4.0 is a publicly available IBM PC compatible computer program developed by the Windows and Daylighting Group at Lawrence Berkeley Laboratory for calculating total window thermal performance indices (e.g. U-values, solar heat gain coefficients, shading coefficients, and visible transmittances). WINDOW 4.0 provides a versatile heat transfer analysis method consistent with the rating procedure developed by the National Fenestration Rating Council (NFRC). The program can be used to design and develop new products, to rate and compare performance characteristics of all types of window products, to assist educators in teaching heat transfer through windows, and to help public officials in developing building energy codes. WINDOW 4.0 is a major revision to WINDOW 3.1 and we strongly urge all users to read this manual before using the program. Users who need professional assistance with the WINDOW 4.0 program or other window performance simulation issues are encouraged to contact one or more of the NFRC-accredited Simulation Laboratories. A list of these accredited simulation professionals is available from the NFRC.

  20. Performance of t1 and t2 mapping cardiovascular magnetic resonance to detect active myocarditis in patients with recent-onset heart failure.

    Science.gov (United States)

    Bohnen, Sebastian; Radunski, Ulf K; Lund, Gunnar K; Kandolf, Reinhard; Stehning, Christian; Schnackenburg, Bernhard; Adam, Gerhard; Blankenberg, Stefan; Muellerleile, Kai

    2015-06-01

    This study evaluated the performance of novel quantitative T1 and T2 mapping cardiovascular magnetic resonance (CMR) techniques to identify active myocarditis in patients with recent-onset heart failure. Thirty-one consecutive patients with recent-onset heart failure, reduced left ventricular function and clinically suspected myocarditis underwent endomyocardial biopsy and CMR at 1.5 Tesla. The CMR protocol included standard Lake-Louise parameters as well as T1 mapping using a modified Look-Locker inversion recovery sequence and T2 mapping using a hybrid gradient and spin-echo sequence. Short-axis maps were generated using an OsiriX plug-in to calculate global myocardial T1, T2, and extracellular volume fraction. Active myocarditis was defined by ongoing inflammation on endomyocardial biopsy. Endomyocardial biopsy revealed active myocarditis in 16 (52%) of 31 patients. Neither clinical characteristics, standard Lake-Louise CMR parameters, global myocardial T1 nor extracellular volume fraction differed significantly between patients with and without active myocarditis. However, median global myocardial T2 was significantly higher in patients with active myocarditis (65 ms [Q1-Q3, 61-70 ms]) than in patients without active myocarditis (59 ms [Q1-Q3, 55-64 ms]; Psuperior when compared with standard CMR parameters, global myocardial T1, and extracellular volume fraction values for assessing the activity of myocarditis in patients with recent-onset heart failure and reduced left ventricular function. © 2015 American Heart Association, Inc.

  1. A High Performance Backend for Array-Oriented Programming on Next-Generation Processing Units

    DEFF Research Database (Denmark)

    Lund, Simon Andreas Frimann

    of benchmarks applications, implemented in these languages, demonstrate the high-level declarative form of the programming model. Performance studies show that the high-level declarative programming model can be used to not only match but also exceed the performance of hand-coded implementations in low......The financial crisis, which started in 2008, spawned the HIPERFIT research center as a preventive measure against future financial crises. The goal of prevention is to be met by improving mathematical models for finance, the verifiable description of them in domain-specific languages...... and the efficient execution of them on high performance systems. This work investigates the requirements for, and the implementation of, a high performance backend supporting these goals. This involves an outline of the hardware available today, in the near future and how to program it for high performance...

  2. Damage mechanics - failure modes

    Energy Technology Data Exchange (ETDEWEB)

    Krajcinovic, D.; Vujosevic, M. [Arizona State Univ., Tempe, AZ (United States)

    1996-12-31

    The present study summarizes the results of the DOE sponsored research program focused on the brittle failure of solids with disordered microstructure. The failure is related to the stochastic processes on the microstructural scale; namely, the nucleation and growth of microcracks. The intrinsic failure modes, such as the percolation, localization and creep rupture, are studied by emphasizing the effect of the micro-structural disorder. A rich spectrum of physical phenomena and new concepts that emerges from this research demonstrates the reasons behind the limitations of traditional, deterministic, and local continuum models.

  3. 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

    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...... quality improvement, product development, automation, etc. Operational performance includes a range of indicators related to cost, quality, time and flexibility. Data were acquired through the International Manufacturing Strategy Survey executed in 2005 in engineering and assembly industries (ISIC 28......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...

  4. When the chips are down: effects of attributional feedback on self-efficacy and task performance following initial and repeated failure.

    Science.gov (United States)

    Coffee, Pete; Rees, Tim

    2011-02-01

    In two experiments, we manipulated the controllability and stability of causes of failure and explored the impact of these factors on self-efficacy and performance. In Experiment 1, participants (N=80; mean age 20.0 years, s=1.0) were provided with false negative feedback following performance on a blindfolded dart-throwing task. Consistent with theory and recent research, an induced belief that failure was beyond control and unlikely to change led to lower self-efficacy and poorer performance (all F1,754>5.49, all Pperformance (all F1,75>4.53, all P0.004). All effects were mediated by self-efficacy: Sobel's (1982) test, all z>1.97 (in absolute magnitude), all P0.22 (in absolute magnitude). These findings suggest that in novel circumstances individuals believe in the best for themselves unless possibilities to self-enhance are explicitly precluded, and only reinvest efforts when opportunities for self-enhancement become clearly admissible.

  5. Impaired aerobic capacity and physical functional performance in older heart failure patients with preserved ejection fraction: role of lean body mass.

    Science.gov (United States)

    Haykowsky, Mark J; Brubaker, Peter H; Morgan, Timothy M; Kritchevsky, Stephen; Eggebeen, Joel; Kitzman, Dalane W

    2013-08-01

    Exercise intolerance is the primary chronic symptom in patients with heart failure and preserved ejection fraction (HFPEF), the most common form of heart failure in older persons, and can result from abnormalities in cardiac, vascular, and skeletal muscle, which can be further worsened by physical deconditioning. However, it is unknown whether skeletal muscle abnormalities contribute to exercise intolerance in HFPEF patients. This study evaluated lean body mass, peak exercise oxygen consumption (VO2), and the short physical performance battery in 60 older (69 ± 7 years) HFPEF patients and 40 age-matched healthy controls. In HFPEF versus healthy controls, peak percent total lean mass (60.1 ± 0.8% vs. 66.6 ± 1.0%, p physical performance battery was reduced (9.9 ± 1.4 vs. 11.3 ± 0.8) and correlated with peak VO2 and total and leg lean mass (all p physical functional performance compared with healthy controls. The markedly decreased peak VO2 indexed to lean body mass in HFPEF versus healthy controls suggests that abnormalities in skeletal muscle perfusion and/or metabolism contribute to the severe exercise intolerance in older HFPEF patients.

  6. Acquisition Program Teamwork and Performance Seen Anew: Exposing the Interplay of Architecture and Behaviors in Complex Defense Programs

    Science.gov (United States)

    2016-04-30

    qÜáêíÉÉåíÜ=^ååì~ä= ^Åèìáëáíáçå=oÉëÉ~êÅÜ= póãéçëáìã= qÜìêëÇ~ó=pÉëëáçåë= sçäìãÉ=ff= = Acquisition Program Teamwork and Performance Seen Anew: Exposing the...Polinpapilinho Katina, Postdoctoral Researcher, Old Dominion University Charles Keating, Professor, Old Dominion University Acquisition Program Teamwork ...Institute of Technology ^Åèìáëáíáçå=oÉëÉ~êÅÜ=mêçÖê~ãW= `êÉ~íáåÖ=póåÉêÖó=Ñçê=fåÑçêãÉÇ=`Ü~åÖÉ= - 215 - Acquisition Program Teamwork and

  7. Risk and Reward: Perspectives on the Implementation of Kentucky's School-Based Performance Award Program.

    Science.gov (United States)

    Kelley, Carolyn; Protsik, Jean

    1997-01-01

    Provides a qualitative analysis of the Kentucky school-based performance award program at four elementary and two secondary schools. Teachers were motivated to modify teaching approaches to enhance student performance, but seemed to be experiencing high stress levels. Teachers and principals at the six award-winning schools reported attitudes and…

  8. Contraceptive failure

    DEFF Research Database (Denmark)

    Rasch, Vibeke

    2002-01-01

    Most studies focusing on contraceptive failure in relation to pregnancy have focused on contraceptive failure among women having induced abortions, thereby neglecting those women who, despite contraceptive failure, accept the pregnancy and intend to carry the fetus to term. To get a more complete...... picture of the problem of contraceptive failure, this study focuses on contraceptive failure among women with diverse pregnancy outcomes. In all, 3520 pregnant women attending Odense University Hospital were included: 373 had induced abortions, 435 had spontaneous abortions, 97 had ectopic pregnancies......, and 2614 received antenatal care. The variables studied comprise age, partner relationship, number of births, occupational and economical situation, and contraceptive use.Contraceptive failure, defined as contraceptive use (condom, diaphragm, IUD, oral contraception, or another modern method...

  9. Applicability of NASA contract quality management and failure mode effect analysis procedures to the USGS Outer Continental Shelf oil and gas lease management program

    Science.gov (United States)

    Dyer, M. K.; Little, D. G.; Hoard, E. G.; Taylor, A. C.; Campbell, R.

    1972-01-01

    An approach that might be used for determining the applicability of NASA management techniques to benefit almost any type of down-to-earth enterprise is presented. A study was made to determine the following: (1) the practicality of adopting NASA contractual quality management techniques to the U.S. Geological Survey Outer Continental Shelf lease management function; (2) the applicability of failure mode effects analysis to the drilling, production, and delivery systems in use offshore; (3) the impact on industrial offshore operations and onshore management operations required to apply recommended NASA techniques; and (4) the probable changes required in laws or regulations in order to implement recommendations. Several management activities that have been applied to space programs are identified, and their institution for improved management of offshore and onshore oil and gas operations is recommended.

  10. How do you feel, developer? An explanatory theory of the impact of affects on programming performance

    Directory of Open Access Journals (Sweden)

    Daniel Graziotin

    2015-08-01

    Full Text Available Affects—emotions and moods—have an impact on cognitive activities and the working performance of individuals. Development tasks are undertaken through cognitive processes, yet software engineering research lacks theory on affects and their impact on software development activities. In this paper, we report on an interpretive study aimed at broadening our understanding of the psychology of programming in terms of the experience of affects while programming, and the impact of affects on programming performance. We conducted a qualitative interpretive study based on: face-to-face open-ended interviews, in-field observations, and e-mail exchanges. This enabled us to construct a novel explanatory theory of the impact of affects on development performance. The theory is explicated using an established taxonomy framework. The proposed theory builds upon the concepts of events, affects, attractors, focus, goals, and performance. Theoretical and practical implications are given.

  11. A library of failure regions

    OpenAIRE

    Shimeall, Timothy J.

    1991-01-01

    A failure region is the set of all possible program inputs that will execute a specific fault and produce a result that varies from the specified or expected program result. The purpose of this report is to document a set of failure regions corresponding to the known faults in a set of redundant program versions. Each failure region is characterized in two ways: by identifying the fault that it reveals and by identifying the boolean conditions necessary and sufficient to consider a program in...

  12. Aquatic Exercise Is Effective in Improving Exercise Performance in Patients with Heart Failure and Type 2 Diabetes Mellitus

    Science.gov (United States)

    Åsa, Cider; Maria, Schaufelberger; Katharina, Stibrant Sunnerhagen; Bert, Andersson

    2012-01-01

    Background. Peak oxygen uptake (VO2peak) and muscle function are more decreased in patients with a combination of chronic heart failure (CHF) and type 2 diabetes mellitus (2DM) compared to patients with only one of the conditions. Further, patients with 2DM have peripheral complications that hamper many types of conventional exercises. Aim. To evaluate the efficacy and applicability of eight-week aquatic exercise in patients with the combination of CHF and 2DM. Methods. Twenty patients (four women) with both CHF and 2DM (age 67.4 ± 7.1, NYHA II-III) were randomly assigned to either aquatic exercise or a control group. The patients exercised for 45 minutes 3 times/week in 33–34°C, swimming pool. Results. The training programme was well tolerated. Work rate (+11.7 ± 6.6 versus −6.4 ± 8.1 watt, P Aquatic exercise could be used to improve exercise capacity and muscle function in patients with the combination of CHF and 2DM. PMID:22593770

  13. Computer-Related Success and Failure: A Longitudinal Field Study of the Factors Influencing Computer-Related Performance.

    Science.gov (United States)

    Rozell, E. J.; Gardner, W. L., III

    1999-01-01

    A model of the intrapersonal processes impacting computer-related performance was tested using data from 75 manufacturing employees in a computer training course. Gender, computer experience, and attributional style were predictive of computer attitudes, which were in turn related to computer efficacy, task-specific performance expectations, and…

  14. A Tandem Cycling Program: Feasibility and Physical Performance Outcomes in People With Parkinson Disease.

    Science.gov (United States)

    McGough, Ellen L; Robinson, Cynthia A; Nelson, Mark D; Houle, Raymond; Fraser, Gabriell; Handley, Leslie; Jones, Emilie R; Amtmann, Dagmar; Kelly, Valerie E

    2016-10-01

    Individuals with Parkinson disease (PD) have motor and nonmotor impairments that interfere with exercise participation. The purpose of this study was to examine the feasibility and physical performance outcomes of a community-based indoor tandem cycling program that was designed to facilitate a higher cadence, consistency, and intensity of training. Forty-one participants with mild to moderate PD were enrolled. A high-cadence cycling protocol using mechanically augmented (or forced) exercise on a tandem bicycle was adapted for our program. Participants cycled 3 times per week for 10 weeks. Feasibility measures included program retention, attendance, and adverse events, as well as the ability to reach training goals for heart rate (HR) and cadence. Physical performance outcomes included the Berg Balance Scale (BBS), Short Physical Performance Battery (SPPB), Five-Times-Sit-to-Stand (FTSTS) Test, Timed Up and Go (TUG), and gait parameters during usual and fast-paced walking. Program feasibility was demonstrated with a high attendance rate (96%) and retention rate (100%). There were no adverse events. The majority of participants reached their exercise training goals for target HR (87%) and cadence (95%). Statistically significant physical performance improvement (P physical performance outcomes were demonstrated in individuals with mild to moderate PD participating in a community-based indoor tandem cycling program.Video Abstract available for more insights from the authors (see supplemental digital content 1, http://links.lww.com/JNPT/A146).

  15. Participation is possible: A case report of integration into a community performing arts program.

    Science.gov (United States)

    Becker, Emily; Dusing, Stacey

    2010-05-01

    Typically developing children frequently participate in community recreation activities that enhance their social/emotional and physical development. The inclusion of children with developmental disabilities in these activities continues to be a challenge. This case report investigated the feasibility of including a child with Down syndrome in a community performing arts program. The participant is an 11-year-old female with Down syndrome and mild cognitive impairment. The participant was enrolled in a 14-week performing arts session that included a combination of acting, voice, and dance instruction. She participated in the program with the support of a one-on-one assistant who was a physical therapy student. The assistant facilitated learning the choreography, appropriate socialization, and positioning on the stage. Peer helpers were used to allow for greater independence toward the end of the session and for the final performance. The participant completed the final performance without the one-on-one assistant. The participant's mother completed the PedsQL before and after the performance, and the participant's scaled scores increased in all subsets except for emotional function and the total scales score increased from 51 to 57. With appropriate modifications and the right child/program fit, children with developmental disabilities such as Down syndrome can successfully be included in community programs. Physical therapists can assist families and community programs to make developmentally appropriate modifications to enhance participation.

  16. Task failure during exercise to exhaustion in normoxia and hypoxia is due to reduced muscle activation caused by central mechanisms while muscle metaboreflex does not limit performance

    Directory of Open Access Journals (Sweden)

    Rafael eTorres-Peralta

    2016-01-01

    Full Text Available To determine whether task failure during incremental exercise to exhaustion (IE is principally due to reduced neural drive and increased metaboreflex activation eleven men (22±2 years performed a 10s control isokinetic sprint (IS; 80 rpm after a short warm-up. This was immediately followed by an IE in normoxia (Nx, PIO2:143 mmHg and hypoxia (Hyp, PIO2:73 mmHg in random order, separated by a 120 min resting period. At exhaustion, the circulation of both legs was occluded instantaneously (300 mmHg during 10 or 60s to impede recovery and increase metaboreflex activation. This was immediately followed by an IS with open circulation. Electromyographic recordings were obtained from the vastus medialis and lateralis. Muscle biopsies and blood gases were obtained in separate experiments. During the last 10s of the IE, pulmonary ventilation, VO2, power output and muscle activation were lower in hypoxia than in normoxia, while pedaling rate was similar. Compared to the control sprint, performance (IS-Wpeak was reduced to a greater extent after the IE-Nx (11% lower P<0.05 than IE-Hyp. The root mean square (EMGRMS was reduced by 38 and 27% during IS performed after IE-Nx and IE-Hyp, respectively (Nx vs. Hyp: P<0.05. Post-ischemia IS-EMGRMS values were higher than during the last 10s of IE. Sprint exercise mean (IS-MPF and median (IS-MdPF power frequencies, and burst duration, were more reduced after IE-Nx than IE-Hyp (P<0.05. Despite increased muscle lactate accumulation, acidification, and metaboreflex activation from 10 to 60s of ischemia, IS-Wmean (+23% and burst duration (+10% increased, while IS-EMGRMS decreased (-24%, P<0.05, with IS-MPF and IS-MdPF remaining unchanged. In conclusion, close to task failure, muscle activation is lower in hypoxia than in normoxia. Task failure is predominantly caused by central mechanisms, which recover to great extent within one minute even when the legs remain ischemic. There is dissociation between the recovery of

  17. Department of Energy Mathematical, Information, and Computational Sciences Division: High Performance Computing and Communications Program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    This document is intended to serve two purposes. Its first purpose is that of a program status report of the considerable progress that the Department of Energy (DOE) has made since 1993, the time of the last such report (DOE/ER-0536, The DOE Program in HPCC), toward achieving the goals of the High Performance Computing and Communications (HPCC) Program. The second purpose is that of a summary report of the many research programs administered by the Mathematical, Information, and Computational Sciences (MICS) Division of the Office of Energy Research under the auspices of the HPCC Program and to provide, wherever relevant, easy access to pertinent information about MICS-Division activities via universal resource locators (URLs) on the World Wide Web (WWW).

  18. Department of Energy: MICS (Mathematical Information, and Computational Sciences Division). High performance computing and communications program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-06-01

    This document is intended to serve two purposes. Its first purpose is that of a program status report of the considerable progress that the Department of Energy (DOE) has made since 1993, the time of the last such report (DOE/ER-0536, {open_quotes}The DOE Program in HPCC{close_quotes}), toward achieving the goals of the High Performance Computing and Communications (HPCC) Program. The second purpose is that of a summary report of the many research programs administered by the Mathematical, Information, and Computational Sciences (MICS) Division of the Office of Energy Research under the auspices of the HPCC Program and to provide, wherever relevant, easy access to pertinent information about MICS-Division activities via universal resource locators (URLs) on the World Wide Web (WWW). The information pointed to by the URL is updated frequently, and the interested reader is urged to access the WWW for the latest information.

  19. Analysis of the effect of risk management practices on the performance of new product development programs

    DEFF Research Database (Denmark)

    Oehmen, Josef; Olechowski, Alison; Kenley, C. Robert

    2014-01-01

    performance: (A) Quality Decision Making; (B) High Program Stability; (C) Open, problem solving organization; (D) Overall new product development project success; and (E) overall product success. The results show that six categories of risk management practices are most effective: (1) Develop risk management...... that the risk management practices indirectly associate with the remaining two categories of outcome measures (project and product success). Additional research is needed to describe the exact mechanisms through which risk management practices influence NPD program success. © 2014 Elsevier Ltd. All rights...... by various standards with new product development programs and their association with various dimensions of risk management success. Based on a survey of 291 product development programs, this paper investigates the association of risk management practices with five categories of product development program...

  20. Effects of human atrial natriuretic peptide on myocardial performance and energetics in heart failure due to previous myocardial infarction.

    Science.gov (United States)

    Ozawa, Toru; Shinke, Toshiro; Shite, Junya; Takaoka, Hideyuki; Inoue, Nobutaka; Matsumoto, Hidenari; Watanabe, Satoshi; Yoshikawa, Ryohei; Otake, Hiromasa; Matsumoto, Daisuke; Ogasawara, Daisuke; Yokoyama, Mitsuhiro; Hirata, Ken-ichi

    2015-09-01

    Human atrial natriuretic peptide (hANP) and spontaneous nitric oxide (NO) donor share cyclic guanosine monophosphate (cGMP) as a second messenger, but their effect on myocardium may differ. We compared the effect of hANP and sodium nitroprusside (SNP) on left ventricular (LV) mechano-energetics in heart failure (HF). Ten patients with HF due to previous myocardial infarction (LV ejection fraction: 45±3%) were instrumented with conductance and coronary sinus thermodilution catheters. LV contractility (Ees: slope of end-systolic pressure-volume relation) and the ratio of LV stroke work (SW) to myocardial oxygen consumption (SW/MVO2=mechanical efficiency) were measured in response to intravenous infusion of ANP (0.05 μg/kg/min) or SNP (0.3 μg/kg/min) to lower blood pressure by at least 10 mmHg, and changes in plasma cGMP. SNP had no effect on Ees, SW, or MVO2, thus SW/MVO2 remained unchanged (40.54±5.84% to 36.59±5.72%, p=0.25). ANP increased Ees, and decreased MVO2 with preserved SW, resulting in improved SW/MVO2 (40.49±6.35% to 50.30±7.96%, p=0.0073). Infusion of ANP (10.42-34.95 pmol/ml, p=0.0003) increased cGMP levels, whereas infusion of SNP had no effect (10.42-12.23 pmol/ml, p=0.75). Compared to SNP, the ANP-dependent increase in cGMP may ameliorate myocardial inotropy and energetics in HF. Copyright © 2015. Published by Elsevier Ltd.

  1. The Role of Mentoring Program in Enhancing Mentees’ Academic Performance

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2014-02-01

    Full Text Available According to institutions of higher learning literature, mentoring program has two important features: communication and support. The ability of mentors to appropriately implement comfortable communication and provide adequate support may ehance positive mentee outcomes, especially academic performance. Although the nature of this relationship is crucial, little is known about the role of mentoring program as an important predictor of mentees’ academic performance in the higher education mentoring research literature. Therefore, this study was conducted to measure the relationship between mentoring program and mentees’ academic performance using self-administered questionnaires gathered from undergraduate students in Malaysian institutions of higher learning in Sarawak. The results of SmartPLS path model showed two important outcomes: firstly, communication positively and significantly correlated with academic performance. Secondly, support positively and significantly correlated with academic performance. The result demonstrates that mentoring program does act as an important predictor of mentees’ academic performance in the organizational sample. Thus, discussion, implications and conclusion are elaborated.

  2. Provider performance measures in private and public programs: achieving meaningful alignment with flexibility to innovate.

    Science.gov (United States)

    Higgins, Aparna; Veselovskiy, German; McKown, Lauren

    2013-08-01

    In recent years there has been a significant expansion in the use of provider performance measures for quality improvement, payment, and public reporting. Using data from a survey of health plans, we characterize the use of such performance measures by private payers. We also compare the use of these measures among selected private and public programs. We studied twenty-three health plans with 121 million commercial enrollees--66 percent of the national commercial enrollment. The health plans reported using 546 distinct performance measures. There was much variation in the use of performance measures in both private and public payment and care delivery programs, despite common areas of focus that included cardiovascular conditions, diabetes, and preventive services. We conclude that policy makers and stakeholders who seek less variability in the use of performance measures to increase consistency should balance this goal with the need for flexibility to meet the needs of specific populations and promote innovation.

  3. 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.

