WorldWideScience

Sample records for program improvement include

  1. Quick Reference Guide: Working with Stakeholders to Identify Potential Improvement Strategies for Program Improvement (Including the SSIP)

    Science.gov (United States)

    Center for IDEA Early Childhood Data Systems (DaSy), 2015

    2015-01-01

    This 2015 quick reference guide is designed to assist states in understanding what information needs to be available in order for stakeholders to assist in selecting potential improvement strategies that will increase capacity of Local Education Agencies (LEAs), Early Intervention Services (EIS) programs, and practitioners to improve results for…

  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. Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing.

    Science.gov (United States)

    Yoshimi, Kaku; Ueki, Jun; Seyama, Kuniaki; Takizawa, Makiko; Yamaguchi, Seiko; Kitahara, Eriko; Fukazawa, Shinji; Takahama, Yukiko; Ichikawa, Masako; Takahashi, Kazuhisa; Fukuchi, Yoshinosuke

    2012-06-01

    Pulmonary rehabilitation has generally relieved symptoms, strengthened exercise endurance and improved health-related quality of life (QOL) in patients with COPD, but recovery of pulmonary function remains questionable. This analysis of our innovative rehabilitation program is directed at documenting changes in patients' expiratory airflow limitation, pulmonary symptoms and QOL. This program is designed to provide "respiratory conditioning", a physical therapist-assisted intensive flexibility training that focuses on stretching and rib cage mobilization. Thirty-one patients with COPD who attended rehabilitation sessions at Juntendo University Hospital from 1999 to 2006 were analyzed. Pulmonary function, expiratory flow limitation during tidal breathing, six minute walk distance (6MWD), respiratory muscle strength, and St. George Respiratory Questionnaire (SGRQ) were measured before and after pulmonary rehabilitation. In participants ages 68±7 years, the FEV(1)% predicted was 39.3±15.7%. 6MWD, SGRQ and respiratory muscle strength were significantly improved after pulmonary rehabilitation. Although neither FEV(1)% predicted nor FEV(1)/FVC was affected to a significant extent, indicating little effect on airflow limitation, expiratory flow limitation in supine as well as seated during tidal breathing improved significantly. Moreover, rehabilitation significantly diminished TLC% predicted, FRC% predicted, RV% predicted and RV/TLC values, thus indicating a reduction of hyperinflation of the lungs at rest. The present results suggest that our rehabilitation program with respiratory conditioning significantly lowered the hyperinflation of lungs at rest as well as the expiratory flow limitation during tidal breathing. In patients with COPD, overall pulmonary function improved, exercise endurance increased and health-related QOL was enhanced.

  5. 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

  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. Project HAPI (Handicapped Achievement Program Improvement): Assessment plus Intervention equal I.E.P. A Handbook on How To Write an Individualized Education Program for Severe Disorders of Language, Including Aphasia and Other Speech-Language Handicapped (Communication Disorders). Book One.

    Science.gov (United States)

    Chapman, Jean

    The first of five handbooks developed by Project HAPI (Handicapped Achievement Program Improvement), a multimedia staff development program to help teachers and specialists write effective individualized education programs (IEPs), is in looseleaf workbook format and focuses on children with severe disorders of language, including aphasia and other…

  8. 24 Command Fire Improvement Action Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    GRIFFIN, G.B.

    2000-12-01

    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.

  9. Diversity: Including People with Disabilities in Outdoor Adventure Programs.

    Science.gov (United States)

    Sugerman, Deb

    1996-01-01

    Organizations that offer outdoor adventure activities can integrate programs to include individuals with disabilities. The paper describes how one organization includes diverse groups of people with and without disabilities in its outdoor activities, focusing on each member's strengths and encouraging cooperation. (SM)

  10. 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.

  11. Valuing preferences over stormwater management outcomes including improved hydrologic function

    Science.gov (United States)

    LondoñO Cadavid, Catalina; Ando, Amy W.

    2013-07-01

    Stormwater runoff causes environmental problems such as flooding, soil erosion, and water pollution. Conventional stormwater management has focused primarily on flood reduction, while a new generation of decentralized stormwater solutions yields ancillary benefits such as healthier aquatic habitat, improved surface water quality, and increased water table recharge. Previous research has estimated values for flood reduction from stormwater management, but no estimates exist for the willingness to pay (WTP) for some of the other environmental benefits of alternative approaches to stormwater control. This paper uses a choice experiment survey of households in Champaign-Urbana, Illinois, to estimate the values of several attributes of stormwater management outcomes. We analyzed data from 131 surveyed households in randomly selected neighborhoods. We find that people value reduced basement flooding more than reductions in yard or street flooding, but WTP for basement flood reduction in the area only exists if individuals are currently experiencing significant flooding themselves. Citizens value both improved water quality and improved hydrologic function and aquatic habitat from runoff reduction. Thus, widespread investment in low impact development stormwater solutions could have very large total benefits, and stormwater managers should be wary of policies and infrastructure plans that reduce flooding at the expense of water quality and aquatic habitat.

  12. 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.)

  13. Program for reduction body mass and cellulite including aesthetic physiotherapy

    OpenAIRE

    Nikolovska, Lence

    2012-01-01

    The study monitored the effect of separate eating, ultrasonic cavitation, presoterapy, radio frequency and vibrating platform (GREEN PLATE) weight reduction, cellulite removal and improved psycho-emotional status. Perform 3 weekly treatments. In the course of three months were examined 45 overweight women and cellulite.

  14. Hearing of Personnel Included in the USAF Hearing Conservation Program

    Science.gov (United States)

    1976-02-01

    ORGNIZTIO NAE AN ADRES - 10. PROGRAM ELEMENT. PROJECT. TASK 9. PFORINGORGAIZAIONNAMEANDADDESSAREA ft WORK UNIT NUMBERS USAF School of Aerospace Medicine...0 0)~’ to (00w " 0 -q N~ m M VC0 CO~j 0 N 01) a)inUjU) tD -4 N o O 0 N 0 a) m m~0 di .. 0 alO1 O0- cn cO N - m -4N (0-00N (0 it) W N n N . o4Ca 0 0

  15. 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.

  16. Information to Include in Curriculum Vitae | Cancer Prevention Fellowship Program

    Science.gov (United States)

    Applicants are encouraged to use their current curriculum vitae and to add any necessary information. Please include your name and a page number on each page of the curriculum vitae. Some of the information requested below will not be applicable to all individuals. Please do not print or type your information on this page. Personal Information Name (First middle last) Gender (optional) Race (optional) Date of birth Place of birth (city,

  17. 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.

  18. How Successful State Education Improvement Programs Work.

    Science.gov (United States)

    Odden, Allan; Anderson, Beverly

    1986-01-01

    States have created two types of educational improvement programs: school-based programs (engaging local school people in planning, problem-solving, and implementing strategies) and instructionally focused programs for bettering teacher and administrator skills. Successful programs progress through initiation, implementation, and…

  19. Conducting a SWOT Analysis for Program Improvement

    Science.gov (United States)

    Orr, Betsy

    2013-01-01

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

  20. 78 FR 7476 - Airport Improvement Program

    Science.gov (United States)

    2013-02-01

    ... Federal Aviation Administration Airport Improvement Program AGENCY: Department of Transportation, Federal Aviation Administration. ACTION: Invitation to comment on draft FAA Order 5100-38, Airport Improvement...-38D, Airport Improvement Program Handbook. When finalized, this Order will replace Order 5100-38C...

  1. 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....

  2. 34 CFR 263.4 - What training costs may a Professional Development program include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What training costs may a Professional Development... GRANT PROGRAMS Professional Development Program § 263.4 What training costs may a Professional Development program include? (a) A Professional Development program may include, as training costs, assistance...

  3. 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.

  4. Digital Competition Game to Improve Programming Skills

    National Research Council Canada - National Science Library

    Julián Moreno

    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...

  5. Resources for Guidance Program Improvement. Volume I.

    Science.gov (United States)

    Walz, Garry R., Comp.; And Others

    Designed for use by counselors, guidance directors, school administrators, school board members, and anyone interested in the improvement of school guidance programs, this resource book provides a collection of over 100 guidance program models and individual guidance practices. The format consists of references (bibliographic information with…

  6. Critical success factors for performance improvement programs.

    Science.gov (United States)

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

    2005-04-01

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

  7. Transportation R and D included in thermal and mechanical sciences program

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    Argonne National Laboratory is a multiprogram research and development laboratory operated by The University of Chicago for the US Department of Energy. At Argonne, applied research in thermal and mechanical sciences is performed within the Thermal and Mechanical Sciences Section of the Energy Technology Division. Current program areas include compact evaporators and condensers for the process and transportation industries, ice slurries for district cooling, advanced fluids for improved heat transfer and reduced pressure drop, flow-induced vibration and flow distribution in shell-and-tube heat exchangers, and dynamics and control of maglev systems. In general, the objective of the research is to extend the technology base in each of these areas and to facilitate its application in solving problems of importance to US industries and utilities. This is accomplished by developing validated design correlations and predictive methods. The staff of the Thermal and Mechanical Sciences Section have extensive experimental and analytical experience in heat transfer, multiphase flow, structural dynamics and control, fluid-structure interaction, transient flow and mixing, thermally driven flows, and flow visualization using ultra-high-speed video. Large, general-purpose test facilities and smaller, single-purpose test apparatuses are available for experiments and component design evaluation. A world-class capability in the study of flow-induced vibrations exists within the Section. Individual fact sheets, describing currently active research program areas, related facilities, and listing, as a contact, the principal investigator, are included.

  8. 34 CFR 86.100 - What must the IHE's drug prevention program include?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What must the IHE's drug prevention program include? 86.100 Section 86.100 Education Office of the Secretary, Department of Education DRUG AND ALCOHOL ABUSE PREVENTION Institutions of Higher Education § 86.100 What must the IHE's drug prevention program include? The...

  9. 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.

  10. 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

  11. Missouri School Improvement Program: Support and Intervention

    Science.gov (United States)

    Missouri Department of Elementary and Secondary Education, 2016

    2016-01-01

    The Missouri State Board of Education and the Department of Elementary and Secondary Education are dedicated to ensuring that all children have access to good schools that prepare them for college and career success. The Missouri School Improvement Program: Support and Intervention Plan takes a differentiated approach to state support based on…

  12. 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…

  13. A Program Master Schedule Can Improve Results

    Science.gov (United States)

    2014-02-01

    A Program Master Schedule Can Improve Results Patrick K. Barker “There cannot be a crisis today; my schedule is already full.” — Henry Kissinger...briefings, so PMOs often rely on static pictures and Gantt charts available on presentation software such as Microsoft PowerPoint. That’s fine—and

  14. 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…

  15. 36 CFR 1223.14 - What elements must a vital records program include?

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false What elements must a vital... RECORDS ADMINISTRATION RECORDS MANAGEMENT MANAGING VITAL RECORDS § 1223.14 What elements must a vital records program include? To achieve compliance with this section, an agency's vital records program must...

  16. Efficacy of an Individualized Prevention Program Including Social Media Support on University Students with Gingivitis

    National Research Council Canada - National Science Library

    Carlos Alberto Serrano Méndez; Karen Andrea Avendaño Calderón; Paula Andrea Moreno Caro

    2017-01-01

    ...: Thirty-eight students with gingivitis participated in a program that included: Individualized oral hygiene instruction, professional removal of plaque and calculus and, recall and support on oral hygiene through the use of social media...

  17. Comprehensive Adolescent Health Programs That Include Sexual and Reproductive Health Services: A Systematic Review

    Science.gov (United States)

    Parekh, Jenita; Tunçalp, Özge; Turke, Shani; Blum, Robert William

    2014-01-01

    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. PMID:25320876

  18. 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

  19. 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

  20. Improving Defense Health Program Medical Research Processes

    Science.gov (United States)

    2017-08-08

    administration and management of all MTFs, including budgetary matters, information technology, administrative policy and procedure, military medical...2013;7(12). 7. Kitchen LW, Vaughn DW, Skillman DR. Role of US military research programs in the development of US Food and Drug Administration ...that would optimally support military medical professionals who oversee and conduct DHP medical research. In response, the DHB assigned the Public

  1. Realizing Improvement through Team Empowerment (RITE): A Team-based, Project-based Multidisciplinary Improvement Program.

    Science.gov (United States)

    Larson, David B; Mickelsen, L Jake; Garcia, Kandice

    2016-01-01

    Performance improvement in a complex health care environment depends on the cooperation of diverse individuals and groups, allocation of time and resources, and use of effective improvement methods. To address this challenge, we developed an 18-week multidisciplinary training program that would also provide a vehicle for effecting needed improvements, by using a team- and project-based model. The program began in the radiology department and subsequently expanded to include projects from throughout the medical center. Participants were taught a specific method for team-based problem solving, which included (a) articulating the problem, (b) observing the process, (c) analyzing possible causes of problems, (d) identifying key drivers, (e) testing and refining interventions, and (f) providing for sustainment of results. Progress was formally reviewed on a weekly basis. A total of 14 teams consisting of 78 participants completed the course in two cohorts; one project was discontinued. All completed projects resulted in at least modest improvement. Mean skill scores increased from 2.5/6 to 4.5/6 (P success include (a) engagement of frontline staff, (b) teams given authority to make process changes, (c) capable improvement coaches, (d) a physician-director with improvement expertise and organizational authority, (e) capable administrative direction, (f) supportive organizational leaders, (g) weekly progress reviews, (h) timely educational material, (i) structured problem-solving methods, and ( j ) multiple projects working simultaneously. The purpose of this article is to review the program, including the methods and results, and discuss perceived keys to program success. © RSNA, 2016.

  2. 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.

  3. Program Review - Geothermal Exploration and Assessment Technology Program; Including a Report of the Reservoir Engineering Technical Advisory Group

    Energy Technology Data Exchange (ETDEWEB)

    Nielson, Dennis L., ed.

    1979-12-01

    In 1978, The Division of Geothermal Energy of the Department of Energy established the Geothermal Exploration and Assessment Technology Program. The purpose of this program is to ''provide assistance to the Nation's industrial community by helping to remove technical and associated economic barriers which presently inhibit efforts to bring geothermal electric power production and direct heat application on line''. In the near term this involves the adaptation of exploration and assessment techniques from the mineral and petroleum industry to geothermal applications. In the near to far term it involves the development of new technology which will improve the cost effectiveness of geothermal exploration.

  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... of drug abuse in the workplace; (b) Your policy of maintaining a drug-free workplace; (c) Any...

  5. 29 CFR 94.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true What must I include in my drug-free awareness program? 94.215 Section 94.215 Labor Office of the Secretary of Labor GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE... inform employees about— (a) The dangers of drug abuse in the workplace; (b) Your policy of maintaining a...

  6. 31 CFR 20.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false What must I include in my drug-free awareness program? 20.215 Section 20.215 Money and Finance: Treasury Office of the Secretary of the Treasury GOVERNMENTWIDE REQUIREMENTS FOR DRUG-FREE WORKPLACE (FINANCIAL ASSISTANCE) Requirements for Recipients Other Than...

  7. 38 CFR 17.255 - Applications for grants for programs which include construction projects.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Applications for grants... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants for Exchange of Information § 17.255 Applications for grants for programs which include construction projects. In addition to the documents and...

  8. 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…

  9. Industrial energy-efficiency improvement program

    Science.gov (United States)

    1980-12-01

    The industrial energy efficiency improvement program to accelerate market penetration of new and emerging industrial technologies is described. Practices which will improve energy efficiency, encourage substitution of more plentiful domestic fuels, and enhance recovery of energy and materials from industrial waste streams are enumerated. Specific reports from the chemicals and allied products; primary metals; petroleum and coal products; stone, clay, and glass, paper and allied products; food and kindred products; fabricated metals; transportation equipment; machinery (except electrical); textile mill products; rubber and miscellaneous plastics; electrical and electronic equipment; lumber and wood; and tobacco products are discussed. A summary on progress in the utilization of recovered materials, and an analysis of industrial fuel mix is presented.

  10. 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)

  11. 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

  12. 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.

  13. Improving Search Properties in Genetic Programming

    Science.gov (United States)

    Janikow, Cezary Z.; DeWeese, Scott

    1997-01-01

    With the advancing computer processing capabilities, practical computer applications are mostly limited by the amount of human programming required to accomplish a specific task. This necessary human participation creates many problems, such as dramatically increased cost. To alleviate the problem, computers must become more autonomous. In other words, computers must be capable to program/reprogram themselves to adapt to changing environments/tasks/demands/domains. Evolutionary computation offers potential means, but it must be advanced beyond its current practical limitations. Evolutionary algorithms model nature. They maintain a population of structures representing potential solutions to the problem at hand. These structures undergo a simulated evolution by means of mutation, crossover, and a Darwinian selective pressure. Genetic programming (GP) is the most promising example of an evolutionary algorithm. In GP, the structures that evolve are trees, which is a dramatic departure from previously used representations such as strings in genetic algorithms. The space of potential trees is defined by means of their elements: functions, which label internal nodes, and terminals, which label leaves. By attaching semantic interpretation to those elements, trees can be interpreted as computer programs (given an interpreter), evolved architectures, etc. JSC has begun exploring GP as a potential tool for its long-term project on evolving dextrous robotic capabilities. Last year we identified representation redundancies as the primary source of inefficiency in GP. Subsequently, we proposed a method to use problem constraints to reduce those redundancies, effectively reducing GP complexity. This method was implemented afterwards at the University of Missouri. This summer, we have evaluated the payoff from using problem constraints to reduce search complexity on two classes of problems: learning boolean functions and solving the forward kinematics problem. We have also

  14. Improved exponential convergence result for generalized neural networks including interval time-varying delayed signals.

    Science.gov (United States)

    Rajchakit, G; Saravanakumar, R; Ahn, Choon Ki; Karimi, Hamid Reza

    2017-02-01

    This article examines the exponential stability analysis problem of generalized neural networks (GNNs) including interval time-varying delayed states. A new improved exponential stability criterion is presented by establishing a proper Lyapunov-Krasovskii functional (LKF) and employing new analysis theory. The improved reciprocally convex combination (RCC) and weighted integral inequality (WII) techniques are utilized to obtain new sufficient conditions to ascertain the exponential stability result of such delayed GNNs. The superiority of the obtained results is clearly demonstrated by numerical examples. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. 77 FR 22376 - Airport Improvement Program (AIP) Grant Assurances

    Science.gov (United States)

    2012-04-13

    ... Federal Aviation Administration Airport Improvement Program (AIP) Grant Assurances AGENCY: Federal Aviation Administration (FAA). ACTION: Notice of modification of Airport Improvement Program grant..., Manager, Airports Financial Assistance, Federal Aviation Administration, 800 Independence Avenue SW...

  16. 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.

  17. The case for including reach as a key element of program theory.

    Science.gov (United States)

    Montague, Steve; Porteous, Nancy L

    2013-02-01

    This paper suggests that there is a need to build reach in the logic models and results frameworks of public health initiatives. A lack of explicit thinking about reach in logic models can lead to problems such as narrow/constricted understanding of impacts chain, favoring of 'narrow and efficient' initiatives over 'wide and engaging' initiatives and biased thinking against equity considerations. An alternative approach described in this paper that explicitly considers reach demonstrates that an explicit description of reach in program theory and results logic depictions can improve equity in health and social systems. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Next Generation Leadership Improving Acquisition Program Management Development

    Science.gov (United States)

    2013-02-14

    TE AIR WAR COLLEGE AIR UNIVERSITY NEXT GENERATION LEADERSHIP IMPROVING ACQUISITION PROGRAM MANAGEMENT DEVELOPMENT by Jeffrey C. Sobel, Lt...strengths and weaknesses in the current Air Force acquisition leader development process. To improve program manager training, this paper recommends...the existing Air Force Mentorship Program to ensure young program managers are matched with experienced senior leaders . Mentor/Teach requires

  19. 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...

  20. Short communication. An improved intersubspecific genetic map in Lens including functional markers

    Directory of Open Access Journals (Sweden)

    R. de la Puente

    2012-12-01

    Full Text Available A previous Lens genetic map was improved by adding 31 molecular genetic markers, reaching a total of 190 markers with undistorted segregation. Data were obtained from the segregational analysis of 113 F2 plants generated from a single hybrid of Lens culinaris ssp. culinaris × L. c. ssp. orientalis. The added markers are predominantly codominant (15 SSRs, five CAPSs, four presence-absence polymorphisms, three length polymorphisms, two RAPDs, and two SRAPs. At a LOD score of 3.0, the 190 markers were grouped into eight linkage groups (LG covering 2,234.4 cM, with an average distance between markers of 12.28 cM. This linkage map has reduced the numbers of linkage groups from ten in the previous map to eight. Most of the added markers must be functional markers since primers were mostly designed to amplify transcribed sequences. Some of the amplicons were sequenced to test if they were functional markers. One of the sequences showed homology with the Pisum TFL1a gene, involved in the transition from vegetative to flowering stages. This lentil gene was located in the LG 1 thanks to the presence of a polymorphic microsatellite in the first intron of the gene. Since L. culinaris ssp. orientalis is the primary source of additional genetic variability for lentil, this improved map could help in the use of such variability in lentil breeding programs.

  1. Concurrent implementation of quality improvement programs.

    Science.gov (United States)

    Nyström, Monica Elisabeth; Garvare, Rickard; Westerlund, Anna; Weinehall, Lars

    2014-01-01

    Competing activities and projects can interfere with implementing new knowledge and approaches. The purpose, therefore, was to investigate processes and impact related to implementing two concurrent quality initiatives in a Swedish hospital. These were a regionally initiated, system-wide organizational learning programme called the Dynamic and Viable Organization (DVO) and a national initiative on stopping healthcare-associated and hospital-acquired infections (SHAI). Both undertakings aspired to increase staff competence in systematic improvement approaches. Multiple methods were applied including surveys, observations, interviews, process diaries, documents and organizational measurements. Respondents were unit managers, change facilitators and improvement team members. Even though both initiatives shared the same improvement approach, there was no strong indication that they were strategically combined to benefit each other. The initiatives existed side by side with some coordination and some conflict. Despite absent management strategies to utilize the national SHAI initiative, positive developments in QI culture and communication were reported. The current study illustrates the inherent difficulties coordinating change initiatives, even in favourable circumstances. This article addresses the lesser studied but common situation of coinciding and competing projects in organizations.

  2. Use of a business excellence model to improve conservation programs.

    Science.gov (United States)

    Black, Simon; Groombridge, Jim

    2010-12-01

    The current shortfall in effectiveness within conservation biology is illustrated by increasing interest in "evidence-based conservation," whose proponents have identified the need to benchmark conservation initiatives against actions that lead to proven positive effects. The effectiveness of conservation policies, approaches, and evaluation is under increasing scrutiny, and in these areas models of excellence used in business could prove valuable. Typically, conservation programs require years of effort and involve rigorous long-term implementation processes. Successful balance of long-term efforts alongside the achievement of short-term goals is often compromised by management or budgetary constraints, a situation also common in commercial businesses. "Business excellence" is an approach many companies have used over the past 20 years to ensure continued success. Various business excellence evaluations have been promoted that include concepts that could be adapted and applied in conservation programs. We describe a conservation excellence model that shows how scientific processes and results can be aligned with financial and organizational measures of success. We applied the model to two well-documented species conservation programs. In the first, the Po'ouli program, several aspects of improvement were identified, such as more authority for decision making in the field and better integration of habitat management and population recovery processes. The second example, the black-footed ferret program, could have benefited from leadership effort to reduce bureaucracy and to encourage use of best-practice species recovery approaches. The conservation excellence model enables greater clarity in goal setting, more-effective identification of job roles within programs, better links between technical approaches and measures of biological success, and more-effective use of resources. The model could improve evaluation of a conservation program's effectiveness and may be

  3. 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

  4. 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.

  5. Quality improvement educational practices in pediatric residency programs: survey of pediatric program directors.

    Science.gov (United States)

    Mann, Keith J; Craig, Mark S; Moses, James M

    2014-01-01

    The Accreditation Council for Graduate Medical Education requires residents to learn quality improvement (QI) methods to analyze, change, and improve their practice. Little is known about how pediatric residency programs design, implement, and evaluate QI curricula to achieve this goal. We sought to describe current QI educational practices, evaluation methods, and program director perceptions through a national survey. A survey of QI curricula was developed, pilot tested, approved by the Association of Pediatric Program Directors (APPD), and distributed to pediatric program directors. Descriptive statistics were used to analyze the data. The response rate was 53% (104 of 197). Most respondents reported presence of a QI curriculum (85%, 88 of 104), including didactic sessions (83%) and resident QI projects (88%). Continuous process improvement was the most common methodology addressed (65%). The most frequent topics taught were "Making a Case for QI" (68%), "PDSA [plan-do-study-act] Cycles" (66%), and "Measurement in QI" (60%). Projects were most frequently designed to improve clinical care (90%), hospital operations (65%), and the residency (61%). Only 35% evaluated patient outcomes, and 17% had no formal evaluation. Programs had a mean of 6 faculty members (standard deviation 4.4, range 2-20) involved in teaching residents QI. Programs with more faculty involved were more likely to have had a resident submit an abstract to a professional meeting about their QI project (9, 92%; P = .003). Barriers to teaching QI included time (66%), funding constraints (39%), and absent local QI expertise (33%). Most PPDs (65%) believed that resident input in hospital QI was important, but only 24% reported resident involvement. Critical factors for success included an experiential component (56%) and faculty with QI expertise (50%). QI curricular practices vary greatly across pediatric residency programs. Although pediatric residency programs commit a fair number of resources to

  6. T-FLAP improvement for VOS Program

    Science.gov (United States)

    Marcelli, Marco; Piermattei, Viviana; Madonia, Alice; Mainardi, Umberto; Manzella, Giuseppe M. R.

    2010-05-01

    The operational oceanography has been engaged in the development of new acquisition, transmission and assimilation systems in order to have the widest possible coverage of real time informations, reflecting the guidelines of the World Meteorological Organization (WMO) and of the Intergovernmental Oceanographic Commission (IOC). Physical and biological processes of marine ecosystems have a high spatial and temporal variability, whose study is possible only through high resolution and synoptic observations. More than for the physical variables, the biological ones have to be observed in situ. Especially in the mid-high latitudes, a deep observation of the water column is needed, because of the typical distribution of phytoplankton's biomass (Mann and Lazier, 1991). In the last times an extensive use of XBT was performed in order to provide near real time analysis of the ocean temperature, but there is still a lack in the biomass estimation. T-FLAP technology (Temperature and Fluorescence LAunchable Probe - Marcelli et al. 2007) was designed to answer to the claim of a cost effective temperature and fluorescence autonomous probe, to be used on ships of opportunity for the Voluntary Observing Ship Program (VOS). During the last three years the probe was upgraded and improved both in materials and in measure sensitivity. New LEDs were mounted to increase the radiant power of the excitation source.. In order to evaluate the red filter efficiency to detect fluorescence chlorophyll a emission wavelengths, transmittance of new available filters in the range 682-685 nm was calculated. In vivo fluorescence spectra of each filter were also performed on samples from Chlorella sp. cultures, to assess the percentage of the fluorescence emission peak transmitted by the filters. A multiple system was designed and realized for a high accuracy dynamic calibration of the probes.

  7. Reliability Analysis of Brittle Material Structures - Including MEMS(?) - With the CARES/Life Program

    Science.gov (United States)

    Nemeth, Noel N.

    2002-01-01

    Brittle materials are being used, or considered, for a wide variety of high tech applications that operate in harsh environments, including static and rotating turbine parts. thermal protection systems, dental prosthetics, fuel cells, oxygen transport membranes, radomes, and MEMS. Designing components to sustain repeated load without fracturing while using the minimum amount of material requires the use of a probabilistic design methodology. The CARES/Life code provides a general-purpose analysis tool that predicts the probability of failure of a ceramic component as a function of its time in service. For this presentation an interview of the CARES/Life program will be provided. Emphasis will be placed on describing the latest enhancements to the code for reliability analysis with time varying loads and temperatures (fully transient reliability analysis). Also, early efforts in investigating the validity of using Weibull statistics, the basis of the CARES/Life program, to characterize the strength of MEMS structures will be described as as well as the version of CARES/Life for MEMS (CARES/MEMS) being prepared which incorporates single crystal and edge flaw reliability analysis capability. It is hoped this talk will open a dialog for potential collaboration in the area of MEMS testing and life prediction.

  8. 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.

  9. 78 FR 67369 - National Vaccine Injury Compensation Program: Addition to the Vaccine Injury Table to Include All...

    Science.gov (United States)

    2013-11-12

    ... HUMAN SERVICES Health Resources and Services Administration National Vaccine Injury Compensation Program: Addition to the Vaccine Injury Table to Include All Vaccines Against Seasonal Influenza AGENCY: Health... vaccines against seasonal influenza are covered under the National Vaccine Injury Compensation Program...

  10. 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.

  11. 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.

  12. Algorithms and Programs for Strong Gravitational Lensing In Kerr Space-time Including Polarization

    Science.gov (United States)

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

    2015-05-01

    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.

  13. 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.

  14. 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.

  15. Sustainable care improvement programs supported by undergraduate health care education

    NARCIS (Netherlands)

    C.H.M. Smits (Carolien); A. Harps (Annelies); A.M.V. Stoopendaal (Annemiek); A.M. Kamper (Ad); M.M.H. Strating (Mathilde); R.A. Bal (Roland)

    2017-01-01

    markdownabstractBackground: The Care for Better Region program was developed to achieve sustainable care improvement focusing onfall prevention. Key ingredients involved improvement teams developing and implementing a falls reduction plan, PracticeDevelopment; facilitation of

  16. Research notes : study recommends changes to Oregon's driver improvement program.

    Science.gov (United States)

    2008-05-01

    The purpose of the Oregon Department of Transportation-Driver and Motor Vehicle Services (DMV) Driver Improvement Program (DIP) is to improve traffic safety by temporarily restricting unsafe drivers or removing them from Oregons highways through t...

  17. 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.

  18. 34 CFR 84.215 - What must I include in my drug-free awareness program?

    Science.gov (United States)

    2010-07-01

    ... awareness program to inform employees about— (a) The dangers of drug abuse in the workplace; (b) Your policy... assistance programs; and (d) The penalties that you may impose upon them for drug abuse violations occurring in the workplace. (Authority: E.O.s 12549 and 12689; 20 U.S.C. 1082, 1094, 1221e-3 and 3474; and Sec...

  19. 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...

  20. The NASA aircraft noise prediction program improved propeller analysis system

    Science.gov (United States)

    Nguyen, L. Cathy

    1991-09-01

    The improvements and the modifications of the NASA Aircraft Noise Prediction Program (ANOPP) and the Propeller Analysis System (PAS) are described. Comparisons of the predictions and the test data are included in the case studies for the flat plate model in the Boundary Layer Module, for the effects of applying compressibility corrections to the lift and pressure coefficients, for the use of different weight factors in the Propeller Performance Module, for the use of the improved retarded time equation solution, and for the effect of the number grids in the Transonic Propeller Noise Module. The DNW tunnel test data of a propeller at different angles of attack and the Dowty Rotol data are compared with ANOPP predictions. The effect of the number of grids on the Transonic Propeller Noise Module predictions and the comparison of ANOPP TPN and DFP-ATP codes are studied. In addition to the above impact studies, the transonic propeller noise predictions for the SR-7, the UDF front rotor, and the support of the enroute noise test program are included.

  1. Intrasystem Analysis Program (IAP) Model Improvement.

    Science.gov (United States)

    1982-02-01

    input impedance of ideal, lossless dipole antennas . Both the biconical and cylindri- cal dipoles, illustrated in Figure 2-2, were studied. a a h h ’I...on reverse ardde it neessary and 1~11’fff by block ambetf) Systems EMC Anaysis, Intrasystem Analysis Code, Frequency Le.- Antenna Models, Nonlinear...Receptor Models, Waveform Sensitive Rezept.;t, Spectral Models, Intrasystem EMC Analysis Program, Antenna Matching Factor, Trans- mission Line Loss

  2. [Michigan Technological University Pre-Service Teacher Enhancement Program]. [Includes a copy of the Student Guide

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, C.S.; Yarroch, W.L.

    1993-04-27

    The Michigan Technological University Teacher Education Program received funding from the US Department of Energy for the purpose of providing capable and suitably inclined, MTU Engineering and Science students a chance to explore high school level science and mathematics teaching as a career option. Ten undergraduate students were selected from nominations and were paired with mentor teachers for the study. This report covers the experience of the first ten nominees and their participation in the program.

  3. Improved General Chemical-Kinetics Program

    Science.gov (United States)

    Bittker, David A.; Scullin, Vincent J.

    1987-01-01

    New general chemical-kinetics code, GCKP84, developed to compute progress of many types of complex gas-phase chemical reactions. Replaces original GCKP code and offers greatly improved efficiency, additional capabilities, and greater convenience. New code written in FORTRAN IV.

  4. 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.

  5. 77 FR 61012 - Expansion of Importer Self-Assessment Program To Include Qualified Importers of Focused...

    Science.gov (United States)

    2012-10-05

    ..., and to discuss the scope and methodology of the self-testing plan developed by the company. Companies... assessment methodology used by the company; the testing methodology; the frequency of self-testing activities... conducted at least annually. ( www.cbp.gov/xp/cgov/trade/trade_programs/importer_self_assessment/ ). Once...

  6. New Brahman breed improvement program at STARS

    Science.gov (United States)

    At the USDA, ARS, Subtropical Agricultural Research Station (STARS) in Brooksville, Florida we have initiated a new ambitious research project that many believe will have a positive influence on the Brahman breed. This research was developed from a meeting held at STARS that included past and prese...

  7. 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…

  8. Hot DA white dwarf model atmosphere calculations: including improved Ni PI cross-sections

    Science.gov (United States)

    Preval, S. P.; Barstow, M. A.; Badnell, N. R.; Hubeny, I.; Holberg, J. B.

    2017-02-01

    To calculate realistic models of objects with Ni in their atmospheres, accurate atomic data for the relevant ionization stages need to be included in model atmosphere calculations. In the context of white dwarf stars, we investigate the effect of changing the Ni IV-VI bound-bound and bound-free atomic data on model atmosphere calculations. Models including photoionization cross-section (PICS) calculated with AUTOSTRUCTURE show significant flux attenuation of up to ˜80 per cent shortward of 180 Å in the extreme ultraviolet (EUV) region compared to a model using hydrogenic PICS. Comparatively, models including a larger set of Ni transitions left the EUV, UV, and optical continua unaffected. We use models calculated with permutations of these atomic data to test for potential changes to measured metal abundances of the hot DA white dwarf G191-B2B. Models including AUTOSTRUCTURE PICS were found to change the abundances of N and O by as much as ˜22 per cent compared to models using hydrogenic PICS, but heavier species were relatively unaffected. Models including AUTOSTRUCTURE PICS caused the abundances of N/O IV and V to diverge. This is because the increased opacity in the AUTOSTRUCTURE PICS model causes these charge states to form higher in the atmosphere, more so for N/O V. Models using an extended line list caused significant changes to the Ni IV-V abundances. While both PICS and an extended line list cause changes in both synthetic spectra and measured abundances, the biggest changes are caused by using AUTOSTRUCTURE PICS for Ni.

  9. 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

    Assessment Methodology for IndustrieS, see Salvi et al 2006). ARAMIS employs the bow-tie approach to modelling hazardous scenarios, and it suggests the outcome of auditing safety management to be connected to a semi-quantitative assessment of the quality of safety barriers. ARAMIS discriminates a number......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...... explosion, and the Mont Blanc Tunnel Fire, such an approach may have helped to maintain the integrity of the designed provisions against major deviations resulting in these disasters. In order to make this paradigm operational, safety management and in particular risk assessment tools need to be refined...

  10. Strategies for Improving Compliance with Health Promotion Programs in Industry.

    Science.gov (United States)

    Feldman, Robert H. L.

    1983-01-01

    Behavioral, educational, and organizational methods for improving the degree to which workers comply with the objectives of industrial health promotion programs are discussed. Compliance can be enhanced through: (1) better program location and scheduling; (2) increased worker satisfaction; (3) use of psychological and educational techniques; and…

  11. The western gulf forest tree improvement program, history and organization

    Science.gov (United States)

    J.P. Van Buijtenen

    1973-01-01

    The following remarks are primarily an account of the experience of the Texas Forest Service in organizing the Western Gulf Forest Tree Improvement Program (WGFTIP) and the philosophy that went into its devetopment. The program of the Texas Forest Service has had two very distinct phases, although in both phases it was a cooperative effort. The initial phase lasted...

  12. 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…

  13. Antifailure therapy including spironolactone improves left ventricular energy supply-demand relations in nonischemic dilated cardiomyopathy.

    Science.gov (United States)

    Bell, Susan P; Adkisson, Douglas W; Lawson, Mark A; Wang, Li; Ooi, Henry; Sawyer, Douglas B; Kronenberg, Marvin W

    2014-08-27

    Left ventricular (LV) energy supply-demand imbalance is postulated to cause "energy starvation" and contribute to heart failure (HF) in nonischemic dilated cardiomyopathy (NIDCM). Using cardiac magnetic resonance (CMR) and [(11)C] acetate positron emission tomography (PET), we evaluated LV perfusion and oxidative metabolism in NIDCM and the effects of spironolactone on LV supply-demand relations. Twelve patients with NIDCM underwent CMR and PET at baseline and after ≥6 months of spironolactone therapy added to a standard HF regimen. The myocardial perfusion reserve index (MPRI) was calculated after gadolinium injection during adenosine, as compared to rest. The monoexponential clearance rate of [(11)C] acetate (kmono) was used to calculate the work metabolic index (WMI), an index of LV mechanical efficiency, and kmono/RPP (rate-pressure product), an index of energy supply/demand. At baseline, the subendocardium was hypoperfused versus the subepicardium (median MPRI, 1.63 vs. 1.80; Penergy starvation. Antifailure therapy improves parameters of energy starvation and is associated with augmented LV performance. http://www.clinicaltrials.gov/ Unique identifier: ID NCT00574119. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  14. Antifailure Therapy Including Spironolactone Improves Left Ventricular Energy Supply‐Demand Relations in Nonischemic Dilated Cardiomyopathy

    Science.gov (United States)

    Bell, Susan P.; Adkisson, Douglas W.; Lawson, Mark A.; Wang, Li; Ooi, Henry; Sawyer, Douglas B.; Kronenberg, Marvin W.

    2014-01-01

    Background Left ventricular (LV) energy supply‐demand imbalance is postulated to cause “energy starvation” and contribute to heart failure (HF) in nonischemic dilated cardiomyopathy (NIDCM). Using cardiac magnetic resonance (CMR) and [11C] acetate positron emission tomography (PET), we evaluated LV perfusion and oxidative metabolism in NIDCM and the effects of spironolactone on LV supply‐demand relations. Methods and Results Twelve patients with NIDCM underwent CMR and PET at baseline and after ≥6 months of spironolactone therapy added to a standard HF regimen. The myocardial perfusion reserve index (MPRI) was calculated after gadolinium injection during adenosine, as compared to rest. The monoexponential clearance rate of [11C] acetate (kmono) was used to calculate the work metabolic index (WMI), an index of LV mechanical efficiency, and kmono/RPP (rate‐pressure product), an index of energy supply/demand. At baseline, the subendocardium was hypoperfused versus the subepicardium (median MPRI, 1.63 vs. 1.80; Psubendocardial hypoperfusion and impaired myocardial oxidative metabolism, consistent with energy starvation. Antifailure therapy improves parameters of energy starvation and is associated with augmented LV performance. Clinical Trial Registration URL: http://www.clinicaltrials.gov/ Unique identifier: ID NCT00574119. PMID:25164945

  15. 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.

