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Sample records for program improvement include

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

    Science.gov (United States)

    National Center for Systemic Improvement at WestEd, 2015

    2015-01-01

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

  2. Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

    Science.gov (United States)

    Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

    2018-04-01

    The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

  3. Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2015-01-01

    Conclusion: Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects.

  4. A water-based training program that include perturbation exercises to improve stepping responses in older adults: study protocol for a randomized controlled cross-over trial

    Directory of Open Access Journals (Sweden)

    Tsedek Irit

    2008-08-01

    Full Text Available Abstract Background Gait and balance impairments may increase the risk of falls, the leading cause of accidental death in the elderly population. Fall-related injuries constitute a serious public health problem associated with high costs for society as well as human suffering. A rapid step is the most important protective postural strategy, acting to recover equilibrium and prevent a fall from initiating. It can arise from large perturbations, but also frequently as a consequence of volitional movements. We propose to use a novel water-based training program which includes specific perturbation exercises that will target the stepping responses that could potentially have a profound effect in reducing risk of falling. We describe the water-based balance training program and a study protocol to evaluate its efficacy (Trial registration number #NCT00708136. Methods/Design The proposed water-based training program involves use of unpredictable, multi-directional perturbations in a group setting to evoke compensatory and volitional stepping responses. Perturbations are made by pushing slightly the subjects and by water turbulence, in 24 training sessions conducted over 12 weeks. Concurrent cognitive tasks during movement tasks are included. Principles of physical training and exercise including awareness, continuity, motivation, overload, periodicity, progression and specificity were used in the development of this novel program. Specific goals are to increase the speed of stepping responses and improve the postural control mechanism and physical functioning. A prospective, randomized, cross-over trial with concealed allocation, assessor blinding and intention-to-treat analysis will be performed to evaluate the efficacy of the water-based training program. A total of 36 community-dwelling adults (age 65–88 with no recent history of instability or falling will be assigned to either the perturbation-based training or a control group (no training

  5. Containment performance improvement program

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  6. Education Program on Fossil Resources Including Coal

    Science.gov (United States)

    Usami, Masahiro

    Fossil fuels including coal play a key role as crucial energies in contributing to economic development in Asia. On the other hand, its limited quantity and the environmental problems causing from its usage have become a serious global issue and a countermeasure to solve such problems is very much demanded. Along with the pursuit of sustainable development, environmentally-friendly use of highly efficient fossil resources should be therefore, accompanied. Kyushu-university‧s sophisticated research through long years of accumulated experience on the fossil resources and environmental sectors together with the advanced large-scale commercial and empirical equipments will enable us to foster cooperative research and provide internship program for the future researchers. Then, this program is executed as a consignment business from the Ministry of Economy, Trade and Industry from 2007 fiscal year to 2009 fiscal year. The lecture that uses the textbooks developed by this program is scheduled to be started a course in fiscal year 2010.

  7. Maintenance improvement program

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  8. Brunswick improvement program

    International Nuclear Information System (INIS)

    Howe, P.W.

    1985-01-01

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

  9. 24 Command Fire Improvement Action Program Plan

    International Nuclear Information System (INIS)

    GRIFFIN, G.B.

    2000-01-01

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

  10. Is Children's Programming Improving?

    Science.gov (United States)

    Potter, Rosemary Lee

    1979-01-01

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

  11. Program improvement and applications

    International Nuclear Information System (INIS)

    Hink, M.; Imke, U.; Pfrang, W.; Porscha, B.; Struwe, D.; Zimmerer, W.; Allan, P.

    1995-01-01

    An account is given about further improvements of the SAS4A-Ref. 94.R0 version of the HCDA code. They concern in particular the DEFORM fuel rod deformation module. For a validation of the new code version, various CABRI experiments have been calculated, especially tests with high burnup fuel rods. Progress was shown to be achieved, but the precise timing and location of the observed fuel failures is still hard to calculate. The work was performed in close cooperation with partners in France, Britain, and Japan. An important application concerns the CAPRA project of a reactor for actinide burning. Its behavior under ULOF conditions was analyzed using the improved SAS4A Ref. 94 R0 code. The core design turned out to tend toward a long-term coolable configuration even more so than the EFR core design would do in an ULOF. (orig.)

  12. Improving the strength of amalgams by including steel fibers

    Energy Technology Data Exchange (ETDEWEB)

    Cochran, Calvin T. [Hendrix College, Conway, AR 72032 (United States); Van Hoose, James R. [Siemens, Orlando, FL 32826 (United States); McGill, Preston B. [Marshall Space Flight Center, EM20, Huntsville, AL 35812 (United States); Grugel, Richard N., E-mail: richard.n.grugel@nasa.gov [Marshall Space Flight Center, EM30, Huntsville, AL 35812 (United States)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer A room temperature liquid Ga-In alloy was successfully substituted for mercury. Black-Right-Pointing-Pointer Physically sound amalgams with included steel fibers can be made. Black-Right-Pointing-Pointer A small volume fraction inclusion of fibers increased strength by {approx}20%. - Abstract: Mercury amalgams, due to their material properties, are widely and successfully used in dental practice. They are, however, also well recognized as having poor tensile strength. With the possibility of expanding amalgam applications it is demonstrated that tensile strength can be increased some 20% by including a small amount of steel fibers. Furthermore, it is shown that mercury can be replaced with a room temperature liquid gallium-indium alloy. Processing, microstructures, and mechanical test results of these novel amalgams are presented and discussed in view of means to further improve their properties.

  13. Software Engineering Program: Software Process Improvement Guidebook

    Science.gov (United States)

    1996-01-01

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

  14. Programs to improve plant performance

    International Nuclear Information System (INIS)

    Felmus, N.L.

    1987-01-01

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

  15. Improved self-exclusion program: preliminary results.

    Science.gov (United States)

    Tremblay, Nicole; Boutin, Claude; Ladouceur, Robert

    2008-12-01

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

  16. Pediatric CT quality management and improvement program

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-10-15

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

  17. Pediatric CT quality management and improvement program

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  18. Power extraction calculation improvement when local parameters are included

    Science.gov (United States)

    Flores-Mateos, L. M.; Hartnett, M.

    2016-02-01

    The improvement of the tidal resource assessment will be studied by comparing two approaches in a two-dimensional, finite difference, hydrodynamic model DIVAST-ADI; in a channel of non-varying cross-sectional area that connects two large basins. The first strategy, considers a constant trust coefficient; the second one, use the local field parameters around the turbine. These parameters are obtained after applying the open channel theory in the tidal stream and after considering the turbine as a linear momentum actuator disk. The parameters correspond to the upstream and downstream, with respect to the turbine, speeds and depths; also the blockage ratio, the wake velocity and the bypass coefficients and they have already been incorporated in the model. The figure (a) shows the numerical configuration at high tide developed with DIVAST-ADI. The experiment undertakes two open boundary conditions. The first one is a sinusoidal forcing introduced as a water level located at (I, J=1) and the second one, indicate that a zero velocity and a constant water depth were kept (I, J=362); when the turbine is introduced it is placed in the middle of the channel (I=161, J=181). The influence of the turbine in the velocity and elevation around the turbine region is evident; figure (b) and (c) shows that the turbine produces a discontinuity in the depth and velocity profile, when we plot a transect along the channel. Finally, the configuration implemented reproduced with satisfactory accuracy the quasi-steady flow condition, even without presenting shock-capturing capability. Also, the range of the parameters 0.01<α 4<0.55, $0

  19. BSN Program Admittance Criteria: Should Emotional Intelligence Be Included?

    Science.gov (United States)

    Smith, Tanya

    2017-01-01

    Emotional intelligence refers to the ability to identify and monitor emotions and remain aware of how emotions affect thoughts and actions. Emotional intelligence has been discussed as a better predictor of personal and occupational success than performance on intellectual intelligence tests. Despite the importance of one's emotional intelligence, BSN (Bachelor of Science in Nursing) nursing schools routinely admit candidates based on the student's cumulative college course grade point average (GPA). Nursing is a profession that requires one's ability to empathize, care, and react in emotionally sound manners. Is the GPA enough to determine if a student will evolve into a professional nurse? This article will explore the routine admittance criteria for BSN nursing programs and propose the concept of using the emotional intelligence tool as an adjunct to the cumulative college course GPA. The emotional intelligence theory will be identified and applied to the nursing profession. © 2016 Wiley Periodicals, Inc.

  20. C-E productivity improvement program

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  1. Improving regulatory oversight of maintenance programs

    International Nuclear Information System (INIS)

    Cook, S.

    2008-01-01

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

  2. Making quality improvement programs more effective.

    Science.gov (United States)

    Shaw-Taylor, Yoku

    2014-01-01

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

  3. Improvements to the adaptive maneuvering logic program

    Science.gov (United States)

    Burgin, George H.

    1986-01-01

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

  4. Conducting a SWOT Analysis for Program Improvement

    Science.gov (United States)

    Orr, Betsy

    2013-01-01

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

  5. Evolution and outcomes of a quality improvement program.

    Science.gov (United States)

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

    2010-01-01

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

  6. Federal Aviation Administration weather program to improve aviation safety

    Science.gov (United States)

    Wedan, R. W.

    1983-01-01

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

  7. ACED Allegheny Home Improvement Loan Program (AHILP)

    Data.gov (United States)

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

  8. AIF programs supporting industry self-improvement

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  9. Simulated selection responses for breeding programs including resistance and resilience to parasites in Creole goats.

    Science.gov (United States)

    Gunia, M; Phocas, F; Gourdine, J-L; Bijma, P; Mandonnet, N

    2013-02-01

    The Creole goat is a local breed used for meat production in Guadeloupe (French West Indies). As in other tropical countries, improvement of parasite resistance is needed. In this study, we compared predicted selection responses for alternative breeding programs with or without parasite resistance and resilience traits. The overall breeding goal included traits for production, reproduction, and parasite resilience and resistance to ensure a balanced selection outcome. The production traits were BW and dressing percentage (DP). The reproduction trait was fertility (FER), which was the number of doe kiddings per mating. The resistance trait was worm fecal egg count (FEC), which is a measurement of the number of gastro-intestinal parasite eggs found in the feces. The resilience trait was the packed cell volume (PCV), which is a measurement of the volume of red blood cells in the blood. Dressing percentage, BW, and FEC were measured at 11 mo of age, which is the mating or selling age. Fertility and PCV were measured on females at each kidding period. The breeding program accounting for the overall breeding goal and a selection index including all traits gave annual selection responses of 800 g for BW, 3.75% for FER, 0.08% for DP, -0.005 ln(eggs/g) for FEC, and 0.28% for PCV. The expected selection responses for BW and DP in this breeding program were reduced by 2% and 6%, respectively, compared with a breeding program not accounting for FEC and PCV. The overall breeding program, proposed for the Creole breed, offers the best breeding strategy in terms of expected selection responses, making it possible to improve all traits together. It offers a good balance between production and adaptation traits and may present some interest for the selection of other goat breeds in the tropics.

  10. 15 CFR 9.3 - Appliances and equipment included in program.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Appliances and equipment included in... VOLUNTARY LABELING PROGRAM FOR HOUSEHOLD APPLIANCES AND EQUIPMENT TO EFFECT ENERGY CONSERVATION § 9.3 Appliances and equipment included in program. The appliances and equipment included in this program are room...

  11. Continuous Improvement in State Funded Preschool Programs

    Science.gov (United States)

    Jackson, Sarah L.

    2012-01-01

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

  12. Including oral health training in a health system strengthening program in Rwanda

    Directory of Open Access Journals (Sweden)

    Brittany Seymour

    2013-03-01

    Full Text Available Objective: Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. Design: In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined ‘vertical’ direct patient care training with ‘horizontal’ interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. Results: The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Conclusions: Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come.

  13. Including oral health training in a health system strengthening program in Rwanda

    Science.gov (United States)

    Seymour, Brittany; Muhumuza, Ibra; Mumena, Chris; Isyagi, Moses; Barrow, Jane; Meeks, Valli

    2013-01-01

    Objective Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH) Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. Design In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined ‘vertical’ direct patient care training with ‘horizontal’ interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. Results The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Conclusions Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come. PMID:23473054

  14. Designing monitoring programs for chemicals of emerging concern in potable reuse ⋯ What to include and what not to include?

    KAUST Repository

    Drewes, Jorg; Anderson, Paul D.; Denslow, Nancy D.; Olivieri, Adam W.; Schlenk, Daniel K.; Snyder, Shane A.; Maruya, Keith

    2012-01-01

    This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than '1' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound. © IWA Publishing 2013.

  15. Designing monitoring programs for chemicals of emerging concern in potable reuse--what to include and what not to include?

    Science.gov (United States)

    Drewes, J E; Anderson, P; Denslow, N; Olivieri, A; Schlenk, D; Snyder, S A; Maruya, K A

    2013-01-01

    This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than '1' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound.

  16. Designing monitoring programs for chemicals of emerging concern in potable reuse ⋯ What to include and what not to include?

    KAUST Repository

    Drewes, Jorg

    2012-11-01

    This study discussed a proposed process to prioritize chemicals for reclaimed water monitoring programs, selection of analytical methods required for their quantification, toxicological relevance of chemicals of emerging concern regarding human health, and related issues. Given that thousands of chemicals are potentially present in reclaimed water and that information about those chemicals is rapidly evolving, a transparent, science-based framework was developed to guide prioritization of which compounds of emerging concern (CECs) should be included in reclaimed water monitoring programs. The recommended framework includes four steps: (1) compile environmental concentrations (e.g., measured environmental concentration or MEC) of CECs in the source water for reuse projects; (2) develop a monitoring trigger level (MTL) for each of these compounds (or groups thereof) based on toxicological relevance; (3) compare the environmental concentration (e.g., MEC) to the MTL; CECs with a MEC/MTL ratio greater than 1 should be prioritized for monitoring, compounds with a ratio less than \\'1\\' should only be considered if they represent viable treatment process performance indicators; and (4) screen the priority list to ensure that a commercially available robust analytical method is available for that compound. © IWA Publishing 2013.

  17. 41 CFR 301-73.1 - What does the Federal travel management program include?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What does the Federal travel management program include? 301-73.1 Section 301-73.1 Public Contracts and Property Management... PROGRAMS General Rules § 301-73.1 What does the Federal travel management program include? The Federal...

  18. Process Evaluation and Continuous Improvement in Community Youth Programs

    Directory of Open Access Journals (Sweden)

    Jennifer V. Trachtenberg

    2008-06-01

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

  19. Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management

    International Nuclear Information System (INIS)

    1993-11-01

    This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities in the operational phase. Portions of this standard are also useful for other DOE processes, activities, and programs. This Part 1 contains foreword, glossary, acronyms, bibliography, and Chapter 1 on operational configuration management program principles. Appendices are included on configuration management program interfaces, and background material and concepts for operational configuration management

  20. Interchange. Program Improvement Products Identified through Networking.

    Science.gov (United States)

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

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

  1. Fostering Quality Improvement in EHDI Programs

    Science.gov (United States)

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

    2011-01-01

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

  2. Status of the PSR improvement program

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  3. Educational program in crisis management for cardiac surgery teams including high realism simulation.

    Science.gov (United States)

    Stevens, Louis-Mathieu; Cooper, Jeffrey B; Raemer, Daniel B; Schneider, Robert C; Frankel, Allan S; Berry, William R; Agnihotri, Arvind K

    2012-07-01

    Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management. We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews. The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly. Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Body Image and quality of life of senior citizens included in a cardiac rehabilitation program

    Directory of Open Access Journals (Sweden)

    Fernanda Vargas Amaral

    2013-12-01

    Full Text Available Most people who have to live with some kind of disease tend to adopt healthy habits and create new ways of seeing themselves. The aim of this study is to explore the relationship between the index of quality of life and self perception of patients included in a cardiovascular rehabilitation program in Florianopolis/Brazil. The sample consists of 24 subjects of 62 ± 1.3 years of age, who have coronary artery disease. The Minnesota Living With Heart Failure Questionnaire (MLHFQ was used to assess the quality of life, and to identify the degree of body image discontentment the Stunkard and Sorensen questionnaire (1993 was applied. Statistical analysis was made through statistics programs and the software SPSS 11.0. The degree of association between variables was studied with Kendall test. It was verified that the higher the BMI and the current body shape, the greatest the degree of body image dissatisfaction. The emotional symptoms also appear to be significantly correlated with a desire for a smaller body shape and with indicators of lower quality of life (r = 0474 = 0735, p major 0.05. The physical symptoms were also considerably associated with the emotional symptoms. These results suggest that the variables concerning the quality of life are meaningful to significant body image and satisfaction, which seems to correlate with fewer emotional problems and better facing of the disease. Cardiovascular Rehabilitation Programs that implement physical activity in daily habits proves to be a suitable tool for improving these ailments in this post-acute phase

  6. Experiences of Students with Specific Learning Disorder (Including ADHD) in Online College Degree Programs: A Phenomenological Study

    Science.gov (United States)

    Bunch, Seleta LeAnn

    2016-01-01

    Enrollment in online degree programs is rapidly expanding due to the convenience and affordability offered to students and improvements in technology. The purpose of this hermeneutical phenomenological study was to understand the shared experiences of students with documented specific learning disorders (including Attention-Deficit/Hyperactivity…

  7. 12 CFR 361.6 - What outreach efforts are included in this program?

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false What outreach efforts are included in this program? 361.6 Section 361.6 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION REGULATIONS AND STATEMENTS OF GENERAL POLICY MINORITY AND WOMEN OUTREACH PROGRAM CONTRACTING § 361.6 What outreach efforts...

  8. 76 FR 35474 - UAW-Chrysler Technical Training Center, Technology Training Joint Programs Staff, Including On...

    Science.gov (United States)

    2011-06-17

    ...-Chrysler Technical Training Center, Technology Training Joint Programs Staff, Including On-Site Leased Workers From Cranks, O/E Learning, DBSI, IDEA, and Tonic/MVP, Detroit, MI; UAW-Chrysler Technical Training... workers and former workers of UAW-Chrysler Technical Training Center, Technology Training Joint Programs...

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

    African Journals Online (AJOL)

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

  10. Digital Competition Game to Improve Programming Skills

    Science.gov (United States)

    Moreno, Julian

    2012-01-01

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

  11. Strategic Planning to Improve EHDI Programs

    Science.gov (United States)

    White, Karl R.; Blaiser, Kristina M.

    2011-01-01

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

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

    Science.gov (United States)

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

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

  13. Comprehensive adolescent health programs that include sexual and reproductive health services: a systematic review.

    Science.gov (United States)

    Kågesten, Anna; Parekh, Jenita; Tunçalp, Ozge; Turke, Shani; Blum, Robert William

    2014-12-01

    We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998-2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects.

  14. Improving Defense Health Program Medical Research Processes

    Science.gov (United States)

    2017-08-08

    research , including a Business Cell; 87 Research Development, 88 Research Oversight, 89 and Research Compliance offices;90 and the Center...needed for DHP medical research , such as the Army’s Clinical and Translational Research Program Office, 38 the Navy’s Research Methods Training Program... research stated, “key infrastructure for a learning health system will encompass three core elements: data networks, methods , and workforce.” 221

  15. Including nonadditive genetic effects in mating programs to maximize dairy farm profitability.

    Science.gov (United States)

    Aliloo, H; Pryce, J E; González-Recio, O; Cocks, B G; Goddard, M E; Hayes, B J

    2017-02-01

    We compared the outcome of mating programs based on different evaluation models that included nonadditive genetic effects (dominance and heterozygosity) in addition to additive effects. The additive and dominance marker effects and the values of regression on average heterozygosity were estimated using 632,003 single nucleotide polymorphisms from 7,902 and 7,510 Holstein cows with calving interval and production (milk, fat, and protein yields) records, respectively. Expected progeny values were computed based on the estimated genetic effects and genotype probabilities of hypothetical progeny from matings between the available genotyped cows and the top 50 young genomic bulls. An index combining the traits based on their economic values was developed and used to evaluate the performance of different mating scenarios in terms of dollar profit. We observed that mating programs with nonadditive genetic effects performed better than a model with only additive effects. Mating programs with dominance and heterozygosity effects increased milk, fat, and protein yields by up to 38, 1.57, and 1.21 kg, respectively. The inclusion of dominance and heterozygosity effects decreased calving interval by up to 0.70 d compared with random mating. The average reduction in progeny inbreeding by the inclusion of nonadditive genetic effects in matings compared with random mating was between 0.25 to 1.57 and 0.64 to 1.57 percentage points for calving interval and production traits, respectively. The reduction in inbreeding was accompanied by an average of A$8.42 (Australian dollars) more profit per mating for a model with additive, dominance, and heterozygosity effects compared with random mating. Mate allocations that benefit from nonadditive genetic effects can improve progeny performance only in the generation where it is being implemented, and the gain from specific combining abilities cannot be accumulated over generations. Continuous updating of genomic predictions and mate

  16. 12 CFR 906.12 - What outreach efforts are included in this program?

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false What outreach efforts are included in this program? 906.12 Section 906.12 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOUSING FINANCE... Minorities, Women, or Individuals With Disabilities § 906.12 What outreach efforts are included in this...

  17. Simulated selection responses for breeding programs including resistance and resilience to parasites in Creole goats

    NARCIS (Netherlands)

    Gunia, M.; Phocas, F.; Gourdine, J.L.; Bijma, P.; Mandonnet, N.

    2013-01-01

    The Creole goat is a local breed used for meat production in Guadeloupe (French West Indies). As in other tropical countries, improvement of parasite resistance is needed. In this study, we compared predicted selection responses for alternative breeding programs with or without parasites resistance

  18. IGUN-A program for the simulation of positive ion extraction including magnetic fields

    International Nuclear Information System (INIS)

    Becker, R.; Herrmannsfeldt, W.B.

    1992-01-01

    IGUN is a program for the simulation of positive ion extraction from plasmas. It is based on the well known program EGUN for the calculation of electron and ion trajectories in electron guns and lenses. The mathematical treatment of the plasma sheath is based on a simple analytical model, which provides a numerically stable calculation of the sheath potentials. In contrast to other ion extraction programs, IGUN is able to determine the extracted ion current in succeeding cycles of iteration by itself. However, it is also possible to set values of current, plasma density, or ion current density. Either axisymmetric or rectangular coordinates can be used, including axisymmetric or transverse magnetic fields

  19. igun - A program for the simulation of positive ion extraction including magnetic fields

    Science.gov (United States)

    Becker, R.; Herrmannsfeldt, W. B.

    1992-04-01

    igun is a program for the simulation of positive ion extraction from plasmas. It is based on the well known program egun for the calculation of electron and ion trajectories in electron guns and lenses. The mathematical treatment of the plasma sheath is based on a simple analytical model, which provides a numerically stable calculation of the sheath potentials. In contrast to other ion extraction programs, igun is able to determine the extracted ion current in succeeding cycles of iteration by itself. However, it is also possible to set values of current, plasma density, or ion current density. Either axisymmetric or rectangular coordinates can be used, including axisymmetric or transverse magnetic fields.

  20. 45 CFR 1355.35 - Program improvement plans.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

    Hopkins, Mona S.

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

  2. Short-term Evaluation of a Comprehensive Education Program Including Inhaler Training and Disease Management on Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Yoo, Kwang Ha; Chung, Wou Young; Park, Joo Hun; Hwang, Sung Chul; Kim, Tae Eun; Oh, Min Jung; Kang, Dae Ryong; Rhee, Chin Kook; Yoon, Hyoung Kyu; Kim, Tae Hyung; Kim, Deog Kyeom; Park, Yong Bum; Kim, Sang Ha; Yum, Ho Kee

    2017-10-01

    Proper education regarding inhaler usage and optimal management of chronic obstructive pulmonary disease (COPD) is essential for effectively treating patients with COPD. This study was conducted to evaluate the effects of a comprehensive education program including inhaler training and COPD management. We enlisted 127 patients with COPD on an outpatient basis at 43 private clinics in Korea. The patients were educated on inhaler usage and disease management for three visits across 2 weeks. Physicians and patients were administered a COPD assessment test (CAT) and questionnaires about the correct usage of inhalers and management of COPD before commencement of this program and after their third visit. The outcomes of 127 COPD patients were analyzed. CAT scores (19.6±12.5 vs. 15.1±12.3) improved significantly after this program (pmanagement and the correct technique for using inhalers than those who did not have improved CAT scores (peducation program including inhaler training and COPD management at a primary care setting improved CAT scores and led to patients' better understanding of COPD management. Copyright©2017. The Korean Academy of Tuberculosis and Respiratory Diseases

  3. 43 CFR 43.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false What must I include in my drug-free awareness program? 43.215 Section 43.215 Public Lands: Interior Office of the Secretary of the Interior GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Requirements for Recipients Other Than Individuals § 43.215 What must I...

  4. 29 CFR 1472.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false What must I include in my drug-free awareness program? 1472.215 Section 1472.215 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Requirements for Recipients Other Than Individuals § 1472.215...

  5. Integrative Biological Chemistry Program Includes the Use of Informatics Tools, GIS and SAS Software Applications

    Science.gov (United States)

    D'Souza, Malcolm J.; Kashmar, Richard J.; Hurst, Kent; Fiedler, Frank; Gross, Catherine E.; Deol, Jasbir K.; Wilson, Alora

    2015-01-01

    Wesley College is a private, primarily undergraduate minority-serving institution located in the historic district of Dover, Delaware (DE). The College recently revised its baccalaureate biological chemistry program requirements to include a one-semester Physical Chemistry for the Life Sciences course and project-based experiential learning…

  6. 77 FR 61012 - Expansion of Importer Self-Assessment Program To Include Qualified Importers of Focused...

    Science.gov (United States)

    2012-10-05

    ... of International Trade, has determined that the company represents an acceptable risk to CBP, if the... Executive Director, Trade Policy and Programs, Office of International Trade, at [email protected] benefits: Entitled to receive entry summary trade data, including analysis support, from CBP. Consultation...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-05-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-07-01

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

  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. Performance improvement program: goals and experience

    International Nuclear Information System (INIS)

    Guglielmi, F.

    2015-01-01

    Following long 54 month refurbishment outage at Point Lepreau Generating Station, operational performance had fallen below industry standards in a number of areas. Leadership development and succession planning had stalled. Operational focus was low primarily due to the construction focus during refurbishment. Condition of balance of plant was poor including several long standing deficiencies. In order to improve performance, the site implemented a framework based on INPO 12-011: Focus on Improving Behaviours; Set common goals and demonstrate results; Align and engage the organization; Drive to achieve high levels of performance and sustain performance.

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

    Science.gov (United States)

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

    2016-12-01

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

  13. Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report.

    Science.gov (United States)

    Farrell, Elizabeth; Naber, Erin; Geigle, Paula

    2010-01-01

    This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go gait trainer, Lite Gait Walkable, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.

  14. SEL's Software Process-Improvement Program

    Science.gov (United States)

    Basili, Victor; Zelkowitz, Marvin; McGarry, Frank; Page, Jerry; Waligora, Sharon; Pajerski, Rose

    1995-01-01

    The goals and operations of the Software Engineering Laboratory (SEL) is reviewed. For nearly 20 years the SEL has worked to understand, assess, and improve software and the development process within the production environment of the Flight Dynamics Division (FDD) of NASA's Goddard Space Flight Center. The SEL was established in 1976 with the goals of reducing: (1) the defect rate of delivered software, (2) the cost of software to support flight projects, and (3) the average time to produce mission-support software. After studying over 125 projects of FDD, the results have guided the standards, management practices, technologies, and the training within the division. The results of the studies have been a 75 percent reduction in defects, a 50 percent reduction in cost, and a 25 percent reduction in development time. Over time the goals of SEL have been clarified. The goals are now stated as: (1) Understand baseline processes and product characteristics, (2) Assess improvements that have been incorporated into the development projects, (3) Package and infuse improvements into the standard SEL process. The SEL improvement goal is to demonstrate continual improvement of the software process by carrying out analysis, measurement and feedback to projects with in the FDD environment. The SEL supports the understanding of the process by study of several processes including, the effort distribution, and error detection rates. The SEL assesses and refines the processes. Once the assessment and refinement of a process is completed, the SEL packages the process by capturing the process in standards, tools and training.

  15. 20 CFR 627.220 - Coordination with programs under title IV of the Higher Education Act including the Pell grant...

    Science.gov (United States)

    2010-04-01

    ... the Higher Education Act including the Pell grant program. 627.220 Section 627.220 Employees' Benefits... of the Higher Education Act including the Pell grant program. (a) Coordination. Financial assistance programs under title IV of the Higher Education Act of 1965, as amended (HEA) (the Pell Grant program, the...

  16. An improved instrument setpoint control program

    International Nuclear Information System (INIS)

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

    1991-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-06-01

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

  18. PTAC: a computer program for pressure-transient analysis, including the effects of cavitation. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Kot, C A; Youngdahl, C K

    1978-09-01

    PTAC was developed to predict pressure transients in nuclear-power-plant piping systems in which the possibility of cavitation must be considered. The program performs linear or nonlinear fluid-hammer calculations, using a fixed-grid method-of-characteristics solution procedure. In addition to pipe friction and elasticity, the program can treat a variety of flow components, pipe junctions, and boundary conditions, including arbitrary pressure sources and a sodium/water reaction. Essential features of transient cavitation are modeled by a modified column-separation technique. Comparisons of calculated results with available experimental data, for a simple piping arrangement, show good agreement and provide validation of the computational cavitation model. Calculations for a variety of piping networks, containing either liquid sodium or water, demonstrate the versatility of PTAC and clearly show that neglecting cavitation leads to erroneous predictions of pressure-time histories.

  19. 40 CFR 63.175 - Quality improvement program for valves.

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

    Stodden, Robert A.

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

  1. Improvement of prediction ability for genomic selection of dairy cattle by including dominance effects.

    Directory of Open Access Journals (Sweden)

    Chuanyu Sun

    Full Text Available Dominance may be an important source of non-additive genetic variance for many traits of dairy cattle. However, nearly all prediction models for dairy cattle have included only additive effects because of the limited number of cows with both genotypes and phenotypes. The role of dominance in the Holstein and Jersey breeds was investigated for eight traits: milk, fat, and protein yields; productive life; daughter pregnancy rate; somatic cell score; fat percent and protein percent. Additive and dominance variance components were estimated and then used to estimate additive and dominance effects of single nucleotide polymorphisms (SNPs. The predictive abilities of three models with both additive and dominance effects and a model with additive effects only were assessed using ten-fold cross-validation. One procedure estimated dominance values, and another estimated dominance deviations; calculation of the dominance relationship matrix was different for the two methods. The third approach enlarged the dataset by including cows with genotype probabilities derived using genotyped ancestors. For yield traits, dominance variance accounted for 5 and 7% of total variance for Holsteins and Jerseys, respectively; using dominance deviations resulted in smaller dominance and larger additive variance estimates. For non-yield traits, dominance variances were very small for both breeds. For yield traits, including additive and dominance effects fit the data better than including only additive effects; average correlations between estimated genetic effects and phenotypes showed that prediction accuracy increased when both effects rather than just additive effects were included. No corresponding gains in prediction ability were found for non-yield traits. Including cows with derived genotype probabilities from genotyped ancestors did not improve prediction accuracy. The largest additive effects were located on chromosome 14 near DGAT1 for yield traits for both

  2. 76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

    Science.gov (United States)

    2011-06-13

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

  3. Improved best estimate plus uncertainty methodology including advanced validation concepts to license evolving nuclear reactors

    International Nuclear Information System (INIS)

    Unal, Cetin; Williams, Brian; McClure, Patrick; Nelson, Ralph A.