  4. Low Cost High Performance Generator Technology Program. Volume 5. Heat pipe topical, appendices

    Energy Technology Data Exchange (ETDEWEB)

    1975-07-01

    Work performed by Dynatherm Corporation for Teledyne Isotopes during a program entitled ''Heat Pipe Fabrication, Associated Technical Support and Reporting'' is reported. The program was initiated on November 29, 1972; the main objectives were accomplished with the delivery of the heat pipes for the HPG. Life testing of selected heat pipe specimens is continuing to and beyond the present date. The program consisted of the following tasks: Heat Pipe Development of Process Definition; Prototype Heat Pipes for Fin Segment Test; HPG Heat Pipe Fabrication and Testing; Controlled Heat Pipe Life Test; and Heat Pipe Film Coefficient Determination. (TFD)

  5. On the Performance of the Python Programming Language for Serial and Parallel Scientific Computations

    Directory of Open Access Journals (Sweden)

    Xing Cai

    2005-01-01

    Full Text Available This article addresses the performance of scientific applications that use the Python programming language. First, we investigate several techniques for improving the computational efficiency of serial Python codes. Then, we discuss the basic programming techniques in Python for parallelizing serial scientific applications. It is shown that an efficient implementation of the array-related operations is essential for achieving good parallel performance, as for the serial case. Once the array-related operations are efficiently implemented, probably using a mixed-language implementation, good serial and parallel performance become achievable. This is confirmed by a set of numerical experiments. Python is also shown to be well suited for writing high-level parallel programs.

  6. A Multidiscipline Study of Education Program Accreditation Type and Certification Exam Performance.

    Science.gov (United States)

    Babcock, Ben

    2016-11-01

    To examine the relationship between radiologic technologists' performance on 3 medical certification exams and the type of accredited education program they attended. Data came from 3 certification exam programs administered by the American Registry of Radiologic Technologists (ARRT). The author used simple means and mixed-effect models to analyze 13 years of data. The difference in performance between programs with and without programmatic accreditation, as modeled with linear mixed-effect models, amounted to approximately 2 exam questions out of 200 for radiography, no difference for nuclear medicine technology, and approximately 4 questions out of 200 for radiation therapy. Exam performance differences among the accreditation types were not large, if they indeed existed, for ARRT certification exam data. © 2016 American Society of Radiologic Technologists.

  7. Impact of Frequent Interruption on Nurses' Patient-Controlled Analgesia Programming Performance.

    Science.gov (United States)

    Campoe, Kristi R; Giuliano, Karen K

    2017-12-01

    The purpose was to add to the body of knowledge regarding the impact of interruption on acute care nurses' cognitive workload, total task completion times, nurse frustration, and medication administration error while programming a patient-controlled analgesia (PCA) pump. Data support that the severity of medication administration error increases with the number of interruptions, which is especially critical during the administration of high-risk medications. Bar code technology, interruption-free zones, and medication safety vests have been shown to decrease administration-related errors. However, there are few published data regarding the impact of number of interruptions on nurses' clinical performance during PCA programming. Nine acute care nurses completed three PCA pump programming tasks in a simulation laboratory. Programming tasks were completed under three conditions where the number of interruptions varied between two, four, and six. Outcome measures included cognitive workload (six NASA Task Load Index [NASA-TLX] subscales), total task completion time (seconds), nurse frustration (NASA-TLX Subscale 6), and PCA medication administration error (incorrect final programming). Increases in the number of interruptions were associated with significant increases in total task completion time ( p = .003). We also found increases in nurses' cognitive workload, nurse frustration, and PCA pump programming errors, but these increases were not statistically significant. Complex technology use permeates the acute care nursing practice environment. These results add new knowledge on nurses' clinical performance during PCA pump programming and high-risk medication administration.

  8. Effects of a new experimental training program on V.O2max and running performance.

    Science.gov (United States)

    Sporis, G; Ruzic, L; Leko, G

    2008-06-01

    By testing the V.O(2max) and running performance in soccer players, the purpose of the study was to determine whether an experimental conditioning program would elicit better effects than the widely used traditional program, especially across longer distances. Laboratory measurements of maximal oxygen consumption and maximal heart rate were performed on 48 soccer players (U19) from two first league soccer teams (Experimental team, n=24; Control team n=24). Exercise intensities were calculated from heart rate maximum. Detailed training programs for both the experimental and control groups were designed for the 13-week period. The main intervention was performed in the conditioning phase where the control group performed traditional conditioning (straight-line running, with stretching exercises in the break) and the experimental group underwent a conditioning training program on designed polygon, very much akin to a real game situation; sprint-runs with or without the ball and rapid changes in direction. During the 20, 40 or 60m sprint-run the players had to perform specific ball drills depending on marked polygon station. Running performance at 60, 100, 200, 400, 800, 1200, 2 400 m distances and V.O(2max) were tested in the initial, transitory (week 6) and final trials. Significant improvement in 200, 400, 800, 1200, 2 400 m running performance and V.O(2max) (Ptrial. However, in this group the gained improvements quickly disappeared after the beginning of the competitive season as recorded at the final trial. Discriminant analysis revealed that the groups differed the most in the 200 m variable. The new experimental program is better suited for the enhancement of V.O(2max) and running performance in soccer players and the gained improvement lasted well into the competition season.

  9. Development of an Enhanced Payback Function for the Superior Energy Performance Program

    Energy Technology Data Exchange (ETDEWEB)

    Therkelsen, Peter; Rao, Prakash; McKane, Aimee; Sabouni, Ridah; Sheihing, Paul

    2015-08-03

    The U.S. DOE Superior Energy Performance (SEP) program provides recognition to industrial and commercial facilities that achieve certification to the ISO 50001 energy management system standard and third party verification of energy performance improvements. Over 50 industrial facilities are participating and 28 facilities have been certified in the SEP program. These facilities find value in the robust, data driven energy performance improvement result that the SEP program delivers. Previous analysis of SEP certified facility data demonstrated the cost effectiveness of SEP and identified internal staff time to be the largest cost component related to SEP implementation and certification. This paper analyzes previously reported and newly collected data of costs and benefits associated with the implementation of an ISO 50001 and SEP certification. By disaggregating “sunk energy management system (EnMS) labor costs”, this analysis results in a more accurate and detailed understanding of the costs and benefits of SEP participation. SEP is shown to significantly improve and sustain energy performance and energy cost savings, resulting in a highly attractive return on investment. To illustrate these results, a payback function has been developed and is presented. On average facilities with annual energy spend greater than $2M can expect to implement SEP with a payback of less than 1.5 years. Finally, this paper also observes and details decreasing facility costs associated with implementing ISO 50001 and certifying to the SEP program, as the program has improved from pilot, to demonstration, to full launch.

  10. External Performance Evaluation Program Participation at Fluor Hanford (FH) 222S Lab

    Energy Technology Data Exchange (ETDEWEB)

    CLARK, G.A.

    2002-06-01

    Fluor Hanford operates the U. S. Department of Energy's (DOE) 2224 Laboratory on the Hanford Site in Southeastern Washington State. 222-S Laboratory recently celebrated its 50th anniversary of providing laboratory services to DOE and DOE contractors on the Hanford Site. The laboratory operated for many years as a production support analytical laboratory, but in the last two decades has supported the Hanford Site cleanup mission. The laboratory performs radioanalytical, inorganic, and organic characterization analyses on highly radioactive liquid and solid tank waste that will eventually be vitrified for long-term storage and or disposal. It is essential that the laboratory report defensible, highly credible data in its role as a service provider to DOE and DOE contractors. Among other things, the participation in a number of performance evaluation (PE) programs helps to ensure the credibility of the laboratory. The laboratory currently participates in Environmental Resource Associates' Water Pollution (WP) Studies and the DOE Environmental Management Laboratory (EML) Quality Assessment Program (QAP). DOE has mandated participation of the laboratory in the EML QAP. This EML program evaluates the competence of laboratories performing environmental radioanalytical measurements for DOE, and is the most comprehensive and well-established PE program in the DOE community for radiochemical laboratories. Samples are received and analyzed for radionuclides in air filter, soil, vegetation, and water matrices on a semiannual basis. The 222-S Laboratory has performed well in this program over the years as evidenced by the scores in the chart below.

  11. A probability metric for identifying high-performing facilities: an application for pay-for-performance programs.

    Science.gov (United States)

    Shwartz, Michael; Peköz, Erol A; Burgess, James F; Christiansen, Cindy L; Rosen, Amy K; Berlowitz, Dan

    2014-12-01

    Two approaches are commonly used for identifying high-performing facilities on a performance measure: one, that the facility is in a top quantile (eg, quintile or quartile); and two, that a confidence interval is below (or above) the average of the measure for all facilities. This type of yes/no designation often does not do well in distinguishing high-performing from average-performing facilities. To illustrate an alternative continuous-valued metric for profiling facilities--the probability a facility is in a top quantile--and show the implications of using this metric for profiling and pay-for-performance. We created a composite measure of quality from fiscal year 2007 data based on 28 quality indicators from 112 Veterans Health Administration nursing homes. A Bayesian hierarchical multivariate normal-binomial model was used to estimate shrunken rates of the 28 quality indicators, which were combined into a composite measure using opportunity-based weights. Rates were estimated using Markov Chain Monte Carlo methods as implemented in WinBUGS. The probability metric was calculated from the simulation replications. Our probability metric allowed better discrimination of high performers than the point or interval estimate of the composite score. In a pay-for-performance program, a smaller top quantile (eg, a quintile) resulted in more resources being allocated to the highest performers, whereas a larger top quantile (eg, being above the median) distinguished less among high performers and allocated more resources to average performers. The probability metric has potential but needs to be evaluated by stakeholders in different types of delivery systems.

  12. Fuel performance improvement program. Quarterly/annual progress report, October 1977--September 1978. [BWR; PWR

    Energy Technology Data Exchange (ETDEWEB)

    Crouthamel, C.E. (comp.)

    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 (BRPR).

  13. Effects of a multidisciplinary care program on disability, autonomy, and nursing needs in subjects recovering from acute respiratory failure in a chronic ventilator facility.

    Science.gov (United States)

    Vitacca, Michele; Paneroni, Mara; Peroni, Roberta; Barbano, Luca; Dodaj, Valmira; Piaggi, Giancarlo; Vanoglio, Fabio; Luisa, Alberto; Giordano, Amerigo; Ceriana, Piero

    2014-12-01

    The aim of this study was to analyze the effects of a multidisciplinary program carried out in a chronic ventilator facility on disability, autonomy, and nursing needs of patients after a prolonged ICU stay. Secondary outcome measures were survival, weaning rate, chronic ventilator facility stay, and discharge destination. Multidisciplinary assessment, clinical stabilization, weaning attempts, and a new Disabled Patients Autonomy Planning tool to assess daily care needs were investigated in 240 subjects in a chronic ventilator facility (52 subjects after cardiovascular surgery, 60 subjects with acute respiratory failure, 71 subjects with COPD, and 57 subjects with neurological disease). At admission, nursing needs, disability, and autonomy differed according to diagnosis (P nursing needs (P nursing needs increased as disability increased (r = 0.59, P nursing needs significantly improved (all, P nursing homes presented mainly neurological diseases, being more disabled and less autonomous, with higher nursing needs (all, P nursing home (odds ratio [OR] of 1.84, P = .04; OR 2.47, P = .003, respectively). Mortality was higher in subjects who were ventilated (OR 8.44, P nursing needs (P = .002), and more severe disabilities (P = .04). A specialized tailored multidisciplinary program in subjects after an ICU stay contributed to recovery from disability, autonomy, and fewer nursing needs irrespective of diagnosis. Subjects discharged to a nursing home were the most severely disabled. Copyright © 2014 by Daedalus Enterprises.

  14. P3T+: A Performance Estimator for Distributed and Parallel Programs

    Directory of Open Access Journals (Sweden)

    T. Fahringer

    2000-01-01

    Full Text Available Developing distributed and parallel programs on today's multiprocessor architectures is still a challenging task. Particular distressing is the lack of effective performance tools that support the programmer in evaluating changes in code, problem and machine sizes, and target architectures. In this paper we introduce P3T+ which is a performance estimator for mostly regular HPF (High Performance Fortran programs but partially covers also message passing programs (MPI. P3T+ is unique by modeling programs, compiler code transformations, and parallel and distributed architectures. It computes at compile-time a variety of performance parameters including work distribution, number of transfers, amount of data transferred, transfer times, computation times, and number of cache misses. Several novel technologies are employed to compute these parameters: loop iteration spaces, array access patterns, and data distributions are modeled by employing highly effective symbolic analysis. Communication is estimated by simulating the behavior of a communication library used by the underlying compiler. Computation times are predicted through pre-measured kernels on every target architecture of interest. We carefully model most critical architecture specific factors such as cache lines sizes, number of cache lines available, startup times, message transfer time per byte, etc. P3T+ has been implemented and is closely integrated with the Vienna High Performance Compiler (VFC to support programmers develop parallel and distributed applications. Experimental results for realistic kernel codes taken from real-world applications are presented to demonstrate both accuracy and usefulness of P3T+.

  15. Evaluation of staff performance and interpretation of the screening program for prevention of thalassemia.

    Science.gov (United States)

    Prommetta, Simaporn; Sanchaisuriya, Kanokwan; Fucharoen, Goonnapa; Yamsri, Supawadee; Chaiboonroeng, Attawut; Fucharoen, Supan

    2017-06-15

    Thalassemia screening program has been implemented for years in Southeast Asia, but no external quality assessment program has been established. We have developed and initiated the proficiency testing (PT) program for the first time in Thailand with the aim to assess the screening performance of laboratory staff and their competency in interpretation of the screening results. Three PT cycles per year were organized. From the first to the third cycle of the PT scheme, a total number of participant laboratories increased from 59 to 67. In each cycle, 2 PT items (assigned as blood samples of the couple) were provided. Performance evaluation was based on the accuracy of screening results, i.e. mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and the dichlorophenolindophenol (DCIP) test for haemoglobin E, including the competency in interpretation of screening results and assessment of foetal risk. Performance was assessed by comparing the participants' result against the assigned value. Of all 3 cycles, most laboratories reported acceptable MCV and MCH values. From the first to the third cycle, incorrect DCIP test and misinterpretation rates were decreased while incorrect risk assessment varied by cycle to cycle. Combining the accuracy of thalassemia screening and the competency in interpretation and risk assessment, approximately half of participants showed excellent performance. Improved performance observed in many laboratories reflects the achievement and benefit of the PT program which should be regularly provided.

  16. Supplementation of a Blend of Beneficial Bacteria and Antibodies on Growth Performance, Intestinal Mucosa Morphology and Right Heart Failure of Japanese Quail (Coturnix coturnix japonica

    Directory of Open Access Journals (Sweden)

    Mohammad Hasan Mehraei Hamzekolaei

    2017-05-01

    Full Text Available Background: Early nutrition of chicks with beneficial bacteria might help in occupying the inner surface of the intestinal tract. Interference of pathogens in intestinal microbiota is well known as barrier effect, bacterial interference, and competitive exclusion. Objectives: It was hypothesized that competitive exclusion in Japanese quails with a blend of beneficial bacteria (Aquablend Avian® probiotic would enhance quails’ growth performance and intestinal mucosal morphology. Furthermore, the study was performed at 2100 m above sea level at Shahrekord University, so another hypothesis was the capability of the probiotic for inhibiting right heart failure. Materials and Methods: One hundred fifty-six Japanese quails were divided into 4 groups: 2 groups (Aquablend and control at standard environmental temperature and 2 (Aqua-stress and Cont-stress at cold-hypoxic environmental situation. Aquablend groups received the probiotic in the first 3 days of life in drinking water (0.5 g/100 birds/day. Results: Feed conversion ratio (FCR was significantly reduced at the end of the experiment (day 35 in both Aquablend and aqua-stress groups compared to control and cont-stress groups, respectively (P 0.05. Cont-stress group had higher RV: TV ratio (0.28 and heterophil: lymphocyte (H: L ratio (1.22 than aqua-stress group: (0.25 and (1.20, respectively (P > 0.05. Data regarding to intestinal mucosa morphology was controversial but the probiotic was able to elevate duodenum villi surface (P < 0.05 and also jejunum and ileum lamina propria thickness. Conclusion: Obtained data suggests that addition of Aquablend Avian® probiotic in the first 3 days of life may improve growth performance and some intestinal mucosa characteristics of Japanese quails. Moreover, the probiotic might reduce right heart failure and stress induced by cold-hypoxic situation.

  17. Prevalence and timing of individual cochlear implant electrode failures.

    Science.gov (United States)

    Carlson, Matthew L; Archibald, David J; Dabade, Tushar S; Gifford, Rene H; Neff, Brian A; Beatty, Charles W; Barrs, David M; Driscoll, Colin L W

    2010-08-01

    To identify the prevalence of individual electrode failures as a result of open and short circuits in the Nucleus N24 and Freedom series and the Advanced Bionics CII and HR90k (Helix and 1J) devices. Retrospective chart review. Tertiary referral center. Age at implantation, date of surgery, device type, and other relevant demographic data in addition to telemetry and impedance data were collected on 636 implants. Individual electrode circuit failures were identified using impedance testing performed intraoperatively and during subsequent programming sessions. Individual electrode failures were categorized as either "short" or "open" circuits as determined by manufacturer software algorithms. Combining all devices, the risk of 1 or more failures as determined by impedance telemetry is 9.0%. Three or more individual electrode circuit failures within an array may indicate impending deterioration of device performance and future need of reimplantation. Open and short circuits are routinely encountered. They can be managed by deactivating the affected electrode(s), and conventional wisdom states that this has little impact on performance. However, it is true that multiple failures are often associated with decreased performance and often lead to revision surgery. Certainly, every patient would prefer to have a fully functional device. Continued reporting of individual electrode circuit failures is critical to product development and improving overall device reliability.

  18. A retrospective study on 1592 consecutively performed operations in one private referral clinic. Part I: Early inflammation and early implant failures.

    Science.gov (United States)

    Antoun, Hadi; Karouni, Michel; Abitbol, Jérémy; Zouiten, Ons; Jemt, Torsten

    2017-06-01

    Few large-scale follow-up studies are reported on routine implant treatment. To report retrospective data on early inflammatory and early implant failures in a large number of routine patients at one private referral clinic. A total of 1017 patients were consecutively provided with 3082 implants with an anodized surface (Nobel Biocare AB) at 1592 implant operations between 2000 and 2011. All patients reported with mucosa inflammation and bone loss and/or implant failures to the first annual examination were identified. A logistic multivariate data analysis was performed to identify possible factors with an association to the two events. Altogether 33 patients/operations presented early inflammation (2.1% operations). "History of periodontitis" (OR 3.91; 95% CI: 1.86-8.21), "numbers of implants" (OR1.33; 95% CI:1.07-1.67 per implant), "two stage surgical technique" (OR 3.70; 95% CI: 1.75-7.85), and "lower jaw" treatment (OR 4.73; 95% CI: 2.12-10.57) increased the risk for early mucositis with bone loss (P 2011; OR 1.22; 95% CI;1.08-1.39). History of periodontitis and two-stage surgery protocols with bone grafts in the (posterior) lower jaw increased the risk for early inflammatory problems after surgery (P clinical practice (P < .05). © 2017 Wiley Periodicals, Inc.

  19. A novel hypothesis comprehensively explains shock, heart failure and aerobic exhaustion through an assumed central physiological control of the momentary cardiovascular performance reserve.

    Science.gov (United States)

    Gabbay, Uri; Bobrovsky, Ben Zion

    2014-06-01

    Heart failure (HF) and shock are incomprehensively understood, inconclusively defined and lack a single conclusive test. The proceedings that preceded and triggered clinical manifestations are occult. The relationships in between different shock and HF types and between each HF type and its matched shock are poorly understood. We suggest that HF and shock are attributed to a momentary cardiovascular performance reserve - "the reserve". The reserve is controlled through an assumed central physiological mechanism that continuously detects and responds accordingly--"the reserve control". The assumed reserve is maximal at rest, and decreases with aerobic activity. When it decreases to a given threshold the reserve control alerts by induces manifestations of dyspnea and fatigue enforcing activity decrease, follow which the manifestations dissolve. HF is a condition of low reserve at baseline; hence, fatigue and dyspnea are frequently experienced following mild activity. Shock is assumed to occur when the cardiovascular reserve deteriorates below a sustainable limit where the reserve control induces a salvage-sacrifice response, preserving vital organ perfusion while impairing microcirculation effective perfusion in non-vital organ in which it causes cellular hypoxia followed by the familiar devastating cascade of events seen in shock. The hereby hypothesis may comprehensively explain the heart failure - shock puzzle as no alternative theory had ever succeeded. It provides the missing link between the different types of HF as of shock and in between. The hypothesis poses a great prove challenge but opens new research and clinical possibilities. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. A switch in the source of ATP production and a loss in capacity to perform glycolysis are hallmarks of hepatocyte failure in advance liver disease.

    Science.gov (United States)

    Nishikawa, Taichiro; Bellance, Nadège; Damm, Aaron; Bing, Han; Zhu, Zhen; Handa, Kan; Yovchev, Mladen I; Sehgal, Vasudha; Moss, Tyler J; Oertel, Michael; Ram, Prahlad T; Pipinos, Iraklis I; Soto-Gutierrez, Alejandro; Fox, Ira J; Nagrath, Deepak

    2014-06-01

    The cause of hepatic failure in the terminal stages of chronic injury is unknown. Cellular metabolic adaptations in response to the microenvironment have been implicated in cellular breakdown. To address the role of energy metabolism in this process we studied mitochondrial number, respiration, and functional reserve, as well as cellular adenosine-5'-triphosphate (ATP) production, glycolytic flux, and expression of glycolysis related genes in isolated hepatocytes from early and terminal stages of cirrhosis using a model that produces hepatic failure from irreversible cirrhosis in rats. To study the clinical relevance of energy metabolism in terminal stages of chronic liver failure, we analyzed glycolysis and energy metabolism related gene expression in liver tissue from patients at different stages of chronic liver failure according to Child-Pugh classification. Additionally, to determine whether the expression of these genes in early-stage cirrhosis (Child-Pugh Class A) is related to patient outcome, we performed network analysis of publicly available microarray data obtained from biopsies of 216 patients with hepatitis C-related Child-Pugh A cirrhosis who were prospectively followed up for a median of 10years. In the early phase of cirrhosis, mitochondrial function and ATP generation are maintained by increasing energy production from glycolytic flux as production from oxidative phosphorylation falls. At the terminal stage of hepatic injury, mitochondria respiration and ATP production are significantly compromised, as the hepatocytes are unable to sustain the increased demand for high levels of ATP generation from glycolysis. This impairment corresponds to a decrease in glucose-6-phosphatase catalytic subunit and phosphoglucomutase 1. Similar decreased gene expression was observed in liver tissue from patients at different stages of chronic liver injury. Further, unbiased network analysis of microarray data revealed that expression of these genes was down

  1. Serum lipid profile on admission for ischemic stroke: failure to meet National Cholesterol Education Program Adult Treatment Panel (NCEP-ATPIII) guidelines.

    Science.gov (United States)

    Smith, Eric E; Abdullah, Abdul R; Amirfarzan, Houman; Schwamm, Lee H

    2007-02-27

    To determine the characteristics of patients with stroke/TIA whose admission low-density lipoprotein (LDL) levels were above goals defined by National Cholesterol Education Program Adult Treatment Panel (NCEP-ATPIII) guidelines. From January 1, 2003, to June 30, 2005, there were 1,212 discharges (1,033 stroke, 179 TIA), of whom 1,040/1,212 (86%) had lipid measurement. The preadmission individual LDL goal was determined using 2001 NCEP-ATPIII guidelines. There were 284/1,040 (27%) whose measured LDL was greater than the individual preadmission LDL goal. Failure to be at goal was common even among those with previously diagnosed dyslipidemia (159/527, 30%) and those taking lipid-lowering agents (LLA) (71/370, 19%). LLA would have been indicated in 121/213 (57%) of those above LDL goal who were not already taking LLA, with optional consideration in 77/213 (36%). Lower LDL therapeutic targets were the strongest predictor, in a multivariable model, of failure to be at goal. Compared to LDL target <160 (reference), the OR for LDL target <130 was 6.4 (95% CI 3.4 to 12.0, p < 0.0001) and for LDL target <100 was 26.2 (95% CI 13.3 to 51.5, p < 0.0001). An increased likelihood of being at goal was associated with preadmission LLA (OR 4.2, 95% CI 2.9 to 6.2, p < 0.0001) and increasing calendar time (OR 1.09 per 3-month period, 95% CI 1.03 to 1.15, p = 0.004). Many patients hospitalized with ischemic stroke/TIA, including those with known dyslipidemia and those taking lipid lowering agents, have measured low-density lipoprotein (LDL) that is higher than recommended by national guidelines. Patients at the greatest risk of cardiovascular events are the least likely to be at guideline-recommended LDL levels.