  16. An improved method for including upper size range plasmids in metamobilomes.

    Directory of Open Access Journals (Sweden)

    Anders Norman

    accessory elements that reside on medium-to-large plasmids has been improved.

  17. Improving Public Health DSSs by Including Saharan Dust Forecasts Through Incorporation of NASA's GOCART Model Results

    Science.gov (United States)

    Berglund, Judith

    2007-01-01

    Approximately 2-3 billion metric tons of soil dust are estimated to be transported in the Earth's atmosphere each year. Global transport of desert dust is believed to play an important role in many geochemical, climatological, and environmental processes. This dust carries minerals and nutrients, but it has also been shown to carry pollutants and viable microorganisms capable of harming human, animal, plant, and ecosystem health. Saharan dust, which impacts the eastern United States (especially Florida and the southeast) and U.S. Territories in the Caribbean primarily during the summer months, has been linked to increases in respiratory illnesses in this region and has been shown to carry other human, animal, and plant pathogens. For these reasons, this candidate solution recommends integrating Saharan dust distribution and concentration forecasts from the NASA GOCART global dust cycle model into a public health DSS (decision support system), such as the CDC's (Centers for Disease Control and Prevention's) EPHTN (Environmental Public Health Tracking Network), for the eastern United States and Caribbean for early warning purposes regarding potential increases in respiratory illnesses or asthma attacks, potential disease outbreaks, or bioterrorism. This candidate solution pertains to the Public Health National Application but also has direct connections to Air Quality and Homeland Security. In addition, the GOCART model currently uses the NASA MODIS aerosol product as an input and uses meteorological forecasts from the NASA GEOS-DAS (Goddard Earth Observing System Data Assimilation System) GEOS-4 AGCM. In the future, VIIRS aerosol products and perhaps CALIOP aerosol products could be assimilated into the GOCART model to improve the results.

  18. 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.

  19. An intensive physiotherapy program improves mobility for trauma patients.

    Science.gov (United States)

    Calthorpe, Sara; Barber, Elizabeth A; Holland, Anne E; Kimmel, Lara; Webb, Melissa J; Hodgson, Carol; Gruen, Russell L

    2014-01-01

    Physiotherapy is integral to modern trauma care. Early physiotherapy and mobility have been shown to improve outcomes in patients with isolated injuries; however, the optimal intensity of physiotherapy in the multitrauma patient population has not yet been examined. The primary aim of this study was to determine whether an intensive physiotherapy program resulted in improved inpatient mobility. We conducted a single-center prospective randomized controlled study of 90 consecutive patients admitted to the Alfred Hospital (a Level 1 trauma center) in Australia between October 2011 and June 2012 who could participate in ward-based physiotherapy. Participants were allocated to either usual care (daily physiotherapy treatment, approximately 30 minutes) or intensive physiotherapy (usual care plus two additional 30-minute treatments each day). The primary outcome measure was the modified Iowa Level of Assistance (mILOA) score, collected by a blinded assessor at Days 3 and 5 (or earlier if discharged). Secondary measures included physical readiness for discharge, hospital and rehabilitation length of stay, a patient confidence and satisfaction scale, and quality of life at 6 months. Groups were comparable at baseline. Participants in the intensive physiotherapy group achieved significantly improved mILOA scores on Day 3 (median, 7 points compared with 10 points; p = 0.02) and Day 5 (median, 7.5 points compared with 16 points; p = 0.04) and were more satisfied with their care (p = 0.01). There was no difference between groups in time to physical readiness, discharge destination, length of stay, or quality-of-life measures. Intensive physiotherapy resulted in improved mobility in trauma inpatients. Further studies are required to determine if specific groups benefit more from intensive physiotherapy and if this translates to long-term improvements in outcomes. Therapeutic study, level 1.

  20. Facilitating Institutional Oversight and Program Improvement Through Educational Competency Committees.

    Science.gov (United States)

    Andolsek, Kathryn M; Fortune, Rhea F; Nagler, Alisa; Stancil, Chrystal; Kuhn, Catherine; McNeill, Diana

    2016-07-01

    The Accreditation Council for Graduate Medical Education (ACGME) requires programs to engage annually in program evaluation and improvement. We assessed the value of creating educational competency committees (ECCs) that use successful elements of 2 established processes-institutional special reviews and institutional oversight of annual program evaluations. The ECCs used a template to review programs' annual program evaluations. Results were aggregated into an institutional dashboard. We calculated the costs, sensitivity, specificity, and predictive value by comparing programs required to have a special review with those that had ACGME citations, requests for a progress report, or a data-prompted site visit. We assessed the value for professional development through a participant survey. Thirty-two ECCs involving more than 100 individuals reviewed 237 annual program evaluations over a 3-year period. The ECCs required less time than internal reviews. The ECCs rated 2 to 8 programs (2.4%-9.8%) as "noncompliant." One to 13 programs (1.2%-14.6%) had opportunities for improvement identified. Institutional improvements were recognized using the dashboard. Zero to 13 programs (0%-16%) were required to have special reviews. The sensitivity of the decision to have a special review was 83% to 100%; specificity was 89% to 93%; and negative predictive value was 99% to 100%. The total cost was $280 per program. Of the ECC members, 86% to 95% reported their participation enhanced their professional development, and 60% to 95% believed the ECC benefited their program. Educational competency committees facilitated the identification of institution-wide needs, highlighted innovation and best practices, and enhanced professional development. The cost, sensitivity, specificity, and predictive value indicated good value.

  1. 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...

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

    Science.gov (United States)

    Pierre, Ketly Dieudonne

    2014-01-01

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

  3. 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...

  4. 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.

  5. 76 FR 9283 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...

    Science.gov (United States)

    2011-02-17

    ... base of an OPPC, we propose to define OPPC to include, at a minimum, wrong surgical or other invasive... experience serious injury and/or death if they undergo erroneous surgical or other invasive procedures and.... Under these NCDs, Medicare does not cover a particular surgical or other invasive procedure to treat a...

  6. 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.

  7. Early Experience with a Hepatobiliary and Pancreatic Quality Improvement Program.

    Science.gov (United States)

    O'Reilly, Derek; Edmiston, Rachel; Bijoor, Pooja; Deshpande, Rahul; de'Liguori Carino, Nicola; Ammori, Basil; Sherlock, David J

    2014-01-01

    This project aims to assess the impact of the introduction of a hepatobiliary and pancreatic (HPB) Quality Improvement Program (QIP) on postoperative complications following liver, biliary and pancreatic surgery. A prospective analysis of postoperative complications over a six month period was performed. Complications were analysed and graded according to internationally agreed definitions. Justification was sought and errors identified. Weekly meetings were performed to review each complication enabling an action plan to be created to prevent future recurrence. Rates were compared with previously audited and published results, using the chi-square test. A total of 326 procedures were performed over the six months including 30 pancreatectomies, 45 liver resections and 251 other procedures. 37 patients developed complications (11.3%) with 47 complications in total including two deaths. Using the ISGPS grading, eight complications were identified; two grade A, four grade B and two grade C. There were three grade A ISGLS complications and one grade B. 30 complications were justified as unavoidable, 16 as avoidable and one as indeterminate. Action plans included continued monitoring (n=41), formulation of new policy (n=3), individual counselling (n=4), educational offering (n=4). When compared with 2010 complication rates, 114 complications occurred in 233 liver operations during the baseline period, compared with 17 complications in 45 liver operations during the QIP period, OR=0.63 (95% CI: 0.33 to 1.22), p=0.17 and 86 complications occurred in 99 pancreatic resections during the baseline period, compared with 20 complications in 30 pancreatic resections during the QIP period OR=0.30 (95% CI: 0.12 to 0.79), p=0.01 The HPB QIP is a rigorous approach to grade every complication and death. A statistically significant reduction in pancreas related complications has already been obtained. Further work is required to determine the persistence and magnitude of this quality

  8. Implementation of an after-school obesity prevention program: helping young children toward improved health.

    Science.gov (United States)

    Nabors, Laura; Burbage, Michelle; Woodson, Kenneth D; Swoboda, Christopher

    2015-03-01

    Obesity prevention programs that are delivered in after-school programs are needed as a focus on curriculum can make it difficult to include this health programming during the school day. The current study examined the implementation of 2 pilot programs in different after-school programs for young children. There were 36 children in the intervention groups and 18 children in comparison groups. Children learned about healthy eating and increasing involvement in physical activity. Lessons were based on the Traffic Light Diet. Results indicated improvement in children's reports of their eating habits. Activity levels improved in 1 school, but not in the other. Parents and children were satisfied with the program and children demonstrated good knowledge of the interventions to promote healthy eating. Future studies should include larger sample sizes and evaluation of the effectiveness of different components of the intervention. Nurses can play a key role in disseminating information and designing and leading after-school programs to improve child knowledge about healthy eating and exercise. Nursing students may also benefit from assisting with conducting these types of programs to improve their experience in health prevention programming.

  9. Guide for Operational Configuration Management Program including the adjunct programs of design reconstitution and material condition and aging management. Part 2

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    This standard presents program criteria and implementation guidance for an operational configuration management program for DOE nuclear and non-nuclear facilities. This Part 2 includes chapters on implementation guidance for operational configuration management, implementation guidance for design reconstitution, and implementation guidance for material condition and aging management. Appendices are included on design control, examples of design information, conduct of walkdowns, and content of design information summaries.

  10. 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.

  11. 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

  12. Afterschool Programs: Making a Difference in America's Communities by Improving Academic Achievement, Keeping Kids Safe and Helping Working Families

    Science.gov (United States)

    Afterschool Alliance, 2008

    2008-01-01

    This 2-page resource describes the benefits of afterschool programs for children, youth, and families, including evidence of improved school attendance and engagement learning, improved test scores and grades, and students at greatest risk showing the greatest gains. Additional benefits of afterschool programs include keeping kids safe, healthy,…

  13. 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...

  14. 12 CFR 303.46 - Financial education programs that include the provision of bank products and services.

    Science.gov (United States)

    2010-01-01

    ... principles of personal financial management, banking operations, or the benefits of saving for the future... 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...

  15. 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 model including FAT. In addition, it was found that single-trait models underestimated genetic trend of fertility traits. These results suggested that genetic evaluation of fertility traits would be improved using a multiple-trait model including MILK or PROT...... within 56 d after first service) were analyzed using single- and multiple-trait sire models including 1 or 3 production traits. Model stability was evaluated by correlation between EBV from 2 sub-data sets (DATAA and DATAB). Model predictive ability was assessed by the correlation between EBV from...

  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

    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 conduct replications of existing program evaluations, identify implementation components linked to impacts

  17. NASA/General Electric Engine Component Improvement Program

    Science.gov (United States)

    Albright, A. J.; Lennard, D. J.; Ziemianski, J. A.

    1978-01-01

    The Engine Component Improvement (ECI) Program has been initiated in connection with projects designed to reduce the impact of the world-wide energy crisis in the area of aviation. The two parts of the ECI program have the overall objective to identify and quantify the sources and causes of CF6 engine performance deterioration, and to reduce the fuel consumption of CF6 engines through the development and the incorporation of various performance improvement concepts. The CF6 high-bypass turbofan engine was selected as a basis for this effort, since it is expected to be a significant fuel user in commercial revenue service for the next 15 to 20 years. The first part of the ECI program represents the initial step in an effort to achieve a goal of five percent reduction in fuel usage for CF6 engines in the 1979-82 time period. The first performance improvement concept selected is an improved efficiency fan blade. Other improvements are related to a short core exhaust system and an improved high pressure turbine.

  18. Program Self-Review Procedures. Ohio Program Review for Improvement, Development, and Expansion in Vocational Education.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    The Ohio Program Review for Improvement, Development, and Expansion (PRIDE) in Vocational Education is a comprehensive program review system designed to define, secure, and provide useful information relative to selected vocational education objectives. This document was designed to assist the local vocational education personnel in planning and…

  19. Geothermal Exploration and Assessment Technology Program (review), including a report of the Reservoir Engineering Technical Advisory Group

    Energy Technology Data Exchange (ETDEWEB)

    Nielson, D.L. (ed.)

    1979-12-01

    The FY 1979 Program, recommended seismic surveys in conjunction with DOE/DGE's industry coupled program in the Northern Basin and Range Province, and the objectives of the Marina del Rey conference are presented. Final reports of six committees which met to define the state-of-the-art in geothermal exploration and to recommend exploration technology development are included. These committees are: structure, stratigraphy, and igneous processes; exploration architecture; electrical methods; seismic methods; thermal methods; water/rock interaction; and reservoir engineering. (MHR)

  20. Improving a Modular Verification Technique for Aspect Oriented Programming

    NARCIS (Netherlands)

    Laarman, Alfons; Huijs, C.

    2006-01-01

    As aspect oriented software becomes more popular, there will be more demand for a method of verifying the correctness of the programs. This paper tries to address the verification issue by improving a modular verification technique proposed by Krisnamuhrti et al. The technique has the problem that

  1. 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…

  2. Standardized Test Results: An Opportunity for English Program Improvement

    Science.gov (United States)

    Jiménez, Maureyra; Rodríguez, Caroll; Rey Paba, Lourdes

    2017-01-01

    This case study explores the relationship between the results obtained by a group of Industrial Engineering students on a national standardized English test and the impact these results had on language program improvement. The instruments used were interviews, document analysis, observations, surveys, and test results analysis. Findings indicate…

  3. Eleventh Annual Report of Accomplishments Under the Airport Improvement Program

    Science.gov (United States)

    1992-01-01

    amended. >S 17. Key Words 18. Distribution Statement Airport Improvement Program ( ALP ) Availability unlimited. Document may be Grants released to the...INSTALL RUNWAY/TAXIWAY SIGNS GLACIER PARK INTERNATIONAL (PRIMARY) MISSOULA 16 $567,000 INSTALL SECURITY SYSTEM AND FENCING MISSOULA INTERNATIONAL

  4. 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…

  5. 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.

  6. 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…

  7. 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; 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 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.

  8. 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.

  9. Accuracy of weight estimation by the Broselow tape is substantially improved by including a visual assessment of body habitus.

    Science.gov (United States)

    Wells, Mike; Goldstein, Lara; Bentley, Alison

    2017-10-18

    BackgroundThe Broselow tape (BT) has been shown to estimate weight poorly primarily because of variations in body habitus. The manufacturers have suggested that a visual assessment of habitus may be used to increase its performance. This study evaluated the ability of habitus-modified models to improve the accuracy thereof.MethodsA post hoc analysis of prospectively collected data from four hospitals in Johannesburg, South Africa, on a population of 1,085 children. Sixteen a priori models generated a modified weight estimation or drug dose based on the BT weight and a gestalt assessment of habitus.ResultsThe habitus-modified method suggested by the manufacturer did not improve the accuracy of the BT. Five dosing and four weight-estimation models were identified that markedly improved dosing and weight estimation accuracy, respectively. The best dosing model improved dosing accuracy (doses within 10% of correct dose) from 52.0 to 69.6% and reduced critical dosing errors from 16.5 to 4.3%. The best weight-estimation model improved accuracy from 59.4 to 81.9% and reduced critical errors from 11.8 to 1.9%.ConclusionThe accuracy of the BT as a drug-dosing and weight-estimation device can be substantially improved by including an appraisal of body habitus in the methodology.Pediatric Research advance online publication, 18 October 2017; doi:10.1038/pr.2017.222.

  10. 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 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.

  11. 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.

  12. The effect of a resilience improvement program for adolescents with complex congenital heart disease.

    Science.gov (United States)

    Lee, Sunhee; Lee, Junga; Choi, Jae Young

    2017-04-01

    Adolescents with congenital heart disease need to increase their resilience in the face of challenges in order to preserve their health and quality of life. This study aimed to develop a resilience improvement program for adolescents with congenital heart disease and also to evaluate any change in resilience and quality of life as a measure of the effectiveness of the resilience improvement programs. A nonequivalent control group pretest-posttest study was designed. Twenty-five adolescents who attended the first resilience improvement program were included in the experimental group, and 31 adolescents who took part in the second program were placed in the control group. Adolescents with congenital heart disease completed a self-report questionnaire on three separate occasions: the pretest, the first posttest and the second posttest. The self-report questionnaire included general characteristics and instruments to measure resilience and quality of life. For the longitudinal analysis, generalized estimating equations were used to evaluate the difference in the estimated average trajectories of resilience and quality of life changes. Independent predictors of resilience improvement in adolescents with congenital heart disease were the experimental group ( p=0.02) and middle and high school students ( p=0.02). Quality of life was not associated with membership in the experimental group. However, males scored higher than females on quality of life measures ( p=0.02). It is essential for healthcare providers to apply various programs, including those targeted at accepting illness, improving autonomy and independently managing disease, to adolescents with congenital heart disease.

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

    Science.gov (United States)

    Silva, Pedro Gabriel Melo de Barros e; Baruzzi, Antônio Claudio do Amaral; Ramos, Denise Louzada; Okada, Mariana Yumi; Garcia, José Carlos Teixeira; Cardoso, Fernanda de Andrade; Rodrigues, Marcelo Jamus; Furlan, Valter

    2015-01-01

    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. PMID:26934408

  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. 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

  16. 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

  17. MSTor: A program for calculating partition functions, free energies, enthalpies, entropies, and heat capacities of complex molecules including torsional anharmonicity

    Science.gov (United States)

    Zheng, Jingjing; Mielke, Steven L.; Clarkson, Kenneth L.; Truhlar, Donald G.

    2012-08-01

    We present a Fortran program package, MSTor, which calculates partition functions and thermodynamic functions of complex molecules involving multiple torsional motions by the recently proposed MS-T method. This method interpolates between the local harmonic approximation in the low-temperature limit, and the limit of free internal rotation of all torsions at high temperature. The program can also carry out calculations in the multiple-structure local harmonic approximation. The program package also includes six utility codes that can be used as stand-alone programs to calculate reduced moment of inertia matrices by the method of Kilpatrick and Pitzer, to generate conformational structures, to calculate, either analytically or by Monte Carlo sampling, volumes for torsional subdomains defined by Voronoi tessellation of the conformational subspace, to generate template input files, and to calculate one-dimensional torsional partition functions using the torsional eigenvalue summation method. Catalogue identifier: AEMF_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEMF_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 77 434 No. of bytes in distributed program, including test data, etc.: 3 264 737 Distribution format: tar.gz Programming language: Fortran 90, C, and Perl Computer: Itasca (HP Linux cluster, each node has two-socket, quad-core 2.8 GHz Intel Xeon X5560 “Nehalem EP” processors), Calhoun (SGI Altix XE 1300 cluster, each node containing two quad-core 2.66 GHz Intel Xeon “Clovertown”-class processors sharing 16 GB of main memory), Koronis (Altix UV 1000 server with 190 6-core Intel Xeon X7542 “Westmere” processors at 2.66 GHz), Elmo (Sun Fire X4600 Linux cluster with AMD Opteron cores), and Mac Pro (two 2.8 GHz Quad-core Intel Xeon

  18. Teacher training program for medical students: improvements needed.

    Science.gov (United States)

    van Diggele, Christie; Burgess, Annette; Mellis, Craig

    2015-01-01

    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. 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. 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. 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.

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

    DEFF Research Database (Denmark)

    Matyusz, Zsolt; Demeter, Krisztina; Boer, Harry

    have broad scope of operations). We apply structural equation modelling (SEM) using PLS path modelling to investigate the effect of scope of operations on the relationship between manufacturing improvement programs and operational performance. Manufacturing improvement programs are programs like...... quality improvement, product development, automation, etc. Operational performance includes a range of indicators related to cost, quality, time and flexibility. Data were acquired through the International Manufacturing Strategy Survey executed in 2005 in engineering and assembly industries (ISIC 28......The link between manufacturing programs and operational performance, and the effects of company internal and external factors on that relationship, are well studied in the literature, both theoretically and empirically. However, previous studies rarely took into account how the scope of operations...

  20. Recommendations for improvements to program and project management

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-01

    Oak Ridge National Laboratory (ORNL) has operated with a balanced matrix organization for over sixteen years. Much of the work at the Laboratory is accomplished with good customer satisfaction through programs, projects, and matrix management. During the past several years concerns about program and project management at ORNL have been expressed by both the Department of Energy and ORNL staff. In May 1993 the ORNL Division/Program/Office Directors Caucus chartered a ``fox team`` to identity and to recommend improvements to matrix management that would lead to resolution of these concerns. Nine experienced ORNL staff members served on this Matrix Management Upgrade Solutions Team (MMUST). The MMUST adopted a four-phase approach in which they first gathered information and then developed and proposed recommended actions. In the fourth phase the team was available to support implementation of the recommendations. They began work in June 1993, gathering and evaluating information in biweekly meetings for six months. Recommendations developed in October and November 1993 were presented to ORNL management in December. The MMUST issued three principal recommendations based on their evaluation of the information gathered. They are: Renew and enhance the ORNL management commitment to matrix management, program managers, and project managers; Implement actions to ensure career path parity between the program/project manager family of positions and the technical line manager family of positions across all directorates and divisions; and Clarify and document program/project manager roles, responsibilities, and authorities.

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

    Directory of Open Access Journals (Sweden)

    Chandrakant Lahariya

    2015-01-01

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

  2. American Organization of Nurse Executives Care Innovation and Transformation program: improving care and practice environments.

    Science.gov (United States)

    Oberlies, Amanda Stefancyk

    2014-09-01

    The American Organization of Nurse Executives conducted an evaluation of the hospitals participating in the Care Innovation and Transformation (CIT) program. A total of 24 hospitals participated in the 2-year CIT program from 2012 to 2013. Reported outcomes include increased patient satisfaction, decreased falls, and reductions in nurse turnover and overtime. Nurses reported statistically significant improvements in 4 domains of the principles and elements of a healthful practice environment developed by the Nursing Organizations Alliance.

  3. Improving Locality for ODE Solvers by Program Transformations

    Directory of Open Access Journals (Sweden)

    Thomas Rauber

    2004-01-01

    Full Text Available Runge-Kutta methods are popular methods for the solution of ordinary differential equations and implementations are provided by many scientific libraries. The performance of Runge-Kutta methods depends on the specific application problem to be solved, but also on the characteristics of the target machine. For processors with a memory hierarchy, the locality of data referencing pattern has a large impact on the efficiency of a program. In this paper, we describe program transformations for Runge-Kutta methods resulting in implementations with improved locality behavior for systems of ODEs. The transformations are based on properties of the solution method but are independent from the specific application problem or the specific target machine so that the resulting implementation is suitable as library function. We show that the locality improvement leads to performance gains on different recent microprocessors.

  4. Improving sleep: outcomes from a worksite healthy sleep program.

    Science.gov (United States)

    Steffen, Mark W; Hazelton, Angela C; Moore, Wendy R; Jenkins, Sarah M; Clark, Matthew M; Hagen, Philip T

    2015-01-01

    Unhealthy and inadequate sleep is a common and significant problem impacting absenteeism, presenteeism, health, and productivity. This study aimed at analyzing the effect of a worksite-based healthy sleep program. Retrospective analysis of 53 adult members of a worksite wellness center who participated in an 8-week healthy sleep program and completed pre- and postintervention health behavior questionnaires. Following the intervention participants felt significantly more rested, more confident in their ability to deal with sleep problems, and more knowledgeable about sleep. In addition, they reported a reduction in their stress level, improved quality of life, and increase energy level. These results support the effectiveness of worksite programs designed to promote healthy sleep. Future randomized studies are needed to further investigate the effectiveness and optimal delivery of healthy sleep promotion.

  5. Interdisciplinary Skills Review Program to Improve Team Responses During Postpartum Hemorrhage.

    Science.gov (United States)

    Bittle, Marianne; O'Rourke, Kathleen; Srinivas, Sindhu K

    2017-12-06

    To develop an interdisciplinary, interactive, skills review program to improve team responses during a postpartum hemorrhage (PPH). Online didactic modules in combination with an interdisciplinary skills program consisting of seven hemorrhage-related stations. The project was conducted in the Women's Health Department in a quaternary-care Magnet- and Baby Friendly-designated academic medical center in Philadelphia, Pennsylvania. Women cared for at this center have comorbidities that place them at greater risk for PPH. A need was identified to implement a multidisciplinary and comprehensive program to assess hemorrhage risk and appropriately recognize and intervene with all PPHs in this setting. The 276 participants, including registered nurses, obstetric and family medicine attending physicians and residents, advanced practice nurses, and ancillary staff in the hospital's Women's Health Department, completed the initial obstetric hemorrhage program. The program included online didactic modules, seven interdisciplinary skills stations led by trained nurses and providers, and an in situ simulation. Successful completion of the online modules was a prerequisite for participation in the skills stations. All participants completed a written program evaluation at the conclusion of the program. Results of the postassessment survey indicated that participants rated the program 3.94 of 4.00 for overall effectiveness to improve interdisciplinary team responses to PPH. Comments were overwhelmingly positive, and participants expressed increased confidence and knowledge related to PPH after completion of the program. An interdisciplinary program that included online didactic modules, interactive skills stations, and simulation improved team confidence and responses to PPH. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  6. 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....

  7. Improving the Productivity of JOBS Programs. Papers for Practitioners.

    Science.gov (United States)

    Bardach, Eugene

    The key to success in Job Opportunities and Basic Skills Training (JOBS) programs is a philosophy of high expectations. The philosophy accommodates both client and societal concerns. Highlights of the philosophy include the following: respecting the client's goals; giving nonjudgmental acceptance, constant encouragement, and emotional support;…

  8. 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.

  9. The Role of Endothelial Dysfunction Markers in Pregnant Women with Chorion Detachment, Included in the Program of Auxiliary Reproductive Technologies

    Directory of Open Access Journals (Sweden)

    Natalya Lytvyn

    2017-10-01

    Full Text Available An urgent medical and social problem is the restoration of reproductive function of womenwho suffer from infertility, which became possible due to auxiliary reproductive technologies. Women with induced pregnancy make thegroup of a high-risk on miscarriage, due to interrelated processes –immunological disorders and endothelial dysfunction that occur in the body of pregnant women after the use of extracorporal fertilization programs, and can lead to the chorion detachment and the formation of subchorionic hematomas. The purpose of the study is to determine the role of endothelial dysfunction as one of the leading factors that determine the development of a local non-progressive chorion detachment in infertile patients included in the program of auxiliary reproductive technologies. Materials and methods. We have examined 130 pregnant women, who were divided into groups: the control group included 30 women, whose pregnancy occurred in the natural cycle and with uncomplicated gestational course; the main group – 50 patients with induced pregnancy and risk factors of the occurrence of chorion detachment, who wereperformed the proposed pre-gravidapreparation; the comparative group – 50 pregnant women who received a standard scheme of pregnancy management before and after in-vitro fertilization. A general clinical examination, ultrasound examination, homocysteine level determination, endothelin-1 and nitrogen oxide metabolites were performed. Results. In women included into the program of auxiliary reproductive technologies with local chorion detachment were recorded changes of vascular endothelial function with a possible increase in endothelin-1 production and a decrease of the nitric oxidesynthesis. During the induced pregnancy with the presence of subchorionic hematoma, an increase of the level of endothelium-damaging factor of homocysteine was noted. Conclusions.This study identifies the parameters that reflect the main links of endothelial

  10. 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…

  11. Improving environmental and social targeting through adaptive management in Mexico's payments for hydrological services program.

    Science.gov (United States)

    Sims, Katharine R E; Alix-Garcia, Jennifer M; Shapiro-Garza, Elizabeth; Fine, Leah R; Radeloff, Volker C; Aronson, Glen; Castillo, Selene; Ramirez-Reyes, Carlos; Yañez-Pagans, Patricia

    2014-10-01

    Natural resource managers are often expected to achieve both environmental protection and economic development even when there are fundamental trade-offs between these goals. Adaptive management provides a theoretical structure for program administrators to balance social priorities in the presence of trade-offs and to improve conservation targeting. We used the case of Mexico's federal Payments for Hydrological Services program (PSAH) to illustrate the importance of adaptive management for improving program targeting. We documented adaptive elements of PSAH and corresponding changes in program eligibility and selection criteria. To evaluate whether these changes resulted in enrollment of lands of high environmental and social priority, we compared the environmental and social characteristics of the areas enrolled in the program with the characteristics of all forested areas in Mexico, all areas eligible for the program, and all areas submitted for application to the program. The program successfully enrolled areas of both high ecological and social priority, and over time, adaptive changes in the program's criteria for eligibility and selection led to increased enrollment of land scoring high on both dimensions. Three factors facilitated adaptive management in Mexico and are likely to be generally important for conservation managers: a supportive political environment, including financial backing and encouragement to experiment from the federal government; availability of relatively good social and environmental data; and active participation in the review process by stakeholders and outside evaluators. © 2014 Society for Conservation Biology.

  12. 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

  13. 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…

  14. Improved design for driven piles based on a pile load test program in Illinois : phase 2.

    Science.gov (United States)

    2014-09-01

    A dynamic load test program consisting of 38 sites and 111 piles with restrikes was conducted throughout Illinois : to improve the Illinois Department of Transportation design of driven piling. Pile types included steel H-piles and : closed-ended pip...

  15. 34 CFR 637.4 - What definitions apply to the Minority Science and Engineering Improvement Program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false What definitions apply to the Minority Science and... ENGINEERING IMPROVEMENT PROGRAM General § 637.4 What definitions apply to the Minority Science and Engineering..., physical, behavorial and social sciences, and the history and philosophy of science; also included are...

  16. [Improved program maintenance of the CIRCIS dosimetric planning system].

    Science.gov (United States)

    Sevast'ianov, A I; Liutova, N A; Ratner, T G

    1983-03-01

    A special computer complex CIRCIS (Informatique, France) is used in the All-Union Cancer Research Center, USSR AMS, for the dosimetric planning of radiotherapy on 5 gamma-beam units and electron accelerator. Mathematical maintenance of the complex includes programs of the calculation of dose distribution for gamma-, inhibition and electron radiation but has no program of the calculation of the time of irradiation. The authors have devised and introduced into the complex such a program in the Fortran language that makes it possible to calculate within 2-3 min the time of irradiation for multifield rotation therapy using several units as a time, thus expediting the dosimetric planning for patients' irradiation.

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

    Energy Technology Data Exchange (ETDEWEB)

    Crouthamel, C.E. (comp.)

    1978-10-01

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

  18. Improving Service Quality of Rusunawa Implementation Program in Kudus

    Directory of Open Access Journals (Sweden)

    Septiana Pancawati

    2014-02-01

    Full Text Available Development of housing and settlements are still faced the main problems as follows: the limited supply of homes, inadequate housing that is not supported by infrastructure, environmental facilities and public utilities, as well as the growing slums widespread. Government issues Rusunawa Implementation Program to overcome those problems. However some problems arose in its implementation, such as poor environmental condition, poor building quality, inadequate infrastructure and public services. The objectives of the research are to describe, to analyze, and to interpret things as follows: (1 The management of Rusunawa implementation program in order to improve service quality, (2 Improving service quality of Rusunawa program by the authorities. This research used qualitative method with descriptive approach. Information can be obtained byinterview stakeholders, field observations and documentation. From research findings, there are some records that should be highlighted as follows: (1 Rusunawa construction and its supervision influence the building quality. Low performance of those service providers will result in low building quality and vice versa. (2 Rent arrears are higher, an indication of dissatisfaction Rusunawa residents during they stay there. Keywords: Rusunawa, building condition, service quality

  19. Program home visit Costa Rica's health system: guidelines for improvement

    Directory of Open Access Journals (Sweden)

    Katherine Solís Cordero

    2015-07-01

    Full Text Available Introduction. Home visit is the main strategy of primary care by bringing health services to the homes and workplaces of people, which allows knowing the needs of the population firsthand. Thus, home visit by the ATAP represents the first contact of the individual, family and community with the health system, with significant benefits both individually and collectively. This research responds to the need to identify the elements that the home visiting program needs to improve modify or replace in order to maximize the provision of this service.Method. It is a qualitative, observational analytic study. Data were collected through documentary research, key informant interviews and focus group. The analysis was performed from the grounded theory.Results. The main results showed the existence of elements at the level of the health system, home visiting program and the figure of the ATAP that should be reviewed, modified or replaced to the home visit, thus it has bigger and better results for the population and the health system.Conclusion. The Home Visiting Program is strength of the Costa Rican health system to address health inequities. However, it is imperative to make decisions and implementation of actions that promote the improvement and increased results of the home visit at a family and community level.

  20. 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.

  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. Introductory Computer Programming Course Teaching Improvement Using Immersion Language, Extreme Programming, and Education Theories

    Science.gov (United States)

    Velez-Rubio, Miguel

    2013-01-01

    Teaching computer programming to freshmen students in Computer Sciences and other Information Technology areas has been identified as a complex activity. Different approaches have been studied looking for the best one that could help to improve this teaching process. A proposed approach was implemented which is based in the language immersion…

  3. Strategies for establishing a comprehensive quality and performance improvement program in a radiology department.

    Science.gov (United States)

    Kruskal, Jonathan B; Anderson, Stephan; Yam, Chun S; Sosna, Jacob

    2009-01-01

    To improve the safety and quality of the care that radiologists provide, and to allow radiologists and radiology personnel to remain competitive in an increasingly complex environment, it is essential that all imaging departments establish and maintain managed, comprehensive, and effective performance improvement programs. Although the structure and focus of these programs can vary, a number of common components exist, many of which are now widely mandated by organizations that regulate the field of radiology. Basic components include patient safety, process improvement, customer service, professional staff assessment, and education, each of which requires strategies for implementing continuous programs to monitor performance, analyzing and depicting data, implementing change, and meeting regulatory requirements. All of these components are part of a comprehensive quality management system in a large academic radiology department. For smaller departments or practices, the gradual introduction of one or more of these components is useful in ensuring the safety and quality of their services. (c) RSNA, 2009.

  4. Program for the improvement of downhole drilling motors

    Energy Technology Data Exchange (ETDEWEB)

    Finger, J.T.

    1983-11-01

    This report describes the work done under contract to Sandia National Labs and to the Department of Energy for improvement of downhole drilling motors. The focus of this program was the development of a better bearing-and-seal assembly that could be used in different kinds of drilling motors in a geothermal environment. Major tasks were: (1) design and construction of seal testing devices, (2) screening and evaluation of candidate seals in a simulated bearing/seal package, (3) tests of the most promising candidates in a full-scale bearing/seal package, and (4) analysis of failed seals after testing. The key results from this program were: (1) identification of seal/shaft/lubricant systems that performed well at high pressure and temperature, (2) identification of other seal designs that should be avoided for similar applications, and (3) evaluation of the test machines' design.

  5. Improving Metabolic and Cardiovascular Health at an Early Psychosis Intervention Program in Vancouver, Canada

    Science.gov (United States)

    Fredrikson, Diane H.; Boyda, Heidi N.; Tse, Lurdes; Whitney, Zachary; Pattison, Mark A.; Ott, Fred J.; Hansen, Laura; Barr, Alasdair M.

    2014-01-01

    Psychotic disorders most commonly appear during the late teenage years and early adulthood. A focused and rapid clinical response by an integrated health team can help to improve the quality of life of the patient, leading to a better long-term prognosis. The Vancouver Coastal Health early psychosis intervention program covers a catchment area of approximately 800,000 people in the cities of Vancouver and Richmond, Canada. The program provides a multidisciplinary approach to supporting patients under the age of 30 who have recently experienced first-break psychosis. The program addresses the needs of the treatment environment, medication, and psychological therapies. A critical part of this support includes a program to specifically improve patients’ physical health. Physical health needs are addressed through a two-pronged, parallel approach. Patients receive routine metabolic health assessments during their first year in the program, where standard metabolic parameters are recorded. Based on the results of clinical interviews and laboratory tests, specific actionable interventions are recommended. The second key strategy is a program that promotes healthy lifestyle goal development. Patients work closely with occupational therapists to develop goals to improve cardiometabolic health. These programs are supported by an active research environment, where patients are able to engage in studies with a focus on improving their physical health. These studies include a longitudinal evaluation of the effects of integrated health coaching on maintaining cardiometabolic health in patients recently admitted to the program, as well as a clinical study that evaluates the effects of low versus higher metabolic risk antipsychotic drugs on central adiposity. An additional pharmacogenomic study is helping to identify genetic variants that may predict cardiometabolic changes following treatment with antipsychotic drugs. PMID:25249985

  6. 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

  7. Improvement in Quality Metrics by the UPMC Enhanced Care Program: A Novel Super-Utilizer Program.

    Science.gov (United States)

    Bryk, Jodie; Fischer, Gary S; Lyons, Anita; Shroff, Swati; Bui, Thuy; Simak, Deborah; Kapoor, Wishwa

    2017-09-25

    The aim was to evaluate pre-post quality of care measures among super-utilizer patients enrolled in the Enhanced Care Program (ECP), a primary care intensive care program. A pre-post analysis of metrics of quality of care for diabetes, hypertension, cancer screenings, and connection to mental health care for participants in the ECP was conducted for patients enrolled in ECP for 6 or more months. Patients enrolled in ECP showed statistically significant improvements in hemoglobin A1c, retinal exams, blood pressure measurements, and screenings for colon cancer, and trends toward improvement in diabetic foot exams and screenings for cervical and breast cancer. There was a significant increase in connecting patients to mental health care. This study shows that super-utilizer patients enrolled in the ECP had significant improvements in quality metrics from those prior to enrollment in ECP.

  8. 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.

  9. 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.

  10. 45 CFR 284.30 - What information must the State include in its assessment of the impact of the TANF program(s) in...

    Science.gov (United States)

    2010-10-01

    ... program(s); (2) The total amount of State and Tribal spending on TANF cash assistance payments; (3) The... Food Stamp Program or other State supportive and assistance programs; (4) The proportion of students...

  11. Improving spatial microsimulation estimates of health outcomes by including geographic indicators of health behaviour: The example of problem gambling.

    Science.gov (United States)

    Markham, Francis; Young, Martin; Doran, Bruce

    2017-07-01

    Gambling is an important public health issue, with recent estimates ranking it as the third largest contributor of disability adjusted life years lost to ill-health. However, no studies to date have estimated the spatial distribution of gambling-related harm in small areas on the basis of surveys of problem gambling. This study extends spatial microsimulation approaches to include a spatially-referenced measure of health behaviour as a constraint variable in order to better estimate the spatial distribution of problem gambling. Specifically, this study allocates georeferenced electronic gaming machine expenditure data to small residential areas using a Huff model. This study demonstrates how the incorporation of auxiliary spatial data on health behaviours such as gambling expenditure can improve spatial microsimulation estimates of health outcomes like problem gambling. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Umatilla River Subbasin Fish Habitat Improvement Program, 1996-2003 Summary Report.

    Energy Technology Data Exchange (ETDEWEB)

    St. Hilaire, Danny R.; Montgomery, Michael; Bailey, Timothy D. (Oregon Department of Fish and Wildlife, John Day, OR)

    2005-01-01

    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 last Annual Program Report was submitted in 1997, and described projects undertaken in 1995. This report describes Program activities carried out in 2003, along with a summary of projects undertaken during the years 1996 through 2002. 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. 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, by restoring stable channel function. This report provides a summary table of past projects (1996-2002), along with a text description of more extensive habitat improvement projects, including: (1) Implementation of a four-phased project on the Lobato property (Birch Creek) beginning in 1996 and involving a demonstration bioengineering site and riparian improvements (fencing, planting), (2) Implementation of stable channel design/instream structure placement on the Houser property, East Birch Creek, beginning in 1998, an (3) Implementation of a joint, US Army Corps of Engineers/ODFW (cost share) project beginning in 2001 on the Brogoitti property, East Birch Creek, which involved implementation of stable channel design/construction and riparian improvement treatments.