    2010-01-01

    Many evolving nuclear energy programs plan to use advanced predictive multi-scale multi-physics simulation and modeling capabilities to reduce cost and time from design through licensing. Historically, the role of experiments was primary tool for design and understanding of nuclear system behavior while modeling and simulation played the subordinate role of supporting experiments. In the new era of multi-scale multi-physics computational based technology development, the experiments will still be needed but they will be performed at different scales to calibrate and validate models leading predictive simulations. Cost saving goals of programs will require us to minimize the required number of validation experiments. Utilization of more multi-scale multi-physics models introduces complexities in the validation of predictive tools. Traditional methodologies will have to be modified to address these arising issues. This paper lays out the basic aspects of a methodology that can be potentially used to address these new challenges in design and licensing of evolving nuclear technology programs. The main components of the proposed methodology are verification, validation, calibration, and uncertainty quantification. An enhanced calibration concept is introduced and is accomplished through data assimilation. The goal is to enable best-estimate prediction of system behaviors in both normal and safety related environments. To achieve this goal requires the additional steps of estimating the domain of validation and quantification of uncertainties that allow for extension of results to areas of the validation domain that are not directly tested with experiments, which might include extension of the modeling and simulation (M and S) capabilities for application to full-scale systems. The new methodology suggests a formalism to quantify an adequate level of validation (predictive maturity) with respect to required selective data so that required testing can be minimized for

  4. Improved best estimate plus uncertainty methodology including advanced validation concepts to license evolving nuclear reactors

    Energy Technology Data Exchange (ETDEWEB)

    Unal, Cetin [Los Alamos National Laboratory; Williams, Brian [Los Alamos National Laboratory; Mc Clure, Patrick [Los Alamos National Laboratory; Nelson, Ralph A [IDAHO NATIONAL LAB

    2010-01-01

    Many evolving nuclear energy programs plan to use advanced predictive multi-scale multi-physics simulation and modeling capabilities to reduce cost and time from design through licensing. Historically, the role of experiments was primary tool for design and understanding of nuclear system behavior while modeling and simulation played the subordinate role of supporting experiments. In the new era of multi-scale multi-physics computational based technology development, the experiments will still be needed but they will be performed at different scales to calibrate and validate models leading predictive simulations. Cost saving goals of programs will require us to minimize the required number of validation experiments. Utilization of more multi-scale multi-physics models introduces complexities in the validation of predictive tools. Traditional methodologies will have to be modified to address these arising issues. This paper lays out the basic aspects of a methodology that can be potentially used to address these new challenges in design and licensing of evolving nuclear technology programs. The main components of the proposed methodology are verification, validation, calibration, and uncertainty quantification. An enhanced calibration concept is introduced and is accomplished through data assimilation. The goal is to enable best-estimate prediction of system behaviors in both normal and safety related environments. To achieve this goal requires the additional steps of estimating the domain of validation and quantification of uncertainties that allow for extension of results to areas of the validation domain that are not directly tested with experiments, which might include extension of the modeling and simulation (M&S) capabilities for application to full-scale systems. The new methodology suggests a formalism to quantify an adequate level of validation (predictive maturity) with respect to required selective data so that required testing can be minimized for cost

  5. A tool to include gamma analysis software into a quality assurance program.

    Science.gov (United States)

    Agnew, Christina E; McGarry, Conor K

    2016-03-01

    To provide a tool to enable gamma analysis software algorithms to be included in a quality assurance (QA) program. Four image sets were created comprising two geometric images to independently test the distance to agreement (DTA) and dose difference (DD) elements of the gamma algorithm, a clinical step and shoot IMRT field and a clinical VMAT arc. The images were analysed using global and local gamma analysis with 2 in-house and 8 commercially available software encompassing 15 software versions. The effect of image resolution on gamma pass rates was also investigated. All but one software accurately calculated the gamma passing rate for the geometric images. Variation in global gamma passing rates of 1% at 3%/3mm and over 2% at 1%/1mm was measured between software and software versions with analysis of appropriately sampled images. This study provides a suite of test images and the gamma pass rates achieved for a selection of commercially available software. This image suite will enable validation of gamma analysis software within a QA program and provide a frame of reference by which to compare results reported in the literature from various manufacturers and software versions. Copyright © 2015. Published by Elsevier Ireland Ltd.

  6. Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

    Science.gov (United States)

    Eby, Chas

    2014-01-01

    The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

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

    Science.gov (United States)

    Bowe, Sarah N

    2016-02-01

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

  8. The utility of including pathology reports in improving the computational identification of patients

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2016-01-01

    Full Text Available Background: Celiac disease (CD is a common autoimmune disorder. Efficient identification of patients may improve chronic management of the disease. Prior studies have shown searching International Classification of Diseases-9 (ICD-9 codes alone is inaccurate for identifying patients with CD. In this study, we developed automated classification algorithms leveraging pathology reports and other clinical data in Electronic Health Records (EHRs to refine the subset population preselected using ICD-9 code (579.0. Materials and Methods: EHRs were searched for established ICD-9 code (579.0 suggesting CD, based on which an initial identification of cases was obtained. In addition, laboratory results for tissue transglutaminse were extracted. Using natural language processing we analyzed pathology reports from upper endoscopy. Twelve machine learning classifiers using different combinations of variables related to ICD-9 CD status, laboratory result status, and pathology reports were experimented to find the best possible CD classifier. Ten-fold cross-validation was used to assess the results. Results: A total of 1498 patient records were used including 363 confirmed cases and 1135 false positive cases that served as controls. Logistic model based on both clinical and pathology report features produced the best results: Kappa of 0.78, F1 of 0.92, and area under the curve (AUC of 0.94, whereas in contrast using ICD-9 only generated poor results: Kappa of 0.28, F1 of 0.75, and AUC of 0.63. Conclusion: Our automated classification system presented an efficient and reliable way to improve the performance of CD patient identification.

  9. 13 CFR 147.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-01-01

    ..., rehabilitation, and employee assistance programs; and (d) The penalties that you may impose upon them for drug...-free awareness program? 147.215 Section 147.215 Business Credit and Assistance SMALL BUSINESS... establish an ongoing drug-free awareness program to inform employees about— (a) The dangers of drug abuse in...

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

    Science.gov (United States)

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

    1998-01-01

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

  11. Improving weather predictability by including land-surface model parameter uncertainty

    Science.gov (United States)

    Orth, Rene; Dutra, Emanuel; Pappenberger, Florian

    2016-04-01

    The land surface forms an important component of Earth system models and interacts nonlinearly with other parts such as ocean and atmosphere. To capture the complex and heterogenous hydrology of the land surface, land surface models include a large number of parameters impacting the coupling to other components of the Earth system model. Focusing on ECMWF's land-surface model HTESSEL we present in this study a comprehensive parameter sensitivity evaluation using multiple observational datasets in Europe. We select 6 poorly constrained effective parameters (surface runoff effective depth, skin conductivity, minimum stomatal resistance, maximum interception, soil moisture stress function shape, total soil depth) and explore their sensitivity to model outputs such as soil moisture, evapotranspiration and runoff using uncoupled simulations and coupled seasonal forecasts. Additionally we investigate the possibility to construct ensembles from the multiple land surface parameters. In the uncoupled runs we find that minimum stomatal resistance and total soil depth have the most influence on model performance. Forecast skill scores are moreover sensitive to the same parameters as HTESSEL performance in the uncoupled analysis. We demonstrate the robustness of our findings by comparing multiple best performing parameter sets and multiple randomly chosen parameter sets. We find better temperature and precipitation forecast skill with the best-performing parameter perturbations demonstrating representativeness of model performance across uncoupled (and hence less computationally demanding) and coupled settings. Finally, we construct ensemble forecasts from ensemble members derived with different best-performing parameterizations of HTESSEL. This incorporation of parameter uncertainty in the ensemble generation yields an increase in forecast skill, even beyond the skill of the default system. Orth, R., E. Dutra, and F. Pappenberger, 2016: Improving weather predictability by

  12. Construction Improvement for the Korean Nuclear Program

    International Nuclear Information System (INIS)

    Yang, T. E.

    1992-01-01

    Construction of the nine Nuclear plants requires an enormous financial investment. The decision to build a nuclear unit is based on both economic and resource requirements. Korea has few natural resources to use for power generation so the use of diversified fuel sources is a part of the planning process. Nuclear has historically had economic advantages over the fossil fueled plant, however, this advantage has been reduced. This is mainly due to increasing decommissioning and waste disposal costs plus the financial outlays associated with gaining public acceptance of new nuclear units. One of the principal means to recover the economic advantage of a nuclear plant is to shorten the time needed for construction. Every extra day of construction costs large sums of money in interest and escalation expenses alone. The challenge is to shorten the construction period to the minimum feasible time and thereby reduce the financing costs. The methods that have to be employed to achieve this goal require the total commitment from the management of all entities involved in the program. Through the application of advanced management and construction techniques a new era in the construction of nuclear plants in Korea will occur. This will include changes to the methods used for managing, planning, licensing, designing and constructing the new plants. The ability to meet the aggressive plan for the construction of new nuclear power plants in Korea rests in the hands of the managers of all the parties involved. These men set all the rules by which the new plants will be constructed. It is their responsibility to tackle the current problems and develop the solutions to enable the plan to be realized. The changes suggested within this paper are major, but the potential benefits will allow the Korean Nuclear Industry to advance into the twenty first Century as a leader. The number of fully trained specialists needed to make this happen will not appear overnight. They will have to be

  13. 78 FR 7476 - Airport Improvement Program

    Science.gov (United States)

    2013-02-01

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

  14. ALGORITHMS AND PROGRAMS FOR STRONG GRAVITATIONAL LENSING IN KERR SPACE-TIME INCLUDING POLARIZATION

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Bin; Maddumage, Prasad [Research Computing Center, Department of Scientific Computing, Florida State University, Tallahassee, FL 32306 (United States); Kantowski, Ronald; Dai, Xinyu; Baron, Eddie, E-mail: bchen3@fsu.edu [Homer L. Dodge Department of Physics and Astronomy, University of Oklahoma, Norman, OK 73019 (United States)

    2015-05-15

    Active galactic nuclei (AGNs) and quasars are important astrophysical objects to understand. Recently, microlensing observations have constrained the size of the quasar X-ray emission region to be of the order of 10 gravitational radii of the central supermassive black hole. For distances within a few gravitational radii, light paths are strongly bent by the strong gravity field of the central black hole. If the central black hole has nonzero angular momentum (spin), then a photon’s polarization plane will be rotated by the gravitational Faraday effect. The observed X-ray flux and polarization will then be influenced significantly by the strong gravity field near the source. Consequently, linear gravitational lensing theory is inadequate for such extreme circumstances. We present simple algorithms computing the strong lensing effects of Kerr black holes, including the effects on polarization. Our algorithms are realized in a program “KERTAP” in two versions: MATLAB and Python. The key ingredients of KERTAP are a graphic user interface, a backward ray-tracing algorithm, a polarization propagator dealing with gravitational Faraday rotation, and algorithms computing observables such as flux magnification and polarization angles. Our algorithms can be easily realized in other programming languages such as FORTRAN, C, and C++. The MATLAB version of KERTAP is parallelized using the MATLAB Parallel Computing Toolbox and the Distributed Computing Server. The Python code was sped up using Cython and supports full implementation of MPI using the “mpi4py” package. As an example, we investigate the inclination angle dependence of the observed polarization and the strong lensing magnification of AGN X-ray emission. We conclude that it is possible to perform complex numerical-relativity related computations using interpreted languages such as MATLAB and Python.

  15. ALGORITHMS AND PROGRAMS FOR STRONG GRAVITATIONAL LENSING IN KERR SPACE-TIME INCLUDING POLARIZATION

    International Nuclear Information System (INIS)

    Chen, Bin; Maddumage, Prasad; Kantowski, Ronald; Dai, Xinyu; Baron, Eddie

    2015-01-01

    Active galactic nuclei (AGNs) and quasars are important astrophysical objects to understand. Recently, microlensing observations have constrained the size of the quasar X-ray emission region to be of the order of 10 gravitational radii of the central supermassive black hole. For distances within a few gravitational radii, light paths are strongly bent by the strong gravity field of the central black hole. If the central black hole has nonzero angular momentum (spin), then a photon’s polarization plane will be rotated by the gravitational Faraday effect. The observed X-ray flux and polarization will then be influenced significantly by the strong gravity field near the source. Consequently, linear gravitational lensing theory is inadequate for such extreme circumstances. We present simple algorithms computing the strong lensing effects of Kerr black holes, including the effects on polarization. Our algorithms are realized in a program “KERTAP” in two versions: MATLAB and Python. The key ingredients of KERTAP are a graphic user interface, a backward ray-tracing algorithm, a polarization propagator dealing with gravitational Faraday rotation, and algorithms computing observables such as flux magnification and polarization angles. Our algorithms can be easily realized in other programming languages such as FORTRAN, C, and C++. The MATLAB version of KERTAP is parallelized using the MATLAB Parallel Computing Toolbox and the Distributed Computing Server. The Python code was sped up using Cython and supports full implementation of MPI using the “mpi4py” package. As an example, we investigate the inclination angle dependence of the observed polarization and the strong lensing magnification of AGN X-ray emission. We conclude that it is possible to perform complex numerical-relativity related computations using interpreted languages such as MATLAB and Python

  16. Improved Riccati Transfer Matrix Method for Free Vibration of Non-Cylindrical Helical Springs Including Warping

    Directory of Open Access Journals (Sweden)

    A.M. Yu

    2012-01-01

    Full Text Available Free vibration equations for non-cylindrical (conical, barrel, and hyperboloidal types helical springs with noncircular cross-sections, which consist of 14 first-order ordinary differential equations with variable coefficients, are theoretically derived using spatially curved beam theory. In the formulation, the warping effect upon natural frequencies and vibrating mode shapes is first studied in addition to including the rotary inertia, the shear and axial deformation influences. The natural frequencies of the springs are determined by the use of improved Riccati transfer matrix method. The element transfer matrix used in the solution is calculated using the Scaling and Squaring method and Pad'e approximations. Three examples are presented for three types of springs with different cross-sectional shapes under clamped-clamped boundary condition. The accuracy of the proposed method has been compared with the FEM results using three-dimensional solid elements (Solid 45 in ANSYS code. Numerical results reveal that the warping effect is more pronounced in the case of non-cylindrical helical springs than that of cylindrical helical springs, which should be taken into consideration in the free vibration analysis of such springs.

  17. BROMOCEA Code: An Improved Grand Canonical Monte Carlo/Brownian Dynamics Algorithm Including Explicit Atoms.

    Science.gov (United States)

    Solano, Carlos J F; Pothula, Karunakar R; Prajapati, Jigneshkumar D; De Biase, Pablo M; Noskov, Sergei Yu; Kleinekathöfer, Ulrich

    2016-05-10

    All-atom molecular dynamics simulations have a long history of applications studying ion and substrate permeation across biological and artificial pores. While offering unprecedented insights into the underpinning transport processes, MD simulations are limited in time-scales and ability to simulate physiological membrane potentials or asymmetric salt solutions and require substantial computational power. While several approaches to circumvent all of these limitations were developed, Brownian dynamics simulations remain an attractive option to the field. The main limitation, however, is an apparent lack of protein flexibility important for the accurate description of permeation events. In the present contribution, we report an extension of the Brownian dynamics scheme which includes conformational dynamics. To achieve this goal, the dynamics of amino-acid residues was incorporated into the many-body potential of mean force and into the Langevin equations of motion. The developed software solution, called BROMOCEA, was applied to ion transport through OmpC as a test case. Compared to fully atomistic simulations, the results show a clear improvement in the ratio of permeating anions and cations. The present tests strongly indicate that pore flexibility can enhance permeation properties which will become even more important in future applications to substrate translocation.

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

    Science.gov (United States)

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

    2015-02-01

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

  19. Sharing reference data and including cows in the reference population improve genomic predictions in Danish Jersey.

    Science.gov (United States)

    Su, G; Ma, P; Nielsen, U S; Aamand, G P; Wiggans, G; Guldbrandtsen, B; Lund, M S

    2016-06-01

    Small reference populations limit the accuracy of genomic prediction in numerically small breeds, such like Danish Jersey. The objective of this study was to investigate two approaches to improve genomic prediction by increasing size of reference population in Danish Jersey. The first approach was to include North American Jersey bulls in Danish Jersey reference population. The second was to genotype cows and use them as reference animals. The validation of genomic prediction was carried out on bulls and cows, respectively. In validation on bulls, about 300 Danish bulls (depending on traits) born in 2005 and later were used as validation data, and the reference populations were: (1) about 1050 Danish bulls, (2) about 1050 Danish bulls and about 1150 US bulls. In validation on cows, about 3000 Danish cows from 87 young half-sib families were used as validation data, and the reference populations were: (1) about 1250 Danish bulls, (2) about 1250 Danish bulls and about 1150 US bulls, (3) about 1250 Danish bulls and about 4800 cows, (4) about 1250 Danish bulls, 1150 US bulls and 4800 Danish cows. Genomic best linear unbiased prediction model was used to predict breeding values. De-regressed proofs were used as response variables. In the validation on bulls for eight traits, the joint DK-US bull reference population led to higher reliability of genomic prediction than the DK bull reference population for six traits, but not for fertility and longevity. Averaged over the eight traits, the gain was 3 percentage points. In the validation on cows for six traits (fertility and longevity were not available), the gain from inclusion of US bull in reference population was 6.6 percentage points in average over the six traits, and the gain from inclusion of cows was 8.2 percentage points. However, the gains from cows and US bulls were not accumulative. The total gain of including both US bulls and Danish cows was 10.5 percentage points. The results indicate that sharing reference

  20. A Call to Include Severe Combined Immunodeficiency in Newborn Screening Program

    Directory of Open Access Journals (Sweden)

    Raz Somech

    2014-01-01

    Full Text Available Quantification of the T cell receptor excision circles (TRECs has recently emerged as a useful non-invasive clinical and research tool to investigate thymic activity. It allows the identification of T cell production by the thymus. Quantification of TREC copies has recently been implemented as the preferred test to screen neonates with severe combined immunodeficiency (SCID or significant lymphopenia. Neonatal genetic screening for SCID is highly important in countries with high rates of consanguinous marriages, such as Israel, and can be used for early diagnosis, enabling prompt therapeutic intervention that will save lives and improve the outcome of these patients. TREC measurement is also applicable in clinical settings where T cell immunity is involved, including any T cell immunodeficiencies, HIV infection, the aging process, autoimmune diseases, and immune reconstitution after bone marrow transplantation.

  1. Student Feedback of Career Development Workshops for Program Improvement

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2008-10-01

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

  5. Parental Preferences for the Organization of Preschool Vaccination Programs Including Financial Incentives: A Discrete Choice Experiment

    Directory of Open Access Journals (Sweden)

    Darren Flynn PhD

    2017-05-01

    Full Text Available Objective: To establish preferences of parents and guardians of preschool children for the organization of preschool vaccination services, including financial incentives. Design: An online discrete choice experiment. Participants: Parents and guardians of preschool children (up to age 5 years who were (n = 259 and were not (n = 262 classified as at high risk of incompletely vaccinating their children. High risk of incomplete vaccination was defined as any of the following: aged less than 20 years, single parents, living in one of the 20% most deprived areas in England, had a preschool child with a disability, or had more than three children. Main Outcome Measures: Participant preferences expressed as positive (utility or negative (disutility on eight attributes and levels describing the organization of preschool vaccination programs. Results: There was no difference in preference for parental financial incentives compared to no incentive in parents “not at high risk” of incomplete vaccination. Parents who were “at high risk” expressed utility for cash incentives. Parents “at high risk” of incomplete vaccination expressed utility for information on the risks and benefits of vaccinations to be provided as numbers rather than charts or pictures. Both groups preferred universally available, rather than targeted, incentives. Utility was identified for shorter waiting times, and there were variable preferences for who delivered vaccinations. Conclusions: Cash incentives for preschool vaccinations in England would be welcomed by parents who are “at high risk” of incompletely vaccinating their children. Further work is required on the optimal mode and form of presenting probabilistic information on vaccination to parents/guardians, including preferences on mandatory vaccination schemes.

  6. A review of a radioactive material shipping container including design, testing, upgrading compliance program and shipping logistics

    International Nuclear Information System (INIS)

    Celovsky, A.; Lesco, R.; Gale, B.; Sypes, J.

    2003-01-01

    Ten years ago Atomic Energy of Canada developed a Type B(U)-85 shipping container for the global transport of highly radioactive materials. This paper reviews the development of the container, including a summary of the design requirements, a review of the selected materials and key design elements, and the results of the major qualification tests (drop testing, fire test, leak tightness testing, and shielding integrity tests). As a result of the testing, improvements to the structural, thermal and containment design were made. Such improvements, and reasons thereof, are noted. Also provided is a summary of the additional analysis work required to upgrade the package from a Type B(U) to a Type B(F), i.e. essentially upgrading the container to include fissile radioisotopes to the authorized radioactive contents list. Having a certified shipping container is only one aspect governing the global shipments of radioactive material. By necessity the shipment of radioactive material is a highly regulated environment. This paper also explores the experiences with other key aspects of radioactive shipments, including the service procedures used to maintain the container certification, the associated compliance program for radioactive material shipments, and the shipping logistics involved in the transport. (author)

  7. An improved technique for breast cancer irradiation including the locoregional lymph nodes

    NARCIS (Netherlands)

    Hurkmans, C. W.; Saarnak, A. E.; Pieters, B. R.; Borger, J. H.; Bruinvis, I. A.

    2000-01-01

    PURPOSE: To find an irradiation technique for locoregional irradiation of breast cancer patients which, compared with a standard technique, improves the dose distribution to the internal mammary-medial supraclavicular (IM-MS) lymph nodes. The improved technique is intended to minimize the lung dose

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

    Science.gov (United States)

    2010-01-01

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

  9. 25 CFR 170.623 - How are IRR Program projects and activities included in a self-governance agreement?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false How are IRR Program projects and activities included in a self-governance agreement? 170.623 Section 170.623 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE... self-governance agreement? To include an IRR Program project or activity in a self-governance agreement...

  10. 12 CFR 303.46 - Financial education programs that include the provision of bank products and services.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Financial education programs that include the provision of bank products and services. 303.46 Section 303.46 Banks and Banking FEDERAL DEPOSIT INSURANCE... Branches and Offices § 303.46 Financial education programs that include the provision of bank products and...

  11. Strategic Improvements to TSA Spot Program

    Science.gov (United States)

    2015-03-01

    supporting me in this program, and specifically, Assistant Administrators Robin Kane, John Sanders, and Chris McLaughlin for their sponsorship. I hope...analysis. Edited by Michael Borenstein, Larry V. Hedges, Julian P. T. Higgins , and Hannah R. Rothstein, 377–387. Chichester, UK: John Wiley & Sons, 2009

  12. The effectiveness of a cardiometabolic prevention program in general practices offering integrated care programs including a patient tailored lifestyle treatment.

    NARCIS (Netherlands)

    Hollander, M.; Eppink, L.; Nielen, M.; Badenbroek, I.; Stol, D.; Schellevis, F.; Wit, N. de

    2016-01-01

    Background & Aim: Selective cardio-metabolic prevention programs (CMP) may be especially effective in well-organized practices. We studied the effect of a CMP program in the academic primary care practices of the Julius Health Centers (JHC) that offer integrated cardiovascular disease management

  13. Individualized Education Programs for Students with Autism: Including Parents in the Process.

    Science.gov (United States)

    Simpson, Richard L.

    1995-01-01

    The involvement of parents in developing individualized education programs (IEPs) for their children with autism is discussed. Essential components of IEP documents are outlined, and strategies that professionals can use to promote significant family involvement are considered. (Author/SW)

  14. 40 CFR 63.1035 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

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

  15. 40 CFR 63.176 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

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

  16. 75 FR 22576 - Minority Science and Engineering Improvement Program

    Science.gov (United States)

    2010-04-29

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

  17. DEVELOPING VENDOR IMPROVEMENT PROGRAM IN MALAYSIA AUTOMOTIVE COMPANY

    Directory of Open Access Journals (Sweden)

    SHUKRIAH ABDULLAH

    2016-04-01

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

  18. Slender body theory programmed for bodies with arbitrary cross section. [including fuselages

    Science.gov (United States)

    Werner, J.; Krenkel, A. R.

    1978-01-01

    A computer program developed for determining the subsonic pressure, force, and moment coefficients for a fuselage-type body using slender body theory is described. The program is suitable for determining the angle of attack and sideslipping characteristics of such bodies in the linear range where viscous effects are not predominant. Procedures developed which are capable of treating cross sections with corners or regions of large curvature are outlined.

  19. Improvement of Scratch and Wear Resistance of Polymers by Fillers Including Nanofillers

    Directory of Open Access Journals (Sweden)

    Witold Brostow

    2017-03-01

    Full Text Available Polymers have lower resistance to scratching and wear than metals. Liquid lubricants work well for metals but not for polymers nor for polymer-based composites (PBCs. We review approaches for improvement of tribological properties of polymers based on inclusion of fillers. The fillers can be metallic or ceramic—with obvious consequences for electrical resistivity of the composites. Distinctions between effectiveness of micro- versus nano-particles are analyzed. For example, aluminum nanoparticles as filler are more effective for property improvement than microparticles at the same overall volumetric concentration. Prevention of local agglomeration of filler particles is discussed along with a technique to verify the prevention.

  20. The soybean and mungbean improvement programs at AVRDC

    International Nuclear Information System (INIS)

    Shanmugasundaram, S.; Ahn, G.S.

    1983-01-01

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

  1. 5 Ways to Improve Tutoring Programs

    Science.gov (United States)

    Gordon, Edward E.

    2009-01-01

    Tutoring has become a familiar tool that schools use to reinforce classroom teaching and improve student achievement. That's especially been the case because of No Child Left Behind (NCLB) and its provisions for supplemental education. Educators faced with developing or supporting tutoring services for students should consider five practical…

  2. Improved remote HEPA filtration development program

    International Nuclear Information System (INIS)

    Wilson, C.E. III.

    1987-03-01

    This paper presents a summary of the prototype development and hot cell mock-up testing program undertaken to adapt a commercial remote HEPA filter housing for use in the Process Facility Modification Project (PFMP). This program was initiated in response to the project design criteria and documentation that required the air from the hot cell environment to be exhausted through three stages of HEPA filtration. Due to the anticipated quantity of radioactive contamination captured by the first stage of filters, it was determined that the first stage would need to be located in a remotely operated and maintained shielded cell adjoining the primary hot cell areas. Commercially available remote filtration equipment was evaluated and candidate unit was identified, which could be developed into a suitable filter housing. A candidate unit was obtained from Flanders Filters, Inc. and a series of hot cell mock-up tests were identified in the 305 facility at the Hanford site. The results of these tests, and further interaction with the vendor, led to a prototype remote filter housing which satisfied most PFMP criteria and proved to be significantly superior to existing commercial units for remote operation/maintenance

  3. Sixty Minutes of Physical Activity per Day Included Within Preschool Academic Lessons Improves Early Literacy.

    Science.gov (United States)

    Kirk, Stacie M; Kirk, Erik P

    2016-03-01

    The effects of increases in physical activity (PA) on early literacy skills in preschool children are not known. Fifty-four African-American preschool children from a low socioeconomic urban Head Start participated over 8 months. A 2-group, quasi-experimental design was used with one preschool site participating in the PA intervention and a second site participating as the control site. The PA program was designed to promote 300 minutes/week of moderate to vigorous PA academic lessons. Academic achievement related to early literacy and phonological awareness in the areas of rhyming and alliteration were assessed at baseline, 4 and 8 months. Over 8 months, rhyming significantly (p literacy. © 2016, American School Health Association.

  4. 4-H Programs with a Focus on Including Youth with Disabilities.

    Science.gov (United States)

    Stumpf, Mitzi; Henderson, Karla; Luken, Karen; Bialeschki, Deb; Casey, Mary, II

    2002-01-01

    Intentionally Inclusive 4-H Club Programs is a pilot project intended to create accessible 4-H environments for people with disabilities. An experiential curriculum for 9-12 year-olds was developed and used in three North Carolina counties. Formative evaluation showed how 4-H staff are raising awareness and involving youth and volunteers with…

  5. Including an Exam P/1 Prep Course in a Growing Actuarial Science Program

    Science.gov (United States)

    Wakefield, Thomas P.

    2014-01-01

    The purpose of this article is to describe the actuarial science program at our university and the development of a course to enhance students' problem solving skills while preparing them for Exam P/1 of the Society of Actuaries (SOA) and the Casualty Actuary Society (CAS). The Exam P/1 prep course, formally titled Mathematical Foundations of…

  6. Including a Programming Course in General Education: Are We Doing Enough?

    Science.gov (United States)

    Ferguson, Roger C.; Leidig, Paul M.; Reynolds, John H.

    2015-01-01

    General education is more than a list of required courses a student must take to complete their degree. For most universities, general education is the groundwork for the student's university experience. These courses span multiple disciplines and allow students to experience a wide range of topics on their path to graduation. Programming classes,…

  7. 38 CFR 21.7120 - Courses included in programs of education.

    Science.gov (United States)

    2010-07-01

    ... officiating, or other sport or athletic courses, except courses of applied music, physical education, or... programs of education. 21.7120 Section 21.7120 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION All Volunteer Force Educational...

  8. Capital Improvement Program (CIP) Project Status

    Data.gov (United States)

    Montgomery County of Maryland — This dataset includes pertinent information relating to a capital project’s status administered by the Department of Transportation and the Department of General...

  9. Program improvement and applications; Programmpflege und Anwendungen

    Energy Technology Data Exchange (ETDEWEB)

    Hink, M.; Imke, U.; Pfrang, W.; Porscha, B.; Struwe, D.; Zimmerer, W.; Allan, P.

    1995-08-01

    An account is given about further improvements of the SAS4A-Ref. 94.R0 version of the HCDA code. They concern in particular the DEFORM fuel rod deformation module. For a validation of the new code version, various CABRI experiments have been calculated, especially tests with high burnup fuel rods. Progress was shown to be achieved, but the precise timing and location of the observed fuel failures is still hard to calculate. The work was performed in close cooperation with partners in France, Britain, and Japan. An important application concerns the CAPRA project of a reactor for actinide burning. Its behavior under ULOF conditions was analyzed using the improved SAS4A Ref. 94 R0 code. The core design turned out to tend toward a long-term coolable configuration even more so than the EFR core design would do in an ULOF. (orig.)

  10. Modelling of safety barriers including human and organisational factors to improve process safety

    DEFF Research Database (Denmark)

    Markert, Frank; Duijm, Nijs Jan; Thommesen, Jacob

    2013-01-01

    It is believed that traditional safety management needs to be improved on the aspect of preparedness for coping with expected and unexpected deviations, avoiding an overly optimistic reliance on safety systems. Remembering recent major accidents, such as the Deep Water Horizon, the Texas City....... A valuable approach is the inclusion of human and organisational factors into the simulation of the reliability of the technical system using event trees and fault trees and the concept of safety barriers. This has been demonstrated e.g. in the former European research project ARAMIS (Accidental Risk...