  2. Spacecraft Parachute Recovery System Testing from a Failure Rate Perspective

    Science.gov (United States)

    Stewart, Christine E.

    2013-01-01

    Spacecraft parachute recovery systems, especially those with a parachute cluster, require testing to identify and reduce failures. This is especially important when the spacecraft in question is human-rated. Due to the recent effort to make spaceflight affordable, the importance of determining a minimum requirement for testing has increased. The number of tests required to achieve a mature design, with a relatively constant failure rate, can be estimated from a review of previous complex spacecraft recovery systems. Examination of the Apollo parachute testing and the Shuttle Solid Rocket Booster recovery chute system operation will clarify at which point in those programs the system reached maturity. This examination will also clarify the risks inherent in not performing a sufficient number of tests prior to operation with humans on-board. When looking at complex parachute systems used in spaceflight landing systems, a pattern begins to emerge regarding the need for a minimum amount of testing required to wring out the failure modes and reduce the failure rate of the parachute system to an acceptable level for human spaceflight. Not only a sufficient number of system level testing, but also the ability to update the design as failure modes are found is required to drive the failure rate of the system down to an acceptable level. In addition, sufficient data and images are necessary to identify incipient failure modes or to identify failure causes when a system failure occurs. In order to demonstrate the need for sufficient system level testing prior to an acceptable failure rate, the Apollo Earth Landing System (ELS) test program and the Shuttle Solid Rocket Booster Recovery System failure history will be examined, as well as some experiences in the Orion Capsule Parachute Assembly System will be noted.

  3. Motivational effects of pay dispersion in pay for performance programs implemented in Romanian companies

    Directory of Open Access Journals (Sweden)

    Urieşi Sebastian

    2016-07-01

    Full Text Available The present study investigates the motivational effects in a sample of Romanian employees in private companies that implement pay for performance programs of one of the characteristics of these programs, namely pay dispersion, and on the potential mediating role of organizational justice in these effects. To this aim, we examined the relationships between the amounts of pay dispersion introduced by the respective financial incentive system, employee perceptions of distributive and procedural justice, work motivation, and base salary, respectively. The results of the data analysis, performed through structural equation modeling, support our hypotheses concerning the positive effect of performance – related pay dispersion on motivation and the mediating role of the two dimensions of organizational justice in this effect. Larger financial rewards allocated by the financial incentive system for high performers increase employee perceptions of distributive and procedural justice, which, in turn, foster work motivation. Base salary was also found to influence pay dispersion, as well as perceived distributive justice.

  4. Evaluating the effect of a reader worker program on team performance

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, H.A. [Los Alamos National Lab., NM (United States); Alvarez, Y.P. [Battelle Pantex, Amarillo, TX (United States)

    1994-03-01

    When safety, security, or other logistical concerns prevent direct objective assessment of team performance, other evaluation techniques become necessary. In this paper, the effect of a Department of Energy-mandated reader worker program on team performance at a particular DOE facility was evaluated using unstructured observations, informal discussions with technicians, and human reliability analysis. The reader worker program is intended to enhance nuclear explosive safety by improving the reliability of team performance. The three methods used for the evaluation combine to provide a strong indication that team performance is in fact enhanced by a properly implemented reader worker procedure. Because direct quantitative data on dependent variables particular to the task of interest is not available, however, there has been some skepticism regarding the results by staff at the facility.

  5. Fuel performance improvement program. Quarterly/annual progress report, April--September 1977. [BWR; PWR

    Energy Technology Data Exchange (ETDEWEB)

    Crouthamel, C.E. (comp.)

    1977-11-01

    The Fuel Performance Improvement Program has as its objective the identification and demonstration of fuel concepts with improved power ramp performance. The program contains a combination of out-of-reactor studies, in-reactor experiments and in-reactor demonstrations. Fuel concepts initially being considered include annular pellets, cladding internally coated with graphite and packed-particle fuels. The performance capability of each concept will be compared to a reference fuel of contemporary pellet design by irradiations in the Halden Boiling Water Reactor. Fuel design and process development is being completed and fuel rod fabrication will begin for the Halden test rods and for the first series of in-reactor demonstrations. The in-reactor demonstrations are being performed in the Big Rock Point reactor to show that the concepts pose no undue risk to commercial operation.

  6. Performance of children at risk for reading difficulties submitted to an intervention program.

    Science.gov (United States)

    Silva, Nathane Sanches Marques; Crenitte, Patrícia Abreu Pinheiro

    To assess the applicability of an intervention program to children at risk for reading disabilities. This experimental study compared 10 children at risk for reading difficulty submitted to a phonological decoding intervention program (study group) with 10 other children at risk for reading difficulty not submitted to the program (control group). The intervention program was based on two international studies. It comprised 24 sessions: the first 12 sessions were conducted with groups of two to three children, whereas the others were performed individually. The sessions lasted 50 minutes and were held twice a week. Statistical analysis was conducted using the Student's t-test and the Wilcoxon Signed-Rank test. Children at risk for reading difficulties submitted to the phonological decoding intervention program showed statistically significant improvement at post-assessment in the performance of the following skills: letter naming; phoneme-grapheme relationship; phonological awareness; phonological working memory for non-words; phonological working memory for digits in direct order; alphabet recognition in sequence; writing under dictation of words and pseudowords; reading of words and pseudowords. The phonological decoding intervention program showed applicability to improve the prerequisite skills of reading and writing of children at risk for reading disabilities.

  7. Warrior Model for Human Performance and Injury Prevention: Eagle Tactical Athlete Program (ETAP) Part II.

    Science.gov (United States)

    Sell, Timothy C; Abt, John P; Crawford, Kim; Lovalekar, Mita; Nagai, Takashi; Deluzio, Jennifer B; Smalley, Brain W; McGrail, Mark A; Rowe, Russell S; Cardin, Sylvain; Lephart, Scott M

    2010-01-01

    Physical training for United States military personnel requires a combination of injury prevention and performance optimization to counter unintentional musculoskeletal injuries and maximize warrior capabilities. Determining the most effective activities and tasks to meet these goals requires a systematic, research-based approach that is population specific based on the tasks and demands of the Warrior. The authors have modified the traditional approach to injury prevention to implement a comprehensive injury prevention and performance optimization research program with the 101st Airborne Division (Air Assault) at Fort Campbell, KY. This is second of two companion papers and presents the last three steps of the research model and includes Design and Validation of the Interventions, Program Integration and Implementation, and Monitor and Determine the Effectiveness of the Program. An 8-week trial was performed to validate the Eagle Tactical Athlete Program (ETAP) to improve modifiable suboptimal characteristics identified in Part I. The experimental group participated in ETAP under the direction of a ETAP Strength and Conditioning Specialist while the control group performed the current physical training at Fort Campbell under the direction of a Physical Training Leader and as governed by FM 21-20 for the 8-week study period. Soldiers performing ETAP demonstrated improvements in several tests for strength, flexibility, performance, physiology, and the APFT compared to current physical training performed at Fort Campbell. ETAP was proven valid to improve certain suboptimal characteristics within the 8-week trial as compared to the current training performed at Fort Campbell. ETAP has long-term implications and with expected greater improvements when implemented into a Division pre-deployment cycle of 10-12 months which will result in further systemic adaptations for each variable.

  8. EGADS: A microcomputer program for estimating the aerodynamic performance of general aviation aircraft

    Science.gov (United States)

    Melton, John E.

    1994-01-01

    EGADS is a comprehensive preliminary design tool for estimating the performance of light, single-engine general aviation aircraft. The software runs on the Apple Macintosh series of personal computers and assists amateur designers and aeronautical engineering students in performing the many repetitive calculations required in the aircraft design process. The program makes full use of the mouse and standard Macintosh interface techniques to simplify the input of various design parameters. Extensive graphics, plotting, and text output capabilities are also included.

  9. Performance And Participation Of Physicians In Year One Of Medicare's Value-Based Payment Modifier Program.

    Science.gov (United States)

    Joynt Maddox, Karen E; Epstein, Arnold M; Samson, Lok Wong; Chen, Lena M

    2017-12-01

    In 2015 Medicare launched the Physician Value-Based Payment Modifier program, the largest US ambulatory care pay-for-performance program to date and a precursor to the forthcoming Merit-based Incentive Payment System. In its first year, the program included practices with a hundred or more clinicians. We found that 1,010 practices met this criterion, 899 of which had at least one attributed beneficiary. Of these latter practices, 263 (29.3 percent) failed to report performance data and received a 1 percent reporting-based penalty. Of the 636 practices that reported performance data, those that elected quality tiering-voluntarily receiving performance-based penalties or bonuses-and those with high use of electronic health records had better performance on quality and costs than other practices. Practices with a primary care focus had better quality than other practices but similar costs. These findings translated into differences in the receipt of penalties and bonuses and may have implications for performance patterns under the Merit-based Incentive Payment System.

  10. Use of Balanced Scorecard Methodology for Performance Measurement of the Health Extension Program in Ethiopia.

    Science.gov (United States)

    Teklehaimanot, Hailay D; Teklehaimanot, Awash; Tedella, Aregawi A; Abdella, Mustofa

    2016-05-04

    In 2004, Ethiopia introduced a community-based Health Extension Program to deliver basic and essential health services. We developed a comprehensive performance scoring methodology to assess the performance of the program. A balanced scorecard with six domains and 32 indicators was developed. Data collected from 1,014 service providers, 433 health facilities, and 10,068 community members sampled from 298 villages were used to generate weighted national, regional, and agroecological zone scores for each indicator. The national median indicator scores ranged from 37% to 98% with poor performance in commodity availability, workforce motivation, referral linkage, infection prevention, and quality of care. Indicator scores showed significant difference by region (P < 0.001). Regional performance varied across indicators suggesting that each region had specific areas of strength and deficiency, with Tigray and the Southern Nations, Nationalities and Peoples Region being the best performers while the mainly pastoral regions of Gambela, Afar, and Benishangul-Gumuz were the worst. The findings of this study suggest the need for strategies aimed at improving specific elements of the program and its performance in specific regions to achieve quality and equitable health services. © The American Society of Tropical Medicine and Hygiene.

  11. Strategies for establishing a comprehensive quality and performance improvement program in a radiology department.

    Science.gov (United States)

    Kruskal, Jonathan B; Anderson, Stephan; Yam, Chun S; Sosna, Jacob

    2009-01-01

    To improve the safety and quality of the care that radiologists provide, and to allow radiologists and radiology personnel to remain competitive in an increasingly complex environment, it is essential that all imaging departments establish and maintain managed, comprehensive, and effective performance improvement programs. Although the structure and focus of these programs can vary, a number of common components exist, many of which are now widely mandated by organizations that regulate the field of radiology. Basic components include patient safety, process improvement, customer service, professional staff assessment, and education, each of which requires strategies for implementing continuous programs to monitor performance, analyzing and depicting data, implementing change, and meeting regulatory requirements. All of these components are part of a comprehensive quality management system in a large academic radiology department. For smaller departments or practices, the gradual introduction of one or more of these components is useful in ensuring the safety and quality of their services. (c) RSNA, 2009.

  12. Predictive performance of the quick Sequential Organ Failure Assessment score as a screening tool for sepsis, mortality, and intensive care unit admission in patients with febrile neutropenia.

    Science.gov (United States)

    Kim, Minsoo; Ahn, Shin; Kim, Won Young; Sohn, Chang Hwan; Seo, Dong Woo; Lee, Yoon-Seon; Lim, Kyung Soo

    2017-05-01

    In Sepsis-3, the quick Sequential Organ Failure Assessment (qSOFA) score was developed as criteria to use for recognizing patients who may have poor outcomes. This study was performed to evaluate the predictive performance of the qSOFA score as a screening tool for sepsis, mortality, and intensive care unit (ICU) admission in patients with febrile neutropenia (FN). We also tried to compare its performance with that of the systemic inflammatory response syndrome (SIRS) criteria and Multinational Association of Supportive Care in Cancer (MASCC) score for FN. We used a prospectively collected adult FN data registry. The qSOFA and SIRS scores were calculated retrospectively using the preexisting data. The primary outcome was the development of sepsis. The secondary outcomes were ICU admission and 28-day mortality. Of the 615 patients, 100 developed sepsis, 20 died, and 38 were admitted to ICUs. In multivariate analysis, qSOFA was an independent factor predicting sepsis and ICU admission. However, compared to the MASCC score, the area under the receiver operating curve of qSOFA was lower. qSOFA showed a low sensitivity (0.14, 0.2, and 0.23) but high specificity (0.98, 0.97, and 0.97) in predicting sepsis, 28-day mortality, and ICU admission. Performance of the qSOFA score was inferior to that of the MASCC score. The preexisting risk stratification tool is more useful for predicting outcomes in patients with FN.

  13. Performing Gender: A Discourse Analysis of Theatre-Based Sexual Violence Prevention Programs

    Science.gov (United States)

    Iverson, Susan V.

    2006-01-01

    Among the numerous approaches that are employed to prevent sexual violence, the performance of scenarios has become one of the "promising practices" in U.S. postsecondary education. This article describes findings from a pilot study to analyze scripts used for theatre-based sexual violence prevention programs. Employing the method of…

  14. 9 CFR 592.90 - Authority and duties of inspection program personnel performing service.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Authority and duties of inspection program personnel performing service. 592.90 Section 592.90 Animals and Animal Products FOOD SAFETY AND... accordance with the regulations in this part or are not fit for human food; (5) To issue a certificate upon...

  15. 77 FR 24740 - Senior Community Service Employment Program (SCSEP) Performance Measurement System

    Science.gov (United States)

    2012-04-25

    ... Community Service Employment Program (SCSEP) Performance Measurement System AGENCY: Department of Labor... Act (PRA) requires this notice to set forth the effectiveness of information collection requirements..., Additional Indicator on Volunteer Work. See 77 FR 4654. ] DATES: On March 27, 2012, the Office of Management...

  16. Effects of Family Functioning and Parenting Style on Early Entrants' Academic Performance and Program Completion

    Science.gov (United States)

    Huey, Erron L.; Sayler, Michael F.; Rinn, Anne N.

    2013-01-01

    The purpose of the current study was to examine the predictive nature of parenting style and overall family environment on the academic performance and program completion of early college entrants. Furthermore, gender and family form were examined as possible moderators to these relationships. A total of 88 early college entrants participated in…

  17. Phosphoric acid fuel cell power plant system performance model and computer program

    Science.gov (United States)

    Alkasab, K. A.; Lu, C. Y.

    1984-01-01

    A FORTRAN computer program was developed for analyzing the performance of phosphoric acid fuel cell power plant systems. Energy mass and electrochemical analysis in the reformer, the shaft converters, the heat exchangers, and the fuel cell stack were combined to develop a mathematical model for the power plant for both atmospheric and pressurized conditions, and for several commercial fuels.

  18. 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.

  19. Sensor Performance Evaluation for Battlefield Environments (SPEBE) C++ Application Programming Interface (API) Version 1.0

    Science.gov (United States)

    2008-01-01

    mistakes and violates one of the basic principles of the API: All calculations are performed by SPEBE m-files. Thus, a few changes were made to the...interference nulls • RAY_TRACE – ray tracing • FFP – Fast Field Program • CPE – finite difference Parabolic Equation • SCAPE – Green’s

  20. Teachers' Attitudes about Teacher Bonuses under School-Based Performance Award Programs.

    Science.gov (United States)

    Heneman, Herbert G., III; Milanowski, Anthony T.

    1999-01-01

    Examines attitudes of 1,150 teachers from Charlotte-Mecklinberg (North Carolina) and 1,748 Kentucky teachers working under school-based performance award programs with monetary bonuses if their schools met or exceeded student achievement goals. Findings suggest that the motivational potential of the incentives can be offset by undesirable program…

  1. Performance-based planning and programming in the context of MAP-21 : a TPCB workshop

    Science.gov (United States)

    2015-01-01

    This report highlights key recommendations and noteworthy practices identified at the workshop on Performance-based Planning and Programming in the Context of MAP-21 held on March 6-7, 2014 in New York City, New York and via video teleconferenc...

  2. A Case Study in Coordination Programming: Performance Evaluation of S-Net vs Intel's Concurrent Collections

    NARCIS (Netherlands)

    Zaichenkov, P.; Gijsbers, B.; Grelck, C.; Tveretina, O.; Shafarenko, A.

    2014-01-01

    We present a programming methodology and runtime performance case study comparing the declarative data flow coordination language S-Net with Intel's Concurrent Collections (CnC). As a coordination language S-Net achieves a near-complete separation of concerns between sequential software components

  3. Predictors of academic performance for applicants to an international dental studies program in the United States.

    Science.gov (United States)

    Pitigoi-Aron, Gabriela; King, Patricia A; Chambers, David W

    2011-12-01

    The number of U.S. and Canadian dental schools offering programs for dentists with degrees from other countries leading to the D.D.S. or D.M.D. degree has increased recently. This fact, along with the diversity of educational systems represented by candidates for these programs, increases the importance of identifying valid admissions predictors of success in international dental student programs. Data from 148 students accepted into the international dental studies program at the University of the Pacific from 1994 through 2004 were analyzed. Dependent variables were comprehensive cumulative GPA at the end of both the first and second years of the two-year program. The Test of English as a Foreign Language (TOEFL) and both Parts I and II of the National Board Dental Examination (NBDE) were significant positive predictors of success. Performance on laboratory tests of clinical skill in operative dentistry and in fixed prosthodontics and ratings from interviewers were not predictive of overall success in the program. Although this study confirms the predictive value of written tests such as the TOEFL and NBDE, it also contributes to the literature documenting inconsistent results regarding other types of predictors. It may be the case that characteristics of individual programs or features of the applicant pools for each may require use of admissions predictors that are unique to schools.

  4. The Tutorial Program in Biochemistry at UFV: Improvement of the Activities and Performance of the Enrolled Students

    Directory of Open Access Journals (Sweden)

    T.R. Costa

    2005-07-01

    Full Text Available The Tutorial Program in Biochemistry  at UFV is reaching  the objectives  since the creation,  in 2001. Based  on the  accomplishment  of weekly sessions (2h,  which  tutor and  programs  students reunite to effects the  apprenticeship marked  by the  inter-activity,  the  Program  aims to give support to stu- dents  with  deficiency of basic knowledge.  For  this  reason,  reproved  students or students with  poor performance  in pre-requisites  subjects  are  automatically inscribed.   The  attending students receive satisfactory grade (S, frequency greater  than  75%, or not satisfactory grade (N. The work method- ology has been modified to obtain  better results.   This  study  aimed  evaluate  the  performance  of the Programs students through  modifications,  as the  elimination  of the theoretical session of 1h-weekly and the implantation of didactic  little-books containing  script classes and exercise lists.  Satisfactory results  indicated  that in 7 analyzed  semesters  (from I-2001 to I-2004, the attending students (S got similar  average  final-grade  (70.48  if compared  with  students not  enrolled  in the  Program  (71.64; not attending students (N, 56.81 got significantly  lower final-grade.  The failure rate  for S grade stu- dents  (8.69% was similar to the rate  of not-enrolled  students (8.97%, both  very lower than  N grade students (30.71%.  Based on the  necessity  of additional didactic material, two didactics  little-books were prepared  to  be used  in sessions.   The  little-books  Tutoria em Bioqu´ımica:  Biomol´eculas  and Tutoria em Bioqu´ımica:  Metabolismo  Celular  guide discussions  in classes, emphasizing  exercises.  It constitutes a considerable  advance,  according  to Programs students:  it  guides  and  encourages  the studies.  A questionnaire revealed  the  high acceptance  degree (97

  5. Scientific Programming with High Performance Fortran: A Case Study Using the xHPF Compiler

    Directory of Open Access Journals (Sweden)

    Eric De Sturler

    1997-01-01

    Full Text Available Recently, the first commercial High Performance Fortran (HPF subset compilers have appeared. This article reports on our experiences with the xHPF compiler of Applied Parallel Research, version 1.2, for the Intel Paragon. At this stage, we do not expect very High Performance from our HPF programs, even though performance will eventually be of paramount importance for the acceptance of HPF. Instead, our primary objective is to study how to convert large Fortran 77 (F77 programs to HPF such that the compiler generates reasonably efficient parallel code. We report on a case study that identifies several problems when parallelizing code with HPF; most of these problems affect current HPF compiler technology in general, although some are specific for the xHPF compiler. We discuss our solutions from the perspective of the scientific programmer, and presenttiming results on the Intel Paragon. The case study comprises three programs of different complexity with respect to parallelization. We use the dense matrix-matrix product to show that the distribution of arrays and the order of nested loops significantly influence the performance of the parallel program. We use Gaussian elimination with partial pivoting to study the parallelization strategy of the compiler. There are various ways to structure this algorithm for a particular data distribution. This example shows how much effort may be demanded from the programmer to support the compiler in generating an efficient parallel implementation. Finally, we use a small application to show that the more complicated structure of a larger program may introduce problems for the parallelization, even though all subroutines of the application are easy to parallelize by themselves. The application consists of a finite volume discretization on a structured grid and a nested iterative solver. Our case study shows that it is possible to obtain reasonably efficient parallel programs with xHPF, although the compiler

  6. FUEL PERFORMANCE IMPROVEMENT PROGRAM Power-Ramp Testing and Postirradiation Examination of PCI- Resistant LWR Fuel Rod Designs

    Energy Technology Data Exchange (ETDEWEB)

    Barner, J. O.; Guenther, R. J.

    1982-09-01

    This report describes the power-ramp testing results from 10 fuel rods irradiated in the Halden Boiling Water Reactor (HBWR), Halden, Norway. Tne work is part of the Fuel Performance Improvement Program (FPIP), which is sponsored by the U.S. Department of Energy (DUE) and is conducted through the joint efforts of Consumers Power Company, Exxon Nuclear Company, lnc., and Pacific Northwest Laboratory. The objective of the FPlP is to identify and demonstrate fuel concepts with improved pellet-cladding interaction (PCl) behavior that will be capable of extended burnup. The postirradiation examination results obtained from one nonramped rod are also presented. The power-ramping behavior of three basic fuel rod types--rods with annular-pellet fuel, sphere-pac fuel, and dished-pellet (reference) fuel--are compared in terms of mechanisms known to promote PCl failures. The effects of graphite coating on the inside cladding surface and helium pressurization in rods witn annular fuel are also evaluated .

  7. Ingestion of branched-chain amino acids and tryptophan during sustained exercise in man: failure to affect performance

    DEFF Research Database (Denmark)

    Van Hall, Gerrit; Raaymakers, J S; Saris, W H

    1995-01-01

    1. An increased uptake of tryptophan in the brain may increase serotoninergic activity and recently has been suggested to be a cause of fatigue during prolonged exercise. The present study, therefore, investigates whether ingestion of tryptophan or the competing branched-chain amino acids (BCAAs......) affect performance. Ten endurance-trained male athletes were studied during cycle exercise at 70-75% maximal power output, while ingesting, ad random and double-blind, drinks that contained 6% sucrose (control) or 6% sucrose supplemented with (1) tryptophan (3 g l-1), (2) a low dose of BCAA (6 g l-1...... or that manipulation of serotoninergic activity functionally does not contribute to mechanisms of fatigue....

  8. The Effectiveness of a Parent-Training Program for Promoting Cognitive Performance in Preschool Children

    Directory of Open Access Journals (Sweden)

    Elahe Vahidi

    2017-08-01

    Full Text Available The study aims to evaluate the effectiveness of a parent training program for promoting cognitive performance of young children through enriching the parent-child interactions among mothers of preschool-aged children in Mashhad, Iran. A total of 29 couples of mothers and their children were assigned to an experimental group (n = 16 couples and a control group (n = 13 couples. Mothers in the experimental group participated in 12 weekly sessions and were trained how to enrich their daily parent-child interactions as such. Children’s cognitive performance was assessed by three subscales of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI. The results of the analysis of covariance (ANCOVA indicated a significant difference between the experimental and control group. The findings support the effectiveness of the parent training program for enhancing cognitive performance in preschoolers.

  9. Fuel Performance Improvement Program. Quarterly progress report, April--June 1977. [BWR, PWR

    Energy Technology Data Exchange (ETDEWEB)

    Rowe, D.S. (comp.)