  13. CD4+ T Cell Help Confers a Cytotoxic T Cell Effector Program Including Coinhibitory Receptor Downregulation and Increased Tissue Invasiveness.

    Science.gov (United States)

    Ahrends, Tomasz; Spanjaard, Aldo; Pilzecker, Bas; Bąbała, Nikolina; Bovens, Astrid; Xiao, Yanling; Jacobs, Heinz; Borst, Jannie

    2017-11-21

    CD4+ T cells optimize the cytotoxic T cell (CTL) response in magnitude and quality, by unknown molecular mechanisms. We here present the transcriptomic changes in CTLs resulting from CD4+ T cell help after anti-cancer vaccination or virus infection. The gene expression signatures revealed that CD4+ T cell help during priming optimized CTLs in expression of cytotoxic effector molecules and many other functions that ensured efficacy of CTLs throughout their life cycle. Key features included downregulation of PD-1 and other coinhibitory receptors that impede CTL activity, and increased motility and migration capacities. "Helped" CTLs acquired chemokine receptors that helped them reach their tumor target tissue and metalloprotease activity that enabled them to invade into tumor tissue. A very large part of the "help" program was instilled in CD8+ T cells via CD27 costimulation. The help program thus enhances specific CTL effector functions in response to vaccination or a virus infection. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Evaluation design of a reactivation care program to prevent functional loss in hospitalised elderly: A cohort study including a randomised controlled trial

    National Research Council Canada - National Science Library

    Asmus-Szepesi, Kirsten; Vreede, Paul; Nieboer, Anna; Wijngaarden, Jeroen; Bakker, Ton; Steyerberg, Ewout; Mackenbach, Johan

    2011-01-01

    ... patients by comparing a new intervention program to two usual care programs. Methods/Design. This study will include an effect, process and cost evaluation using a mixed methods design of quantitative and qualitative methods...

  15. Does the parental stretching programs improve metatarsus adductus in newborns?

    Science.gov (United States)

    Eamsobhana, Perajit; Rojjananukulpong, Karn; Ariyawatkul, Thanase; Chotigavanichaya, Chatupon; Kaewpornsawan, Kamolporn

    2017-01-01

    Metatarsus adductus (MA) is a common pediatric foot deformity. Current recommendations suggest observation until 4-6 months, then casting if the deformity persists. Based on our review of the literatures, no randomized controlled trial has been conducted to study the effectiveness of parental stretching in the correction of MA in newborn. Ninety-four newborn feet that were diagnosed as MA by clinical examination were enrolled. Feet were randomized into two groups: observation group and stretching group. Outcome measurements were performed to compare success rate between groups. According to Pearson's χ(2) test, there were no statistically significant differences between groups with regard to the overall success of the parental stretching program ( p = 0.191). There was also no significant difference between groups for mild degree or moderate-to-severe degree ( p = 0.134, p = 0.274, respectively). A more rapid success rate was observed in the stretching group at the first month follow-up, but rate of improvement then decreased. The stretching group tended to have a lower success rate compared to the observation group in moderate-to-severe feet, but the difference was not statistically significant. Parental stretching program found no benefit over observation group in this study. Parental stretching program should not be applied for newborn babies with moderate-to-severe MA as the result from the study appeared to have lower success rate compared to observation group. Observe until 4-6 months, then corrective casting for the persisting deformity is recommended.

  16. 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.

  17. 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. 

  18. Improving disclosure of medical error through educational program as a first step toward patient safety.

    Science.gov (United States)

    Kim, Chan Woong; Myung, Sun Jung; Eo, Eun Kyung; Chang, Yerim

    2017-03-04

    Although physicians believe that medical errors should be disclosed to patients and their families, they often hesitate to do so. In this study, we assessed the effectiveness of an education program for medical error disclosure. In 2015, six medical interns and 79 fourth-year medical students participated in this study. The education program included practice of error disclosure using a standardized patient scenario, feedback, and short didactic sessions. Participant performance was evaluated with a previously developed rating scale that measures error disclosure performance on five specific component skills. Following education program, we surveyed participant perceptions of medical error disclosure with varying severity of error outcome and their satisfaction with the education program using a 5-point Likert scale. We also surveyed the change of attitude or confidence of participants after education program. The performance score was not significantly different between medical interns and medical students (p = 0.840). Following the education program, 65% of participants said that they had become more confident in coping with medical errors, and most participants (79.7%) were satisfied with the education program. They also indicated that they felt a greater duty to disclose medical errors and deliver an apology when the medical error outcome is more severe. An education program for disclosing medical errors was helpful in improving confidence in medical error disclosure. Extending the program to more diverse scenarios and a more diverse group of physicians is needed.

  19. Wire rope improvement program. Final report. [For draglines

    Energy Technology Data Exchange (ETDEWEB)

    Alzheimer, J.M.; Anderson, W.E.; Beeman, G.H.; Dudder, G.B.; Erickson, R.; Glaeser, W.A.; Jentgen, R.L.; Rice, R.R.; Strope, L.A.

    1981-09-01

    Activities in five major areas were undertaken during the WRIP: experiments using PNL-developed bend-over-sheave fatigue test machines to generate data on which to base a model for predicting large-diameter rope performance from that of small-diameter ropes; bend-over-sheave fatigue testing to determine differences in rope failure rates at varying rope loads; analyses to determine how wire ropes actually fail; development of a load sensor to record and quantity operational loads on drag and hoist ropes; and technology transfer activities to disseminate useful program findings to coal mine operators. Data obtained during the 6-year program support are included. High loads on wire ropes are damaging. As an adjunct, however, potentially useful countermeasures to high loads were identified. Large-diameter rope bend-over-sheave performance can be predicted from small-diameter rope test behavior, over some ranges.

  20. 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.

  1. A home balance exercise program improves walking in people with cerebellar ataxia.

    Science.gov (United States)

    Keller, Jennifer L; Bastian, Amy J

    2014-10-01

    Physical therapy intervention is the primary treatment for gait ataxia and imbalance in individuals with cerebellar damage. Our aim was to determine if a home balance exercise program is feasible for improving locomotor and balance abilities in these individuals. A total of 14 patients with cerebellar ataxia participated in a 6-week individualized home-based balance exercise program and attended 5 testing sessions (2 pretraining, 1 midtraining, 1 posttraining, and 1 one-month follow-up visit). Pretraining, posttraining, and follow-up testing included a neurological assessment, clinical gait and balance tests, and laboratory assessments of balance and walking. Participants kept logs of the frequency and level of balance challenge during their training. Walking speed improved across visits, as did stride length, percentage double-limb support time, Timed Up and Go (TUG), and Dynamic Gait Index. Post hoc comparisons in these measures revealed that significant rehabilitative improvements occurred over the 6-week training period, and all but TUG gains were retained 1 month later. There were no changes across the other measures for the group. Regression analysis indicated that improvements in walking speed were affected by the level of balance challenge but not by age, ataxia severity, proprioception, or duration of exercise. Improvement in locomotor performance in people with cerebellar ataxia was observable after a 6-week home balance exercise program. The exercise program must be designed to provide a significant challenge to the person's balance. © The Author(s) 2014.

  2. Self-efficacy and health status improve after a wellness program in persons with multiple sclerosis.

    Science.gov (United States)

    Ng, Alexander; Kennedy, Patricia; Hutchinson, Brian; Ingram, Anna; Vondrell, Suzanne; Goodman, Terri; Miller, Deborah

    2013-06-01

    To determine if an intensive wellness program for persons with MS results in improved self-efficacy, quality of life (QOL), or physical activity outcomes. 129 subjects participated in one of seven 4-day interdisciplinary educational wellness programs throughout the United States. This intervention was based on the philosophy that health management is important to disease management. The program consisted of psychological and physiological evaluations, lectures and workshops. Before the intervention and after at 1, 3 and 6 months, self-efficacy (MS Self-Efficacy Scale, MSSE, control), health related QOL (SF-36) and physical activity (Physical Activity Scale for Persons with Physical Disabilities, PASAID) was assessed. Improvements were noted at 1, 3 and 6 months post-intervention. Those present at 6 months included, MSSE, role physical, vitality and mental health scales of the SF-36. PASAID did not change. Improvements were independent of disability (EDSS). A 4-day multidisciplinary educational wellness program can result in improvement in self-efficacy and health-related QOL in persons with MS and can be stable up to at least 6 months. Improvements do not depend on degree of disability.

  3. Cancer and Fertility Program Improves Patient Satisfaction With Information Received

    Science.gov (United States)

    Thom, Bridgette; Benedict, Catherine; Carter, Jeanne; Corcoran, Stacie; Dickler, Maura N.; Goodman, Karyn A.; Margolies, Allison; Matasar, Matthew J.; Noy, Ariela; Goldfarb, Shari B.

    2016-01-01

    Purpose A cancer and fertility program was established at a large cancer center to support clinicians in discussing treatment-related fertility risks and fertility preservation (FP) options with patients and in referring patients to reproductive specialists. The program provides resources, clinician education, and fertility clinical nurse specialist consultation. This study evaluated the program’s impact on patient satisfaction with information received. Patients and Methods Retrospective cross-sectional surveys assessed satisfaction before (cohort 1 [C1]) and after (cohort 2 [C2]) program initiation. Questionnaires were investigator-designed, gender-specific, and anonymous. Results Most C1 (150 males, 271 females) and C2 (120 males, 320 females) respondents were 2 years postdiagnosis; the most frequently reported cancers were testicular, breast, and lymphoma. A significant difference in satisfaction with the amount of information received was seen between C1 and C2. For males, satisfaction with information on fertility risks was high in both cohorts but significantly greater in C2 for information on sperm banking (χ2 = 9.3, P = .01) and finding a sperm bank (χ2 = 13.3, P = .001). For females, satisfaction with information was significantly greater in C2 for information on fertility risks (χ2 = 62.1, P < .001), FP options (χ2 = 71.9, P < .001), help with decision making (χ2 = 80.2, P < .001), and finding a reproductive endocrinologist (χ2 = 60.5, P < .001). Among patients who received and read information materials, 96% of males and 99% of females found them helpful. Among C2 females, fertility clinical nurse specialist consultation was associated with significantly greater satisfaction with information on FP options (χ2 = 11.2, P = .004), help with decision making (χ2 = 10.4, P = .006), and finding a reproductive endocrinologist (χ2 = 22.6, P < .001), with 10% reporting lack of knowledge as a reason for not pursuing FP. Conclusion Improvements in

  4. An evaluation of NASA's program for improving aircraft fuel efficiency

    Science.gov (United States)

    1980-01-01

    The report provides commentary and recommendations where appropriate on each of the major elements of the program. Key findings of the committee included a recommendation that closer ties be established between NASA and the FAA to expedite the use and acceptance of the new technology. The committee also cited the potential for fuel savings through an imporved air traffic control system and recommended that the management of NASA and the FAA discuss ways and means to work together to exploit more effectively the capabilities and responsibilities of each to develop air traffic control.

  5. Combating Obesity at Community Health Centers (COACH): a quality improvement collaborative for weight management programs.

    Science.gov (United States)

    Wilkes, Abigail E; John, Priya M; Vable, Anusha M; Campbell, Amanda; Heuer, Loretta; Schaefer, Cynthia; Vinci, Lisa; Drum, Melinda L; Chin, Marshall H; Quinn, Michael T; Burnet, Deborah L

    2013-01-01

    Community health centers (CHCs) seek effective strategies to address obesity. MidWest Clinicians' Network partnered with [an academic medical center] to test feasibility of a weight management quality improvement (QI) collaborative. MidWest Clinicians' Network members expressed interest in an obesity QI program. This pilot study aimed to determine whether the QI model can be feasibly implemented with limited resources at CHCs to improve weight management programs. Five health centers with weight management programs enrolled with CHC staff as primary study participants; this study did not attempt to measure patient outcomes. Participants attended learning sessions and monthly conference calls to build QI skills and share best practices. Tailored coaching addressed local needs. Topics rated most valuable were patient recruitment/retention strategies, QI techniques, evidence-based weight management, motivational interviewing. Challenges included garnering provider support, high staff turnover, and difficulty tracking patient-level data. This paper reports practical lessons about implementing a weight management QI collaborative in CHCs.

  6. 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.

  7. Measuring improvement in knowledge of drug policy reforms following a police education program in Tijuana, Mexico

    National Research Council Canada - National Science Library

    J. Arredondo; S. A. Strathdee; J. Cepeda; D. Abramovitz; I. Artamonova; E. Clairgue; E. Bustamante; M. L. Mittal; T. Rocha; A. Bañuelos; H. O. Olivarria; M. Morales; G. Rangel; C. Magis; L. Beletsky

    2017-01-01

    .... 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...

  8. FFY 2012-2015 transportation improvement program for the Dubuque, Iowa, Illinois and Wisconsin urbanized area.

    Science.gov (United States)

    2011-08-18

    "A Transportation Improvement Program (TIP) is the Dubuque Metropolitan Area : Transportation Study (DMATS) 4- year financial implementation program listing of : transportation improvement projects eligible for Federal funding. It is DMATS : transpor...

  9. 76 FR 78343 - HOME Investment Partnerships Program: Improving Performance and Accountability; and Updating...

    Science.gov (United States)

    2011-12-16

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

  10. 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.

  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. 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.

  13. [Study of the nutritional status of patients over 65 years included in the home care program in an urban population].

    Science.gov (United States)

    Muñoz Díaz, Belén; Arenas de Larriva, Antonio P; Molina-Recio, Guillermo; Moreno-Rojas, Rafael; Martínez de la Iglesia, Jorge

    2018-02-01

    To analyse the nutritional status of patients older than 65 years included in the home care program (PAD). Croos-sectional study. 3 urban health centers. 218 patients in the PAD. Mini Nutritional Assessment questionnaire (MNA) was applied. Sociodemographic, anthropometric, dependency, emotional and cognitive status and analytical parameters: 57 variables were collected. Possible associations were analysed by applying the chi square and variance analysis. The level of significance was considered to be Pnutritional status and older age, lower BMI, greater dependence on basic and instrumental activities of daily living and greater cognitive impairment. The lowest mean hemoglobin, albumin, and iron levels were also associated with malnutrition and risk of malnutrition. More than half of PAD patients are malnourished or at risk for it, and a high proportion of them some laboratory abnormality susceptible to be corrected. Most cognitive impairment and functional dependence are closely related to malnutrition; so patients with these characteristics should receive more attention from the nutritional point of view. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. Fuel Performance Improvement Program. Quarterly progress report, April--June 1977. [BWR, PWR

    Energy Technology Data Exchange (ETDEWEB)

    Rowe, D.S. (comp.)

    1977-07-01

    The Fuel Performance Improvement Program has as its objective the identification and demonstration of fuel concepts with improved power ramp performance. Improved fuels are being sought to allow reduction or elimination of fuel related operating guidelines on nuclear power plants such that the fuel may be power maneuvered within the rates allowed by the system technical specifications. The program contains a combination of out-of-reactor studies, in-reactor experiments and in-reactor demonstrations. Fuel concepts initially being considered include annular-pellets, cladding internally coated with graphite and packed-particle fuels. The performance capability of each concept is being compared to a reference fuel of contemporary pellet design through test reactor experiments.

  15. 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...

  16. Effectiveness of disease-management programs for improving diabetes care: a meta-analysis.

    Science.gov (United States)

    Pimouguet, Clément; Le Goff, Mélanie; Thiébaut, Rodolphe; Dartigues, Jean François; Helmer, Catherine

    2011-02-08

    We conducted a meta-analysis of randomized controlled trials to assess the effectiveness of disease-management programs for improving glycemic control in adults with diabetes mellitus and to study which components of programs are associated with their effectiveness. We searched several databases for studies published up to December 2009. We included randomized controlled trials involving adults with type 1 or 2 diabetes that evaluated the effect of disease-management programs on glycated hemoglobin (hemoglobin A₁(C)) concentrations. We performed a meta-regression analysis to determine the effective components of the programs. We included 41 randomized controlled trials in our review. Across these trials, disease-management programs resulted in a significant reduction in hemoglobin A₁(C) levels (pooled standardized mean difference between intervention and control groups -0.38 [95% confidence interval -0.47 to -0.29], which corresponds to an absolute mean difference of 0.51%). The finding was robust in the sensitivity analyses based on quality assessment. Programs in which the disease manager was able to start or modify treatment with or without prior approval from the primary care physician resulted in a greater improvement in hemoglobin A₁(C) levels (standardized mean difference -0.60 v. -0.28 in trials with no approval to do so; p management programs had a clinically moderate but significant impact on hemoglobin A₁(C) levels among adults with diabetes. Effective components of programs were a high frequency of patient contact and the ability for disease managers to adjust treatment with or without prior physician approval.

  17. 76 FR 65769 - Airport Improvement Program: Modifications to Benefit Cost Analysis (BCA) Threshold

    Science.gov (United States)

    2011-10-24

    ... Federal Aviation Administration Airport Improvement Program: Modifications to Benefit Cost Analysis (BCA... Airport Improvement Program (AIP) discretionary funds. On December 16, 2010, the FAA issued a Notice of... which BCAs are required from $5 million to $10 million in Airport Improvement Program (AIP...

  18. Sustainable practice improvements: impact of the Comprehensive Advanced Palliative Care Education (CAPCE) program.

    Science.gov (United States)

    Harris, Diane; Hillier, Loretta M; Keat, Nancy

    2007-01-01

    This paper describes an education program designed to improve palliative care practice through the development of workplace hospice palliative care resources (PCRs), and its impact on knowledge transfer and longer-term changes to clinical practice. Evaluation methods included pre- and post-program questionnaires, and a survey of learners' (n=301) perceptions of program learning strategies. Interviews (n=21) were conducted with a purposeful sample of PCRs and representatives from their work sites. Ratings of the sessions indicated that they were relevant to learners' clinical practice. At follow up, the majority of learners (83%) continued to serve as PCRs. Many positive effects were identified, including enhanced pain and symptom management, staff education, and development of care policies and guidelines. Management support, particularly the prioritization of palliative care and staff development, were factors facilitating sustained implementation. These findings highlight the importance of multimodal learning strategies and supportive work environments in the development of PCRs to enhance palliative care practice.

  19. Integrating information from disparate sources: the Walter Reed National Surgical Quality Improvement Program Data Transfer Project.

    Science.gov (United States)

    Nelson, Victoria; Nelson, Victoria Ruth; Li, Fiona; Green, Susan; Tamura, Tomoyoshi; Liu, Jun-Min; Class, Margaret

    2008-11-06

    The Walter Reed National Surgical Quality Improvement Program Data Transfer web module integrates with medical and surgical information systems, and leverages outside standards, such as the National Library of Medicine's RxNorm, to process surgical and risk assessment data. Key components of the project included a needs assessment with nurse reviewers and a data analysis for federated (standards were locally controlled) data sources. The resulting interface streamlines nurse reviewer workflow by integrating related tasks and data.

  20. 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... INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Recreation, Tourism and Trails § 170.137 What types of activities can a recreation, tourism, and...

  1. Improving Adherence to Screening Colonoscopy Preparation and Appointments: A Multicomponent Quality Improvement Program.

    Science.gov (United States)

    Kalayjian, Eve; Bringman, Diane; Naughton, Angel; Bond, Sheila; Sarver, Wendy; Mion, Lorraine C

    2015-01-01

    Colorectal screening for cancer by colonoscopy is recommended for adults 50 years and older. Scheduling patients for sedated endoscopic procedures involves balancing physician schedules, room availability and equipment, proper patient preparedness, and necessary personnel. Both nonattendance and poor preparations contribute to inefficiency, wasted resources, and increased costs. We noted nonattendance rates ranging from 21% to 29%. As a first step, we examined patient factors associated with nonattendance using a retrospective case control study. Younger patients (attendance rate, concomitantly we discovered cancellation rates increasing. Subsequently, an interdisciplinary and interdepartmental quality improvement program has been ongoing to target a number of system-, nurse-, and patient-specific factors contributing to nonattendance and cancellations due to poor preparations. Rates have improved but require ongoing monitoring and surveillance. We describe the ongoing efforts and challenges aimed at both nonattendance and cancellations.

  2. 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…

  3. Improving children’s health and education by working together on school health and nutrition (SHN) programming in Nepal

    OpenAIRE

    Rai, Chandra; Lee, Seunghee F.; Rana, Hari Bahadur; Shrestha, Bharat Kumar

    2010-01-01

    Although the school-age children’s mortality rate is low, they face diseases that keep them from succeeding in school; therefore, the objective of a School Health and Nutrition (SHN) program is to improve the health and nutrition status of school children which leads to improved school performance. The program activities include iron supplementation and deworming; health and nutrition education; capacity building of partners, teachers, and students; and provision of safe drinking water and to...

  4. [Action Plan to Improve the Utilization of Stationary Bikes in a Health Promotion Exercise Program].

    Science.gov (United States)

    Huang, Yu-Yen; Chen, Hsiu-Yuen; Wu, Chia-Chien; Chen, Yao-Mei

    2015-06-01

    Research has shown that exercise helps reduce the risk and the severity of metabolic syndrome. Since 2009, KMHK hospital has implemented a primary-prevention health promotion program that targets individuals who are at elevated risk of metabolic syndrome. The program engages participants in an exercise protocol that asks them to exercise regularly on a stationary bike three times a week for six months. The utilization rate of the stationary bikes averaged 75% in 2010, but reduced to 34.7% in 2011, with an average withdrawal rate of 24.3%. Therefore, an action team was assembled in order to enhance the effectiveness of the program. This project used two primary strategies to increase the utilization of stationary bikes. These strategies included: increasing referrals and decreasing withdrawals. Surveys of participants who, respectfully, failed to complete and successfully completed the exercise protocol were conducted to identify the factors associated with non-completion / completion. The enrollment policies, the equipment, and the environment were inspected comprehensively. After identifying the causes and effects, several interventions were implemented. These interventions included: installing insulation curtains to block direct sunlight, upgrading the stationary bikes to newer models, creating an environment more conducive to exercise, promoting the referral policies, marketing the health promotion program, and securing family support. After three months, the utilization rate of stationary bikes increased to 77.8%, representing an improvement rate of 124%. Furthermore, the number of case referrals significantly increased and the withdrawal rate decreased to 4.8%. Finally, longer-term follow up indicates that the utilization rate and the withdrawal rate have continued to improve. The program implemented in the present study successfully enrolled more participants in the exercise protocol, as evidenced by the increased utilization of stationary bikes and by the

  5. Geother evaluation and improvement: A progress report including test cases for two-dimensional BWIP (Basalt Waste Isolation Project) analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bian, S.H.; Budden, M.J.; Bartley, C.L.; Yung, S.C.

    1988-03-01

    The objective of the work is to evaluate the GEOTHER code and peform necessary improvements to make it specifically suitable for predicting the environmental conditions of the waste package for the Basalt Waste Isolation Project (BWIP); and to perform resaturation analyses, that is, the analyses of steam formation and condensation, for the repository and waste package using the improved GEOTHER code. This is a progress report to BWIP documenting the status of GEOTHER code testing, evaluation, and improvements. The computational results documented in this report reflect the current condition of the code and the condition before code improvements. The test cases used are intended for examining the code features in sufficient detail and are not intended to be taken as final conclusions for BWIP applications.

  6. Improving bovine udder health: a national mastitis control program in the Netherlands.

    Science.gov (United States)

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

    2013-02-01

    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), which had the task to coordinate the program. The program consisted of 2 parts: a research part and a knowledge-transfer part, which were integrated as much as possible. The knowledge-transfer part comprised 2 communication strategies: a central and a peripheral approach. The central approach was based on educating farmers using comprehensive science-based and rational argumentation about mastitis prevention and included on-farm study group meetings. Comprehensive education materials were developed for farmers that were internally motivated to improve udder health. In the peripheral approach it was tried to motivate farmers to implement certain management measures using nontechnical arguments. Mass media campaigns were used that focused on one single aspect of mastitis prevention. These communication strategies, as well as an integrated approach between various stakeholders and different scientific disciplines were used to reach as many farmers as possible. It should be noted that, because this intervention took place at a national level, no control group was available, as it would be impossible to isolate farmers from all forms of communication for 5 years. Based on several studies executed during and after the program, however, the results suggest that udder health seemed to have improved on a national level during the course of the program from 2005 to 2010. Within a cohort of dairy herds monitored during the program, the prevalence of subclinical mastitis did not change significantly (23.0 in 2004 vs. 22.2 in 2009). The incidence rate of clinical mastitis, however, decreased significantly, from 33.5 to 28.1 quarter cases per 100 cow years at risk. The most important

  7. Algorithm Improvement Program Nuclide Identification Algorithm Scoring Criteria And Scoring Application - DNDO.

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-01

    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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. Expanding the Lessons Learned Program to Include Corps Support Command Commanders and Theater Army Area Command Commanders

    Science.gov (United States)

    1989-03-10

    INTRODUCTION The Oral History Program’s purpose is to supplement oFficial histories , to isolate successful command, leadership and managerial...of -the program is to capture the experience of senior leaders in the areas of command, leadership , and management . The individual is interviewed...used to gain insight into command and management techniques and to further research in military history . In June of 1984, the Chief of Staff, General

  13. How Effective are Cash Transfer Programs at Improving Nutritional Status?

    OpenAIRE

    Gitter, Seth R.; James Manley; Vanya Slavchevska

    2011-01-01

    Cash transfer programs have not always affected children�s nutritional status. We reviewed 30,000 articles relating cash transfer programs and height for age, finding 21 papers on 17 programs. Applying meta-analysis we examine the overarching relationship, finding that the programs� average impact on height-for-age is positive, but small and not statistically significant. We evaluate many program, child and local characteristics� correlation with estimated outcome. Conditional programs ...

  14. Evaluation of a continuous quality improvement program in anticoagulant therapy: Feasibility, satisfaction and perception.

    Science.gov (United States)

    Cantin, Ariane; Lahaie, Alexandre; Odobasic, Bojan; Tremblay, Marie-Philip; Wazzan, Dana; Caron, Stéphanie; Leblanc, Caroline; Martineau, Josée; Lalonde, Lyne

    2016-11-01

    The ACO Program (Programme ACO), a continuous quality improvement program (CQIP) in anticoagulation therapy, was offered in community pharmacies as a pilot project. To evaluate the participants' appreciation for the various activities of the program. Participants had access to training activities, including an audit with feedback, online training activities (OTA), clinical tools and support from facilitators. Cognitive behavioural learning determinants were evaluated before and 5 months after the beginning of the program. Participants' satisfaction and perception were documented via online questionnaires and a semistructured interview. Of the 52 pharmacists in the ACO Program, 47 participated in this evaluation. Seventy-seven percent of the participants completed at least 1 OTA and 6% published on the forum. The feeling of personal effectiveness rose from 8.01 (7.67-8.35) to 8.62 (8.24-8.99). The audit and feedback, as well as the high-quality OTA and their lecturers, were the most appreciated elements. There was a high OTA participation rate. The facilitators seemed to play a key role in the CQIP. The low level of participation in the forum reflects the known phenomenon of social loafing. Technical difficulties affecting the platform and data collection for the audit with feedback constituted limitations. The CQIP in anticoagulation therapy is appreciated by community pharmacists and is associated with an improved feeling of personal effectiveness.

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

    Science.gov (United States)

    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. PMID:27382638

  16. 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.

  17. Patient education programs ? can they improve outcomes in COPD?

    OpenAIRE

    Harris, Melanie; Brian J. Smith; Veale, Antony

    2008-01-01

    It is important to assess the effectiveness of patient education programs for people with COPD (chronic obstructive pulmonary disease) to ensure that limited health resources are being spent effectively. We aimed to assess the effectiveness of programs reported to date, and to look for ways of designing more effective programs. COPD patient education to date has produced little demonstrated success, but studies, education programs and study reports all show limitations. To demonstrate links b...

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

    Science.gov (United States)

    Romaniuk, Mary-Jo; Haycock, Ken

    2011-01-01

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

  19. Attitudes of Pulmonary and Critical Care Training Program Directors toward Quality Improvement Education

    Science.gov (United States)

    Feemster, Laura C.; Fruci, Carolyn M.; Hyzy, Robert C.; Savant, Adrienne P.; Siner, Jonathan M.; Weiss, Curtis H.; Patel, Bela

    2015-01-01

    Rationale: Quality improvement (QI) is a required component of fellowship training in pulmonary, critical care, and sleep medicine. However, little is known about how training programs approach QI education. Objectives: We sought to understand the perceptions of pulmonary, critical care, and sleep medicine training program directors toward QI education. Methods: We developed and fielded an internet survey of pulmonary, critical care, and sleep medicine training program directors during 2013. Survey domains included program characteristics, the extent of trainee and faculty involvement in QI, attitudes toward QI education, and barriers to successful QI education in their programs. Measurements and Main Results: A total of 75 program directors completed the survey (response rate = 45.2%). Respondents represented both adult (n = 43, 57.3%) and pediatric (n = 32, 42.7%) programs. Although the majority of directors (n = 60, 80.0%) reported substantial fellow involvement in QI, only 19 (26.0%) reported having a formal QI education curriculum. QI education was primarily based around faculty mentoring (n = 46, 61.3%) and lectures (n = 38, 50.7%). Most directors agreed it is an important part of fellowship training (n = 63, 84.0%). However, fewer reported fellows were well integrated into ongoing QI activities (n = 45, 60.0%) or graduating fellows were capable of carrying out independent QI (n = 28, 50.7%). Key barriers to effective QI education included lack of qualified faculty, lack of interest among fellows, and lack of time. Conclusions: Training program directors in pulmonary, critical care, and sleep medicine value QI education but face substantial challenges to integrating it into fellowship training. PMID:25723649

  20. A Quality Improvement Project: What First-year Nursing Students Include in Their Nursing Care Plans for Patients With Acute or Chronic Wounds.

    Science.gov (United States)

    Pieper, Barbara; Monahan, Janean; Keves-Foster, Mary Kathryn; Farner, Julia; Alhasanat, Dalia; Albdour, Maha

    2017-10-01

    Nursing education research is lacking with regard to nursing care plans for patients who have a wound and use of the nursing diagnosis impaired skin integrity. The purpose of this quality improvement project was to inform teaching about nursing care planning for patients with wounds by examining what rst-year nursing students attending a fundamentals of nursing course in a Bachelor of Science in Nursing program included in a nursing process assignment when caring for an assigned patient who had an acute or chronic wound. Because they were in their clinical rotation, students had access to the patients' medical records to facilitate composing the care plan; they also could ask the patient for information. Assessment data were entered on a predetermined form based on Gordon's Functional Patterns. Using this information, students had to provide 3 possible diagnoses and select 1 upon which they developed the care plan intended to include patient description, wound description, dressing, and nursing diagnoses and impressions. The forms then were ana- lyzed for assessment completeness. Thirty-eighty (38) care plans completed by students were collected on patients that included 23 men and 28 African-Americans; mean age of the patients was 60.11 ± 14.17 (range 20-87) years. Wounds included 25 surgical incisions, 4 pressure ulcers/injuries, 7 "other" wounds, and 2 not identi ed. None of the students' assessments provided a detailed wound description. The most common wound descriptors were location (n =19) and drainage (n = 15). For 8 patients, students stated the wound was covered by a dressing. Thirty (30) nursing diagnoses were listed. The most common nursing diagnoses were impaired physical mobility or activity intolerance, impaired com- fort, impaired skin integrity, imbalanced nutrition, and risk for infection. These nursing students had beginning skills in patient and wound assessment and writing nursing care plans about patients with impaired skin integrity

  1. Fuel performance improvement program. Quarterly/annual progress report, April--September 1977. [BWR; PWR

    Energy Technology Data Exchange (ETDEWEB)

    Crouthamel, C.E. (comp.)

    1977-11-01

    The Fuel Performance Improvement Program has as its objective the identification and demonstration of fuel concepts with improved power ramp performance. The program contains a combination of out-of-reactor studies, in-reactor experiments and in-reactor demonstrations. Fuel concepts initially being considered include annular pellets, cladding internally coated with graphite and packed-particle fuels. The performance capability of each concept will be compared to a reference fuel of contemporary pellet design by irradiations in the Halden Boiling Water Reactor. Fuel design and process development is being completed and fuel rod fabrication will begin for the Halden test rods and for the first series of in-reactor demonstrations. The in-reactor demonstrations are being performed in the Big Rock Point reactor to show that the concepts pose no undue risk to commercial operation.

  2. Remote sensing inputs to National Model Implementation Program for water resources quality improvement

    Science.gov (United States)

    Eidenshink, J. C.; Schmer, F. A.

    1979-01-01

    The Lake Herman watershed in southeastern South Dakota has been selected as one of seven water resources systems in the United States for involvement in the National Model Implementation Program (MIP). MIP is a pilot program initiated to illustrate the effectiveness of existing water resources quality improvement programs. The Remote Sensing Institute (RSI) at South Dakota State University has produced a computerized geographic information system for the Lake Herman watershed. All components necessary for the monitoring and evaluation process were included in the data base. The computerized data were used to produce thematic maps and tabular data for the land cover and soil classes within the watershed. These data are being utilized operationally by SCS resource personnel for planning and management purposes.

  3. Evaluation of a multi-faceted diabetes care program including community-based peer educators in Takeo province, Cambodia, 2007-2013.

    Directory of Open Access Journals (Sweden)

    Dawn Taniguchi

    Full Text Available Early detection and treatment for diabetes are essential for reducing disability and death from the disease. Finding effective screening and treatment for individuals living with diabetes in resource-limited countries is a challenge. MoPoTsyo, a Cambodian non-governmental organization, addressed this gap by utilizing a multi-pronged approach with community-based peer educators, access to laboratory procedures, local outpatient medical consultation, and a revolving drug fund. This study evaluated outcomes of MoPoTsyo's diabetes program in Takeo Province by assessing glycemic and blood pressure outcomes for individuals diagnosed with diabetes over a 24-month follow-up period between 2007-2013.This is a retrospective cohort analysis of records without a comparison group. We calculated the mean fasting blood glucose (FBG and blood pressure (BP at regular intervals of follow-up. The proportion of patients reaching recommended treatment targets for FBG and BP was assessed.Of the 3411 patients enrolled in the program, 2230 were included in the study. The cohort was predominantly female (68.9% with a median age of 54 years. Median follow-up time in the program was 16 months (4.9-38.4 months. Mean FBG decreased 63.9 mg/dl in mean FBG (95% CI 58.5 to 69.3 at one year of follow-up (p<0.001. After one year, 45% (321/708 of patients achieved goal FBG < 126. Of the 41.6% (927/2230 with elevated BP at enrollment, systolic and diastolic BP levels significantly decreased (p<0.001 by 16.9 mmHg (95% CI 1.2 to 22.9 and 10 mm Hg (95% CI 0.7 to 12.9 respectively between enrollment and one year of follow-up. At one year of follow-up, 51.1%% (183/355 of these patients reached the BP goal < 140/90.The improved outcome indicators of diabetes care for MoPoTsyo's Takeo program evaluation showed promise. The program demonstrated a reasonable and practical approach to delivering effective diabetes care in a rural area and may serve as a model for other low-income communities

  4. Evaluation of a multi-faceted diabetes care program including community-based peer educators in Takeo province, Cambodia, 2007-2013.

    Science.gov (United States)

    Taniguchi, Dawn; LoGerfo, James; van Pelt, Maurits; Mielcarek, Bessie; Huster, Karin; Haider, Mahri; Thomas, Bernadette

    2017-01-01

    Early detection and treatment for diabetes are essential for reducing disability and death from the disease. Finding effective screening and treatment for individuals living with diabetes in resource-limited countries is a challenge. MoPoTsyo, a Cambodian non-governmental organization, addressed this gap by utilizing a multi-pronged approach with community-based peer educators, access to laboratory procedures, local outpatient medical consultation, and a revolving drug fund. This study evaluated outcomes of MoPoTsyo's diabetes program in Takeo Province by assessing glycemic and blood pressure outcomes for individuals diagnosed with diabetes over a 24-month follow-up period between 2007-2013. This is a retrospective cohort analysis of records without a comparison group. We calculated the mean fasting blood glucose (FBG) and blood pressure (BP) at regular intervals of follow-up. The proportion of patients reaching recommended treatment targets for FBG and BP was assessed. Of the 3411 patients enrolled in the program, 2230 were included in the study. The cohort was predominantly female (68.9%) with a median age of 54 years. Median follow-up time in the program was 16 months (4.9-38.4 months). Mean FBG decreased 63.9 mg/dl in mean FBG (95% CI 58.5 to 69.3) at one year of follow-up (p<0.001). After one year, 45% (321/708) of patients achieved goal FBG < 126. Of the 41.6% (927/2230) with elevated BP at enrollment, systolic and diastolic BP levels significantly decreased (p<0.001) by 16.9 mmHg (95% CI 1.2 to 22.9) and 10 mm Hg (95% CI 0.7 to 12.9) respectively between enrollment and one year of follow-up. At one year of follow-up, 51.1%% (183/355) of these patients reached the BP goal < 140/90. The improved outcome indicators of diabetes care for MoPoTsyo's Takeo program evaluation showed promise. The program demonstrated a reasonable and practical approach to delivering effective diabetes care in a rural area and may serve as a model for other low-income communities

  5. A pilot program to improve vaccination status for hospitalized children.

    Science.gov (United States)

    Pahud, Barbara; Clark, Shannon; Herigon, Joshua C; Sherman, Ashley; Lynch, Daryl A; Hoffman, Amber; Jackson, Mary Anne

    2015-01-01

    Screening of immunization status at each health care encounter is recommended to improve immunization coverage rates but is often limited to primary care practices. A pilot intervention study was performed to ascertain the immunization status of hospitalized children and determine if development of an immunization plan before discharge would improve the vaccination status for such children. On the basis of power calculations estimated to detect an increase in immunization status from 60% to 70% with 80% power, 356 randomly selected children were enrolled between March 6, 2012 and June 14, 2012. Immunization records were obtained, immunization status determined, and parent/guardian informed if catch-up dose(s) were needed. If parent requested vaccine dose(s), they were administered before discharge. Vaccination status was current per Advisory Committee on Immunization Practices guidelines in 73% of hospitalized children, and 27% children required catch-up dose(s) (200 doses for 95 children). Human papilloma virus vaccine (dose 1), varicella zoster vaccine (dose 2), and meningococcal conjugate vaccine were the most commonly identified dose(s) needed. Of those requiring catch-up dose(s), 25% were caught up, increasing vaccination status to 80% at 1-month post hospital discharge. This is the first study to determine the immunization status of hospitalized pediatric patients of all ages, including adolescents, providing new data on the immunization status of the inpatient pediatric population. A pilot intervention consisting of obtaining immunization records, determining immunization status, and discussing catch-up dose(s) before discharge resulted in improvement of immunization status, suggesting that the inpatient setting may be used along with many other national strategies to help address missed vaccination opportunities. Copyright © 2015 by the American Academy of Pediatrics.

  6. From Guide to Practice: Improving Your After School Science Program to Increase Student Academic Achievement

    Science.gov (United States)

    Taylor, J.

