WorldWideScience

Sample records for providing improved technical

  1. Improvements to Technical Specifications surveillance requirements

    International Nuclear Information System (INIS)

    Lobel, R.; Tjader, T.R.

    1992-12-01

    In August 1983 an NRC task group was formed to investigate problems with surveillance testing required by Technical Specifications, and to recommend approaches to effect improvements. NUREG-1024 (''Technical Specifications-Enhancing Safety Impact'') resulted, and it contained recommendations to review the basis for test frequencies; to ensure that the tests promote safety and do not degrade equipment; and to review surveillance tests so that they do not unnecessarily burden personnel. The Technical Specifications Improvement Program (TSIP) was established in December 1984 to provide the framework for rewriting and improving the Technical Specifications. As an element of the TSIP, all Technical Specifications surveillance requirements were comprehensively examined as recommended in NUREG-1024. The results of that effort are presented in this report. The study found that while some testing at power is essential to verify equipment and system operability, safety can be improved, equipment degradation decreased, and unnecessary personnel burden relaxed by reducing the amount of testing at power

  2. 75 FR 81832 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-12-29

    ... DEPARTMENT OF AGRICULTURE Natural Resources Conservation Service 7 CFR Part 652 Technical Service... as of Jan. 1, 2010, on page 565, in Sec. 652.2, the first definition for ``Technical service'' is removed. [FR Doc. 2010-32945 Filed 12-28-10; 8:45 am] BILLING CODE 1505-01-D ...

  3. Improving knowledge, technical skills, and confidence among pediatric health care providers in the management of chronic tracheostomy using a simulation model.

    Science.gov (United States)

    Agarwal, Amit; Marks, Nancy; Wessel, Valerie; Willis, Denise; Bai, Shasha; Tang, Xinyu; Ward, Wendy L; Schellhase, Dennis E; Carroll, John L

    2016-07-01

    The results from a recent national survey about catastrophic complications following tracheostomy revealed that the majority of events involved a loss of airway. Most of the events due to airway loss involved potentially correctable deficits in caregiver education. Training in a simulated environment allows skill acquisition without compromising patient safety. We assessed the knowledge and confidence level of pediatric health care providers at a large tertiary care children's hospital in routine and emergency tracheostomy care and evaluated the efficacy of a comprehensive simulation-based tracheostomy educational program. The prospective observational study was comprised of 33 subjects including pediatric residents, internal medicine-pediatric residents, pediatric hospitalist faculty physicians, and advanced practice registered nurses who are involved in the care of patients with tracheostomies within a tertiary-care children's hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course that employed patient simulation. The outcome measurements included pre- and post-course questionnaires, pre- and post-course test scores, and observational data from the simulation sessions. Before the education and simulation, the subjects' comfort and confidence levels on a five-point Likert scale in performing routine tracheostomy tube care, routine tracheostomy tube change, and an emergency tracheostomy tube change were as follows (median (Q1, Q3)): 1 (1, 2), 1 (1, 2), and 1 (1, 2), respectively (n = 28). The levels of comfort and confidence after completing the course improved significantly to 4 (4, 5), 4 (4, 5), 4 (4, 5), respectively (P tracheostomy tubes (e.g., cuffed versus uncuffed), physiological significance of the cuff, mechanism of action and physiological significance of the speaking valve, and the importance of the obturator in changing the tracheostomy tube

  4. Providing Technical assistance on corruption control

    OpenAIRE

    Serge, Lortie

    2012-01-01

    The phenomenon referred to as corruption has now been generating a high degree of interest for over twenty years. It has in fact spawned not only an abundant literature but also a monitoring and advisory industry whose specific outlook heavily shapes the debate on integrity issues. This industry is widely supported by aid providers, be it the international financing institutions or national development agencies. At this juncture, it therefore seemed worthwhile to examine more critically an ar...

  5. Technical specification improvement through safety margin considerations

    International Nuclear Information System (INIS)

    Howard, R.C.; Jansen, R.L.