    1977-07-01

    The Fuel Performance Improvement Program has as its objective the identification and demonstration of fuel concepts with improved power ramp performance. Improved fuels are being sought to allow reduction or elimination of fuel related operating guidelines on nuclear power plants such that the fuel may be power maneuvered within the rates allowed by the system technical specifications. The program contains a combination of out-of-reactor studies, in-reactor experiments and in-reactor demonstrations. Fuel concepts initially being considered include annular-pellets, cladding internally coated with graphite and packed-particle fuels. The performance capability of each concept is being compared to a reference fuel of contemporary pellet design through test reactor experiments.

  10. Effects of low-load, higher-repetition versus high-load, lower-repetition resistance training not performed to failure on muscle strength, mass, and echo intensity in healthy young men: a time-course study.

    Science.gov (United States)

    Ikezoe, T; Kobayashi, T; Nakamura, M; Ichihashi, N

    2017-10-07

    The aim of the present study was to compare the effects of low-load, higher-repetition training (LLHR) with those of high-load, lower-repetition training (HLLR) on muscle strength, mass, and echo intensity in healthy young men. Fifteen healthy men (age, 23.1 ± 2.6 years) were randomly assigned to one of the two groups: LLHR or HLLR group. Resistance training on knee extensor muscles was performed 3 days per week for 8 weeks. One-repetition maximum (1RM) strength, maximum isometric strength, muscle thickness and muscle echo intensity on ultrasonography of the rectus femoris muscle were assessed every 2 weeks. Analysis of variance showed no significant group × time interaction, and only a significant main effect of time was observed for all variables. The 8-week resistance training increased 1RM, maximum isometric muscle strength, and muscle thickness by 36.2%-40.9%, 24.0%-25.5%, and 11.3%-20.4%, respectively, whereas it decreased echo intensity by 8.05%-16.3%. Significant improvements in muscle strength, thickness, and echo intensity were observed at weeks 2, 4, and 8, respectively. The lack of difference in time-course changes between LLHR and HLLR programs suggests that low-load training can exert similar effects on muscle mass and characteristics as high-load training by increasing the number of repetitions, even when not performed to failure.

  11. Effects of a veterinary student leadership program on measures of stress and academic performance.

    Science.gov (United States)

    Moore, Dale A; Truscott, Marla L; St Clair, Lisa; Klingborg, Donald J

    2007-01-01

    Assuming leadership roles in veterinary student governance or club activities could be considered an added stressor for students because of the impact on time available for personal and academic activities. The study reported here evaluated the effects of participation in a leadership program and leadership activity across two classes of veterinary students on measures of stress, using the Derogatis Stress Profile (DSP), and on veterinary school academic performance, measured as annual grade-point average (GPA) over a three-year period. Program participants and their classmates completed the DSP three times across the first three years of veterinary school. On average, participating students reported self-declared stress levels that were higher and measured DSP stress levels that were lower than those of the general population. Students were more likely to assume elected or appointed leadership roles while in their first three years of the veterinary degree program if they participated in the optional leadership program and demonstrated lower stress in several dimensions. Some increased stress, as measured in some of the DSP stress dimensions, had a small but statistically significant influence on professional school GPA. The study determined that the most important predictors of students' cumulative GPA across the three-year period were the GPA from the last 45 credits of pre-veterinary coursework and their quantitative GRE scores. The results of the study indicate that neither participation in the leadership program nor taking on leadership roles within veterinary school appeared to influence veterinary school academic performance or to increase stress.

  12. Assessing the Costs and Benefits of the Superior Energy Performance Program

    Energy Technology Data Exchange (ETDEWEB)

    Therkelsen, Peter; McKane, Aimee; Sabouini, Ridah; Evans, Tracy

    2013-07-01

    Industrial companies are seeking to manage energy consumption and costs, mitigate risks associated with energy, and introduce transparency into reports of their energy performance achievements. Forty industrial facilities are participating in the U.S. DOE supported Superior Energy Performance (SEP) program in which facilities implement an energy management system based on the ISO 50001 standard, and pursue third-party verification of their energy performance improvements. SEP certification provides industrial facilities recognition for implementing a consistent, rigorous, internationally recognized business process for continually improving energy performance and achievement of established energy performance improvement targets. This paper focuses on the business value of SEP and ISO 50001, providing an assessment of the costs and benefits associated with SEP implementation at nine SEP-certified facilities across a variety of industrial sectors. These cost-benefit analyses are part of the U.S. DOE?s contribution to the Global Superior Energy Performance (GSEP) partnership, a multi-country effort to demonstrate, using facility data, that energy management system implementation enables companies to improve their energy performance with a greater return on investment than business-as-usual (BAU) activity. To examine the business value of SEP certification, interviews were conducted with SEP-certified facilities. The costs of implementing the SEP program, including internal facility staff time, are described and a marginal payback of SEP certification has been determined. Additionally, more qualitative factors with regard to the business value and challenges related to SEP and ISO 50001 implementation are summarized.

  13. Effect of a Lower Extremity Preventive Training Program on Physical Performance Scores in Military Recruits.

    Science.gov (United States)

    Peck, Karen Y; DiStefano, Lindsay J; Marshall, Stephen W; Padua, Darin A; Beutler, Anthony I; de la Motte, Sarah J; Frank, Barnett S; Martinez, Jessica C; Cameron, Kenneth L

    2017-11-01

    Peck, KY, DiStefano, LJ, Marshall, SW, Padua, DA, Beutler, AI, de la Motte, SJ, Frank, BS, Martinez, JC, and Cameron, KL. Effect of a lower extremity preventive training program on physical performance scores in military recruits. J Strength Cond Res 31(11): 3146-3157, 2017-Exercise-based preventive training programs are designed to improve movement patterns associated with lower extremity injury risk; however, the impact of these programs on general physical fitness has not been evaluated. The purpose of this study was to compare fitness scores between participants in a preventive training program and a control group. One thousand sixty-eight freshmen from a U.S. Service Academy were cluster-randomized into either the intervention or control group during 6 weeks of summer training. The intervention group performed a preventive training program, specifically the Dynamic Integrated Movement Enhancement (DIME), which is designed to improve lower extremity movement patterns. The control group performed the Army Preparation Drill (PD), a warm-up designed to prepare soldiers for training. Main outcome measures were the Army Physical Fitness Test (APFT) raw and scaled (for age and sex) scores. Independent t tests were used to assess between-group differences. Multivariable logistic regression models were used to control for the influence of confounding variables. Dynamic Integrated Movement Enhancement group participants completed the APFT 2-mile run 20 seconds faster compared with the PD group (p APFT sit-up scores. The DIME group had significantly higher total APFT scores compared with the PD group (p < 0.001). Similar results were observed in multivariable models after controlling for sex and body mass index (BMI). Committing time to the implementation of a preventive training program does not appear to negatively affect fitness test scores.

  14. The effects of two different explosive strength training programs on vertical jump performance in basketball.

    Science.gov (United States)

    Ciacci, Simone; Bartolomei, Sandro

    2017-06-08

    The aim of this study was to compare the effects of two different training programs oriented to improve vertical jump performance and leg stiffness in basketball players. Fifty-eight male basketball players were involved, divided into three age groups (Senior, U19 and U17). Subsequently, within any age group, the players were randomly divided into two training groups, respectively performing a 16-week "hang-clean" training program (HCL), and a "half-squat" training program (HSQ), lasting for the same duration. HCL was based on the hang clean exercise and included also jump rope training; HSQ was based on the half squat exercise and included also speed ladder training. The Squat jump (SJ), the Countermovement jump without and with arm swing, and with one step approach (respectively, CMJ, CMJS, and TCMJS) and explosive strength indices obtained with a leg stiffness test were assessed pre- and post-training. In Senior and U19 athletes both training programs involved an improvement of Vertical Jump performance, with some differences between different age groups. Instead, for the U17 players, only the HSQ led to an enhancement of SJ and TCMJS. Significant enhancement of leg stiffness was observed only in U19 and U17 groups after training. The present study showed that the programs based on the hang-clean and half squat allowed to improve explosive strength in basketball training. However, only HSQ was effective for the U17 group. Thus, the present findings demonstrate that specific training programs should be designed according to the age of the players.

  15. Effects of an anterior cruciate ligament injury prevention program on performance in adolescent female soccer players.

    Science.gov (United States)

    Vescovi, J D; VanHeest, J L

    2010-06-01

    Female soccer players are three times more likely to suffer a non-contact anterior cruciate ligament (ACL) tear compared with male soccer players. Several ACL injury prevention programs have been developed and are used to reduce injury risk. However, to date there is limited information on how such programs affect physical performance. The aim of this randomized controlled study was to investigate the effects of the Prevent Injury Enhance Performance (PEP) program in adolescent female soccer players. Four soccer teams were randomly assigned to an intervention (PEP) or control (CON) group and assessed at baseline, 6 weeks, and 12 weeks on linear sprinting, countermovement jump (CMJ), and two agility tests. A mixed model factorial ANOVA with repeated measures was used to assess for treatment effects on the dependent variables. Improvements in 27.3 and 36.6 m sprint times (ACL injury prevention programs designed as a structured warm-up routine seem to lack the necessary stimulus to enhance athletic performance.

  16. Collective dose as a performance measure for occupational radiation protection programs: Issues and recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Strom, D.J.; Harty, R.; Hickey, E.E.; Martin, J.B.; Peffers, M.S. [Pacific Northwest National Lab., Richland, WA (United States); Kathren, R.L. [Washington State Univ., Pullman, WA (United States)

    1998-07-01

    Collective dose is one of the performance measures used at many US Department of Energy (DOE) contractor facilities to quantitatively assess the objectives of the radiation protection program. It can also be used as a management tool to improve the program for keeping worker doses as low as reasonably achievable (ALARA). Collective dose is used here to mean the sum of all total effective dose equivalent values for all workers in a specified group over a specified time. It is often used as a surrogate estimate of radiological risk. In principle, improvements in radiation protection programs and procedures will result in reduction of collective dose, all other things being equal. Within the DOE, most frequently, a single collective dose number, which may or may not be adjusted for workload and other factors, is used as a performance measure for a contractor. The purpose of this report is to evaluate the use of collective dose as a performance measure for ALARA programs at DOE sites.

  17. Performance and failure analysis of concentrator solar cells after intensive stressing with thermal, electrical, and combined load

    Science.gov (United States)

    Eltermann, Fabian; Ziegler, Lisa; Wiesenfarth, Maike; Wilde, Jürgen; Bett, Andreas W.

    2017-09-01

    In this work, we investigated the impact of intensive heat loads on concentrator solar cells assemblies. As test samples, we employed lattice-matched and lattice-mismatched triple-junction solar cells made of GaInP/GaInAs/Ge. The thermal loads were induced by different manners. We used drying cabinets, external power supplies, and a combination of both to achieve maximum test temperatures of 180 °C. For the performance analysis, we utilized flash light solar simulators and an electroluminescence (EL) imaging tool. Our experiments revealed a significant difference depending on the applied manner of heating. The highest impact was observed for the pure heat treatment in drying cabinets. This was particularly visible in the spatial EL images, but also in the IV curves. In contrast, running the concentrator solar cells as forward-biased diodes using an external current supply of 2000 mA, which corresponds to 2000 suns, did not lead to any significant changes in EL and IV curves. However, deformation of the front metallization was observed. In conclusion, pure heat treatment can be considered as a cost-efficient alternative to pinpoint weak points in solar cell receivers.

  18. Failure to Perform Cholecystectomy for Acute Cholecystitis in Elderly Patients is Associated with Increased Morbidity, Mortality, and Cost

    Science.gov (United States)

    Riall, Taylor S; Zhang, Dong; Townsend, Courtney M; Kuo, Yong-Fang; Goodwin, James S

    2010-01-01

    Background Cholecystectomy during initial hospitalization is the current recommended therapy for acute cholecystitis. The rate of cholecystectomy and subsequent healthcare trajectory in elderly patients with acute cholecystitis has not been evaluated. Study Design We used 5% national Medicare sample claims data from 1996–2005 to identify a cohort of patients ≥66 requiring urgent/emergent admission for acute cholecystitis. We evaluated cholecystectomy rates on initial hospitalization, the factors independently predicting receipt of cholecystectomy, the factors predicting further gallstone-related complications, and 2-year survival in the cholecystectomy and no cholecystectomy group in univariate and multivariate models. Results 29,818 Medicare beneficiaries were urgently/emergently admitted for acute cholecystitis from 1996–2005. The mean age was 77.7±7.3 years. 89% of patients were white and 58% were female. 25% of patients did not undergo cholecystectomy during the index admission. Lack of definitive therapy was associated with a 27% subsequent cholecystectomy rate and a 38% gallstone-related readmission rate over in the two years after discharge, while the readmission rate was only 4% in patients undergoing cholecystectomy (Pacute cholecystitis in elderly patients should be performed during initial hospitalization to prevent recurrent episodes of cholecystitis, multiple readmissions, higher readmission rates, and increased costs. PMID:20421027

  19. The Ethiopian Health Extension Program and Variation in Health Systems Performance: What Matters?

    Directory of Open Access Journals (Sweden)

    Netsanet Fetene

    Full Text Available Primary health care services are fundamental to improving health and health equity, particularly in the context of low and middle-income settings where resources are scarce. During the past decade, Ethiopia undertook an ambitious investment in primary health care known as the Ethiopian Health Extension Program that recorded impressive gains in several health outcomes. Despite this progress, substantial disparities in health outcomes persist across the country. The objective of this study was to understand how variation in the implementation of the primary health care efforts may explain differences in key health outcomes.We conducted a qualitative study of higher-performing and lower-performing woredas using site visits and in-depth interviews undertaken in 7 woredas. We classified woredas as higher-performing or lower-performing based on data on 5 indicators. We conducted a total of 94 open-ended interviews; 12-15 from each woreda. The data were analyzed using the constant comparative method of qualitative data analysis. Substantial contrasts were apparent between higher-performing and lower-performing woredas in use of data for problem solving and performance improvement; collaboration and respectful relationships among health extension workers, community members, and health center staff; and coordination between the woreda health office and higher-level regulatory and financing bodies at the zonal and regional levels. We found similarities in what was reported to motivate or demotivate health extension workers and other staff. Additionally, higher-performing and lower-performing woredas shared concerns about hospitals being isolated from health centers and health posts. Participants from both woredas also highlighted a mismatch between the urban health extension program design and the urban-dwelling communities' expectations for primary health care.Data-informed problem solving, respectful and supportive relationships with the community, and

  20. Decline in HAV-associated fulminant hepatic failure and liver transplant in children in Argentina after the introduction of a universal hepatitis A vaccination program

    Directory of Open Access Journals (Sweden)

    Cervio G

    2011-09-01

    Full Text Available Guillermo Cervio1, Julio Trentadue2, Daniel D'Agostino3, Carlos Luque4, Mariano Giorgi5, Judith Armoni6, Roberto Debbag6 1Unidad de Transplante Hepatico, Hospital Prof Dr Juan P Garrahan, 2Unidad de Terapia Intensiva, Hospital Universitario Fundación Favaloro, 3Unidad de Gastroenterología, Hospital Italiano De Buenos Aires, 4Unidad de Transplante Hepatico, Hospital Universitario Austral, 5Departamento de Farmacologia, Escuela de Medicina de la Universidad Austral, 6Sanofi Pasteur, Buenos Aires, Argentina Introduction: Hepatitis A virus (HAV infection is a vaccine-preventable disease. The most severe complication in children is fulminant hepatic failure (FHF, estimated to occur in 0.4% of cases; patients with FHF often require a liver transplant (LT. Following another outbreak of HAV infection in Argentina during 2003–2004, a one-dose HAV universal immunization (UI program was started in 2005, resulting in a reduction in the incidence of HAV infection. We have investigated the impact of HAV UI on the trends in the occurrence of FHF and LT in children. Methods: All pediatric cases of FHF admitted to four pediatric centers in Buenos Aires during March 1993–July 2005 were retrospectively reviewed, and data of cases during August 2005–December 2008 were collected. Information about demography, HAV infections and vaccination status, diagnostic data for FHF using the Pediatric Acute Liver Failure criteria, clinical laboratory results, encephalopathy, the severity of liver disease using the Pediatric End Stage Liver Disease score, assessment of patients on the LT waiting list using King's College Criteria for LT, treatment given for FHF (pre- and post-transplant, and clinical outcome were collected using a case report form. The frequency and outcomes of HAV-associated FHF and LT cases before and after UI were analyzed. Results: During the pre-immunization period, March 1993–July 2005, 54.6% (N = 165 of FHF cases were caused by HAV; HAV

  1. Performance Evaluation of Remote Memory Access (RMA) Programming on Shared Memory Parallel Computers

    Science.gov (United States)

    Jin, Hao-Qiang; Jost, Gabriele; Biegel, Bryan A. (Technical Monitor)

    2002-01-01

    The purpose of this study is to evaluate the feasibility of remote memory access (RMA) programming on shared memory parallel computers. We discuss different RMA based implementations of selected CFD application benchmark kernels and compare them to corresponding message passing based codes. For the message-passing implementation we use MPI point-to-point and global communication routines. For the RMA based approach we consider two different libraries supporting this programming model. One is a shared memory parallelization library (SMPlib) developed at NASA Ames, the other is the MPI-2 extensions to the MPI Standard. We give timing comparisons for the different implementation strategies and discuss the performance.

  2. High performance parallelism pearls 2 multicore and many-core programming approaches

    CERN Document Server

    Jeffers, Jim

    2015-01-01

    High Performance Parallelism Pearls Volume 2 offers another set of examples that demonstrate how to leverage parallelism. Similar to Volume 1, the techniques included here explain how to use processors and coprocessors with the same programming - illustrating the most effective ways to combine Xeon Phi coprocessors with Xeon and other multicore processors. The book includes examples of successful programming efforts, drawn from across industries and domains such as biomed, genetics, finance, manufacturing, imaging, and more. Each chapter in this edited work includes detailed explanations of t

  3. European contribution to heat exchanger design/performance: HTFS research and computer programs. Final report. [SCON4 and CEMP1

    Energy Technology Data Exchange (ETDEWEB)

    Lang, C.; Skrovanek, T.

    1979-01-01

    The performance of selected HTFS computer program in solving example heat exchanger design/performance situations is evaluated. In addition, the specific inputs required by the program are presented to give an idea of the amount of detail the user must supply concerning the heat transfer system. Comments on the versatility of each program and technical details necessary for running each program are also provided. The computer programs examined rate the performance of shell-and-tube type condensers and plate-fin heat exchangers.

  4. Cardiovascular Disease Performance Measures in the Outpatient Setting in India: Insights From the American College of Cardiology’s PINNACLE India Quality Improvement Program (PIQIP)

    Science.gov (United States)

    Kalra, Ankur; Pokharel, Yashashwi; Hira, Ravi S; Risch, Samantha; Vicera, Veronique; Li, Qiong; Kalra, Ram N; Kerkar, Prafulla G; Kumar, Ganesh; Maddox, Thomas M; Oetgen, William J; Glusenkamp, Nathan; Turakhia, Mintu P; Virani, Salim S

    2015-01-01

    Background India has a growing burden of cardiovascular disease (CVD), yet data on the quality of outpatient care for patients with coronary artery disease, heart failure, and atrial fibrillation in India are very limited. We collected data on performance measures for 68 196 unique patients from 10 Indian cardiology outpatient departments from January 1, 2011, to February 5, 2014, in the American College of Cardiology’s PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP). PIQIP is India’s first national outpatient CVD quality-improvement program. Methods and Results In the PIQIP registry, we estimated the prevalence of CVD risk factors (hypertension, diabetes, dyslipidemia, and current tobacco use) and CVD among outpatients. We examined adherence with performance measures established by the American College of Cardiology, the American Heart Association, and the American Medical Association Physician Consortium for Performance Improvement for coronary artery disease, heart failure, and atrial fibrillation. There were a total of 68 196 patients (155 953 patient encounters), with a mean age of 50.6 years (SD 18.2 years). Hypertension was present in 29.7% of patients, followed by diabetes (14.9%), current tobacco use (7.6%), and dyslipidemia (6.5%). Coronary artery disease was present in 14.8%, heart failure was noted in 4.0%, and atrial fibrillation was present in 0.5% of patients. Among eligible patients, the reported use of medications was as follows: aspirin in 48.6%, clopidogrel in 37.1%, and statin-based lipid-lowering therapy in 50.6% of patients with coronary artery disease; RAAS (renin–angiotensin–aldosterone system) antagonist in 61.9% and beta-blockers in 58.1% of patients with heart failure; and oral anticoagulants in 37.0% of patients with atrial fibrillation. Conclusions This pilot study, initiated to improve outpatient CVD care in India, presents our preliminary results and barriers to data

  5. Association of HIV/AIDS Clinician Warm Line Utilization with Diagnosis and Management of Antiretroviral Treatment Failure in Mozambique: A Retrospective Analysis of Program Data.

    Science.gov (United States)

    Ruano Camps, Maria; Brentlinger, Paula E; Augusto, Gerito; Nguimfack, Alexandre; Mudender, Florindo

    In accordance with global HIV/AIDS goals, Mozambique is attempting to improve management of antiretroviral treatment failure (TF). We sought to determine whether the utilization of a national HIV/AIDS clinician telephone consultation service increased recognition and reporting of TF. In a retrospective analysis of routinely collected program data from telephone consultation logs and Mozambique's national registry of second-line antiretroviral requests, we used linear mixed methods to describe the association between TF-related telephone consultations and submission of second-line requests, which required documentation of the TF diagnosis. The unit of analysis was the health facility. Available data included 1417 consultations (390 [27.5%] TF related) and 2662 second-line requests from 1011 health units (2015-2016 data). In multivariable analyses, each TF-related consultation was associated with an increase of 0.61 (95% confidence interval 0.15 to 1.06) second-line requests. In this setting, TF-related telephone consultation was positively and significantly associated with diagnosis and reporting of antiretroviral TF.

  6. Physiological and performance changes from the addition of a sprint interval program to wrestling training.

    Science.gov (United States)

    Farzad, Babak; Gharakhanlou, Reza; Agha-Alinejad, Hamid; Curby, David G; Bayati, Mahdi; Bahraminejad, Morteza; Mäestu, Jarek

    2011-09-01

    Increasing the level of physical fitness for competition is the primary goal of any conditioning program for wrestlers. Wrestlers often need to peak for competitions several times over an annual training cycle. Additionally, the scheduling of these competitions does not always match an ideal periodization plan and may require a modified training program to achieve a high level of competitive fitness in a short-time frame. The purpose of this study was to examine the effects of 4 weeks of sprint-interval training (SIT) program, on selected aerobic and anaerobic performance indices, and hormonal and hematological adaptations, when added to the traditional Iranian training of wrestlers in their preseason phase. Fifteen trained wrestlers were assigned to either an experimental (EXP) or a control (CON) group. Both groups followed a traditional preparation phase consisting of learning and drilling technique, live wrestling and weight training for 4 weeks. In addition, the EXP group performed a running-based SIT protocol. The SIT consisted of 6 35-m sprints at maximum effort with a 10-second recovery between each sprint. The SIT protocol was performed in 2 sessions per week, for the 4 weeks of the study. Before and after the 4-week training program, pre and posttesting was performed on each subject on the following: a graded exercise test (GXT) to determine VO(2)max, the velocity associated with V(2)max (νVO(2)max), maximal ventilation, and peak oxygen pulse; a time to exhaustion test (T(max)) at their νVO(2)max; and 4 successive Wingate tests with a 4-minute recovery between each trial for the determination of peak and mean power output (PPO, MPO). Resting blood samples were also collected at the beginning of each pre and posttesting period, before and after the 4-week training program. The EXP group showed significant improvements in VO(2)max (+5.4%), peak oxygen pulse (+7.7%) and T(max) (+32.2%) compared with pretesting. The EXP group produced significant increases

  7. The Linear Programming to evaluate the performance of Oral Health in Primary Care.

    Science.gov (United States)

    Colussi, Claudia Flemming; Calvo, Maria Cristina Marino; Freitas, Sergio Fernando Torres de

    2013-01-01

    To show the use of Linear Programming to evaluate the performance of Oral Health in Primary Care. This study used data from 19 municipalities of Santa Catarina city that participated of the state evaluation in 2009 and have more than 50,000 habitants. A total of 40 indicators were evaluated, calculated using the Microsoft Excel 2007, and converted to the interval [0, 1] in ascending order (one indicating the best situation and zero indicating the worst situation). Applying the Linear Programming technique municipalities were assessed and compared among them according to performance curve named "quality estimated frontier". Municipalities included in the frontier were classified as excellent. Indicators were gathered, and became synthetic indicators. The majority of municipalities not included in the quality frontier (values different of 1.0) had lower values than 0.5, indicating poor performance. The model applied to the municipalities of Santa Catarina city assessed municipal management and local priorities rather than the goals imposed by pre-defined parameters. In the final analysis three municipalities were included in the "perceived quality frontier". The Linear Programming technique allowed to identify gaps that must be addressed by city managers to enhance actions taken. It also enabled to observe each municipal performance and compare results among similar municipalities.