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

    Science.gov (United States)

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

    2015-01-01

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

  12. An Intervention Including an Online Game to Improve Grade 6 Students' Performance in Early Algebra

    Science.gov (United States)

    Kolovou, Angeliki; van den Heuvel-Panhuizen, Marja; Koller, Olaf

    2013-01-01

    This study investigated whether an intervention including an online game contributed to 236 Grade 6 students' performance in early algebra, that is, solving problems with covarying quantities. An exploratory quasi-experimental study was conducted with a pretest-posttest-control-group design. Students in the experimental group were asked to solve…

  13. Including RNA secondary structures improves accuracy and robustness in reconstruction of phylogenetic trees.

    Science.gov (United States)

    Keller, Alexander; Förster, Frank; Müller, Tobias; Dandekar, Thomas; Schultz, Jörg; Wolf, Matthias

    2010-01-15

    In several studies, secondary structures of ribosomal genes have been used to improve the quality of phylogenetic reconstructions. An extensive evaluation of the benefits of secondary structure, however, is lacking. This is the first study to counter this deficiency. We inspected the accuracy and robustness of phylogenetics with individual secondary structures by simulation experiments for artificial tree topologies with up to 18 taxa and for divergency levels in the range of typical phylogenetic studies. We chose the internal transcribed spacer 2 of the ribosomal cistron as an exemplary marker region. Simulation integrated the coevolution process of sequences with secondary structures. Additionally, the phylogenetic power of marker size duplication was investigated and compared with sequence and sequence-structure reconstruction methods. The results clearly show that accuracy and robustness of Neighbor Joining trees are largely improved by structural information in contrast to sequence only data, whereas a doubled marker size only accounts for robustness. Individual secondary structures of ribosomal RNA sequences provide a valuable gain of information content that is useful for phylogenetics. Thus, the usage of ITS2 sequence together with secondary structure for taxonomic inferences is recommended. Other reconstruction methods as maximum likelihood, bayesian inference or maximum parsimony may equally profit from secondary structure inclusion. This article was reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin. Reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber) and Eugene V. Koonin. For the full reviews, please go to the Reviewers' comments section.

  14. Program plan for environmental qualification of mechanical and dynamic (including seismic) qualification of mechanical and electrical equipment program (EDQP)

    International Nuclear Information System (INIS)

    Weidenhamer, G.H.

    1986-06-01

    The equipment qualification program described in this plan is intended to provide the technical basis for resolving uncertainties in existing equipment qualification standards. In addition, research results are contributing to the resolution of safety issues GI-23, GI-87, USI-A44, titled, ''Reactor Coolant Pump Seal Failure,'' ''Failure of HPCI Steam Line Without Isolation,'' and ''Station Blackout,'' respectively. Also, research effort is being directed at providing information on the behavior of containment isolation valves under severe accident environments. Although the results of the latter research will not contribute to resolving uncertainties in qualification standards, it has proven cost effective to obtain this information under this program

  15. Including RNA secondary structures improves accuracy and robustness in reconstruction of phylogenetic trees

    Directory of Open Access Journals (Sweden)

    Dandekar Thomas

    2010-01-01

    Full Text Available Abstract Background In several studies, secondary structures of ribosomal genes have been used to improve the quality of phylogenetic reconstructions. An extensive evaluation of the benefits of secondary structure, however, is lacking. Results This is the first study to counter this deficiency. We inspected the accuracy and robustness of phylogenetics with individual secondary structures by simulation experiments for artificial tree topologies with up to 18 taxa and for divergency levels in the range of typical phylogenetic studies. We chose the internal transcribed spacer 2 of the ribosomal cistron as an exemplary marker region. Simulation integrated the coevolution process of sequences with secondary structures. Additionally, the phylogenetic power of marker size duplication was investigated and compared with sequence and sequence-structure reconstruction methods. The results clearly show that accuracy and robustness of Neighbor Joining trees are largely improved by structural information in contrast to sequence only data, whereas a doubled marker size only accounts for robustness. Conclusions Individual secondary structures of ribosomal RNA sequences provide a valuable gain of information content that is useful for phylogenetics. Thus, the usage of ITS2 sequence together with secondary structure for taxonomic inferences is recommended. Other reconstruction methods as maximum likelihood, bayesian inference or maximum parsimony may equally profit from secondary structure inclusion. Reviewers This article was reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber and Eugene V. Koonin. Open peer review Reviewed by Shamil Sunyaev, Andrea Tanzer (nominated by Frank Eisenhaber and Eugene V. Koonin. For the full reviews, please go to the Reviewers' comments section.

  16. Improvement on a science curriculum including experimental demonstration of environmental radioactivity for secondary school students

    International Nuclear Information System (INIS)

    Watanabe, Kenji; Matsubara, Shizuo; Aiba, Yoshio; Eriguchi, Hiroshi; Kiyota, Saburo; Takeyama, Tetsuji.

    1988-01-01

    A science curriculum previously prepared for teaching environmental radioactivity was modified on the basis of the results of trial instructions in secondary schools. The main subject of the revised curriculum is an understanding of the natural radioactivity through the experimental demonstration about air-borne β and γ ray emitters. The other subjects included are the radioactive decay, the biological effects of radiation, the concept of risk-benefit balance (acceptable level) and the peaceful uses of nuclear energy and radiation. The work sheets and reference data prepared as learning materials are in two levels corresponding to the ability of students for this curriculum. (author)

  17. The surgical care improvement project and prevention of post-operative infection, including surgical site infection.

    Science.gov (United States)

    Rosenberger, Laura H; Politano, Amani D; Sawyer, Robert G

    2011-06-01

    In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention on the Surgical Infection Prevention (SIP) project, introduced in 2002. Quality improvement measures were developed to standardize processes to increase compliance. In 2006, the Surgical Care Improvement Project (SCIP) developed out of the SIP project and its process measures. These initiatives, published in the Specifications Manual for National Inpatient Quality Measures, outline process and outcome measures. This continually evolving manual is intended to provide standard quality measures to unify documentation and track standards of care. Seven of the SCIP initiatives apply to the peri-operative period: Prophylactic antibiotics should be received within 1 h prior to surgical incision (1), be selected for activity against the most probable antimicrobial contaminants (2), and be discontinued within 24 h after the surgery end-time (3); (4) euglycemia should be maintained, with well-controlled morning blood glucose concentrations on the first two post-operative days, especially in cardiac surgery patients; (6) hair at the surgical site should be removed with clippers or by depilatory methods, not with a blade; (9) urinary catheters are to be removed within the first two post-operative days; and (10) normothermia should be maintained peri-operatively. There is strong evidence that implementation of protocols that standardize practices reduce the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity as well as cost. One of the goals of the SCIP guidelines was a 25% reduction in the incidence of surgical site infections from implementation through 2010. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons and scientists, to be active

  18. Should CAM and CAM Training Programs Be Included in the Curriculum of Schools That Provide Health Education?

    Directory of Open Access Journals (Sweden)

    2016-12-01

    Full Text Available Objectives: This study aimed to determine the knowledge levels and attitudes of School of Health and Vocational School of Health students toward complementary and alternative medicine (CAM. Methods: Three hundred thirty-three (333 students studying at the Mehmet Akif Ersoy University School of Health and the Golhisar Vocational School of Health in Burdur, Turkey, were included in the study. Research data were collected by using a survey method based on the expressed opinions of the participants. Results: Of the participants, 69.7% were female and 97% were single (unmarried. Of cigarette users and those with chronic illnesses, 46.8% and 47.8%, respectively, used CAM. Those using CAM were statistically more likely to be female (P < 0.021, to have higher grades (P < 0.007, to be single (P < 0.005, to be vocational school of health graduates (P < 0.008, and to have fathers at work (P < 0.021. While 9.6% of the students thought CAM to be nonsense, 10.8% thought that the methods of CAM should be tried before consulting a doctor. Conclusion: A majority of the students in the study population were found to use complementary and alternative medicine, but that they lacked information about its methods. As a way to address this, CAM should be included in the curriculum of schools that provide health education, and CAM training programs should be given to healthcare professionals to improve their knowledge of CAM. In Turkey, many more studies should be performed to determine nurses’ and doctors’ knowledge of and attitudes about CAM methods so that they can give correct guidance to society and take more active responsibility in improving patient safety.

  19. [Productivity of doctoral programs in Psychology with Quality Mention in journal articles included in Journal Citation Reports].

    Science.gov (United States)

    Musi-Lechuga, Bertha; Olivas-Ávila, José; Castro, Angel

    2011-08-01

    The main objective of the present study was to classify doctoral programs with Quality Mention in Psychology based on their scientific productivity. For this purpose, articles in the Web of Science published by professors teaching in these doctoral programs were analyzed. In addition, we analyzed scientific journals in which these professors tend to publish more papers and the evolution in the number of papers published until 2009. Results showed that the most productive doctoral program was the Neurosciences program at the University of Oviedo. This program showed a ratio of 40 articles--published in journals included in Journal Citation Reports--by each professor. In contrast, other programs did not reach a ratio of 10 articles per professor. Regarding journals, results showed that 9 out of the 20 most popular journals are Hispanic and a gradual increase in the number of published papers was also observed. Lastly, results and implications for quality assessment are discussed.

  20. How to include frequency dependent complex permeability Into SPICE models to improve EMI filters design?

    Science.gov (United States)

    Sixdenier, Fabien; Yade, Ousseynou; Martin, Christian; Bréard, Arnaud; Vollaire, Christian

    2018-05-01

    Electromagnetic interference (EMI) filters design is a rather difficult task where engineers have to choose adequate magnetic materials, design the magnetic circuit and choose the size and number of turns. The final design must achieve the attenuation requirements (constraints) and has to be as compact as possible (goal). Alternating current (AC) analysis is a powerful tool to predict global impedance or attenuation of any filter. However, AC analysis are generally performed without taking into account the frequency-dependent complex permeability behaviour of soft magnetic materials. That's why, we developed two frequency-dependent complex permeability models able to be included into SPICE models. After an identification process, the performances of each model are compared to measurements made on a realistic EMI filter prototype in common mode (CM) and differential mode (DM) to see the benefit of the approach. Simulation results are in good agreement with the measured ones especially in the middle frequency range.

  1. Including everyone: A peer learning program that works for under-represented minorities?

    Directory of Open Access Journals (Sweden)

    Jacques van der Meer

    2013-04-01

    Full Text Available Peer learning has long been recognised as an effective way to induct first-year students into the academic skills required to succeed at university. One recognised successful model that has been extensively researched is the Supplemental Instruction (SI model; it has operated in the US since the mid-1970s. This model is commonly known in Australasia as the Peer Assisted Study Sessions (PASS program. Although there is a considerable amount of research into SI and PASS, very little has been published about the impact of peer learning on different student groups, for example indigenous and other ethnic groups. This article reports on the results from one New Zealand university of the effectiveness of PASS for Māori and Pasifika students. The questions this article seeks to address are whether attendance of the PASS program results in better final marks for these two groups of students, and whether the number of sessions attended has an impact on the final marks.

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Stephenson, Ginny

    2007-01-01

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

  5. Crash Data Improvement Program : An RSPCB Peer Exchange

    Science.gov (United States)

    2011-08-04

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

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

    Science.gov (United States)

    1992-07-01

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

  7. Advanced neuroblastoma: improved response rate using a multiagent regimen (OPEC) including sequential cisplatin and VM-26.

    Science.gov (United States)

    Shafford, E A; Rogers, D W; Pritchard, J

    1984-07-01

    Forty-two children, all over one year of age, were given vincristine, cyclophosphamide, and sequentially timed cisplatin and VM-26 (OPEC) or OPEC and doxorubicin (OPEC-D) as initial treatment for newly diagnosed stage III or IV neuroblastoma. Good partial response was achieved in 31 patients (74%) overall and in 28 (78%) of 36 patients whose treatment adhered to the chemotherapy protocol, compared with a 65% response rate achieved in a previous series of children treated with pulsed cyclophosphamide and vincristine with or without doxorubicin. Only six patients, including two of the six children whose treatment did not adhere to protocol, failed to respond, but there were five early deaths from treatment-related complications. Tumor response to OPEC, which was the less toxic of the two regimens, was at least as good as tumor response to OPEC-D. Cisplatin-induced morbidity was clinically significant in only one patient and was avoided in others by careful monitoring of glomerular filtration rate and hearing. Other centers should test the efficacy of OPEC or equivalent regimens in the treatment of advanced neuroblastoma.

  8. Improved best estimate plus uncertainty methodology, including advanced validation concepts, to license evolving nuclear reactors

    International Nuclear Information System (INIS)

    Unal, C.; Williams, B.; Hemez, F.; Atamturktur, S.H.; McClure, P.

    2011-01-01

    Research highlights: → The best estimate plus uncertainty methodology (BEPU) is one option in the licensing of nuclear reactors. → The challenges for extending the BEPU method for fuel qualification for an advanced reactor fuel are primarily driven by schedule, the need for data, and the sufficiency of the data. → In this paper we develop an extended BEPU methodology that can potentially be used to address these new challenges in the design and licensing of advanced nuclear reactors. → The main components of the proposed methodology are verification, validation, calibration, and uncertainty quantification. → The methodology includes a formalism to quantify an adequate level of validation (predictive maturity) with respect to existing data, so that required new testing can be minimized, saving cost by demonstrating that further testing will not enhance the quality of the predictive tools. - Abstract: Many evolving nuclear energy technologies use advanced predictive multiscale, multiphysics modeling and simulation (M and S) capabilities to reduce the cost and schedule of design and licensing. Historically, the role of experiments has been as a primary tool for the design and understanding of nuclear system behavior, while M and S played the subordinate role of supporting experiments. In the new era of multiscale, multiphysics computational-based technology development, this role has been reversed. The experiments will still be needed, but they will be performed at different scales to calibrate and validate the models leading to predictive simulations for design and licensing. Minimizing the required number of validation experiments produces cost and time savings. The use of multiscale, multiphysics models introduces challenges in validating these predictive tools - traditional methodologies will have to be modified to address these challenges. This paper gives the basic aspects of a methodology that can potentially be used to address these new challenges in

  9. Nuclear data libraries for gamma analysis programs, including special purpose libraries

    International Nuclear Information System (INIS)

    Westmeier, W.; Reus, U.; Siemon, K.; Westmeier, H.

    2002-01-01

    A complete set of gamma ray and other data relating to the decay of all known nuclides has been compiled from the literature and electronic sources. The data were critically reviewed, evaluated and the consistency was checked. The total catalogue is comprised of data-sets for 3841 nuclides and isomers with 106,355 gamma ray and 19,347 X ray entries. A subset of 1,627 nuclides with 32,456 gamma ray entries is extracted into a database, which provides the basis for the generation of nuclide libraries for the application in spectrometry programmes. The WINDOWS based program NUC M AN was developed which serves for the updating and editing of the database as well as the generation of task-specific user libraries for special purposes. The literature cut-off date for this catalogue is January 1, 1998. (author)

  10. Improving English Instruction through Neuro-Linguistic Programming

    Science.gov (United States)

    Helm, David Jay

    2009-01-01

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

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

    Science.gov (United States)

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

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

  12. 30 CFR 250.415 - What must my casing and cementing programs include?

    Science.gov (United States)

    2010-07-01

    ... included in API RP 65, Recommended Practice for Cementing Shallow Water Flow Zones in Deep Water Wells... and are in either of the following two areas: (1) An “area with an unknown shallow water flow potential” is a zone or geologic formation where neither the presence nor absence of potential for a shallow...

  13. 42 CFR 137.275 - May Self-Governance Tribes include IHS construction programs in a construction project agreement...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May Self-Governance Tribes include IHS construction... OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Construction Purpose and Scope § 137.275 May Self-Governance Tribes include IHS construction programs in a construction project agreement or in a funding...

  14. Advanced theoretical and experimental studies in automatic control and information systems. [including mathematical programming and game theory

    Science.gov (United States)

    Desoer, C. A.; Polak, E.; Zadeh, L. A.

    1974-01-01

    A series of research projects is briefly summarized which includes investigations in the following areas: (1) mathematical programming problems for large system and infinite-dimensional spaces, (2) bounded-input bounded-output stability, (3) non-parametric approximations, and (4) differential games. A list of reports and papers which were published over the ten year period of research is included.

  15. 34 CFR 611.2 - What management plan must be included in a Teacher Quality Enhancement Grants Program application?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What management plan must be included in a Teacher... TEACHER QUALITY ENHANCEMENT GRANTS PROGRAM General Provisions § 611.2 What management plan must be... appropriate, a management plan that includes a proposed multiyear workplan. (b) At a minimum, this workplan...

  16. Palliative sedation for cancer patients included in a home care program: a retrospective study.

    Science.gov (United States)

    Calvo-Espinos, Claudio; Ruiz de Gaona, Estefania; Gonzalez, Cristina; Ruiz de Galarreta, Lucia; Lopez, Cristina

    2015-06-01

    Palliative sedation is a common treatment in palliative care. The home is a difficult environment for research, and there are few studies about sedation at home. Our aim was to analyze this practice in a home setting. We conducted a retrospective cross-sectional descriptive study in a home cohort during 2011. The inclusion criteria were as follows: 18 years or older and enrolled in the Palliative Home Care Program (PHCP) with advanced cancer. The variables employed were: sex, age, primary tumor location, and place of death. We also registered indication, type, drug and dose, awareness of diagnosis and prognosis, consent, survival, presence or absence of rales, painful mouth, and ulcers in patients sedated at home. We also collected the opinions of family members and professionals about the suffering of sedated patients. A total of 446 patients (56% at home) of the 617 admitted to the PHCP between January and December of 2011 passed away. The typical patient in our population was a 70-year-old man with a lung tumor. Some 35 (14%) home patients required sedation, compared to 93 (49%) at the hospital. The most frequent indication was delirium (70%), with midazolam the most common drug (mean dose, 40 mg). Survival was around three days. Rales were frequent (57%) as well as awareness of diagnosis and prognosis (77 and 71%, respectively). Perception of suffering after sedation was rare among relatives (17%) and professionals (8%). In most cases, the decision was made jointly by professionals and family members. Our study confirmed the role of palliative sedation as an appropriate therapeutic tool in the home environment.

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

    Science.gov (United States)

    Mark, Melvin M.; Pines, Edward

    1995-01-01

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

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

    Science.gov (United States)

    General Accounting Office, Washington, DC.

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

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

    Science.gov (United States)

    Arthur R. Tiedemann; Carlos F. Lopez

    2004-01-01

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

  20. Closing the Loop on a Continuous Program Improvement Process

    Science.gov (United States)

    Booth, Vickie; Booth, Larry

    2010-01-01

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

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

    Science.gov (United States)

    Pierre, Ketly Dieudonne

    2014-01-01

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

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

    Science.gov (United States)

    Andrus, Len Hughes; Fenley, Mary D.

    1976-01-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2018-06-01

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

  5. [Training of residents in obstetrics and gynecology: Assessment of an educational program including formal lectures and practical sessions using simulators].

    Science.gov (United States)

    Jordan, A; El Haloui, O; Breaud, J; Chevalier, D; Antomarchi, J; Bongain, A; Boucoiran, I; Delotte, J

    2015-01-01

    Evaluate an educational program in the training of residents in gynecology-obstetrics (GO) with a theory session and a practical session on simulators and analyze their learning curve. Single-center prospective study, at the university hospital (CHU). Two-day sessions were leaded in April and July 2013. An evaluation on obstetric and gynecological surgery simulator was available to all residents. Theoretical knowledge principles of obstetrics were evaluated early in the session and after formal lectures was taught to them. At the end of the first session, a satisfaction questionnaire was distributed to all participants. Twenty residents agreed to participate to the training sessions. Evaluation of theoretical knowledge: at the end of the session, the residents obtained a significant improvement in their score on 20 testing knowledge. Obstetrical simulator: a statistically significant improvement in scores on assessments simulator vaginal delivery between the first and second session. Subjectively, a larger increase feeling was seen after breech delivery simulation than for the cephalic vaginal delivery. However, the confidence level of the resident after breech delivery simulation has not been improved at the end of the second session. Simulation in gynecological surgery: a trend towards improvement in the time realized on the peg-transfer between the two sessions was noted. In the virtual simulation, no statistically significant differences showed, no improvement for in salpingectomy's time. Subjectively, the residents felt an increase in the precision of their gesture. Satisfaction: All residents have tried the whole program. They considered the pursuit of these sessions on simulators was necessary and even mandatory. The approach chosen by this structured educational program allowed a progression for the residents, both objectively and subjectively. This simulation program type for the resident's training would use this tool in assessing their skills and develop

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

    International Nuclear Information System (INIS)

    1995-06-01

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

  7. Gap Analysis Approach for Construction Safety Program Improvement

    Directory of Open Access Journals (Sweden)

    Thanet Aksorn

    2007-06-01

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

  8. 45 CFR 287.130 - Can NEW Program activities include job market assessments, job creation and economic development...

    Science.gov (United States)

    2010-10-01

    ... assessments, job creation and economic development activities? 287.130 Section 287.130 Public Welfare... creation and economic development activities? (a) A Tribe may conduct job market assessments within its NEW Program. These might include the following: (1) Consultation with the Tribe's economic development staff...

  9. 41 CFR 105-74.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What must I include in my drug-free awareness program? 105-74.215 Section 105-74.215 Public Contracts and Property Management Federal Property Management Regulations System (Continued) GENERAL SERVICES ADMINISTRATION...

  10. Inpo programs for improvement of nuclear power plant operations

    International Nuclear Information System (INIS)

    Edward Moore, C.

    1989-01-01

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

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

    Science.gov (United States)

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

  12. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Manlove J

    2015-04-01

    Full Text Available Jennifer Manlove, Heather Fish, Kristin Anderson Moore Child Trends, Bethesda, MD, USA Background: US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs, highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods: This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results: Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome. We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use. Conclusion: Future efforts should

  13. Evaluation of 8-week body weight control program including sea tangle (Laminaria japonica) supplementation in Korean female college students

    Science.gov (United States)

    You, Jeong Soon; Sung, Min Jung

    2009-01-01

    This study was conducted to evaluate the effects of a body weight control program with supplementation of sea tangle (20 g/day) on 22 female college students. The contents of the program for 8 weeks contained diet therapy, exercise and behavioral modification through nutrition education. Body composition, dietary habit scores, serum lipid profiles, daily nutrient intakes and the quality of life were assessed at the beginning and at the end of the program. Average age of subjects and height were 20.8 years and 161.9 cm, respectively. After 8 weeks, there were significant reductions in body weight, body fat mass, percent body fat, waist-hip ratio and BMI. The dietary habit score such as a balanced diet, regularity of mealtime, overeating, eating while watching TV or using the computer and eating salty food were increased significantly. Serum lipid levels such as total cholesterol level, LDL-cholesterol level and triglyceride level were decreased but not significantly. There were decreases in intake of energy, protein and fat and increases in intakes of dietary fiber, folic acid, calcium and potassium from the beginning to the end of the program. There were significant improvements on subcomponents of quality of life; physical functioning, general-health and vitality. The limitation of this study was the fact that there was no control group, but an overall evaluation suggests the 8-week body weight control program consisting of diet therapy, exercise and behavioral modification with supplementation of sea tangle would be helpful to improve the body composition, dietary habits, daily nutrient intakes and quality of life in Korean female college students. PMID:20098584

  14. The program of continuous improvements in factory in Juzbado

    International Nuclear Information System (INIS)

    Prieto, M.

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-08-12

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

  16. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence.

    Science.gov (United States)

    Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson

    2015-01-01

    US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants - sexual activity, number of sexual partners, condom use, and other contraceptive use - among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent-youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent-youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts, rigorously evaluate programs that appear promising, and

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

    Science.gov (United States)

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

    2018-02-21

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

  18. Campus Partnerships Improve Impact Documentation of Nutrition Programs

    Science.gov (United States)

    Brinkman, Patricia

    2015-01-01

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

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

    Science.gov (United States)

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

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

    Science.gov (United States)

    Shapiro, Joel; Bray, Christopher

    2011-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

    Emiliani, M. L.

    2005-01-01

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

  3. Improving Reading Comprehension Skills through the SCRATCH Program

    Science.gov (United States)

    Papatga, Erdal; Ersoy, Ali

    2016-01-01

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

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

    International Nuclear Information System (INIS)

    Montes Navarro, J.

    1998-01-01

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

  5. An Improvement for Fuzzy Stochastic Goal Programming Problems

    Directory of Open Access Journals (Sweden)

    Shu-Cheng Lin

    2017-01-01

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

  6. Implementation and evaluation of a simulation curriculum for paediatric residency programs including just-in-time in situ mock codes.

    Science.gov (United States)

    Sam, Jonathan; Pierse, Michael; Al-Qahtani, Abdullah; Cheng, Adam

    2012-02-01

    To develop, implement and evaluate a simulation-based acute care curriculum in a paediatric residency program using an integrated and longitudinal approach. Curriculum framework consisting of three modular, year-specific courses and longitudinal just-in-time, in situ mock codes. Paediatric residency program at BC Children's Hospital, Vancouver, British Columbia. The three year-specific courses focused on the critical first 5 min, complex medical management and crisis resource management, respectively. The just-in-time in situ mock codes simulated the acute deterioration of an existing ward patient, prepared the actual multidisciplinary code team, and primed the surrounding crisis support systems. Each curriculum component was evaluated with surveys using a five-point Likert scale. A total of 40 resident surveys were completed after each of the modular courses, and an additional 28 surveys were completed for the overall simulation curriculum. The highest Likert scores were for hands-on skill stations, immersive simulation environment and crisis resource management teaching. Survey results also suggested that just-in-time mock codes were realistic, reinforced learning, and prepared ward teams for patient deterioration. A simulation-based acute care curriculum was successfully integrated into a paediatric residency program. It provides a model for integrating simulation-based learning into other training programs, as well as a model for any hospital that wishes to improve paediatric resuscitation outcomes using just-in-time in situ mock codes.

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

    Science.gov (United States)

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

    2012-04-01

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

  8. Improve Problem Solving Skills through Adapting Programming Tools

    Science.gov (United States)

    Shaykhian, Linda H.; Shaykhian, Gholam Ali

    2007-01-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

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

  14. 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.

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

    CERN Document Server

    Porter-Reynolds, Daisy

    2014-01-01

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

  16. Teacher training program for medical students: improvements needed

    Directory of Open Access Journals (Sweden)

    van Diggele C

    2015-04-01

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

  17. Benchmarking spliced alignment programs including Spaln2, an extended version of Spaln that incorporates additional species-specific features.

    Science.gov (United States)

    Iwata, Hiroaki; Gotoh, Osamu

    2012-11-01

    Spliced alignment plays a central role in the precise identification of eukaryotic gene structures. Even though many spliced alignment programs have been developed, recent rapid progress in DNA sequencing technologies demands further improvements in software tools. Benchmarking algorithms under various conditions is an indispensable task for the development of better software; however, there is a dire lack of appropriate datasets usable for benchmarking spliced alignment programs. In this study, we have constructed two types of datasets: simulated sequence datasets and actual cross-species datasets. The datasets are designed to correspond to various real situations, i.e. divergent eukaryotic species, different types of reference sequences, and the wide divergence between query and target sequences. In addition, we have developed an extended version of our program Spaln, which incorporates two additional features to the scoring scheme of the original version, and examined this extended version, Spaln2, together with the original Spaln and other representative aligners based on our benchmark datasets. Although the effects of the modifications are not individually striking, Spaln2 is consistently most accurate and reasonably fast in most practical cases, especially for plants and fungi and for increasingly divergent pairs of target and query sequences.

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

    Science.gov (United States)

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

    2013-06-01

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

  19. Improvement in genetic evaluation of female fertility in dairy cattle using multiple-trait models including milk production traits

    DEFF Research Database (Denmark)

    Sun, C; Madsen, P; Lund, M S

    2010-01-01

    This study investigated the improvement in genetic evaluation of fertility traits by using production traits as secondary traits (MILK = 305-d milk yield, FAT = 305-d fat yield, and PROT = 305-d protein yield). Data including 471,742 records from first lactations of Denmark Holstein cows, covering...... the years of inseminations during first lactations from 1995 to 2004, were analyzed. Six fertility traits (i.e., interval in days from calving to first insemination, calving interval, days open, interval in days from first to last insemination, numbers of inseminations per conception, and nonreturn rate...... stability and predictive ability than single-trait models for all the fertility traits, except for nonreturn rate within 56 d after first service. The stability and predictive ability for the model including MILK or PROT were similar to the model including all 3 milk production traits and better than...

  20. Improving Program Design and Assessment with Broadening Participation Resources

    Science.gov (United States)

    Siegfried, D.; Johnson, A.; Thomas, S. H.; Fauver, A.; Detrick, L.

    2012-12-01

    Many theoretical and research-based approaches suggest how to best use mentoring to enhance an undergraduate research program. The Institute for Broadening Participation's Pathways to Engineering and Pathways to Ocean Sciences projects synthesized a set of mentoring studies, theoretical sources, and other texts pertinent to undergraduate research program design into a suite of practical tools that includes an online mentoring manual, an online reference library of mentoring and diversity literature, and practical guides such as Using Social Media to Build Diversity in Your REU. The overall goal is to provide easy-to-access resources that can assist faculty and program directors in implementing or honing the mentoring elements in their research programs for undergraduates. IBP's Online Mentoring Manual addresses common themes, such as modeling, student self-efficacy, career development, retention and evaluation. The Online Diversity Reference Library provides a comprehensive, annotated selection of key policy documents, research studies, intervention studies, and other texts on broadening participation in science, technology, engineering and mathematics. IBP's suite of tools provides the theoretical underpinnings and research findings that can help leaders in education integrate site-appropriate mentoring elements into their educational programs. Program directors and faculty from a variety of program types and disciplines have benefitted from using the Manual and other resources. IBP continues the work of translating and synthesizing theory to practice and welcomes your participation and partnership in that effort.

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

    Science.gov (United States)

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

    2015-01-01

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

  2. Prevention of diabetes in overweight/obese children through a family based intervention program including supervised exercise (PREDIKID project): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Arenaza, Lide; Medrano, María; Amasene, María; Rodríguez-Vigil, Beatriz; Díez, Ignacio; Graña, Manuel; Tobalina, Ignacio; Maiz, Edurne; Arteche, Edurne; Larrarte, Eider; Huybrechts, Inge; Davis, Catherine L; Ruiz, Jonatan R; Ortega, Francisco B; Margareto, Javier; Labayen, Idoia

    2017-08-10

    The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise. A total of 84 children, aged 8-12 years, with a high risk of T2D will be included and randomly assigned to control (N = 42) or intervention (N = 42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry). Prevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity. ClinicalTrials.gov, ID: NCT03027726 . Registered on 16 January 2017.

  3. Improved Sorting-Based Procedure for Integer Programming

    DEFF Research Database (Denmark)

    Dantchev, Stefan

    2002-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  5. Joint program for the improvement of bimetallic weld inspection

    International Nuclear Information System (INIS)

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

    1985-02-01

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

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

    Science.gov (United States)

    Tyk, R C; Hylton, P G

    1998-09-01

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

  7. Improvement in Detection of Wrong-Patient Errors When Radiologists Include Patient Photographs in Their Interpretation of Portable Chest Radiographs.

    Science.gov (United States)

    Tridandapani, Srini; Olsen, Kevin; Bhatti, Pamela

    2015-12-01

    This study was conducted to determine whether facial photographs obtained simultaneously with radiographs improve radiologists' detection rate of wrong-patient errors, when they are explicitly asked to include the photographs in their evaluation. Radiograph-photograph combinations were obtained from 28 patients at the time of portable chest radiography imaging. From these, pairs of radiographs were generated. Each unique pair consisted of one new and one old (comparison) radiograph. Twelve pairs of mismatched radiographs (i.e., pairs containing radiographs of different patients) were also generated. In phase 1 of the study, 5 blinded radiologist observers were asked to interpret 20 pairs of radiographs without the photographs. In phase 2, each radiologist interpreted another 20 pairs of radiographs with the photographs. Radiologist observers were not instructed about the purpose of the photographs but were asked to include the photographs in their review. The detection rate of mismatched errors was recorded along with the interpretation time for each session for each observer. The two-tailed Fisher exact test was used to evaluate differences in mismatch detection rates between the two phases. A p value of error detection rates without (0/20 = 0%) and with (17/18 = 94.4%) photographs were different (p = 0.0001). The average interpretation times for the set of 20 radiographs were 26.45 (SD 8.69) and 20.55 (SD 3.40) min, for phase 1 and phase 2, respectively (two-tailed Student t test, p = 0.1911). When radiologists include simultaneously obtained photographs in their review of portable chest radiographs, there is a significant improvement in the detection of labeling errors. No statistically significant difference in interpretation time was observed. This may lead to improved patient safety without affecting radiologists' throughput.