    1986-01-01

    Westinghouse has developed an approach for utilizing safety analysis margin considerations to improve plant operability through technical specification revision. This approach relies on the identification and use of parameter interrelations and sensitivities to identify acceptable operating envelopes. This paper summarizes technical specification activities to date and presents the use of safety margin considerations as another viable method to obtain technical specification improvement

  6. 77 FR 46658 - Proposed Priority; Technical Assistance To Improve State Data Capacity-National Technical...

    Science.gov (United States)

    2012-08-06

    ... Assistance To Improve State Data Capacity--National Technical Assistance Center To Improve State Capacity To... and later years. We take this action to focus attention on an identified national need to provide TA to improve the capacity of States to meet the data collection requirements of the Individuals with...

  7. Technical improvement of uranium purification

    International Nuclear Information System (INIS)

    Huang Lunguang; Zhuang Haixing; Niu Yuqing; Zhou Mi

    1996-01-01

    The authors introduces the present process of producing nuclear-grade UO 2 in Hengyang Uranium Processing Mill of China. At the beginning of 1990's, in order to suit the needs of nuclear-grade products which are needed by the construction of nuclear power station in China, the authors studied the process of using national yellow cake as crude material to produce nuclear-grade UO 2 , which includes drying and calcining of yellow cake, HNO 3 dissolving, extracting and purifying uranium with TBP-kerosene solvent extraction, ADU precipitating, AUTC converting and crystallizing, calcining AUTC crystal, and finally nuclear-grade UO 2 products are obtained. Through these studies, the authors have grasped the technology that is needed by the nuclear-grade products. Therefore, the authors could make improvements in both process flow and process engineering

  8. Engaging service providers in improving industry performance

    International Nuclear Information System (INIS)

    Oberth, R.

    2012-01-01

    Effective task leadership is the key to achieving results in the nuclear industry and in most other industries. One of the themes of this conference is to discuss how the nuclear industry can undertake Issue-Identification and Definition as a means of 'identifying what needs attention' and then 'defining what needs to be done to make that happen'. I will explore this theme from the perspective of the 'Service Provider' - which by the definition of this conference includes everyone not within an operating utility - meaning 'those involved in everything from inspection and repair to research and plant architecture' - basically the member companies of my association, OCI. Our members take the definition of the roles and responsibilities of the 'Service Provider' community very seriously. In the context of this discussion a key utility function is the early definition of requirements and expectations of Service Providers in supplying to these requirements. Let's explore for a moment the Service Provider role and perspective. Service Providers are by nature pro-active - they seek ways to engage with utilities (and tier one vendors) to solve problems and achieve good outcomes. They come to industry conferences like this one to learn about upcoming utility programs and supply opportunities and how they can improve performance. Service Providers particularly want to hear senior utility people comment on emerging issues even those at the very early identification stage. Some Clarification of Roles is in Order - as that is the focus of this conference: 'Issue-Identification and Definition'. 'Issue-Identification' is the utility's job - it is the utility's role to identify as early as possible 'what needs attention and what their needs and expectations are'. This takes place before service provider engagement. 'Issue-Definition' is more challenging. It means 'determining and prioritizing what needs to be done to deal with the situation at hand'. This typically involves

  9. Technical report for effective estimation and improvement of quality system

    International Nuclear Information System (INIS)

    Kim, Kwan Hyun

    2000-06-01

    This technical report provides the methods on how to improve the Quality System, in R and D part. This report applies on the quality assurance(QA) programmes of the design, fabrication in nuclear projects. The organization having overall responsibility for the nuclear power item design, preservation, fabrication shall be described in this report in each stage of improvement of QA systems

  10. Conversion of NEK standard technical specifications into improved technical specifications

    International Nuclear Information System (INIS)

    Glaser, B.