  8. TOF plotter—a program to perform routine analysis time-of-flight mass spectral data

    Science.gov (United States)

    Knippel, Brad C.; Padgett, Clifford W.; Marcus, R. Kenneth

    2004-03-01

    The main article discusses the operation and application of the program to mass spectral data files. This laboratory has recently reported the construction and characterization of a linear time-of-flight mass spectrometer (ToF-MS) utilizing a radio frequency glow discharge ionization source. Data acquisition and analysis was performed using a digital oscilloscope and Microsoft Excel, respectively. Presently, no software package is available that is specifically designed for time-of-flight mass spectral analysis that is not instrument dependent. While spreadsheet applications such as Excel offer tremendous utility, they can be cumbersome when repeatedly performing tasks which are too complex or too user intensive for macros to be viable. To address this situation and make data analysis a faster, simpler task, our laboratory has developed a Microsoft Windows-based software program coded in Microsoft Visual Basic. This program enables the user to rapidly perform routine data analysis tasks such as mass calibration, plotting and smoothing on x- y data sets. In addition to a suite of tools for data analysis, a number of calculators are built into the software to simplify routine calculations pertaining to linear ToF-MS. These include mass resolution, ion kinetic energy and single peak identification calculators. A detailed description of the software and its associated functions is presented followed by a characterization of its performance in the analysis of several representative ToF-MS spectra obtained from different GD-ToF-MS systems.

  9. Performance characteristics of finger-stick dried blood spots (DBS on the determination of human immunodeficiency virus (HIV treatment failure in a pediatric population in Mozambique.

    Directory of Open Access Journals (Sweden)

    Joy Chang

    Full Text Available Quantitative plasma viral load (VL at 1000 copies /mL was recommended as the threshold to confirm antiretroviral therapy (ART failure by the World Health Organization (WHO. Because of ongoing challenges of using plasma for VL testing in resource-limited settings (RLS, especially for children, this study collected 717 DBS and paired plasma samples from children receiving ART ≥1 year in Mozambique and compared the performance of DBS using Abbott's VL test with a paired plasma sample using Roche's VL test. At a cut-off of 1000 copies/mL, sensitivity of DBS using Abbott DBS VL test was 79.9%, better than 71.0% and 63.9% at 3000 and 5000 copies/mL, respectively. Specificities were 97.6%, 98.8%, 99.3% at 1000, 3000, and 5000 copies/mL, respectively. The Kappa value at 1000 copies/mL, 0.80 (95% CI: 0.73, 0.87, was higher than 0.73 (95% CI: 0.66, 0.80 and 0.66 (95% CI: 0.59, 0.73 at 3000, 5000 copies/mL, respectively, also indicating better agreement. The mean difference between the DBS and plasma VL tests with 95% limits of agreement by Bland-Altman was 0.311 (-0.908, 1.530. Among 73 children with plasma VL between 1000 to 5000 copies/mL, the DBS results were undetectable in 53 at the 1000 copies/mL threshold. While one DBS sample in the Abbott DBS VL test may be an alternative method to confirm ART failure at 1000 copies/mL threshold when a plasma sample is not an option for treatment monitoring, because of sensitivity concerns between 1,000 and 5,000 copies/ml, two DBS samples may be preferred accompanied by careful patient monitoring and repeat testing.

  10. Field Operations Program, Toyota PRIUS Hybrid Electric Vehicle Performance Characterization Report

    Energy Technology Data Exchange (ETDEWEB)

    Francfort, James Edward; Nguyen, N.; Phung, J.; Smith, J.; Wehrey, M.

    2001-12-01

    The U.S. Department of Energy’s Field Operations Program evaluates advanced technology vehicles in real-world applications and environments. Advanced technology vehicles include pure electric, hybrid electric, hydrogen, and other vehicles that use emerging technologies such as fuel cells. Information generated by the Program is targeted to fleet managers and others considering the deployment of advanced technology vehicles. As part of the above activities, the Field Operations Program has initiated the testing of the Toyota Prius hybrid electric vehicle (HEV), a technology increasingly being considered for use in fleet applications. This report describes the Pomona Loop testing of the Prius, providing not only initial operational and performance information, but also a better understanding of HEV testing issues. The Pomona Loop testing includes both Urban and Freeway drive cycles, each conducted at four operating scenarios that mix minimum and maximum payloads with different auxiliary (e.g., lights, air conditioning) load levels.

  11. Warrior Model for Human Performance and Injury Prevention: Eagle Tactical Athlete Program (ETAP) Part I.

    Science.gov (United States)

    Sell, Timothy C; Abt, John P; Crawford, Kim; Lovalekar, Mita; Nagai, Takashi; Deluzio, Jennifer B; Smalley, Brain W; McGrail, Mark A; Rowe, Russell S; Cardin, Sylvain; Lephart, Scott M

    2010-01-01

    Physical training for United States military personnel requires a combination of injury prevention and performance optimization to counter unintentional musculoskeletal injuries and maximize warrior capabilities. Determining the most effective activities and tasks to meet these goals requires a systematic, research-based approach that is population specific based on the tasks and demands of the warrior. We have modified the traditional approach to injury prevention to implement a comprehensive injury prevention and performance optimization research program with the 101st Airborne Division (Air Assault) at Ft. Campbell, KY. This is Part I of two papers that presents the research conducted during the first three steps of the program and includes Injury Surveillance, Task and Demand Analysis, and Predictors of Injury and Optimal Performance. Injury surveillance based on a self-report of injuries was collected on all Soldiers participating in the study. Field-based analyses of the tasks and demands of Soldiers performing typical tasks of 101st Soldiers were performed to develop 101st-specific laboratory testing and to assist with the design of the intervention (Eagle Tactical Athlete Program (ETAP)). Laboratory testing of musculoskeletal, biomechanical, physiological, and nutritional characteristics was performed on Soldiers and benchmarked to triathletes to determine predictors of injury and optimal performance and to assist with the design of ETAP. Injury surveillance demonstrated that Soldiers of the 101st are at risk for a wide range of preventable unintentional musculoskeletal injuries during physical training, tactical training, and recreational/sports activities. The field-based analyses provided quantitative data and qualitative information essential to guiding 101st specific laboratory testing and intervention design. Overall the laboratory testing revealed that Soldiers of the 101st would benefit from targeted physical training to meet the specific demands of

  12. Simulation of cracking and failure of concrete structures

    OpenAIRE

    Cervenka, Vladimir; Eligehausen, Rolf

    1990-01-01

    The computer simulation of the cracking process in concrete structures is performed by means of the program system SBETA. The program is based on nonlinear hypo-elastic constitutive model, which covers all important, experimentally derived material properties, namely, cracking, nonlinear stress-strain law in compression, softenning in compression and tension, biaxial failure function, etc. The nonlinear fracture mechanics is included by means of the fictitious crack model and smeared crack ap...

  13. Applications of mathematical learning models to student performance on general chemistry: Microcomputer drill and practice programs

    Science.gov (United States)

    Zitzewitz, Barbara S.; Berger, Carl F.

    Four drill and practice programs in general chemistry (Butler & Hough, 1982) were altered to keep records of response, scores, and response times as students used the programs. Mathematical learning models were applied to the resulting score and time data. When data for groups of students using the same programs were analyzed using the polynomial fit model of Kerlinger and Pedhazur (1973), significant results were found and in most cases the linear fit provided the only significant explanation for the variance in the data. The performance of individual students on selected programs was also analyzed using a linear model, a simple exponential saturation model, and a more complex model which incorporated ability and motivation factors into the exponential saturation model (Aldridge, 1983). Most of the students improved their performance linearly with time and none exhibited patterns characteristic of the Aldridge model. In some cases, the simple exponential saturation model provided an explanation of the data as probable as that of the linear model. The implications of the findings for science teaching are discussed.

  14. 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 contains appendixes on pump design, cavitation damage, performance testing, hydraulics, two-phase flow in pumps, flow stability, and rotor dynamics.

  15. Correlations between PANCE performance, physician assistant program grade point average, and selection criteria.

    Science.gov (United States)

    Brown, Gina; Imel, Brittany; Nelson, Alyssa; Hale, LaDonna S; Jansen, Nick

    2013-01-01

    The purpose of this study was to examine correlations between first-time Physician Assistant National Certifying Exam (PANCE) scores and pass/fail status, physician assistant (PA) program didactic grade point average (GPA), and specific selection criteria. This retrospective study evaluated graduating classes from 2007, 2008, and 2009 at a single program (N = 119). There was no correlation between PANCE performance and undergraduate grade point average (GPA), science prerequisite GPA, or health care experience. There was a moderate correlation between PANCE pass/fail and where students took science prerequisites (r = 0.27, P = .003) but not with the PANCE score. PANCE scores were correlated with overall PA program GPA (r = 0.67), PA pharmacology grade (r = 0.68), and PA anatomy grade (r = 0.41) but not with PANCE pass/fail. Correlations between selection criteria and PANCE performance were limited, but further research regarding the influence of prerequisite institution type may be warranted and may improve admission decisions. PANCE scores and PA program GPA correlations may guide academic advising and remediation decisions for current students.

  16. Development of Thermal Performance Analysis Computer Program on Turbine Cycle of Yoggwang 3,4 Units

    Energy Technology Data Exchange (ETDEWEB)

    Hong, S.Y.; Choi, K.H.; Jee, M.H.; Chung, S.I. [Korea Electric Power Research Institute, Taejon (Korea)

    2002-07-01

    The objective of the study ''Development of Thermal Performance Analysis Computer Program on Turbine Cycle of Yonggwang 3,4 Units'' is to utilize computerized program to the performance test of the turbine cycle or the analysis of the operational status of the thermal plants. In addition, the result can be applicable to the analysis of the thermal output at the abnormal status and be a powerful tool to find out the main problems for such cases. As a results, the output of this study can supply the way to confirm the technical capability to operate the plants efficiently and to obtain the economic gains remarkably. (author). 27 refs., 73 figs., 6 tabs.

  17. Naval Academy athletic programs as predictors of midshipmen academic and military performance

    OpenAIRE

    Zettler, Gregory M.

    2002-01-01

    Approved for public release; distribution is unlimited. This research analyzes the impact of the United States Naval Academy's club sport and varsity athletic programs on midshipman academic and military performance. Linear regression models are developed for the Naval Academy classes of 1998 and 1999 to analyze the effect of explanatory variables on midshipmen Academic Quality Point Rating (AQPR) and Military Quality Point Rating (MQPR). It is important to understand the relationship betw...

  18. A Performance Analysis of Simple Runtime System for Actor Programming in C++

    OpenAIRE

    Vostokin, Sergey; Skoryupina, Ekaterina

    2017-01-01

    In this paper, we propose the Templet -- a runtime system for actor programming of high performance computing in C++. We provide a compact source code of the runtime system, which uses standard library of C++11 only. We demonstrate how it differs from the classic implementations of the actor model. The practical significance of the Templet was examined by comparative study on the performance of three applications: the reference code in C++, managed by the OpenMP; the actor code in C++, manage...

  19. An intensive exercise program improves motor performances in patients with dementia: translational model of geriatric rehabilitation.

    Science.gov (United States)

    Schwenk, Michael; Dutzi, Ilona; Englert, Stefan; Micol, William; Najafi, Bijan; Mohler, Jane; Hauer, Klaus

    2014-01-01

    Translation of intensive exercise programs developed specifically for patients with dementia into clinical settings is lacking. To determine if a progressive resistance and functional training program, previously evaluated in dementia outpatients, can be implemented in a geriatric inpatient setting in order to improve motor performances in patients with dementia. Eligible patients in one ward of a German geriatric hospital were assigned to the intervention group (IG, n = 74) and received intensive exercise training specifically designed for patients with dementia. Patients in the second ward were observed as a control group (CG, n = 74). All patients received usual care treatment. Primary endpoints were maximal lower extremity strength measured by a leg-press device and duration of the 5-chair-stand test for functional performance. Secondary outcomes included a number of parameters for strength and function. The rehabilitation period averaged 18.1 ± 6.8 days. The IG significantly improved in both primary endpoints (change: maximal strength, IG: +51.9 ± 42.3% versus CG: +13.5 ± 51.8%, p exercise program can be implemented in a geriatric rehabilitation setting to improve motor performances in patients with dementia. Results suggest that an intensification of training is feasible in the target group and substantially increases the benefits in comparison to receiving usual care exercise only.

  20. Effects of donor proliferation in development aid for health on health program performance: A conceptual framework.

    Science.gov (United States)

    Pallas, Sarah Wood; Ruger, Jennifer Prah

    2017-02-01

    Development aid for health increased dramatically during the past two decades, raising concerns about inefficiency and lack of coherence among the growing number of global health donors. However, we lack a framework for how donor proliferation affects health program performance to inform theory-based evaluation of aid effectiveness policies. A review of academic and gray literature was conducted. Data were extracted from the literature sample on study design and evidence for hypothesized effects of donor proliferation on health program performance, which were iteratively grouped into categories and mapped into a new conceptual framework. In the framework, increases in the number of donors are hypothesized to increase inter-donor competition, transaction costs, donor poaching of recipient staff, recipient control over aid, and donor fragmentation, and to decrease donors' sense of accountability for overall development outcomes. There is mixed evidence on whether donor proliferation increases or decreases aid volume. These primary effects in turn affect donor innovation, information hoarding, and aid disbursement volatility, as well as recipient country health budget levels, human resource capacity, and corruption, and the determinants of health program performance. The net effect of donor proliferation on health will vary depending on the magnitude of the framework's competing effects in specific country settings. The conceptual framework provides a foundation for improving design of aid effectiveness practices to mitigate negative effects from donor proliferation while preserving its potential benefits. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Performance of Fixed Heart Rate Increment Targets of 20 vs 30 Beats per Minute for Exercise Rehabilitation Prescription in Outpatients With Heart Failure.

    Science.gov (United States)

    Reed, Jennifer L; Blais, Angelica Z; Keast, Marja-Leena; Pipe, Andrew L; Reid, Robert D

    2017-06-01

    Patients with heart failure (HF) should exercise at 40%-60% heart rate reserve (HRR) during the first 3 weeks of an outpatient cardiac rehabilitation (CR) program and at 50%-80% HRR thereafter. Arbitrary methods to prescribe exercise intensity such as resting HR (RHR) plus 20 or 30 beats per minute (bpm) (RHR + 20 or RHR + 30) are recommended for inpatients after a myocardial infarction or those recovering from heart surgery. This approach has been repurposed by outpatient CR programs to prescribe exercise intensity for patients with HF, yet its efficacy has not been evaluated. We examined the appropriateness of RHR + 20/30 for prescribing exercise intensity and improving functional capacity for 55 patients with HF in an outpatient CR program. RHR + 20/30 values were compared to % HRR derived from peak exercise testing in patients with HF. Changes in functional capacity as measured by 6-minute walk test (6MWT) distance, and differences in ratings of perceived exertion (RPE), were examined between patients exercising at RHR + 20-29 and those exercising at RHR + ≥ 30. During weeks 1-3 and exercise at RHR + 20, 26% of participants would exercise at 40%-60% HRR. At RHR + 30, 38% would exercise at 40%-60% HRR. During weeks 4-12 and exercise at RHR + 20, 20% of participants would exercise at 50%-80% HRR. At RHR + 30, 41% would exercise at 50%-80% HRR. A smaller change in 6MWT distance was observed in participants exercising at RHR + 20-29 than in those exercising at RHR + ≥ 30 (Δ86.6 ± 70.3 vs Δ135.8 ± 73.7 m; P = 0.005). No differences in RPE were observed between participants exercising at RHR + 20-29 and those exercising at RHR + ≥ 30 (P > 0.05). RHR + 30 was more effective than RHR + 20 in assisting outpatients with HF achieve recommended exercise intensities and improve functional capacity. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  2. Failure Modes

    DEFF Research Database (Denmark)

    Jakobsen, K. P.; Burcharth, H. F.; Ibsen, Lars Bo

    1999-01-01

    The present appendix contains the derivation of ten different limit state equations divided on three different failure modes. Five of the limit state equations can be used independently of the characteristics of the subsoil, whereas the remaining five can be used for either drained or undrained s...

  3. Performance of UNHCR nutrition programs in post-emergency refugee camps.

    Science.gov (United States)

    Doocy, Shannon; Tappis, Hannah; Haskew, Christopher; Wilkinson, Caroline; Spiegel, Paul

    2011-10-26

    The United Nations High Commissioner for Refugees (UNHCR) launched a health information system (HIS) in 2005 to enhance quality and consistency of routine health information available in post-emergency refugee camps. This paper reviews nutrition indicators and examines their application for monitoring and evaluating the performance of UNHCR nutrition programs in more than 90 refugee camps in 18 countries. The HIS is a primary source of feeding program data which is collected using standardized case definitions and reporting formats across refugee camps in multiple settings. Data was aggregated across time periods and within and across countries for analysis. Basic descriptive statistics were then compared to UNHCR program performance standards. Camp populations covered by the HIS ranged from 192,000 to 219,000 between 2007 and mid-2009; 87% of under five children covered by the HIS were in Africa and 13% in Asia. Average moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) rates reported in 74 of 81 camps for the 2007-2009 time periods were 7.0% and 1.6%, respectively. The supplementary feeding program (SFP) admission rate was 151/1000/yr with 93% of SFP admissions occurring in Africa. SFP performance consistently exceeded all UNHCR standards with the exception of length of enrollment. Average length of SFP enrollment was 12 weeks in Africa and 22 weeks in Asia as compared to the UNHCR standard of UNHCR standards with the exception of daily weight gain. Inclusion of children identified as moderately and severely wasted in the HIS would allow UNHCR to better track and respond to changes in nutrition status. Improved growth monitoring coverage or active malnutrition surveillance would increase UNHCR's ability to identify and treat cases of acute malnutrition. Expansion of nutrition reporting to address the transition to community-based therapeutic care is essential for adequate performance monitoring in the future. In terms of program priorities, a

  4. Potential seismic structural failure modes associated with the Zion Nuclear Plant. Seismic safety margins research program (Phase I). Project VI. Fragilities

    Energy Technology Data Exchange (ETDEWEB)

    1979-10-01

    The Zion 1 and 2 Nuclear Power Plant consists of a number of structures. The most important of these from the viewpoint of safety are the containment buildings, the auxiliary building, the turbine building, and the crib house (or intake structure). The evaluation of the potential seismic failure modes and determination of the ultimate seismic capacity of the structures is a complex undertaking which will require a large number of detailed calculations. As the first step in this evaluation, a number of potential modes of structural failure have been determined and are discussed. The report is principally directed towards seismically induced failure of structures. To some extent, modes involving soil foundation failures are discussed in so far as they affect the buildings. However, failure modes involving soil liquefaction, surface faulting, tsunamis, etc., are considered outside the scope of this evaluation.

  5. What Is Heart Failure?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  6. What Causes Heart Failure?

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  7. Living with Heart Failure

    Science.gov (United States)

    ... Intramural Research Home / Heart Failure Heart Failure Also known as Congestive heart failure What ... diseases for many years that led to heart failure. Heart failure is a leading cause of hospital stays ...

  8. BIOASSAY VESSEL FAILURE ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Vormelker, P

    2008-09-22

    Two high-pressure bioassay vessels failed at the Savannah River Site during a microwave heating process for biosample testing. Improper installation of the thermal shield in the first failure caused the vessel to burst during microwave heating. The second vessel failure is attributed to overpressurization during a test run. Vessel failure appeared to initiate in the mold parting line, the thinnest cross-section of the octagonal vessel. No material flaws were found in the vessel that would impair its structural performance. Content weight should be minimized to reduce operating temperature and pressure. Outer vessel life is dependent on actual temperature exposure. Since thermal aging of the vessels can be detrimental to their performance, it was recommended that the vessels be used for a limited number of cycles to be determined by additional testing.

  9. Kidney Failure

    Science.gov (United States)

    ... Become a Kidney Health Coach Clinical Scientist in Nephrology program Online continuining education Clinical trials Research Advocacy ... Become a Kidney Health Coach Clinical Scientist in Nephrology program Current CSN Fellow Previous CSN award recipients ...

  10. Implementation of exercise training programs in a hemodialysis unit: effects on physical performance.

    Science.gov (United States)

    Bulckaen, Massimo; Capitanini, Alessandro; Lange, Sara; Caciula, Andrea; Giuntoli, Franco; Cupisti, Adamasco

    2011-01-01

    Exercise training is beneficial for hemodialysis patients, but it should be tailored to individual abilities and willingness to participate. This study evaluated the effects of different 6-month programs of physical activity in 18 patients of a single hemodialysis unit. Before and after a 12-month control period (T0), and following 3 (T3) and 6 (T6) months of training, the patients underwent the 6-minute walk test (6MWT) and constant treadmill test at 3 km/hour speed and 10% grade; spontaneous physical activity was assessed by pedometers. All patients trained for coordination, flexibility and muscular strengthening for 30 minutes within the first 2 hours of hemodialysis sessions: 9 patients underwent home exercise walking training (advised walking group [AWG]); the other 9 patients underwent the advised home training program plus an additional supervised gym training session, twice weekly (supervised walking group [SWG]). In both AWG and SWG, no changes occurred during the control period (232 ± 204 m and 248 ± 187 m at T0). In contrast, endurance performance at treadmill increased at T3 and T6 in the AWG (377 ± 272 m and 615 ± 413 m; p<0.01) and in the SWG (424 ± 272 m and 890 ± 364 m; p<0.001). No unwanted side effects occurred. This study shows that physical exercise programs can safely increase physical performance in hemodialysis patients. The training program should be continued for at least 6 months to increase muscle strength and endurance. Intradialytic exercise and home-based, pedometer-based regimens may be a useful and easy approach, whereas supervised programs can give additional benefits in motivated, selected patients.

  11. Relationship of Provider and Practice Volume to Performance Measure Adherence for Coronary Artery Disease, Heart Failure, and Atrial Fibrillation: Results From the National Cardiovascular Data Registry.

    Science.gov (United States)

    Fleming, Lisa M; Jones, Philip; Chan, Paul S; Andrei, Adin-Christian; Maddox, Thomas M; Farmer, Steven A

    2016-01-01

    There is a reported association between high clinical volume and improved outcomes. Whether this relationship is true for outpatients with coronary artery disease (CAD), heart failure (HF), and atrial fibrillation (AF) remains unknown. Using the PINNACLE Registry (2009-2012), average monthly provider and practice volumes were calculated for CAD, HF, and AF. Adherence with 4 American Heart Association CAD, 2 HF, and 1 AF performance measure were assessed at the most recent encounter for each patient. Hierarchical logistic regression models were used to assess the relationship between provider and practice volume and performance on eligible quality measures. Data incorporated patients from 1094 providers at 71 practices (practice level analyses n=654 535; provider level analyses n=529 938). Median monthly provider volumes were 79 (interquartile range [IQR], 51-117) for CAD, 27 (16-45) for HF, and 37 (24-54) for AF. Median monthly practice volumes were 923 (IQR, 476-1455) for CAD, 311 (145-657) for HF, and 459 (185-720) for AF. Overall, 55% of patients met all CAD measures, 72% met all HF measures, and 58% met the AF measure. There was no definite relationship between practice volume and concordance for CAD, AF, or HF (P=0.56, 0.52, and 0.79, respectively). In contrast, higher provider volume was associated with increased concordance for CAD and AF performance measures (Pperformance was modest and variable. Higher provider volume was positively associated with quality, whereas practice volume was not. © 2015 American Heart Association, Inc.