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

    International Nuclear Information System (INIS)

    Bokov, Dmitry; Byers, Kenneth R.

    2004-01-01

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

  9. Evaluation and study of advanced optical contamination, deposition, measurement, and removal techniques. [including computer programs and ultraviolet reflection analysis

    Science.gov (United States)

    Linford, R. M. F.; Allen, T. H.; Dillow, C. F.

    1975-01-01

    A program is described to design, fabricate and install an experimental work chamber assembly (WCA) to provide a wide range of experimental capability. The WCA incorporates several techniques for studying the kinetics of contaminant films and their effect on optical surfaces. It incorporates the capability for depositing both optical and contaminant films on temperature-controlled samples, and for in-situ measurements of the vacuum ultraviolet reflectance. Ellipsometer optics are mounted on the chamber for film thickness determinations, and other features include access ports for radiation sources and instrumentation. Several supporting studies were conducted to define specific chamber requirements, to determine the sensitivity of the measurement techniques to be incorporated in the chamber, and to establish procedures for handling samples prior to their installation in the chamber. A bibliography and literature survey of contamination-related articles is included.

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

    Science.gov (United States)

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

    2008-07-01

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

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Science.gov (United States)

    American Psychologist, 2009

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sano K

    2018-02-01

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

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

    Science.gov (United States)

    McFarland, Dan

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Elizangela Gianini Gonsalez

    2017-09-01

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

  17. Effect of generic issues program on improving safety

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

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

    International Nuclear Information System (INIS)

    Crouthamel, C.E.

    1978-10-01

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

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

    Science.gov (United States)

    2011-10-24

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-02-01

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

  2. LWR-PV Surveillance Dosimetry Improvement Program review graphics

    International Nuclear Information System (INIS)

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

    1979-10-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Science.gov (United States)

    Nugent, Elinor; LaRocco, Susan

    2014-01-01

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

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

    Science.gov (United States)

    Fernandes, Marcelo Vicente Forestieri

    2012-01-01

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

  6. Recent improvements in program packages SHUFFLE and FAR

    International Nuclear Information System (INIS)

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

    1996-01-01

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

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

    International Nuclear Information System (INIS)

    Gautier, A.; Miossec, C.

    1985-12-01

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

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

    Science.gov (United States)

    Cho, Yu Kyung

    2016-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Chia-Der Lin

    2015-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Emma eBlakey

    2015-11-01

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

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

    Science.gov (United States)

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

    2015-05-23

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  14. Strategies for improving memory: a randomized trial of memory groups for older people, including those with mild cognitive impairment.

    Science.gov (United States)

    Kinsella, Glynda J; Ames, David; Storey, Elsdon; Ong, Ben; Pike, Kerryn E; Saling, Michael M; Clare, Linda; Mullaly, Elizabeth; Rand, Elizabeth

    2016-01-01

    Governments are promoting the importance of maintaining cognitive health into older age to minimize risk of cognitive decline and dementia. Older people with amnestic mild cognitive impairment (aMCI) are particularly vulnerable to memory challenges in daily activities and are seeking ways to maintain independent living. To evaluate the effectiveness of memory groups for improving memory strategies and memory ability of older people, especially those with aMCI. 113 healthy older adults (HOA) and 106 adults with aMCI were randomized to a six-week memory group or a waitlist control condition. Outcome was evaluated through knowledge and use of memory strategies, memory ability (self-report and neuropsychological tests), and wellbeing. Assessments included a six-month follow-up. Using intention to treat analyses, there were intervention effects for HOA and aMCI groups in strategy knowledge (HOA: η2= 0.20; aMCI: η2= 0.06), strategy use (HOA: η2= 0.18; aMCI: η2= 0.08), and wellbeing (HOA: η2= 0.11; aMCI: η2= 0.05). There were also intervention effects in the HOA group, but not the aMCI group, in self-reported memory ability (η2= 0.06) and prospective memory tests (η2= 0.02). By six-month follow-up, gains were found on most HOA outcomes. In the aMCI group gains were found in strategy use, and by this stage, gains in prospective memory were also found. Memory groups can engage older people in techniques for maintaining cognitive health and improve memory performance, but more modest benefits are seen for older adults with aMCI.

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

    International Nuclear Information System (INIS)

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

    1989-12-01

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

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

    Science.gov (United States)

    Maity, Sayan; Gunjan, Kumar; Das, Swagatam

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

  17. Design basis programs and improvements in plant operation

    International Nuclear Information System (INIS)

    Metcalf, M.F.

    1991-01-01

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

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

    Directory of Open Access Journals (Sweden)

    ŞUTEU Marius

    2016-05-01

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

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

    Science.gov (United States)

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

    2018-04-24

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

  20. 23 CFR 450.216 - Development and content of the statewide transportation improvement program (STIP).

    Science.gov (United States)

    2010-04-01

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

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

    International Nuclear Information System (INIS)

    1982-01-01

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

  2. ICECON: a computer program used to calculate containment back pressure for LOCA analysis (including ice condenser plants)

    International Nuclear Information System (INIS)

    1976-07-01

    The ICECON computer code provides a method for conservatively calculating the long term back pressure transient in the containment resulting from a hypothetical Loss-of-Coolant Accident (LOCA) for PWR plants including ice condenser containment systems. The ICECON computer code was developed from the CONTEMPT/LT-022 code. A brief discussion of the salient features of a typical ice condenser containment is presented. Details of the ice condenser models are explained. The corrections and improvements made to CONTEMPT/LT-022 are included. The organization of the code, including the calculational procedure, is outlined. The user's manual, to be used in conjunction with the CONTEMPT/LT-022 user's manual, a sample problem, a time-step study (solution convergence) and a comparison of ICECON results with the results of the NSSS vendor are presented. In general, containment pressure calculated with the ICECON code agree with those calculated by the NSSS vendor using the same mass and energy release rates to the containment

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    V. M. Naskalov

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Viveka P Jyotsna

    2012-01-01

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

  6. Improving reading comprehension skills through the SCRATCH program

    Directory of Open Access Journals (Sweden)

    Erdal Papatga

    2016-09-01

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

  7. Improvements in scaling of counter-current imbibition recovery curves using a shape factor including permeability anisotropy

    Science.gov (United States)

    Abbasi, Jassem; Sarafrazi, Shiva; Riazi, Masoud; Ghaedi, Mojtaba

    2018-02-01

    Spontaneous imbibition is the main oil production mechanism in the water invaded zone of a naturally fractured reservoir (NFR). Different scaling equations have been presented in the literature for upscaling of core scale imbibition recovery curves to field scale matrix blocks. Various scale dependent parameters such as gravity effects and boundary influences are required to be considered in the upscaling process. Fluid flow from matrix blocks to the fracture system is highly dependent on the permeability value in the horizontal and vertical directions. The purpose of this study is to include permeability anisotropy in the available scaling equations to improve the prediction of imbibition assisted oil production in NFRs. In this paper, a commercial reservoir simulator was used to obtain imbibition recovery curves for different scenarios. Then, the effect of permeability anisotropy on imbibition recovery curves was investigated, and the weakness of the existing scaling equations for anisotropic rocks was demonstrated. Consequently, an analytical shape factor was introduced that can better scale all the curves related to anisotropic matrix blocks.

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

    Directory of Open Access Journals (Sweden)

    Daniel T.L. Shek

    2006-01-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  10. Modifying the Sleep Treatment Education Program for Students to include technology use (STEPS-TECH): Intervention effects on objective and subjective sleep outcomes.

    Science.gov (United States)

    Barber, Larissa K; Cucalon, Maria S

    2017-12-01

    University students often have sleep issues that arise from poor sleep hygiene practices and technology use patterns. Yet, technology-related behaviors are often neglected in sleep hygiene education. This study examined whether the Sleep Treatment Education Program for Students-modified to include information regarding managing technology use (STEPS-TECH)-helps improve both subjective and objective sleep outcomes among university students. Results of an experimental study among 78 university students showed improvements in objective indicators of sleep quantity (total sleep time) and sleep quality (less awakenings) during the subsequent week for students in the STEPS-TECH intervention group compared to a control group. Exploratory analyses indicated that effects were driven by improvements in weekend days immediately following the intervention. There were also no intervention effects on subjective sleep quality or quantity outcomes. In terms of self-reported behavioral responses to educational content in the intervention, there were no group differences in sleep hygiene practices or technology use before bedtime. However, the intervention group reported less technology use during sleep periods than the control group. These preliminary findings suggest that STEPS-TECH may be a useful educational tool to help improve objective sleep and reduce technology use during sleep periods among university students. Copyright © 2017 John Wiley & Sons, Ltd.

  11. The Effects of a Family Support Program Including Respite Care on Parenting Stress and Family Quality of Life Perceived by Primary Caregivers of Children with Disabilities in Korea

    Science.gov (United States)

    Sung, Minjung; Park, Jiyeon

    2012-01-01

    In this study, a family support program was carried out for primary caregivers of children with disabilities. The program included respite care, recreation programs, counseling, and social support coordination based on individual needs of each family. In order to verify the intervention effects, parenting stress and family quality of life were…

  12. Evaluation of 8-week body weight control program including sea tangle (Laminaria japonica) supplementation in Korean female college students

    OpenAIRE

    You, Jeong Soon; Sung, Min Jung; Chang, Kyung Ja

    2009-01-01

    This study was conducted to evaluate the effects of a body weight control program with supplementation of sea tangle (20 g/day) on 22 female college students. The contents of the program for 8 weeks contained diet therapy, exercise and behavioral modification through nutrition education. Body composition, dietary habit scores, serum lipid profiles, daily nutrient intakes and the quality of life were assessed at the beginning and at the end of the program. Average age of subjects and height we...

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

    Science.gov (United States)

    Ruza, Nadiah; Mustafa, Zainol

    2013-04-01

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

  14. Compression planning for continuous improvement in quality programs

    International Nuclear Information System (INIS)

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

    1992-01-01

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

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

    Science.gov (United States)

    1998-08-26

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

  16. Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money.

    Science.gov (United States)

    Davis, Jennifer J J

    2008-09-01

    Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, "Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense." This promising approach to improving health and reducing healthcare costs could potentially be applied to other employer groups.

  17. Nuclear security. DOE actions to improve the personnel clearance program

    International Nuclear Information System (INIS)

    Fultz, Keith O.; Bannerman, Carl J.; Daniel, Beverly A.

    1988-11-01

    The status of the Department of Energy's (DOE) implementation of recommendations in our two reports on DOE's personnel security clearance program was determined. The recommendations were aimed at improving the timeliness, accuracy, and efficiency of personnel security clearance decisions. Specifically, the objective was to determine and report on steps DOE is taking to implement these recommendations. In summary, it was found that DOE has either initiated action or is studying ways to address all the recommendations, but none of the recommendations have been completely implemented. The effectiveness of the DOE actions will depend, in part, on the adequacy of its internal control system for overseeing and evaluating program operations. DOE's personnel security clearance program is intended to provide reasonable assurance that personnel with access to classified information and materials are trustworthy. The Department requests that the Office of Personnel Management or the Federal Bureau of Investigation collect personal data on each person who requires such access to do his or her job. Based on these background investigations, DOE officials authorize individuals whose personal histories indicate that they are trustworthy to have access to classified information, secured facilities, and controlled materials as needed to perform their jobs. DOE has five types of these authorizations or personnel security clearances and must update information on personnel holding each type at 5-year intervals to confirm their continuing reliability. The five types are based on the types of security interests to which the person needs access, e.g., persons needing nuclear weapons-related data must have a Q clearance, and persons with a top secret clearance can have access to national security data classified as top secret

  18. Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money

    Science.gov (United States)

    Davis, Jennifer “J. J.”

    2008-01-01

    Background Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. Objectives As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. Methods The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. Results In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Conclusions Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, “Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense.” This promising approach to improving health and reducing healthcare costs could potentially be applied to other

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

    Science.gov (United States)

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

    2017-01-01

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

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

    DEFF Research Database (Denmark)

    Olszak, Andrzej; Jørgensen, Bo Nørregaard

    2011-01-01

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

  1. NRC program for the resolution of generic issues related to nuclear power plants. (Includes plans for the resolution of ''unresolved safety issues'' pursuant to Section 210 of the Energy Reorganization Act of 1974, as amended)

    International Nuclear Information System (INIS)

    1977-12-01

    This report provides a description of the Nuclear Regulatory Commission's Program for the Resolution of Generic Issues Related to Nuclear Power Plants. The NRC program is of considerably broader scope than the ''Unresolved Safety Issues Plan'' required by Section 210. The NRC program does include plans for the resolution of ''Unresolved Safety Issues''; however, in addition, it includes generic tasks for the resolution of environmental issues, for the development of improvements in the reactor licensing process and for consideration of less conservative design criteria or operating limitations in areas where over conservatisms may be unnecessarily restrictive or costly

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

    International Nuclear Information System (INIS)

    Dieckhoner, J.E.

    1978-01-01

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Minnesota 4-H Youth Program Quality Improvement Model

    Science.gov (United States)

    Herman, Margo; Grant, Samantha

    2015-01-01

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

  6. Ca analysis: an Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis.

    Science.gov (United States)

    Greensmith, David J

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. Copyright © 2013 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

  7. Ca analysis: An Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis☆

    Science.gov (United States)

    Greensmith, David J.

    2014-01-01

    Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. PMID:24125908

  8. KENO IV: an improved Monte Carlo criticality program

    International Nuclear Information System (INIS)

    Petrie, L.M.; Cross, N.F.

    1975-11-01

    KENO IV is a multigroup Monte Carlo criticality program written for the IBM 360 computers. It executes rapidly and is flexibly dimensioned so the allowed size of a problem (i.e., the number of energy groups, number of geometry cards, etc., are arbitrary) is limited only by the total data storage required. The input data, with the exception of cross sections, fission spectra and albedos, may be entered in free form. The geometry input is quite simple to prepare and complicated three-dimensional systems can often be described with a minimum of effort. The results calculated by KENO IV include k-effective, lifetime and generation time, energy-dependent leakages and absorptions, energy- and region-dependent fluxes and region-dependent fission densities. Criticality searches can be made on unit dimensions or on the number of units in an array. A summary of the theory utilized by KENO IV, a section describing the logical program flow, a compilation of the error messages printed by the code and a comprehensive data guide for preparing input to the code are presented. 14 references

  9. Sciences literacy on nutrition program for improving public wellness

    Science.gov (United States)

    Rochman, C.; Nasrudin, D.; Helsy, I.; Rokayah; Kusbudiah, Y.

    2018-05-01

    Increased wellness for a person becomes a necessity now and for the future. Various ways people do to get fit include following and understanding nutrition. This review will inventory the concepts of science involved to understand the nutritional program and its impact on fitness levels. The method used is a quantitative and qualitative descriptive mixed method based on treatment to a number of nutrition group participants in a nutrition group in Bandung. The concepts of science that are the subject of study are the concepts of physics, chemistry, and biology. The results showed that the ability of science literacy and respondent's wellness level varies and there is a relationship between science literacy with one's wellness level. The implications of this research are the need for science literacy and wellness studies for community based on educational level and more specific scientific concepts.

  10. [Verification of doubtful PAP smear results of women included in the screening program in the Podlaskie province].

    Science.gov (United States)

    Błońska, Ewa; Knapp, Piotr Andrzej

    2013-08-01

    Verification of uncertain PAP-smear results in a group of women covered by the cervical screening program in the Podlaski province. The main aim of the study was to identify CIN (Cervical Intraepithelial Neoplasia) lesions present, with varying degrees of severity in women with cytological diagnosis of ASCUS (atypical squamous cells of undetermined significance), LSIL (low grade squamous intraepithelial lesion), and ASC-H (atypical squamous cells - cannot exclude high grade squamous intraepithelial lesion). The study evaluated 101 cervical smears taken from the vaginal part of the cervix in a group of screened women in the Podlaski province. Cytological evaluation was performed according the Bethesda System. We analyzed abnormal smears selected from a total of 7296 cytological examinations performed during 2012 at the University Center for Pathomorphological and Genetic - Molecular Diagnosis, Medical University in Białystok. The cytological results which were of interest to us included 19 cases with ASCUS, 59 with LSIL, and 23 with ASC-H, as well as with morphological features of the presence of Human Papilloma Virus (HPV). Staining was performed using CINtecPLUS test according to the manufacturer's instructions. CINtecPLUS is a immunocytochemical test based on specially designed monoclonal antibodies (E6H4TM) that let us identify protein p16ink4a within the cervical smear Additionally the diagnostic kit was provided with antibodies for diagnosing the presence of Ki-67 protein, a known marker of cell proliferation. The result was considered positive when staining of the nucleus and the cytoplasm appeared in red and brown, respectively. All abnormal results were eventually verified by histological examination of the tissue taken from cervical lesions by diagnostic-therapeutic procedure following colposcopic evaluation of cervical lesion topography In the group of cytological smears with ASCUS, the diagnosis was positive in 5 cases (26.3%), negative in 14 (73

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

    Science.gov (United States)

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

    2018-04-01

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

  12. Improved survival in HIV treatment programs in Asia

    Science.gov (United States)

    De La Mata, Nicole L; Kumarasamy, Nagalingeswaran; Khol, Vohith; Ng, Oon Tek; Van Nguyen, Kinh; Merati, Tuti Parwati; Pham, Thuy Thanh; Lee, Man Po; Durier, Nicolas; Law, Matthew

    2016-01-01

    Background Antiretroviral treatment (ART) for HIV-positive patients has expanded rapidly in Asia over the last ten years. Our study aimed to describe the time trends and risk factors for overall survival in patients receiving first-line ART in Asia. Methods We included HIV-positive adult patients who initiated ART between 2003–2013 (n=16 546), from seven sites across six Asia-Pacific countries. Patient follow-up was to May 2014. We compared survival for each country and overall by time period of ART initiation using Kaplan-Meier curves. Factors associated with mortality were assessed using Cox regression, stratified by site. We also summarized first-line ART regimens, CD4 count at ART initiation, and CD4 and HIV viral load testing frequencies. Results There were 880 deaths observed over 54 532 person-years of follow-up, a crude rate of 1.61 (1.51, 1.72) per 100 person-years. Survival significantly improved in more recent years of ART initiation. The survival probabilities at 4 years follow-up for those initiating ART in 2003–05 was 92.1%, 2006–09 was 94.3% and 2010–2013 was 94.5% (pAsia have improved survival in more recent years of ART initiation. This is likely a consequence of improvements in treatment and, patient management and monitoring over time. PMID:26961354

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

    Science.gov (United States)

    Sidik, S. M.

    1972-01-01

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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-01

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

  16. Development of a Web-Based Quality Dashboard Including a Toolbox to Improve Pain Management in Dutch Intensive Care

    NARCIS (Netherlands)

    Roos-Blom, Marie-José; Gude, Wouter T.; de Jonge, Evert; Spijkstra, Jan Jaap; van der Veer, Sabine N.; Dongelmans, Dave A.; de Keizer, Nicolette F.

    2017-01-01

    Audit and feedback (A&F) is a common strategy to improve quality of care. Meta-analyses have indicated that A&F may be more effective in realizing desired change when baseline performance is low, it is delivered by a supervisor or colleague, it is provided frequently and in a timely manner, it is

  17. Benefits of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise on albuminuria in diabetic and non-diabetic Japanese populations.

    Science.gov (United States)

    Yamamoto-Kabasawa, Keiko; Hosojima, Michihiro; Yata, Yusuke; Saito, Mariko; Tanaka, Noriko; Tanaka, Junta; Tanabe, Naohito; Narita, Ichiei; Arakawa, Masaaki; Saito, Akihiko

    2015-12-01

    Albuminuria is a biomarker for chronic kidney disease and an independent predictor of cardiovascular and all-cause mortality. A recent meta-analysis concluded that these risks increase with urinary albumin concentration, even when below the microalbuminuria threshold. Thus, minimizing urinary albumin may be a valuable therapeutic goal regardless of disease status. We investigated the benefits and safety of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise for reducing albuminuria in 295 normoalbuminuric or microalbuminuric Japanese adults, including 30 with type 2 diabetes mellitus (T2DM), 104 with metabolic syndrome (MS), and 145 with hypertension (HT). In the study population, the urinary albumin:creatinine ratio (UACR) was reduced significantly (ΔUACR -3.8 ± 16.8 mg/g, P < 0.001) with no change in estimated glomerular filtration rate (eGFR) (ΔeGFR -0.4 ± 7.4 mL/min/1.73 m(2), P = 0.343). The reduction in UACR was associated with decreased fasting plasma glucose (P < 0.05). The UACR was also reduced in the T2DM, MS, and HT groups with no change in eGFR. Reduced UACR was associated with decreased fasting plasma glucose in the MS group and decreased systolic blood pressure in the HT group. The UACR was also reduced in 46 subjects using renin-angiotensin system inhibitors with no change in eGFR. Our 12-week lifestyle modification program reduced UACR, maintained eGFR, and improved multiple fitness findings in Japanese subjects including T2DM, MS, and HT patients.

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

    Science.gov (United States)

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

    2016-07-01

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

  19. Skin tumor area extraction using an improved dynamic programming approach.

    Science.gov (United States)

    Abbas, Qaisar; Celebi, M E; Fondón García, Irene

    2012-05-01

    Border (B) description of melanoma and other pigmented skin lesions is one of the most important tasks for the clinical diagnosis of dermoscopy images using the ABCD rule. For an accurate description of the border, there must be an effective skin tumor area extraction (STAE) method. However, this task is complicated due to uneven illumination, artifacts present in the lesions and smooth areas or fuzzy borders of the desired regions. In this paper, a novel STAE algorithm based on improved dynamic programming (IDP) is presented. The STAE technique consists of the following four steps: color space transform, pre-processing, rough tumor area detection and refinement of the segmented area. The procedure is performed in the CIE L(*) a(*) b(*) color space, which is approximately uniform and is therefore related to dermatologist's perception. After pre-processing the skin lesions to reduce artifacts, the DP algorithm is improved by introducing a local cost function, which is based on color and texture weights. The STAE method is tested on a total of 100 dermoscopic images. In order to compare the performance of STAE with other state-of-the-art algorithms, various statistical measures based on dermatologist-drawn borders are utilized as a ground truth. The proposed method outperforms the others with a sensitivity of 96.64%, a specificity of 98.14% and an error probability of 5.23%. The results demonstrate that this STAE method by IDP is an effective solution when compared with other state-of-the-art segmentation techniques. The proposed method can accurately extract tumor borders in dermoscopy images. © 2011 John Wiley & Sons A/S.

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2014-09-01

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

  2. Program management plan for the conduct of a research, development, and demonstration program for improving the safety of nuclear powerplants

    International Nuclear Information System (INIS)

    1981-12-01

    Congress passed Public Law 96-567, Nuclear Safety Research, Development, and Demonstration Act of 1980, (hereafter referred to as the Act) to provide for an accelerated and coordinated program of light water reactor safety research, development, and demonstration to be carried out by the Department of Energy. In order to assure that this program would be compatible with the needs of Nuclear Regulatory Commission (NRC) and industry, the Department of Energy (DOE) initiated its response to Section 4 of the Act by conducting individual information gathering meetings with NRC and a wide cross section of the nuclear industry. The Department received recommendations on needs of what type of activities would and would not be appropriate for the Department to assist in satisfying these needs. Based on the evaluation of these inputs, it is concluded that the Department's ongoing Light Water Reactor (LWR) safety program is responsive to the Act. Specifically, the Department's ongoing program includes tasks in the areas of regulatory assessment, risk assessment, fission product source term, and emergency preparedness as well as providing technical assistance to the Institute of Nuclear Power Operations (INPO) to improve training of nuclear power personnel. These were among the very high priority efforts that were identified as necessary and appropriate for support by the Department

  3. Improving the accuracy of self-assessment of practical clinical skills using video feedback--the importance of including benchmarks.

    Science.gov (United States)

    Hawkins, S C; Osborne, A; Schofield, S J; Pournaras, D J; Chester, J F

    2012-01-01

    Isolated video recording has not been demonstrated to improve self-assessment accuracy. This study examines if the inclusion of a defined standard benchmark performance in association with video feedback of a student's own performance improves the accuracy of student self-assessment of clinical skills. Final year medical students were video recorded performing a standardised suturing task in a simulated environment. After the exercise, the students self-assessed their performance using global rating scales (GRSs). An identical self-assessment process was repeated following video review of their performance. Students were then shown a video-recorded 'benchmark performance', which was specifically developed for the study. This demonstrated the competency levels required to score full marks (30 points). A further self-assessment task was then completed. Students' scores were correlated against expert assessor scores. A total of 31 final year medical students participated. Student self-assessment scores before video feedback demonstrated moderate positive correlation with expert assessor scores (r = 0.48, p benchmark performance demonstration, self-assessment scores demonstrated a very strong positive correlation with expert scores (r = 0.83, p benchmark performance in combination with video feedback may significantly improve the accuracy of students' self-assessments.

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

    Science.gov (United States)

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

    2013-06-01

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

  5. Building a Steganography Program Including How to Load, Process, and Save JPEG and PNG Files in Java

    Science.gov (United States)

    Courtney, Mary F.; Stix, Allen

    2006-01-01

    Instructors teaching beginning programming classes are often interested in exercises that involve processing photographs (i.e., files stored as .jpeg). They may wish to offer activities such as color inversion, the color manipulation effects archived with pixel thresholding, or steganography, all of which Stevenson et al. [4] assert are sought by…

  6. 25 CFR 170.137 - What types of activities can a recreation, tourism, and trails program include?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What types of activities can a recreation, tourism, and... Eligibility Recreation, Tourism and Trails § 170.137 What types of activities can a recreation, tourism, and... may perform under a recreation, tourism, and trails program: (1) Transportation planning for tourism...

  7. Pilot monitoring program: geologic input for the hillslope component (includes a discussion of Caspar Creek geology and geomorphology)

    Science.gov (United States)

    T. E. Spittler

    1995-01-01

    The California Department of Conservation, Division of Mines and Geology (DMG) is submitting this report and accompanying maps to the California Department of Forestry and Fire Protection (CDF) to fulfill Interagency Agreement number 8CA38400, Pilot Monitoring Program -- Geologic Input for the Hillslope Component. Under this agreement, DMG has assisted CDF in the...

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

    Science.gov (United States)

    Sato, Nanae; Hayashi, Fumi; Yoshiike, Nobuo

    2016-01-01

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

  9. Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial.

    Science.gov (United States)

    Nakagami, Yukako; Kubo, Hiroaki; Katsuki, Ryoko; Sakai, Tomomichi; Sugihara, Genichi; Naito, Chisako; Oda, Hiroyuki; Hayakawa, Kohei; Suzuki, Yuriko; Fujisawa, Daisuke; Hashimoto, Naoki; Kobara, Keiji; Cho, Tetsuji; Kuga, Hironori; Takao, Kiyoshi; Kawahara, Yoko; Matsumura, Yumi; Murai, Toshiya; Akashi, Koichi; Kanba, Shigenobu; Otsuka, Kotaro; Kato, Takahiro A

    2018-01-01

    Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. Design was a single-arm study with relatively small sample size and short-term follow up. The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Improvement of the including sink material for around steel pot hot water department; Yokoka yuataribuyo nagashikomizai no kaizen

    Energy Technology Data Exchange (ETDEWEB)

    Hakiwara, R.

    1999-02-01

    As for life of steel pot, there are many rates which a place hit part occupies even in some copies. How to construct the castable which was different from other parts was examined, and it worked for high durability performance only around the hot water hit city for that. It worked for the life extension by this report to prevent spool for which to be a main damage factor thunder big fault grains were increased it was added .20% of the durability improvement could be confirmed so far more than goods as that result by adding big fault grain 40%. (translated by NEDO)

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

    International Nuclear Information System (INIS)

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

    1995-01-01

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

  12. The disconnected values model improves mental well-being and fitness in an employee wellness program.

    Science.gov (United States)

    Anshel, Mark H; Brinthaupt, Thomas M; Kang, Minsoo

    2010-01-01

    This study examined the effect of a 10-week wellness program on changes in physical fitness and mental well-being. The conceptual framework for this study was the Disconnected Values Model (DVM). According to the DVM, detecting the inconsistencies between negative habits and values (e.g., health, family, faith, character) and concluding that these "disconnects" are unacceptable promotes the need for health behavior change. Participants were 164 full-time employees at a university in the southeastern U.S. The program included fitness coaching and a 90-minute orientation based on the DVM. Multivariate Mixed Model analyses indicated significantly improved scores from pre- to post-intervention on selected measures of physical fitness and mental well-being. The results suggest that the Disconnected Values Model provides an effective cognitive-behavioral approach to generating health behavior change in a 10-week workplace wellness program.

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  14. FCI: remedy development for the fuel performance improvement program

    International Nuclear Information System (INIS)

    Buckman, F.W.; Crouthamel, C.E.; Freshley, M.D.

    1979-01-01

    Out-of-reactor experiments and irradiations are being utilized to develop and demonstrate the efficacy of specific advanced fuel designs to improve FCI behavior. The advanced light water reactor fuel designs being evaluated combine annular pellets, graphite coating on the inner surface of the cladding, and helium pressurization. A sphere-pac fuel design is also being developed. Characterization of the graphite coatings includes studies of composition, application methods, thickness control, moisture control, thermal conductivity, compatibility with the zircaloy cladding, strain-to-failure, and friction and wear characteristics. Rods of the different fuel designs, as well as reference rods, are being irradiated in the Halden Boiling Water Reactor and the Big Rock Point Reactor to accumulate burnup prior to ramping tests

  15. Rapid Improvement of thyroid storm-related hemodynamic collapse by aggressive anti-thyroid therapy including steroid pulse

    OpenAIRE

    Kiriyama, Hiroyuki; Amiya, Eisuke; Hatano, Masaru; Hosoya, Yumiko; Maki, Hisataka; Nitta, Daisuke; Saito, Akihito; Shiraishi, Yasuyuki; Minatsuki, Shun; Sato, Tatsuyuki; Murakami, Haruka; Uehara, Masae; Manaka, Katsunori; Makita, Noriko; Watanabe, Masafumi

    2017-01-01

    Abstract Rationale: Heart failure is relatively common in patients with hyperthyroidism, but thyrotoxic cardiomyopathy with poor left ventricular (LV) systolic function is very rare. Patient concerns: We experienced a representative case of a patient who presented with severe LV dysfunction related to thyroid storm and needed extracorporeal membrane oxygenation (ECMO) temporally. Diagnosis: Thyrotoxic cardiomyopathy. Interventions and Outcomes: Aggressive antithyroid therapy, including steroi...

  16. Novel feed including bioactive compounds from winery wastes improved broilers' redox status in blood and tissues of vital organs.

    Science.gov (United States)

    Makri, Sotiria; Kafantaris, Ioannis; Stagos, Dimitrios; Chamokeridou, Theodora; Petrotos, Konstantinos; Gerasopoulos, Konstantinos; Mpesios, Anastasios; Goutzourelas, Nikolaos; Kokkas, Stylianos; Goulas, Panagiotis; Komiotis, Dimitrios; Kouretas, Dimitrios

    2017-04-01

    Currently, there is a great interest in the production of animal feed with antioxidant activity. The aim of this study was to examine the potential antioxidant effects of a feed supplemented with grape pomace (GP), a winery by-product with high environmental load, in chickens. Broilers of 15 days post birth were separated into two groups fed either with standard diet or with diet supplemented with GP for 35 days. Blood and tissues collections were performed after feeding for 15 and 35 days with the experimental diet (i.e. at 30 and 50 days post birth). Free radical toxicity markers, namely thiobarbituric acid reactive substances, protein carbonyls, total antioxidant capacity, reduced glutathione, catalase activity and rate of H 2 O 2 decomposition were determined in blood and tissues of vital organs. The results indicated that feed supplemented with GP decreased oxidative stress-induced toxic effects and improved chickens' redox status, and so it may also improve their wellness and productivity. On the other hand, this exploitation of GP may solve problems of environmental pollution in areas with wineries. Copyright © 2017. Published by Elsevier Ltd.