    2013-12-01

    Numerous science organizations, such as NASA, offer educational outreach activities geared towards after school. For some programs, the primary goal is to grow students' love of science. For others, the programs are also intended to increase academic achievement. For those programs looking to support student learning in out-of-school time environments, aligning the program with learning during the classroom day can be a challenge. The Institute for Education Sciences, What Works Clearinghouse, put together a 'Practice Guide' for maximizing learning time beyond the regular school day. These practice guides provide concrete recommendations for educators supported by research. While this guide is not specific to any content or subject-area, the recommendations provided align very well with science education. After school science is often viewed as a fun, dynamic environment for students. Indeed, one of the recommendations to ensure time is structured according to students' needs is to provide relevant and interesting experiences. Given that our after school programs provide such creative environments for students, what other components are needed to promote increased academic achievement? The recommendations provided to academic achievement, include: 1. Align Instruction, 2. Maximize Attendance and Participation, 3. Adapt Instruction, 4. Provide Engaging Experiences, and 5. Evaluate Program. In this session we will examine these five recommendations presented in the Practice Guide, discuss how these strategies align with science programs, and examine what questions each program should address in order to provide experiences that lend themselves to maximizing instruction. Roadblocks and solutions for overcoming challenges in each of the five areas will be presented. Jessica Taylor will present this research based on her role as an author on the Practice Guide, 'Improving Academic Achievement in Out-of-School Time' and her experience working in various informal science

  7. [THE EFFECTIVENESS OF EDUCATIONAL PROGRAMS FOR THE IMPROVEMENT OF POPULATION DIETARY PATTERNS AND PREVENTION OF ANEMIAS].

    Science.gov (United States)

    Glagoleva, O N; Turchaninov, D V; Vilms, E A

    2015-01-01

    There was performed an experimental study of the use of educational programs as tools of the improvement of the structure of nutrition and primary prevention of anemias associated with nutrition. Educational programs were differentiated for each of the target audience (pupils of 5-7 classes, 1-4 year students of the medical school, the adult unorganized population; n = 645). Their efficacy was evaluated with the use of issues included in the educational program and analysis of the actual nutrition (only in groups of students and adults). Performance assessment were: testing on the issues included in the educational program and analysis of actual of dietary intake (only in groups of students and adults). Testing was performed at the points: before the intervention, immediately after 6 and 12 months after intervention. An analysis of the frequency of food consumption with an estimation of the actual consumption of nutrients was carried out at the initial and final points. There was noted the low level of public knowledge about the principles ofrational nutrition: the proportion ofcorrect answers, reflecting the level of awareness ofconstructing an optimal diet in the starting point of the study was 25%for schoolchildren, 45%--in adults, 35%--the students, after the intervention--75%, 90% and 85% respectively. One year after the implementation of the educational program the level ofresidual knowledge of study participants remained at a level above the original (the proportion of correct answers during testing of schoolchildren--50% (p anemia.

  8. 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...

  9. 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…

  10. 77 FR 22790 - ``Low Income Levels'' Used for Various Health Professions and Nursing Programs Included in Titles...

    Science.gov (United States)

    2012-04-17

    ... HUMAN SERVICES Health Resources and Services Administration ``Low Income Levels'' Used for Various... backgrounds, or (3) individuals from ``low-income'' families. SUPPLEMENTARY INFORMATION: The various health..., public or private nonprofit schools which offer graduate programs in behavioral health and mental health...

  11. 76 FR 14417 - ``Low Income Levels'' Used for Various Health Professions and Nursing Programs Included in Titles...

    Science.gov (United States)

    2011-03-16

    ... HUMAN SERVICES Health Resources and Services Administration ``Low Income Levels'' Used for Various... backgrounds, or (3) individuals from ``low-income'' families. SUPPLEMENTARY INFORMATION: The various health..., public or private nonprofit schools which offer graduate programs in behavioral health and mental health...

  12. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Semenzin, Elena [Consorzio Venezia Ricerche, c/o VEGApark, Via della Liberta 5-12, 30175 Marghera-Venice (Italy)]. E-mail: semenzin.cvr@vegapark.ve.it; Temminghoff, Erwin J.M. [Wageningen University, Department of Environmental Science, Subdepartment of Soil Quality, PO Box 8005, 6700 EC Wageningen (Netherlands)]. E-mail: erwin.temminghoff@wur.nl; Marcomini, Antonio [Ca' Foscari University of Venice, Department of Environmental Sciences, Santa Marta - Dorsoduro 2137, 30121 Venice (Italy)]. E-mail: marcom@unive.it

    2007-07-15

    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{sub 2}) extractable concentration were compared to SSDs for terrestrial plants derived from literature toxicity data. Also the 'free' nickel (Ni{sup 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{sub 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)

  14. 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.

  15. DIADORIM: a Monte Carlo Program for liquid simulations including quantum mechanics and molecular mechanics (QM/MM) facilities: applications to liquid ethanol

    OpenAIRE

    Freitas,Luiz Carlos Gomide

    2009-01-01

    This paper presents a Metropolis Monte Carlo (MMC) computer program developed to simulate liquids and solutions including QM/MM facilities: the energy from intermolecular interactions is calculated with classical force field functions and the internal molecular energies are calculated using Quantum Chemistry methods. The following facilities were implemented: (i) the semiempirical MOPAC 6 quantum chemistry package was included as a subroutine of the main MMC simulation program; (ii) alternati...

  16. Designing interventions to overcome poor numeracy and improve medication adherence in chronic illness, including HIV/AIDS.

    Science.gov (United States)

    Moore, John O; Boyer, Edward W; Safren, Steven; Robbins, Gregory K; Boudreaux, Edwin D; Rosen, Rochelle; Barton, Bruce; Moss, Frank

    2011-06-01

    Numeracy is an element of health literacy that refers to the ability to understand numerically related information. When applied to health behaviors, it describes the degree to which individuals have the capacity to access, process, interpret, and act on graphical and probabilistic health information. As a cognitive and functional skill, low numeracy correlates with poor outcomes in the management of chronic diseases; numeracy is therefore an essential component of patients' capacity to adhere to medication regimens. In this manuscript, we describe novel visual interventions to improve medication adherence in difficult, chronically ill populations. We have used personalized graphical representations of plasma medication concentration and dynamic disease state simulation to overcome poor numeracy. These methods incorporate efficient, precise, and clear graphical data; cartographical techniques focused on judicious use of color intensities; and animation that increases engagement and accentuates information transfer.

  17. Physical activity mediates the relationship between program participation and improved mental health in older adults.

    Science.gov (United States)

    Becofsky, K; Baruth, M; Wilcox, S

    2016-03-01

    There is an implicit assumption that increased physical activity (PA) levels are responsible for the mental health benefits resulting from participation in PA programs. Other factors associated with participation may in fact be responsible. The purpose of this study was to examine whether changes in PA mediated the effects of two PA programs (Active Choices [AC] and Active Living Every Day [ALED]) on mental health outcomes. Secondary data analyses of quasi-experimental study. A sub-sample of older adults who participated in AC (n = 744) and ALED (n = 853) were included in the current analyses. MacKinnon's product of coefficients was used to test change in PA as a mediator of the relationship between program dose and change in mental health outcomes (depressive symptoms, stress, and number of days with poor mental health). Change in PA explained 19% (AC) and 13% (ALED) of the absolute effects of program dose on depressive symptoms, 18% (AC) and 14% (ALED) of the effects on stress, and 37% (ALED) of the effects on days with poor mental health. Mounting evidence from both epidemiological studies and controlled trials suggests that PA can improve mental health. This study adds that increasing PA levels may improve mental health in older adults in 'real-world' settings. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Improvement of program-goal method in defence planning system

    Directory of Open Access Journals (Sweden)

    Р.М. Федоренко

    2005-01-01

    Full Text Available  The article proposes the conception of defence planning system development with program-goal method application that based on analysis of advanced experience of developed countries. Article specified the place of program-goal method in resolving defence planning tasks of national security.

  19. 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.

  20. Improving Math Performance through a Peer Tutoring Program.

    Science.gov (United States)

    Greenfield, Susan D.; McNeil, Mary E.

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

  1. 77 FR 36924 - Airport Concessions Disadvantaged Business Enterprise: Program Improvements

    Science.gov (United States)

    2012-06-20

    ... [Docket No. OST-2011-0101] RIN 2105-AE10 Airport Concessions Disadvantaged Business Enterprise: Program... the Department of Transportation's Airport Concessions Disadvantaged Business Enterprise (ACDBE..., transit, and airport financial assistance programs. This rule also amends small business size limits to...

  2. A Classroom Program To Improve Self-Concept

    Science.gov (United States)

    Schulman, Jerome L.; And Others

    1973-01-01

    Describes a mental health program that makes use of teacher-taught materials that do not require extensive preparation by the teachers involved. The program attempts to alter personality through the use of techniques that promote education in mental health and experimentation with group and individual behavior. (Author)

  3. Improving Quality of Elementary Music Programs through Common Curriculum

    Science.gov (United States)

    Edele, Cameron

    2011-01-01

    Developing a music program based on quality curriculum is the key to success. The purpose of my research was to explore whether teachers used curriculum for quality control in an Elementary music program. Using student questionnaires, teacher interviews, and teacher observations I found that the music curriculum in each school was different. There…

  4. An intensive exercise program improves motor performances in patients with dementia: translational model of geriatric rehabilitation.

    Science.gov (United States)

    Schwenk, Michael; Dutzi, Ilona; Englert, Stefan; Micol, William; Najafi, Bijan; Mohler, Jane; Hauer, Klaus

    2014-01-01

    Translation of intensive exercise programs developed specifically for patients with dementia into clinical settings is lacking. To determine if a progressive resistance and functional training program, previously evaluated in dementia outpatients, can be implemented in a geriatric inpatient setting in order to improve motor performances in patients with dementia. Eligible patients in one ward of a German geriatric hospital were assigned to the intervention group (IG, n = 74) and received intensive exercise training specifically designed for patients with dementia. Patients in the second ward were observed as a control group (CG, n = 74). All patients received usual care treatment. Primary endpoints were maximal lower extremity strength measured by a leg-press device and duration of the 5-chair-stand test for functional performance. Secondary outcomes included a number of parameters for strength and function. The rehabilitation period averaged 18.1 ± 6.8 days. The IG significantly improved in both primary endpoints (change: maximal strength, IG: +51.9 ± 42.3% versus CG: +13.5 ± 51.8%, p exercise program can be implemented in a geriatric rehabilitation setting to improve motor performances in patients with dementia. Results suggest that an intensification of training is feasible in the target group and substantially increases the benefits in comparison to receiving usual care exercise only.

  5. Improving teaching strategies in an undergraduate community health nursing (CHN) program: implementation of a service-learning preceptor program.

    Science.gov (United States)

    Kazemi, Donna; Behan, Jennifer; Boniauto, Maria

    2011-08-01

    A service-learning component was added to the existing preceptor practicum program at the University of North Carolina Charlotte's School of Nursing (UNCC SON) in the fall of 2007 for nursing students in the community health nursing (CHN) practicum course. The preceptorship model is commonly used in undergraduate nursing education. The aim of this study was to improve teaching strategies in the existing school health nursing (SHN) preceptor program by the addition of a service-learning community partnership. Adding the service-learning component was based on the Polvika model. A total of 27 nursing students and 33 preceptors participated in the study. Percentages, means, standard deviations, and rankings were used to analyze the data. The participants completed a multiple-choice survey and ranked a list of tasks. The students were able to fulfill their task responsibilities, and the service-learning preceptor program was cost effective for the SHN preceptors through hours saved by the nursing students. The preceptor role is associated with many factors, including perceived burden, which affects their willingness to work with students. The findings demonstrated that service learning is an effective teaching strategy in the CHN nursing students' learning by fostering the preceptors' benefits, rewards, support, and commitment to the role. Published by Elsevier Ltd.

  6. A program against bacterial bioterrorism: improved patient management and acquisition of new knowledge on infectious diseases.

    Science.gov (United States)

    Kemp, Michael; Dargis, Rimtas; Andresen, Keld; Christensen, Jens Jørgen E

    2012-06-01

    In 2002 it was decided to establish laboratory facilities in Denmark for diagnosing agents associated with bioterrorism in order to make an immediate appropriate response to the release of such agents possible. Molecular assays for detection of specific agents and molecular and proteomic techniques for identification of bacteria were introduced as part of the program. All assays and techniques were made accessible for use in diagnosing patients, even when an intentional release was not suspected. Medical expertise on different diseases was established at the department as an integrated part of the program. The analyses included PCR assays for specific bacteria, identification of isolated bacteria by DNA sequencing, detection and identification of bacteria in clinical sample material by universal bacterial PCR and DNA sequencing, and identification of bacteria by mass spectrometry. The established analyses formed a basis on which a series of further developments was built. In addition to reducing the time for obtaining diagnoses and improving the accuracy of diagnosis of individual infected patients, the analyses provided new knowledge on the frequency and distribution of some bacterial infections, including Q fever, tularemia, trench fever, brucellosis, and melioidosis. The implementation of an antibioterrorism program in a clinical diagnostic setting improved the diagnostic possibilities for patients in Denmark and provided new epidemiologic information. It also introduced a number of diagnostic assays for bacterial infections not associated with bioterrorism that are difficult to culture or identify.

  7. Healthcare technologies, quality improvement programs and hospital organizational culture in Canadian hospitals

    OpenAIRE

    Tyagi, Rajesh K; Cook, Lori; Olson, John; Belohlav, James

    2013-01-01

    Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was co...

  8. Meat texture and antioxidant status are improved when carnosic acid is included in the diet of fattening lambs.

    Science.gov (United States)

    Morán, Lara; Andrés, Sonia; Bodas, Raúl; Prieto, Nuria; Giráldez, F Javier

    2012-08-01

    Thirty-two Merino lambs fed barley straw and a concentrate alone (CONTROL group) or enriched with carnosic acid [0.6 g kg(-1) dry matter (DM), CARN006 group; 1.2 g kg(-1) DM, CARN012 group] or vitamin E (0.6 g kg(-1) DM, VITE006 group) were used to assess the effect of these antioxidant compounds on meat quality. After being fed the experimental diets for at least 5 weeks, the animals were slaughtered with the 25 kg intended body weight and the different muscles (longissimus lumborum; LL, gluteus medius; GM) were sliced and kept refrigerated under modified atmosphere packaging during 0, 7 and 14 days. The results indicate that carnosic acid seemed to be useful to delay lipid peroxidation in a medium colour-stable muscle such as GM, but this effect was lower than that observed when vitamin E was supplemented to fattening lambs. On the contrary, meat texture and protection against cholesterol oxidation were equally improved with both compounds. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Eicosanoids: Exploiting Insect Immunity to Improve Biological Control Programs

    Science.gov (United States)

    Stanley, David; Haas, Eric; Miller, Jon

    2012-01-01

    Insects, like all invertebrates, express robust innate, but not adaptive, immune reactions to infection and invasion. Insect immunity is usually resolved into three major components. The integument serves as a physical barrier to infections. Within the hemocoel, the circulating hemocytes are the temporal first line of defense, responsible for clearing the majority of infecting bacterial cells from circulation. Specific cellular defenses include phagocytosis, microaggregation of hemocytes with adhering bacteria, nodulation and encapsulation. Infections also stimulate the humoral component of immunity, which involves the induced expression of genes encoding antimicrobial peptides and activation of prophenoloxidase. These peptides appear in the hemolymph of challenged insects 6–12 hours after the challenge. Prostaglandins and other eicosanoids are crucial mediators of innate immune responses. Eicosanoid biosynthesis is stimulated by infection in insects. Inhibition of eicosanoid biosynthesis lethally renders experimental insects unable to clear bacterial infection from hemolymph. Eicosanoids mediate specific cell actions, including phagocytosis, microaggregation, nodulation, hemocyte migration, hemocyte spreading and the release of prophenoloxidase from oenocytoids. Some invaders have evolved mechanisms to suppress insect immunity; a few of them suppress immunity by targeting the first step in the eicosanoid biosynthesis pathways, the enzyme phospholipase A2. We proposed research designed to cripple insect immunity as a technology to improve biological control of insects. We used dsRNA to silence insect genes encoding phospholipase A2, and thereby inhibited the nodulation reaction to infection. The purpose of this article is to place our view of applying dsRNA technologies into the context of eicosanoid actions in insect immunity. The long-term significance of research in this area lies in developing new pest management technologies to contribute to food security in

  10. Impact of a quality improvement program on primary healthcare in Canada: a mixed-method evaluation.

    Science.gov (United States)

    Harris, Stewart B; Green, Michael E; Brown, Judith Belle; Roberts, Sharon; Russell, Grant; Fournie, Meghan; Webster-Bogaert, Susan; Paquette-Warren, Jann; Kotecha, Jyoti; Han, Han; Thind, Amardeep; Stewart, Moira; Reichert, Sonja; Tompkins, Jordan W; Birtwhistle, Richard

    2015-04-01

    Rigorous comprehensive evaluations of primary healthcare (PHC) quality improvement (QI) initiatives are lacking. This article describes the evaluation of the Quality Improvement and Innovation Partnership Learning Collaborative (QIIP-LC), an Ontario-wide PHC QI program targeting type 2 diabetes management, colorectal cancer (CRC) screening, access to care, and team functioning. This article highlights the primary outcome results of an external retrospective, multi-measure, mixed-method evaluation of the QIIP-LC, including: (1) matched-control pre-post chart audit of diabetes management (A1c/foot exams) and rate of CRC screening; (2) post-only advanced access survey (third-next available appointment); and (3) post-only semi-structured interviews (team functioning). Chart audit data was collected from 34 consenting physicians per group (of which 88% provided access data). Between-group differences were not statistically significant (A1c [p=0.10]; foot exams [p=0.45]; CRC screening [p=0.77]; advanced access [p=0.22]). Qualitative interview (n=42) themes highlighted the success of the program in helping build interdisciplinary team functioning and capacity. The rigorous design and methodology of the QIIP-LC evaluation utilizing a control group is one of the most significant efforts thus far to demonstrate the impact of a QI program in PHC, with improvements over time in both QIIP and control groups offering a likely explanation for the lack of statistically significant primary outcomes. Team functioning was a key success, with team-based chronic care highlighted as pivotal for improved health outcomes. Policy makers should strive to endorse QI programs with proven success through rigorous evaluation to ensure evidence-based healthcare policy and funding. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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

  16. 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.

  17. Improving programming skills of Mechanical Engineering students by teaching in C# multi-objective optimizations methods

    National Research Council Canada - National Science Library

    Adrian Florea; Ileana Ioana Cofaru

    2017-01-01

    .... This paper represents a software development guide for designers of suspension systems with less programming skills that will enable them to implement their own optimization methods that improve...

  18. American College of Surgeons National Surgical Quality Improvement Program Pediatric: a phase 1 report.

    Science.gov (United States)

    Raval, Mehul V; Dillon, Peter W; Bruny, Jennifer L; Ko, Clifford Y; Hall, Bruce L; Moss, R Lawrence; Oldham, Keith T; Richards, Karen E; Vinocur, Charles D; Ziegler, Moritz M

    2011-01-01

    There has been a long-standing desire to implement a multi-institutional, multispecialty program to address surgical quality improvement for children. This report documents results of the initial phase of the American College of Surgeons National Surgical Quality Improvement Program Pediatric. From October 2008 to December 2009, patients from 4 pediatric referral centers were sampled using American College of Surgeons National Surgical Quality Improvement Program methodology tailored to children. A total of 7,287 patients were sampled, representing general/thoracic surgery (n = 2,237; 30.7%), otolaryngology (n = 1,687; 23.2%), orthopaedic surgery (n = 1,367; 18.8%), urology (n = 893; 12.3%), neurosurgery (n = 697; 9.6%), and plastic surgery (n = 406; 5.6%). Overall mortality rate detected was 0.3% and 287 (3.9%) patients had postoperative occurrences. After accounting for demographic, preoperative, and operative factors, occurrences were 4 times more likely in those undergoing inpatient versus outpatient procedures (odds ratio [OR] = 4.71; 95% CI, 3.01-7.35). Other factors associated with higher likelihood of postoperative occurrences included nutritional/immune history, such as preoperative weight loss/chronic steroid use (OR = 1.49; 95% CI, 1.03-2.15), as well as physiologic compromise, such as sepsis/inotrope use before surgery (OR = 1.68; 95% CI, 1.10-1.95). Operative factors associated with occurrences included multiple procedures under the same anesthetic (OR = 1.58; 95% CI, 1.21-2.06) and American Society of Anesthesiologists classification category 4/5 versus 1 (OR = 5.74; 95% CI, 2.94-11.24). Specialty complication rates varied from 1.5% for otolaryngology to 9.0% for neurosurgery (p Pediatric has the potential to identify outcomes of children's surgical care that can be targeted for quality improvement efforts. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  19. How the ESRD quality incentive program could potentially improve quality of life for patients on dialysis.

    Science.gov (United States)

    Moss, Alvin H; Davison, Sara N

    2015-05-07

    For over 20 years, the quality of medical care of the Medicare ESRD Program has been a concern. The Centers for Medicare and Medicaid Services have implemented the ESRD Quality Incentive Program, which uses the principles of value-based purchasing; dialysis providers are paid for performance on predefined quality measures, with a goal of improving patient outcomes and the quality of patient care. The ESRD Quality Incentive Program measures have been criticized, because they are largely disease oriented and use easy-to-obtain laboratory-based indicators, such as Kt/V and hemoglobin, that do not reflect outcomes that are most important to patients and have had a minimal effect on survival or quality of life. A key goal of improving quality of care is to enhance quality of life, a patient-important quality measure that matters more to many patients than even survival. None of the ESRD Quality Incentive Program measures assess patient-reported quality of life. As outlined in the National Quality Strategy, the Centers for Medicare and Medicaid Services are holding providers accountable in six priority domains, in which quality measures have been and are being developed for value-based purchasing. Three measures-patient experience and engagement, clinical care, and care coordination-are particularly relevant to quality care in the ESRD Program; the 2014 ESRD Quality Incentive Program includes six measures, none of which provide data from a patient-centered perspective. Value-based purchasing is a well intentioned step to improve care of patients on dialysis. However, the Centers for Medicare and Medicaid Services need to implement significant change in what is measured for the ESRD Quality Incentive Program to be patient centered and aligned with patients' values, preferences, and needs. This paper provides examples of potential quality measures for patient experience and engagement, clinical care, and care coordination, which if implemented, would be much more likely to

  20. Connecting the learners: improving uptake of a nursing home educational program by focusing on staff interactions.

    Science.gov (United States)

    Colón-Emeric, Cathleen S; Pinheiro, Sandro O; Anderson, Ruth A; Porter, Kristie; McConnell, Eleanor; Corazzini, Kirsten; Hancock, Kathryn; Lipscomb, Jeffery; Beales, Julie; Simpson, Kelly M

    2014-06-01

    The CONNECT intervention is designed to improve staff connections, communication, and use of multiple perspectives for problem solving. This analysis compared staff descriptions of the learning climate, use of social constructivist learning processes, and outcomes in nursing facilities receiving CONNECT with facilities receiving a falls education program alone. Qualitative evaluation of a randomized controlled trial was done using a focus group design. Facilities (n = 8) were randomized to a falls education program alone (control) or CONNECT followed by FALLS (intervention). A total of 77 staff participated in 16 focus groups using a structured interview protocol. Transcripts were analyzed using framework analysis, and summaries for each domain were compared between intervention and control facilities. Notable differences in descriptions of the learning climate included greater learner empowerment, appreciation of the role of all disciplines, and seeking diverse viewpoints in the intervention group. Greater use of social constructivist learning processes was evidenced by the intervention group as they described greater identification of communication weaknesses, improvement in communication frequency and quality, and use of sense-making by seeking out multiple perspectives to better understand and act on information. Intervention group participants reported outcomes including more creative fall prevention plans, a more respectful work environment, and improved relationships with coworkers. No substantial difference between groups was identified in safety culture, shared responsibility, and self-reported knowledge about falls. CONNECT appears to enhance the use of social constructivist learning processes among nursing home staff. The impact of CONNECT on clinical outcomes requires further study.

  1. The Case for Diabetes Population Health Improvement: Evidence-Based Programming for Population Outcomes in Diabetes

    Science.gov (United States)

    Maruthur, Nisa; Mathioudakis, Nestoras; Spanakis, Elias; Rubin, Daniel; Zilbermint, Mihail; Hill-Briggs, Felicia

    2017-01-01

    Purpose of Review The goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Recent Findings Recent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low incremental medial cost effectiveness ratio for health systems. Effective outpatient interventions that improve diabetes control and process outcomes are multi-level, targeting the patient, provider, and healthcare system simultaneously and integrate community health workers as a liaison between the patient and community-based healthcare resources. A multi-faceted approach to diabetes management is also effective in the inpatient setting. Interventions shown to promote safe and effective glycemic control and use of evidence-based glucose management practices include provider reminder and clinical decision support systems, automated computer order entry, provider education, and organizational change. Summary Future studies should examine the cost-effectiveness of multi-faceted outpatient and inpatient diabetes management programs to determine the best financial models for incorporating them into diabetes population health strategies. PMID:28567711

  2. Including total EGFR staining in scoring improves EGFR mutations detection by mutation-specific antibodies and EGFR TKIs response prediction.

    Directory of Open Access Journals (Sweden)

    Shang-Gin Wu

    Full Text Available Epidermal growth factor receptor (EGFR is a novel target for therapy in subsets of non-small cell lung cancer, especially adenocarcinoma. Tumors with EGFR mutations showed good response to EGFR tyrosine kinase inhibitors (TKIs. We aimed to identify the discriminating capacity of immunohistochemical (IHC scoring to detect L858R and E746-A750 deletion mutation in lung adenocarcinoma patients and predict EGFR TKIs response. Patients with surgically resected lung adenocarcinoma were enrolled. EGFR mutation status was genotyped by PCR and direct sequencing. Mutation-specific antibodies for L858R and E746-A750 deletion were used for IHC staining. Receiver operating characteristic (ROC curves were used to determine the capacity of IHC, including intensity and/or quickscore (Q score, in differentiating L858R and E746-A750 deletion. We enrolled 143 patients during September 2000 to May 2009. Logistic-regression-model-based scoring containing both L858R Q score and total EGFR expression Q score was able to obtain a maximal area under the curve (AUC: 0.891 to differentiate the patients with L858R. Predictive model based on IHC Q score of E746-A750 deletion and IHC intensity of total EGFR expression reached an AUC of 0.969. The predictive model of L858R had a significantly higher AUC than L858R intensity only (p = 0.036. Of the six patients harboring complex EGFR mutations with classical mutation patterns, five had positive IHC staining. For EGFR TKI treated cancer recurrence patients, those with positive mutation-specific antibody IHC staining had better EGFR TKI response (p = 0.008 and longer progression-free survival (p = 0.012 than those without. In conclusion, total EGFR expression should be included in the IHC interpretation of L858R. After adjusting for total EGFR expression, the scoring method decreased the false positive rate and increased diagnostic power. According to the scoring method, the IHC method is useful to predict the

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

    Directory of Open Access Journals (Sweden)

    Neudecker Denise

    2017-01-01

    Full Text Available 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.

  4. 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 ...

  5. 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

  6. 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

  7. Combinations of Osmolytes, Including Monosaccharides, Disaccharides, and Sugar Alcohols Act in Concert During Cryopreservation to Improve Mesenchymal Stromal Cell Survival.

    Science.gov (United States)

    Pollock, Kathryn; Yu, Guanglin; Moller-Trane, Ralph; Koran, Marissa; Dosa, Peter I; McKenna, David H; Hubel, Allison

    2016-11-01

    There is demand for non-dimethyl sulfoxide (DMSO) cryoprotective agents that maintain cell viability without causing poor postthaw function or systemic toxicity. The focus of this investigation involves expanding our understanding of multicomponent osmolyte solutions and their ability to preserve cell viability during freezing. Controlled cooling rate freezing, Raman microscopy, and differential scanning calorimetry (DSC) were utilized to evaluate the differences in recovery and ice crystal formation behavior for solutions containing multiple cryoprotectants, including sugars, sugar alcohols, and small molecule additives. Postthaw recovery of mesenchymal stem cells (MSCs) in solutions containing multiple osmolytes have been shown to be comparable or better than that of MSCs frozen in 10% DMSO at 1°C/min when the solution composition is optimized. Maximum postthaw recovery was observed in these multiple osmolyte solutions with incubation times of up to 2 h before freezing. Raman images demonstrate large ice crystal formation in cryopreserved cells incubated for shorter periods of time (∼30 min), suggesting that longer permeation times are needed for these solutions. Recovery was dependent upon the concentration of each component in solution, and was not strongly correlated with osmolarity. It is noteworthy that the postthaw recovery varied significantly with the composition of solutions containing the same three components and this variation exhibited an inverted U-shape behavior, indicating that there may be a "sweet spot" for different combinations of osmolytes. Raman images of freezing behavior in different solution compositions were consistent with the observed postthaw recovery. Phase change behavior (solidification patterns and glass-forming tendency) did not differ for solutions with similar osmolarity, but differences in postthaw recovery suggest that biological, not physical, methods of protection are at play. Lastly, molecular substitution of

  8. Improving Cancer Risk Awareness Including Obesity as a Risk Factor for Cancer in a Small U.S. Community.

    Science.gov (United States)

    Thapa, Janani R; Lyford, Conrad; McCool, Barent; Pence, Barbara; McCool, Audrey; Belasco, Eric

    2017-12-01

    Obesity is a risk for certain types of cancer; however, awareness of obesity as a risk factor for cancer is low. This study evaluated increases in cancer risk awareness, including obesity as a risk factor for cancer, from a quasi-experimental intervention that provided educational materials and community reinforcement for healthy living. The study uses data on participant's awareness of cancer risk factors along with sociodemographic variables collected from in-person surveys (N = 863) at baseline (June 2011) and post intervention (June 2012). The average awareness that overweight and obesity are risk factors for cancer was low (35 %) compared to chewing tobacco (92 %), using tanning bed (73 %), and sunburn (97 %) at baseline. The intervention significantly increased participants' awareness that overweight and obesity are risk factors for cancer. Based on regression analysis, the unadjusted intervention effect on cancer risk awareness was significant: 0.392 ± 0.165 (p value = 0.020) for matched participants and 0.282 ± 0.125 (p value = 0.024) for community participants. The adjusted intervention effect was significant in the matched participants (0.528 ± 0.189, p value = 0.006). Education, income, gender, and age had a significant impact on cancer risk awareness for the community participants. The results show that community intervention that incorporates community reinforcement can have the desired effect regardless of differences at participant level. Such interventions could be used to prevent cancer risk in communities that are at high risk.

  9. 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.

  10. 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

    ... (Including Related Services) for Preschool Children and Children With Disabilities (3-21 years Inclusive) B... Related Services) for Preschool Children and Children With Disabilities (3-21 years Inclusive) A... of a parent of each preschool child or child, evaluate all preschool children or children who are...

  11. Real-world program evaluation of integrated behavioral health care: Improving scientific rigor.

    Science.gov (United States)

    Funderburk, Jennifer S; Shepardson, Robyn L

    2017-06-01

    Designing systematic, scientifically rigorous program evaluations (PE) is 1 way to contribute to the significant need to build best practices and a stronger evidence base for integrated behavioral health care. However, there are many potential pitfalls when conducting PE in real-world settings, and many clinicians and administrators may be hesitant to engage in PE due to lack of training or resources. Rigorous PE can be achieved feasibly and efficiently. This article discusses common challenges that arise when conducting PE in integrated behavioral health care settings and illustrates ways to increase the methodological quality of PE efforts using lessons learned from 2 real-world case examples. The first example included a PE of a training program for brief alcohol interventions, and the second example included a PE of a depression medication monitoring service. The case examples demonstrate the need for strategic planning beforehand, including the use of a conceptual framework as well as appropriate study designs/methodology, measurement, and the need for consistency to achieve a well-designed PE. Using the recommendations within this article, it is hoped that the quality of PEs can be improved resulting in more generalizable data that can be used to inform organizations and policymakers to improve health care delivery. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. HMMWV Improvements "Monster Garage(copyrighted)" Program

    Science.gov (United States)

    2008-10-29

    manufacturing and development (EMD) phase, for a total of 27. Twenty- four are incorporated in the Expanded Capacity Vehicle ( ECV ) 2 with 5 improvements...percent. Twenty-four are incorporated in the ECV 2 with five improvements expected in the EMD phase, for a total of 29, or 91 percent. The PM is

  13. 100 Area process improvement program for the period November 1954--April 1955

    Energy Technology Data Exchange (ETDEWEB)

    Reinker, P.H.; Bupp, L.P.

    1954-11-19

    This is the second of a series of documents issued quarterly. The documents present, for critical examination by management and for the information of related groups, that portion of the future 100 Area technical program which relates directly and more or less immediately to the Technical-Manufacturing efforts to increase both power levels and production. An attempt is made to describe and justify the key production tests planned for the following six month period. Only those tests necessary for the relief of technical and process limitations and vital to the slug improvement program are included. Best estimates of changes in current Process Specifications during the ensuing six months are also given. To further longer range planning, power level forecasts based on foreseeable changes of technical limits and scheduled physical changes of the water plants and reactors are extended several years into the future.

  14. 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.

  15. 42 CFR 438.240 - Quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

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

  16. Evaluating Improvements to the Student Learning Experience in an Honours Earth and Environmental Sciences Program

    Science.gov (United States)

    Eyles, C. H.; Vajoczki, S.; Zobel, G.

    2002-12-01

    The School of Geography and Geology (SGG) at McMaster University recently received funding for a three-year project to apply new teaching strategies to enhance the undergraduate learning experience. A major focus of this project is to develop multiple opportunities for inquiry-based and experiential learning in the four-year Honours B.Sc program in Earth and Environmental Sciences. A second aim of the project is to enhance systematic personal transferable skills development in all students enrolled in this program. The aims of the SGG educational project are being met through progressive revision and refinement of instructional methodologies and the introduction of increased opportunities for experimental lab work, fieldwork, co-op and volunteer placements. Introductory level laboratory assignments are now up to 70% inquiry-based and fieldwork opportunities exist for all students within the program. A major hurdle to assessing the success of the project is evaluation of the effectiveness of the educational changes made in the programs. To date, a number of evaluation tools have been used to assess improvements to the learning experience including formative and summative student feedback (both informal and formal), student performance evaluations (pre- and post-course), and surveys of program alumni and potential employers. A system for the evaluation of personal transferable skills development is currently being developed using a skills attainment grid. By comparing future student attainment and feedback with that documented in a `baseline' survey carried out at the beginning of the project, it is hoped that assessment of improvements to the student learning experience can be made.

  17. 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

    ... school completion, including dropout prevention strategies; (2) Alternative secondary school offerings... 664.470; (5) Occupational skill training; (6) Leadership development opportunities, which include... individual service strategy. (WIA sec. 129(c)(2).) ...

  18. 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

  19. Designing and piloting a program to provide water filters and improved cookstoves in Rwanda.

    Directory of Open Access Journals (Sweden)

    Christina K Barstow

    Full Text Available In environmental health interventions addressing water and indoor air quality, multiple determinants contribute to adoption. These may include technology selection, technology distribution and education methods, community engagement with behavior change, and duration and magnitude of implementer engagement. In Rwanda, while the country has the fastest annual reduction in child mortality in the world, the population is still exposed to a disease burden associated with environmental health challenges. Rwanda relies both on direct donor funding and coordination of programs managed by international non-profits and health sector businesses working on these challenges.This paper describes the design, implementation and outcomes of a pilot program in 1,943 households across 15 villages in the western province of Rwanda to distribute and monitor the use of household water filters and improved cookstoves. Three key program design criteria include a. an investment in behavior change messaging and monitoring through community health workers, b. free distributions to encourage community-wide engagement, and c. a private-public partnership incentivized by a business model designed to encourage "pay for performance". Over a 5-month period of rigorous monitoring, reported uptake was maintained at greater than 90% for both technologies, although exclusive use of the stove was reported in only 28.5% of households and reported water volume was 1.27 liters per person per day. On-going qualitative monitoring suggest maintenance of comparable adoption rates through at least 16 months after the intervention.High uptake and sustained adoption of a water filter and improved cookstove was measured over a five-month period with indications of continued comparable adoption 16 months after the intervention. The design attributes applied by the implementers may be sufficient in a longer term. In particular, sustained and comprehensive engagement by the program implementer

  20. The Climate Variability & Predictability (CVP) Program at NOAA - Improved Understanding of Tropical Pacific Processes, Biases, and Climatology

    Science.gov (United States)

    Lucas, S. E.; Todd, J. F.

    2016-02-01

    The Climate Variability & Predictability (CVP) Program at NOAA supports research aimed at providing process-level understanding of the climate system through observation, modeling, analysis, and field studies. This vital knowledge is needed to improve climate models and predictions so that scientists can better anticipate the impacts of future climate variability and change. To achieve its mission, the CVP Program supports research carried out at NOAA and other federal laboratories, NOAA Cooperative Institutes, and academic institutions. The Program also coordinates its sponsored projects with major national and international scientific bodies including the World Climate Research Programme (WCRP), the International and U.S. Climate Variability and Predictability (CLIVAR/US CLIVAR) Program, and the U.S. Global Change Research Program (USGCRP). The CVP program sits within NOAA's Climate Program Office (http://cpo.noaa.gov/CVP). A leading-order issue for improvement of predictions and projections of the El Niño/Southern Oscillation (ENSO), Madden-Julian Oscillation (MJO), Pacific Decadal Oscillation (PDO), and other important climate phenomena is the need for climate models to correctly and consistently produce the seasonally-varying background state. The CVP Program currently supports eleven projects in area of "Improved Understanding of Tropical Pacific Processes, Biases, and Climatology." Recent results from CVP-funded projects will be summarized in this poster and the development of the NOAA CVP Pacific Task Force will be discussed.

  1. Using process evaluation for program improvement in dose, fidelity and reach: the ACT trial experience

    Directory of Open Access Journals (Sweden)

    Kitzman-Ulrich Heather

    2009-11-01

    Full Text Available Abstract Background The purpose of this study was to demonstrate how formative program process evaluation was used to improve dose and fidelity of implementation, as well as reach of the intervention into the target population, in the "Active by Choice Today" (ACT randomized school-based trial from years 1 to 3 of implementation. Methods The intervention integrated constructs from Self-Determination Theory and Social Cognitive Theory to enhance intrinsic motivation and behavioral skills for increasing long-term physical activity (PA behavior in underserved adolescents (low income, minorities. ACT formative process data were examined at the end of each year to provide timely, corrective feedback to keep the intervention "on track". Results Between years 1 and 2 and years 2 and 3, three significant changes were made to attempt to increase dose and fidelity rates in the program delivery and participant attendance (reach. These changes included expanding the staff training, reformatting the intervention manual, and developing a tracking system for contacting parents of students who were not attending the after-school programs regularly. Process outcomes suggest that these efforts resulted in notable improvements in attendance, dose, and fidelity of intervention implementation from years 1 to 2 and 2 to 3 of the ACT trial. Conclusion Process evaluation methods, particularly implementation monitoring, are useful tools to ensure fidelity in intervention trials and for identifying key best practices for intervention delivery.