  12. Constraints on the performance of school-based dental program in Yogyakarta, Indonesia: A qualitative study

    Directory of Open Access Journals (Sweden)

    Rosa Amalia

    2011-06-01

    Full Text Available Background: A high prevalence of caries at ages ≥ 12 in Yogyakarta province (DMFT = 6.5, raises the question of the effectiveness of the school-based dental program (SBDP which, as a national oral health program in schools, is organized by community health centers (CHCs. Purpose: The aim of this study is to explore the possible constraints on work processes which might affect the performance of SBDPs in controlling caries. Methods: In-depth interviews was conducted in twelve CHCs, covering all five districts both in urban and rural areas. Subjects were 41 dentists and dental nurses working in these CHCs. The interviews were structured according to the following themes: resources and logistics; program planning; target achievement; monitoring and evaluation; and suggestions for possible improvements. The data were analyzed using content analysis. Results: The main constraints identified were limited resources and inflexible regulations for resource allocation in the CHC, and inadequate program planning and program evaluation. Inadequate participation of parents was also identified. Another constraint is thatpolicy at the district level orientates oral health towards curative intervention rather than prevention. Suggestions from interviewees include encouraging a policy for oral health, task delegation, a funding program using school health insurance, and a reorientation towards prevention. Conclusion: The weakness of management processes and the unsupported policy of the SBDP at the local level result in a lack of effectiveness. The constraints identified and suggestions for improvements could constitute a basis for improving program quality.Latar Belakang: Tingginya prevalensi karies pada usia ≥ 12 tahun (DMFT = 6.5 di Provinsi Daerah Istimewa Yogyakarta (DIY menimbulkan pertanyaan akan efektifitas Usaha Kesehatan Gigi Sekolah (UKGS. UKGS adalah salah satu program nasional di bidang kesehatan gigi dan mulut yang dilaksanakan oleh Puskesmas

  13. A three-step approach for the derivation and validation of high-performing predictive models using an operational dataset: congestive heart failure readmission case study.

    Science.gov (United States)

    AbdelRahman, Samir E; Zhang, Mingyuan; Bray, Bruce E; Kawamoto, Kensaku

    2014-05-27

    The aim of this study was to propose an analytical approach to develop high-performing predictive models for congestive heart failure (CHF) readmission using an operational dataset with incomplete records and changing data over time. Our analytical approach involves three steps: pre-processing, systematic model development, and risk factor analysis. For pre-processing, variables that were absent in >50% of records were removed. Moreover, the dataset was divided into a validation dataset and derivation datasets which were separated into three temporal subsets based on changes to the data over time. For systematic model development, using the different temporal datasets and the remaining explanatory variables, the models were developed by combining the use of various (i) statistical analyses to explore the relationships between the validation and the derivation datasets; (ii) adjustment methods for handling missing values; (iii) classifiers; (iv) feature selection methods; and (iv) discretization methods. We then selected the best derivation dataset and the models with the highest predictive performance. For risk factor analysis, factors in the highest-performing predictive models were analyzed and ranked using (i) statistical analyses of the best derivation dataset, (ii) feature rankers, and (iii) a newly developed algorithm to categorize risk factors as being strong, regular, or weak. The analysis dataset consisted of 2,787 CHF hospitalizations at University of Utah Health Care from January 2003 to June 2013. In this study, we used the complete-case analysis and mean-based imputation adjustment methods; the wrapper subset feature selection method; and four ranking strategies based on information gain, gain ratio, symmetrical uncertainty, and wrapper subset feature evaluators. The best-performing models resulted from the use of a complete-case analysis derivation dataset combined with the Class-Attribute Contingency Coefficient discretization method and a voting

  14. Java Programs for Using Newmark's Method and Simplified Decoupled Analysis to Model Slope Performance During Earthquakes

    Science.gov (United States)

    Jibson, Randall W.; Jibson, Matthew W.

    2003-01-01

    Landslides typically cause a large proportion of earthquake damage, and the ability to predict slope performance during earthquakes is important for many types of seismic-hazard analysis and for the design of engineered slopes. Newmark's method for modeling a landslide as a rigid-plastic block sliding on an inclined plane provides a useful method for predicting approximate landslide displacements. Newmark's method estimates the displacement of a potential landslide block as it is subjected to earthquake shaking from a specific strong-motion record (earthquake acceleration-time history). A modification of Newmark's method, decoupled analysis, allows modeling landslides that are not assumed to be rigid blocks. This open-file report is available on CD-ROM and contains Java programs intended to facilitate performing both rigorous and simplified Newmark sliding-block analysis and a simplified model of decoupled analysis. For rigorous analysis, 2160 strong-motion records from 29 earthquakes are included along with a search interface for selecting records based on a wide variety of record properties. Utilities are available that allow users to add their own records to the program and use them for conducting Newmark analyses. Also included is a document containing detailed information about how to use Newmark's method to model dynamic slope performance. This program will run on any platform that supports the Java Runtime Environment (JRE) version 1.3, including Windows, Mac OSX, Linux, Solaris, etc. A minimum of 64 MB of available RAM is needed, and the fully installed program requires 400 MB of disk space.

  15. Experiences of general practices with a participatory pay-for-performance program: a qualitative study in primary care

    NARCIS (Netherlands)

    Kirschner, K.; Braspenning, J.C.C.; Jacobs, J.E.; Grol, R.P.

    2013-01-01

    The involvement of target users in the design choices of a pay-for-performance program may enhance its impact, but little is known about the views of participants in these programs. To explore general practices' experiences with pay-for-performance in primary care we conducted a qualitative study in

  16. A Comparison of Student Academic Performance with Traditional, Online, And Flipped Instructional Approaches in a C# Programming Course

    OpenAIRE

    Jason H. Sharp; Laurie A. Sharp

    2017-01-01

    Aim/Purpose: Compared student academic performance on specific course requirements in a C# programming course across three instructional approaches: traditional, online, and flipped. Background: Addressed the following research question: When compared to the online and traditional instructional approaches, does the flipped instructional approach have a greater impact on student academic performance with specific course requirements in a C# programming course? Methodology: Quantitative...

  17. Deployment of Performance Management Methodology as part of Liquid Waste Program at Savannah River Site - 12178

    Energy Technology Data Exchange (ETDEWEB)

    Prod' homme, A.; Drouvot, O.; Gregory, J. [AREVA, Paris (France); Barnes, B.; Hodges, B.; Hart, M. [SRR, Aiken, SC (United States)

    2012-07-01

    In 2009, Savannah River Remediation LLC (SRR) assumed the management lead of the Liquid Waste (LW) Program at the Savannah River Site (SRS). The four SRR partners and AREVA, as an integrated subcontractor are performing the ongoing effort to safely and reliably: - Close High Level Waste (HLW) storage tanks; - Maximize waste throughput at the Defense Waste Processing Facility (DWPF); - Process salt waste into stable final waste form; - Manage the HLW liquid waste material stored at SRS. As part of these initiatives, SRR and AREVA deployed a performance management methodology based on Overall Equipment Effectiveness (OEE) at the DWPF in order to support the required production increase. This project took advantage of lessons learned by AREVA through the deployment of Total Productive Maintenance and Visual Management methodologies at the La Hague reprocessing facility in France. The project also took advantage of measurement data collected from different steps of the DWPF process by the SRR team (Melter Engineering, Chemical Process Engineering, Laboratory Operations, Plant Operations). Today the SRR team has a standard method for measuring processing time throughout the facility, a reliable source of objective data for use in decision-making at all levels, and a better balance between engineering department goals and operational goals. Preliminary results show that the deployment of this performance management methodology to the LW program at SRS has already significantly contributed to the DWPF throughput increases and is being deployed in the Saltstone facility. As part of the liquid waste program on Savannah River Site, SRR committed to enhance production throughput of DWPF. Beyond technical modifications implemented at different location of the facility, SRR deployed performance management methodology based on OEE metrics. The implementation benefited from the experience gained by AREVA in its own facilities in France. OEE proved to be a valuable tool in order

  18. Exercise Capacity and Functional Performance in Heart Failure Patients Supported by a Left Ventricular Assist Device at Discharge From Inpatient Rehabilitation.

    Science.gov (United States)

    Schmidt, Thomas; Bjarnason-Wehrens, Birna; Bartsch, Petra; Deniz, Ezin; Schmitto, Jan; Schulte-Eistrup, Sebastian; Willemsen, Detlev; Reiss, Nils

    2017-06-16

    Adequate physical and functional performance is an important prerequisite for renewed participation and integration in self-determined private and (where appropriate) professional lives following left ventricular assist device (LVAD) implantation. During cardiac rehabilitation (CR), individually adapted exercise programs aim to increase exercise capacity and functional performance. A retrospective analysis of cardiopulmonary exercise capacity and functional performance in LVAD patients at discharge from a cardiac rehabilitation program was conducted. The results from 68 LVAD patients (59 males, 9 females; 55.9 ± 11.7 years; 47 HVAD, 2 MVAD, 15 HeartMate II, 4 HeartMate 3, and 4 different implanting centers) were included in the analysis. Exercise capacity was assessed using a cardiopulmonary exercise test on a bicycle ergometer (ramp protocol; 10 W/min). The 6-min walk test was used to determine functional performance. At discharge from CR (53 ± 17 days after implantation), the mean peak work load achieved was 62.2 ± 19.3 W (38% of predicted values) or 0.79 ± 0.25 W/kg body weight. The mean cardiopulmonary exercise capacity (relative peak oxygen uptake) was 10.6 ± 5.3 mL/kg/min (37% of predicted values). The 6-min walk distance improved significantly during CR (325 ± 106 to 405 ± 77 m; P exercise capacity remains considerably restricted. In contrast, functional performance, measured by the 6-min walk distance, reaches an acceptable level. Light everyday tasks seem to be realistically surmountable for patients, making discharge from inpatient rehabilitation possible. Long-term monitoring is required in order to evaluate the situation and how it develops further. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  19. A social work study on major causes of educational failure

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Iravani

    2013-05-01

    Full Text Available Education is one of the most important parts of every one’s life, higher education helps people get better job offers and build their future, more successfully. Any failure in educational programs could possibly hurt society as well as country’s economy. Therefore, we need to find the major causes of educational failure and setup appropriate plans to reduce the undesirable consequences. In this study, we perform a comprehensive study on previous studies on finding major causes of educational failure in different provinces of Iran and try to focus on major factors influencing this problem. The results of our survey have concluded that there are three common factors including little interest in learning, working along with education and living status. The implementation of some statistical tests has revealed that these factors have some moderate impacts on educational failure.

  20. The relationship between neuroleptic drug dose and the performance of psychiatric patients in a maximum security token economy program.

    Science.gov (United States)

    Harris, G T

    1989-03-01

    This study examined the relationship between neuroleptic medication dose and performance in a token economy program on two maximum security psychiatric wards. Patients receiving higher than average doses exhibited poorer than average program performance but there was a small but statistically significant positive relationship between neuroleptic drug dose (measured in CPZ units/kg) and program performance. However, this positive relationship existed only for the first few weeks of patients' hospital stays, and there was a delay (approximately 2 weeks) between the administration of the drug and the maximal positive effect on program performance. Only a very small minority of medication changes were ever followed by improvements in program performance. The results are discussed in terms of what is a rational strategy for the provision of psychiatric medication and other forms of treatment in institutional settings.

  1. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States); Peeks, Brady [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States)

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50% over typical manufactured homes produced in the northwest.

  2. Computer Program Application Study for Newly Constructed Fossil Power Plant Performance Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun; Park, Jong Jeng [Korea Electric Power Research Institute, Taejon (Korea, Republic of)

    1996-12-31

    The power plant is affected in its availability and economy significantly by the equipment degraded gradually as operation continues, which makes it quite important to evaluate the plant performance more accurately and analyze its effects to the plant economy quantitatively. The methodology thereof includes many calculation steps and requires huge man hours and efforts but would produce relatively less precise results than desired. The object of the project first aims to figure out a methodology which can analyze numerically the inherent effects of each equipment on the cycle performance as well as its performance evaluation and which further helps to determine more reasonable investment for the effective plant economy. Another aspect of the project results in the implementation of the methodology which is embodied in the sophisticated computer programs based on the conventional personal computer with the interactive graphic user interface facilities. (author). 44 refs., figs.

  3. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom [National Renewable Energy Lab. (NREL), Golden, CO (United States); Peeks, Brady [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50 percent over typical manufactured homes produced in the northwest.

  4. Analysis Of Performance Factors Of Construction Management Consultant Affecting The Failure In Achieving Time And Quality Targets On Construction Project Of Samarinda Baru Airport

    Directory of Open Access Journals (Sweden)

    Maryudi Utomo

    2017-11-01

    Full Text Available This research aims to determine the performance factors of construction management consultants affecting the failure in achieving time and quality targets on construction project of Samarinda Baru Airport. This research uses survey method by collecting respondents opinion experience and attitude by taking primary data from questionnaires and secondary data from related institutions. The results of the research are 1 Factors directly affecting the Time Target Y1 are the Understanding of Contract Document X1 Material Requirements X3 Worker Requirements X4 and Equipment Completeness X5 while factors indirectly affecting the Time Target Y1 are the Understanding of Technical Specifications X2 and Local Government Regulations X7 2 Factors directly affecting the Quality Target Y2 are the Understanding of Contract Document X1 the Understanding of Technical Specifications X2 Material Requirements X3 Worker Requirements X4 Equipment Completeness X5 and Time Target Y1 while factor indirectly affecting the Quality Target Y1 is Local Government Regulations X7 3 The most dominant factor affecting the unsuccessful Time Target Y1 is the Worker Requirements X4 with the path coefficient value of 0.431. While the most dominant factor affecting the unsuccessful Quality Target Y2 is Worker Requirements X4 with path coefficient value of 0.579 4.

  5. AZOrange - High performance open source machine learning for QSAR modeling in a graphical programming environment

    Directory of Open Access Journals (Sweden)

    Stålring Jonna C

    2011-07-01

    Full Text Available Abstract Background Machine learning has a vast range of applications. In particular, advanced machine learning methods are routinely and increasingly used in quantitative structure activity relationship (QSAR modeling. QSAR data sets often encompass tens of thousands of compounds and the size of proprietary, as well as public data sets, is rapidly growing. Hence, there is a demand for computationally efficient machine learning algorithms, easily available to researchers without extensive machine learning knowledge. In granting the scientific principles of transparency and reproducibility, Open Source solutions are increasingly acknowledged by regulatory authorities. Thus, an Open Source state-of-the-art high performance machine learning platform, interfacing multiple, customized machine learning algorithms for both graphical programming and scripting, to be used for large scale development of QSAR models of regulatory quality, is of great value to the QSAR community. Results This paper describes the implementation of the Open Source machine learning package AZOrange. AZOrange is specially developed to support batch generation of QSAR models in providing the full work flow of QSAR modeling, from descriptor calculation to automated model building, validation and selection. The automated work flow relies upon the customization of the machine learning algorithms and a generalized, automated model hyper-parameter selection process. Several high performance machine learning algorithms are interfaced for efficient data set specific selection of the statistical method, promoting model accuracy. Using the high performance machine learning algorithms of AZOrange does not require programming knowledge as flexible applications can be created, not only at a scripting level, but also in a graphical programming environment. Conclusions AZOrange is a step towards meeting the needs for an Open Source high performance machine learning platform, supporting the

  6. AZOrange - High performance open source machine learning for QSAR modeling in a graphical programming environment.

    Science.gov (United States)

    Stålring, Jonna C; Carlsson, Lars A; Almeida, Pedro; Boyer, Scott

    2011-07-28

    Machine learning has a vast range of applications. In particular, advanced machine learning methods are routinely and increasingly used in quantitative structure activity relationship (QSAR) modeling. QSAR data sets often encompass tens of thousands of compounds and the size of proprietary, as well as public data sets, is rapidly growing. Hence, there is a demand for computationally efficient machine learning algorithms, easily available to researchers without extensive machine learning knowledge. In granting the scientific principles of transparency and reproducibility, Open Source solutions are increasingly acknowledged by regulatory authorities. Thus, an Open Source state-of-the-art high performance machine learning platform, interfacing multiple, customized machine learning algorithms for both graphical programming and scripting, to be used for large scale development of QSAR models of regulatory quality, is of great value to the QSAR community. This paper describes the implementation of the Open Source machine learning package AZOrange. AZOrange is specially developed to support batch generation of QSAR models in providing the full work flow of QSAR modeling, from descriptor calculation to automated model building, validation and selection. The automated work flow relies upon the customization of the machine learning algorithms and a generalized, automated model hyper-parameter selection process. Several high performance machine learning algorithms are interfaced for efficient data set specific selection of the statistical method, promoting model accuracy. Using the high performance machine learning algorithms of AZOrange does not require programming knowledge as flexible applications can be created, not only at a scripting level, but also in a graphical programming environment. AZOrange is a step towards meeting the needs for an Open Source high performance machine learning platform, supporting the efficient development of highly accurate QSAR models

  7. The association between school-to-work programs and school performance.

    Science.gov (United States)

    Welsh, Erin C; Appana, Savi; Anderson, Henry A; Zierold, Kristina M

    2014-02-01

    The School-to-Work (STW) Opportunities Act was passed to aid students in transitioning from education to employment by offering work-based learning opportunities. In the United States, 72% of high schools offer work-based learning opportunities for credit. This is the first study to describe school performance and school-based behaviors among students enrolled in STW programs and compare them with nonworking and other-working students. In 2003, a questionnaire was administered to five school districts and one large urban school in Wisconsin. Between 2008 and 2010, analyses were completed to characterize STW students and compare them with other students. Of the 6,519 students aged 14-18 years included in the analyses, 461 were involved in an STW program (7%), 3,108 were non-working (48%), and 2,950 were other-working students (45%). Compared with other students, STW students were less likely to have a grade point average >2.0, more likely to have three or more unexcused absences from school, and more likely to spend school-sponsored activities. Holding multiple jobs also negatively affected a student's academic performance. School-to-Work students reported poorer academic performance and more unhealthy school-related behaviors compared with nonworking students and other-working students. Whereas many factors have a role in why students perform poorly in school, more research on students enrolled in STW programs is needed to understand whether participating has a negative impact on students' academic achievement. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Three Women’s Educational Doctoral Program Experiences: A Case Study of Performances and Journeys

    Directory of Open Access Journals (Sweden)

    Erin Goodykoontz

    2011-07-01

    Full Text Available Three academic women joined to write this piece to explore individual doctoral program experiences and to establish common understandings. They collectively analyzed their experiences using the conceptual approach of doctoral program performances and journeys. This case study shares their experiences within the conceptual approach through emerging themes. The common understandings developed herein about doctoral education based on these themes are also shared. The broader contributions of the three women’s work are two-fold. First, the entire case study provides a way to view, discuss, and consider women’s doctoral education pluralistically. Secondly, perhaps readers of this piece will recognize that individual and common understandings with others are a way to develop professional knowledge as academics. Further, readers of this piece might be able to relate more deeply to their own and others’ unique doctoral program experiences through the lens of performances or journeys. Some of these connections might be based on the overarching framework, while others might be specific to the shared women’s experiences.

  9. The use of check valve performance data to support new concepts (probabilistic risk assessment, condition monitoring) for check valve program

    Energy Technology Data Exchange (ETDEWEB)

    Hart, K.A.; Gower, D.

    1996-12-01

    The concept of developing an integrated check valve database based on the Nuclear Power Reliability Data System (NPRDS) data was presented at the last Symposium. The Nuclear Industry Check Valve Group (NIC), working in cooperation with the Oak Ridge National Laboratory (ORNL), has completed an operational database of check valve performance from 1984 to the present. NIC has committed to the nuclear industry to periodically update the data and maintain this information accessible. As the new concepts of probabilistic risk analysis and condition monitoring are integrated into the American Society of Mechanical Engineers (ASME) Code, a critical element will be performance data. From check valve performance data, feasible failure modes and rates can be established. When a failure rate or frequency of failures can be established based on a significant enough population (sampling), a more solid foundation for focusing resources and determining appropriate frequencies and testing can be determined. The presentation will give the updated status of the NIC Check Valve Performance Database covering (1) methodology used to combine the original ORNL data; (2) process/controls established for continuing update and refinement of the data; (3) discussion of how this data is being utilized by (a) OM-22 for condition monitoring, and (b) risk-based inservice testing work of Westinghouse Owners` Group; and (4) results/trends of data evaluations. At the 1994 Symposium, ORNL provided an update as of 1991 to their original work of 1984 -1990 which they had performed to characterize check valve degradations and failures in the nuclear industry. These characterizations will be updated to 1995 and additional reviews provided to give insight into the current condition and trends of check valve performance.

  10. Primary investigation the impacts of the external memory (DDR3) failures on the performance of Xilinx Zynq-7010 SoC based system (MicroZed) using laser irradiation

    Science.gov (United States)

    Liu, Shuhuan; Du, Xuecheng; Du, Xiaozhi; Zhang, Yao; Mubashiru, Lawal Olarewaju; Luo, Dongyang; yuan, Yuan; Deng, Tianxiang; Li, Zhuoqi; Zang, Hang; Li, Yonghong; He, Chaohui; Ma, Yingqi; Shangguan, Shipeng

    2017-09-01

    The impacts of the external dynamic memory (DDR3) failures on the performance of 28 nm Xilinx Zynq-7010 SoC based system (MicroZed) were investigated with two sets of 1064 nm laser platforms. The failure sensitive area distributionsons on the back surface of the test DDR3 were primarily localized with a CW laser irradiation platform. During the CW laser scanning on the back surface of the DDR3 of the test board system, various failure modes except SEU and SEL (MBU, SEFI, data storage address error, rebooting, etc) were found in the testing embedded modules (ALU, PL, Register, Cache and DMA, etc) of SoC. Moreover, the experimental results demonstrated that there were 16 failure sensitive blocks symmetrically distributed on the back surface of the DDR3 with every sensitive block area measured was about 1 mm × 0.5 mm. The influence factors on the failure modes of the embedded modules were primarily analyzed and the SEE characteristics of DDR3 induced by the picoseconds pulsed laser were tested. The failure modes of DDR3 found were SEU, SEFI, SEL, test board rebooting by itself, unknown data, etc. Furthermore, the time interval distributions of failure occurrence in DDR3 changes with the pulsed laser irradiation energy and the CPU operating frequency were measured and compared. Meanwhile, the failure characteristics of DDR3 induced by pulsed laser irradiation were primarily explored. The measured results and the testing techniques designed in this paper provide some reference information for evaluating the reliability of the test system or other similar electronic system in harsh environment.

  11. Implementing Applied Performance Assessment: The External Diploma Program. EDP: Profile of a Mature, High Stakes, Large Scale, Applied-Performance Assessment System.

    Science.gov (United States)

    Harvey, Florence

    The External Diploma Program (EDP) of the American Council on Education is an applied-performance, competency-based assessment program that provides credentials to skilled adults who have acquired their high-school-level abilities through their life experience. Through the EDP mature adults can do the following: demonstrate their abilities in a…

  12. Failure Assessment

    Science.gov (United States)

    Lutz, Robyn; Nikora, Allen

    2005-01-01

    Three questions to which software developers want accurate, precise answers are "How can the software system fail?", "mat bad things will happen if the software fails?t', and "How many failures will the software experience?". Numerous techniques have been devised to answer these questions; three of the best known are: 1) Software Fault Tree Analysis (SFTA) 2) Software Failure Modes, Effects, and Criticality Analysis (SFMECA 3) Software Fault/Failure Modeling. SFTA and SFMECA have been successfully used to analyze the flight software for a number of robotic planetary exploration missions, including Galileo, Cassini, and Deep Space 1. Given the increasing interest in reusing software components from mission to mission, one of us has developed techniques for reusing the corresponding portions of the SFTA and SFMECA, reducing the effort required to conduct these analyses. SFTA has also been shown to be effective in analyzing the security aspects of software systems; intrusion mechanisms and effects can easily be modeled using these techniques. The Bi- Directional Safety Analysis (BDSA) method combines a forward search (similar to SFMECA) from potential failure modes to their effects, with a backward search (similar to SFTA) from feasible hazards to the contributing causes of each hazard. BDSA offers an efficient way to identify latent failures. Recent work has extended BDSA to product-line applications such as flight-instrumentation displays and developed tool support for the reuse of the failure-analysis artifacts within a product line. BDSA has also been streamlined to support those projects having tight cost and/or schedule constraints for their failure analysis efforts. We discuss lessons learned from practice, describe available tools, and identi@ some future directions for the topic. A substantial amount of research has been devoted to estimating the number of failures that a software system will experience during test and operations, as well as the number of

  13. Metallization failures

    Science.gov (United States)

    Beatty, R.