  17. Improving ecological risk assessment by including bioavailability into species sensitivity distributions: An example for plants exposed to nickel in soil

    International Nuclear Information System (INIS)

    Semenzin, Elena; Temminghoff, Erwin J.M.; Marcomini, Antonio

    2007-01-01

    The variability of species sensitivity distribution (SSD) due to contaminant bioavailability in soil was explored by using nickel as metal of concern. SSDs of toxicity test results of Avena sativa L. originating from different soils and expressed as total content and available (0.01 M CaCl 2 ) extractable concentration were compared to SSDs for terrestrial plants derived from literature toxicity data. Also the 'free' nickel (Ni 2+ ) concentration was calculated and compared. The results demonstrated that SSDs based on total nickel content highly depend on the experimental conditions set up for toxicity testing (i.e. selected soil and pH value) and thus on metal bioavailability in soil, resulting in an unacceptable uncertainty for ecological risk estimation. The use in SSDs of plant toxicity data expressed as 0.01 M CaCl 2 extractable metal strongly reduced the uncertainty in the SSD curve and thus can improve the ERA procedure remarkably by taking bioavailability into account. - The use of bioavailability toxicity data can improve species sensitivity distribution (SSD) curves and thus ecological risk assessment (ERA)

  18. Improved uranium-utilization program, Phase I. First semiannual report, September 1979-March 1980

    International Nuclear Information System (INIS)

    Hopkins, G.C.

    1980-11-01

    The Improved Uranium Utilization Program includes a Phase I evaluation of BWR design alternatives which have potential to reduce uranium ore requirements in once-through fuel cycles. The Phase I project is evaluating the alternatives in detail, including considerations of reliability, performance, manufacturing, safety and economics; is establishing implementation development requirements, costs and schedules; is selecting the most promising alternatives; and is developing detailed plans for Phase II projects for implementation. Emphasis is being placed on developing practical alternatives which can be demonstrated at the earliest possible date in existing operating BWR nuclear power stations. Priority is being given to alternatives which have the maximum payoff, measured by reduction of the nation's uranium resource requirements, on the shortest schedule. Alternatives included in current evaluations are: improved refueling and control rod pattern optimization, spectral shift, extended burnup, reduction in gadolinia residual, axial blanket optimization, reconstitution, and combinations of these alternatives

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

    Science.gov (United States)

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

    2015-11-01

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

  20. International program to improve decay data for transactinium nuclides

    International Nuclear Information System (INIS)

    Helmer, R.G.; Reich, C.W.

    1985-01-01

    To help meet an identified need for precise decay data, in 1977 the IAEA organized an international Coordinated Research Program (CRP) to measure and evaluate half-lives and γ - and α - emission probabilities for selected transactinium nuclides of importance for reactor technology. The CRP goals were (1) to determine a list of data that needed improvement, (2) to encourage new measurements, and (3) to evaluate the available data. All three phases of this work are now complete. Our participation in this effort has involved the measurement of γ-ray emission probabilities for /sup 232, 233, 235/U, /sup 238, 239, 240, 241/Pu, 229 Th and 233 Pa, as well as participating in the data evaluation. The γ-emission probabilities were determined from the measurement of γ-emission rates with the goal of obtaining uncertainties of less than or equal to 1%. γ measurements were made on calibrated Ge detectors. These calibrations were done by standard methods, generally involving measurements at approx. 60 γ-ray energies from 14 to 2700 keV. The efficiency-calibration functions were assigned uncertainties ranging from 2% below 50 keV to 0.50% from 400 to 1400 keV. The determination of the decay rates of the various sources involved several techniques. The 238 Pu, 239 Pu and 240 Pu samples were calibrated by gross α-emission-rate measurements at NBS. The 235 U sample was taken from an NBS-calibrated spike solution. The 241 Pu and 233 U samples were calibrated by isotope-dilution mass spectrometry based on spikes of the calibrated 239 Pu, 240 Pu and 235 U materials. Some of our results are given, together with a comparison of some present and previous results. 20 refs

  1. How effective are tree improvement programs in the 50 states?

    Science.gov (United States)

    Christopher D. Risbrudt; Stephen E. McDonald

    1986-01-01

    All 50 states were surveyed to determine the extent of their activities in producing genetically improved trees for timber production. Describes the funds expended, the species being improved, and the use of State and Private Forestry funds provided for genetic improvement. Projects future timber volumes attributable to genetic improvement, and estimates benefit cost...

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

    Science.gov (United States)

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

    2016-08-01

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

  3. Opportunities to Improve Air Quality through Transportation Pricing Programs

    Science.gov (United States)

    This document is intended to give state and local air quality and transportation planners,elected government officials, and other interested parties background information on transportation pricing programs.

  4. Radiation-curing of acrylate composites including carbon fibres: A customized surface modification for improving mechanical performances

    International Nuclear Information System (INIS)

    Martin, Arnaud; Pietras-Ozga, Dorota; Ponsaud, Philippe; Kowandy, Christelle; Barczak, Mariusz; Defoort, Brigitte; Coqueret, Xavier

    2014-01-01

    The lower transverse mechanical properties of radiation-cured acrylate-based composites reinforced with carbon-fibre with respect to the thermosettable analogues was investigated from the viewpoint of chemical interactions at the interface between the matrix and the carbon material. XPS analysis of representative commercial carbon fibres revealed the presence of a significant amount of chemical functions potentially exerting an adverse effect on the initiation and propagation of the free radical polymerization initiated under high energy radiation. The EB-induced polymerization of n-butyl acrylate as a simple model monomer was conducted in the presence of various aromatic additives exhibiting a strong inhibiting effect, whereas thiols efficiently sensitize the initiation mechanism and undergo transfer reactions. A method based on the surface modification of sized fibres by thiomalic acid is proposed for overcoming the localized inhibition phenomenon and for improving the mechanical properties of the resulting acrylate-based composites. - Highlights: • Surface functions of C-fibres are analyzed for their effect on radical reaction. • Irradiation of nBu-acrylate in presence of aromatic additives reveals inhibition. • Thiol groups sensitize the radiation-initiated polymerization of nBu-acrylate. • Modification of C-fibres with thiomalic acid enhances composite properties

  5. An improved coupled-states approximation including the nearest neighbor Coriolis couplings for diatom-diatom inelastic collision

    Science.gov (United States)

    Yang, Dongzheng; Hu, Xixi; Zhang, Dong H.; Xie, Daiqian

    2018-02-01

    Solving the time-independent close coupling equations of a diatom-diatom inelastic collision system by using the rigorous close-coupling approach is numerically difficult because of its expensive matrix manipulation. The coupled-states approximation decouples the centrifugal matrix by neglecting the important Coriolis couplings completely. In this work, a new approximation method based on the coupled-states approximation is presented and applied to time-independent quantum dynamic calculations. This approach only considers the most important Coriolis coupling with the nearest neighbors and ignores weaker Coriolis couplings with farther K channels. As a result, it reduces the computational costs without a significant loss of accuracy. Numerical tests for para-H2+ortho-H2 and para-H2+HD inelastic collision were carried out and the results showed that the improved method dramatically reduces the errors due to the neglect of the Coriolis couplings in the coupled-states approximation. This strategy should be useful in quantum dynamics of other systems.

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2007-11-01

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

  8. Impact of a multifaceted educational intervention including serious games to improve the management of invasive candidiasis in critically ill patients.

    Science.gov (United States)

    Ferrer, R; Zaragoza, R; Llinares, P; Maseda, E; Rodríguez, A; Quindós, G

    Infections caused by Candida species are common in critically ill patients and contribute to significant morbidity and mortality. The EPICO Project (Epico 1 and Epico 2.0 studies) recently used a Delphi approach to elaborate guidelines for the diagnosis and treatment of this condition in critically ill adult patients. We aimed to evaluate the impact of a multifaceted educational intervention based on the Epico 1 and Epico 2.0 recommendations. Specialists anonymously responded to two online surveys before and after a multifaceted educational intervention consisting of 60-min educational sessions, the distribution of slide kits and pocket guides with the recommendations, and an interactive virtual case presented at a teleconference and available for online consultation. A total of 74 Spanish hospitals. Specialists of the Intensive Care Units in the participating hospitals. Specialist knowledge and reported practices evaluated using a survey. The McNemar test was used to compare the responses in the pre- and post-intervention surveys. A total of 255 and 248 specialists completed both surveys, in both periods, respectively. The pre-intervention surveys showed many specialists to be unaware of the best approach for managing invasive candidiasis. After both educational interventions, specialist knowledge and reported practices were found to be more in line with nearly all the recommendations of the Epico 1 and Epico 2.0 guidelines, except as regards de-escalation from echinocandins to fluconazole in Candida glabrata infections (p=0.055), and the duration of antifungal treatment in both candidemia and peritoneal candidiasis. This multifaceted educational intervention based on the Epico Project recommendations improved specialist knowledge of the management of invasive candidiasis in critically ill patients. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  9. Darlington refurbishment - performance improvement programs goals and experience

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, N. [Ontario Power Generation, Toronto, ON (Canada)

    2015-07-01

    This paper discusses the refurbishment program at the Darlington site. The program focuses on safety, integrity, excellence and personnel. Worker safety and public safety are of the highest priority. Success resulted from collaborative engineering interface, collaborative front end planning, highly competent people and respectful relationship with partners and regulators.

  10. Using management action plans to integrate program improvement efforts

    Energy Technology Data Exchange (ETDEWEB)

    Meador, S.W.; Kidwell, R.J.; Shangraw, W.R.; Cardamone, E.N. [Project Performance Corporation, Sterling, VA (United States)

    1994-12-31

    The Department of Energy`s (DOE`s) Environmental Management Program is the country`s largest and most sophisticated environmental program to date. The rapid expansion of the DOE`s environmental restoration efforts has led to increased scrutiny of its management processes and systems. As the program continues to grow and mature, maintaining adequate accountability for resources and clearly communicating progress will be essential to sustaining public confidence. The Office of Environmental Management must ensure that adequate processes and systems are in place at Headquarters, Operation Offices, and contractor organizations. These systems must provide the basis for sound management, cost control, and reporting. To meet this challenge, the Office of Environmental Restoration introduced the Management Action Plan process. This process was designed to serve three primary functions: (1) define the program`s management capabilities at Headquarters and Operations Offices; (2) describe how management initiatives address identified program deficiencies; and (3) identify any duplication of efforts or program deficiencies. The Environmental Restoration Management Action Plan is a tracking, reporting, and statusing tool, used primarily at the Headquarters level, for assessing performance in key areas of project management and control. BY DOE to communicate to oversight agencies and stakeholders a clearer picture of the current status of the environmental restoration project management system. This paper will discuss how Management Action Plans are used to provide a program-wide assessment of management capabilities.

  11. Uranium Holdup Survey Program (UHSP) Lean Improvement Project

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Jeff [Y-12 National Security Complex, Oak Ridge, TN (United States); Univ. of Tennessee, Knoxville, TN (United States)

    2017-10-13

    This report discusses the UHSP monitoring program, a radioactive material accounting process and its purpose. The systematic approach to implementing Lean principles, determining key requirements, root causes of variation and disruption that interfere with program efficiency and effectiveness. Preexisting issues within the UHSP are modeled to illustrate the impact that they have on the large and extensive systems.

  12. 75 FR 13735 - Fund for the Improvement of Postsecondary Education (FIPSE)-Special Focus Competition: Program...

    Science.gov (United States)

    2010-03-23

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

  13. Evaluation of the 235U prompt fission neutron spectrum including a detailed analysis of experimental data and improved model information

    Science.gov (United States)

    Neudecker, Denise; Talou, Patrick; Kahler, Albert C.; White, Morgan C.; Kawano, Toshihiko

    2017-09-01

    We present an evaluation of the 235U prompt fission neutron spectrum (PFNS) induced by thermal to 20-MeV neutrons. Experimental data and associated covariances were analyzed in detail. The incident energy dependence of the PFNS was modeled with an extended Los Alamos model combined with the Hauser-Feshbach and the exciton models. These models describe prompt fission, pre-fission compound nucleus and pre-equilibrium neutron emissions. The evaluated PFNS agree well with the experimental data included in this evaluation, preliminary data of the LANL and LLNL Chi-Nu measurement and recent evaluations by Capote et al. and Rising et al. However, they are softer than the ENDF/B-VII.1 (VII.1) and JENDL-4.0 PFNS for incident neutron energies up to 2 MeV. Simulated effective multiplication factors keff of the Godiva and Flattop-25 critical assemblies are further from the measured keff if the current data are used within VII.1 compared to using only VII.1 data. However, if this work is used with ENDF/B-VIII.0β2 data, simulated values of keff agree well with the measured ones.

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

    Science.gov (United States)

    Landers, Judith C.; Knuth, Barbara A.

    1991-03-01

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

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

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  16. Clean Diesel Engine Component Improvement Program Diesel Truck Thermoelectric Generator

    Energy Technology Data Exchange (ETDEWEB)

    Elsner, N. B. [Hi-Z Technology, Inc., San Diego, CA (United States); Bass, J. C. [Hi-Z Technology, Inc., San Diego, CA (United States); Ghamaty, S. [Hi-Z Technology, Inc., San Diego, CA (United States); Krommenhoek, D. [Hi-Z Technology, Inc., San Diego, CA (United States); Kushch, A. [Hi-Z Technology, Inc., San Diego, CA (United States); Snowden, D. [Hi-Z Technology, Inc., San Diego, CA (United States); Marchetti, S. [Hi-Z Technology, Inc., San Diego, CA (United States)

    2005-03-16

    Hi-Z Technology, Inc. (Hi-Z) is currently developing four different auxiliary generator designs that are used to convert a portion (5 to 20%) of the waste heat from vehicle engines exhaust directly to electricity. The four designs range from 200 Watts to 10 kW. The furthest along is the 1 kW Diesel Truck Thermoelectric Generator (DTTEG) for heavy duty Class 8 Diesel trucks, which, under this program, has been subjected to 543,000 equivalent miles of bouncing and jarring on PACCAR's test track. Test experience on an earlier version of the DTTEG on the same track showed the need for design modifications incorporated in DTTEG Mod 2, such as a heavy duty shock mounting system and reinforcement of the electrical leads mounting system, the thermocouple mounting system and the thermoelectric module restraints. The conclusion of the 543,000 mile test also pointed the way for an upgrading to heavy duty hose or flex connections for the internal coolant connections for the TEG, and consideration of a separate lower temperature cooling loop with its own radiator. Fuel savings of up to $750 per year and a three to five year payback are believed to be possible with the 5 % efficiency modules. The economics are expected to improve considerably to approach a two year payback when the 5 kW to 10 kW generators make it to the market in a few years with a higher efficiency (20%) thermoelectric module system called Quantum Wells, which are currently under development by Hi-Z. Ultimately, as automation takes over to reduce material and labor costs in the high volume production of QW modules, a one year payback for the 5 kW to10 kW generator appears possible. This was one of the stated goals at the beginning of the project. At some future point in time, with the DTTEG becoming standard equipment on all trucks and automobiles, fuel savings from the 25% conversion of exhaust heat to useable electricity nationwide equates to a 10% reduction in the 12 to 15 million barrels per day of

  17. TWO-DIMENSIONAL STELLAR EVOLUTION CODE INCLUDING ARBITRARY MAGNETIC FIELDS. II. PRECISION IMPROVEMENT AND INCLUSION OF TURBULENCE AND ROTATION

    International Nuclear Information System (INIS)

    Li Linghuai; Sofia, Sabatino; Basu, Sarbani; Demarque, Pierre; Ventura, Paolo; Penza, Valentina; Bi Shaolan

    2009-01-01

    In the second paper of this series we pursue two objectives. First, in order to make the code more sensitive to small effects, we remove many approximations made in Paper I. Second, we include turbulence and rotation in the two-dimensional framework. The stellar equilibrium is described by means of a set of five differential equations, with the introduction of a new dependent variable, namely the perturbation to the radial gravity, that is found when the nonradial effects are considered in the solution of the Poisson equation. Following the scheme of the first paper, we write the equations in such a way that the two-dimensional effects can be easily disentangled. The key concept introduced in this series is the equipotential surface. We use the underlying cause-effect relation to develop a recurrence relation to calculate the equipotential surface functions for uniform rotation, differential rotation, rotation-like toroidal magnetic fields, and turbulence. We also develop a more precise code to numerically solve the two-dimensional stellar structure and evolution equations based on the equipotential surface calculations. We have shown that with this formulation we can achieve the precision required by observations by appropriately selecting the convergence criterion. Several examples are presented to show that the method works well. Since we are interested in modeling the effects of a dynamo-type field on the detailed envelope structure and global properties of the Sun, the code has been optimized for short timescales phenomena (down to 1 yr). The time dependence of the code has so far been tested exclusively to address such problems.

  18. Using management action plans to integrate program improvement efforts

    International Nuclear Information System (INIS)

    Meador, S.W.; Kidwell, R.J.; Shangraw, W.R.; Cardamone, E.N.

    1994-01-01

    The Department of Energy's (DOE's) Environmental Management Program is the country's largest and most sophisticated environmental program to date. The rapid expansion of the DOE's environmental restoration efforts has led to increased scrutiny of its management processes and systems. As the program continues to grow and mature, maintaining adequate accountability for resources and clearly communicating progress will be essential to sustaining public confidence. The Office of Environmental Management must ensure that adequate processes and systems are in place at Headquarters, Operation Offices, and contractor organizations. These systems must provide the basis for sound management, cost control, and reporting. To meet this challenge, the Office of Environmental Restoration introduced the Management Action Plan process. This process was designed to serve three primary functions: (1) define the program's management capabilities at Headquarters and Operations Offices; (2) describe how management initiatives address identified program deficiencies; and (3) identify any duplication of efforts or program deficiencies. The Environmental Restoration Management Action Plan is a tracking, reporting, and statusing tool, used primarily at the Headquarters level, for assessing performance in key areas of project management and control. BY DOE to communicate to oversight agencies and stakeholders a clearer picture of the current status of the environmental restoration project management system. This paper will discuss how Management Action Plans are used to provide a program-wide assessment of management capabilities

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

    Science.gov (United States)

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

    2017-04-01

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

  20. RC2S: a cognitive remediation program to improve social cognition in schizophrenia and related disorders

    Directory of Open Access Journals (Sweden)

    Elodie ePEYROUX

    2014-06-01

    Full Text Available In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind, attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (Cognitive Remediation of Social Cognition in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients’ functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual-reality techniques. In the RC2S program, the patient’s goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters’ mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with

  1. RC2S: A Cognitive Remediation Program to Improve Social Cognition in Schizophrenia and Related Disorders.

    Science.gov (United States)

    Peyroux, Elodie; Franck, Nicolas

    2014-01-01

    In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind (ToM), attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (cognitive remediation of social cognition) in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients' functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual reality techniques. In the RC2S program, the patient's goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters' mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with psychiatric disorders.

  2. RC2S: A Cognitive Remediation Program to Improve Social Cognition in Schizophrenia and Related Disorders

    Science.gov (United States)

    Peyroux, Elodie; Franck, Nicolas

    2014-01-01

    In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind (ToM), attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (cognitive remediation of social cognition) in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients’ functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual reality techniques. In the RC2S program, the patient’s goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters’ mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with psychiatric disorders

  3. Undergraduate Students' Perceptions of the Mathematics Courses Included in the Primary School Teacher Education Program

    Science.gov (United States)

    Serin, Mehmet Koray; Incikabi, Semahat

    2017-01-01

    Mathematics educators have reported on many issues regarding students' mathematical education, particularly students who received mathematics education at different departments such as engineering, science or primary school, including their difficulties with mathematical concepts, their understanding of and preferences for mathematical concepts.…

  4. 32 CFR Appendix B to Part 80 - Procedures for Special Educational Programs (Including Related Services) for Preschool Children...

    Science.gov (United States)

    2010-07-01

    ... arts, and mathematics, to determine whether a preschool child or child may be in need of special... special educator, school psychologist, speech therapist, or a reading specialist, in conformity with the... a multidisciplinary team and shall include a teacher or other specialist with knowledge in the areas...

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

    Science.gov (United States)

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

    2015-07-01

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

  6. Improved Navy Maintenance Through Corrosion-Fatigue Assessment Program

    National Research Council Canada - National Science Library

    Hoppe, Wally

    2008-01-01

    ... to evaluate issues relevant to corrosion-fatigue of aircraft components. In this multi-year, multi-contract program, tools have been developed to assist in the establishment of maintenance options for corroded components...

  7. Participation in a National Lifestyle Change Program is associated with improved diabetes Control outcomes.

    Science.gov (United States)

    Jackson, Sandra L; Staimez, Lisa R; Safo, Sandra; Long, Qi; Rhee, Mary K; Cunningham, Solveig A; Olson, Darin E; Tomolo, Anne M; Ramakrishnan, Usha; Narayan, Venkat K M; Phillips, Lawrence S

    2017-09-01

    Clinical trials show lifestyle change programs are beneficial, yet large-scale, successful translation of these programs is scarce. We investigated the association between participation in the largest U.S. lifestyle change program, MOVE!, and diabetes control outcomes. This longitudinal, retrospective cohort study used Veterans Health Administration databases of patients with diabetes who participated in MOVE! between 2005 and 2012, or met eligibility criteria (BMI ≥25kg/m 2 ) but did not participate. Main outcomes were diabetic eye disease, renal disease, and medication intensification. There were 400,170 eligible patients with diabetes, including 87,366 (22%) MOVE! Included patients were 96% male, 77% white, with mean age 58years and BMI 34kg/m 2 . Controlling for baseline measurements and age, race, sex, BMI, and antidiabetes medications, MOVE! participants had lower body weight (-0.6kg), random plasma glucose (-2.8mg/dL), and HbA1c (-0.1%) at 12months compared to nonparticipants (each plifestyle change programs in U.S. health systems may improve health among the growing patient population with diabetes. Published by Elsevier Inc.

  8. Heat stress management program improving worker health and operational effectiveness: a case study.

    Science.gov (United States)

    Huss, Rosalyn G; Skelton, Scott B; Alvis, Kimberly L; Shane, Leigh A

    2013-03-01

    Heat stress monitoring is a vital component of an effective health and safety program when employees work in exceptionally warm environments. Workers at hazardous waste sites often wear personal protective equipment (PPE), which increases the body heat stress load. No specific Occupational Safety and Health Administration (OSHA) regulations address heat stress; however, OSHA does provide several guidance documents to assist employers in addressing this serious workplace health hazard. This article describes a heat stress and surveillance plan implemented at a hazardous waste site as part of the overall health and safety program. The PPE requirement for work at this site, coupled with extreme environmental temperatures, made heat stress a significant concern. Occupational health nurses and industrial hygienists developed a monitoring program for heat stress designed to prevent the occurrence of significant heat-related illness in site workers. The program included worker education on the signs of heat-related illness and continuous physiologic monitoring to detect early signs of heat-related health problems. Biological monitoring data were collected before workers entered the exclusion zone and on exiting the zone following decontamination. Sixty-six site workers were monitored throughout site remediation. More than 1,700 biological monitoring data points were recorded. Outcomes included improved worker health and safety, and increased operational effectiveness. Copyright 2013, SLACK Incorporated.

  9. An Improved Dynamic Programming Decomposition Approach for Network Revenue Management

    OpenAIRE

    Dan Zhang

    2011-01-01

    We consider a nonlinear nonseparable functional approximation to the value function of a dynamic programming formulation for the network revenue management (RM) problem with customer choice. We propose a simultaneous dynamic programming approach to solve the resulting problem, which is a nonlinear optimization problem with nonlinear constraints. We show that our approximation leads to a tighter upper bound on optimal expected revenue than some known bounds in the literature. Our approach can ...

  10. Improving Perinatal Mental Health Care for Women Veterans: Description of a Quality Improvement Program.

    Science.gov (United States)

    Katon, Jodie G; Lewis, Lacey; Hercinovic, Selma; McNab, Amanda; Fortney, John; Rose, Susan M

    2017-08-01

    Purpose We describe results from a quality improvement project undertaken to address perinatal mental healthcare for women veterans. Description This quality improvement project was conducted in a single VA healthcare system between 2012 and 2015 and included screening for depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) three times during the perinatal period, a dedicated maternity care coordinator (MCC), an on-site clinical social worker, and an on-site obstetrician/gynecologist (Ob/gyn). Information on prior mental health diagnosis was collected by the MCC or Ob/gyn. The prevalence of perinatal depressive symptoms and receipt of mental healthcare among those with such symptoms are reported by presence of a pre-pregnancy mental health diagnosis. Assessment Of the 199 women who used VA maternity benefits between 2012 and 2015, 56% (n = 111) had at least one pre-pregnancy mental health diagnosis. Compared to those without a pre-pregnancy mental health diagnosis, those with such a diagnosis were more likely to be screened for perinatal depressive symptoms at least once (61.5% vs. 46.8%, p = 0.04). Prevalence of depressive symptoms was 46.7% among those with a pre-pregnancy mental health diagnosis and 19.2% among those without. Among those with a pre-pregnancy mental health diagnosis and depressive symptoms (n = 35), 88% received outpatient mental healthcare and 77% met with the clinical social worker. Among those without a pre-pregnancy mental health diagnosis and depressive symptoms (n = 8), none received outpatient mental healthcare, but 77.8% met with the clinical social worker. Conclusion Improving perinatal mental healthcare for women veterans requires a multidisciplinary approach, including on-site integrated mental healthcare.

  11. 20 CFR 664.410 - Must local programs include each of the ten program elements listed in WIA section 129(c)(2) as...

    Science.gov (United States)

    2010-04-01

    ... available to youth participants: (1) Tutoring, study skills training, and instruction leading to secondary school completion, including dropout prevention strategies; (2) Alternative secondary school offerings... 664.470; (5) Occupational skill training; (6) Leadership development opportunities, which include...

  12. CASKS (Computer Analysis of Storage casKS): A microcomputer based analysis system for storage cask design review. User's manual to Version 1b (including program reference)

    International Nuclear Information System (INIS)

    Chen, T.F.; Gerhard, M.A.; Trummer, D.J.; Johnson, G.L.; Mok, G.C.

    1995-02-01

    CASKS (Computer Analysis of Storage casKS) is a microcomputer-based system of computer programs and databases developed at the Lawrence Livermore National Laboratory (LLNL) for evaluating safety analysis reports on spent-fuel storage casks. The bulk of the complete program and this user's manual are based upon the SCANS (Shipping Cask ANalysis System) program previously developed at LLNL. A number of enhancements and improvements were added to the original SCANS program to meet requirements unique to storage casks. CASKS is an easy-to-use system that calculates global response of storage casks to impact loads, pressure loads and thermal conditions. This provides reviewers with a tool for an independent check on analyses submitted by licensees. CASKS is based on microcomputers compatible with the IBM-PC family of computers. The system is composed of a series of menus, input programs, cask analysis programs, and output display programs. All data is entered through fill-in-the-blank input screens that contain descriptive data requests

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

    Science.gov (United States)

    1996-06-20

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

  14. 75 FR 13740 - Office of Innovation and Improvement; Overview Information; Charter Schools Program (CSP) Grants...

    Science.gov (United States)

    2010-03-23

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  17. LWR surveillance dosimetry improvement program: PSF metallurgical blind test results

    International Nuclear Information System (INIS)

    Kam, F.B.K.; Maerker, R.E.; Stallmann, F.W.

    1984-01-01

    The metallurgical irradiation experiment at the Oak Ridge Research Reactor Poolside Facility (ORR-PSF) was designed as a benchmark to test the accuracy of radiation embrittlement predictions in the pressure vessel wall of light water reactors on the basis of results from surveillance capsules. The PSF metallurgical Blind Test is concerned with the simulated surveillance capsule (SSC) and the simulated pressure vessel capsule (SPVC). The data from the ORR-PSF benchmark experiment are the basis for comparison with the predictions made by participants of the metallurgical ''Blind Test''. The Blind Test required the participants to predict the embrittlement of the irradiated specimen based only on dosimetry and metallurgical data from the SSC1 capsule. This exercise included both the prediction of damage fluence and the prediction of embrittlement based on the predicted fluence. A variety of prediction methodologies was used by the participants. No glaring biases or other deficiencies were found, but neither were any of the methods clearly superior to the others. Closer analysis shows a rather complex and poorly understood relation between fluence and material damage. Many prediction formulas can give an adequate approximation, but further improvement of the prediction methodology is unlikely at this time given the many unknown factors. Instead, attention should be focused on determining realistic uncertainties for the predicted material changes. The Blind Test comparisons provide some clues for the size of these uncertainties. In particular, higher uncertainties must be assigned to materials whose chemical composition lies outside the data set for which the prediction formula was obtained. 16 references, 14 figures, 5 tables

  18. Epstein-Barr Virus Infection in Children: Improving the Diagnosis and Treatment Program

    Directory of Open Access Journals (Sweden)

    E. N. Simovanyan

    2016-01-01

    Full Text Available Widespread, severe course, frequent development of chronic forms, adverse effects of the Epstein-Barr virus infection to the health of children, the difficulties of diagnosis and therapy dictate the need to improve the diagnostic and treatment programs in this disease. A total of 286 patients with acute and chronic Epstein-Barr virus infection. It was established, that for the timely diagnosis of the disease requires a comprehensive analysis of anamnesis, clinical symptoms, including symptoms of acute and chronic mononucleosis syndrome in combination with multiorgan pathology, and the results of laboratory examination (enzyme immunoassay, polymerase chain reaction, immune status.

  19. THE INFLUENCE OF COMBINATION NON-MEDICAL TREATMENT INCLUDING FUNCTIONAL PROGRAMMED ELECTRICAL STIMULATION ON THE CLINICAL AND INSTRUMENTAL PARAMETERS IN PATIENTS WITH CEREBRAL PALSY WITH SPASTIC DIPLEGIA

    Directory of Open Access Journals (Sweden)

    V. V. Eliseev

    2015-01-01

    Full Text Available Background: Cerebral palsy is the leading cause of physical disability in pediatric  age. The search for new methods and improvement of old rehabil- itation techniques is ongoing, due to low efficacy of the latter. Aim: To assess the efficacy of a func- tional programmed electrical muscle stimulation as a part  of combination treatment of patients with cerebral palsy in the form of spastic diplegia. Materials and methods: We analyzed the results of treatment of 71 children with cerebral palsy and spastic diplegia, who had  been  randomized  into two groups  depending on the type of treatment. In  the  first group,  the  patients  (n = 38 received a course of functional programmed electric stim- ulation  in combination with  other  non-medical treatment  methods.  The  second   group   (n = 33 underwent a usual  course  of electrical  stimula- tion in combination with non-medical  treatment, similar to that  in the first group. The third group (control   included   41   children   without    cere- bral palsy. Clinical and  instrumental parameters were  assessed  in all study  participants. Results: After the course of combination treatment in the group  1, the  tonus  of m. gastrocnemius was de- creased significantly by 41%, that of the posterior group  of femur muscles by 43%, adductor group of femur muscles by 36%. In the group  2, the re- spective parameters decreased by 24, 21 and 21%. Muscle power  endurance was  increased  signifi- cantly in patients of both groups: that of long back extensors by 12.5 and 6.2 sec, of m. rectus abdomi- nis by 10.6 sec and 5.2 sec, of gluteal muscles by 9.3 and 4.6 sec, of m. quadriceps  by 19.8 and 7.2 sec, of m. anterior  tibialis by 12.1 and 4.6 sec, respec- tively. After the  treatment, the  active movement volume in the large joints of lower extremities  in the group 1 patients  improved as follows: by 15.6° in hip joints, by 11.1° in knee joints and by

  20. Improving the Programs against Poverty: from Income to Welfare

    Directory of Open Access Journals (Sweden)

    Mariano Rojas

    2010-01-01

    Full Text Available Many social programs, and most poverty–fighting programs, are based on the assumption that increasing income automatically translates into a raise in well–being. This investigation questions this assumption on the basis of the subjective well–being literature and on empirical analyses from Mexico. It is shown that it is possible to get people out of income poverty without necessarily increasing their well–being. The paper enunciates some general principles that can enhance social programs. It is argued that it is fine to be concerned about getting people out of income poverty, but it is even better to be concerned about placing them in a situation that favors their satisfaction with life.