  2. Using process evaluation for program improvement in dose, fidelity and reach: the ACT trial experience.

    Science.gov (United States)

    Wilson, Dawn K; Griffin, Sarah; Saunders, Ruth P; Kitzman-Ulrich, Heather; Meyers, Duncan C; Mansard, Leslie

    2009-11-30

    The purpose of this study was to demonstrate how formative program process evaluation was used to improve dose and fidelity of implementation, as well as reach of the intervention into the target population, in the "Active by Choice Today" (ACT) randomized school-based trial from years 1 to 3 of implementation. The intervention integrated constructs from Self-Determination Theory and Social Cognitive Theory to enhance intrinsic motivation and behavioral skills for increasing long-term physical activity (PA) behavior in underserved adolescents (low income, minorities). ACT formative process data were examined at the end of each year to provide timely, corrective feedback to keep the intervention "on track". Between years 1 and 2 and years 2 and 3, three significant changes were made to attempt to increase dose and fidelity rates in the program delivery and participant attendance (reach). These changes included expanding the staff training, reformatting the intervention manual, and developing a tracking system for contacting parents of students who were not attending the after-school programs regularly. Process outcomes suggest that these efforts resulted in notable improvements in attendance, dose, and fidelity of intervention implementation from years 1 to 2 and 2 to 3 of the ACT trial. Process evaluation methods, particularly implementation monitoring, are useful tools to ensure fidelity in intervention trials and for identifying key best practices for intervention delivery.

  3. Improvement of air quality according to Mobile reduction measures to establish Korean Auto-oil program

    Science.gov (United States)

    Sunwoo, Y.; Jo, H.; Ma, Y.; Kim, S.; Hong, K.; Lim, Y.; Javascript:Setnextpage('sponsor')

    2011-12-01

    The mobile of NOx and PM10 emission of Korea in 2007 accounted for 42%, 23%, respectively (excluded fugitive dust). Seoul highly affected mobile emission which accounted for 46%, 49%, respectively. Korean government ,therefore, established "Special Act for improvement of air quality in Seoul metropolitan area" including mobile emission reduction measures and organized research forum including reformation of fuel and cars, risk assessment, control of greenhouse gas and assessment of air quality to establish Korean Auto-oil program This study quantitatively analyses improvement of air quality in Seoul according to the reformation of fuel and supply of DPF in Korean Auto-oil program. WRF-SMOKE-CMAQ were emploied for this study. SO2, CO, NOx, PM10 and VOCs emission are based on the INTEX-B emission inventory, NH3 were from the REAS emission inventory. Korea emission is derived by CAPSS (Clean Air Policy Support System) data. The reduction through reformation of fuel and supply of DPF is calculated by reduction ratio of air pollutants with strengthen fuel quality standard and number of car supplied DPF, refer to Metropolitan Air Quality Management Office Republic of Korea (2011) in detail. The effect of air quality is quantifiably comparing modeling results which are applied/not applied on the measures. This study will be provided basic data to establish Korean Auto-oil program through quantifying and predicting to improvement of air quality according to the mobile measures. Acknowledgement This research was supported in part by the "Assessment of risk and health benefits considering exposure characteristics of fuel" project sponsored by the Korea Automobile Environmental Association.

  4. Program Evaluation for School Improvement: Guidelines for School Administrators.

    Science.gov (United States)

    Gillies, Warna D.

    1995-01-01

    Fourth-generation program evaluation is a collaborative, responsive approach that attaches great importance to the claims, concerns, and issues set forth by various stakeholders. This model stresses value pluralism and has several community-involvement phases: planning, data collection, results, final evaluation report, and follow-up. (20…

  5. Orthopaedic Outreach Program in Uganda: A Strategy to Improve ...

    African Journals Online (AJOL)

    Background: Musculoskeletal diseases are on the increase worldwide. Greater than 80% of Ugandans live in rural areas, facing formidable barriers to specialized care. In 1991 the Orthopedics Outreach Program (OOP) was initiated as a plausible solution to the inequity of orthopedic care between the urban and rural ...

  6. The PIC Youth Primer: Improving JTPA Programs for Youth.

    Science.gov (United States)

    Snedeker, Bonnie; And Others

    This guide for Private Industry Council (PIC) officers, members, and staff is written to assist in planning and overseeing effective programs for youth at risk in the local labor market using resources allocated under the Job Training Partnership Act (JTPA). Section I takes a broad view of the problem of building effective employability…

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

    Science.gov (United States)

    Alturki, Raad A.

    2016-01-01

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

  8. Evaluating a New and Aspiring County Extension Director Leadership Education Program: Determining Outcomes and Needed Improvements

    Science.gov (United States)

    Jayaratne, K. S. U.; Owen, Mitchel; Jones, David

    2010-01-01

    This leadership education evaluation study explored the leadership development outcomes of potential county extension directors and the ways to improve the program. The leadership education program aimed to improve participants' leadership abilities in understanding self, building relationships and managing resources. The analysis of quantitative…

  9. 75 FR 78798 - Airport Improvement Program: Proposed Changes to Benefit Cost Analysis (BCA) Threshold

    Science.gov (United States)

    2010-12-16

    ... Federal Aviation Administration Airport Improvement Program: Proposed Changes to Benefit Cost Analysis... requiring benefit cost analyses (BCA) for capacity projects when applying for Airport Improvement Program... Friday, except Federal holidays. Privacy: We will post all comments we receive, without change, to http...

  10. 78 FR 45231 - Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality...

    Science.gov (United States)

    2013-07-26

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare and Medicaid Programs; Initial Approval of Center for Improvement in Healthcare Quality's (CIHQ's) Hospital Accreditation Program AGENCY... announces our decision to approve the Center for Improvement in Healthcare Quality (CIHQ) as a national...

  11. 78 FR 40625 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

    Science.gov (United States)

    2013-07-08

    ... Food and Nutrition Service 7 CFR Parts 245 and 272 RIN 0584-AE10 National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010; Approval of... ``National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the Healthy...

  12. Accelerated Math and Science Program Improvement Project Evaluation Report YR2.

    Science.gov (United States)

    Ochoa, Alberto M.

    The Accelerated Math and Science (AMS) Project is a 3 year program funded by the California Migrant Education Program Improvement Program. It targets 6th, 7th, and 8th grade low-achieving migrant students who are 2 to 4 years behind their language peer group. Two questions guided the second year evaluation study for the Region IX Migrant Education…

  13. Improving the Designated Priority Skills of Reading and Mathematics Through the Career Awareness Program.

    Science.gov (United States)

    Chorost, Sherwood B.

    This report evaluated the sixth year of the Career Awareness Program for elementary school students in New York City. The program was designed to interest, motivate, and improve language skills of students. Two activity modules, the Publishing Activity Centers (PAC) and the Industrial Arts Mobile Unit were used in the program. The PAC module was…

  14. Beyond the Numbers: Data Use for Continuous Improvement of Programs Serving Disconnected Youth

    Science.gov (United States)

    Pate, Austin; Lerner, Jennifer Brown; Browning, Andrea

    2012-01-01

    This publication is a series of in-depth case studies to examine how three programs which serve a disconnected youth population are utilizing data as a tool for continuous program improvement and ongoing accountability. The report features the following programs: (1) Roca, an organization in Massachusetts which engages the highest-risk youth in…

  15. The Administrator and the Reading Program: The School Improvement Project.

    Science.gov (United States)

    Rauch, Sidney J.

    1982-01-01

    Discusses the School Improvement Project of the New York City public schools. Lists five factors identified by the Project as determinants of student academic success and outlines the job responsibilities of the school Project liaison person. (FL)

  16. Indian reservation safety improvement program : a methodology and case study.

    Science.gov (United States)

    2015-11-01

    Improving roadway safety on Indian reservations requires a comprehensive approach. Limited : resources, lack of crash data, and few cross-jurisdictions coordination has made it difficult for : Native American communities to address their roadway safe...

  17. Utilizing Collaborative Analysis of Student Learning in Educator Preparation Programs for Continuous Improvement

    Directory of Open Access Journals (Sweden)

    Susan Colby

    2016-12-01

    Full Text Available In this results-oriented era of accountability, educator preparation programs are called upon to provide comprehensive data related to student and program outcomes while also providing evidence of continuous improvement. Collaborative Analysis of Student Learning (CASL is one approach for fostering critical inquiry about student learning. Graduate educator preparation programs in our university used collaborative analysis as the basis for continuous improvement during an accreditation cycle. As authors of this study, we sought to better understand how graduate program directors and faculty used collaborative analysis to inform practice and improve programs. Our findings suggested that CASL has the potential to foster collective responsibility for student learning, but only with a strong commitment from administrators and faculty, purposefully designed protocols and processes, fidelity to the CASL method, and a focus on professional development. Through CASL, programs have the ability to produce meaningful data related to student and program outcomes and meet the requirements for accreditation.

  18. Improving outcomes of transported newborns in Panama: impact of a nationwide neonatal provider education program.

    Science.gov (United States)

    Spector, J M; Villanueva, H Solano; Brito, M E; Sosa, P Gallardo

    2009-07-01

    To determine whether national distribution of a neonatal provider education program (the S.T.A.B.L.E. Program) positively impacts the health of ill newborns that require transport in Panama. The investigation used a prospective, pre- and postintervention study design with a double pretest. The 10 birthing centers in Panama that routinely transport the greatest number of newborns received the education program intervention. Primary outcomes were body temperature and serum glucose level on arrival at the referral facility. Length of stay and mortality were evaluated as secondary outcomes. Variation in outcome indicators was compared for 7 months before and after the intervention. Data from all live newborns transported from outlying birthing center study sites during the study dates were included in the investigation. A total of 136 and 146 newborns were transported during the observation and postintervention periods, respectively. Significantly more patients in the postintervention group had temperatures within the normal range (56% in postintervention group vs 34% in observation group; P<0.01). No statistical difference was observed in serum glucose levels, length of stay or mortality. Distribution of a neonatal provider educational program was associated with improved thermal management of transported newborns in Panama. Further study will help to confirm this association and determine the extent to which these findings are generalizable to other resource-constrained settings.

  19. 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.

  20. 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…

  1. Improvement of Unbalanced Load Flow Program for Large Power Systems

    Science.gov (United States)

    Imai, Shinichi; Suzuki, Haruhiko; Iba, Kenji; Fujiwara, Shuhei

    The idea of unbalanced power flow calculation was proposed many years ago. At that time, however, the needs for such techniques was not an argent issue. But modern power system networks are comprised of long untransposed transmission lines. Therefore, for some kind of analysis, it is now almost impossible to treat a system as though it were a symmetrical network. The aims of most previous studies were oriented to solve voltage/current imbalance in local or small system because local imbalance was a serious concern. This is still an important issue, but more recently our needs have become concentrated on practical bulk power systems, since principal EHV lines are entirely untransposed. Following such a background, we have developed a practical unbalanced load flow program. This program was developed for steady state analysis of large scale of practical networks under many possible unbalanced conditions.

  2. Report of Accomplishments under the Airport Improvement Program.

    Science.gov (United States)

    1983-09-30

    0) RUNLWAYMLhy>, FRIEDMAN MEMORIA :. ACCESLS WAY :fHppjV’EMO;:tr, * (COMMERCIAL, HAIILEY U.. 43t, 1% ISCELLAINiAUS SA!L: :v -YT;;:- FRIEDMAN MEMORIA ...N U:. AN U-H DC 1;.;.S’, 7 PC . F’VF.P I TABLE 11 AIRPORTS GRANT-IN-AID PROGRAM PROJECTS PLACED UNDER GRANT AGREEMENT EISLAL YE 4R IMA Location and

  3. Final Creech Air Force Base Capital Improvements Program Environmental Assessment

    Science.gov (United States)

    2013-11-01

    time aerial reconnaissance, surveillance , target acquisition and attack flying the remotely piloted MQ-1 Predator and the MQ-9 Reaper. All Predator...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

  4. Cardiovascular program to improve physical fitness in those over 60 years old – pilot study

    Science.gov (United States)

    Castillo-Rodríguez, Alfonso; Chinchilla-Minguet, José Luis

    2014-01-01

    Background In Spain, more than 50% of 60-year-olds are obese. Obesity is a disease with serious cardiovascular risks. The mortality rate for cardiovascular disease in Spain is 31.1%. Objectives To improve aerobic fitness, strength, flexibility and balance, and body composition (BC) in persons over 60 years old. Materials and methods A clinical intervention study of 24 participants was carried out over a period of 3 months. Aerobic fitness was assessed using the Rockport 1-Mile Walk Test. Upper-body strength was evaluated with an ad hoc test. Flexibility and balance were evaluated using the Sit and Reach Test and the Stork Balance Stand Test, respectively. Anthropometric measurements were taken by bioelectrical impedance. Results After 3 months of training, aerobic fitness was improved, as demonstrated by improved test times (pretest 13.04 minutes, posttest 12.13 minutes; P<0.05). Body composition was also improved, but the results were not statistically significant (fat mass pretest 31.58%±5.65%, posttest 30.65%±6.31%; skeletal muscle mass pretest 43.99±9.53 kg, posttest 46.63±10.90 kg). Conclusion Our data show that in subjects over 60 years old, aerobic fitness was improved due to program intervention. However, these results should be treated with caution, because of the limited sample size and the brief time period of this pilot study. A more rigorous study would include a sample of at least 100 participants. PMID:25143714

  5. Cardiovascular program to improve physical fitness in those over 60 years old - pilot study.

    Science.gov (United States)

    Castillo-Rodríguez, Alfonso; Chinchilla-Minguet, José Luis

    2014-01-01

    In Spain, more than 50% of 60-year-olds are obese. Obesity is a disease with serious cardiovascular risks. The mortality rate for cardiovascular disease in Spain is 31.1%. To improve aerobic fitness, strength, flexibility and balance, and body composition (BC) in persons over 60 years old. A clinical intervention study of 24 participants was carried out over a period of 3 months. Aerobic fitness was assessed using the Rockport 1-Mile Walk Test. Upper-body strength was evaluated with an ad hoc test. Flexibility and balance were evaluated using the Sit and Reach Test and the Stork Balance Stand Test, respectively. Anthropometric measurements were taken by bioelectrical impedance. After 3 months of training, aerobic fitness was improved, as demonstrated by improved test times (pretest 13.04 minutes, posttest 12.13 minutes; P<0.05). Body composition was also improved, but the results were not statistically significant (fat mass pretest 31.58%± 5.65%, posttest 30.65%± 6.31%; skeletal muscle mass pretest 43.99 ± 9.53 kg, posttest 46.63 ± 10.90 kg). Our data show that in subjects over 60 years old, aerobic fitness was improved due to program intervention. However, these results should be treated with caution, because of the limited sample size and the brief time period of this pilot study. A more rigorous study would include a sample of at least 100 participants.

  6. A novel simulation-based training program to improve clinical teaching and mentoring skills.

    Science.gov (United States)

    Unterman, Avraham; Achiron, Anat; Gat, Itai; Tavor, Oren; Ziv, Amitai

    2014-03-01

    Physicians are often insufficiently trained in bedside teaching and mentoring skills. To develop, implement and assess a simulation-based training program designed to improve clinical teaching among physicians. We developed a one-day tutor training program based on six simulated scenarios with video-based debriefing. The program's efficacy was assessed using questionnaires completed by the participating physicians and their students. Main outcome measures were self-perceived teaching skills at baseline, after participation in the program, and following completion of the tutor role. Secondary outcome measures were the students' perceptions regarding their tutor skills. Thirty-two physicians (mean age 35.5 years, 56% females) participated in the program. Self-assessment questionnaires indicated statistically significant improvement following the program in 13 of 20 measures of teaching skills. Additional improvement was observed upon completion of the tutor role, leading to significant improvement in 19 of the .20 measures. Questionnaires completed by their students indicated higher scores in all parameters as compared to a matched control group of tutors who did not participate in the program, though not statistically significant. Most participants stated that the program enhanced their teaching skills (88%), they implement program-acquired skills when teaching students (79%), and they would recommend it to their peers (100%). Satisfaction was similar among participants with and without previous teaching experience. A novel one-day simulation-based tutor training program was developed and implemented with encouraging results regarding its potential to improve clinical teaching and mentoring skills.

  7. Appraisal and analysis of opportunities for a joint DOE/DOD energy demonstration program. Final report. [Includes possible site information

    Energy Technology Data Exchange (ETDEWEB)

    Ziem, R.W.

    1980-05-01

    The basic objective of this study was to assess the potential for cooperative projects between the Department of Energy (DOE) and the Department of Defense (DOD) in areas concerned with the development of Total Energy (TE) Systems and to do the groundwork and liaison necessary to initiate those projects. The scope of the potential joint projects includes cooperative effort in the development and test of a variety of heat engines (prime movers) capable of utilizing coal as well as synthetic liquid fuels derived from coal and oil shale; as well as the indication of potential Military Department sites which would be suitable for the demonstration of TE systems based on a variety of such prime movers. In order to accomplish the objective of the study, it was necessary to review a large number of DOD studies and plans and to discuss the objective of the TETAS studies with a large number of Military Department people. The DOD recognizes the requirement for an assured energy supply and the need to learn how to use the synthetic fuels from coal and shale being developed by the DOE. The need to modify engine systems to adapt them to differing fuel characteristics and make those engines more flexible relative to the range of fuels they will accept is clear. What is not so clear is the fact that the DOD has a much greater opportunity to conserve energy in now inefficient facility operations than it has in mobility operations which must continue to stress mission and high performance. This report indicates guidelines for the conduct of joint projects between the DOE and the DOD which can aid both in meeting their energy objective.

  8. 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.

  9. 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

  10. International Programs and Centers for Instruction, Research and Public Service in the Western States (Including Instruction in Less Common Foreign Languages).

    Science.gov (United States)

    Abbott, Frank C., Ed.

    Programs of education and research on international economy and trade, foreign cultures and languages, and other aspects of international affairs and located in the western states are listed in an annotated directory. The units are of varying types and include informal interdepartmental committees within academic institutions, well-established…

  11. Designing a Large-Scale Multilevel Improvement Initiative: The Improving Performance in Practice Program

    Science.gov (United States)

    Margolis, Peter A.; DeWalt, Darren A.; Simon, Janet E.; Horowitz, Sheldon; Scoville, Richard; Kahn, Norman; Perelman, Robert; Bagley, Bruce; Miles, Paul

    2010-01-01

    Improving Performance in Practice (IPIP) is a large system intervention designed to align efforts and motivate the creation of a tiered system of improvement at the national, state, practice, and patient levels, assisting primary-care physicians and their practice teams to assess and measurably improve the quality of care for chronic illness and…

  12. Improving Healthy Living Youth Development Program Outreach in Extension: Lessons Learned from the 4-H Health Rocks! Program

    Science.gov (United States)

    Kumaran, Muthusami; Fogarty, Kate; Fung, Whitney M.; Terminello, Amanda

    2015-01-01

    This article discusses a qualitative evaluation of the Florida 4-H Health Rocks! program aimed at youth alcohol, tobacco, and other drug use prevention. A questionnaire was distributed to Extension professionals across Florida to gain insight into the strengths and barriers they faced with programming. Programmatic strengths included targeting a…

  13. 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.

  14. 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.

  15. Improving Air Force Depot Programming by Linking Resources to Capabilities

    Science.gov (United States)

    2012-01-01

    achieved (this would be accomplished by spreading the cuts proportionally across these business areas, often referred to as a peanut butter spread); and...institution that helps improve policy and decisionmaking through research and analysis . This electronic document was made available from www.rand.org as a...decisionmaking through research and analysis . RAND’s publications do not necessarily reflect the opinions of its research clients and sponsors. R® is a

  16. Lack of perceived sleep improvement after 4-month structured exercise programs.

    Science.gov (United States)

    Elavsky, Steriani; McAuley, Edward

    2007-01-01

    Many middle-aged women experience decreases in their sleep quality during the menopausal transition. Physical activity has been shown to improve sleep, but few randomized, controlled trials investigating such effects in this population exist. In 164 previously low-active middle-aged women (mean age = 49.9, SD = 3.6), using a 4-month randomized, controlled trial, we examined structured exercise in the form of walking or yoga to determine the effects on perceived sleep quality. Participants completed body composition and fitness assessments and a battery of psychological measures, including the Pittsburgh Sleep Quality Index, at the beginning and end of a 4-month randomized, controlled exercise trial with three arms: walking, yoga, and control. A series of mixed-model repeated-measures univariate analyses of covariance did not reveal any statistically significant intervention effects for total sleep quality or any individual sleep-quality domain. The pattern of effect sizes indicated that the walking group tended to experience small improvements in five of the seven assessed sleep-quality domains. Residual changes in menopausal symptoms and depression were associated with residual changes in total sleep quality. However, after controlling for the effects of physical activity, only menopausal symptoms contributed a unique amount of variance in residual change in total sleep quality. In this study, 4-month moderate-intensity walking and low-intensity yoga programs were ineffective in yielding statistically significant improvements in sleep quality. Exercise interventions of longer durations or greater intensity may be needed for such improvements.

  17. Does self-control improve with practice? Evidence from a six-week training program.

    Science.gov (United States)

    Miles, Eleanor; Sheeran, Paschal; Baird, Harriet; Macdonald, Ian; Webb, Thomas L; Harris, Peter R

    2016-08-01

    Can self-control be improved through practice? Several studies have found that repeated practice of tasks involving self-control improves performance on other tasks relevant to self-control. However, in many of these studies, improvements after training could be attributable to methodological factors (e.g., passive control conditions). Moreover, the extent to which the effects of training transfer to real-life settings is not yet clear. In the present research, participants (N = 174) completed a 6-week training program of either cognitive or behavioral self-control tasks. We then tested the effects of practice on a range of measures of self-control, including lab-based and real-world tasks. Training was compared with both active and no-contact control conditions. Despite high levels of adherence to the training tasks, there was no effect of training on any measure of self-control. Trained participants did not, for example, show reduced ego depletion effects, become better at overcoming their habits, or report exerting more self-control in everyday life. Moderation analyses found no evidence that training was effective only among particular groups of participants. Bayesian analyses suggested that the data were more consistent with a null effect of training on self-control than with previous estimates of the effect of practice. The implication is that training self-control through repeated practice does not result in generalized improvements in self-control. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. 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

  19. 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

  20. Sleep Promotion Program for Improving Sleep Behaviors in Adolescents: A Randomized Controlled Pilot Study.

    Science.gov (United States)

    John, Bindu; Bellipady, Sumanth Shetty; Bhat, Shrinivasa Undaru

    2016-01-01

    Aims. The purpose of this pilot trial was to determine the efficacy of sleep promotion program to adapt it for the use of adolescents studying in various schools of Mangalore, India, and evaluate the feasibility issues before conducting a randomized controlled trial in a larger sample of adolescents. Methods. A randomized controlled trial design with stratified random sampling method was used. Fifty-eight adolescents were selected (mean age: 14.02 ± 2.15 years; intervention group, n = 34; control group, n = 24). Self-report questionnaires, including sociodemographic questionnaire with some additional questions on sleep and activities, Sleep Hygiene Index, Pittsburgh Sleep Quality Index, The Cleveland Adolescent Sleepiness Questionnaire, and PedsQL™ Present Functioning Visual Analogue Scale, were used. Results. Insufficient weekday-weekend sleep duration with increasing age of adolescents was observed. The program revealed a significant effect in the experimental group over the control group in overall sleep quality, sleep onset latency, sleep duration, daytime sleepiness, and emotional and overall distress. No significant effect was observed in sleep hygiene and other sleep parameters. All target variables showed significant correlations with each other. Conclusion. The intervention holds a promise for improving the sleep behaviors in healthy adolescents. However, the effect of the sleep promotion program treatment has yet to be proven through a future research. This trial is registered with ISRCTN13083118.

  1. Sleep Promotion Program for Improving Sleep Behaviors in Adolescents: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Bindu John

    2016-01-01

    Full Text Available Aims. The purpose of this pilot trial was to determine the efficacy of sleep promotion program to adapt it for the use of adolescents studying in various schools of Mangalore, India, and evaluate the feasibility issues before conducting a randomized controlled trial in a larger sample of adolescents. Methods. A randomized controlled trial design with stratified random sampling method was used. Fifty-eight adolescents were selected (mean age: 14.02 ± 2.15 years; intervention group, n=34; control group, n=24. Self-report questionnaires, including sociodemographic questionnaire with some additional questions on sleep and activities, Sleep Hygiene Index, Pittsburgh Sleep Quality Index, The Cleveland Adolescent Sleepiness Questionnaire, and PedsQL™ Present Functioning Visual Analogue Scale, were used. Results. Insufficient weekday-weekend sleep duration with increasing age of adolescents was observed. The program revealed a significant effect in the experimental group over the control group in overall sleep quality, sleep onset latency, sleep duration, daytime sleepiness, and emotional and overall distress. No significant effect was observed in sleep hygiene and other sleep parameters. All target variables showed significant correlations with each other. Conclusion. The intervention holds a promise for improving the sleep behaviors in healthy adolescents. However, the effect of the sleep promotion program treatment has yet to be proven through a future research. This trial is registered with ISRCTN13083118.

  2. 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.

  3. Improvement in Vision Parameters for Participants Treated With Alternative Therapies in a 3-day Program.

    Science.gov (United States)

    Kondrot, Edward C

    2015-01-01

    Eye conditions that are considered progressive and degenerative and for which the causation is generally poorly understood or not understood within conventional medicine can respond to natural therapeutic interventions that result in arrest and/or improvement of morbidity, with enhanced functional results. Because many of the treated conditions are age related, a delay of disease progression for 5 or even 10 y can mean an additional decade of independence for seniors. The 11 included ocular conditions are ordinarily considered incurable by any method except surgery and, even with surgery, the outcomes can be variable and/or transient. The research intended to demonstrate the effectiveness of alternative modalities-intravenous (IV) nutrition, oxidative therapy, microcurrent stimulation, and syntonic light therapy-in improving vision in chronic eye conditions, even when administered for a short period. The study was a retrospective, open-label, single-group design. All participants in the 3-d conference during the period covered were selected. The setting was ophthalmologist Edward Kondrot's Healing the Eye and Wellness Center near Tampa, FL, USA. The participants in this study were all patients attending 1 of 11 CAM treatment events at the author's center within 2 y. Each session lasted 3 d and the number of participants in each session ranged from 5-15 (mean = 13). The cohort numbered 152 patients who were diagnosed with ≥1 of 11 types of eye disease. Seventy-eight percent of the patients had either age-related macular degeneration (ARMD) or glaucoma, which, taken together, are the leading cause of blindness in persons >65 y. Each of 4 alternative modalities was provided at least once to each participant: (1) IV nutrition, (2) oxidative therapy, (3) microcurrent stimulation, and (4) syntonic light therapy. On the first day, a detailed treatment plan for each participant was developed. Each day consisted of 2 therapeutic eye programs, a stress reduction program

  4. Improving the Held and Karp Approach with Constraint Programming

    Science.gov (United States)

    Benchimol, Pascal; Régin, Jean-Charles; Rousseau, Louis-Martin; Rueher, Michel; van Hoeve, Willem-Jan

    Held and Karp have proposed, in the early 1970s, a relaxation for the Traveling Salesman Problem (TSP) as well as a branch-and-bound procedure that can solve small to modest-size instances to optimality [4, 5]. It has been shown that the Held-Karp relaxation produces very tight bounds in practice, and this relaxation is therefore applied in TSP solvers such as Concorde [1]. In this short paper we show that the Held-Karp approach can benefit from well-known techniques in Constraint Programming (CP) such as domain filtering and constraint propagation. Namely, we show that filtering algorithms developed for the weighted spanning tree constraint [3, 8] can be adapted to the context of the Held and Karp procedure. In addition to the adaptation of existing algorithms, we introduce a special-purpose filtering algorithm based on the underlying mechanisms used in Prim's algorithm [7]. Finally, we explored two different branching schemes to close the integrality gap. Our initial experimental results indicate that the addition of the CP techniques to the Held-Karp method can be very effective.

  5. [Education reform with the support of the faculty--introduction of a supplementary education program including teacher support and individual guidance].

    Science.gov (United States)

    Wada, Keiji; Yoshimura, Teruki

    2015-01-01

      To deal with declining levels of academic ability and motivation among students (a situation attributable to fewer high school graduates, a greater number of universities, and the diversification of entrance examination methods), one must comprehend the conditions of faculties collectively, and take appropriate measures. Using the results of examinations carried out in each grade as indices, we examined levels of academic ability and established various support programs based on the results. Basic chemistry, biology, and physics courses were designed to help first-year students acquire essential academic skills. For second, third, and fourth-year students, two types of support programs were implemented: supplementary instruction to help students improve their understanding of basic topics in pharmaceutical sciences, and an e-learning system to promote self-study, requiring minimal assistance from teachers. Although educational benefits were observed in many students, the number of learners whose understanding failed to improve as a result of the support programs continued to increase. Consequently, The Support Section for Pharmaceutical Education opened in October 2011 to address these concerns. The support section functions mainly to provide individual assistance to students who lack strong academic abilities, and provides teachers with information useful for educational reform. Here, we describe the educational support provided by our faculty and its effectiveness.

  6. 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.

  7. 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

  8. Is there a need to include HIV, HBV and HCV viruses in the Saudi premarital screening program on the basis of their prevalence and transmission risk factors?

    Science.gov (United States)

    Alswaidi, F M; O'Brien, S J

    2010-11-01

    In January 2008, the Saudi Arabian health authority included mandatory testing for HIV, HBV and HCV viruses in the premarital screening program. Epidemiologically, there were few justifications for their inclusion as disease prevalences and distributions are poorly understood in the population. This study aims to provide information about HBV, HCV and HIV prevalences and risk factors for disease transmission and so produce evidence for informed decision-making on the inclusion of these infectious diseases in the screening program. This is a cross-sectional descriptive study embedded in the existing national premarital screening program for thalassaemia and sickle cell disease to estimate the prevalence of HIV, HBV and HCV infections (n=74,662 individuals), followed by a case-control study to identify risk factors responsible for infection transmission (n=540). The average HIV prevalence is 0.03%, 1.31% for HBV and 0.33% for HCV. Sharing personal belongings particularly razors, blood transfusions, cuts at barbershops and extramarital relationships showed the highest significant associations with the transmission of these viruses. The prevalences of HIV, HBV and HCV in Saudi Arabia are among the lowest worldwide. However, all the important risk factors associated with transmitting these viruses are significantly present in the Saudi community. Saudi Arabia is financially capable of screening for these infections in the mandatory premarital program and of providing medical care for the discovered cases, but focusing on the health education programs may offset the need to mandatory testing.

  9. 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.

  10. 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 ...

  11. 77 FR 51948 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property...

    Science.gov (United States)

    2012-08-28

    ... Federal Aviation Administration 14 CFR Chapter 1 Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property; Correction AGENCY: Federal Aviation Administration (FAA... paragraph in the Proposed Policy Regarding Access to Airports From Residential Property that was published...

  12. Audit-based education: a potentially effective program for improving guideline achievement in CKD patients

    National Research Council Canada - National Science Library

    de Goeij, Moniek C M; Rotmans, Joris I

    2013-01-01

    ... this. Audit-based education is a program that may contribute to this improvement. de Lusignana et al. investigated whether audit-based education is effective in lowering systolic blood pressure in a primary-care setting...

  13. A Children’s Asthma Education Program: Roaring Adventures of Puff (RAP, Improves Quality of Life

    Directory of Open Access Journals (Sweden)

    Shawna L McGhan

    2010-01-01

    Full Text Available BACKGROUND: It is postulated that children with asthma who receive an interactive, comprehensive education program would improve their quality of life, asthma management and asthma control compared with children receiving usual care.

  14. A sample theory-based logic model to improve program development, implementation, and sustainability of Farm to School programs.

    Science.gov (United States)

    Ratcliffe, Michelle M

    2012-08-01

    Farm to School programs hold promise to address childhood obesity. These programs may increase students’ access to healthier foods, increase students’ knowledge of and desire to eat these foods, and increase their consumption of them. Implementing Farm to School programs requires the involvement of multiple people, including nutrition services, educators, and food producers. Because these groups have not traditionally worked together and each has different goals, it is important to demonstrate how Farm to School programs that are designed to decrease childhood obesity may also address others’ objectives, such as academic achievement and economic development. A logic model is an effective tool to help articulate a shared vision for how Farm to School programs may work to accomplish multiple goals. Furthermore, there is evidence that programs based on theory are more likely to be effective at changing individuals’ behaviors. Logic models based on theory may help to explain how a program works, aid in efficient and sustained implementation, and support the development of a coherent evaluation plan. This article presents a sample theory-based logic model for Farm to School programs. The presented logic model is informed by the polytheoretical model for food and garden-based education in school settings (PMFGBE). The logic model has been applied to multiple settings, including Farm to School program development and evaluation in urban and rural school districts. This article also includes a brief discussion on the development of the PMFGBE, a detailed explanation of how Farm to School programs may enhance the curricular, physical, and social learning environments of schools, and suggestions for the applicability of the logic model for practitioners, researchers, and policy makers.

  15. Tiotropium improves lung function, exacerbation rate, and asthma control, independent of baseline characteristics including age, degree of airway obstruction, and allergic status

    DEFF Research Database (Denmark)

    Kerstjens, Huib A M; Moroni-Zentgraf, Petra; Tashkin, Donald P

    2016-01-01

    , compared with placebo, independent of baseline characteristics including gender, age, body mass index, disease duration, age at asthma onset, and FEV1 % predicted at screening and reversibility. CONCLUSION: Once-daily tiotropium 5 μg compared with placebo improved lung function, reduced the risk of asthma...... exacerbations and asthma worsening, and improved asthma symptom control, independent of a broad range of baseline characteristics, as add-on to ICS plus LABAs in patients with severe symptomatic asthma. TRIAL REGISTRY: ClinicalTrials.gov; numbers NCT00772538 and NCT00776984 URL: www.clinicaltrials.gov....

  16. Including a Lower-Extremity Component during Hand-Arm Bimanual Intensive Training does not Attenuate Improvements of the Upper Extremities: A Retrospective Study of Randomized Trials

    Directory of Open Access Journals (Sweden)

    Geoffroy Saussez

    2017-09-01

    Full Text Available Hand-Arm Bimanual Intensive Therapy (HABIT promotes hand function using intensive practice of bimanual functional and play tasks. This intervention has shown to be efficacious to improve upper-extremity (UE function in children with unilateral spastic cerebral palsy (USCP. In addition to UE function deficits, lower-extremity (LE function and UE–LE coordination are also impaired in children with USCP. Recently, a new intervention has been introduced in which the LE is simultaneously engaged during HABIT (Hand-Arm Bimanual Intensive Therapy Including Lower Extremities; HABIT-ILE. Positive effects of this therapy have been demonstrated for both the UE and LE function in children with USCP. However, it is unknown whether the addition of this constant LE component during a bimanual intensive therapy attenuates UE improvements observed in children with USCP. This retrospective study, based on multiple randomized protocols, aims to compare the UE function improvements in children with USCP after HABIT or HABIT-ILE. This study included 86 children with USCP who received 90 h of either HABIT (n = 42 or HABIT-ILE (n = 44 as participants in previous studies. Children were assessed before, after, and 4–6 months after intervention. Primary outcomes were the ABILHAND-Kids and the Assisting Hand Assessment. Secondary measures included the Jebsen-Taylor Test of Hand Function, the Pediatric Evaluation of Disability Inventory [(PEDI; only the self-care functional ability domain] and the Canadian Occupational Performance Measure (COPM. Data analysis was performed using two-way repeated-measures analysis of variance with repeated measures on test sessions. Both groups showed similar, significant improvements for all tests (test session effect p < 0.001; group × test session interaction p > 0.05 except the PEDI and COPM. Larger improvements on these tests were found for the HABIT-ILE group (test session effect p < 0.001; group

  17. Infant feeding practices in the Peruvian Amazon: implications for programs to improve feeding

    Directory of Open Access Journals (Sweden)

    Gwenyth Lee

    2014-09-01

    Full Text Available OBJECTIVE: To characterize feeding practices in a community in the Peruvian Amazon and to consider how this information could be used to strengthen programs and policies designed to improve nutrition and reduce child malnutrition in vulnerable communities METHODS: Data from three structured questionnaires were combined to produce a comprehensive depiction of feeding in a sample of 246 infants from birth through 8 months of life in the community of Santa Clara de Nanay near Iquitos, Peru. Breastfeeding initiation practices, exclusive breastfeeding in the first 180 days of life, the introduction of solids, and complementary feeding practices from 6-8 months, were described and related to maternal, infant, and household characteristics, including food insecurity RESULTS: The median duration of exclusive breastfeeding was 19 days. However, over the first 180 days of life, children were exclusively breastfed on 46.1% of days. Overall, 68.3% of infants received some semi-solid or solid food between 0-6 months and all had received semi-solids by the end of 8 months of age. The proportion of infants consuming a minimally acceptable (frequent and diverse complementary diet was 2.9%, 7.9%, and 16.1% at 6, 7, and 8 months respectively CONCLUSIONS: Although breastfeeding is nearly universal, promotion programs are needed in Santa Clara to 1 delay the introduction of plain water, other non-breast milk liquids, and semi-solid foods; 2 extend the period of exclusive breastfeeding; and 3 increase food diversity and the frequency of feeding during the period of complementary feeding. These results can be used to guide programs and policies to improve nutrition and reduce child malnutrition.

  18. Formal peer-teaching in medical school improves academic performance: the MUSC supplemental instructor program.

    Science.gov (United States)

    Wong, Jeffrey G; Waldrep, Thomas D; Smith, Thomas G

    2007-01-01

    Formal systems of peer teaching are common in many advanced-degree graduate school programs but are less prevalent in medical schools. In 1997, The Medical University of South Carolina's Center for Academic Excellence created a Supplemental Instructor (SI) program in which interested upper-level medical students are hired to teach a small group of junior peers, primarily in basic science topics. The purpose of this study was to examine if participation as an SI leader resulted inmeasurable academic improvement for those students. This study examined if participation as a teacher in the SI program (SI leader) resulted in measurable academic improvement for those students. Admission characteristics (grade point average [GPA], Medical College Aptitude Test score, age, year of enrollment, and gender) of all SI leaders were compiled from the academic years 1996-2001. A second cohort of students, who shared the first group's admission characteristics but who chose not to teach as SIs, was identified as a comparison control group. Outcome measures included United States Medical Licensing Examination (USMLE) Step 1 and 2 scores and final medical school GPA. Paired student two-tailed t -test statistics compared group means on all outcome variables. There were 199 SI leaders with non-SI students matched controls studied. There were no significant differences upon admission between the two groups; however, the SI leader group had significantly higher USMLE Step 1 and Step 2 scores and final medical school GPA compared to the non-SI group. The activity of formal peer-teaching was beneficial to the SI leaders' own academic success as measured by GPA and USMLE test scores.

  19. 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

    2017-07-03

    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

  20. 75 FR 9879 - Office of Innovation and Improvement; Overview Information Magnet Schools Assistance Program...

    Science.gov (United States)

    2010-03-04

    ... Office of Innovation and Improvement; Overview Information Magnet Schools Assistance Program; Notice... eligible local educational agencies (LEAs) and consortia of LEAs to support magnet schools that are part of an approved desegregation plan. Through the implementation of magnet schools, these program resources...

  1. 42 CFR 460.134 - Minimum requirements for quality assessment and performance improvement program.

    Science.gov (United States)

    2010-10-01

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

  2. 78 FR 12325 - Medicare and Medicaid Programs; Application From the Center for Improvement in Healthcare Quality...

    Science.gov (United States)

    2013-02-22

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare and Medicaid Programs; Application From the Center for Improvement in Healthcare Quality (CIHQ) for CMS-Approval of Its Hospital Accreditation Program AGENCY: Centers for Medicare & Medicaid Services, HHS. ACTION: Proposed notice. SUMMARY: This...