    1971-01-01

    Metallization-related failure mechanisms were shown to be a major cause of integrated circuit failures under accelerated stress conditions, as well as in actual use under field operation. The integrated circuit industry is aware of the problem and is attempting to solve it in one of two ways: (1) better understanding of the aluminum system, which is the most widely used metallization material for silicon integrated circuits both as a single level and multilevel metallization, or (2) evaluating alternative metal systems. Aluminum metallization offers many advantages, but also has limitations particularly at elevated temperatures and high current densities. As an alternative, multilayer systems of the general form, silicon device-metal-inorganic insulator-metal, are being considered to produce large scale integrated arrays. The merits and restrictions of metallization systems in current usage and systems under development are defined.

  14. Landing Technique and Performance in Youth Athletes After a Single Injury-Prevention Program Session.

    Science.gov (United States)

    Root, Hayley; Trojian, Thomas; Martinez, Jessica; Kraemer, William; DiStefano, Lindsay J

    2015-11-01

    Injury-prevention programs (IPPs) performed as season-long warm-ups improve injury rates, performance outcomes, and jump-landing technique. However, concerns regarding program adoption exist. Identifying the acute benefits of using an IPP compared with other warm-ups may encourage IPP adoption. To examine the immediate effects of 3 warm-up protocols (IPP, static warm-up [SWU], or dynamic warm-up [DWU]) on jump-landing technique and performance measures in youth athletes. Randomized controlled clinical trial. Gymnasiums. Sixty male and 29 female athletes (age = 13 ± 2 years, height = 162.8 ± 12.6 cm, mass = 37.1 ± 13.5 kg) volunteered to participate in a single session. Participants were stratified by age, sex, and sport and then were randomized into 1 protocol: IPP, SWU, or DWU. The IPP consisted of dynamic flexibility, strengthening, plyometric, and balance exercises and emphasized proper technique. The SWU consisted of jogging and lower extremity static stretching. The DWU consisted of dynamic lower extremity flexibility exercises. Participants were assessed for landing technique and performance measures immediately before (PRE) and after (POST) completing their warm-ups. One rater graded each jump-landing trial using the Landing Error Scoring System. Participants performed a vertical jump, long jump, shuttle run, and jump-landing task in randomized order. The averages of all jump-landing trials and performance variables were used to calculate 1 composite score for each variable at PRE and POST. Change scores were calculated (POST - PRE) for all measures. Separate 1-way (group) analyses of variance were conducted for each dependent variable (α .05). The Landing Error Scoring System scores improved after the IPP (change = -0.40 ± 1.24 errors) compared with the DWU (0.27 ± 1.09 errors) and SWU (0.43 ± 1.35 errors; P = .04). An IPP did not impair sport performance and may have reduced injury risk, which supports the use of these programs before sport activity.

  15. Value-based performance measures for Hanford Tank Waste Remedition System (TWRS) Program

    Energy Technology Data Exchange (ETDEWEB)

    Keeney, R.L.; von Winterfeldt, D.

    1996-01-01

    The Tank Waste Remediation Systems (TWRS) Program is responsible for the safe storage, retrieval, treatment, and preparation for disposal of high-level waste currently stored in underground storage tanks at the Hanford site in Richland. The TWRS program has adopted a logical approach to decision making that is based on systems engineering and decision analysis (Westinghouse Hanford Company, 1995). This approach involves the explicit consideration of stakeholder values and an evaluation of the TWRS alternatives in terms of these values. Such evaluations need to be consistent across decisions. Thus, an effort was undertaken to develop a consistent, quantifiable set of measures that can be used by TVVRS to assess alternatives against the stakeholder values. The measures developed also met two additional requirements: 1) the number of measure should be relatively small; and 2) performance with respect to the measures should be relatively easy to estimate.

  16. The patient work system: an analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers.

    Science.gov (United States)

    Holden, Richard J; Schubert, Christiane C; Mickelson, Robin S

    2015-03-01

    Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in "patient-engaged human factors," or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers. A Patient Work System model was developed to guide the collection and analysis of interviews, surveys, and observations of patients with heart failure (n = 30) and their informal caregivers (n = 14). Iterative analyses revealed the nature and prevalence of self-care barriers across components of the Patient Work System. Person-related barriers were common and stemmed from patients' biomedical conditions, limitations, knowledge deficits, preferences, and perceptions as well as the characteristics of informal caregivers and healthcare professionals. Task barriers were also highly prevalent and included task difficulty, timing, complexity, ambiguity, conflict, and undesirable consequences. Tool barriers were related to both availability and access of tools and technologies and their design, usability, and impact. Context barriers were found across three domains-physical-spatial, social-cultural, and organizational-and multiple "spaces" such as "at home," "on the go," and "in the community." Barriers often stemmed not from single factors but from the interaction of several work system components. Study findings suggest the need to further explore multiple actors, contexts, and interactions in the patient work system during research and intervention design, as well as the need to develop new models and measures for studying patient and family work. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  17. Comparison of myocardial performance index obtained either by conventional echocardiography or tissue Doppler echocardiography in healthy subjects and patients with heart failure.

    Science.gov (United States)

    Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Aygul, Nazif; Soylu, Ahmet; Aygul, Meryem Ulku; Gök, Hasan

    2009-01-01

    This study was planned to investigate the normal reference values of myocardial performance index (MPI) obtained by tissue Doppler echocardiography (TDE) and the agreement between MPI measured by TDE and conventional MPI measured by pulsed-wave Doppler (PWD) in healthy subjects and patients with heart failure (HF). Two hundred and three patients with HF and 190 healthy subjects were enrolled in this study. Isovolumic contraction and relaxation time (ICT and IRT) and ejection time (ET) were measured from mitral inflow and left ventricular (LV) outflow. Tissue Doppler echocardiography recordings were obtained at the septal, lateral, inferior, and anterior of the mitral annulus and same time intervals were measured. Myocardial performance index was calculated. The functional capacity of the patients with HF was determined according to New York Heart Association classification. TDE-MPI values were higher than conventional PWD-MPI values in both groups (53%+/-8% vs 48%+/-11%, P<0.0001 in the healthy subjects; 84%+/-21% vs 72%+/-19%, P<0.0001 in the patients with HF). Moderate agreement was found between PWD-MPI and LV mean TDE-MPI in both groups. In identifying patients with moderately or severely decreased LV ejection fraction, TDE-MPI had higher cutoff values than conventional PWD-MPI, and TDE-MPI had higher specificity, sensitivity, negative predictive value, and diagnostic accuracy. In patients with HF, TDE-MPI had a stronger correlation with LV ejection fraction and functional capacity than did PWD-MPI. TDE-MPI is an alternative to conventional PWD-MPI in assessment of cardiac function. However, the higher MPI cutoff points should be considered when this method is used for the evaluation of cardiac function.

  18. The effect of a novel tactical training program on physical fitness and occupational performance in firefighters.

    Science.gov (United States)

    Pawlak, Ross; Clasey, Jody L; Palmer, Thomas; Symons, Thorburn B; Abel, Mark G

    2015-03-01

    Structural firefighting is a dangerous and physically demanding profession. Thus, it is critical that firefighters exercise regularly to maintain optimal physical fitness levels. However, little is known about optimal training methods for firefighters, and exercise equipment is often not available to on-duty firefighters. Therefore, the purpose of this study was to determine the effect of a novel supervised on-duty physical training program on the physical fitness and occupational performance of structural firefighters. Twenty professional male firefighters were divided into a supervised exercise group (SEG; n = 11) and a control group (CG; n = 9). The SEG participated in a 12-week circuit training intervention. The SEG exercised for 1 hour on 2 d·wk. At baseline and after the intervention, subjects performed a battery of physical fitness tests and a simulated fire ground test (SFGT). At baseline, there were no significant differences (p = 0.822) in the completion rate of the SFGT in the SEG (82%) vs. the CG (78%). After the intervention, a significantly greater proportion of the firefighters in the SEG completed the SFGT compared with the CG (SEG = 100% vs. CG = 56%; p firefighter equipment improved occupational performance and anthropometric outcomes in incumbent firefighters. Furthermore, implementing a supervised exercise program using firefighter equipment can be done so in a safe and feasible manner.

  19. Performance of a career development and compensation program at an academic health science center.

    Science.gov (United States)

    O'Brodovich, Hugh; Beyene, Joseph; Tallett, Susan; MacGregor, Daune; Rosenblum, Norman D

    2007-04-01

    The academic physicians of our department developed a novel Career Development and Compensation Program to outline job expectations, enhance career development, and provide a peer-review process to assess performance. The Career Development and Compensation Program was founded on the principle that sustained achievement in education, clinical care, or research should be valued, supported, and rewarded in an equivalent manner and that reward for clinical work should not be limited by the focus of the university on research and education. The objective of this study was to determine whether the principles of the Career Development and Compensation Program were sustained during the initial 7 years of its implementation. The outcome of the 7 triennial reviews that occurred from 1999 to 2005 was evaluated. For the purposes of some analyses, physicians were classified as predominately clinical (clinician-specialists and clinician-teachers), predominately education (clinician-educators), or predominately research (clinician-investigators and clinician-scientists). Each of the job profiles had a similar probability to increase a level within the Career Development and Compensation Program at the time of triennial review. Similarly, all 5 job profiles had a similar rate of increase in their level in relation to the total number of years of experience at an academic health science center. Neither the university academic rank nor gender of the physician affected the probability of increasing a level at the time of the triennial review. The peer-reviewed Career Development and Compensation Program recognizes sustained achievement in each area of education, clinical care, and research in an equivalent manner with no detectable effect of academic rank or gender.

  20. Evaluation of the effects of the French pay-for-performance program-IFAQ pilot study.

    Science.gov (United States)

    Lalloué, Benoît; Jiang, Shu; Girault, Anne; Ferrua, Marie; Loirat, Philippe; Minvielle, Etienne

    2017-10-01

    Most studies showed no or little effect of pay-for-performance (P4P) programs on different outcomes. In France, the P4P program IFAQ was generalized to all acute care hospitals in 2016. A pilot study was launched in 2012 to design, implement and assess this program. This article aims to assess the immediate impact of the 2012-14 pilot study. From nine process quality indicators (QIs), an aggregated score was constructed as the weighted average, taking into account both achievement and improvement. Among 426 eligible volunteer hospitals, 222 were selected to participate. Eligibility depended on documentation of QIs and results of hospital accreditation. Hospitals with scores above the median received a financial reward based on their ranking and budget. Several characteristics known to have an influence on P4P results (patient age, socioeconomic status, hospital activity, casemix and location) were used to adjust the models. To assess the effect of the program, comparison between the 185 eligible selected hospitals and the 192 eligible not selected volunteers were done using the difference-in-differences method. Whereas all hospitals improved from 2012 to 2014, the difference-in-differences effect was positive but not significant both in the crude (2.89, P = 0.29) and adjusted models (4.07, P = 0.12). These results could be explained by several reasons: low level of financial incentives, unattainable goals, too short study period. However, the lack of impact for the first year should not undermine the implementation of other P4P programs. Indeed, the pilot study helped to improve the final model used for generalization.

  1. PROKRASTINASI AKADEMIK MAHASISWA PROGRAM STUDI BIMBINGAN DAN KONSELING IKIP PGRI MADIUN DITINJAU DARI EFIKASI DIRI, FEAR OF FAILURE, GAYA PENGASUHAN ORANG TUA, DAN IKLIM AKADEMIK

    OpenAIRE

    Asri, Dahlia Novarianing; Dewi, Noviyanti Kartika

    2015-01-01

    Numerous studies have reported that several factors negatively and positively affect academic procrastination among college students, such as time management, motivation, self-efficacy, coping styles, self-worth, self esteem, and etc. The studies reported that self-efficacy, fear of failure, parent style, and academic climate are related with academic procrastination. Students with high level of procrastination reported that they have low level of self-efficacy, fear of failure, parent style,...

  2. Effect of short-term exercise program on trunk muscles performance in women basketball players

    Directory of Open Access Journals (Sweden)

    Tina Grapar Žargi

    2018-01-01

    Full Text Available Background: Several studies showed that the addition of trunk muscle or core stability exercises in the sport training programs is an effective prevention of spinal and other musculoskeletal injuries. Methods: Twelve female basketball players performed supervised five-week exercise program focused on strengthening the trunk muscles. The program was performed three times per week during pre-season. Sorensen test, Fitnessgram Dynamic Curl-Up test, Prone Plank test and Side Bridge test were used to evaluate trunk muscles performance prior to and immediately after the exercise program completion and again after a three-month follow up period. Results: The results of Sorensen test and Prone Plank test significantly improved immediately after the program, but values returned to baseline at follow-up. In contrast, the results of Fitnessgram Dynamic Curl-Up test and Side Bridge test improved significantly with exercise program and remained significantly higher also at follow-up. Conclusions: Exercise program with emphasis on strengthening the trunk and core muscles can improve muscle performance, however, the results deteriorate shortly after program termination. In order to achieve long-term results, trunk and core muscle exercises have to be performed on regular basis, hence they must be incorporated into general strengthening programs of basketball players.

  3. Program Plan for Revision of the Z-Area Saltstone Disposal Facility Performance Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Cook, James R.

    2005-12-07

    Savannah River National Laboratory (SRNL) and the Saltstone Project, are embarking on the next revision to the Saltstone Disposal Facility (SDF) performance assessment (PA). This program plan has been prepared to outline the general approach, scope, schedule and resources for the PA revision. The plan briefly describes the task elements of the PA process. It discusses critical PA considerations in the development of conceptual models and interpretation of results. Applicable quality assurance (QA) requirements are identified and the methods for implementing QA for both software and documentation are described. The plan identifies project resources supporting the core team and providing project oversight. Program issues and risks are identified as well as mitigation of those risks. Finally, a preliminary program schedule has been developed and key deliverables identified. A number of significant changes have been implemented since the last PA revision resulting in a new design for future SDF disposal units. This revision will encompass the existing and planned disposal units, PA critical radionuclides and exposure pathways important to SDF performance. An integrated analysis of the overall facility layout, including all disposal units, will be performed to assess the impact of plume overlap on PA results. Finally, a rigorous treatment of uncertainty will be undertaken using probabilistic simulations. This analysis will be reviewed and approved by DOE-SR, DOE-HQ and potentially the Nuclear Regulatory Commission (NRC). This revision will be completed and ready for the start of the DOE review at the end of December 2006. This work supports a Saltstone Vault 2 fee-bearing milestone. This milestone includes completion of the Vault 2 module of the PA revision by the end of FY06.

  4. Programming Environment for a High-Performance Parallel Supercomputer with Intelligent Communication

    Directory of Open Access Journals (Sweden)

    A. Gunzinger

    1996-01-01

    Full Text Available At the Electronics Laboratory of the Swiss Federal Institute of Technology (ETH in Zürich, the high-performance parallel supercomputer MUSIC (MUlti processor System with Intelligent Communication has been developed. As applications like neural network simulation and molecular dynamics show, the Electronics Laboratory supercomputer is absolutely on par with those of conventional supercomputers, but electric power requirements are reduced by a factor of 1,000, weight is reduced by a factor of 400, and price is reduced by a factor of 100. Software development is a key issue of such parallel systems. This article focuses on the programming environment of the MUSIC system and on its applications.

  5. High Performance Computing - Power Application Programming Interface Specification Version 2.0.

    Energy Technology Data Exchange (ETDEWEB)

    Laros, James H. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Grant, Ryan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Levenhagen, Michael J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Olivier, Stephen Lecler [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Pedretti, Kevin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ward, H. Lee [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Younge, Andrew J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-03-01

    Measuring and controlling the power and energy consumption of high performance computing systems by various components in the software stack is an active research area. Implementations in lower level software layers are beginning to emerge in some production systems, which is very welcome. To be most effective, a portable interface to measurement and control features would significantly facilitate participation by all levels of the software stack. We present a proposal for a standard power Application Programming Interface (API) that endeavors to cover the entire software space, from generic hardware interfaces to the input from the computer facility manager.

  6. Enhancing Application Performance Using Mini-Apps: Comparison of Hybrid Parallel Programming Paradigms

    Science.gov (United States)

    Lawson, Gary; Sosonkina, Masha; Baurle, Robert; Hammond, Dana

    2017-01-01

    In many fields, real-world applications for High Performance Computing have already been developed. For these applications to stay up-to-date, new parallel strategies must be explored to yield the best performance; however, restructuring or modifying a real-world application may be daunting depending on the size of the code. In this case, a mini-app may be employed to quickly explore such options without modifying the entire code. In this work, several mini-apps have been created to enhance a real-world application performance, namely the VULCAN code for complex flow analysis developed at the NASA Langley Research Center. These mini-apps explore hybrid parallel programming paradigms with Message Passing Interface (MPI) for distributed memory access and either Shared MPI (SMPI) or OpenMP for shared memory accesses. Performance testing shows that MPI+SMPI yields the best execution performance, while requiring the largest number of code changes. A maximum speedup of 23 was measured for MPI+SMPI, but only 11 was measured for MPI+OpenMP.

  7. Effect of Advanced Trauma Life Support program on medical interns' performance in simulated trauma patient management

    Directory of Open Access Journals (Sweden)

    Ahmadi Koorosh

    2013-06-01

    Full Text Available 【Abstract】Objective: Since appropriate and time-table methods in trauma care have an important impact on patients’ outcome, we evaluated the effect of Advanced Trauma Life Support (ATLS program on medical interns' performance in simulated trauma patient management. Methods: A descriptive and analytical study before and after the training was conducted on 24 randomly se-lected undergraduate medical interns from Imam Reza Hos-pital in Mashhad, Iran. On the first day, we assessed in-terns' clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre-and post- ATLS periods, were compared through SPSS ver-sion 15.0 software. P values less than 0.05 were considered statistically significant. Results: Our findings showed that interns’ ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns' clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P<0.001, P=0.016 and P=0.01 respectively. Conclusion: ATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns. Key words: Advanced Trauma Life Support Care; Knowledge; Inservice training; Wounds and injuries

  8. Management of Patients Admitted with Acute Decompensated Heart Failure

    Science.gov (United States)

    Krim, Selim R.; Campbell, Patrick T.; Desai, Sapna; Mandras, Stacy; Patel, Hamang; Eiswirth, Clement; Ventura, Hector O.

    2015-01-01

    Background Hospital admission for the treatment of acute decompensated heart failure is an unfortunate certainty in the vast majority of patients with heart failure. Regardless of the etiology, inpatient treatment for acute decompensated heart failure portends a worsening prognosis. Methods This review identifies patients with heart failure who need inpatient therapy and provides an overview of recommended therapies and management of these patients in the hospital setting. Results Inpatient therapy for patients with acute decompensated heart failure should be directed at decongestion and symptom improvement. Clinicians should also treat possible precipitating events, identify comorbid conditions that may exacerbate heart failure, evaluate and update current guideline-directed medical therapy, and perform risk stratification for all patients. Finally, efforts should be made to educate patients about the importance of restricting salt and fluid, monitoring daily weights, and adhering to a graded exercise program. Conclusion Early discharge follow-up and continued optimization of guideline-directed medical therapy are key to preventing future heart failure readmissions. PMID:26413005

  9. Heart failure - tests

    Science.gov (United States)

    CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests ... the best test to: Identify which type of heart failure (systolic, diastolic, valvular) Monitor your heart failure and ...

  10. Acute kidney failure

    Science.gov (United States)

    ... kidney injury. Alternative Names Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute Images Kidney anatomy References Devarajan P. Biomarkers for assessment of renal ...

  11. Energy efficiency, market failures, and government policy

    Energy Technology Data Exchange (ETDEWEB)

    Levine, M.D.; Koomey, J.G.; McMahon, J.E.; Sanstad, A.H. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.; Hirst, E. [Oak Ridge National Lab., TN (United States). Energy Div.

    1994-03-01

    This paper presents a framework for evaluating engineering-economic evidence on the diffusion of energy efficiency improvements. Four examples are evaluated within this framework. The analysis provides evidence of market failures related to energy efficiency. Specific market failures that may impede the adoption of cost-effective energy efficiency are discussed. Two programs that have had a major impact in overcoming these market failures, utility DSM programs and appliance standards, are described.

  12. Effects of anticoccidial and antibiotic growth promoter programs on broiler performance and immune status.

    Science.gov (United States)

    Lee, Kyung-Woo; Ho Hong, Yeong; Lee, Sung-Hyen; Jang, Seung I; Park, Myeong-Seon; Bautista, Daniel A; Ritter, G Donald; Jeong, Wooseog; Jeoung, Hye-Young; An, Dong-Jun; Lillehoj, Erik P; Lillehoj, Hyun S

    2012-10-01

    This study investigated the effects of various coccidiosis control programs in combination with antibiotic growth promoters (AGPs) on growth performance and host immune responses in broiler chickens. The coccidiosis programs that were investigated included in ovo coccidiosis vaccination (CVAC) with Inovocox or in-feed medication with diclazuril as Clinacox (CLIN) or salinomycin (SAL). The AGPs were virginiamycin or bacitracin methylene disalicylate plus roxarsone. As a negative control, chickens were non-vaccinated and fed with non-supplemented diets (NONE). All animals were exposed to used litter from a commercial broiler farm with confirmed contamination by Eimeria parasites to simulate in-field exposure to avian coccidiosis. Broiler body weights in the CVAC group were greater at 14 and 32 days of age, but not at day 42, compared with the NONE, CLIN, and SAL groups. At day 14, the SAL group showed decreased body weight and reduced ConA-stimulated spleen cell proliferation compared with the CLIN and SAL groups. In contrast, at days 34 and 43, splenocyte proliferation was greater in the CVAC and CLIN groups compared with the NONE and SAL groups. Lymphocyte subpopulations and cytokine mRNA expression levels in the intestine and spleen were also altered by the denoted treatments. Collectively, these results suggest that in ovo coccidiosis vaccination or coccidiostat drug medication programs in combination with AGPs influences chicken growth and immune status in an Eimeria-contaminated environment. Published by Elsevier India Pvt Ltd.

  13. Chronic renal failure in children.

    Science.gov (United States)

    Hari, Pankaj; Singla, Ish Kumar; Mantan, Mukta; Kanitkar, Madhuri; Batra, Bobby; Bagga, Arvind

    2003-11-01

    To determine the etiology of chronic renal failure amongst children attending the Pediatric Nephrology services at a tertiary care center. We reviewed the records of 305 children, diagnosed to have chronic renal failure (CRF) over a 7-year period. CRF was defined as glomerular filtration rate (GFR) below 50-mL/1.73 m2/min persisting for more than 3 months. The mean age at onset and presentation of CRF in these patients was 5.9 and 8 years respectively. Ninety-six children were below 5 years of age. Mean (SD) levels of blood urea and creatinine at presentation were 150 and 4.6 mg/dL respectively. The median GFR at presentation was 18.5 mL/min/1.73 m(2) while 25.3 patients were already in end stage renal failure indicating that these patients were referred late. The mean (SD) hemoglobin at presentation was 7.6 (2.6) g/dL. The mean height and weight SD scores were 2.9 and 2.4 respectively. Obstructive uropathy was the commonest cause of CRF present in 97 children. Other causes included chronic glomerulonephritis in 84, reflux nephropathy in 51, hereditary nephritis in 20, renal dysplasia in 15 and hemolytic uremic syndrome in 5 children. The mean (SD) duration of follow-up was 11(15) months. Peritoneal or hemodialysis was performed in 63 patients. Fifteen patients underwent a live-related renal transplantation. The rest opted out of dialysis program and were conservatively managed due to financial constraints. The commonest causes of CRF were obstructive and reflux nephropathy. A significant proportion of patients presented late; had severe CRF and were malnourished and stunted. Majority of these were managed conservatively due to lack of financial resources.

  14. [Iatrogenic biliary ducts lesions after laparoscopic cholecystectomy: a medical technical error or a therapeutic failure in a routinely performed procedure. A medico-legal evaluation of selected cases].

    Science.gov (United States)

    Chowaniec, Czesław; Chowaniec, Małgorzata; Kobek, Mariusz; Nowak, Agnieszka

    2007-01-01

    Laparoscopic cholecystectomy due to cholelithiasis is associated with a higher risk of intraoperative lesions of biliary duct in comparison to classic surgery. Technical difficulties, a limited access to operating area, the presence of cholecystic adhesions and inflammatory lesions, as well as possible anomalies or anatomical variations of the extrahepatic biliary ducts pose the risk of damaging the biliary tract. At times, laparoscopic procedures are performed by surgeons with insufficient operator skills and qualifications. The medico-legal evaluation of intraoperative damage to the biliary tract with resulting complications--the so-called "biliary damage"--is very difficult. The presented analysis included six cases of intraoperative biliary ducts lesions evaluated by the Forensic Medicine Department, Medical University, Katowice. Three instances were associated with investigations carried out by public prosecutors in medical error cases, and in three others, civil cases were brought in the court, with the plaintiffs advancing a claim. While defining the scope of the management--both diagnostic, therapeutic and decision-making--in the pre-, intra- and postoperative period, attention was drawn to the prescriptive character of patient management in such cases, including indications for laparoscopic surgery, an increased potential therapeutic risk that also included a possibility of the patient developing "normal, typical" complications, referring the above factors to the scope and limits of the physician's professional and criminal liability and analyzing them to assess whether a medical error had been committed, or else the events had represented a therapeutic failure within the limits of the accepted therapeutic risk. A separate problem emphasized by the authors focused on difficulties in objective evaluation of health-associated consequences that might be defined in a tabular manner as long-term or permanent detriment to health.