  1. Effective intervention programming: improving maternal adjustment through parent education.

    Science.gov (United States)

    Farris, Jaelyn R; Bert, Shannon S Carothers; Nicholson, Jody S; Glass, Kerrie; Borkowski, John G

    2013-05-01

    This study assessed the secondary effects of a parent training intervention program on maternal adjustment, with a focus on understanding ways in which program efficacy differed for participants as a function of whether or not their children had behavior problems. Mothers (N = 99) of toddlers (2-3 years of age) were randomly assigned to receive one of three levels of intervention: (1) informational booklet (2) booklet + face-to-face parent training sessions, or (3) booklet + web-based parent training sessions. Findings indicated that all levels of intervention were associated with increases in maternal well-being for participants with typically developing children. Mothers of toddlers with behavior problems, however, did not benefit from receiving only the booklet but significantly benefitted from receiving either the face-to-face or web-based interventions. Findings are discussed in terms of efficient and efficacious program dissemination and the resulting implications for public policy.

  2. Expanding Free School-based Human Papilloma Virus (HPV Vaccination Programs to Include School-aged Males in Nova Scotia, Canada

    Directory of Open Access Journals (Sweden)

    Hannah Krater-Melamed

    2017-06-01

    Full Text Available Bill 70 (HPV Vaccine Act was presented to the Nova Scotia House of Assembly with the aim of expanding the current Nova Scotia school-based HPV vaccination program to include males. In recent years, increased awareness of HPV and HPV-caused cancers has led to the implementation of school-based female HPV vaccination programs across Canada. Changing guidelines, based on recent evidence, suggest that males should also be included in these programs. Program expansion to include males aims to reduce the prevalence of HPV-causing cancers and their ensuing costs, to promote equal access to healthcare services, and to make Nova Scotia a leader in HPV prevention. Support from the Canadian public and high profile political actors along with pressure from other provinces and interest groups, including the Society of Obstetricians and Gynaecologists of Canada, influenced the passing of the HPV Vaccine Act. In order to implement this reform, the provincial financial commitment to the previous HPV program was expanded to cover the cost of male vaccination.

  3. Improving the quality control program for patient dose calibrator according to IEC 60580

    International Nuclear Information System (INIS)

    Costa, Nathalia Almeida; Potiens, Maria da Penha Albuquerque

    2013-01-01

    The objective of this work was to improve the program quality control of this equipment based on the International Standard IEC 60580 - Medical electrical equipment - Dose area product meters . The initial program was established following the recommendations of IEC 61674 quoting dosimeters with ionization chambers and / or semiconductor detectors used in diagnostic X-ray image, however, the IEC 60580 is referred specifically to gauges and KAP (kerma-area product) presents additional tests. Tests included: intrinsic relative error, repeatability, scanning resolution, settling time, restarting, float values, response time and spatial uniformity of response. As a rule, all measurements are within the range characteristic of equipment performance. Thus, the PDC (Patient Dose Calibrator) again shows a device with excellent functionality and reliability in characterization tests carried out to quality control as( for the test in clinical PKA meters

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

    Directory of Open Access Journals (Sweden)

    Viveka P Jyotsna

    2013-01-01

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

  5. PTA-1 computer program for treating pressure transients in hydraulic networks including the effect of pipe plasticity

    International Nuclear Information System (INIS)

    Youngdahl, C.K.; Kot, C.A.

    1977-01-01

    Pressure pulses in the intermediate sodium system of a liquid-metal-cooled fast breeder reactor, such as may originate from a sodium/water reaction in a steam generator, are propagated through the complex sodium piping network to system components such as the pump and intermediate heat exchanger. To assess the effects of such pulses on continued reliable operation of these components and to contribute to system designs which result in the mitigation of these effects, Pressure Transient Analysis (PTA) computer codes are being developed for accurately computing the transmission of pressure pulses through a complicated fluid transport system, consisting of piping, fittings and junctions, and components. PTA-1 provides an extension of the well-accepted and verified fluid hammer formulation for computing hydraulic transients in elastic or rigid piping systems to include plastic deformation effects. The accuracy of the modeling of pipe plasticity effects on transient propagation has been validated using results from two sets of Stanford Research Institute experiments. Validation of PTA-1 using the latter set of experiments is described briefly. The comparisons of PTA-1 computations with experiments show that (1) elastic-plastic deformation of LMFBR-type piping can have a significant qualitative and quantitative effect on pressure pulse propagation, even in simple systems; (2) classical fluid-hammer theory gives erroneous results when applied to situations where piping deforms plastically; and (3) the computational model incorporated in PTA-1 for predicting plastic deformation and its effect on transient propagation is accurate

  6. Balance improvements in female high school basketball players after a 6-week neuromuscular-training program.

    Science.gov (United States)

    McLeod, Tamara C Valovich; Armstrong, Travis; Miller, Mathew; Sauers, Jamie L

    2009-11-01

    Poor balance has been associated with increased injury risk among athletes. Neuromuscular-training programs have been advocated as a means of injury prevention, but little is known about the benefits of these programs on balance in high school athletes. To determine whether there are balance gains after participation in a neuromuscular-training program in high school athletes. Nonrandomized controlled trial. All data were collected at each participating high school before and after a 6-wk intervention or control period. 62 female high school basketball players recruited from the local high school community and assigned to a training (n = 37) or control (n = 25) group. Training-group subjects participated in a 6-wk neuromuscular-training program that included plyometric, functional-strengthening, balance, and stability-ball exercises. Data were collected for the Balance Error Scoring System (BESS) and Star Excursion Balance Test (SEBT) before and after the 6-wk intervention or control period. The authors found a significant decrease in total BESS errors in the trained group at the posttest compared with their pretest and the control group (P = .003). Trained subjects also scored significantly fewer BESS errors on the single-foam and tandem-foam conditions at the posttest than the control group and demonstrated improvements on the single-foam compared with their pretest (P = .033). The authors found improvements in reach in the lateral, anteromedial, medial, and posterior directions in the trained group at the posttest compared with the control group (P training program can increase the balance and proprioceptive capabilities of female high school basketball players and that clinical balance measures are sensitive to detect these differences.

  7. A Case Study of Culturally Relevant School-Based Programming for First Nations Youth: Improved Relationships, Confidence and Leadership, and School Success

    Science.gov (United States)

    Crooks, Claire V.; Burleigh, Dawn; Snowshoe, Angela; Lapp, Andrea; Hughes, Ray; Sisco, Ashley

    2015-01-01

    Schools are expected to promote social and emotional learning skills among youth; however, there is a lack of culturally-relevant programming available. The Fourth R: Uniting Our Nations programs for Aboriginal youth include strengths-based programs designed to promote healthy relationships and cultural connectedness, and improve school success…

  8. 42 CFR 482.21 - Condition of participation: Quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Diego Orcioli-Silva

    2018-03-01

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

  10. Productivity Sharing Programs: Can They Contribute to Productivity Improvement?

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    Productivity sharing plans were studied to determine how they operate, what benefits result, and whether long-term increases in productivity can be realized through the program. Thirty-six firms were interviewed that had productivity sharing plans. Nine firms that had either rejected adoption of a productivity sharing plan or were still…

  11. Breeding strategies for north central tree improvement programs

    Science.gov (United States)

    Ronald P. Overton; Hyun Kang

    1985-01-01

    The rationales and concepts of long-term tree breeding are discussed and compared with those for short-term breeding. A model breeding program is reviewed which maximizes short-term genetic gain for currently important traits and provides genetic resources that can be used effectively in future short-term breeding. The resources of the north-central region are examined...

  12. 40 CFR 65.116 - Quality improvement program for pumps.

    Science.gov (United States)

    2010-07-01

    ... (for example, piston, horizontal or vertical centrifugal, gear, bellows); pump manufacturer; seal type and manufacturer; pump design (for example, external shaft, flanged body); materials of construction... program. (4) Pump or pump seal inspection. The owner or operator shall inspect all pumps or pump seals...

  13. Assessing Program Learning Objectives to Improve Undergraduate Physics Education

    Science.gov (United States)

    Menke, Carrie

    2014-03-01

    Our physics undergraduate program has five program learning objectives (PLOs) focusing on (1) physical principles, (2) mathematical expertise, (3) experimental technique, (4) communication and teamwork, and (5) research proficiency. One PLO is assessed each year, with the results guiding modifications in our curriculum and future assessment practices; we have just completed our first cycle of assessing all PLOs. Our approach strives to maximize the ease and applicability of our assessment practices while maintaining faculty's flexibility in course design and delivery. Objectives are mapped onto our core curriculum with identified coursework collected as direct evidence. We've utilized mostly descriptive rubrics, applying them at the course and program levels as well as sharing them with the students. This has resulted in more efficient assessment that is also applicable to reaccreditation efforts, higher inter-rater reliability than with other rubric types, and higher quality capstone projects. We've also found that the varied quality of student writing can interfere with our assessment of other objectives. This poster outlines our processes, resources, and how we have used PLO assessment to strengthen our undergraduate program.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  16. [Development and Evaluation of a Motivational Interviewing Program for Exercise Improvement in Persons with Physical Disabilities].

    Science.gov (United States)

    Jeong, Jeong Hee; Jeong, Ihn Sook

    2017-06-01

    The aims of this study were to develop a motivational interviewing program for exercise improvement in persons with physical disabilities and to examine the effect of this motivational interviewing intervention. The study employed a nonequivalent control group pretest and posttest design. A total of 62 persons with physical disabilities (30 in the experimental group, 32 in the control group) were recruited from 2 community rehabilitation centers. The experimental group received 8 sessions of a group motivational interviewing program, scheduled once a week, with each session lasting 60 minutes. Test measures were completed before the intervention, immediately after the end of the intervention, 2 weeks later, and 6 weeks after the end of the intervention. Measures included self-efficacy for exercise, decisional balance for exercise, stage of change for exercise, regularity of exercise, exercise maintenance, and independent living ability. Data were analyzed using the χ²-test, Fisher's exact test, Independent samples t-test, and repeated measures ANOVA, conducted using IBM SPSS Statistics version 18. The experimental group showed a significant increase in self-efficacy for exercise (F=50.98, pmotivational interviewing program has the potential to improve exercise levels in persons with physical disabilities. © 2017 Korean Society of Nursing Science

  17. Insurance Regulation: The NAIC Accreditation Program Can be Improved

    National Research Council Canada - National Science Library

    DIngell, John

    2001-01-01

    ... environment of the insurance industry and insurance regulation. In addition, it has revised the way accreditation reviews are performed and scored and has improved training for members of review teams.

  18. BWR Servicing and Refueling Improvement Program: Phase I summary report

    Energy Technology Data Exchange (ETDEWEB)

    Perry, D.R.

    1978-09-01

    Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was to identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development.

  19. BWR Servicing and Refueling Improvement Program: Phase I summary report

    International Nuclear Information System (INIS)

    Perry, D.R.

    1978-09-01

    Under the U.S. Department of Energy sponsorship, General Electric Co. (GE) undertook a study of boiling water reactor (BWR) refueling outages for the purpose of recommending the development and demonstration of critical path time savings improvements. The Tennessee Valley Authority (TVA) joined the study as a subcontractor, providing monitoring assistance and making the Browns Ferry Site available for improvement demonstrations. Agreement was also reached with Georgia Power Co., Power Authority of the State of New York, and Commonwealth Edison Co. for monitoring and data collection at Hatch 1, FitzPatrick, and Quad Cities 1 nuclear plants, respectively. The objective was to identify, develop, and demonstrate improved refueling, maintenance, and inspection procedures and equipment. The improvements recommended in this study are applicable to BWR nuclear plants currently in operation as well as those in the design and construction phases. The recommendations and outage information can be used as a basis to plan and conduct the first outages of new plants and to improve the planning and facilities of currently operating plants. Many of the recommendations can readily be incorporated in plants currently in the design and construction phases as well as in the design of future plants. Many of these recommended improvements can be implemented immediately by utilities without further technical development

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    1970-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  3. 34 CFR 403.204 - What are the State's responsibilities for program evaluation and improvement?

    Science.gov (United States)

    2010-07-01

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

  4. 76 FR 41246 - Pesticide Program Dialogue Committee, Pesticide Registration Improvement Act Process Improvement...

    Science.gov (United States)

    2011-07-13

    ... Committee, Pesticide Registration Improvement Act Process Improvement Workgroup; Notice of Public Meeting...) Process Improvement Work Group. EPA plans to meet its ESA consultation obligations through the pesticide... a pesticide during the registration review process. This meeting of the PRIA Process Improvement...

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

    Science.gov (United States)

    Tschannen, Dana

    2017-11-01

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

  6. Applying Positive Deviance for Improving Compliance to Adolescent Anemia Control Program in Tribal Communities of India.

    Science.gov (United States)

    Sethi, Vani; Sternin, Monique; Sharma, Deepika; Bhanot, Arti; Mebrahtu, Saba

    2017-09-01

    Positive deviance (PD) is an asset-based social and behavior change communication strategy, utilizing successful outliers within a specific context. It has been applied to tackling major public health problems but not adolescent anemia. The study, first of its kind, used PD to improve compliance to adolescent anemia control program in Jharkhand, India, where anemia prevalence in adolescent girls is 70%, and program compliance is low. With leadership of state government, the study was designed and implemented by a multidisciplinary 42 member PD team, in Khunti district, in 2014. Participatory appraisals were undertaken with 434 adolescent girls, 18 frontline workers, 15 teachers, and 751 community leaders/parents/relatives. Stakeholders were interviewed to identify positive deviants and PD determinants across 17 villages. Perceived benefits of iron folic acid tablet and nutritional care during adolescence are low. Positive deviants exist among adolescent girls (26 of 434), villages (2 of 17), and schools (2 of 17). Positive deviant adolescent girls consumed variety of iron-rich foods and in higher frequency, consumed iron folic acid tablets, and practiced recommended personal hygiene behaviors. Deviant practices in schools included supervision of students during tablet distribution among others. Government-led PD approach uncovered local solutions and provided a forum for government functionaries to listen to and dialogue with, and an opportunity to adapt the program according to the needs of the affected communities, who are missing partners in program design and management.

  7. A school-based health education program can improve cholesterol values for middle school students.

    Science.gov (United States)

    Cotts, T B; Goldberg, C S; Palma Davis, L M; Durussel-Weston, J E; Aaronson, S M; Lin, K; Eagle, K A

    2008-09-01

    This prospective study aimed to measure the impact of a school-based multidisciplinary education program on risk factors for atherosclerosis in sixth-grade students. A prospective study was performed in which patients served as their own controls. Healthy sixth-grade students from three middle schools in a city of approximately 100,000 were exposed to an educational program promoting healthful habits through behavioral and environmental change. Risk factors including body mass index (BMI), systolic and diastolic blood pressure (SBP and DBP), cholesterol panel, and random blood glucose were measured before program initiation, then 5 months afterward. Of 711 sixth-graders at three middle schools, 287 (47% boys; mean age, 11.5 +/- 0.37 years) consented to participate in the study. The mean total cholesterol value decreased from 169 +/- 26 to 154 +/- 26 mg/dl (p value decreased from 86 +/- 25 to 84 +/- 23 mg/dl (p = 0.01), and the high-density lipoprotein (HDL) cholesterol value decreased from 56 +/- 13 to 50 +/- 13 mg/dl (p value decreased from 96 +/- 13 to 93 +/- 15 mm/dl (p = 0.01). The mean SBP did not change, showing 109 +/- 12.5 mmHg before the program and 108 +/- 11.5 mmHg afterward. The DBP decreased from 63.6 +/- 8.6 to 62.3 +/- 7.8 mmHg (p = 0.01). The Project Healthy Schools program is feasible and appears to be effective. The results showed significant improvement in risk factors for early atherosclerosis among sixth-grade students including total cholesterol, LDL cholesterol, random glucose levels, and diastolic blood pressure. Further study with a larger group and a longer follow-up period would be valuable.

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

    Science.gov (United States)

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

    2015-01-01

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

  9. The Accident Sequence Precursor program: Methods improvements and current results

    International Nuclear Information System (INIS)

    Minarick, J.W.; Manning, F.M.; Harris, J.D.

    1987-01-01

    Changes in the US NRC Accident Sequence Precursor program methods since the initial program evaluations of 1969-81 operational events are described, along with insights from the review of 1984-85 events. For 1984-85, the number of significant precursors was consistent with the number observed in 1980-81, dominant sequences associated with significant events were reasonably consistent with PRA estimates for BWRs, but lacked the contribution due to small-break LOCAs previously observed and predicted in PWRs, and the frequency of initiating events and non-recoverable system failures exhibited some reduction compared to 1980-81. Operational events which provide information concerning additional PRA modeling needs are also described

  10. Final Creech Air Force Base Capital Improvements Program Environmental Assessment

    Science.gov (United States)

    2013-11-01

    acts as a shell to softer, more vulnerable soils below. Lenses of caliche (sediment cemented together with sodium salts) and clay are also known to be...requirements. Contact Air Quality Program Manager YES Page 2 WATER QUALITY 99 CES/CEIEC, 652-2834 Any process that discharges to sanitary or industrial... Sanitary Wastewater Will the project result in the discharge of any sanitary wastewaters (e.g., wastewater from sinks, showers, toilets, etc)? A

  11. Shaw Air Force Base Capital Improvement Program Environmental Assessment

    Science.gov (United States)

    2010-05-01

    A FB Capital Im provem ent Program Environm ental A ssessm ent 3-21 Figure 3.6-1. W ater R esources at Shaw A FB under the Proposed A ction...Figure 3.6-2. W ater R esources at Shaw A FB under A lternative 1 0 Key c::::J Shaw!IFB C’l1 Proposed Project ~ Number -- Creek/Stream c:::::J w

  12. How to improve the program for Japanese Studies Students

    OpenAIRE

    澤田, 田津子

    2010-01-01

    Japanese Studies Students (=international students who specialize in Japanese language and culture in Japan; Hereafter referred to as J.students) show a variety of language skill and interests depending on the features of education in Japanese in their respective countries. All the J.students, however, receive an education at our university for one year based on one education program for the J.students. This paper shows first the variety of J.students through analysis of their final theses of...

  13. Tools to improve Angra 1/2 general training program

    International Nuclear Information System (INIS)

    Barroso, Haroldo Jr.

    2003-01-01

    Since Brazil restarted Angra 2 construction in 1995, as a result of the studies of future energy consumption, the Training Department of Eletronuclear developed the training program for site personnel. This new situation has demanded additional efforts and new routines. In the following paragraphs there is a description of significant aspects in this concern. Most of them are now under discussion in the Training Department and some alternative solutions are being adopted in order to face the new challenges. (author)

  14. Social Validity of the Social Skills Improvement System--Classwide Intervention Program (SSIS-CIP) in the Primary Grades

    Science.gov (United States)

    Wollersheim Shervey, Sarah; Sandilos, Lia E.; DiPerna, James C.; Lei, Pui-Wa

    2017-01-01

    The purpose of this study was to examine the social validity of the Social Skills Improvement System--Classwide Intervention Program (SSIS-CIP) for teachers in the primary grades. Participants included 45 first and second grade teachers who completed a 16-item social validity questionnaire during each year of the SSIS-CIP efficacy trial. Findings…

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

    OpenAIRE

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

    2015-01-01

    Introduction: Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements.Methods: A redesigned clinical mentoring program ...

  16. Developing a system engineering program to improve performance and reliability

    International Nuclear Information System (INIS)

    Keuter, D.

    1985-01-01

    After several maintenance, operational, and equipment problems last year, Trojan set out on a mission to improve plant performance and reliability by strengthening its on-site engineering organization. This paper presents Trojan's plans in developing an on-site system engineering organization

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2017-08-01

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

  19. ALTERNATIVES TO IMPROVE HYBRIDIZATION EFFICIENCY IN Eucalyptus BREEDING PROGRAMS

    Directory of Open Access Journals (Sweden)

    Roselaine Cristina Pereira

    2002-01-01

    Full Text Available Simple and quick hybridization procedures and ways to keep pollen grains viable for long periods are sought in plant breeding programs to provide greater work flexibility. The presentstudy was carried out to assess the efficiency of pollinations made shortly after flower emasculationand the viability of stored pollen from Eucalyptus camaldulensis and Eucalyptus urophylla clones cultivated in Northwestern Minas Gerais State. Controlled pollinations were carried out at zero, one,three, five and seven days after emasculation. Hybridization efficiency was assessed by thepercentage of viable fruits, number of seeds produced per fruit, percentage of viable seeds and also bycytological observation of the pollen development along the style. Flower buds from clones of the twospecies were collected close to anthesis to assess the viability of pollen grain storage. Pollen was thencollected and stored in a freezer (-18oC for 1, 2 and 3 months. Pollen assessed was carried out by invitro and in vivo germination tests. The efficiency of the pollinations varied with their delay and alsobetween species. The greatest pollination efficiency was obtained when they were carried out on thethird and fifth day after emasculation, but those performed simultaneously with emasculationproduced enough seeds to allow this practice in breeding programs. The decrease in pollen viabilitywith storage was not sufficiently significant to preclude the use of this procedure in artificialhybridization.

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

    Science.gov (United States)

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

    2017-07-01

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

  1. A home monitoring program including real-time wireless home spirometry in idiopathic pulmonary fibrosis: a pilot study on experiences and barriers.

    Science.gov (United States)

    Moor, C C; Wapenaar, M; Miedema, J R; Geelhoed, J J M; Chandoesing, P P; Wijsenbeek, M S

    2018-05-29

    In idiopathic pulmonary fibrosis (IPF), home monitoring experiences are limited, not yet real-time available nor implemented in daily care. We evaluated feasibility and potential barriers of a new home monitoring program with real-time wireless home spirometry in IPF. Ten patients with IPF were asked to test this home monitoring program, including daily home spirometry, for four weeks. Measurements of home and hospital spirometry showed good agreement. All patients considered real-time wireless spirometry useful and highly feasible. Both patients and researchers suggested relatively easy solutions for the identified potential barriers regarding real-time home monitoring in IPF.

  2. A crew resource management program tailored to trauma resuscitation improves team behavior and communication.

    Science.gov (United States)

    Hughes, K Michael; Benenson, Ronald S; Krichten, Amy E; Clancy, Keith D; Ryan, James Patrick; Hammond, Christopher

    2014-09-01

    Crew Resource Management (CRM) is a team-building communication process first implemented in the aviation industry to improve safety. It has been used in health care, particularly in surgical and intensive care settings, to improve team dynamics and reduce errors. We adapted a CRM process for implementation in the trauma resuscitation area. An interdisciplinary steering committee developed our CRM process to include a didactic classroom program based on a preimplementation survey of our trauma team members. Implementation with new cultural and process expectations followed. The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tool were used to design, evaluate, and validate our CRM program. The initial trauma communication survey was completed by 160 team members (49% response). Twenty-five trauma resuscitations were observed and scored using Communication and Teamwork Skills. Areas of concern were identified and 324 staff completed our 3-hour CRM course during a 3-month period. After CRM training, 132 communication surveys and 38 Communication and Teamwork Skills observations were completed. In the post-CRM survey, respondents indicated improvement in accuracy of field to medical command information (p = 0.029); accuracy of emergency department medical command information to the resuscitation area (p = 0.002); and team leader identity, communication of plan, and role assignment (p = 0.001). After CRM training, staff were more likely to speak up when patient safety was a concern (p = 0.002). Crew Resource Management in the trauma resuscitation area enhances team dynamics, communication, and, ostensibly, patient safety. Philosophy and culture of CRM should be compulsory components of trauma programs and in resuscitation of injured patients. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Applying the model of Goal-Directed Behavior, including descriptive norms, to physical activity intentions: A contribution to improving the Theory of Planned Behavior

    Science.gov (United States)

    The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contributed to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) ap...

  4. People's Republic of Bangladesh - Revenue Mobilization Program for Results : VAT Improvement Program

    OpenAIRE

    World Bank

    2014-01-01

    In accordance with the Bank s OP/BP 9.0 an Integrated Fiduciary Systems Assessment (IFSA) was carried out to determine whether the fiduciary systems pertaining to the Program provide reasonable assurances that the Program funds will be used for their intended purpose. The IFSA comprised an assessment of the fiduciary risks relating to: (a) procurement; (b) financial management; and (c) gov...

  5. Case Studies of Successful Assistance in Urban School Improvement Programs. I. The Teacher Growth Program.

    Science.gov (United States)

    Piety-Jacobs, Sharon R.

    As part of a research project on "Patterns of Successful Assistance in Urban School Programs," this paper presents a case study of an assister's work in a Teacher Growth Program (TGP) at an elementary school in Staten Island, New York. The school has an experienced teaching staff, a supportive principal, a cross-sectional student…

  6. 78 FR 40625 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

    Science.gov (United States)

    2013-07-08

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

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

    Science.gov (United States)

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

    2008-01-01

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

  8. A Peer-Support and Mindfulness Program to Improve the Mental Health of Medical Students.

    Science.gov (United States)

    Moir, Fiona; Henning, Marcus; Hassed, Craig; Moyes, Simon A; Elley, C Raina

    2016-01-01

    There is evidence that peer-support programs can improve mental health indices and help-seeking behavior among students in some secondary school and university settings and that mindfulness can improve mental health in medical students. Peer-led programs have not been formally assessed in a medical student population, where psychological issues exist and where it has been shown that students approach peers for help in preference to staff members or professional services. Medical students elected peer leaders who underwent training and then provided the intervention. The peer leaders provided support to students in the intervention group, as well as offering teaching in mindfulness meditation. An exploratory study was conducted with 2nd- and 3rd-year medical students at 1 medical school in New Zealand randomized into 2 groups. In addition to existing mental health resources, intervention participants received a program including peer support and peer-taught mindfulness practice. Study participants not offered the intervention participants could use existing mental health resources. Primary measures included depression (PHQ-9) and anxiety (GAD-7) scores. Secondary measures were quality of life, resilience (15-item resilience scale), academic self-concept, and motivation to learn, assessed at baseline and 6 months. Of the 402 students eligible, 275 (68%) participated and 232 (58%) completed the study. At baseline, 53% were female and mean age was 21 years (SD = 3)-PHQ-9 score (M = 5.2, SD = 3.7) and GAD-7 score (M = 4.5, SD = 3.4). Twelve peer leaders were elected. There was good participation in the intervention. One fourth of intervention students used the face-to-face peer support and more than 50% attended a peer social event and/or participated in the mindfulness program. Although improvements in mental health were seen in the intervention group, the difference between the intervention and nonintervention groups did not reach statistical significance. Although

  9. Improving Your Organisation's Workplace Learning. Consortium Research Program

    Science.gov (United States)

    National Centre for Vocational Education Research (NCVER), 2008

    2008-01-01

    Many organisations, including VET providers, are looking to find ways to achieve competitive advantage through the people they employ. Creating this advantage has a number of facets and most of these depend on training and developing people, and their ability to learn. The VET sector also faces significant changes in the ways it does business.…

  10. 77 FR 22376 - Airport Improvement Program (AIP) Grant Assurances

    Science.gov (United States)

    2012-04-13

    ... established after December 30, 1987, will be expended by it for the capital or operating costs of the airport... structures (such as runways, taxiways, aprons, terminal buildings, hangars, and roads), including all... the Airport and Airway Trust Fund. * * * * * Issued in Washington, DC on April 10, 2012. Benito De...

  11. Martin Marietta Energy Systems Nuclear Criticality Safety Improvement Program

    International Nuclear Information System (INIS)

    Speas, I.G.

    1987-01-01

    This report addresses questions raised by criticality safety violation at several DOE plants. Two charts are included that define the severity and reporting requirements for the six levels of accidents. A summary is given of all reported criticality incident at the DOE plants involved. The report concludes with Martin Marietta's Nuclear Criticality Safety Policy Statement

  12. Method Improving Reading Comprehension In Primary Education Program Students

    Science.gov (United States)

    Rohana

    2018-01-01

    This study aims to determine the influence of reading comprehension skills of English for PGSD students through the application of SQ3R learning method. The type of this research is Pre-Experimental research because it is not yet a real experiment, there are external variables that influence the formation of a dependent variable, this is because there is no control variable and the sample is not chosen randomly. The research design is used is one-group pretest-post-test design involving one group that is an experimental group. In this design, the observation is done twice before and after the experiment. Observations made before the experiment (O1) are called pretests and the post-experimental observation (O2) is called posttest. The difference between O1 and O2 ie O2 - O1 is the effect of the treatment. The results showed that there was an improvement in reading comprehension skills of PGSD students in Class M.4.3 using SQ3R method, and better SQ3R enabling SQ3R to improve English comprehension skills.

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

    Science.gov (United States)

    Heller, Gerard H.; Page, Gerald T.

    1990-01-01

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

  14. Beyond quality improvement: exploring why primary care teams engage in a voluntary audit and feedback program.

    Science.gov (United States)

    Wagner, Daniel J; Durbin, Janet; Barnsley, Jan; Ivers, Noah M

    2017-12-02

    Despite its popularity, the effectiveness of audit and feedback in support quality improvement efforts is mixed. While audit and feedback-related research efforts have investigated issues relating to feedback design and delivery, little attention has been directed towards factors which motivate interest and engagement with feedback interventions. This study explored the motivating factors that drove primary care teams to participate in a voluntary audit and feedback initiative. Interviews were conducted with leaders of primary care teams who had participated in at least one iteration of the audit and feedback program. This intervention was developed by an organization which advocates for high-quality, team-based primary care in Ontario, Canada. Interview transcripts were coded using the Consolidated Framework for Implementation Research and the resulting framework was analyzed inductively to generate key themes. Interviews were completed with 25 individuals from 18 primary care teams across Ontario. The majority were Executive Directors (14), Physician leaders (3) and support staff for Quality Improvement (4). A range of motivations for participating in the audit and feedback program beyond quality improvement were emphasized. Primarily, informants believed that the program would eventually become a best-in-class audit and feedback initiative. This reflected concerns regarding existing initiatives in terms of the intervention components and intentions as well as the perception that an initiative by primary care, for primary care would better reflect their own goals and better support desired patient outcomes. Key enablers included perceived obligations to engage and provision of support for the work involved. No teams cited an evidence base for A&F as a motivating factor for participation. A range of motivating factors, beyond quality improvement, contributed to participation in the audit and feedback program. Findings from this study highlight that efforts to

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

    International Nuclear Information System (INIS)

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

    1978-05-01

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

  16. Cognitive Training Program to Improve Working Memory in Older Adults with MCI.

    Science.gov (United States)

    Hyer, Lee; Scott, Ciera; Atkinson, Mary Michael; Mullen, Christine M; Lee, Anna; Johnson, Aaron; Mckenzie, Laura C

    2016-01-01

    Deficits in working memory (WM) are associated with age-related decline. We report findings from a clinical trial that examined the effectiveness of Cogmed, a computerized program that trains WM. We compare this program to a Sham condition in older adults with Mild Cognitive Impairment (MCI). Older adults (N = 68) living in the community were assessed. Participants reported memory impairment and met criteria for MCI, either by poor delayed memory or poor performance in other cognitive areas. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Delayed Memory Index) and the Clinical Dementia Rating scale (CDR) were utilized. All presented with normal Mini Mental State Exams (MMSE) and activities of daily living (ADLs). Participants were randomized to Cogmed or a Sham computer program. Twenty-five sessions were completed over five to seven weeks. Pre, post, and follow-up measures included a battery of cognitive measures (three WM tests), a subjective memory scale, and a functional measure. Both intervention groups improved over time. Cogmed significantly outperformed Sham on Span Board and exceeded in subjective memory reports at follow-up as assessed by the Cognitive Failures Questionnaire (CFQ). The Cogmed group demonstrated better performance on the Functional Activities Questionnaire (FAQ), a measure of adjustment and far transfer, at follow-up. Both groups, especially Cogmed, enjoyed the intervention. Results suggest that WM was enhanced in both groups of older adults with MCI. Cogmed was better on one core WM measure and had higher ratings of satisfaction. The Sham condition declined on adjustment.