  3. Improving Attitudes toward Elderly People: Evaluation of an Intervention Program for Adolescents.

    Science.gov (United States)

    Dooley, Stephen; Frankel, B. Gail

    1990-01-01

    In an experimental evaluation of a "friendly visitor" type of program in which adolescents visited senior citizens, it was found that general attitudes toward elderly people improved following weekly contact with specific elderly persons. Two outcomes of these programs were found: the provision of service to the elderly and the change of negative…

  4. Ohio Program Review for Improvement, Development, and Expansion in Vocational Education.

    Science.gov (United States)

    Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

    The Ohio Program Review for Improvement, Development, and Expansion (PRIDE) in Vocational Education is a comprehensive program review system designed to define, secure, and provide useful information relative to selected vocational education objectives. This document was designed to assist the local vocational education personnel in planning and…

  5. Impact of a primary healthcare quality improvement program on diabetes in Canada: evaluation of the Quality Improvement and Innovation Partnership (QIIP).

    Science.gov (United States)

    Reichert, Sonja M; Harris, Stewart B; Tompkins, Jordan W; Belle-Brown, Judith; Fournie, Meghan; Green, Michael; Han, Han; Kotecha, Jyoti; Mequanint, Selam; Paquette-Warren, Jann; Roberts, Sharon; Russell, Grant; Stewart, Moira; Thind, Amardeep; Webster-Bogaert, Susan; Birtwhistle, Richard

    2017-01-01

    Primary healthcare (PHC) quality improvement (QI) initiatives are designed to improve patient care and health outcomes. We evaluated the Quality Improvement and Innovation Partnership (QIIP), an Ontario-wide PHC QI program on access to care, diabetes management and colorectal cancer screening. This manuscript highlights the impact of QIIP on diabetes outcomes and associated vascular risk factors. A cluster matched-control, retrospective prechart and postchart audit was conducted. One physician per QIIP-PHC team (N=34) and control (N=34) were recruited for the audit. Eligible charts were reviewed for prespecified type 2 diabetes mellitus clinical process and outcome data at baseline, during (intervention range: 15-17.5 months) and post. Primary outcome measures were the A1c of patients above study target and proportion of patients with an annual foot exam. Secondary outcome measures included glycemic, hypertension and lipid outcomes and management, screening for diabetes-related complications, healthcare utilization, and diabetes counseling, education and self-management goal setting. More patients in the QIIP group achieved statistically improved lipid testing, eye examinations, peripheral neuropathy exams, and documented body mass index. No statistical differences in A1c, low-density lipoprotein or systolic/diastolic blood pressure values were noted, with no significant differences in medication prescription, specialist referrals, or chart-reported diabetes counseling, education or self-management goals. Patients of QIIP physicians had significantly more PHC visits. The QIIP-learning collaborative program evaluation using stratified random selection of participants and the inclusion of a control group makes this one of the most rigorous and promising efforts to date evaluating the impact of a QI program in PHC. The chart audit component of this evaluation highlighted that while QIIP improved some secondary diabetes measures, no improvements in clinical outcomes

  6. 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

    2015-03-01

    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 via the SSIS rating scale for all participants, and direct observations were completed for a subsample of participants within each classroom. Results indicated that the SSIS-CIP demonstrated positive effects on teacher ratings of participants' social skills and internalizing behaviors, with the greatest changes occurring in classrooms with students who exhibited lower skill proficiency prior to implementation. Statistically significant differences were not observed between treatment and control participants on teacher ratings of externalizing problem behaviors or direct observation.

  7. Access to Archived Astronaut Data for Human Research Program Researchers: Update on Progress and Process Improvements

    Science.gov (United States)

    Lee, L. R.; Montague, K. A.; Charvat, J. M.; Wear, M. L.; Thomas, D. M.; Van Baalen, M.

    2016-01-01

    Since the 2010 NASA directive to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for astronaut medical data has increased greatly. LSAH and LSDA personnel are working with Human Research Program on many fronts to improve data access and decrease lead time for release of data. Some examples include the following: Feasibility reviews for NASA Research Announcement (NRA) data mining proposals; Improved communication, support for researchers, and process improvements for retrospective Institutional Review Board (IRB) protocols; Supplemental data sharing for flight investigators versus purely retrospective studies; Work with the Multilateral Human Research Panel for Exploration (MHRPE) to develop acceptable data sharing and crew consent processes and to organize inter-agency data coordinators to facilitate requests for international crewmember data. Current metrics on data requests crew consenting will be presented, along with limitations on contacting crew to obtain consent. Categories of medical monitoring data available for request will be presented as well as flow diagrams detailing data request processing and approval steps.

  8. Compilation of Quality Improvement Standards of General Dentistry Program in Islamic Republic

    Directory of Open Access Journals (Sweden)

    Fakhrossadat Hosseini

    Full Text Available Introduction: The importance of quality assurance makes the standard compilation in educational systems as a high priority subject in medical education. The purpose of this study was to study the compilation of quality improvement standards in general dentistry program in Islamic Republic of Iran.Materials & Methods: This descriptive study was performed during the years of 2011 & 2012 in three phases. In the first phase, previous literature and similar standards were included in a comparative study and screened based on national health policies in Health map. Results were evaluated by 16 dental school representatives using modified Delphi methodology and open-closed questionnaires were filled by their faculty members and were reported back to the dental secretariat of ministry of health in the second phase. In the final phase, results were evaluated in the secretariat by a focus group and the final criteria were introduced based on the secretariat politics. Results: Fifty-eight criteria were created in the first phase. Data were collected from 13 faculties in the second phase (response rate=81%. Eighteen criteria had less than 90% agreement of the participants; however, all of the criteria were agreed by more than 70% of the participants. In the final phase, 48 quality improvement standards in seven areas were accepted and introduced in dental secretariat of the ministry of health.Conclusion: The final standard documents could be used as a national covenant of quality improvement based on their high agreement rate and dependence by national politics in the health map.

  9. 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 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 bundling occupational safety information with relevant legal content demonstrate clear promise. Our findings underscore additional efforts needed to raise technical knowledge of the law among personnel tasked with its enforcement. Police professionalization, including minimum educational standards, appear critical for aligning policing with harm reduction goals.

  10. Applying the model of goal-directed behavior, including descriptive norms, to physical activity intentions: A contribution to improving the theory of planned behavior

    OpenAIRE

    ESPOSITO GABRIELE; VAN BAVEL Rene; Baranowski, Tom; DUCH BROWN NESTOR

    2016-01-01

    The theory of planned behaviour (TPB) has received its fair share of criticism lately, including calls for it to retire. We contribute to improving the theory by testing extensions such as the model of goal-directed behaviour (MGDB, which adds desire and anticipated positive and negative emotions) applied to physical activity (PA) intention. We also test the inclusion of a descriptive norm construct as an addition to the subjective norms construct, also applied to PA, resulting in two additio...

  11. Evidence Based Improvements in Clinical Pharmacy Clerkship Program in Undergraduate Pharmacy Education: The Evidence Based Improvement (EBI Initiative

    Directory of Open Access Journals (Sweden)

    Atta Abbas

    2014-11-01

    Full Text Available Although clinical pharmacy training in Pakistan is a novelty in the undergraduate pharmacy curriculum, it has significantly improved the practical knowledge of the undergraduate students with regards practice of pharmacy in health care settings. The implementation of the curriculum change was a major innovation but the possible negative implications were not contemplated at the time of execution and combined with a failure in regular review and assessment of the plan. This led to undesirable outcomes such as breaching of health care protocols and ethics by students, inadequate aptitude and poor clinical research skills. These shortcomings were analyzed and an evidence based improvement program known as the Evidence Based Improvement (EBI initiative was designed containing structured modules to empower undergraduates in those areas. It was implemented by the authorities and has led to positive outcomes which render it very useful and this improvement program can serve as a guide to develop clinical pharmacy training programs in those countries where the practice of pharmacy is evolving.

  12. 34 CFR 303.15 - Include; including.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Include; including. 303.15 Section 303.15 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH...

  13. Exercise improves physical and psychological quality of life in people with depression: A meta-analysis including the evaluation of control group response.

    Science.gov (United States)

    Schuch, Felipe B; Vancampfort, Davy; Rosenbaum, Simon; Richards, Justin; Ward, Philip B; Stubbs, Brendon

    2016-07-30

    Exercise has established efficacy as an antidepressant in people with depression. However, few meta-analyses have assessed the effects of exercise across different domains of Quality of Life (QoL) in people with depression. Furthermore, there has been no previous meta-analysis of control group response in relation to QoL in exercise trials for depression. Randomized Clinical Trials(RCTs) were initially identified from a Cochrane review, and those including QoL assessments were included in the analysis. Search of major electronic databases were conducted to identify RCTs that compared the exercise effects on QoL versus control condition in people with depression. A random effects meta-analysis was employed to evaluate the Standardized Mean Difference (SMD). Six RCTs were included. Exercise significantly improved physical and psychological domains and overall QoL. Effects on social relationship and environment domains were not significant. No significant control group response was found for any domain or overall QoL. Exercise can be considered as a therapeutic strategy to improve physical and psychological domains and overall QoL of people with depression, with no effect evident across the social and environmental domains. The lack of improvement among control groups reinforces the role of exercise as a treatment for depression with benefits to QoL. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. 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.

  15. 78 FR 29139 - Medicare Program; Bundled Payments for Care Improvement Model 1 Open Period

    Science.gov (United States)

    2013-05-17

    ... Payments for Care Improvement Deadline: Interested organizations must submit a Model 1 Open Period... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program; Bundled Payments for Care Improvement Model 1 Open Period AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice...

  16. West Coast tree improvement programs: a break-even, cost-benefit analysis

    Science.gov (United States)

    F. Thomas Ledig; Richard L Porterfield

    1981-01-01

    Three tree improvement programs were analyzed by break-even, cost-benefit technique: one for ponderosa pine in the Pacific Northwest, and two for Douglas-fir in the Pacific Northwest-one of low intensity and the other of high intensity. A return of 8 percent on investment appears feasible by using short rotations or by accompanying tree improvement with thinning....

  17. Improving the Use of Data in Early Reading Intervention Programs in Northwest Florida

    Science.gov (United States)

    Thompson, Carla J.

    2012-01-01

    Improving student performance for high-need student populations by improving the use of data in decision-making for early reading intervention programs in northwest Florida is the focus of this research to practice effort. The study is conceptually based on using a relational-feedback intervention (RFI) database model in early learning…

  18. Efficacy of an Intervention Program to Improve Employability of University Students.

    Science.gov (United States)

    Hernández-Fernaud, Estefanía; Ruiz-de la Rosa, Carmen Inés; Negrín, Fátima; Ramos-Sapena, Yeray; Hernández, Bernardo

    2017-01-19

    In the current socioeconomic situation, the need to improve employability of potential workers is especially relevant. The aim of this study was to evaluate the efficacy of an intervention program focusing on improving employability of university students. To do this, a two-group study was designed: one group undertook the intervention program and the other group were used for comparison. Two measurements were taken at different times (pre-intervention and post-intervention). The sample consisted of 271 university students. The results show that the group that underwent the intervention program improved their perceived employability F(1, 269) = 17.49, p employment resources F(1, 269) = 512.89, p < .001; η2 = .66 compared to the group that did not. Furthermore, there was a high level of satisfaction of participants with the intervention program.

  19. 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

  20. Shooting from the HIP: Hyperion's efforts to clean Santa Monica Bay. [Hyperion Improvement Program (HIP)

    Energy Technology Data Exchange (ETDEWEB)

    Crosse, J.T. (Hyperion Treatment Plant, Playa del Rey, CA (United States)); Smith, D.L. (James M. Montgomery Consulting Engineers, Pasadena, CA (United States)); Sizemore, H.M. (Bureau of Sanitation, Los Angeles, CA (United States)); Abkian, V.; Horenstein, B.K. (Hyperion Treatment Plant, Los Angeles, CA (United States))

    1991-11-01

    The Outstanding Achievement Award in Water Pollution Control' is intended to recognize the water pollution control program that best demonstrates achieving significant, lasting, and measurable excellence in water-quality improvement in preventing water-quality degradation in a region, basin, or water body. This article is about the 1991 Award. This year, WPCF honored Los Angeles Hyperion Treatment Plant with a citation of outstanding achievement. To qualify for this honor, Hyperion has remarkably improved the quality of wastewater discharged to Santa Monica Bay since 1985. Capital programs developed by Los Angeles to achieve this rapid improvement, coined the Hyperion Improvement Program (HIP), reflect the city's commitment to protect the valuable resource of Santa Monica Bay. The HIP was conceived in 1986 to cease sludge ocean disposal by the end of 1987 and expedite effluent quality improvement before 1991, when the full secondary expansion is scheduled for completion. The program included implementing chemical addition to enhance primary treatment performance; installing fine bubble diffusers to double the level of secondary treatment from 3.38 to 8.76 m{sup 3}/s (100 to 200 mgd); increasing waste activated sludge thickening capacity to handle the doubled secondary flow; improving digester performance, increasing sludge dewatering capacity; ceasing ocean disposal of sludge; and completing a truck loading facility to support the EPA-award-winning off-site beneficial sludge reuse program. The successful HIP effort resulted in the plant's meeting more stringent 1991 discharge standards in 1986 and meeting 1998 full secondary treatment standards (except for biochemical oxygen demand) in 1989.

  1. 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

  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. 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.

  4. Is health of the aging improved by conditional cash transfer programs? Evidence from Mexico.

    Science.gov (United States)

    Behrman, Jere R; Parker, Susan W

    2013-08-01

    Conditional cash transfer (CCT) programs link public transfers to human capital investment in the hopes of alleviating current poverty and reducing its intergenerational transmission. Whereas nearly all studies of their effects have focused on youth, CCT programs may also have an impact on aging adults by increasing household resources or inducing changes in allocations of time of household members, which may be of substantial interest, particularly given the rapid aging of most populations. This article contributes to this underresearched area by examining health and work impacts on the aging for the best-known and most influential of these programs, the Mexican PROGRESA/Oportunidades program. For a number of health indicators, the program appears to significantly improve health, with larger effects for recipients with a greater time receiving benefits from the program. Most of these health effects are concentrated on women.

  5. Is Health of the Aging Improved by Conditional Cash Transfer Programs? Evidence From Mexico

    Science.gov (United States)

    Behrman, Jere R.

    2013-01-01

    Conditional cash transfer (CCT) programs link public transfers to human capital investment in the hopes of alleviating current poverty and reducing its intergenerational transmission. Whereas nearly all studies of their effects have focused on youth, CCT programs may also have an impact on aging adults by increasing household resources or inducing changes in allocations of time of household members, which may be of substantial interest, particularly given the rapid aging of most populations. This article contributes to this underresearched area by examining health and work impacts on the aging for the best-known and most influential of these programs, the Mexican PROGRESA/Oportunidades program. For a number of health indicators, the program appears to significantly improve health, with larger effects for recipients with a greater time receiving benefits from the program. Most of these health effects are concentrated on women. PMID:23494570

  6. IMPROVING EXPERIMENT DESIGN SKILLS: USING THE JOKO TINGKIR PROGRAM AS A LEARNING TOOL OF TSUNAMI TOPIC

    Directory of Open Access Journals (Sweden)

    Madlazim

    2014-07-01

    Full Text Available Students are rarely given an opportunity to think deeply about experimental design or asked to develop experimental skills on their own. Without participating in these endeavors, they are often unaware of the many decisions necessary to construct a precise methodology. This article describes the Joko Tingkir Program as an Early Warning Tsunami, and how we have used this program as a learning tool for physics teacher candidates to improve their experimental design skills. The Joko Tingkir computer program has implemented a Tsunami Faulting Model (TFM. The TFM uses the principle that the tsunami is affected by the length and width of earthquake rupture. Both can be represented by the duration of rupture (Tdur or Exceed 50 second duration (T50Ex and the dominant period (Td. The TFM has been implemented by the Joko Tingkir computer program. When students are given a simple method using the Joko Tingkir program - such as the tutorial, observation of seismic station distribution, seismograms of the earthquake, equipment and software for this experiment, measurement of P time onset and determination of Tdur, Td and T50Ex - it allows them to focus exclusively on improving experiment design skills as indicated by significantly improved gain scores. Based on the gain analysis it can be inferred that the experiment design skills can be improved by implementation of Joko Tingkir Program as a Learning Tool of Tsunami Warning in the learning process

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics.

    Science.gov (United States)

    Kuo, Benjamin J; Vissoci, Joao Ricardo N; Egger, Joseph R; Smith, Emily R; Grant, Gerald A; Haglund, Michael M; Rice, Henry E

    2017-03-01

    OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform. METHODS Data on 9996 pediatric neurosurgical patients were acquired from the 2012-2014 NSQIP-Peds participant user file. Neurosurgical cases were analyzed by the NSQIP-Peds targeted procedure categories, including craniotomy/craniectomy, defect repair, laminectomy, shunts, and implants. The primary outcome measure was 30-day mortality, with secondary outcomes including individual AEs, composite morbidity (all AEs excluding mortality and unplanned reoperation), surgical-site infection, and unplanned reoperation. Univariate analysis was performed between individual AEs and patient characteristics using Fischer's exact test. Associations between individual AEs and continuous variables (duration from admission to operation, work relative value unit, and operation time) were examined using the Student t-test. Patient characteristics and continuous variables associated with any AE by univariate analysis were used to develop category-specific multivariable models through backward stepwise logistic regression. RESULTS The authors analyzed 3383 craniotomy/craniectomy, 242 defect repair, 1811 laminectomy, and 4560 shunt and implant cases and found a composite overall morbidity of 30.2%, 38.8%, 10.2%, and 10.7%, respectively. Unplanned reoperation rates were highest for defect repair (29.8%). The mortality rate ranged from 0.1% to 1.2%. Preoperative ventilator dependence was a significant predictor of any AE for all procedure groups, whereas

  12. A long-term physical activity training program increases strength and flexibility, and improves balance in older adults.

    Science.gov (United States)

    Seco, Jesús; Abecia, Luis Carlos; Echevarría, Enrique; Barbero, Ismael; Torres-Unda, Juan; Rodriguez, Vicente; Calvo, Jose Ignacio

    2013-01-01

    Physical activity training programs in older adults have recognized health benefits. Evidence suggests that training should include a combination of progressive resistance, balance, and functional training. Our aim was to assess the effects of a simple physical activity program working on strength, flexibility, cardiovascular fitness, and balance in older adults, as well as the effects of a detraining period, at various different ages. This was longitudinal prospective study, including a convenience sample of 227 independent older adults (54 men, 173 women) who completed a simple 9-month training program and 3-month detraining follow-up. The subjects were categorized into two age groups (65-74 [n = 180], and >74 years [n = 47]). At the beginning of the study (baseline), the end of the training period, and 3 months later (postdetraining), body mass index, body fat percentage, triceps skinfold thickness, hand grip strength, lower limb and trunk flexibility, resting heart rate, heart rate after exercise, and balance were measured, while VO(2 max) was estimated using the Rockport fitness test and/or measured directly. Significant improvements in strength (p < .0001), flexibility (p < .0001), heart rate after exercise (p < .0001), and balance (p < .0001) were observed at the end of the training program. Flexibility and balance (p < .0001) improvements were maintained at the end of the detraining. A simple long-term physical activity training program increases strength in both sexes, improves flexibility in women, and improves balance in older adults. The results also indicate the importance of beginning early in old age and maintaining long-term training. © 2013 Association of Rehabilitation Nurses.

  13. Brief internet-based cognitive behavior therapy program with a supplement drink improved anxiety and somatic symptoms in Japanese workers.

    Science.gov (United States)

    Shirotsuki, Kentaro; Nonaka, Yuji; Takano, Jiro; Abe, Keiichi; Adachi, So-Ichiro; Adachi, Shohei; Nakao, Mutsuhiro

    2017-01-01

    Self-help cognitive behavior therapy (CBT) is a useful approach for the treatment of psychological problems. Recent research on the effectiveness of self-help internet-based CBT (ICBT) indicates that the paradigm moderately improves psychological problems. Furthermore, previous studies have shown that food and drinks containing supplements improve various health conditions. We investigated the effect of a brief self-help ICBT administered with a supplement drink on psychological well-being and somatic symptoms. In total, 101 healthy workers were enrolled in the 4-week ICBT program, which consisted of psychoeducation on stress management, behavior activation, and cognitive restructuring. The supplement soft drink was taken every day during the program. The participants were instructed to watch on-demand video clips and read the self-help guidebook and supporting comic strip weekly on the Internet or smartphone. The Japanese version of the Profile of Mood States (POMS) was administered before and after completion of the program. Scores on the POMS tension-anxiety (POMS-TA), depression (POMS-D), and fatigue (POMS-F) subscales were used to assess the effect of the program. Somatic symptoms were assessed using the Brief Job Stress Questionnaire. In total, 75 participants continued the program for 4 weeks; however, of those, 27 failed to complete all weekly tasks or meet the post-assessment deadlines. Therefore, the data of 48 participants were included in the analysis. Pre-post intervention comparisons using paired t-tests revealed significant improvement on the POMS-TA, but not the POMS-D or POMS-F subscales. Moreover, participants reported a significant reduction in the severity of low back pain. Our brief intervention moderately improved anxiety levels and the symptom of low back pain. These findings suggest that the brief ICBT program is effective in non-patient populations. Future directions for brief ICBT are discussed. This study was registered on February 10

  14. 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.

  15. [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.

  16. Impact of supplemental training programs on improving medical students' confidence in providing diabetes self-management education and support.

    Science.gov (United States)

    Fazel, Maryam T; Fazel, Mohammad; Bedrossian, Nora L; Picazo, Fernando; Sobel, Julia D; Fazel, Mahdieh; Te, Charisse; Pendergrass, Merri L

    2017-01-01

    The purpose of this study was to evaluate the effectiveness of supplemental diabetes-related training modalities and volunteer activities in increasing first-year medical students' knowledge/comfort in providing diabetes self-management education and support (DSMES) to patients. A group of medical students developed supplemental diabetes-related training/volunteer programs. The training modalities included an optional 7-session interprofessionally taught Diabetes Enrichment Elective and a 3-hour endocrinologist-led training session intended to prepare students for involvement in an inpatient DSMES volunteer program. The volunteer program provided the students with the opportunity to provide DSMES to patients with diabetes admitted to an academic medical center. Those participating in any of the stated programs were compared to those with no such training regarding confidence in providing DSMES using an optional online survey. The results were analyzed by using Mann-Whitney U test and descriptive analyses. A total of 18 first-year medical students responded to the optional survey with a response rate of ~30% (10 of 33) among participants in any training/volunteer program. First-year medical students who attended any of the offered optional programs had statistically significant higher comfort level in 4 of the 6 areas assessed regarding providing DSMES compared with those with no such training (ptraining modalities/volunteer programs can provide benefit in providing medical students with practical knowledge while improving their confidence in providing DSMES to patients with diabetes.

  17. 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.

  18. 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,…

  19. [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

  20. Project Learning T.I.P. (To Improve Productivity) Workplace Literacy Program at Lindsey Hopkins Technical Education Center, 1989-1990. Final Evaluation.

    Science.gov (United States)

    Friedenberg, Joan E.

    Project Learning TIP (To Improve Productivity) was a federally-funded 18-month workplace literacy program for hospital workers in Miami, Florida. Students enrolled in courses designed to improve work-related skills, including English as a Second Language, basic literacy, general basic skills, pre-nursing, and high school equivalency test…

  1. [Investigation of the educational effectiveness of including small group discussion as part of a drug abuse prevention program for junior high school students].

    Science.gov (United States)

    Yamada, Junichi; Takayanagi, Risa; Yokoyama, Haruko; Suzuki, Yasuhiro; Sinohara, Satomi; Yamada, Yasuhiko

    2014-01-01

    We evaluated the effectiveness of small group discussion (SGD) in association with a drug abuse prevention program for junior high school students. The students first received a lecture about drug abuse prevention, then participated in SGD. The discussion focused on how to take action when tempted to abuse drugs. We gave a questionnaire 3 times; before and after the lecture (before SGD), and after SGD. Seventy-seven students replied to these questionnaires. After the lecture, knowledge about drug abuse was improved and all students answered that they had never abused drugs. However, in answer to a different question, a few students noted that they might use drugs in some situations. We consider it necessary to give more consideration to this problem. After the lecture, 35.5% of the students felt that they had definitely acquired skills for drug abuse prevention, whereas after the SGD this was increased to 73.7%. In addition, more than 75% of the students answered that the SGD program was useful since the opinions of other students could be heard. These results suggest that more students acquired skills to prevent drug abuse by participation in SGD. Our findings showed that SGD was useful and that the students were able to more effectively understand important concepts related to drug abuse prevention.

  2. The Tripler Tobacco-Cessation Program: predictors for success and improved efficacy.

    Science.gov (United States)

    Faue, M; Folen, R A; James, L C; Needels, T

    1997-07-01

    This study analyzed differences in baseline, course of treatment, and post-quit variables of participants in a tobacco-cessation program to identify factors predictive of outcome that could be used as a focus for intervention. The program offered a 10-week course of transdermal nicotine replacement combined with education and cognitive/behavioral therapy in a group format at a major military medical center. Demonstrated differences were found among abstainers, early relapsers, and late relapsers in age-initiated tobacco use, use of liquor, levels of exhaled carbon monoxide at intake, tobacco use during the program, and perceived reasons for relapse. The abstinence rate at follow-up was 27%. Based on our findings, we discuss recommendations to improve treatment. This information is offered as a model to evaluate and improve the efficacy of established clinic-based tobacco-cessation programs.

  3. Improvement in sentinel node biopsy results in a teaching community hospital: results of a multidisciplinary quality improvement program.

    Science.gov (United States)

    Orr, Richard K; Wheeler, Kerry L; Barrineau, Devonne D; Hird, R Barry

    2008-10-01

    In 2001 we reported poor results for sentinel node biopsy and marked variability among surgeons. Subsequently, we initiated a multidisciplinary protocol involving standardized radiocolloid injection, physician education, and surgeon proctoring. The current study presents follow-up data (2004-2006) after this quality improvement initiative. Data recorded included technical details and patient factors, related to each surgeon. Results were compared with our previously published data. The overall identification rate was improved markedly from 2001 (92% vs 66%). Eleven general surgeons performed 151 sentinel node biopsies. Seven surgeons had a 100% identification rate, the others had identification rates of 84% (N = 44), 86% (N = 29), 92% (N = 12), and 0% (N = 1). Differences still persist among surgeons, including number of sentinel nodes sampled, performance of axillary dissections, and breast conservation. A multidisciplinary protocol improved sentinel node biopsy performance in a community teaching hospital. However, further work is needed to standardize and improve overall breast surgery results.

  4. The Role of Counseling in an Associate Degree in Labor Studies Program: Counseling in a Work Oriented Setting (The Importance of Including Counseling Courses within the Curriculum of the Associate Degree in Labor Studies Program at the Community College Level).

    Science.gov (United States)

    Kingery, Bruce

    This research had a two-fold purpose: (1) to assess the need for a labor studies program at the community college level; and (2) to consider the advisability of including within such a curriculum a cross-section of adult/family/worker-oriented counseling and guidance courses. The study employed a questionnaire completed by union delegates, which…

  5. Improving Program Success Through Systems Engineering Tools in Pre-Milestone B Acquisition Phase

    Science.gov (United States)

    2013-10-01

    Massachusetts Institute of Technology and Southampton Universities ( Furlong , McPhail, & Stevenson, 2007). We developed a Improving Program Success...technologies for achieving endurance that were based on experience with the Autosub UUV ( Furlong , McPhail, & Stevenson, 2007) being designed for an...Faulkenberg, S., & Wiecek, M. (2010). Quality discrete representation in multiple objective programming. Optimization and Engineering, 11(3), 423–440. Furlong

  6. Rapid Health Care Improvement Science Curriculum Integration Across Programs in a School of Nursing.

    Science.gov (United States)

    Oliver, Brant J; Potter, Mertie; Pomerleau, Mimi; Phillips, Andrew; O'Donnell, Mimi; Cowley, Connie; Sipe, Margie

    This article describes the systematic efforts undertaken by a school of nursing in the Northeastern United States to foster innovation in health professions education. We present an application of modified team coaching and plan-do-study-act improvement methods in an educational context to rapidly integrate a quality and safety curriculum across programs. We discuss applications in generalist, advanced practice, doctoral, residency, and advanced fellowship programs and provide examples of each.

  7. Effects of Physical Activity Programs on the Improvement of Dementia Symptom: A Meta-Analysis

    OpenAIRE

    Han Suk Lee; Sun Wook Park; Yoo Jung Park

    2016-01-01

    Objective. To confirm that physical activity program improves the symptoms of dementia and the most effective physical activity was selected to help establish exercise programs. Methods. Three databases, PubMed, Science Direct, and Willey online, were used to collect articles. The databases were published between January 2005 and December 2015. Keywords such as “dementia,” and “physical activity” were used in searching for papers. As a result, nine studies were selected in the second screenin...

  8. Validation of the age-adjusted shock index using pediatric trauma quality improvement program data.

    Science.gov (United States)

    Nordin, Andrew; Coleman, Alan; Shi, Junxin; Wheeler, Krista; Xiang, Henry; Acker, Shannon; Bensard, Denis; Kenney, Brian

    2017-10-12

    In adults, shock index (SI; heart rate/systolic blood pressure) >0.9 predicts injury severity and trauma outcomes. However, age-adjusted shock index (SIPA) out-performs SI in blunt trauma patients 4-16years old. We sought to confirm these findings and expand this tool to include penetrating trauma and children aged 1-4years. We developed cutoff values for patients 1-3years old using age-based vital signs and queried the 2014 Pediatric Trauma Quality Improvement Program (TQIP) database for patients aged 1-16years sustaining blunt or penetrating trauma. Outcomes measured included injury severity, transfusion within 24h, intensive care unit (ICU) and hospital length of stay (LOS), and mortality. SI and SIPA were compared using Student's t-test and chi-square tests. We identified 22,344 blunt and 613 penetrating trauma patients. SI was elevated in 41.3% and 40.0% of these groups, respectively, whereas SIPA was elevated in 15.6% and 19.4% of patients. SIPA was a significantly better predictor of transfusion needs, injury severity, ICU admission, ventilator use, and mortality for both blunt and penetrating trauma. SIPA identifies severe injury and predicts transfusion needs and mortality more effectively than SI for both blunt and penetrating pediatric trauma. Further investigation should evaluate its use as a triage tool. Prognosis Study. II. Copyright © 2017. Published by Elsevier Inc.

  9. 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.

  10. 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

    2017-02-01

    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 aquatic exercise program for adults with ID may promote improvements in endurance and balance/mobility.

  11. Key Informants' Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran.

    Science.gov (United States)

    Ghodsi, Delaram; Omidvar, Nasrin; Rashidian, Arash; Raghfar, Hossein; Eini-Zinab, Hassan; Ebrahimi, Marziyeh

    2016-01-01

    Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children. This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation. Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants. Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition. Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.

  12. A training program to improve neuromuscular indices in female high school volleyball players.

    Science.gov (United States)

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

    2011-08-01

    The purpose of this study was to determine if a sports-specific training program could improve neuromuscular indices in female high school volleyball players. We combined components from a previously published knee ligament injury prevention intervention program for jump and strength training with additional 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 indices in high school female volleyball players. Thirty-four athletes (age 14.5 years ± 1.0) participated in the supervised 6-week program, 3 d·wk(-1) for approximately 90-120 minutes per session. The program was conducted on the school's volleyball court and weight room facilities. The athletes underwent a video drop-jump test, multistage fitness test, vertical jump test, and sit-up test before and after training. A significant increase was found in the mean VO2max score (p volleyball programs.

  13. 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

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

    Science.gov (United States)

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

    2017-06-13

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

  15. Improvement of training process of powerlifters on the basis of an interactive program "PersTrainer"

    Directory of Open Access Journals (Sweden)

    Volodymyr Ashanin

    2017-12-01

    Full Text Available Purpose: to develop and scientifically substantiate the program "PersTrainer" for improving the training process of powerlifters. Material & Methods: the study involved the powerlifters of 16–18 years. The following research methods were used: analysis and generalization of the literary sources and data of the Internet, pedagogical observation and the method of information modeling. Results: the interactive program "PersTrainer" is developed and theoretically justified, which allows individually calculating the training load in different training cycles. Conclusion: it is possible to plan training loads on the basis of individually proposed exercise complexes, which are presented in the interactive program "PersTrainer".

  16. Intergenerational Service Learning Program Improves Aging Knowledge and Expectations and Reduces Ageism in Younger Adults

    Directory of Open Access Journals (Sweden)

    Sarah L. Francis

    2014-09-01

    Full Text Available This article discusses a study which evaluated the effects of an intergenerational service-learning exergaming program for older adults on younger adults’ aging knowledge, expectations, and perceptions. Eighteen college students (ages 19-26 years served as trainers for an 8-week exergaming physical activity program for older adults (12 contact hours. Questionnaires assessing aging knowledge, ageist attitudes and aging expectations were completed at Weeks 1, 8, and 25 (follow-up; program evaluations were completed at Weeks 8 and 25. Significant improvement from Week 1 to Week 25 was found for: Aging knowledge scores (p

  17. 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

  18. Modification of two capripoxvirus quantitative real-time PCR assays to improve diagnostic sensitivity and include beta-actin as an internal positive control.

    Science.gov (United States)

    Das, Amaresh; Deng, Ming Y; Babiuk, Shawn; McIntosh, Michael T

    2017-05-01

    Capripoxviruses (CaPVs), consisting of Sheeppox virus (SPV), Goatpox virus (GPV), and Lumpy skin disease virus (LSDV) species, cause economically significant diseases in sheep, goats, and cattle, respectively. Quantitative real-time polymerase chain reaction (qPCR) assays are routinely used for rapid detection of CaPVs in surveillance and outbreak management programs. We further modified and optimized 2 previously published CaPV qPCR assays, referred to as the Balinsky and Bowden assays, by changing commercial PCR reagents used in the tests. The modified assays displayed 100% analytical specificity and showed no apparent changes in analytical sensitivities for detection of CaPVs compared with the original assays. Diagnostic sensitivities, assessed using 50 clinical reference samples from experimentally infected sheep, goats, and cattle, improved from 82% to 92% for the modified Balinsky assay and from 58% to 82% for the modified Bowden assay. The modified qPCR assays were multiplexed for detection of beta-actin as an indicator for potential false-negative results. The multiplex modified qPCR assays exhibited the same diagnostic sensitivities as the singleplex assays suggesting their utility in the detection of CaPVs.

  19. 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.

  20. Improvements in Balance in Older Adults Engaged in a Specialized Home Care Falls Prevention Program

    Science.gov (United States)

    Whitney, Susan L.; Marchetti, Gregory F.; Ellis, Jennifer L.; Otis, Laurie

    2016-01-01

    Background and Purpose To determine if persons older than 65 years receiving a combination of physical therapy, occupational therapy, speech, or nursing interventions in their home demonstrated changes in gait/balance function after an episode of home care services. Methods Charts from 11 667 persons who were at risk for falling and who were participating in an exercise program in the home were included. Study design Data were retrieved from the Outcome and Assessment Information Set, Version B, and the computerized database of physical therapist–collected outcome data. Recorded physical therapist–data may have included a neuropathic pain rating, the Berg Balance Scale (BBS), the Performance Oriented Measurement Assessment (POMA), the Dynamic Gait Index (DGI), and the modified Clinical Test of Sensory Integration and Balance (mCTSIB). Data analysis Data were extracted by an honest broker and were analyzed. Mean (SD) change in each performance test and the percentage of participants in the total sample and in the 9 age/health condition strata that exceeded the minimum detectable change (MDC) for each gait/balance measure were described. The value of MDC95 describes the amount of true change in participant status beyond measurement error with 95% certainty. Results The gait/balance measures demonstrated MDCs ranging between 68% and 91% for the study sample. Mean (SD) of improvement on the BBS was 12 (8) points, with 88% of all participants exceeding the BBS MDC95 value of 5 points. Mean (SD) of improvement in gait/balance performance as measured by the POMA was 8 (4) points, with 91% of all participants exceeding the POMA MDC95 value of 3 points. Among all patients, mean (SD) of improvement on the DGI was 7 (4) points with 91% of all participants exceeding the DGI MDC95 value of 2 points by discharge. At admission, the median number of mCTSIB conditions that could be completed was 1 and the median number of completed conditions on the mCTSIB increased to 3 at

  1. The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review.

    Science.gov (United States)

    Jongen, Crystal Sky; McCalman, Janya; Bainbridge, Roxanne Gwendalyn

    2017-01-01

    Cultural competency is a multifaceted intervention approach, which needs to be implemented at various levels of health-care systems to improve quality of care for culturally and ethnically diverse populations. One level of health care where cultural competency is required is in the provision of health promotion services and programs targeted to diverse patient groups who experience health-care and health inequalities. To inform the implementation and evaluation of health promotion programs and services to improve cultural competency, research must assess both intervention strategies and intervention outcomes. This scoping review was completed as part of a larger systematic literature search conducted on evaluations of cultural competence interventions in health care in Canada, the United States, Australia, and New Zealand. Seventeen peer-reviewed databases, 13 websites and clearinghouses, and 11 literature reviews were searched. Overall, 64 studies on cultural competency interventions were found, with 22 being health promotion programs and services. A process of thematic analysis was utilized to identify key intervention strategies and outcomes reported in the literature. The review identified three overarching strategies utilized in health promotion services and programs to improve cultural competency: community-focused strategies, culturally focused strategies, and language-focused strategies. Studies took different approaches to delivering culturally competent health interventions, with the majority incorporating multiple strategies from each overarching category. There were various intermediate health-care and health outcomes reported across the included studies. Most commonly reported were positive reports of patient satisfaction, patient/participant service access, and program/study retention rates. The health outcome results indicate positive potential of health promotion services and programs to improve cultural competency to impact cardiovascular disease

  2. Factor Analysis of Obstacles Restraining Productivity Improvement Programs in Manufacturing Enterprises in Oman

    Directory of Open Access Journals (Sweden)

    Hamdi A. Bashir

    2014-01-01

    Full Text Available Manufacturing enterprises can face obstacles that make productivity improvement efforts ineffective or even prevent improvement operations. This paper reports on an investigation of the internal obstacles restraining productivity improvement programs in the manufacturing enterprises of developing countries, using Oman as a case study. Data required for this study were collected through a questionnaire given to production and operations managers at 51 manufacturing enterprises in Oman. The results of applying factor analysis to a dataset of 15 obstacles showed that these obstacles can be reduced to three major factors. Ranked according to their importance, these factors are poor management practices, employee job dissatisfaction, and poor human resource management. The findings of this research are of value to production and operations managers of manufacturing enterprises who are interested in conducting productivity improvement programs not only in Oman but also in developing countries with environments similar to that of Oman, such as the Gulf Cooperation Council (GCC countries.

  3. Do some of physiotherapy and rehabilitation programs improve the health state of patients suffering from cerebral clot?

    Directory of Open Access Journals (Sweden)

    Ayad OMAR

    2014-09-01

    Full Text Available Cerebral stroke represents one of the most important diseases resulting from blood clot in the middle cerebral artery, this is due to atherosclerotic clot and the brain has area of deprived blood , therefore blood becomes unable to pass the clot, in this case leads to total or partial paralysis. Rehabilitation programs are one of the most effective therapies for cerebral stroke. These pr ograms include rehabilitation exercises, therapeutic massage and kinet otherapy. The present study deals with the application of organized rehabilitation program and identify it's effect on the movement system and joints. This study examined the effect of rehabilitation program to improve the efficiency of the Locomotor system of patient who complain of cerebral stroke.

  4. FAR EAST TECHNICAL ASSISTANCE PROGRAMS OF U.S. NON-PROFIT ORGANIZATIONS (INCLUDING VOLUNTARY AGENCIES, MISSIONS, AND FOUNDATIONS), DIRECTORY - 1966.