  15. Performance of semiquantitative and quantitative D-dimer assays in the ECAT external quality assessment program.

    Science.gov (United States)

    de Maat, M P; Meijer, P; Nieuwenhuizen, W; Haverkate, F; Kluft, C

    2000-01-01

    D-dimer levels are used in clinical practice as markers for the presence or exclusion of venous thrombosis. Therefore, it is important that the performance of the D-dimer tests is well controlled. One of the components of a laboratory quality program is external quality assessment (EQA). The main aim of EQA is to identify the degree of agreement among laboratories. In addition to identifying the individual laboratory performance, it also identifies the characteristics of the different reagents and methods that are used in different laboratories. Recently, the D-dimer test was included in the ECAT External Quality Assessment program. Eighty-one laboratories in four rounds applied semiquantitative and quantitative D-dimer assays to three samples (concentrations normal, slightly elevated, and elevated). Although the reported values varied widely, the classification of the samples was mostly correct for the normal and the elevated samples. The slightly elevated sample was classified as normal by all laboratories using semiquantitative methods and by 60% of the laboratories using quantitative methods, and this varied between 45% and 86% for the different methods. In conclusion, D-dimer methods show a large variation, and the quality of the D-dimer assessment could be improved by standardization and by using cut-off ranges.

  16. The Medicare Electronic Health Record Incentive Program: provider performance on core and menu measures.

    Science.gov (United States)

    Wright, Adam; Feblowitz, Joshua; Samal, Lipika; McCoy, Allison B; Sittig, Dean F

    2014-02-01

    To measure performance by eligible health care providers on CMS's meaningful use measures. Medicare Electronic Health Record Incentive Program Eligible Professionals Public Use File (PUF), which contains data on meaningful use attestations by 237,267 eligible providers through May 31, 2013. Cross-sectional analysis of the 15 core and 10 menu measures pertaining to use of EHR functions reported in the PUF. Providers in the dataset performed strongly on all core measures, with the most frequent response for each of the 15 measures being 90-100 percent compliance, even when the threshold for a particular measure was lower (e.g., 30 percent). PCPs had higher scores than specialists for computerized order entry, maintaining an active medication list, and documenting vital signs, while specialists had higher scores for maintaining a problem list, recording patient demographics and smoking status, and for providing patients with an after-visit summary. In fact, 90.2 percent of eligible providers claimed at least one exclusion, and half claimed two or more. Providers are successfully attesting to CMS's requirements, and often exceeding the thresholds required by CMS; however, some troubling patterns in exclusions are present. CMS should raise program requirements in future years. © Health Research and Educational Trust.

  17. Elderly online: effects of a digital inclusion program in cognitive performance.

    Science.gov (United States)

    Ordonez, Tiago Nascimento; Yassuda, Mônica Sanches; Cachioni, Meire

    2011-01-01

    There is little empirical data about the impact of digital inclusion on cognition among older adults. This paper aimed at investigating the effects of a digital inclusion program in the cognitive performance of older individuals who participated in a computer learning workshop named "Idosos On-Line" (Elderly Online). Forty-two aged individuals participated in the research study: 22 completed the computer training workshop and 20 constituted the control group. All subjects answered a sociodemographic questionnaire and completed the Addenbrooke's cognitive examination, revised (ACE-R), which examines five cognitive domains: orientation and attention, memory, verbal fluency, language, and visuo-spatial skills. It was noted that the experimental group's cognitive performance significantly improved after the program, particularly in the language and memory domains, when compared to the control group. These findings suggest that the acquisition of new knowledge and the use of a new tool, that makes it possible to access the Internet, may bring gains to cognition. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  18. LIAR -- A computer program for the modeling and simulation of high performance linacs

    Energy Technology Data Exchange (ETDEWEB)

    Assmann, R.; Adolphsen, C.; Bane, K.; Emma, P.; Raubenheimer, T.; Siemann, R.; Thompson, K.; Zimmermann, F.

    1997-04-01

    The computer program LIAR (LInear Accelerator Research Code) is a numerical modeling and simulation tool for high performance linacs. Amongst others, it addresses the needs of state-of-the-art linear colliders where low emittance, high-intensity beams must be accelerated to energies in the 0.05-1 TeV range. LIAR is designed to be used for a variety of different projects. LIAR allows the study of single- and multi-particle beam dynamics in linear accelerators. It calculates emittance dilutions due to wakefield deflections, linear and non-linear dispersion and chromatic effects in the presence of multiple accelerator imperfections. Both single-bunch and multi-bunch beams can be simulated. Several basic and advanced optimization schemes are implemented. Present limitations arise from the incomplete treatment of bending magnets and sextupoles. A major objective of the LIAR project is to provide an open programming platform for the accelerator physics community. Due to its design, LIAR allows straight-forward access to its internal FORTRAN data structures. The program can easily be extended and its interactive command language ensures maximum ease of use. Presently, versions of LIAR are compiled for UNIX and MS Windows operating systems. An interface for the graphical visualization of results is provided. Scientific graphs can be saved in the PS and EPS file formats. In addition a Mathematica interface has been developed. LIAR now contains more than 40,000 lines of source code in more than 130 subroutines. This report describes the theoretical basis of the program, provides a reference for existing features and explains how to add further commands. The LIAR home page and the ONLINE version of this manual can be accessed under: http://www.slac.stanford.edu/grp/arb/rwa/liar.htm.

  19. Degradation and failure characteristics of NPP containment protective coating systems

    Energy Technology Data Exchange (ETDEWEB)

    Sindelar, R.L.

    2000-03-30

    A research program to investigate the performance and potential for failure of Service Level 1 coating systems used in nuclear power plant containment is in progress. The research activities are aligned to address phenomena important to cause failure as identified by the industry coatings expert panel. The period of interest for performance covers the time from application of the coating through 40 years of service, followed by a medium-to-large break loss-of-coolant accident scenario, which is a design basis accident (DBA) scenario. The interactive program elements are discussed in this report and the application of these elements to the System 5 coating system (polyamide epoxy primer, carbon steel substrate) is used to evaluate performance.

  20. The Relationship between Institutional, Departmental and Program-Specific Variables and the Academic Performance of Division I FBS Football Programs

    Science.gov (United States)

    Eigenbrot, Steven C.

    2012-01-01

    This study investigated the connection between the academic evaluation of Division I FBS football programs and the various social settings that influenced these student-athletes. These social settings were classified as: institutional, departmental and program-specific. The experience of the student-athlete is thought to be impacted by all three…

  1. Comparison of 2 training programs for basic laparoscopic skills and simulated surgery performance in veterinary students.

    Science.gov (United States)

    Chen, Chi-Ya; Ragle, Claude A; Lencioni, Rachael; Fransson, Boel A

    2017-11-01

    To compare the effects of 2 training curricula on laparoscopic skills and performance of simulated surgery in veterinary students. Prospective study. Veterinary students (n = 33) with no prior hands-on experience in minimally invasive surgery. Basic laparoscopic skills (BLS) were assessed based on 5 modified McGill inanimate system for training and evaluation of laparoscopic skills. Motion metrics and an objective structured assessment of technical skills (OSATS) were used to evaluate surgical skills during a simulated laparoscopic cholecystectomy performed in an augmented reality simulator. Students were randomly assigned to either skill-based (group A) or procedural-based (group B) training curriculum. Both tests were performed prior to and after a 10-session training curriculum. Post-training BLS results were improved in both training groups (P difference was detected in OSATS before and after training. Both training curricula improved BLS, but significant differences were not detected between the procedural-based training program and basic skills training alone in veterinary students. Motion metrics such as time, economy of movement, and instrument path were superior to an OSATS, when assessing surgical performance. Further studies are needed to compare the effects of different simulators on the training of veterinarians with diverse laparoscopic surgical experience. © 2017 The American College of Veterinary Surgeons.

  2. Terminal Performance Objectives for Selected Programs in Business Education, Distributive Education, Work Experience Education, and Career Guidance.

    Science.gov (United States)

    San Mateo Union High School District, CA.

    San Mateo Union High School District staff members participated in a workshop for the purpose of identifying the minimum Terminal Performance Objectives for selected programs. The objectives were written in detail to indicate (1) the student performance expected, (2) the conditions under which the student will perform, and (3) the extent to which…

  3. Grand Challenges: High Performance Computing and Communications. The FY 1992 U.S. Research and Development Program.

    Science.gov (United States)

    Federal Coordinating Council for Science, Engineering and Technology, Washington, DC.

    This report presents a review of the High Performance Computing and Communications (HPCC) Program, which has as its goal the acceleration of the commercial availability and utilization of the next generation of high performance computers and networks in order to: (1) extend U.S. technological leadership in high performance computing and computer…

  4. Heart failure - overview

    Science.gov (United States)

    ... heart failure; Right-sided heart failure - cor pulmonale; Cardiomyopathy - heart failure; HF ... Disease Section. Heart Failure as a newly approved diagnosis for cardiac rehabilitation: challenges and opportunities. J Am ...

  5. Performing only one cardiovascular reflex test has a high positive predictive value for diagnosing autonomic neuropathy in patients with chronic renal failure on hemodialysis.

    Science.gov (United States)

    Sahin, Mesut; Kayatas, Mansur; Urun, Yuksel; Sennaroglu, Engin; Akdur, Saadet

    2006-01-01

    Autonomic neuropathy is an important cause of morbidity and mortality in patients with chronic renal failure (CRF) on hemodialysis. Generally, cardiovascular reflex tests are used to determine autonomic neuropathy. Our purpose in this study was to determine the frequency of autonomic neuropathy in patients with CRF on hemodialysis by using cardiovascular reflex tests and compare the sensitivity of each test. The authors performed five tests: heart rate response to the Valsalva maneuver, heart rate variation during deep breathing, heart rate response to standing up, blood pressure response to standing up, and blood pressure response to hand grip exercise in order to determine autonomic neuropathy. Each test subject was evaluated as normal, borderline, and abnormal and scored as 0, 1, and 2, respectively. Subjects with a total score > or = 5 were considered to have autonomic neuropathy. Forty subjects with CRF on hemodialysis were included in this study. None of the subjects had diabetes mellitus or any other etiology that could cause autonomic neuropathy. Thirty-five of 40 subjects (87.5%) had abnormal autonomic tests. In 35 subjects, the relationship between autonomic neuropathy and biochemical parameters, effects of treatment with vitamin D and erythropoietin, and urea reduction rate were studied. No relationship was found between autonomic neuropathy and age, time on hemodialysis, urea reduction rate, albumin, ferritin, calcium, inorganic phosphorus, intact parathyroid hormone, hemoglobin levels, and treatment with vitamin D and erythropoietin. The abnormal test results were as follows: 20 subjects (50%) in the heart rate response to the Valsalva Maneuver, 31 (77.5%) in the heart rate variation during deep breathing, 28 (70%) in the heart rate response to standing up, 6 (15%) in the blood pressure response to standing up, and 31 subjects (77.5%) in the blood pressure response to hand grip exercise tests. Among these five tests, the two most abnormal tests were

  6. A new approach to the measurement of heart rate in patients with chronic heart failure-heart rate performance index: an observational study.

    Science.gov (United States)

    Akyüz, Aydın; Alpsoy, Şeref; Akkoyun, Dursun Çayan; Güler, Niyazi

    2013-05-01

    In order to evaluate the utility of the heart rate performance index (HRPI), which is obtained by dividing HR mean by the difference of HR max and HR min in the context of Holter monitoring, we sought to determine whether there was any correlation or relationship between the HRPI and LVEF values as determined by echocardiography and to compare the HRPI between the study and control groups. This study is a cross-sectional, controlled observational study. Thirty-two patients with symptomatic or asymptomatic left ventricular systolic dysfunction (LVEF heart failure (CHF) were included as a control group. In the study group, 10 patients were in NYHA class I (31.2%), 12 - were in NYHA class II (37.6%) and 10 - were in NYHA class III (31.2%). Heart rate analysis was measured using 24-hour Holter ambulatory electrocardiography. To determine the HRPI, the difference between maximum (HR max) and minimum heart rate (HR min) was divided by mean heart rate (HR mean) (beats/minute): HRPI=(HR max-HR min) / HR mean. Statistical analysis was performed using t-test for independent samples, Mann-Whitney U test, Chi-square test, Kruskal-Wallis test, Pearson's correlation and linear regression analyses. The HRPI index value was markedly decreased [0.83 (0.58-1.1) and 1.10 (0.74-1.3), pheart rate derivatives (unstandardized β=42.43 95% CI: 21.98-50.51, p=0.231). According to our findings, patients with CHF exhibited higher HR mean values, reduced HR max-min values and significantly decreased HRPI values. There is a positive correlation between HRPI and LVEF, a decreased HRPI is associated with a decreased LVEF, but there is no relationship between these two variables. Therefore, HRPI values may represent a viable option for assessing daily exercise activity and potentially sympathetic activation in patients with CHF. The assessment of HRPI may be helpful the evaluation of CHF patients, as well as resting HR.

  7. Performance based pay : an empirical investigation of the impact of performance pay increases on perceptions critical to successful merit pay programs

    OpenAIRE

    Vest, Michael J.

    1985-01-01

    The purpose of this study was to investigate the impact of size of performance pay increases on employee perceptions critical to the success of merit pay programs. Perceptions investigated in this study included: 1) instrumentality, 2) expectancy, 3) performance appraisal administration, 4) performance appraisal content, 5) trust in city management, 6) pay communication, and 7) importance of pay. It was hypothesized that individuals who received above average performan...

  8. Performance on the Green Word Memory Test following Operation Enduring Freedom/Operation Iraqi Freedom-era military service: Test failure is related to evaluation context.

    Science.gov (United States)

    McCormick, Cortney L; Yoash-Gantz, Ruth E; McDonald, Scott D; Campbell, Thomas C; Tupler, Larry A

    2013-12-01

    This study investigates prior reports of high neuropsychological symptom validity test (SVT) failure rates in post-deployed Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) active and veteran military personnel, using a large, multi-site sample (N = 214) drawn from three levels of the Department of Defense/Department of Veterans Affairs (VA) Polytrauma System of Care. The sample failure rate and its relationship to research versus dual research/clinical context of evaluation were examined, in addition to secondary variables explored in prior studies. Results yielded an overall failure rate of 25%, lower than prior reports describing OEF/OIF active-duty and veteran military personnel. Findings also supported the hypothesis that SVT failure rates would differ by context (dual > research). Participants with traumatic brain injury (TBI) failed more frequently than those without TBI in the dual context but not in the research context. Secondary analyses revealed that failure rates increased in the presence of depression, posttraumatic stress disorder, and male sex but were unrelated to active versus veteran military status, service connection (SC) or percentage of SC, age, education, or ethnicity. Further research is required to elucidate the underpinnings of these findings in light of the limited literature and variability between OEF/OIF-related SVT studies, as well as the substantial diagnostic and treatment implications for VA.

  9. BEAGLE: an application programming interface and high-performance computing library for statistical phylogenetics.

    Science.gov (United States)

    Ayres, Daniel L; Darling, Aaron; Zwickl, Derrick J; Beerli, Peter; Holder, Mark T; Lewis, Paul O; Huelsenbeck, John P; Ronquist, Fredrik; Swofford, David L; Cummings, Michael P; Rambaut, Andrew; Suchard, Marc A

    2012-01-01

    Phylogenetic inference is fundamental to our understanding of most aspects of the origin and evolution of life, and in recent years, there has been a concentration of interest in statistical approaches such as Bayesian inference and maximum likelihood estimation. Yet, for large data sets and realistic or interesting models of evolution, these approaches remain computationally demanding. High-throughput sequencing can yield data for thousands of taxa, but scaling to such problems using serial computing often necessitates the use of nonstatistical or approximate approaches. The recent emergence of graphics processing units (GPUs) provides an opportunity to leverage their excellent floating-point computational performance to accelerate statistical phylogenetic inference. A specialized library for phylogenetic calculation would allow existing software packages to make more effective use of available computer hardware, including GPUs. Adoption of a common library would also make it easier for other emerging computing architectures, such as field programmable gate arrays, to be used in the future. We present BEAGLE, an application programming interface (API) and library for high-performance statistical phylogenetic inference. The API provides a uniform interface for performing phylogenetic likelihood calculations on a variety of compute hardware platforms. The library includes a set of efficient implementations and can currently exploit hardware including GPUs using NVIDIA CUDA, central processing units (CPUs) with Streaming SIMD Extensions and related processor supplementary instruction sets, and multicore CPUs via OpenMP. To demonstrate the advantages of a common API, we have incorporated the library into several popular phylogenetic software packages. The BEAGLE library is free open source software licensed under the Lesser GPL and available from http://beagle-lib.googlecode.com. An example client program is available as public domain software.

  10. A methodology for setting state and local regression-adjusted performance targets for workforce investment act programs

    OpenAIRE

    Randall W. Eberts; Huang, Wei-Jang; Cai, Jing

    2013-01-01

    Beginning with PY2009, the U.S. Department of Labor's Employment and Training Administration (USDOL/ETA) adopted a regression-adjusted approach for setting national targets for several federal workforce development programs, including WIA Adult, Dislocated Worker, and Youth programs. Prior to that time, national targets were based on past performance and the desire to encourage continuous improvement in the workforce programs. The continuous improvement approach typically increased target lev...

  11. Effectiveness of Selected Advanced Placement Programs on the Academic Performance and College Readiness of High School Students

    Science.gov (United States)

    Lewis, Traschell S.

    2012-01-01

    The purpose of this study was to examine the effectiveness of selected Advanced Placement (AP) programs on the academic performance and college readiness of high school students. Specifically, the researcher was concerned with ascertaining the effectiveness of social science, math, science, English, music/art and language AP programs on the…

  12. M-DCPS Student Performance in International Baccalaureate and Cambridge Advanced International Certificate of Education Programs. Research Brief. Volume 1102

    Science.gov (United States)

    Blazer, Christie

    2011-01-01

    This Research Brief summarizes the performance of M-DCPS students participating in the International Baccalaureate (IB) and Cambridge Advanced International Certificate of Education (AICE) programs. Outcome data are provided for the eight M-DCPS schools offering the two programs and corresponding examinations. Participation in international…

  13. Effects of a Specifically Designed Physical Conditioning Program on the Load Carriage and Lifting Performance of Female Soldiers

    National Research Council Canada - National Science Library

    Harman, Everett

    1997-01-01

    Forty-six women were studied to determine whether their ability to perform 'very heavy' Army jobs could be improved by a specially designed 24-week physical training program administered within normal...

  14. Effects of a Specifically Designed Physical Conditioning Program on the Load Carriage and Lifting Performance of Female Soldiers

    National Research Council Canada - National Science Library

    Harman, Everett

    1997-01-01

    Forty-six women were studied to determine whether their ability to perform "very heavy" Army jobs could be improved by a specially designed 24-week physical training program administered within normal...

  15. Regional cooperation and performance-based planning and programming in Indiana : a regional models of cooperation peer exchange summary report

    Science.gov (United States)

    2016-05-01

    This report highlights key themes identified at the Regional Cooperation and Performance-Based Planning and Programming in Indiana Peer Exchange held on May 25, 2016 in Indianapolis, Indiana. The Regional Models of Cooperation Initiative, which...

  16. Chinese Preservice Teachers' Professional Identity Links with Education Program Performance: The Roles of Task Value Belief and Learning Motivations

    National Research Council Canada - National Science Library

    Zhang, Yan; Hawk, Skyler T; Zhang, Xiaohui; Zhao, Hongyu

    2016-01-01

    .... This study explored the professional identity of Chinese preservice teachers, and its links with task value belief, intrinsic learning motivation, extrinsic learning motivation, and performance in the education program...

  17. Metabolic mechanisms in heart failure.

    Science.gov (United States)

    Ashrafian, Houman; Frenneaux, Michael P; Opie, Lionel H

    2007-07-24

    Although neurohumoral antagonism has successfully reduced heart failure morbidity and mortality, the residual disability and death rate remains unacceptably high. Though abnormalities of myocardial metabolism are associated with heart failure, recent data suggest that heart failure may itself promote metabolic changes such as insulin resistance, in part through neurohumoral activation. A detrimental self-perpetuating cycle (heart failure --> altered metabolism --> heart failure) that promotes the progression of heart failure may thus be postulated. Accordingly, we review the cellular mechanisms and pathophysiology of altered metabolism and insulin resistance in heart failure. It is hypothesized that the ensuing detrimental myocardial energetic perturbations result from neurohumoral activation, increased adverse free fatty acid metabolism, decreased protective glucose metabolism, and in some cases insulin resistance. The result is depletion of myocardial ATP, phosphocreatine, and creatine kinase with decreased efficiency of mechanical work. On the basis of the mechanisms outlined, appropriate therapies to mitigate aberrant metabolism include intense neurohumoral antagonism, limitation of diuretics, correction of hypokalemia, exercise, and diet. We also discuss more novel mechanistic-based therapies to ameliorate metabolism and insulin resistance in heart failure. For example, metabolic modulators may optimize myocardial substrate utilization to improve cardiac function and exercise performance beyond standard care. The ultimate success of metabolic-based therapy will be manifest by its capacity further to lessen the residual mortality in heart failure.

  18. The Religion Teachers Performance at Aliya Madrasa After Their Completing Training Program in Province of West Nusa Tenggara

    OpenAIRE

    Wibowo, AM

    2013-01-01

    This research aims to evaluated the religions teachers performance at Aliya Madrasa after attending training functional programs which managed by Balai Diklat Keagamaan on province of West Nusa Tenggara. This research important to do to seeing the change of religion teacher performance on Aliya Madrasa whether increase or decrease after attending training functional program. By using analysis of context, input, process, product (CIPP) this study had 4 findings, there are: (1) In pedagogic com...

  19. Medicare Program; Medicare Shared Savings Program: Extreme and Uncontrollable Circumstances Policies for Performance Year 2017. Interim final rule with comment period.

    Science.gov (United States)

    2017-12-26

    This interim final rule with comment period establishes policies for assessing the financial and quality performance of Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) affected by extreme and uncontrollable circumstances during performance year 2017, including the applicable quality reporting period for the performance year. Under the Shared Savings Program, providers of services and suppliers that participate in ACOs continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. ACOs in performance-based risk agreements may also share in losses. This interim final rule with comment period establishes extreme and uncontrollable circumstances policies for the Shared Savings Program that will apply to ACOs subject to extreme and uncontrollable events, such as Hurricanes Harvey, Irma, and Maria, and the California wildfires, effective for performance year 2017, including the applicable quality data reporting period for the performance year.

  20. The Effect of an Ecological Imagery Program on Soccer Performance of Elite Players

    Science.gov (United States)

    Seif-Barghi, Tohid; Kordi, Ramin; Memari, Amir-Hossein; Mansournia, Mohammad-Ali; Jalali-Ghomi, Majid

    2012-01-01

    Purpose Despite the acknowledged impact of imagery on performance, ecologically sound studies investigating imagery and its effects on performance subcomponents in real games are surprisingly limited. The aim of this study was to investigate the effects of imagery training on passing improvement in elite soccer players. Methods Sixty nine soccer players taking part in the national championship leagues in four age categories including U16, U19, U21 and over 21 were randomly assigned to the imagery and control groups. Interventional group participants completed an 8 week video-aided, cognitive imagery program on how to make a perfect soccer pass. Results Performance analysis through close video analysis showed that successful pass rate increased significantly in the intervention group compared to control (OR = 1.19, P=0.002, 95%CI = 1.06-1.33). Further analysis revealed that the results are statistically significant in U16 and U21 but not other categories. Conclusions We concluded that successful soccer passing through real competitions as a multidimensional and critical open skill could be enhanced by an ecologically sound method of mental imagery. PMID:22942993