  17. A comprehensive medical student career development program improves medical student satisfaction with career planning.

    Science.gov (United States)

    Zink, Brian J; Hammoud, Maya M; Middleton, Eric; Moroney, Donney; Schigelone, Amy

    2007-01-01

    In 1999, the University of Michigan Medical School (UMMS) initiated a new career development program (CDP). The CDP incorporates the 4-phase career development model described by the Association of American Medical Colleges (AAMC) Careers in Medicine (CiM). The CDP offers self-assessment exercises with guidance from trained counselors for 1st- and 2nd-year medical students. Career exploration experiences include Career Seminar Series luncheons, shadow experiences with faculty, and a shadow program with second-year (M2) and fourth-year (M4) medical students. During the decision-making phase, students work with trained faculty career advisors (FCA). Mandatory sessions are held on career selection, preparing the residency application, interviewing, and program evaluation. During the implementation phase, students meet with deans or counselors to discuss residency application and matching. An "at-risk plan" assists students who may have difficulty matching. The CiM Web site is extensively used during the 4 stages. Data from the AAMC and UMMS Graduation Questionnaires (GQ) show significant improvements for UMMS students in overall satisfaction with career planning services and with faculty mentoring, career assessment activities, career information, and personnel availability. By 2003, UMMS students had significantly higher satisfaction in all measured areas of career planning services when compared with all other U.S. medical students.

  18. Making didactics proposals aimed at improving socioeducational programs for youngters at risk of social exclusion

    Directory of Open Access Journals (Sweden)

    María Violeta Álvarez Fernández

    2013-12-01

    Full Text Available Educators at Sograndio Juvenile Detention Center in Asturias were sure that they were able to offer new alternatives to improve their socio-educational intervention. That is the reason why they got involved in an action research training process aimed at making didactic proposals which tried to optimize the development of social competence programs for youngsters with criminal behavior. In order to do this, the Short Version of the Prosocial Thinking Program for Young People (Alba et al., 2005 was applied to nine inmates, eight males between 14 and 20 years old and a female of 16 years old. Theywere the basis and reflection of ourmethodological intervention. The teamtaking part in this intervention is formed by nine inmates and three external members (two coordinators and a woman psychologist. The investigation, mainly qualitative, includes different instruments (both qualitative and quantitative, such as: observation registries, discussion groups, questionnaires and notebooks. After the implementation of the program, positive changes must be highlighted in the emotional dimension, the resolution of problems, self-control and frustration tolerance. Besides, very high levels of satisfaction have been observed among youngsters, educators and external informants. It is important to have created a climate of professional compromise towards change and this way to have abandoned a passive attitude towards training, so that we were able to start an active search for practical answers, adjusted to our necessities and professional interests. Finally, we make several observations and intervention proposals that contribute to generate didactic knowledge thought and adapted for social education.

  19. Federal Educational Assistance Programs Available to Service Members: Program Features and Recommendations for Improved Delivery

    Science.gov (United States)

    2015-01-01

    results suggest a need to modify the original program design or the logic model (W.K. Kellogg Foundation, 2010). Figure 3.1 outlines the proposed RAND... Kellogg Foundation, 2004). This logic model also illustrates a number of broader impacts. The expectation is that, ultimately, these programs will...Veterans Affairs. W.K. Kellogg Foundation, Using Logic Models to Bring Together Planning, Evaluation, and Action: Logic Model Development Guide

  20. Prevention of HPV-related cancers in Norway: cost-effectiveness of expanding the HPV vaccination program to include pre-adolescent boys.

    Science.gov (United States)

    Burger, Emily A; Sy, Stephen; Nygård, Mari; Kristiansen, Ivar S; Kim, Jane J

    2014-01-01

    Increasingly, countries have introduced female vaccination against human papillomavirus (HPV), causally linked to several cancers and genital warts, but few have recommended vaccination of boys. Declining vaccine prices and strong evidence of vaccine impact on reducing HPV-related conditions in both women and men prompt countries to reevaluate whether HPV vaccination of boys is warranted. A previously-published dynamic model of HPV transmission was empirically calibrated to Norway. Reductions in the incidence of HPV, including both direct and indirect benefits, were applied to a natural history model of cervical cancer, and to incidence-based models for other non-cervical HPV-related diseases. We calculated the health outcomes and costs of the different HPV-related conditions under a gender-neutral vaccination program compared to a female-only program. Vaccine price had a decisive impact on results. For example, assuming 71% coverage, high vaccine efficacy and a reasonable vaccine tender price of $75 per dose, we found vaccinating both girls and boys fell below a commonly cited cost-effectiveness threshold in Norway ($83,000/quality-adjusted life year (QALY) gained) when including vaccine benefit for all HPV-related diseases. However, at the current market price, including boys would not be considered 'good value for money.' For settings with a lower cost-effectiveness threshold ($30,000/QALY), it would not be considered cost-effective to expand the current program to include boys, unless the vaccine price was less than $36/dose. Increasing vaccination coverage to 90% among girls was more effective and less costly than the benefits achieved by vaccinating both genders with 71% coverage. At the anticipated tender price, expanding the HPV vaccination program to boys may be cost-effective and may warrant a change in the current female-only vaccination policy in Norway. However, increasing coverage in girls is uniformly more effective and cost-effective than expanding

  1. A MULTI-SENSORRESEARCH PROGRAM TO IMPROVE TSUNAMIFORECASTING

    Directory of Open Access Journals (Sweden)

    George D. Curtis

    2001-01-01

    Full Text Available While the warning systems do an increasingly good job of warning of all probable events, there are still apparent false alarms and a lack of magnitude prediction. History shows that major advances in technology occur when several components mature to be combined into a final system. An example is the communications satellite: around 1960, the silicon solar cell, the RF transistor, the integrated circuit, the large rocket, knowledge of the synchronous orbit, reliable components, and supporting systems came together to produce systems so workable that the early ones are still usable and the current ones just have more channels. We are now in a “1960 position” in tsunami work. Deep ocean sensors are in place, numerous tide gauges and sea level gauges are telemetered (via satellite, real-time numerical analysis programs are under development, Mw can now be calculated in an hour and Mwp in a minute, a global infrasonic network has been deployed, T-phase data are readily available, and so are ionospheric sounders. We have the capability to cheaply and quickly record, correlate, analyze, transmit, and discard data from all these sensor systems. Thus, we should have the means to develop the ability to evaluate a tsunamigenic earthquake and early tsunami waves, reliably and even quantitatively.I suggest the ideal way to accomplish this is to establish a small, dedicated laboratory which will bring together a selection of data from these sensor systems to evaluate every possible tsunamigenic event. It is now easy to temporarily store these data in volatile memory for analyses, retention, and discard. An earthquake that would be checked and discarded by the warning center can provide the trigger for storage and evaluation. Most of the data are low frequency, easy to transmit (part of it is on the Internet now, and store. Information on prior experiments with some of the components, current status, and processing estimates is provided, along with ample

  2. 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.

  3. Primary care program improves reimbursement. The Federally Qualified Health Center program helps hospitals improve services to the medically indigent.

    Science.gov (United States)

    Fahey, T M; Gallitano, D G

    1993-03-01

    Under a program created by Congress in 1989, certain primary care treatment centers serving the medically and economically indigent can become Federally Qualified Health Centers (FQHCs). Recently enacted rules and regulations allow participants in the FQHC program to receive 100 percent reasonable cost reimbursement for Medicaid services and 80 percent for Medicare services. An all-inclusive annual cost report is the basis for determining reimbursement rates. The report factors in such expenses as physician and other healthcare and professional salaries and benefits, medical supplies, certain equipment depreciation, and overhead for facility and administrative costs. Both Medicaid and Medicare reimbursement is based on an encounter rate, and states employ various methodologies to determine the reimbursement level. In Illinois, for example, typical reimbursement for a qualified encounter ranges from $70 to $88. To obtain FQHC status, an organization must demonstrate community need, deliver the appropriate range of healthcare services, satisfy management and finance requirements, and function under a community-based governing board. In addition, an FQHC must provide primary healthcare by physicians and (where appropriate) midlevel practitioners; it must also offer its community diagnostic laboratory and x-ray services, preventive healthcare and dental care, case management, pharmacy services, and arrangements for emergency services. Because FQHCs must be freestanding facilities, establishing them can trigger a number of ancillary legal issues, such as those involved in forming a new corporation, complying with not-for-profit corporation regulations, applying for tax-exempt status, and applying for various property and sales tax exemptions. Hospitals that establish FQHCs must also be prepared to relinquish direct control over the delivery of primary care services.

  4. A model for improving endangered species recovery programs

    Science.gov (United States)

    Miller, Brian; Reading, Richard; Conway, Courtney; Jackson, Jerome A.; Hutchins, Michael; Snyder, Noel; Forrest, Steve; Frazier, Jack; Derrickson, Scott

    1994-09-01

    This paper discusses common organizational problems that cause inadequate planning and implementation processes of endangered species recovery across biologically dissimilar species. If these problems occur, even proven biological conservation techniques are jeopardized. We propose a solution that requires accountability in all phases of the restoration process and is based on cooperative input among government agencies, nongovernmental conservation organizations, and the academic community. The first step is formation of a task-oriented recovery team that integrates the best expertise into the planning process. This interdisciplinary team should be composed of people whose skills directly address issues critical for recovery. Once goals and procedures are established, the responsible agency (for example, in the United States, the US Fish and Wildlife Service) could divest some or all of its obligation for implementing the plan, yet still maintain oversight by holding implementing entities contractually accountable. Regular, periodic outside review and public documentation of the recovery team, lead agency, and the accomplishments of implementing bodies would permit evaluation necessary to improve performance. Increased cooperation among agency and nongovernmental organizations provided by this model promises a more efficient use of limited resources toward the conservation of biodiversity.

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

    Science.gov (United States)

    Choi, Yun-Jung

    2017-08-01

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

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

    Science.gov (United States)

    2010-01-01

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

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

    Science.gov (United States)

    2006-01-01

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

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

    Science.gov (United States)

    2011-01-01

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

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

    Science.gov (United States)

    2017-07-10

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

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

    Science.gov (United States)

    2014-09-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

    2009-04-01

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

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

    Science.gov (United States)

    2015-01-01

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

  14. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Proceedings of a final research co-ordination meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    The Co-ordinated Research Programme (CRP) on Improvement of Basic Food Crops in Africa Through Plant Breeding, Including the Use of Induced Mutations, funded by the Italian Government, was initiated in 1989 in the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture. The primary objective of this CRP was to breed improved varieties of stable food crops of Africa with the main emphasis on the indigenous species and their local cultivars. The fourth and final Research Co-ordination meeting under the CRP was held in Naples, Italy from 30 October - 3 November 1995. This publication includes the reports, conclusions and recommendations made by the participants. We hope that it will be of value to researchers, students and policy makers alike in their endeavour to promote plant breeding and increase food productions in Africa. Refs, figs, tabs.

  15. Improvement of basic food crops in Africa through plant breeding, including the use of induced mutations. Proceedings of a final research co-ordination meeting

    International Nuclear Information System (INIS)

    1997-07-01

    The Co-ordinated Research Programme (CRP) on Improvement of Basic Food Crops in Africa Through Plant Breeding, Including the Use of Induced Mutations, funded by the Italian Government, was initiated in 1989 in the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture. The primary objective of this CRP was to breed improved varieties of stable food crops of Africa with the main emphasis on the indigenous species and their local cultivars. The fourth and final Research Co-ordination meeting under the CRP was held in Naples, Italy from 30 October - 3 November 1995. This publication includes the reports, conclusions and recommendations made by the participants. We hope that it will be of value to researchers, students and policy makers alike in their endeavour to promote plant breeding and increase food productions in Africa. Refs, figs, tabs

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

    Science.gov (United States)

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

    2018-05-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  20. 78 FR 45231 - Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality...

    Science.gov (United States)

    2013-07-26

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

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

    Science.gov (United States)

    Devaney, Elizabeth; Smith, Charles; Wong, Kenneth

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Joshua Montroy

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

  3. Long-term efficacy of an ergonomics program that includes patient-handling devices on reducing musculoskeletal injuries to nursing personnel.

    Science.gov (United States)

    Garg, Arun; Kapellusch, Jay M

    2012-08-01

    The aim of this study was to evaluate long-term efficacy of an ergonomics program that included patient-handling devices in six long-term care facilities (LTC) and one chronic care hospital (CCH). Patient handling is recognized as a major source of musculoskeletal disorders (MSDs) among nursing personnel, and several studies have demonstrated effectiveness of patient-handling devices in reducing those MSDs. However, most studies have been conducted in a single facility, for a short period, and/or without a comprehensive ergonomics program. Patient-handling devices along with a comprehensive ergonomics program was implemented in six LTC facilities and one CCH. Pre- and postintervention injury data were collected for 38.9 months (range = 29 to 54 months) and 51.2 months (range = 36 to 60 months), respectively. Postintervention patient-handling injuries decreased by 59.8% (rate ratio [RR] = 0.36, 95% confidence interval [CI] [0.28, 0.49], p nursing staff were fairly low. A vast majority of patients found the devices comfortable and safe. Longer transfer times with the use of devices was not an issue. Implementation of patient-handling devices along with a comprehensive program can be effective in reducing MSDs among nursing personnel. Strategies to expand usage of patient-handling devices in most health care settings should be explored.

  4. A statewide model program to improve emergency department readiness for pediatric care.

    Science.gov (United States)

    Cichon, Mark E; Fuchs, Susan; Lyons, Evelyn; Leonard, Daniel

    2009-08-01

    Pediatric emergency patients have unique needs, requiring specialized personnel, training, equipment, supplies, and medications. Deficiencies in these areas have resulted in historically poorer outcomes for pediatric patients versus adults. Since 1985, federally funded Emergency Medical Services for Children (EMSC) programs in each state have been working to improve the quality of pediatric emergency care. The Health Resources and Services Administration now requires that all EMSC grantees report on specific performance measures. This includes implementation of a standardized system recognizing hospitals that are able to stabilize or manage pediatric medical emergencies and trauma cases. We describe the steps involved in implementing Illinois' 3-level facility recognition process to illustrate a model that other states might use to provide appropriate pediatric care and comply with new Health Resources and Services Administration performance measures.

  5. Environmental process improvement feasibility study and demonstration program

    Science.gov (United States)

    Martin, Rodger L.

    1994-01-01

    This report is the final product of an environmental study conducted by Western Commercial Space Center, Inc. under contract to Tennessee-Calspan Center for Space Transportation and Applied Research. The purpose of this investigation is to accurately document the current environmental and permitting processes associated with commercial space launch activity at Vandenberg AFB, and make recommendations to streamline those processes. The particular areas of interest focus on: identifying applicable Federal, state, and local laws, Department of Defense directives, and Air force regulations; defining the environmental process on Vandenberg AFB and how it relates with other agencies, including Federal and state regulatory agencies; and defining the air quality permit process. Study investigation results are applied to an example Pilot Space Launch Vehicle (PSLV) planning to launch from Vandenberg AFB. The PSLV space hardware is analyzed with respect to environmental and permitting issues associated with vehicle processing, facilities required (existing or new), and launch. The PSLV verified the earlier findings of the study and gave insight into streamlining recommendations.

  6. Skill improvement among coalition members in the California Healthy Cities and Communities Program.

    Science.gov (United States)

    Kegler, Michelle C; Norton, Barbara L; Aronson, Robert

    2007-06-01

    Community-driven, collaborative approaches to health promotion have the potential to enhance skills among community members and, in turn, increase community capacity. This study uses data from an evaluation of the California Healthy Cities and Communities (CHCC) Program to examine whether, and how, community problem-solving and collaboration skills are improved among coalition members and local coordinators in 20 participating communities. Methods include semi-structured interviews with coordinators and mailed surveys with coalition members (n=330 in planning phase and n=243 in implementation phase). The largest number of coordinators reported skill improvement in defining health broadly and assessing needs and assets. Similarly, coalition members reported greatest skill improvement for defining health broadly, assessing needs and assets and setting priorities and developing action plans. Modest correlations were observed between number of roles played in the local healthy cities and communities project and each skill area assessed. Time committed to the local CHCC coalition and its activities was not meaningfully correlated with any of the skills. Types of skill-building opportunities may be more important than number of hours devoted to meetings and activities in strengthening community problem-solving and collaboration skills among coalition members.

  7. Teachers' participation in research programs improves their students' achievement in science.

    Science.gov (United States)

    Silverstein, Samuel C; Dubner, Jay; Miller, Jon; Glied, Sherry; Loike, John D

    2009-10-16

    Research experience programs engage teachers in the hands-on practice of science. Program advocates assert that program participation enhances teachers' skills in communicating science to students. We measured the impact of New York City public high-school science teachers' participation in Columbia University's Summer Research Program on their students' academic performance in science. In the year before program entry, students of participating and nonparticipating teachers passed a New York State Regents science examination at the same rate. In years three and four after program entry, participating teachers' students passed Regents science exams at a rate that was 10.1% higher (P = 0.049) than that of nonparticipating teachers' students. Other program benefits include decreased teacher attrition from classroom teaching and school cost savings of U.S. $1.14 per $1 invested in the program.

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

    Science.gov (United States)

    Francis, Sarah L; Taylor, Martha L

    2009-12-01

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

  9. Effectiveness of a psycho-educational program for improving quality of life of fibromyalgia patients

    Directory of Open Access Journals (Sweden)

    Montesano Adrián

    2008-01-01

    Full Text Available Abstract Background Most fibromyalgia patients are seen in primary care (PC. However, the effectiveness of the treatments prescribed by general practitioners is usually minimal. The main objective of the present research is to assess the efficacy of structured psycho-educational intervention, combined with relaxation, developed to improve the quality of life of patients suffering fibromyalgia (FM. The second objective is to assess the cost-effectiveness of this multimodal intervention. Method/Design Design. Randomized controlled trial with a 12-month follow-up involving two groups, one of which is the intervention group that includes patients receiving a psychoeducational program and the other the control group consisting of patients treated for FM in the usual way. Setting. Three urban PC centers in the province of Barcelona (Spain. Sample. The total sample comprises 218 patients (over 18 years of age suffering FM, selected from a database (Rheumatology service-Viladecans Hospital of patients with this illness. Only those patients introduced in the database between the years 2005 and 2007 were included in the selection. Selected patients will be asked for written informed consent to participate in the study. Intervention. Multi-component program including information about the illness, counselling about physical exercise and training in autogenic relaxation. The intervention consists of nine 2-hour sessions delivered during a two-month period. The pharmacological treatment prescribed by the physician was maintained in both groups. Main variables. Sociodemographic characteristics, quality of life, use and cost of healthcare and social services. Measures. Quality of life is to be measured with the FIQ and the EuroQol-5D, and the use of healthcare services with an adapted version of the Client Service Receipt Inventory (CSRI. These variables will be measured before the beginning of the program (baseline and 1, 2, 6 and 12 months later. Discussion

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    National Research Council Canada - National Science Library

    1992-01-01

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

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

    Science.gov (United States)

    Ballard, Paul J.

    2013-01-01

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

  13. 75 FR 72830 - Medicare Program; Quality Improvement Organization (QIO) Contracts: Solicitation of Proposals...

    Science.gov (United States)

    2010-11-26

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

  14. 34 CFR 637.1 - What is the Minority Science and Engineering Improvement Program (MSEIP)?

    Science.gov (United States)

    2010-07-01

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

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

    DEFF Research Database (Denmark)

    Matyusz, Zsolt; Demeter, Krisztina; Boer, Harry

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

  16. Prevention of HPV-related cancers in Norway: cost-effectiveness of expanding the HPV vaccination program to include pre-adolescent boys.

    Directory of Open Access Journals (Sweden)

    Emily A Burger

    Full Text Available BACKGROUND: Increasingly, countries have introduced female vaccination against human papillomavirus (HPV, causally linked to several cancers and genital warts, but few have recommended vaccination of boys. Declining vaccine prices and strong evidence of vaccine impact on reducing HPV-related conditions in both women and men prompt countries to reevaluate whether HPV vaccination of boys is warranted. METHODS: A previously-published dynamic model of HPV transmission was empirically calibrated to Norway. Reductions in the incidence of HPV, including both direct and indirect benefits, were applied to a natural history model of cervical cancer, and to incidence-based models for other non-cervical HPV-related diseases. We calculated the health outcomes and costs of the different HPV-related conditions under a gender-neutral vaccination program compared to a female-only program. RESULTS: Vaccine price had a decisive impact on results. For example, assuming 71% coverage, high vaccine efficacy and a reasonable vaccine tender price of $75 per dose, we found vaccinating both girls and boys fell below a commonly cited cost-effectiveness threshold in Norway ($83,000/quality-adjusted life year (QALY gained when including vaccine benefit for all HPV-related diseases. However, at the current market price, including boys would not be considered 'good value for money.' For settings with a lower cost-effectiveness threshold ($30,000/QALY, it would not be considered cost-effective to expand the current program to include boys, unless the vaccine price was less than $36/dose. Increasing vaccination coverage to 90% among girls was more effective and less costly than the benefits achieved by vaccinating both genders with 71% coverage. CONCLUSIONS: At the anticipated tender price, expanding the HPV vaccination program to boys may be cost-effective and may warrant a change in the current female-only vaccination policy in Norway. However, increasing coverage in girls is

  17. Prevention of HPV-Related Cancers in Norway: Cost-Effectiveness of Expanding the HPV Vaccination Program to Include Pre-Adolescent Boys

    Science.gov (United States)

    Burger, Emily A.; Sy, Stephen; Nygård, Mari; Kristiansen, Ivar S.; Kim, Jane J.

    2014-01-01

    Background Increasingly, countries have introduced female vaccination against human papillomavirus (HPV), causally linked to several cancers and genital warts, but few have recommended vaccination of boys. Declining vaccine prices and strong evidence of vaccine impact on reducing HPV-related conditions in both women and men prompt countries to reevaluate whether HPV vaccination of boys is warranted. Methods A previously-published dynamic model of HPV transmission was empirically calibrated to Norway. Reductions in the incidence of HPV, including both direct and indirect benefits, were applied to a natural history model of cervical cancer, and to incidence-based models for other non-cervical HPV-related diseases. We calculated the health outcomes and costs of the different HPV-related conditions under a gender-neutral vaccination program compared to a female-only program. Results Vaccine price had a decisive impact on results. For example, assuming 71% coverage, high vaccine efficacy and a reasonable vaccine tender price of $75 per dose, we found vaccinating both girls and boys fell below a commonly cited cost-effectiveness threshold in Norway ($83,000/quality-adjusted life year (QALY) gained) when including vaccine benefit for all HPV-related diseases. However, at the current market price, including boys would not be considered ‘good value for money.’ For settings with a lower cost-effectiveness threshold ($30,000/QALY), it would not be considered cost-effective to expand the current program to include boys, unless the vaccine price was less than $36/dose. Increasing vaccination coverage to 90% among girls was more effective and less costly than the benefits achieved by vaccinating both genders with 71% coverage. Conclusions At the anticipated tender price, expanding the HPV vaccination program to boys may be cost-effective and may warrant a change in the current female-only vaccination policy in Norway. However, increasing coverage in girls is uniformly more

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

    Science.gov (United States)

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

    2018-01-01

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

  19. Measuring improvement in knowledge of drug policy reforms following a police education program in Tijuana, Mexico.

    Science.gov (United States)

    Arredondo, J; Strathdee, S A; Cepeda, J; Abramovitz, D; Artamonova, I; Clairgue, E; Bustamante, E; Mittal, M L; Rocha, T; Bañuelos, A; Olivarria, H O; Morales, M; Rangel, G; Magis, C; Beletsky, L

    2017-11-08

    Mexico's 2009 "narcomenudeo reform" decriminalized small amounts of drugs, shifting some drug law enforcement to the states and mandating drug treatment diversion instead of incarceration. Data from Tijuana suggested limited implementation of this harm reduction-oriented policy. We studied whether a police education program (PEP) improved officers' drug and syringe policy knowledge, and aimed to identify participant characteristics associated with improvement of drug policy knowledge. Pre- and post-training surveys were self-administered by municipal police officers to measure legal knowledge. Training impact was assessed through matched paired nominal data using McNemar's tests. Multivariable logistic regression was used to identify predictors of improved legal knowledge, as measured by officers' ability to identify conceptual legal provisions related to syringe possession and thresholds of drugs covered under the reform. Of 1750 respondents comparing pre- versus post training, officers reported significant improvement (p < 0.001) in their technical understanding of syringe possession (56 to 91%) and drug amounts decriminalized, including marijuana (9 to 52%), heroin (8 to 71%), and methamphetamine (7 to 70%). The training was associated with even greater success in improving conceptual legal knowledge for syringe possession (67 to 96%) (p < 0.001), marijuana (16 to 91%), heroin (11 to 91%), and methamphetamine (11 to 89%). In multivariable modeling, those with at least a high school education were more likely to exhibit improvement of conceptual legal knowledge of syringe possession (adjusted odds ratio [aOR] 2.6, 95% CI 1.4-3.2) and decriminalization for heroin (aOR 2.7, 95% CI 1.3-4.3), methamphetamine (aOR 2.2, 95% CI 1.4-3.2), and marijuana (aOR 2.5, 95% CI 1.6-4). Drug policy reform is often necessary, but not sufficient to achieve public health goals because of gaps in translating formal laws to policing practice. To close such gaps, PEP initiatives

  20. Measuring improvement in knowledge of drug policy reforms following a police education program in Tijuana, Mexico

    Directory of Open Access Journals (Sweden)

    J. Arredondo

    2017-11-01

    Full Text Available Abstract Background Mexico’s 2009 “narcomenudeo reform” decriminalized small amounts of drugs, shifting some drug law enforcement to the states and mandating drug treatment diversion instead of incarceration. Data from Tijuana suggested limited implementation of this harm reduction-oriented policy. We studied whether a police education program (PEP improved officers’ drug and syringe policy knowledge, and aimed to identify participant characteristics associated with improvement of drug policy knowledge. Methods Pre- and post-training surveys were self-administered by municipal police officers to measure legal knowledge. Training impact was assessed through matched paired nominal data using McNemar’s tests. Multivariable logistic regression was used to identify predictors of improved legal knowledge, as measured by officers’ ability to identify conceptual legal provisions related to syringe possession and thresholds of drugs covered under the reform. Results Of 1750 respondents comparing pre- versus post training, officers reported significant improvement (p < 0.001 in their technical understanding of syringe possession (56 to 91% and drug amounts decriminalized, including marijuana (9 to 52%, heroin (8 to 71%, and methamphetamine (7 to 70%. The training was associated with even greater success in improving conceptual legal knowledge for syringe possession (67 to 96% (p < 0.001, marijuana (16 to 91%, heroin (11 to 91%, and methamphetamine (11 to 89%. In multivariable modeling, those with at least a high school education were more likely to exhibit improvement of conceptual legal knowledge of syringe possession (adjusted odds ratio [aOR] 2.6, 95% CI 1.4–3.2 and decriminalization for heroin (aOR 2.7, 95% CI 1.3–4.3, methamphetamine (aOR 2.2, 95% CI 1.4–3.2, and marijuana (aOR 2.5, 95% CI 1.6–4. Conclusions Drug policy reform is often necessary, but not sufficient to achieve public health goals because of gaps in translating

  1. Improving Adherence to Mediterranean-Style Diet With a Community Culinary Coaching Program: Methodology Development and Process Evaluation.

    Science.gov (United States)

    Polak, Rani; Pober, David; Morris, Avigail; Arieli, Rakefet; Moore, Margaret; Berry, Elliot; Ziv, Mati

    The Community Culinary Coaching Program is a community-based participatory program aimed at improving communal settlement residents' nutrition. The residents, central kitchens, preschools, and communal dining rooms were identified as areas for intervention. Evaluation included goals accomplishment assessed by food purchases by the central kitchens, and residents' feedback through focus groups. Purchasing included more vegetables (mean (standard error) percent change), (+7% (4); P = .32), fish (+115% (11); P < .001), whole grains, and legumes (+77% (9); P < .001); and less soup powders (-40% (9); P < .05), processed beef (-55% (8); P < .001), and margarine (-100% (4); P < .001). Residents recommended continuing the program beyond the project duration. This model might be useful in organizations with communal dining facilities.

  2. Improving clinician competency in communication about schizophrenia: a pilot educational program for psychiatry trainees.

    Science.gov (United States)

    Loughland, Carmel; Kelly, Brian; Ditton-Phare, Philippa; Sandhu, Harsimrat; Vamos, Marina; Outram, Sue; Levin, Tomer

    2015-04-01

    Important gaps are observed in clinicians' communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be taught, and models for education in these skills have been developed in other fields of medicine, such as oncology, providing a framework for training communication skills relevant to psychiatric practice. This study evaluated a pilot communication skills education program for psychiatry trainees, focusing on discussing schizophrenia diagnosis and prognosis. Communication skills training modules were developed based on an existing theoretical framework (ComSkil), adapted for discussing a schizophrenia diagnosis and prognosis. Pre-post training rating of self-reported confidence in a range of communication tasks was obtained, along with trainee views on the training methods. Thirty-eight participants completed the training. Significant improvements in confidence were reported post training for discussing schizophrenia prognosis, including an increased capacity to critically evaluate their own communication skills. Participants reported high levels of satisfaction with the program. This preliminary study provides support for the translation of a well-established educational model to psychiatric training addressing core clinical communication tasks and provides the foundation for the development of a more comprehensive evaluation and an extended curriculum regarding other aspects of care for patients with schizophrenia: ongoing management and recovery, dealing with conflict, and conducting a family interview.

  3. Nuclear power plant life time improvement and management program in Korea

    International Nuclear Information System (INIS)

    Sung Yull Hong; Ill Seok Jeong; Taek Ho Song

    1995-01-01

    Korea Electric Power Research Institute (KEPRI) of Korea Electric Power Corporation (KEPCO) has performed a lifetime management of nuclear power plant program (LMNPP), ''Nuclear Power Plant Lifetime Management (PLIM) (I)'', since November 1993, which is a feasibility study of the Kori Unit 1 lifetime management including aging evaluation of the thirteen major components. The results of the PLIM(I) will provide information which is necessary for decision making of the Kori Unit 1 lifetime improvement. A plan of the work scope and schedule for the next phase, PLIM(II), will also be provided by this project. This paper introduced KEPRI's basic strategy of LMNPP, PLIM organization, current status, some interim results of the PLIM(I), and other related programs in Korea. So far, we have done field data survey, systems/structures screening, components prioritization, lifetime evaluation methodology study, and fracture mechanics tests of the Kori Unit 1 reactor pressure vessel surveillance coupons. Currently life assessment of the major components and PLIM economic evaluation of Kori Unit 1 are under way. (author)

  4. The power of the National Surgical Quality Improvement Program--achieving a zero pneumonia rate in general surgery patients.