    Science.gov (United States)

    BURGESS, MARY ELLEN, ED.

    PART 1 OF THIS PROGRAM GUIDE LISTS TECHNICAL ASSISTANCE AGENCIES AND OTHER ORGANIZATIONS FOR THE FAR EAST, TOGETHER WITH ADDRESSES, TELEPHONE NUMBERS, EXECUTIVE OFFICERS, PROGRAM DIRECTORS, COUNTRIES SERVED, AND ESTIMATED COSTS. PART 2 GIVES PROGRAM DATA (ORGANIZATIONS, OPERATING AND SUPPORT PROGRAMS, TYPES OF ASSISTANCE, REGIONAL REPRESENTATIVES,…

  5. 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)

    Esposito, Gabriele; van Bavel, René; Baranowski, Tom; Duch-Brown, Néstor

    2016-08-01

    The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contribute 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) applied to physical activity (PA) intention. We also test the inclusion of a descriptive norms construct as an addition to the subjective norms construct, also applied to PA, resulting in two additional models: TPB including descriptive norms (TPB + DN) and MGDB including descriptive norms (MGDB + DN). The study is based on an online survey of 400 young adult Internet users, previously enrolled in a subject pool. Confirmatory factor analysis (CFA) showed that TPB and TPB + DN were not fit for purpose, while MGDB and MGDB + DN were. Structural equation modelling (SEM) conducted on MGDB and MGDB + DN showed that the inclusion of descriptive norms took over the significance of injunctive norms, and increased the model's account of total variance in intention to be physically active. © The Author(s) 2016.

  6. Thrombocytopenia and craniotomy for tumor: A National Surgical Quality Improvement Program analysis.

    Science.gov (United States)

    Dasenbrock, Hormuzdiyar H; Devine, Christopher A; Liu, Kevin X; Gormley, William B; Claus, Elizabeth B; Smith, Timothy R; Dunn, Ian F

    2016-06-01

    To the authors' knowledge, the current study is the first national analysis of the association between preoperative platelet count and outcomes after craniotomy. Patients who underwent craniotomy for tumor were extracted from the prospective National Surgical Quality Improvement Program registry (2007-2014) and stratified by preoperative thrombocytopenia, defined as mild (125,000-149,000/μL), moderate (100,000-124,000/μL), severe (75,000-99,000/μL), or very severe (thrombocytopenia and 30-day mortality, and multivariable logistic regression with complications and unplanned reoperation. Covariates included patient age, sex, tumor histology, American Society of Anesthesiologists class, functional status, comorbidities, and surgical time. A total of 14,852 patients were included in the current study and thrombocytopenia was classified as mild in 4.4% (646 patients), moderate in 2.0% (290 patients), severe in 0.7% (105 patients), or very severe in 0.4% (66 patients) of patients. The adjusted hazard of 30-day death was significantly higher for patients with moderate (6.6%; hazard ratio [HR], 2.13 [95% confidence interval (95% CI), 1.30-3.49; P =  0.003]), severe (10.5%; HR, 2.33 [95% CI, 1.18-4.60; P =  0.02]), and very severe (10.6%; HR, 3.65 [95% CI, 1.71-7.82; P =  0.001]) thrombocytopenia, compared with patients without thrombocytopenia (2.9%), with an increased effect size noted with greater thrombocytopenia. Likewise, when the platelet count was evaluated continuously, a higher platelet count was associated with a lower hazard of 30-day mortality (HR, 0.987 [95% CI, 0.981-0.993; Pthrombocytopenia. In this National Surgical Quality Improvement Program analysis, moderate and severe thrombocytopenia were associated with mortality and reoperation after craniotomy for tumor. Cancer 2016;122:1708-17. © 2016 American Cancer Society. © 2016 American Cancer Society.

  7. Transiting Exoplanet Survey Satellite (TESS) Community Observer Program including the Science Enhancement Option Box (SEO Box) - 12 TB On-board Flash Memory for Serendipitous Science

    Science.gov (United States)

    Schingler, Robert; Villasenor, J. N.; Ricker, G. R.; Latham, D. W.; Vanderspek, R. K.; Ennico, K. A.; Lewis, B. S.; Bakos, G.; Brown, T. M.; Burgasser, A. J.; Charbonneau, D.; Clampin, M.; Deming, L. D.; Doty, J. P.; Dunham, E. W.; Elliot, J. L.; Holman, M. J.; Ida, S.; Jenkins, J. M.; Jernigan, J. G.; Kawai, N.; Laughlin, G. P.; Lissauer, J. J.; Martel, F.; Sasselov, D. D.; Seager, S.; Torres, G.; Udry, S.; Winn, J. N.; Worden, S. P.

    2010-01-01

    The Transiting Exoplanet Survey Satellite (TESS) will perform an all-sky survey in a low-inclination, low-Earth orbit. TESS's 144 GB of raw data collected each orbit will be stacked, cleaned, cut, compressed and downloaded. The Community Observer Program is a Science Enhancement Option (SEO) that takes advantage of the low-radiation environment, technology advances in flash memory, and the vast amount of astronomical data collected by TESS. The Community Observer Program requires the addition of a 12 TB "SEO Box” inside the TESS Bus. The hardware can be built using low-cost Commercial Off-The-Shelf (COTS) components and fits within TESS's margins while accommodating GSFC gold rules. The SEO Box collects and stores a duplicate of the TESS camera data at a "raw” stage ( 4.3 GB/orbit, after stacking and cleaning) and makes them available for on-board processing. The sheer amount of onboard storage provided by the SEO Box allows the stacking and storing of several months of data, allowing the investigator to probe deeper in time prior to a given event. Additionally, with computation power and data in standard formats, investigators can utilize data-mining techniques to investigate serendipitous phenomenon, including pulsating stars, eclipsing binaries, supernovae or other transient phenomena. The Community Observer Program enables ad-hoc teams of citizen scientists to propose, test, refine and rank algorithms for on-board analysis to support serendipitous science. Combining "best practices” of online collaboration, with careful moderation and community management, enables this `crowd sourced’ participatory exploration with a minimal risk and impact on the core TESS Team. This system provides a powerful and independent tool opening a wide range of opportunity for science enhancement and secondary science. Support for this work has been provided by NASA, the Kavli Foundation, Google, and the Smithsonian Institution.

  8. Structured Exercise Program is Feasible and Improves Functional Capacity among Older Adults in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Osvaldo J Hernandez Soto

    2014-09-01

    Full Text Available Physical inactivity is a major risk factor affecting overall health and functional capacity among older adults. In this study we evaluated functional capacity in 22 older adults in Puerto Rico (mean age ± standard deviation = 73.3 ± 8.2 years before, during and after eight weeks participation in a structured exercise program. Functional capacity was evaluated using a field test battery (body composition, flexibility, coordination, agility and balance, muscle endurance and cardiorespiratory endurance validated for this population. Also, cardiorespiratory fitness (VO2max and blood lipid levels were evaluated in a sub-sample (n = 7. A repeated measures ANOVA was used to detect changes in functional capacity before, during and after the exercise program. A paired t-test was used to evaluate changes in VO2max and lipids before and after the program. Flexibility improved significantly during the exercise program (51.6 ± 12.2 vs. 57.7 ± 8.1 cm, p=0.04 and this change was sustained at the end of the program (54.4 ± 10.2 cm. At eight weeks into the program, time in the agility and balance test improved by two seconds and muscle endurance improved by five repetitions (p<0.05 for all. No changes were observed in body composition, coordination, VO2max and lipid levels (p>0.05. These results suggest that participation in a structured exercise program for eight weeks can positively impact factors that improve movement capacity in older adults.

  9. The "I" in QRIS Survey: Collecting Data on Quality Improvement Activities for Early Childhood Education Programs. REL 2017-221

    Science.gov (United States)

    Faria, Ann-Marie; Hawkinson, Laura; Metzger, Ivan; Bouacha, Nora; Cantave, Michelle

    2017-01-01

    A quality rating and improvement system (QRIS) is a voluntary state assessment system that uses multidimensional data on early childhood education programs to rate program quality, support quality improvement efforts, and provide information to families about the quality of available early childhood education programs. QRISs have two components:…

  10. [Effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients after a myocardial infarction].

    Science.gov (United States)

    Kong, Jung-Hyeon; Ha, Yeongmi

    2013-08-01

    This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI). This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks. At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (pstages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

  11. 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

  12. Accreditation council for graduate medical education (ACGME annual anesthesiology residency and fellowship program review: a "report card" model for continuous improvement

    Directory of Open Access Journals (Sweden)

    Long Timothy R

    2010-02-01

    Full Text Available Abstract Background The Accreditation Council for Graduate Medical Education (ACGME requires an annual evaluation of all ACGME-accredited residency and fellowship programs to assess program quality. The results of this evaluation must be used to improve the program. This manuscript describes a metric to be used in conducting ACGME-mandated annual program review of ACGME-accredited anesthesiology residencies and fellowships. Methods A variety of metrics to assess anesthesiology residency and fellowship programs are identified by the authors through literature review and considered for use in constructing a program "report card." Results Metrics used to assess program quality include success in achieving American Board of Anesthesiology (ABA certification, performance on the annual ABA/American Society of Anesthesiology In-Training Examination, performance on mock oral ABA certification examinations, trainee scholarly activities (publications and presentations, accreditation site visit and internal review results, ACGME and alumni survey results, National Resident Matching Program (NRMP results, exit interview feedback, diversity data and extensive program/rotation/faculty/curriculum evaluations by trainees and faculty. The results are used to construct a "report card" that provides a high-level review of program performance and can be used in a continuous quality improvement process. Conclusions An annual program review is required to assess all ACGME-accredited residency and fellowship programs to monitor and improve program quality. We describe an annual review process based on metrics that can be used to focus attention on areas for improvement and track program performance year-to-year. A "report card" format is described as a high-level tool to track educational outcomes.

  13. Improved unit hydrograph characterisation of the daily flow regime (including low flows for the River Teifi, Wales: towards better rainfall-streamflow models for regionalisation

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    I.G. Littlewood

    2002-01-01

    Full Text Available An established rainfall-streamflow modelling methodology employing a six-parameter unit hydrograph-based rainfall-runoff model structure is developed further to give an improved model-fit to daily flows for the River Teifi at Glan Teifi. It is shown that a previous model of this type for the Teifi, which (a accounted for 85% of the variance in observed streamflow, (b incorporated a pure time delay of one day and (c was calibrated using a trade-off between two model-fit statistics (as recommended in the original methodology, systematically over-estimates low flows. Using that model as a starting point the combined application of a non-integer pure time delay and further adjustment of a temperature modulation parameter in the loss module, using the flow duration curve as an additional model-fit criterion, gives a much improved model-fit to low flows, while leaving the already good model-fit to higher flows essentially unchanged. The further adjustment of the temperature modulation loss module parameter in this way is much more effective at improving model-fit to low flows than the introduction of the non-integer pure time delay. The new model for the Teifi accounts for 88% of the variance in observed streamflow and performs well over the 5 percentile to 95 percentile range of flows. Issues concerning the utility and efficacy of the new model selection procedure are discussed in the context of hydrological studies, including regionalisation. Keywords: unit hydrographs, rainfall-runoff modelling, low flows, regionalisation.

  14. A Progressive 5-Week Exercise Therapy Program Leads to Significant Improvement in Knee Function Early After Anterior Cruciate Ligament Injury

    Science.gov (United States)

    EITZEN, INGRID; MOKSNES, HÅVARD; SNYDER-MACKLER, LYNN; RISBERG, MAY ARNA

    2011-01-01

    STUDY DESIGN Prospective cohort study without a control group. OBJECTIVES Firstly, to present our 5-week progressive exercise therapy program in the early stage after anterior cruciate ligament (ACL) injury. Secondly, to evaluate changes in knee function after completion of the program for patients with ACL injury in general and also when classified as potential copers or noncopers, and, finally, to examine potential adverse events. BACKGROUND Few studies concerning early-stage ACL rehabilitation protocols exist. Consequently, little is known about the tolerance for, and outcomes from, short-term exercise therapy programs in the early stage after injury. METHODS One-hundred patients were included in a 5-week progressive exercise therapy program, within 3 months after injury. Knee function before and after completion of the program was evaluated from isokinetic quadriceps and hamstrings muscle strength tests, 4 single-leg hop tests, 2 different self-assessment questionnaires, and a global rating of knee function. A 2-way mixed-model analysis of variance was conducted to evaluate changes from pretest to posttest for the limb symmetry index for muscle strength and single-leg hop tests, and the change in scores for the patient-reported questionnaires. In addition, absolute values and the standardized response mean for muscle strength and single-leg hop tests were calculated at pretest and posttest for the injured and uninjured limb. Adverse events during the 5-week period were recorded. RESULTS The progressive 5-week exercise therapy program led to significant improvements (Ptherapy programs are well tolerated and should be incorporated in early-stage ACL rehabilitation, either to improve knee function before ACL reconstruction or as a first step in further nonoperative management. PMID:20710097

  15. Assessing and Improving Student Organizations: Resources for Facilitators CD-ROM. The Assessing and Improving Student Organization (AISO) Program

    Science.gov (United States)

    Nolfi, Tricia; Ruben, Brent D.

    2010-01-01

    This companion to the "Guide for Students" and "Student Workbook" includes the complete set of PowerPoint slides, a PDF of the Facilitator's Guide in PPT (PowerPoint) slide show format, and PDFs of all scoring sheets, handouts and project planning guides needed for the AISO (Assessing and Improving Student Organization) process. The Assessing and…

  16. 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

  17. 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.

  18. Is expanding HPV vaccination programs to include school-aged boys likely to be value-for-money: a cost-utility analysis in a country with an existing school-girl program.

    Science.gov (United States)

    Pearson, Amber L; Kvizhinadze, Giorgi; Wilson, Nick; Smith, Megan; Canfell, Karen; Blakely, Tony

    2014-06-26

    Similar to many developed countries, vaccination against human papillomavirus (HPV) is provided only to girls in New Zealand and coverage is relatively low (47% in school-aged girls for dose 3). Some jurisdictions have already extended HPV vaccination to school-aged boys. Thus, exploration of the cost-utility of adding boys' vaccination is relevant. We modeled the incremental health gain and costs for extending the current girls-only program to boys, intensifying the current girls-only program to achieve 73% coverage, and extension of the intensive program to boys. A Markov macro-simulation model, which accounted for herd immunity, was developed for an annual cohort of 12-year-olds in 2011 and included the future health states of: cervical cancer, pre-cancer (CIN I to III), genital warts, and three other HPV-related cancers. In each state, health sector costs, including additional health costs from extra life, and quality-adjusted life-years (QALYs) were accumulated. The model included New Zealand data on cancer incidence and survival, and other cause mortality (all by sex, age, ethnicity and deprivation). At an assumed local willingness-to-pay threshold of US$29,600, vaccination of 12-year-old boys to achieve the current coverage for girls would not be cost-effective, at US$61,400/QALY gained (95% UI $29,700 to $112,000; OECD purchasing power parities) compared to the current girls-only program, with an assumed vaccine cost of US$59 (NZ$113). This was dominated though by the intensified girls-only program; US$17,400/QALY gained (95% UI: dominant to $46,100). Adding boys to this intensified program was also not cost-effective; US$128,000/QALY gained, 95% UI: $61,900 to $247,000).Vaccination of boys was not found to be cost-effective, even for additional scenarios with very low vaccine or program administration costs - only when combined vaccine and administration costs were NZ$125 or lower per dose was vaccination of boys cost-effective. These results suggest that

  19. Can a Remotely Delivered Auditory Training Program Improve Speech-in-Noise Understanding?

    Science.gov (United States)

    Abrams, Harvey B; Bock, Kirsten; Irey, Ryan L

    2015-09-01

    The aims of this study were to determine if a remotely delivered, Internet-based auditory training (AT) program improved speech-in-noise understanding and if the number of hours spent engaged in the program influenced postintervention speech-in-noise understanding. Twenty-nine first-time hearing aid users were randomized into an AT group (hearing aids + 3 week remotely delivered, Internet-based auditory training program) or a control group (hearing aids alone). The Hearing in Noise Test (Nilsson, Soli, & Sullivan, 1994) and the Words-in-Noise test (Wilson, 2003) were administered to both groups at baseline + 1 week and immediately at the completion of the 3 weeks of auditory training. Speech-in-noise understanding improved for both groups at the completion of the study; however, there was not a statistically significant difference in postintervention improvement between the AT and control groups. Although the number of hours the participants engaged in the AT program was far fewer than prescribed, time on task influenced the postintervention Words-in-Noise but not Hearing in Noise Test scores. Although remotely delivered, Internet-based AT programs represent an attractive alternative to resource-intensive, clinic-based interventions, their demonstrated efficacy continues to remain a challenge due in part to issues associated with compliance.

  20. Improving Nutritional Status of Older Persons with Dementia Using a National Preventive Care Program.

    Science.gov (United States)

    Johansson, L; Wijk, H; Christensson, L

    2017-01-01

    The aim of the study was to investigate the outcome of change in body weight associated with use of a structured preventive care process among persons with dementia assessed as at risk of malnutrition or malnourished. The preventive care process is a pedagogical model used in the Senior Alert (SA) quality register, where nutrition is one of the prioritized areas and includes four steps: assessment, analysis of underlying causes, actions performed and outcome. An analysis of data from SA with a pre-post design was performed. The participants were living in ordinary housing or special housing in Sweden. 1912 persons, 65 years and older, registered in both SA and the dementia quality register Svedem were included. A national preventive care program including individualized actions. The Mini Nutritional Assessment-Short Form was used to assess nutritional status at baseline. Body weight was measured during baseline and follow-up (7-106 days after baseline). 74.3% persons were malnourished or at risk of malnutrition. Those at risk of malnutrition or malnourished who were registered in all four steps of the preventive care process, increased in body weight from baseline (Md 60.0 kg) to follow-up (Md 62.0 kg) (p=0.013). In those with incomplete registration no increase in body weight was found. Using all steps in the structured preventive care process seems to improve nutritional status of persons with dementia assessed as at risk of malnutrition or malnourished. This study contributes to the development of evidence-based practice regarding malnutrition and persons with dementia.

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

    Science.gov (United States)

    2016-12-20

    Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self ‑Assessment Evaluations Management Comments and Our...and control of the Compliance Assessment Management System (CAMS);9 • provide and coordinate protocols and instructions to the CDDs to complete self ...assessments; • notify DLA Disposition Services management of self -assessments results, repeat findings, suggested corrective actions, best practices

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  3. Improving Student Reading through Parents' Implementation of a Structured Reading Program

    Science.gov (United States)

    Mitchell, Courtney; Begeny, John C.

    2014-01-01

    Parent tutoring offers potential as a means for assisting the large percentage of students who need to improve their reading skills. The primary purpose of this study was to examine the impact of a reading fluency intervention program when used by parents in the home during the summer months. Specifically, this study evaluated the effects of the…

  4. Educational Triage: A Comparative Study of Two High School Principals Serving Program Improvement Schools

    Science.gov (United States)

    Garrity, Kyle Matthew

    2013-01-01

    The guiding question for this qualitative study centered on what it means to be a principal in a high school that has been put on notice as a failure and labeled "Program Improvement" (PI). The evidence shed light on the unique challenges, role expectations, and varying social conditions faced by two female principals as they managed…

  5. The Effectiveness of a Tablet Computer-Aided Intervention Program for Improving Reading Fluency

    Science.gov (United States)

    Özbek, Ahmet Bilal; Girli, Alev

    2017-01-01

    The purpose of this study is to determine the effectiveness of a tablet computer-aided intervention program for improving reading fluency. It also investigates the opinions of students and parents about this intervention by using skill- and performance-based techniques, which have been investigated qualitatively. Three students with a learning…

  6. 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.

  7. Improving Empathy and Communication Skills of Visually Impaired Early Adolescents through a Psycho-Education Program

    Science.gov (United States)

    Yildiz, Mehmet Ali; Duy, Baki

    2013-01-01

    The purpose of this study was to investigate the effectiveness of an interpersonal communication skills psycho-education program to improve empathy and communication skills of visually impaired adolescents. Participants of the study were sixteen early adolescents schooling in an elementary school for visually impaired youth in Diyarbakir. The…

  8. Somatic Cell Count in Milk of Goats Enrolled in Dairy Herd Improvement Program in 2007

    Science.gov (United States)

    The effects of breed, parity, stage of lactation (month), herd size, and regions/states on somatic cell count (SCC) and production of milk from dairy goats enrolled in the Dairy Herd Improvement (DHI) program in the United States in 2007 were investigated to monitor the current status of SCC and to ...

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

    Science.gov (United States)

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

  10. 78 FR 59704 - Medicare, Medicaid, and CLIA Programs; Clinical Laboratory Improvement Amendments of 1988...

    Science.gov (United States)

    2013-09-27

    ... requirements of the Clinical Laboratory Improvement Amendments of 1988 (CLIA) for a period of 6 years. DATES... (approximately 5 percent) of the laboratories inspected by the Washington State Office of Laboratory Quality... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare, Medicaid, and CLIA Programs; Clinical...

  11. 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…

  12. 77 FR 30350 - Airport Improvement Program (AIP) Use of Mineral Revenue at Certain Airports

    Science.gov (United States)

    2012-05-22

    ... Federal Aviation Administration Airport Improvement Program (AIP) Use of Mineral Revenue at Certain Airports AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of guidance; opportunity to... other means at a general aviation airport to be revenue greater than the amount needed to carry out the...

  13. 78 FR 42419 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2013-07-16

    ... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Final... through-the-fence access to a federally-obligated airport from an adjacent or nearby property, when that...

  14. 77 FR 44515 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2012-07-30

    ... Federal Aviation Administration 14 CFR Chapter I Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... policy, based on Federal law, concerning through-the-fence access to a federally obligated airport from...

  15. 76 FR 15028 - Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential...

    Science.gov (United States)

    2011-03-18

    ... Federal Aviation Administration Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential Property AGENCY: Federal Aviation Administration (FAA). ACTION: Interim policy... clarifying FAA policy concerning through-the-fence access to a federally-obligated airport from an adjacent...

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

    Science.gov (United States)

    Gipson, Frances Marie

    2012-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  18. The Effects of Two Different Reading Acceleration Training Programs on Improving Reading Skills of Second Graders

    Science.gov (United States)

    Nevo, Einat; Brande, Sigalit; Shaul, Shelley

    2016-01-01

    It has been well established that poor reading skills in the first grades of primary school can lead to poor reading skills in all coming years. A reading acceleration program (RAP) known to improve reading skills in adults and children with and without reading difficulties (RD) was tested for its effect on children in second grade with standard…

  19. A Therapeutic Program To Improve the Body Image of Pre-Puberty Exceptional Education Girls.

    Science.gov (United States)

    Pfeiffer, Linda Jo

    This practicum designed and implemented a body image improvement program for seven severely emotionally disturbed latency-aged girls. Students participated once per week for 12 weeks in individual art therapy and in group sessions. The practicum incorporated therapeutic art activities with verbal interactions and utilized human growth films,…

  20. Improving programming skills of Mechanical Engineering students by teaching in C# multi-objective optimizations methods

    Directory of Open Access Journals (Sweden)

    Florea Adrian

    2017-01-01

    Full Text Available Designing an optimized suspension system that meet the main functions of comfort, safety and handling on poor quality roads is a goal for researchers. This paper represents a software development guide for designers of suspension systems with less programming skills that will enable them to implement their own optimization methods that improve traditional methods by using their domain knowledge.

  1. The Effectiveness of an Additional Stretching Exercise Program in Improving Flexibility Level among Preschool Boys

    Science.gov (United States)

    Lee, Wee Akina Sia Seng; Rengasamy, Shabeshan A/L; Raju, Subramaniam A/L

    2014-01-01

    This study was conducted to examine the effectiveness of a two minutes' additional stretching exercise program in a 30 minutes games teaching lesson in improving the flexibility level of 6 year old preschool boys (M = 5.92, SD = 0.27) in a preschool in Malaysia. Fifty (50) preschool boys were selected for the study based on the intact sampling…

  2. The Evolution of Improved Baghouse Filter Media as Observed in the Environmental Technology Verification Program

    Science.gov (United States)

    The U.S. EPA implemented the Environmental Technology Verification (ETV) program in 1995 to generate independent and credible data on the performance of innovative technologies that have the potential to improve protection of public health and the environment. Results are publicl...

  3. 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.

  4. Development and implementation of a writing program to improve resident authorship rates.

    Science.gov (United States)

    Clemmons, Amber Bradley; Hoge, Stephanie C; Cribb, Ashley; Manasco, Kalen B

    2015-09-01

    The development, implementation, and evaluation of a writing program with a formalized writing project as a component of postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) pharmacy residencies are described. The writing program at Georgia Regents Medical Center/University of Georgia College of Pharmacy, a collaborative and jointly funded program, was initiated in the 2010-11 residency year. The goals of the program are to teach residents to communicate effectively, apply leadership skills, employ project management skills, and provide medication- and practice- related education and training. The program combines both writing experiences and mentorship. At the beginning of the residency year, trainees are presented with opportunities to participate in both research projects and writing projects. Specifically, opportunities within the writing program include involvement in review articles, case reports, drug information rounds, book chapters, letters to the editor, and high-quality medication-use evaluations for potential publication. The writing project is highly encouraged, and completion of a manuscript to be submitted for publication is expected by graduation. Nine papers were published by 8 of 18 PGY1 and PGY2 residents in the four years before program implementation. A total of 23 publications were published by 18 (72%) of the 25 PGY1 and PGY2 residents in the four years after implementation of the writing program. Implementation of a formal writing program increased the overall publication rate of residents. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  5. Qualitative evaluation: a critical and interpretative complementary approach to improve health programs and services.

    Science.gov (United States)

    Tayabas, Luz María Tejada; León, Teresita Castillo; Espino, Joel Monarrez

    2014-01-01

    This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders' perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs' implementation processes from the perspective of intended beneficiaries.

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

    Directory of Open Access Journals (Sweden)

    I.V. Vlaskina

    2013-04-01

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

  7. Quality Improvement Efforts among Early Childhood Education Programs Participating in Iowa's Quality Rating System. REL 2017-244

    Science.gov (United States)

    Hawkinson, Laura E.; Faria, Ann-Marie; Bouacha, Nora; Lee, Dong Hoon; Metzger, Ivan

    2017-01-01

    This report describes the quality improvement efforts of early childhood education programs participating in Iowa's Quality Rating System (QRS). It identifies supports and barriers to quality improvement and examines how quality improvement supports and activities relate to changes in program quality ratings across time. The study team developed…

  8. Predicting Improvement After a Bystander Program for the Prevention of Sexual and Dating Violence.

    Science.gov (United States)

    Hines, Denise A; Palm Reed, Kathleen M

    2015-07-01

    Although evidence suggests that bystander prevention programs are promising interventions for decreasing sexual violence and dating violence on college campuses, there have been no studies to date evaluating moderators of bystander program effectiveness. The current study evaluates whether different demographic characteristics, attitudes, knowledge, and behaviors at pretest predict change over a 6-month follow-up for students who participated in a bystander prevention program. Participants in the three assessments (pretest, posttest, 6-month follow-up) included 296 college students who were mandated to attend a bystander program during their first year orientation. Analyses showed that with few exceptions, the bystander program worked best for students who were most at risk given their pretest demographics and levels of attitudes condoning dating violence and sexual violence, bystander efficacy, and bystander behaviors. Results are discussed in terms of suggestions for future research. © 2014 Society for Public Health Education.

  9. Pulmonary complications after major abdominal surgery: National Surgical Quality Improvement Program analysis.

    Science.gov (United States)

    Yang, Chun Kevin; Teng, Annabelle; Lee, David Y; Rose, Keith

    2015-10-01

    Postoperative pulmonary complications (PPCs) after major abdominal surgery are common and associated with significant morbidity and high cost of care. The objective of this study was to identify the risk factors for PPCs after major abdominal surgery. The American College of Surgeons' National Surgical Quality Improvement Program database from 2005-2012 was queried for patients who underwent major abdominal surgery (esophagectomy, gastrectomy, pacnreatectomy, enterectomy, hepatectomy, colectomy, and proctectomy). Predictors of PPCs were identified using multivariate logistic regression. Of 165,196 patients who underwent major abdominal surgery 9595 (5.8%) suffered PPCs (pneumonia 3.2%, prolonged ventilator support ≥48 h 3.0%, and unplanned intubation 2.8%). On multivariate analysis, significant predictors of overall and individual PPCs include esophagectomy, advanced American Society of Anesthesiology Classification System, dependent functional status, prolonged operative time, age ≥80 y, severe chronic obstructive pulmonary disease, preoperative shock, ascites, and smoking. Obesity was not a risk factor. Female gender was overall protective for PPCs. PPCs after abdominal procedures are associated with a number of clinical variables. Esophageal operations and American Society of Anesthesiology Classification System were the strongest predictors. These results provide a framework for identifying patients at risk for developing pulmonary complications after major abdominal surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Improving physician clinical documentation quality: evaluating two self-efficacy-based training programs.

    Science.gov (United States)

    Russo, Ruthann; Fitzgerald, Stephen P; Eveland, J D; Fuchs, Barry D; Redmon, D Patrick

    2013-01-01

    Clinical documentation is critical to health care quality and cost. The generally poor quality of such documentation has been well recognized, yet medical students, residents, and physicians receive little or no training in it. When clinical documentation quality (CDQ) training for residents and/or physicians is provided, it excludes key constructs of self-efficacy: vicarious learning (e.g., peer demonstration) and mastery (i.e., practice). CDQ training that incorporates these key self-efficacy constructs is more resource intensive. If such training could be shown to be more effective at enhancing clinician performance, it would support the investment of the additional resources required by health care systems and residency training programs. The aim of this study was to test the impact of CDQ training on clinician self-efficacy and performance and the relative efficacy of intervention designs employing two versus all four self-efficacy constructs. Ninety-one internal medicine residents at a major academic medical center in the northeastern United States were assigned to one of two self-efficacy-based training groups or a control group, with CDQ and clinical documentation self-efficacy measured before and after the interventions. A structural equation model (AMOS) allowed for testing the six hypotheses in the context of the whole study, and findings were cross-validated using traditional regression. Although both interventions increased CDQ, the training designed to include all four self-efficacy constructs had a significantly greater impact on improving CDQ. It also increased self-efficacy. CDQ may be significantly improved and sustained by (a) training physicians in clinical documentation and (b) employing all four self-efficacy constructs in such training designs.

  11. Journal Aspirations: Improving Scientific Writing and Publication Through a Writing Mentorship Program.

    Science.gov (United States)

    Kennedy, Ann Blair

    2017-06-01

    Looking to help novice scientific writers improve their skills and enhance the likelihood of scientific publication, the IJTMB launched a writing mentorship program. Research indicates that when novice writers have a mentor and work on writing as a team, the authors can gain self-efficacy, manuscripts are improved, thoughts and writing are clarified, and differing perspectives are added. This editorial identifies the process for being recommended to use a writing mentor, discusses recommendations in the forming of a mentor/mentee relationship, describes the qualities of good mentors and mentees, and offers suggestions for improving writing for scientific publication. As our database of writing mentors grows, we encourage those who join this program both as mentors and as mentees to consider what it means to be in these roles. It is my hope that the suggestions herein help in developing these relationships.

  12. An Assessment of Operational Energy Capability Improvement Fund (OECIF) Programs 17-S-2544

    Science.gov (United States)

    2017-09-19

    identifies one or more specific themes for each year to reflect Department priorities and focus the evaluation and management of S&T investments...thirteen programs were successful, both from a technical and transition perspective , and their transition partners have either already funded or will...persistently attack key operational energy problems . OECIF themes are summarized in Table 1, and Appendix A includes more detail on the programs within

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

    Science.gov (United States)

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

    2017-08-25

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

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

    Directory of Open Access Journals (Sweden)

    Perry Cary

    2008-07-01

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

  15. Improving the Knowledge and Attitude on 'Standard Days Method' of Family Planning Through a Promotional Program Among Indian Postgraduate Students.

    Science.gov (United States)

    Menachery, Philby Babu; Noronha, Judith Angelitta; Fernanades, Sweety

    2017-08-01

    The 'Standard Days Method' is a fertility awareness-based method of family planning that identifies day 8 through day 19 of the menstrual cycle as fertile days during which a woman is likely to conceive with unprotected intercourse. The study was aimed to determine the effectiveness of a promotional program on the 'Standard Days Method' in terms of improving the knowledge scores and attitude scores. A pre-experimental one-group pretest-posttest research design was adopted. The samples included 365 female postgraduate students from selected colleges of Udupi Taluk, Karnataka. The data was collected using self-administered questionnaires. The plan for the promotional program was also established. The findings of the study were analyzed using the descriptive and inferential statistics. The mean pretest and posttest knowledge scores were computed, and it was found that there was an increase in the mean knowledge score from 8.96 ± 3.84 to 32.64 ± 5.59, respectively. It was observed that the promotional program on 'Standard Days Method' was effective in improving the knowledge (p improving the knowledge and attitude of the postgraduate female students. This will enable the women to adopt this method and plan their pregnancies naturally and reduce the side effects of using oral contraceptives.

  16. [Intervention program to improve secondary prevention of myocardial infarction. Results of the PRESENTE (early secondary prevention) study].

    Science.gov (United States)

    de Velasco, José A; Cosín, Juan; de Oya, Manuel; de Teresa, Eduardo

    2004-02-01

    Secondary prevention measures for myocardial infarction are inadequate. In Spain, the earlier PREVESE studies provided preliminary data. The aim of this study was to document the results of a simple intervention program for secondary prevention, implemented during the hospital stay. We included 4174 patients (mean age 63.7 years, 73% men) discharged from 110 hospitals after myocardial infarction. Lipid profile was determined during the first 24 h after admission, and before discharge patients and relatives were informed about the disease and its prevention, and were given printed informative materials. The patients were seen again 6 months later. After 6 months, 82.9% of the patients were examined and 10% were lost to follow-up. Mean blood pressure, weight and body mass index of the sample were lower, and lifestyle variables had improved. At discharge 87% were prescribed statins, 59.4% beta blockers, 51.2% ACE inhibitors and angiotensin blockers, and 94.1% antiplatelet drugs. These prescriptions were still being used 6 months later. There were substantial improvements in lipid values. The implementation of a simple intervention program for patients with myocardial infarction and their relatives, and the determination of lipid levels within 24 hours of admission, improved the secondary prevention measures at discharge and during the 6-month follow-up period. Acceptance of the program among the patients was good.

  17. [Improvement of lumbal motor control and trunkmuscle conditions with a novel low back pain prevention exercise program].

    Science.gov (United States)

    Kovácsné Bobály, Viktória; Szilágyi, Brigitta; Makai, Alexandra; Koller, Ákos; Járomi, Melinda

    2017-01-01

    Ballet dancers often suffer from low back pain. Low back pain can be reduced by strengthening the core muscles with the help of a special exercise program. In the study 62 ballet dancer women (average age: 14.89 ± 1.21 years) were included. Intervention group: n = 30 participant, average age: 14.86 ± 1.00 years, control group: n = 32 participant, average age: 14.91 ± 1.37 years. We examined the pain intensity that occurs during training with visual analog scale, the habitual posture with photogrammetry, the abdominal muscle strength with Kraus-Weber test, the static muscle strength of the trunk muscles with core test and the lumbar motor control with leg lowering test. The intervention group did a trunk prevented exercise program during 3 months, and then we examined them again. In the intervention group the intensity of pain significantly decreased (VAS1: p = 0.012; VAS2: p = 0.021), the abdominal muscle strength significantly improved (K-W. B: p=0.025; K-W. C: pview: 34.78%, side view: 52.17%). In ballet dancers with a special exercise program, which improves the conditions of trunk muscles, the motor control of lumbar regions can be improved and the lower back pain and the incidence of injuries can be reduced. Orv., Hetil., 2017, 158(2), 58-66.

  18. Improved application of the electrophoretic tissue clearing technology, CLARITY, to intact solid organs including brain, pancreas, liver, kidney, lung, and intestine.

    Science.gov (United States)

    Lee, Hyunsu; Park, Jae-Hyung; Seo, Incheol; Park, Sun-Hyun; Kim, Shin

    2014-12-21

    Mapping of tissue structure at the cellular, circuit, and organ-wide scale is important for understanding physiological and biological functions. A bio-electrochemical technique known as CLARITY used for three-dimensional anatomical and phenotypical mapping within transparent intact tissues has been recently developed. This method provided a major advance in understanding the structure-function relationships in circuits of the nervous system and organs by using whole-body clearing. Thus, in the present study, we aimed to improve the original CLARITY procedure and developed specific CLARITY protocols for various intact organs. We determined the optimal conditions for reducing bubble formation, discoloration, and depositing of black particles on the surface of tissue, which allowed production of clearer organ images. We also determined the appropriate replacement cycles of clearing solution for each type of organ, and convincingly demonstrated that 250-280 mA is the ideal range of electrical current for tissue clearing. We then acquired each type of cleared organs including brain, pancreas, liver, lung, kidney, and intestine. Additionally, we determined the images of axon fibers of hippocampal region, the Purkinje layer of cerebellum, and vessels and cellular nuclei of pancreas. CLARITY is an innovative biochemical technology for the structural and molecular analysis of various types of tissue. We developed improved CLARITY methods for clearing of the brain, pancreas, lung, intestine, liver, and kidney, and identified the appropriate experimental conditions for clearing of each specific tissue type. These optimized methods will be useful for the application of CLARITY to various types of organs.

  19. Nutritional status and feeding-tube placement in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy-based larynx preservation program.

    Science.gov (United States)

    Bozec, Alexandre; Benezery, Karen; Chamorey, Emmanuel; Ettaiche, Marc; Vandersteen, Clair; Dassonville, Olivier; Poissonnet, Gilles; Riss, Jean-Christophe; Hannoun-Lévi, Jean-Michel; Chand, Marie-Eve; Leysalle, Axel; Saada, Esma; Sudaka, Anne; Haudebourg, Juliette; Hebert, Christophe; Falewee, Marie-Noelle; Demard, François; Santini, José; Peyrade, Frédéric

    2016-09-01

    The objective of the study is to evaluate the nutritional status and determine its impact on clinical outcomes in patients with locally advanced hypopharyngeal cancer included in an induction chemotherapy (ICT)-based larynx preservation program without prophylactic feeding-tube placement. All patients with locally advanced (T3/4, N0-3, M0) hypopharyngeal squamous cell carcinoma, technically suitable for total pharyngolaryngectomy, treated by docetaxel, cisplatin and 5-fluorouracil (TPF)-ICT for larynx preservation at our institution between 2004 and 2013, were included in this retrospective study. Patients' nutritional status was closely monitored. Enteral nutrition was used if and when a patient was unable to sustain per-oral nutrition and hydration. The impact of nutritional status on clinical outcomes was investigated in univariate and multivariate analysis. A total of 53 patients (42 men and 11 women, mean age = 58.6 ± 8.2 years) were included in this study. Six (11.3 %) patients had lost more than 10 % of their usual body weight before therapy. Compared with patients' usual weight, the mean maximum patient weight loss during therapeutic management was 8.7 ± 4.5 kg. Enteral nutrition was required in 17 patients (32 %). We found no influence of the tested nutritional status-related factors on response to ICT, toxicity of ICT, overall, cause-specific and recurrence-free survival, and on post-therapeutic swallowing outcome. Maximum weight loss was significantly associated with a higher risk of enteral tube feeding during therapy (p = 0.03) and of complications (grade ≥3, p = 0.006) during RT. Without prophylactic feeding-tube placement, approximately one-third of the patients required enteral nutrition. There was no significant impact of nutritional status on oncologic or functional outcomes.