    2003-01-01

    Neck is currently using a standard format of operation's Technical Specifications - STS (based on NUREG-0452), which are planned to be converted into Improved Technical Specifications - ITS (based on NUREG-1431). To facilitate the development of individual ITS, each reactor vendor owners group (OG) and the NRC staff developed improved standard TS (ISTS). For Westinghouse plants, the ISTS are published as NUREG-1431, and this document is going to be the basis for the new NEK ITS. It has been recognized that nuclear safety in all plants would benefit from improvement and standardization of ITS, so this was also addressed and recognized by the NRC. There are several plants around Europe and US, which have replaced the format into ITS which brings a lot of improvements and practical value in operations. The main objective of conversion is to completely rewrite, reformat, and streamline the existing STS. Emphasis is placed on human factors principles to improve clarity and understanding. The Bases section will be significantly expanded to clarify and better explain the purpose and foundation of each specification. There might be some proposed changes to the existing STS that deviated from the ITS in NUREG-1431 and constitute a relaxation of the existing STS. Each of these additional proposed changes will be described and evaluated in amendment application and justified on a case-by-case basis. Since the NEK is going to operate for more than 20 year without considering life extension, such conversion will be beneficial for operation personnel as well as regulation, surveillance and focus on operation's safety. At the present, only preliminary plan of STS conversion exists, showing the time frame of approximately 2 years of conversion process and numerous tasks that need to be performed. The plan is to begin with process in year 2004 and finish project in 2006, which means use of new ITS in main control room in year 2007. Beside the main process of conversion, there are

  11. Risk based technique for improving technical specifications

    International Nuclear Information System (INIS)

    Kim, I. S.; Jae, M. S.; Kim, B. S.; Hwang, S. W.; Kang, K. M.; Park, S. S.; Yu, Y. S.

    2001-03-01

    The objective of this study is to develop the systematic guidance for reviewing the documents associated with the changes of technical specifications. The work done in this fiscal year is the following : surveys in TS requirements, TS improvements and TS regulations in foreign countries as well as Korea, surveys on the state-of-the-art of RITSs and their use in Korea, development of a decision-making framework for both the licensee and the regulation agency, description of risk measures, assessment methodology on STI/AOT, and adverse effects caused by periodic maintenance, which are explained in appendix. The results of this study might contribute to enhancing the quality of the current technical specifications and contribute to preparing the risk informed regulation program using the decision-making framework developed in this study

  12. Patients Provide Recommendations for Improving Patient Satisfaction.

    Science.gov (United States)

    Moore, Angelo D; Hamilton, Jill B; Krusel, Jessica L; Moore, LeeAntoinette G; Pierre-Louis, Bosny J

    2016-04-01

    National Committee for Quality Assurance recommends patient-centered medical homes incorporate input from patient populations; however, many health care organizations do not. This qualitative study used two open-ended questions from 148 active duty Army Soldiers and their family members to illicit recommendations for primary care providers and clinic leadership that would improve their health care experiences. Content analysis and descriptive statistics were used to analyze responses. Participant responses were related to four major themes: Access to Care, Interpersonal Interaction, Satisfaction of Care, and Quality of Care. Participants were overall satisfied with their care; however, spending less time waiting for appointments and to see the provider or specialist were the most frequently requested improvements related to Access to Care. For Interpersonal Interaction, 82% of the responses recommended that providers be more attentive listeners, courteous, patient, caring, and respectful. Decreasing wait times and improving interpersonal skills would improve health care experiences and patient satisfaction. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  13. TECHNICAL AND ORGANIZATIONAL IMPROVEMENTS OF PACKAGING PRODUCTION PROCESS

    Directory of Open Access Journals (Sweden)

    Anna Rudawska

    2016-06-01

    Full Text Available Due to customer driven economies, today’s world markets are characterized by high fluctuations in market demand and the frequent arrival of new technologies and new products. To stay competitive in such markets manufacturing companies require continuous improvements both in technical and organizational areas of their activity. The paper presents results of the diagnosis provided in the manufacturing area of the company producing cardboard packages and recommendations to make the production process more efficient. Especially, among the proposed technical and organizational recommendations the most important ones are: automation of certain elements of the production process and changes in production plant layout.

  14. Efficiency of Australian Technical and Further Education Providers

    Science.gov (United States)

    Fieger, Peter; Villano, Renato; Cooksey, Ray

    2016-01-01

    Budgetary constraints on the public purse have led Australian Federal and State governments to focus increasingly on the efficiency of public institutions, including Technical and Further Education (TAFE) institutes. In this study, we define efficiency as the relationship between financial and administrative inputs and educational outputs. We…

  15. Technical issues to improve diuresis renography

    International Nuclear Information System (INIS)

    Ponnappan, Asha; Mathur, M.; Kumar, S.