    Science.gov (United States)

    Fuchshuber, Pascal R; Greif, William; Tidwell, Chantal R; Klemm, Michael S; Frydel, Cheryl; Wali, Abdul; Rosas, Efren; Clopp, Molly P

    2012-01-01

    The National Surgical Quality Improvement Program (NSQIP) of the American College of Surgeons provides risk-adjusted surgical outcome measures for participating hospitals that can be used for performance improvement of surgical mortality and morbidity. A surgical clinical nurse reviewer collects 135 clinical variables including preoperative risk factors, intraoperative variables, and 30-day postoperative mortality and morbidity outcomes for patients undergoing major surgical procedures. A report on mortality and complications is prepared twice a year. This article summarizes briefly the history of NSQIP and how its report on surgical outcomes can be used for performance improvement within a hospital system. In particular, it describes how to drive performance improvement with NSQIP data using the example of postoperative respiratory complications--a major factor of postoperative mortality. In addition, this article explains the benefit of a collaborative of several participating NSQIP hospitals and describes how to develop a "playbook" on the basis of an outcome improvement project.

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

    International Nuclear Information System (INIS)

    Vine, Edward

    2008-01-01

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

  6. 76 FR 46814 - Medicare Program; Evaluation Criteria and Standards for Quality Improvement Program Contracts...

    Science.gov (United States)

    2011-08-03

    ... management; and integrating health information technology to achieve meaningful use and improve care... that each policy, action, and decision is made with an educated and strategic consideration of the... CMS-sponsored training sessions and serve as brand ambassadors with branding responsibilities as...

  7. Improving the care of people with traumatic brain injury through the Neurotrauma Evidence Translation (NET program: protocol for a program of research

    Directory of Open Access Journals (Sweden)

    Green Sally E

    2012-08-01

    Full Text Available Abstract The Neurotrauma Evidence Translation (NET program was funded in 2009 to increase the uptake of research evidence in the clinical care of patients who have sustained traumatic brain injury. This paper reports the rationale and plan for this five-year knowledge translation research program. The overarching aims of the program are threefold: to improve outcomes for people with traumatic brain injury; to create a network of neurotrauma clinicians and researchers with expertise in knowledge translation and evidence-based practice; and to contribute knowledge to the field of knowledge translation research. The program comprises a series of interlinked projects spanning varying clinical environments and disciplines relevant to neurotrauma, anchored within four themes representing core knowledge translation activities: reviewing research evidence; understanding practice; developing and testing interventions for practice change; and building capacity for knowledge translation in neurotrauma. The program uses a range of different methods and study designs, including: an evidence fellowship program; conduct of and training in systematic reviews; mixed method study designs to describe and understand factors that influence current practices (e.g., semi-structured interviews and surveys; theory-based methods to develop targeted interventions aiming to change practice; a cluster randomised trial to test the effectiveness of a targeted theory-informed intervention; stakeholder involvement activities; and knowledge translation events such as consensus conferences.

  8. improvement of the programs of formation of Asco in the period 2010-2015. achievements and actions in March

    International Nuclear Information System (INIS)

    Diaz Heredia, R.

    2015-01-01

    The improvement plan is one of the plans of action included in the Strategic Plan of ANAV and is focused on achieving and consolidating the commitment of managers with the training, being them the training program for their unit owners. also the gradual implementation of the methodology Systematic Approach to Training and consolidate the structure of committees of training as a tool of management of training programmes. (Author)

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2010-12-01

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

  11. Education and exercise program improves osteoporosis knowledge and changes calcium and vitamin D dietary intake in community dwelling elderly.

    Science.gov (United States)

    Park, Ki-Soo; Yoo, Jun-Il; Kim, Ha-Young; Jang, Sunmee; Park, Yongsoon; Ha, Yong-Chan

    2017-12-19

    Several educational intervention programs have been designed and developed to improve osteoporosis diagnosis and treatment. However, most of the prior studies focused on how educational intervention programs affected diagnosis and treatment of condition of osteoporosis. The purpose of this prospective and educational intervention study was to evaluate the changes in osteoporosis knowledge, osteoporosis self-efficacy, fall self-efficacy, physical exercise and changes in dietary pattern of calcium and vitamin D intake after osteoporosis education. From November 1, 2015 to August 31, 2016, 271 eligible candidates (who were over 50 years old and from 23 different community centers) were recruited through an announcement made by the public office, by two health care providers. The intervention involved an individualized education program to allow for differences in antecedent educational levels regarding several aspects of osteoporosis, including osteoporosis knowledge, osteoporosis self-efficacy, awareness of self-efficacy risk factors relating to an accidental fall and nutritional education (including the importance of sufficient calcium and vitamin D intake). The researchers revisited the community centers three months after the initial visit. Of the 271 potential participants, 199 (73.4%; 43 men and 156 women) completed the education program and the second questionnaire. After education intervention, parameters including osteoporosis knowledge, osteoporosis self-efficacy and fall self-efficacy were improved (P vitamin D intake below recommended cut-offs, inadequate dietary calcium and vitamin D intake were decreased (P vitamin D intake.

  12. Accreditation of Medical Education Programs: Moving From Student Outcomes to Continuous Quality Improvement Measures.

    Science.gov (United States)

    Blouin, Danielle; Tekian, Ara

    2018-03-01

    Accreditation of undergraduate medical education programs aims to ensure the quality of medical education and promote quality improvement, with the ultimate goal of providing optimal patient care. Direct linkages between accreditation and education quality are, however, difficult to establish. The literature examining the impact of accreditation predominantly focuses on student outcomes, such as performances on national examinations. However, student outcomes present challenges with regard to data availability, comparability, and contamination.The true impact of accreditation may well rest in its ability to promote continuous quality improvement (CQI) within medical education programs. The conceptual model grounding this paper suggests accreditation leads medical schools to commit resources to and engage in self-assessment activities that represent best practices of CQI, leading to the development within schools of a culture of CQI. In line with this model, measures of the impact of accreditation on medical schools need to include CQI-related markers. The CQI orientation of organizations can be measured using validated instruments from the business and management fields. Repeated determinations of medical schools' CQI orientation at various points throughout their accreditation cycles could provide additional evidence of the impact of accreditation on medical education. Strong CQI orientation should lead to high-quality medical education and would serve as a proxy marker for the quality of graduates and possibly for the quality of care they provide.It is time to move away from a focus on student outcomes as measures of the impact of accreditation and embrace additional markers, such as indicators of organizational CQI orientation.

  13. [A mental health awareness anti-stigma program including user-trainers has a significant impact on knowledge, beliefs and attitudes of job centre professionals in Paris].

    Science.gov (United States)

    Jouet, E; Moineville, M; Favriel, S; Leriche, P; Greacen, T

    2014-04-01

    Developing programs and actions to fight stigma and discrimination against people living with mental disorders is a priority both internationally and in France. Involving mental health service users in these anti-stigma programs has proved to be a key element for effective programs. The present study evaluates the impact of user-trainers in an anti-stigma campaign with job counselors on their knowledge, beliefs, and desire for social distance with regard to mental illness and the mentally ill. Eighty-nine professionals participated in eight mental health awareness days from December 2008 to June 2009. Each training day was built around two pedagogical units: firstly, a psychiatrist providing a theoretical overview of mental illness and care and secondly, user-trainers describing their point of view on mental illness and exchanging with participants. A questionnaire administered at the beginning and at the end of the mental health awareness day assessed the impact of the day on participants' knowledge, beliefs, and desire for social distance. Answers to open questions were evaluated using thematic qualitative analysis. The intervention had statistically significant positive effects on all three training objectives: knowledge, beliefs and desire for social distance. Analysis of qualitative data confirmed participants' need for information and training with regard to providing support to clients with mental health problems; participants frequently attributed their improved self-confidence at the end of the day with regard to providing job coaching for this population group to the presence of user-trainers. A mental health awareness day using mental health service users and psychiatrists as trainers had significant positive effects in terms of reducing stigma with regard to people with mental illness. Further research is needed to understand whether the impact of such awareness approaches can be maintained in everyday professional practice over time. Copyright © 2013

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

    Science.gov (United States)

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

    2013-06-01

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

  15. 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.

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

    Science.gov (United States)

    Perry, Cary

    2008-07-23

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

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

    Science.gov (United States)

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

    2013-03-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  19. Evaluation of a nursing student health fair program: Meeting curricular standards and improving community members' health.

    Science.gov (United States)

    Salerno, John P; McEwing, Evan; Matsuda, Yui; Gonzalez-Guarda, Rosa M; Ogunrinde, Olutola; Azaiza, Mona; Williams, Jessica R

    2018-04-17

    Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN. The purpose of this manuscript is to describe a PHN-student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge. Health fairs were held at community agencies that served the homeless or victims of intimate partner violence. A total of 113 community members that attended a health fair were assessed at baseline and immediate posttest using open-ended questionnaires. The design of the health fairs included a community assessment, intervention, and evaluation flow that followed the nursing process. We report that results from participants surveyed indicated that PHN-student delivered health fairs improved health knowledge among community members in this sample (p = .000). Health fairs conducted by PHN students appear to be promising community health promotion and disease prevention interventions that can serve as an effective strategy for teaching PHN student competencies and facilitating engagement with the community. © 2018 Wiley Periodicals, Inc.

  20. 76 FR 9331 - Professional Development for Arts Educators Program; Office of Innovation and Improvement...

    Science.gov (United States)

    2011-02-17

    ... in elementary and secondary education for music, dance, drama, media arts, or visual arts, including... DEPARTMENT OF EDUCATION Professional Development for Arts Educators Program; Office of Innovation... education programs and to help ensure that all students meet challenging State academic content standards...

  1. Does Information Improve the Health Behavior of Adults Targeted by a Conditional Transfer Program?

    Science.gov (United States)

    Avitabile, Ciro

    2012-01-01

    We use data from the evaluation sample of Mexico's Food Assistance Program (PAL) to study whether including the attendance at health and nutrition classes among the requirements for receiving a transfer affects the health behavior of adults living in localities targeted by the program. The experimental trial has four different treatment types,…

  2. Does Competition Improve Public Schools? New Evidence from the Florida Tax-Credit Scholarship Program

    Science.gov (United States)

    Figlio, David; Hart, Cassandra M. D.

    2011-01-01

    Programs that enable students to attend private schools, including both vouchers and scholarships funded with tax credits, have become increasingly common in recent years. This study examines the impact of the nation's largest private school scholarship program on the performance of students who remain in the public schools. The Florida Tax Credit…

  3. Comparison the Impact of Spark Motor Program and Basketball Techniques on Improving Gross Motor Skills in Educable Intellectually Disabled Boys

    Directory of Open Access Journals (Sweden)

    Hashem Faal Moghanlo

    2014-09-01

    Full Text Available Background & objectives : Different types of practises are known for improving motor skills in intellectually disabled boys. The purpose of this study was to compar e the impact of spark motor program and basketball on improving of gross motor skills in this people.   Methods: In this semi-experimental study , from 98 educable intellectually disabled students who studied in special school in Urmia, 30 children ( age range of 9 to 13 years and IQ mean 64.4 were selected objectively and divided in three groups (2 experimental and 1 control based on pre - test. BOTMP was used as a measurement of motor ability. Selected motor program (Spark motor program including strengthening training, games, sports and basketball techniques was performed for 24 sessions. T-tests (dependent and co-variance were used to comparison of results.   Results: In Spark group after 24 sessions, there were significant effects on balance (p= 0.000, bilateral coordination (p=0.000 and strength (p=0.001. There was no significant effect in agility and speed (p= 0.343 in basketball techniques group after 24 sessions, there were significant effects in agility and speed (p= 0.001, balance (p= 0.000, bilateral coordination (p= 0.013 and strength (p= 0.007.   Conclusion: Based on the results of this study, it can be claimed that the Spark program and basketball techniques improve gross motor skills in educable intellectually disabled students. We also found a significant difference between the Spark program and basketball techniques efficacy on the improved skills. Furthermore, the efficacy of Spark program was significantly higher than basketball techniques (p<0.05.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  6. [Evaluation of a grant program for improving health and safety in small and medium companies in Andalusia (Spain)].

    Science.gov (United States)

    Carrillo Castrillo, Jesús Antonio; Onieva Giménez, Luis; Ruiz Frutos, Carlos

    2012-01-01

    To evaluate a grant program for the development and support of occupational safety projects in small and medium companies (SMC) in Andalusia. The analysis includes data and results of the program between 2006 and 2008. We analyzed the program characteristics in terms of budget, proposals submitted and projects financed. The views of participating companies regarding the program were evaluated through a voluntary and anonymous postal survey. Occupational injury rates in 2006 and 2007 in a subgroup of companies that had obtained a grant in 2006 were calculated. Public investment in the program (> 17 million euros) covered 44% of the investment in occupational health projects proposed by participating companies. Nearly 50% of the projects presented received grant funding. The survey was completed by 573 companies (24% of the submitted questionnaires). Among grantee companies, 89% considered the investment to have been effective and 87% considered that working conditions in the company had improved. Most of the companies (>90%) considered that lack of economic resources is an obstacle for prevention activities and that these kinds of public subsidies are necessary. Occupational injury rates decreased between 2006 and 2007 (incidence rate 0.93; 95%confidence interval, 0.78-1.11). The grant program was viewed positively by participating companies and was accompanied by a reduction of occupational injury rates among grantee companies. These programs should incorporate evaluation criteria and indicators in their design. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

  7. Limites e possibilidades dos programas de aceleração de aprendizagem The limits and possibilities of including students from remedial learning programs in regular schooling

    Directory of Open Access Journals (Sweden)

    Clarilza Prado de Sousa

    1999-11-01

    Full Text Available Pretendi neste trabalho analisar os limites e possibilidades da escola integrar alunos com atraso de escolaridade em processos de educação regular, que receberam apoio de programas de aceleração da aprendizagem. Baseada nas avaliações realizadas desses programas por professores do Programa de Estudos Pós-Graduados em Psicologia da Educação da PUCSP e por pesquisadores do Núcleo de Avaliação Educacional da Fundação Carlos Chagas, discuto os resultados efetivamente alcançados considerando duas categorias de análise. Na primeira categoria, analiso os efeitos da estratégia pedagógica promovida pelos programas, nas aprendizagens e progressos dos alunos participantes. Na segunda categoria, procuro analisar as possibilidades de integração/inclusão desses alunos no processo de educação regular. Finalmente, à guisa de conclusão, procuro fazer algumas considerações teórico-metodológicas. Distinguindo integração de inclusão, discuto os limites e possibilidades que as ações dos programas têm de realmente promoverem o desenvolvimento de uma escola sem exclusão.This article analyzes the limits and possibilities for schools to include students with schooling deficits who receive support from the accelerated learning programs, in their regular education processes. Based on evaluations of these programs done by professors from the Post Graduate Program in Educational Psychology of the Pontifical Catholic University of São Paulo and by researchers from the Nucleus for Educational Evaluation of the Carlos Chagas Foundation, the results will be discussed in two analytical categories. In the first category, I analyze the effects of the teaching strategies promoted by the programs on the learning and progress of the participating students. In the second category, I seek to analyze the possibilities for integration/inclusion of these students in the regular educational process. Finally by way of conclusion, I try to make some

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Dong-Fei Xue

    2014-04-01

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

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

    Science.gov (United States)

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

    2012-03-01

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

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

    International Nuclear Information System (INIS)

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

    1994-01-01

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

  13. A Community-Based Sensory Training Program Leads to Improved Experience at a Local Zoo for Children with Sensory Challenges

    Directory of Open Access Journals (Sweden)

    Michele Kong

    2017-09-01

    Full Text Available Sensory processing difficulties are common among many special needs children, especially those with autism spectrum disorder (ASD. The sensory sensitivities often result in interference of daily functioning and can lead to social isolation for both the individual and family unit. A quality improvement (QI project was undertaken within a local zoo to systematically implement a sensory training program targeted at helping special needs individuals with sensory challenges, including those with ASD, Down’s syndrome, attention-deficit/hyperactivity disorder, and speech delay. We piloted the program over a 2-year period. The program consisted of staff training, provision of sensory bags and specific social stories, as well as creation of quiet zones. Two hundred family units were surveyed before and after implementation of the sensory training program. In this pilot QI study, families reported increased visitation to the zoo, improved interactions with staff members, and the overall quality of their experience. In conclusion, we are able to demonstrate that a sensory training program within the community zoo is feasible, impactful, and has the potential to decrease social isolation for special needs individuals and their families.

  14. A community-based aquatic exercise program to improve endurance and mobility in adults with mild to moderate intellectual disability

    Science.gov (United States)

    Hakim, Renée M.; Ross, Michael D.; Runco, Wendy; Kane, Michael T.

    2017-01-01

    The purpose of this study was to investigate the impact of a community-based aquatic exercise program on physical performance among adults with mild to moderate intellectual disability (ID). Twenty-two community-dwelling adults with mild to moderate ID volunteered to participate in this study. Participants completed an 8-week aquatic exercise program (2 days/wk, 1 hr/session). Measures of physical performance, which were assessed prior to and following the completion of the aquatic exercise program, included the timed-up-and-go test, 6-min walk test, 30-sec chair stand test, 10-m timed walk test, hand grip strength, and the static plank test. When comparing participants’ measures of physical performance prior to and following the 8-week aquatic exercise program, improvements were seen in all measures, but the change in scores for the 6-min walk test, 30-sec chair stand test, and the static plank test achieved statistical significance (P<0.05). An 8-week group aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility. PMID:28349039

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

    International Nuclear Information System (INIS)

    Simoneaux, G.E.

    1985-01-01

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

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

    Science.gov (United States)

    Peng, Hao; Yang, Yaoquan; Liu, Chunyu

    2018-02-01

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

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

    OpenAIRE

    de Blanche, Andreas; Lundqvist, Thomas

    2017-01-01

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

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

    International Nuclear Information System (INIS)

    Cardenas, J.

    1993-01-01

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

  19. CF6 jet engine performance improvement program. Task 1: Feasibility analysis

    Science.gov (United States)

    Fasching, W. A.

    1979-01-01

    Technical and economic engine improvement concepts selected for subsequent development include: (1) fan improvement; (2) short core exhaust; (3) HP turbine aerodynamic improvement; (4) HP turbine roundness control; (5) HP turbine active clearance control; and (6) cabin air recirculation. The fuel savings for the selected engine modification concepts for the CF6 fleet are estimated.

  20. Improvements to the Ionizing Radiation Risk Assessment Program for NASA Astronauts

    Science.gov (United States)

    Semones, E. J.; Bahadori, A. A.; Picco, C. E.; Shavers, M. R.; Flores-McLaughlin, J.

    2011-01-01

    To perform dosimetry and risk assessment, NASA collects astronaut ionizing radiation exposure data from space flight, medical imaging and therapy, aviation training activities and prior occupational exposure histories. Career risk of exposure induced death (REID) from radiation is limited to 3 percent at a 95 percent confidence level. The Radiation Health Office at Johnson Space Center (JSC) is implementing a program to integrate the gathering, storage, analysis and reporting of astronaut ionizing radiation dose and risk data and records. This work has several motivations, including more efficient analyses and greater flexibility in testing and adopting new methods for evaluating risks. The foundation for these improvements is a set of software tools called the Astronaut Radiation Exposure Analysis System (AREAS). AREAS is a series of MATLAB(Registered TradeMark)-based dose and risk analysis modules that interface with an enterprise level SQL Server database by means of a secure web service. It communicates with other JSC medical and space weather databases to maintain data integrity and consistency across systems. AREAS is part of a larger NASA Space Medicine effort, the Mission Medical Integration Strategy, with the goal of collecting accurate, high-quality and detailed astronaut health data, and then securely, timely and reliably presenting it to medical support personnel. The modular approach to the AREAS design accommodates past, current, and future sources of data from active and passive detectors, space radiation transport algorithms, computational phantoms and cancer risk models. Revisions of the cancer risk model, new radiation detection equipment and improved anthropomorphic computational phantoms can be incorporated. Notable hardware updates include the Radiation Environment Monitor (which uses Medipix technology to report real-time, on-board dosimetry measurements), an updated Tissue-Equivalent Proportional Counter, and the Southwest Research Institute

  1. Improving epistemological beliefs and moral judgment through an STS-based science ethics education program.

    Science.gov (United States)

    Han, Hyemin; Jeong, Changwoo

    2014-03-01

    This study develops a Science-Technology-Society (STS)-based science ethics education program for high school students majoring in or planning to major in science and engineering. Our education program includes the fields of philosophy, history, sociology and ethics of science and technology, and other STS-related theories. We expected our STS-based science ethics education program to promote students' epistemological beliefs and moral judgment development. These psychological constructs are needed to properly solve complicated moral and social dilemmas in the fields of science and engineering. We applied this program to a group of Korean high school science students gifted in science and engineering. To measure the effects of this program, we used an essay-based qualitative measurement. The results indicate that there was significant development in both epistemological beliefs and moral judgment. In closing, we briefly discuss the need to develop epistemological beliefs and moral judgment using an STS-based science ethics education program.

  2. Improving the composition of voluntary programs in the category of Women in fitness

    Directory of Open Access Journals (Sweden)

    Iryna Bilenka

    2018-04-01

    Full Text Available Purpose: to reveal the basic directions of perfection of construction of compositions of voluntary programs in the category of Women in fitness. Material & Methods: judges-experts analyzed the structure and content of voluntary competitive programs of performances of six female athletes'-finalists of the championship of Ukraine on bodybuilding and fitness in 2016. Results: voluntary programs include elements of structural groups of varying complexity: "acrobatic", "choreographic", "strength" and "flexibility"; female athletes with better indicators in the quantitative analysis of competitive compositions received higher grades for performance; the results of athletes for an arbitrary program are directly proportional to the number of complex elements in the composition. Conclusions: in an voluntary program in women's fitness for a competitive result affects the saturation of the program, the variety and complexity of the elements.

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

    Science.gov (United States)

    American Pharmacists Association; Bough, Marcie

    2011-01-01

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

  4. Integron, Plasmid and Host Strain Characteristics of Escherichia coli from Humans and Food Included in the Norwegian Antimicrobial Resistance Monitoring Programs.

    Science.gov (United States)

    Sunde, Marianne; Simonsen, Gunnar Skov; Slettemeås, Jannice Schau; Böckerman, Inger; Norström, Madelaine

    2015-01-01

    Antimicrobial resistant Escherichia coli (n=331) isolates from humans with bloodstream infections were investigated for the presence of class 1 and class 2 integrons. The integron cassettes arrays were characterized and the findings were compared with data from similar investigations on resistant E. coli from meat and meat products (n=241) produced during the same time period. All isolates were obtained from the Norwegian monitoring programs for antimicrobial resistance in human pathogens and in the veterinary sector. Methods used included PCR, sequencing, conjugation experiments, plasmid replicon typing and subtyping, pulsed-field-gel-electrophoresis and serotyping. Integrons of class 1 and 2 occurred significantly more frequently among human isolates; 45.4% (95% CI: 39.9-50.9) than among isolates from meat; 18% (95% CI: 13.2 -23.3), (pfood source and from a human clinical sample highlights the possible role of meat as a source of resistance elements for pathogenic bacteria.

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Science.gov (United States)

    Chinn, Courtney Hugh

    2011-01-01

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

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

    International Nuclear Information System (INIS)

    1991-11-01

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

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

    Science.gov (United States)

    2016-12-20

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

  9. Identifying barriers to mental health system improvements: an examination of community participation in assertive community treatment programs

    Directory of Open Access Journals (Sweden)

    Wakefield Patricia A

    2011-11-01

    Full Text Available Abstract Background Integrating the best available evidence into program standards is essential if system-wide improvements in the delivery of community-based mental health services are to be achieved. Since the beginning of the Assertive Community Treatment (ACT program movement, program standards have included a role for the community. In particular, ACT program standards have sought to ensure that members of the local community are involved in governance and that former clients participate in service delivery as "Peer Support Specialists". This paper reports on the extent to which ACT program standards related to community participation have been implemented and identifies barriers to full compliance. Methods Qualitative and quantitative data were collected through a telephone survey of ACT Program Coordinators in Ontario, Canada, using a census sample of the existing 66 ACT programs. A thematic approach to content analysis was used to analyze respondents' qualitative comments. Quantitative data were analyzed using SPSS 16.0 and included means, frequencies, independent t-tests and Pearson Correlations. Results An 85% response rate was achieved. Of the 33 program standards, the two that received the lowest perceived compliance ratings were the two standards directly concerning community participation. Specifically, the standard to have a functioning Community Advisory Body and the standard requiring the inclusion of a Peer Support Specialist. The three major themes that emerged from the survey data with respect to the barriers to fully implementing the Community Advisory Body were: external issues; standard related issues; and, organizational/structural related issues. The three major themes concerning barriers to implementing the Peer Support Specialist role were: human resource related issues; organizational/structural related issues; and, standard related issues. Conclusions The reasons for low compliance of ACT programs with community

  10. 25 CFR 170.808 - Can BIA Road Maintenance Program funds be used to improve IRR transportation facilities?

    Science.gov (United States)

    2010-04-01

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

  11. Post discharge issues identified by a call-back program: identifying improvement opportunities.

    Science.gov (United States)

    Ojeda, Patricia I; Kara, Areeba

    2017-12-01

    The period following discharge from the hospital is one of heightened vulnerability. Discharge instructions serve as a guide during this transition. Yet, clinicians receive little feedback on the quality of this document that ties into the patients' experience. We reviewed the issues voiced by discharged patients via a call-back program and compared them to the discharge instructions they had received. At our institution, patients receive an automated call forty-eight hours following discharge inquiring about progress. If indicated by the response to the call, they are directed to a nurse who assists with problem solving. We reviewed the nursing documentation of these encounters for a period of nine months. The issues voiced were grouped into five categories: communication, medications, durable medical equipment/therapies, follow up and new or ongoing symptoms. The discharge instructions given to each patient were reviewed. We retrieved data on the number of discharges from each specialty from the hospital over the same period. A total of 592 patients voiced 685 issues. The numbers of patients discharged from medical or surgical services identified as having issues via the call-back line paralleled the proportions discharged from medical and surgical services from the hospital during the same period. Nearly a quarter of the issues discussed had been addressed in the discharge instructions. The most common category of issues was related to communication deficits including missing or incomplete information which made it difficult for the patient to enact or understand the plan of care. Medication prescription related issues were the next most common. Resource barriers and questions surrounding medications were often unaddressed. Post discharge issues affect patients discharged from all services equally. Data from call back programs may provide actionable targets for improvement, identify the inpatient team's 'blind spots' and be used to provide feedback to clinicians.

  12. Use of a web-based education program improves nurses' knowledge of breastfeeding.

    Science.gov (United States)

    Deloian, Barbara J; Lewin, Linda Orkin; O'Connor, Mary E

    2015-01-01

    To evaluate the baseline knowledge and knowledge gained of nurses, nursing students, midwives, and nurse practitioners who completed Breastfeeding Basics, an online educational program. This study reports on an anonymous evaluation of an online breastfeeding education program developed and maintained to promote evidence-based breastfeeding practice. Included in the study were 3736 nurses, 728 nurse practitioners/midwives, and 3106 nursing students from the United States who completed ≥ one pretest or posttest on the Breastfeeding Basics website between April 1999 and December 31, 2011. Baseline scores were analyzed to determine if nurses' baseline knowledge varied by selected demographic variables such as age, gender, professional level, personal or partner breastfeeding experience, and whether they were required to complete the website for a job or school requirement and to determine knowledge gaps. Pretest and posttest scores on all modules and in specific questions with low pretest scores were compared as a measure of knowledge gained. Lower median pretest scores were found in student nurses (71%), males (71%), those required to take the course (75%), and those without personal breastfeeding experience (72%). The modules with the lowest median pretest scores were Anatomy/Physiology (67%), Growth and Development of the Breastfed Infant (67%), the Breastfeeding Couple (73%), and the Term Infant with Problems (60%). Posttest scores in all modules increased significantly (p nurses and nursing students. Gaps exist in nurses' breastfeeding knowledge. Knowledge improved in all areas based on comparison of pretest and posttest scores. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  13. THE ARTHRITIS AND MUSCULOSKELETAL QUALITY IMPROVEMENT PROGRAM (AMQUIP: A BREAKTHROUGH SERIES METHODOLOGY PROJECT

    Directory of Open Access Journals (Sweden)

    MASTURA I

    2008-01-01

    Full Text Available The Australian government had funded the National Primary Care Collaborative (NPCC program with funding of $14.6 million over three years. One of the pilots project was the Arthritis and Musculoskeletal Quality Improvement Program (AMQuIP.The study aims to optimize general practitioners (GPs management of patients with osteoarthritis (OA of the hip and knee by identifying gaps between their current practice and best practice. The Breakthrough Series Collaborative methodology with several Plan-Do-Study-Act (PDSA cycles was employed. Participants comprises of 12 GPs/practices from two Victorian Divisions of general Practice (one rural, one metropolitan with 10 patients per GP/practice. GPs/practices attended an orientation and three learning workshops and a videoconference. GPs/practices completed PDSA cycles between workshop and reported results at workshops. GPs/practices reported use of guidelines, change in patient management and change in practice management/systems. All recruited patients completed the SF-12v2 Health Survey and WOMAC OA Index Questionnaire twice. Follow up activities including focus groups and face-to-face interviews were held six months after the final workshop. All GPs/practices used the guidelines/key messages, introduced “new” management strategies to patients, and made positive changes to their practice management/systems. Patient reported positive changes and outcomes. By using a structured methodology and evidence-based guidelines/key messages; GPs can introduce new patient management strategies, and by identifying gaps in practice management systems, positive changes can be achieved.

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

    Directory of Open Access Journals (Sweden)

    Lemstra ME

    2016-03-01

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

  15. 75 FR 43510 - Office of Innovation and Improvement; Overview Information; Charter Schools Program (CSP) Grants...

    Science.gov (United States)

    2010-07-26

    ... providing financial assistance for the planning, program design, and initial implementation of charter... schools. The Secretary also encourages the applicant to include a description of the degree of autonomy... performance report, including financial information, as directed by the Secretary. If you receive a multi-year...

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yi-Wei Kuo

    2016-12-01

    Conclusion: Dental injury incidence was significantly reduced and remained at low levels after implementation of the quality improvement program. We suggest the implementation of a standardized dental examination into the preoperative evaluation system adding pathologic teeth fixed or protected devices to minimize dental injury associated with anesthesia.

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

    Science.gov (United States)

    Tucker, Beatrice; Jones, Sue; Straker, Leon

    2008-01-01

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

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

    International Nuclear Information System (INIS)

    Almoguera, R.; Garcia Fernandez, N.

    1995-01-01

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

  20. Use of protoplast, cell, and shoot tip culture in an elm germ plasm improvement program

    Science.gov (United States)

    R. Daniel Lineberger; M.B. Sticklen; P.M. Pijut; Mark A. Kroggel; C.V.M. Fink; S.C. Domir

    1990-01-01

    An elm germplasm improvement program was established using three distinct approaches: (1) development of protoplast regeneration protocols with the goal of attempting somatic hybridization between Ulmus americana and disease resistant hybrids; (2) evaluation of the extent of somaclonal variation in plants regenerated from protoplasts; and (3)...