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

    Directory of Open Access Journals (Sweden)

    Yano Elizabeth M

    2009-11-01

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

  1. Medication Synchronization Programs Improve Adherence To Cardiovascular Medications And Health Care Use.

    Science.gov (United States)

    Krumme, Alexis A; Glynn, Robert J; Schneeweiss, Sebastian; Gagne, Joshua J; Dougherty, J Samantha; Brill, Gregory; Choudhry, Niteesh K

    2018-01-01

    Medication synchronization programs based in pharmacies simplify the refill process by enabling patients to pick up all of their medications on a single visit. This can be especially important for improving medication adherence in patients with complex chronic diseases. We evaluated the impact of two synchronization programs on adherence, cardiovascular events, and resource use among Medicare beneficiaries treated between 2011 and 2014 for two or more chronic conditions-at least one of which was hypertension, hyperlipidemia, or diabetes. Among nearly 23,000 patients matched by propensity score, the mean proportion of days covered (a measure of medication adherence) for the control group of patients without a synchronization program was 0.84 compared to 0.87 for synchronized patients-a gain of 3 percentage points. Adherence improvement in synchronized versus control patients was three times greater in patients with low baseline adherence, compared to those with higher baseline adherence. Rates of hospitalization and emergency department visits and rates of outpatient visits were 9 percent and 3 percent lower in the synchronized group compared to the control group, respectively, while cardiovascular event rates were similar. Synchronization programs were associated with improved adherence for patients with cardiovascular disease, especially those with low baseline adherence.

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

    Science.gov (United States)

    Azmi, K.; Kusnanik, N. W.

    2018-01-01

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

  3. Longitudinal integration of cultural components into a physician assistant program's clinical year may improve cultural competency.

    Science.gov (United States)

    Bahrke, Barbara; De Oliveira, Kathleen; Scheel, Matthew H; Beck, Barbra; Hopp, Jane

    2014-01-01

    This study assessed the efficacy of longitudinal integration of cultural components into the clinical year of a 2-year master of science in physician assistant studies (MSPAS) program. Students submitted cultural reflection papers, gave a medical case/cultural presentation, and participated in cultural awareness discussion groups throughout the clinical year. Students completed the same cultural awareness survey at the conclusion of their clinical year that they had completed at benchmarked intervals during their didactic year. Additionally, cultural competency was assessed during the students' summative objective structured clinical examination (OSCE) using a combination of the program's objectives and established professional standards. Qualitative data suggested that students recognized the importance of cultural competency in providing quality patient care and recognized that remaining culturally competent is an ongoing process. Linear trend analyses revealed significant positive relationships between survey response scores and time in the program. The OSCE's cultural assessment scores indicated cultural competency in broad, general categories, but scores declined as cultural categories narrowed and became more detailed. Continued integration of cultural awareness training and assessment throughout the clinical year of a physician assistant (PA) program may have a positive impact on improving cultural competency. PA programs seeking to improve cultural competency in their students should consider continued integration of cultural components throughout the clinical year.

  4. Clinical Clerkship Education Improves With Implementing a System of Internal Program Evaluation Using Medical Students' Feedbacks

    Directory of Open Access Journals (Sweden)

    Anahita Sadeghi

    2016-09-01

    Full Text Available Quality of clinical education for medical students has always been a concern in academic medicine. This concern has increased in today’s time-squeeze while faculty members have to fulfill their complementary roles as a teacher, researcher, and practitioner. One of the strategies for program evaluation is obtaining trainees’ feedbacks since they are the main customers of educational programs; however, there are debates about the efficacy of student feedback as a reliable source for reforms. We gathered Likert scores on a 16-item questionnaire from 2,771 medical students participating in all clerkship programs in a multidisciplinary teaching hospital. An expert panel consisting of 8 attending physicians established content validity of the questionnaire while a high Cronbach’s Alpha (0.93 proved its reliability. Summary reports of these feedbacks were presented to heads of departments, clerkship program directors, and hospital administrators, at the end of each semester. Analysis of variance was used for comparing hospital scores across different time periods and different departments. Significant changes (P<0.001 were observed in mean scores between different semesters (partial η2=0.090, different departments (partial η2=0.149 as well as the interaction term between departments and semesters (partial η2=0.111. A significant improvement in mean clinical education score is noticeable after three semesters from the beginning of the survey. Periodic, systematic trainee’s feedback to program directors can lead to an improved educational performance in teaching hospitals.

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

    Science.gov (United States)

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

    2009-01-01

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

  6. A mentor training program improves mentoring competency for researchers working with early-career investigators from underrepresented backgrounds.

    Science.gov (United States)

    Johnson, Mallory O; Gandhi, Monica

    2015-08-01

    Mentoring is increasingly recognized as a critical element in supporting successful careers in academic research in medicine and related disciplines, particularly for trainees and early career investigators from underrepresented backgrounds. Mentoring is often executed ad hoc; there are limited programs to train faculty to become more effective mentors, and the few that exist have a dearth of empirical support of their impact. In 2013, we recruited 34 faculty from across the US engaged in HIV-related clinical research to participate in a 2-day Mentoring the Mentors workshop. The workshop included didactic and interactive content focused on a range of topics, such as mentor-mentee communication, leadership styles, emotional intelligence, understanding the impact of diversity (unconscious bias, microaggressions, discrimination, tokenism) for mentees, and specific tools and techniques for effective mentoring. Pre- and post-workshop online evaluations documented high rates of satisfaction with the program and statistically significant improvements in self-appraised mentoring skills (e.g. addressing diversity in mentoring, communication with mentees, aligning mentor-mentee expectations), as assessed via a validated mentoring competency tool. This is the first mentoring training program focused on enhancing mentors' abilities to nurture investigators of diversity, filling an important gap, and evaluation results offer support for its effectiveness. Results suggest a need for refinement and expansion of the program and for more comprehensive, long-term evaluation of distal mentoring outcomes for those who participate in the program.

  7. Effectiveness of a Clinically Relevant Educational Program for Improving Medical Communication and Clinical Skills of International Medical Graduates

    Directory of Open Access Journals (Sweden)

    David Watt

    2010-07-01

    Conclusions:  IMGs who participated in a clinically relevant educational program improved their English language proficiency, clinical skills and professionalism for medical practice in a host country.

  8. Preliminary findings on the use of pulsatile machine reperfusion of a placenta to improve the cord blood collection yield including primitive hematopoietic stem cell fractions.

    Science.gov (United States)

    Takebe, Naoko; Gage, Fred; Cheng, Xiangfei; Lauw, Marietya I S

    2009-09-01

    Umbilical cord blood (CB) use is limited in most adults since the mean amount of hematopoietic stem cells (HSCs) collected is generally insufficient to engraft successfully. This study demonstrates for the first time the feasibility of pulsatile machine placenta reperfusion (PMPR), which significantly improves CB collection quantity and quality compared to standard collection methods. PMPR was performed on eight delivered placentas up to 39 hours after venipuncture-based collection. PMPR was performed on average for 26 (20-30) minutes, 17 hours after delivery (6.25-39), using perfusate approved for donated organ reperfusion. Both PMPR and conventional collection-derived CB cells were analyzed using immunophenotyping and colony assays. The combination of PMPR and the conventional venipuncture method yielded a mean of 1.5-, 4.9-, 11-, 7.5-, 7.5-, and 7.7-fold increased number of total mononuclear, CD34+, CD34+/CD38-, CD133+, CD133+/CD34+, and CD133+/CD34- cells, respectively, compared to conventional venipuncture alone. CB cells obtained by PMPR alone generally demonstrated a significant increase in percentages of primitive HSC phenotype with equivalent cell viability between PMPR and venipuncture. This article demonstrates for the first time that CB can be collected up to 39 hours after delivery with PMPR while maximizing CB collection including HSCs with primitive phenotypes.

  9. Improvement of ocean loading correction for superconducting gravimeter data of GGP including Syowa Station, Antarctica, and the effect on fluid core resonance (FCR) parameters

    Science.gov (United States)

    Kim, Taehee; Shibuya, Kazuo; Doi, Koichiro; Aoyama, Yuichi; Hayakawa, Hideaki

    2010-05-01

    The free core nutation (FCN), also refered to as the nearly diurnal free wobble, is due to the pressure coupling between the liquid core and the solid mantle. The FCN enhances the resonance with the diurnal earth tide. Investigation of resonance parameters of FCR (eigenperiod, quality factor Q, and resonance strength) is essential for the Earth's deep interior dynamics and structure. The eigenperiod directly depends on the core-mantle boundary (CMB) ellipticity and on the mantle's inelasticity. The quality factor Q is a direct consequence of damping mechanisms inside the Earth (Sasao et al., 1980; Sasao and Wahr, 1981; Florsch and Hinderer, 2000). For determining theseresonance parameters, the tidal gravimetric factor based on superconducting gravimeter (SG) data is used. We used the gravity data of 4 stations, from 1992 through 2002 at Syowa Station, from 1997 through 2007 at Strasbourg, from 1998 through 2007 at Metsahovi, from 2000 through 2006 at Sutherland, of the GGP Data Center. The tidal gravity parameters were determined using the BAYTAP-G software package (Ishiguro et al., 1981; Tamura et al., 1991). In this study, we focused on the influence of ocean loading effect on precise estimation of FCN parameters. The global ocean tidal models, CSR4.0 (Eanes and Bettadpur, 1999), GOT99.2b (Ray, 1999), FES2004 (Lyard et al., 2006) and TPXO7.1 (Egbert and Erofeeva, 2002) models are tested. These models are accomodated to the GOTIC2 for ocean loading estimation program (Matsumoto et al. 2001). The quality factor Q is dependent on the phase delay of the tidal waves, that means the imaginary part of gravimetric factor corrected for ocean loading effect is an important point for this inverse problem(Florsch and Hinderer, 2000). We present how much the accuracy of FCR parameters can be improved by adopting proper ocean models to each station (Le provost et al., 2001). For this work, we have applied minor waves for ocean loading correction (Matsumoto, 2003), and the

  10. 78 FR 63999 - Notice of Vitamin D Standardization Program (VDSP) Symposium: Tools To Improve Laboratory...

    Science.gov (United States)

    2013-10-25

    ...) Symposium: Tools To Improve Laboratory Measurement SUMMARY: The National Institutes of Health, Office of... include commercial assay manufacturers; commercial, clinical, and research laboratory personnel; vitamin D...-laboratory comparison and commutability studies demonstrating its effectiveness; (3) demonstrate how tools...

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

    Science.gov (United States)

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

    2008-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Julie A. Bierer

    2016-06-01

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

  13. Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial.

    Science.gov (United States)

    Engel, Roger Mark; Gonski, Peter; Beath, Ken; Vemulpad, Subramanyam

    2016-05-01

    Randomized clinical trial. To investigate the effect of including manual therapy (MT) in a pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease (COPD). The primary source of exercise limitation in people with COPD is dyspnea. The dyspnea is partly caused by changes in chest wall mechanics, with an increase in chest wall rigidity (CWR) contributing to a decrease in lung function. As MT is known to increase joint mobility, administering MT to people with COPD carries with it the potential to influence CWR and lung function. Thirty-three participants with COPD, aged between 55 and 70 years (mean = 65·5±4 years), were randomly assigned to three groups: pulmonary rehabilitation (PR) only, soft tissue therapy (ST) and PR, and ST, spinal manipulative therapy (SM), and PR. Outcome measures including forced expiratory volume in the 1st second (FEV1), forced vital capacity (FVC), 6-minute walking test (6MWT), St. George's respiratory questionnaire (SGRQ), and the hospital anxiety and depression (HAD) scale were recorded at 0, 8, 16, and 24 weeks. There was a significant difference in FVC between the three groups at 24 weeks (P = 0·04). For the ST+SM+PR group versus PR only the increase was 0·40 l (CI: 0·02, 0·79; P = 0·03). No major or moderate adverse events (AE) were reported following the administration of 131 ST and 272 SM interventions. The increase in FVC is a unique finding. Although the underlying mechanisms responsible for this outcome are not yet understood, the most likely explanation is the synergistic effect resulting from the combination of interventions. These results support the call for a larger clinical trial in the use of MT for COPD.

  14. Adherence to a behavioral weight loss treatment program enhances weight loss and improvements in biomarkers

    Directory of Open Access Journals (Sweden)

    Sushama D Acharya

    2009-06-01

    Full Text Available Sushama D Acharya3, Okan U Elci3, Susan M Sereika1,2,3, Edvin Music3, Mindi A Styn3, Melanie Warziski Turk3, Lora E Burke2,31Department of Biostatistics, Graduate School of Public Health, 2Department of Epidemiology, Graduate School of Public Health, 3School of Nursing, University of Pittsburgh, Pittsburgh, PA, USAObjectives: To describe participants’ adherence to multiple components (attendance, energy intake, fat gram, exercise goals, and self-monitoring eating and exercise behaviors of a standard behavioral treatment program (SBT for weight loss and how adherence to these components may influence weight loss and biomarkers (triglycerides, low density lipoproteins [LDL], high density lipoprotein, and insulin during the intensive and less-intensive intervention phases. Methods: A secondary analysis of a randomized clinical trial consisting of a SBT with either fat-restricted standard or lacto-ovo vegetarian diet. The 12-month intervention was delivered in 33 group sessions. The first six months reflected the intensive phase; the second six months, the less-intensive intervention phase. We conducted the analysis without regard to treatment assignment. Eligible participants included overweight/obese adults (N = 176; mean body mass index = 34.0 kg/m2. The sample was 86.9% female, 70.5% White, and 44.4 ± 8.6 years old. The outcome measures included weight and biomarkers. Results: There was a significant decline in adherence to each treatment component over time (P < 0.0001. In the first six months, adherence to attendance, self-monitoring and the energy goal were significantly associated with greater weight loss (P < 0.05. Adherence to attendance and exercise remained significantly associated with weight loss in the second six months (P < 0.05. Adherence to attendance, self-monitoring and exercise had indirect effects through weight loss on LDL, triglycerides, and insulin (P < 0.05.Conclusions: We observed a decline in adherence to each

  15. Coaching the Debriefer: Peer Coaching to Improve Debriefing Quality in Simulation Programs.

    Science.gov (United States)

    Cheng, Adam; Grant, Vincent; Huffman, James; Burgess, Gavin; Szyld, Demian; Robinson, Traci; Eppich, Walter

    2017-10-01

    Formal faculty development programs for simulation educators are costly and time-consuming. Peer coaching integrated into the teaching flow can enhance an educator's debriefing skills. We provide a practical guide for the who, what, when, where, why, and how of peer coaching for debriefing in simulation-based education. Peer coaching offers advantages such as psychological safety and team building, and it can benefit both the educator who is receiving feedback and the coach who is providing it. A feedback form for effective peer coaching includes the following: (1) psychological safety, (2) framework, (3) method/strategy, (4) content, (5) learner centeredness, (6) co-facilitation, (7) time management, (8) difficult situations, (9) debriefing adjuncts, and (10) individual style and experience. Institutional backing of peer coaching programs can facilitate implementation and sustainability. Program leaders should communicate the need and benefits, establish program goals, and provide assessment tools, training, structure, and evaluation to optimize chances of success.

  16. Improving pharmacy practice through public health programs: experience from Global HIV/AIDS initiative Nigeria project.

    Science.gov (United States)

    Oqua, Dorothy; Agu, Kenneth Anene; Isah, Mohammed Alfa; Onoh, Obialunamma U; Iyaji, Paul G; Wutoh, Anthony K; King, Rosalyn C

    2013-01-01

    The use of medicines is an essential component of many public health programs (PHPs). Medicines are important not only for their capacity to treat and prevent diseases. The public confidence in healthcare system is inevitably linked to their confidence in the availability of safe and effective medicines and the measures for ensuring their rational use. However, pharmacy services component receives little or no attention in most public health programs in developing countries. This article describes the strategies, lessons learnt, and some accomplishments of Howard University Pharmacists and Continuing Education (HU-PACE) Centre towards improving hospital pharmacy practice through PHP in Nigeria. In a cross-sectional survey, 60 hospital pharmacies were randomly selected from 184 GHAIN-supported health facilities. The assessment was conducted at baseline and repeated after at least 12 months post-intervention using a study-specific instrument. Interventions included engagement of stakeholders; provision of standards for infrastructural upgrade; development of curricula and modules for training of pharmacy personnel; provision of job aids and tools amongst others. A follow-up hands-on skill enhancement based on identified gaps was conducted. Chi-square was used for inferential statistics. All reported p-values were 2-tailed at 95% confidence interval. The mean duration of service provision at post-intervention assessment was 24.39 (95% CI, 21.70-27.08) months. About 16.7% of pharmacies reported been trained in HIV care at pre-intervention compared to 83.3% at post-intervention. The proportion of pharmacies with audio-visual privacy for patient counseling increased significantly from 30.9% at pre-intervention to 81.4% at post-intervention. Filled prescriptions were cross-checked by pharmacist (61.9%) and pharmacy technician (23.8%) before dispensing at pre-intervention compared to pharmacist (93.1%) and pharmacy technician (6.9%) at post intervention. 40.0% of

  17. Entrepreneurial program of research and service to improve nursing home care.

    Science.gov (United States)

    Rantz, Marilyn J; Mehr, David R; Hicks, Lanis; Scott-Cawiezell, Jill; Petroski, Gregory F; Madsen, Richard W; Porter, Rose; Zwygart-Stauffacher, Mary

    2006-12-01

    This is a methodological article intended to demonstrate the integration of multiple goals, multiple projects with diverse foci, and multiple funding sources to develop an entrepreneurial program of research and service to directly affect and improve the quality of care of older adults, particularly nursing home residents. Examples that illustrate how clinical ideas build on one another and how the research ideas and results build on one another are provided. Results from one study are applied to the next and are also applied to the development of service delivery initiatives to test results in the real world. Descriptions of the Quality Improvement Program for Missouri and the Aging in Place Project are detailed to illustrate real-world application of research to practice.

  18. Outcomes of continuous process improvement of a nutritional care program incorporating TTR measurement.

    Science.gov (United States)

    Mears, Elia

    2002-12-01

    Early assessment of protein calorie malnutrition (PCM) can improve the outcome for hospitalized patients by allowing the initiation of nutrition support if required. In addition, monitoring nutritional status during the hospital stay can identify a decline in or improvement of PCM so that alterations to treatment regimens can be made if needed. The visceral protein albumin is the traditional laboratory indicator of PCM. In the past decade another protein has been lauded as a superior marker that can be used in conjunction. We undertook several studies to test the effectiveness of TTR as an aid in nutritional assessment. We found TTR to be a sensitive measure of nutritional status, allowing for earlier assessment and intervention, thus reducing length of stay and other hospital associated costs. Based on these findings, our hospital generated and implemented a multidisciplinary nutrition care program. Transthyretin is an integral portion of this program; levels are determined on admission and repeated twice weekly until discharge.

  19. Industrial Energy-Efficiency Improvement Program. Annual report to the Congress and the President 1979

    Energy Technology Data Exchange (ETDEWEB)

    1980-12-01

    The industrial energy efficiency improvement program to accelerate market penetration of new and emerging industrial technologies and practices which will improve energy efficiency; encourage substitution of more plentiful domestic fuels; and enhance recovery of energy and materials from industrial waste streams is described. The role of research, development, and demonstration; technology implementation; the reporting program; and progress are covered. Specific reports from the chemicals and allied products; primary metals; petroleum and coal products; stone, clay, and glass, paper and allied products; food and kindred products; fabricated metals; transportation equipment; machinery (except electrical); textile mill products; rubber and miscellaneous plastics; electrical and electronic equipment; lumber and wood; and tobacco products are discussed. Additional data from voluntary submissions, a summary on progress in the utilization of recovered materials, and an analysis of industrial fuel mix are briefly presented. (MCW)

  20. Park-based afterschool program to improve cardiovascular health and physical fitness in children with disabilities.

    Science.gov (United States)

    Haney, Kanathy; Messiah, Sarah E; Arheart, Kristopher L; Hanson, Eric; Diego, Allison; Kardys, Jack; Kirwin, Kevin; Nottage, Renae; Ramirez, Shawn; Somarriba, Gabriel; Binhack, Lucy

    2014-07-01

    Children with disabilities are more likely to be overweight or obese and less likely to engage in physical activities versus their peers without disabilities. The effect of a structured afterschool program housed in a large county parks system on several obesity-related health outcomes among children with disabilities was examined. Children/adolescents with a developmental and/or intellectual disability ages 6-22 (N = 52, mean age 13.7 years) who participated in an afterschool (either 2010-2011 or 2011-2012 school year) health and wellness program called Fit-2-Play™ were assessed. Pre-post comparison of outcome variables (mean height, weight, waist/hip/midarm circumference, fitness tests, and a 9-item health and wellness knowledge assessment) via general linear mixed models analysis was conducted to evaluate the effectiveness of the program for normal and overweight/obese participants. Normal weight participants significantly improved pre-post mean number of push-ups (9.69-14.23, p = 0.01) and laps on the PACER test (8.54-11.38, p < 0.01) and the overweight/obese group significantly improved the number of sit ups (7.51-9.84, p < 0.01) and push ups (4.77-9.89, p < 0.001). Pre-post mean health and wellness knowledge composite scores significantly improved for all participants (p < 0.01). Parks-based afterschool programs can be effective community resources for instilling physical health in both normal weight and overweight/obese children with disabilities. More studies are needed to ascertain whether community-based afterschool health and wellness programs can be implemented and sustained across this population. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Connecting the Learners: Improving Uptake of a Nursing Home Educational Program by Focusing on Staff Interactions

    OpenAIRE

    Colón-Emeric, Cathleen S.; Pinheiro, Sandro O.; Anderson, Ruth A.; Porter, Kristie; McConnell, Eleanor; Corazzini, Kirsten; Hancock, Kathryn; Lipscomb, Jeffery; Beales, Julie; Simpson, Kelly M.

    2013-01-01

    Purpose of the Study: The CONNECT intervention is designed to improve staff connections, communication, and use of multiple perspectives for problem solving. This analysis compared staff descriptions of the learning climate, use of social constructivist learning processes, and outcomes in nursing facilities receiving CONNECT with facilities receiving a falls education program alone. Design and Methods: Qualitative evaluation of a randomized controlled trial was done using a focus group design...

  2. Can we improve children’s mental health with Why Try Program?

    OpenAIRE

    Miloseva, Lence; Vukosavljevic-Gvozden, Tanja; Milosev, Vladimir

    2014-01-01

    Introduction: The WhyTry Program is a strength-based approach aiming to help young people overcome their challenges and improve outcomes by emphasizing their self-determination and strengths when solving problems. They are taught social and emotional principles through a series of 10 pictures reinforced by music, videos and physical activities teaching a discrete principle. Aim of the study: The goal of the paper is to try answering the research questions about the possibility of deve...

  3. Management of COPD in general practice in Denmark--participating in an educational program substantially improves adherence to guidelines

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Hansen, Ejvind Frausing; Jensen, Michael Skov

    2010-01-01

    BACKGROUND AND AIM: The general practitioner (GP) is the first contact with the health care system for most patients with COPD in Denmark. We studied, if participating in an educational program could improve adherence to guidelines, not least for diagnosis, staging, and treatment of the disease....... DESIGN AND SETTING: Two cross-sectional surveys were performed precisely one year apart before and after an educational program for the participating GPs. A total of 124 GPs completed the study; 1716 and 1342 patients with GP-diagnosed COPD and no concomitant asthma, respectively, were included...... in the two surveys. RESULTS: The proportion of patients having FEV(1) registered in the GPs files increased from 45% to 69% (P

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-03-01

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

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

    Science.gov (United States)

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

    2014-09-03

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

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

    Science.gov (United States)

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

    2012-04-01

    Strength training (ST) is an important health behavior for aging women; it helps maintain strength and function and reduces risk for chronic diseases. This study assessed change in physical fitness following participation in a ST program implemented and evaluated by community leaders. The StrongWomen Program is a nationally disseminated, research-based, community ST program active in 40 states. The Senior Fitness Test is used to assess upper and lower body strength, upper and lower body flexibility, aerobic fitness, and agility; data are collected prior to and following program participation. For these analyses, five states provided deidentified data for 367 female participants, mean age 63 (±11) years. Attendance in approximately 10 weeks of twice-weekly classes was 69.4%. Paired t tests were used to analyze pre-post change. Significant improvements were observed (p < .01) in all Senior Fitness Test measures. Data are stratified by age-group and compared with published, age-based norms. This study demonstrates that it is feasible for community leaders to conduct pre-post physical fitness evaluations with participants and that participants experienced improvements across several important domains of physical fitness.

  7. California Public Hospitals Improved Quality of Care Under Medicaid Waiver Program.

    Science.gov (United States)

    Pourat, Nederah

    2017-06-01

    California has 12 county-owned and operated hospital systems and 5 University of California hospitals designated as public hospitals. These organizations deliver the majority of inpatient care and a significant amount of outpatient care to Medicaid patients in the state. In 2010, California was the first state in the nation to implement a five-year Delivery System Reform Incentive Payment (DSRIP) program under the Section §1115 Medicaid "Bridge to Reform" waiver to improve the capacity of these hospitals to deliver high quality and more efficient care. The California DSRIP was the first program in a continuing national initiative to reform the Medicaid delivery system while remaining budget neutral. An extensive evaluation revealed major advances in infrastructure development, delivery of health care, and patient outcomes during the program. The results highlight the importance of joint federal and state investments in bolstering the capacity of safety net providers to deliver high-quality care, and they emphasize the need for continued investment in the safety net. The California DSRIP was followed by a program called Public Hospital Redesign and Incentives in Medi-Cal (PRIME), which incentivizes improvements in expanded and new areas of care not addressed by DSRIP

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

    Science.gov (United States)

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

    2017-06-08

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

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

    Directory of Open Access Journals (Sweden)

    Xuelei Meng

    2014-01-01

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

  10. Improving the Attitudes of 4th Graders toward Older People through a Multidimensional Intergenerational Program

    Science.gov (United States)

    Lynott, Patricia P.; Merola, Pamela R.

    2007-01-01

    The purpose of this study was to examine the effects of an intergenerational program on children's attitudes toward older people. Four 4th grade classes, one each during the years 2002 through 2005, participated in the study. The elders and school children engaged in meaningful activities over a 5 month period, including the performance of a play…

  11. A Nutrition Education Program in Rural Bangladesh Was Associated with Improved Feeding Practices but Not with Child Growth.

    Science.gov (United States)

    Owais, Aatekah; Schwartz, Benjamin; Kleinbaum, David G; Suchdev, Parminder S; Faruque, Abu Syed Golam; Das, Sumon K; Rahman, Shahed; Stein, Aryeh D

    2017-05-01

    Background: Childhood undernutrition is a major public health problem in Bangladesh. Evaluating child nutrition programs is a priority. Objective: The objective of this study was to evaluate a community-based nutrition education program (implemented from 2011 to 2013) aimed at improving infant and young child feeding (IYCF) practices and growth in rural Bangladesh. Methods: A cohort-based evaluation was conducted that included 2400 women (1200 from Karimganj, the intervention subdistrict, and 1200 from Katiadi, the control subdistrict) enrolled at 28-31 wk gestation in 3 waves between January and October 2011. Follow-up occurred at 3, 9, 16, and 24 mo of offspring age. The main outcomes were exclusive breastfeeding (EBF), measured at 3 mo, timing of complementary feeding (CF) initiation and minimum acceptable diet (MAD), measured at 9 mo, and child growth [assessed via length-for-age z score (LAZ) and weight-for-length z score], measured at all follow-ups. The main exposures were subdistrict of residence and wave of enrollment. For IYCF practices as outcome, logistic regressions were used. Generalized estimating equations were used for child growth as outcome. Results: EBF rates at 3 mo remained unchanged between waves 1 and 3 in Karimganj (55.6% compared with 57.3%), but the proportion of infants receiving timely CF initiation and MAD at 9 mo increased significantly (CF: 27.1-54.7%; MAD: 8.4-35.3%). Mean LAZ at 24 mo remained unchanged between waves 1 and 3 in Karimganj (-2.18 compared with -1.98). Conclusions: The program was successful in improving the quality of infant diet at 9 mo and timely CF initiation, but not EBF at 3 mo or LAZ. These findings support the case for implementing simple messages in all programs aimed at improving infant diet, especially in settings in which supplementing overall household diet may not be feasible. © 2017 American Society for Nutrition.

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

    Directory of Open Access Journals (Sweden)

    Alesi M

    2014-03-01

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

  13. Detection of nosocomial malnutrition is improved in Amazon region by a standard clinical nutrition education program.

    Science.gov (United States)

    Acuña, K; Pires, C; Santos, G; Hashimoto, R; Pinheiro, L; Mazuy, N; Machado, A; Oliveira, C; Camilo, M; Wismann, P; Lima, M; Costa-Matos, A; Waitzberg, D L; Cruz, T

    2008-01-01

    In Brazil hospital malnutrition is highly prevalent, physician awareness of malnutrition is low, and nutrition therapy is underprescribed. One alternative to approach this problem is to educate health care providers in clinical nutrition. The present study aims to evaluate the effect of an intensive education course given to health care professionals and students on the diagnosis ability concerning to hospital malnutrition. An intervention study, based on a clinical nutrition educational program, offered to medical and nursing students and professionals, was held in a hospital of the Amazon region. Participants were evaluated through improvement of diagnostic ability, according to agreement of malnutrition diagnosis using Subjective Global Assessment before and after the workshop, as compared to independent evaluations (Kappa Index, k). To evaluate the impact of the educational intervention on the hospital malnutrition diagnosis, medical records were reviewed for documentation of parameters associated with nutritional status of in-patients. The SPSS statistical software package was used for data analysis. A total of 165 participants concluded the program. The majority (76.4%) were medical and nursing students. Malnutrition diagnosis improved after the course (before k = 0.5; after k = 0.64; p Clinical nutrition education improved the ability of diagnosing malnutrition; however the primary impact was on medical and nursing students. To sustain diagnostic capacity a clinical nutrition program should be part of health professional curricula and be coupled with continuing education for health care providers.

  14. Investigation of the effect of swimming programs on improving vocational relationships

    Directory of Open Access Journals (Sweden)

    Iman Nazerian

    2012-04-01

    Full Text Available Recreational activities play important role on workers' health conditions and improve people's creativity. Steel industry is one of industries, where workers mainly face with hard working conditions. There are various techniques to help human resources increase their potentials such as providing recreational centers, athletic facilities, etc. In this paper, we study the impact of regular swimming exercises on improving the efficiency of employees in management level in a steel complex unit called Mobarakeh Steel Complex. In this company, there were about 85 middle level managers and supervisors and the proposed study selects 30 people, randomly and divides them into two equal groups. In the first stage of the study, questionnaire of vocational relation are distributed among the participants of this study and some important factors, which could improve vocational relationships are measured. Next, the experimental groups are invited to take part in some selective aerobic programs for 8 weeks and 3 sessions per week and 1 hour and 15 minutes per session, regularly. Finally, we repeat the same experiments after the aerobic programs end and compare the results with the first one. The preliminary results indicate that the routine swimming programs have increased people self confidence, creativity and working group skills.

  15. 'Only systems thinking can improve family planning program in Pakistan': A descriptive qualitative study.

    Science.gov (United States)

    Zafar, Saira; Shaikh, Babar Tasneem

    2014-12-01

    Family Planning (FP) program in Pakistan has been struggling to achieve the desired indicators. Despite a well-timed initiation of the program in late 50s, fertility decline has been sparingly slow. As a result, rapid population growth is impeding economic development in the country. A high population growth rate, the current fertility rate, a stagnant contraceptive prevalence rate and high unmet need remain challenging targets for population policies and FP programs. To accelerate the pace of FP programs and targets concerned, it is imperative to develop and adopt a holistic approach and strategy for plugging the gaps in various components of the health system: service delivery, information systems, drugs-supplies, technology and logistics, Human Resources (HRs), financing, and governance. Hence, World Health Organization (WHO) health systems building blocks present a practical framework for overall health system strengthening. This descriptive qualitative study, through 23 in-depth interviews, explored the factors related to the health system, and those responsible for a disappointing FP program in Pakistan. Provincial representatives from Population Welfare and Health departments, donor agencies and non-governmental organizations involved with FP programs were included in the study to document the perspective of all stakeholders. Content analysis was done manually to generate nodes, sub-nodes and themes. Performance of FP programs is not satisfactory as shown by the indicators, and these programs have not been able to deliver the desired outcomes. Interviewees agreed that inadequate prioritization given to the FP program by successive governments has led to this situation. There are issues with all health system areas, including governance, strategies, funding, financial management, service delivery systems, HRs, technology and logistic systems, and Management Information System (MIS); these have encumbered the pace of success of the program. All stakeholders

  16. ‘Only Systems Thinking Can Improve Family Planning Program in Pakistan’: A Descriptive Qualitative Study

    Directory of Open Access Journals (Sweden)

    Saira Zafar

    2014-12-01

    Full Text Available Background Family Planning (FP program in Pakistan has been struggling to achieve the desired indicators. Despite a well-timed initiation of the program in late 50s, fertility decline has been sparingly slow. As a result, rapid population growth is impeding economic development in the country. A high population growth rate, the current fertility rate, a stagnant contraceptive prevalence rate and high unmet need remain challenging targets for population policies and FP programs. To accelerate the pace of FP programs and targets concerned, it is imperative to develop and adopt a holistic approach and strategy for plugging the gaps in various components of the health system: service delivery, information systems, drugs-supplies, technology and logistics, Human Resources (HRs, financing, and governance. Hence, World Health Organization (WHO health systems building blocks present a practical framework for overall health system strengthening. Methods This descriptive qualitative study, through 23 in-depth interviews, explored the factors related to the health system, and those responsible for a disappointing FP program in Pakistan. Provincial representatives from Population Welfare and Health departments, donor agencies and non-governmental organizations involved with FP programs were included in the study to document the perspective of all stakeholders. Content analysis was done manually to generate nodes, sub-nodes and themes. Results Performance of FP programs is not satisfactory as shown by the indicators, and these programs have not been able to deliver the desired outcomes. Interviewees agreed that inadequate prioritization given to the FP program by successive governments has led to this situation. There are issues with all health system areas, including governance, strategies, funding, financial management, service delivery systems, HRs, technology and logistic systems, and Management Information System (MIS; these have encumbered the pace of

  17. Too little but not too late: Results of a literature review to improve routine immunization programs in developing countries

    Directory of Open Access Journals (Sweden)

    Cairns K Lisa

    2008-06-01

    community level. However it was startling to see how few papers were identified and in particular how few were of strong scientific quality. Further well-designed and well-conducted scientific research is warranted. Proposed areas of additional research include integration of additional services with immunization delivery, collaboration of immunization programs with new partners, best approaches to new vaccine introduction, and how to improve service delivery.

  18. Improving Undergraduate Research Experiences With An Intentional Mentoring Program: Lessons Learned Through Assessment of Keck Geology Consortium Programs

    Science.gov (United States)

    Wirth, K. R.; Garver, J. I.; Greer, L.; Pollock, M.; Varga, R. J.; Davidson, C. M.; Frey, H. M.; Hubbard, D. K.; Peck, W. H.; Wobus, R. A.

    2015-12-01

    The Keck Geology Consortium, with support from the National Science Foundation (REU Program) and ExxonMobil, is a collaborative effort by 18 colleges to improve geoscience education through high-quality research experiences. Since its inception in 1987 more than 1350 undergraduate students and 145 faculty have been involved in 189 yearlong research projects. This non-traditional REU model offers exceptional opportunities for students to address research questions at a deep level, to learn and utilize sophisticated analytical methods, and to engage in authentic collaborative research that culminates in an undergraduate research symposium and published abstracts volume. The large numbers of student and faculty participants in Keck projects also affords a unique opportunity to study the impacts of program design on undergraduate research experiences in the geosciences. Students who participate in Keck projects generally report significant gains in personal and professional dimensions, as well as in clarification of educational and career goals. Survey data from student participants, project directors, and campus advisors identify mentoring as one of the most critical and challenging elements of successful undergraduate research experiences. Additional challenges arise from the distributed nature of Keck projects (i.e., participants, project directors, advisors, and other collaborators are at different institutions) and across the span of yearlong projects. In an endeavor to improve student learning about the nature and process of science, and to make mentoring practices more intentional, the Consortium has developed workshops and materials to support both project directors and campus research advisors (e.g., best practices for mentoring, teaching ethical professional conduct, benchmarks for progress, activities to support students during research process). The Consortium continues to evolve its practices to better support students from underrepresented groups.

  19. Incorporating robotic-assisted telerehabilitation in a home program to improve arm function following stroke.

    Science.gov (United States)

    Linder, Susan M; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Rosenfeldt, Anson B; Clark, Cindy; Wolf, Steven L; Alberts, Jay L

    2013-09-01

    After stroke, many individuals lack resources to receive the intensive rehabilitation that is thought to improve upper extremity motor function. This case study describes the application of a telerehabilitation intervention using a portable robotic device combined with a home exercise program (HEP) designed to improve upper extremity function. The participant was a 54-year-old man, 22 weeks following right medullary pyramidal ischemic infarct. At baseline, he exhibited residual paresis of the left upper extremity, resulting in impaired motor control consistent with a flexion synergistic pattern, scoring 22 of 66 on the Fugl-Meyer Assessment. The participant completed 85 total hours of training (38 hours of robotic device and 47 hours of HEP) over the 8-week intervention period. The participant demonstrated an improvement of 26 points on the Action Research Arm Test, 5 points on the Functional Ability Scale portion of the Wolf Motor Function Test, and 20 points on the Fugl-Meyer Assessment, all of which surpassed the minimal clinically important difference. Of the 17 tasks of the Wolf Motor Function Test, he demonstrated improvement on 11 of the 15 time-based tasks and both strength measures. The participant reported an overall improvement in his recovery from stroke on the Stroke Impact Scale quality-of-life questionnaire from 40 of 100 to 65 of 100. His score on the Center for Epidemiologic Studies Depression Scale improved by 19 points. This case demonstrates that robotic-assisted therapy paired with an HEP can be successfully delivered within a home environment to a person with stroke. Robotic-assisted therapy may be a feasible and efficacious adjunct to an HEP program to elicit substantial improvements in upper extremity motor function, especially in those persons with stroke who lack access to stroke rehabilitation centers.

  20. Meal programs improve nutritional risk: a longitudinal analysis of community-living seniors.

    Science.gov (United States)

    Keller, Heather H

    2006-07-01

    To determine the independent association of meal programs (eg, Meals On Wheels and other meal programs with a social component) and shopping help on seniors' nutritional risk. Cohort design. Baseline data were collected with an in-person interview and subjects were followed up for 18 months via telephone interview. Cognitively well, vulnerable (ie, required informal or formal supports for activities of daily living) seniors were recruited through community service agencies in southwestern Ontario, Canada. Three hundred sixty-seven seniors participated in baseline interviews and 263 completed data collection at 18-month follow-up; 70% participated in meal programs at baseline. The 15-item Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN) questionnaire identified nutritional risk at 18 months. Descriptive and bivariate analyses were performed and significant associations (Pnutritional risk for vulnerable seniors. Increased use of these programs over time may indicate a senior's declining status. Seniors who are in need of informal or formal supports for food shopping or preparation should be encouraged to participate in meal programs as a means of maintaining or improving their nutrition.