    2011-01-01

    Radionuclide renal scintigraphy is a safe and valuable method provides important functional data to assist in the diagnosis and management of patients with a variety of known or suspected diseases involving the kidney, ureters and bladder. The objective of this article is optimal technique for renography which can improve image quality, which in turn improves diagnostic efficacy

  16. Examining the Highs and Lows of the Collaborative Relationship Between Technical Assistance Providers and Prevention Implementers.

    Science.gov (United States)

    Chilenski, Sarah M; Welsh, Janet; Olson, Jonathan; Hoffman, Lesa; Perkins, Daniel F; Feinberg, Mark E

    2018-02-01

    The PROSPER model uses a three-tiered community partnership, university researcher, and Cooperative Extension-based technical assistance system to support the delivery of evidence-based interventions in communities. This study examines the trajectory and predictors of the collaborative relationship between technical assistance providers and community teams across the three phases of organization, implementation, and sustainability. Members of 14 PROmoting School-university-community Partnerships to Enhance Resilience (PROSPER) community teams and directors of local agencies rated communities' levels of readiness and adolescent substance use norms. Technical assistance providers rated their collaborative relationship with their teams at 14 occasions across 4.5 years. Results from mixed models show that levels of collaboration were stable until the sustainability phase, when they increased significantly. Team differences in change were significant during the implementation phase. Community readiness predicted levels of the collaborative relationship over time: high community readiness was associated with a high level of collaboration during organization, but a decline in collaboration during implementation. These results provide a more nuanced understanding of the relationship between technical assistance provision and community prevention teams and lead to recommendations to improve dissemination models to achieve a greater public health impact.

  17. Providing a Scientific and Technical Basis for Repository Decisions

    International Nuclear Information System (INIS)

    2001-01-01

    The Nuclear Waste Policy Act (NWPA) of 1982 directed the U. S. Department of Energy (DOE) to research sites and design a deep geologic repository for the disposal of our nation's spent nuclear fuel and high-level radioactive waste. In 1987, Congress amended the NWPA and directed the DOE to focus only on Yucca Mountain, Nevada, to determine whether it is a suitable site for a repository. For more than 15 years, the DOE has been studying Yucca Mountain and has accumulated an enormous amount of scientific and technical information about the mountain and the area surrounding it. The secretary of energy will decide whether to recommend Yucca Mountain to the president as a suitable site for a repository. This decision will be based on the scientific and technical information resulting from the Department of Energy's studies of Yucca Mountain and on the views and comments submitted by other governmental groups and the public. One required basis for the secretary's decision will be a scientific analysis called a total system performance assessment

  18. 78 FR 29239 - Final Priority; Technical Assistance To Improve State Data Capacity-National Technical Assistance...

    Science.gov (United States)

    2013-05-20

    ... Assistance To Improve State Data Capacity--National Technical Assistance Center To Improve State Capacity To... Education and Rehabilitative Services announces a priority under the Technical Assistance to Improve State... (FY) 2013 and later years. We take this action to focus attention on an identified national need to...

  19. Best Technical Approach Analysis (BTA) for Force Provider Wastewater Management

    Science.gov (United States)

    1994-07-07

    TC/ AEAGC- FMD (CONT) I L ,1 I* ATCD-SE SUBJECT: Operational Requirements Document (ORD) for the Force Provider (FP) DISTRIBUTION: (CONT) Commander...MISSION 09 OP"RATI09AL FTA "tI*E Of TNE ALTIENATIVEI ONIDPOWO ... OXIDATION P*N) OR W~AAGE LAC" (300 9900 1 1 fEE?) PERPO*M ... IWNAT ARt ?NJ PSINCIVAi

  20. Utilization of a technical review group during a BWR owners group technical specification improvement study

    International Nuclear Information System (INIS)

    Hansell, H.F.; Moyer, D.P.

    1986-01-01

    A BWR Owners' Group Technical Specification Improvement (TSI) Committee was formed in late 1983. A primary goal of this Committee was to encourage the development of a probabilistic methodology for technical specification improvements which could be readily applied by utilities. The TSI Committee elected to hire a Contractor to develop and demonstrate a method. After the Contractor was selected and has started work, the committee decided to establish a Technical Review Group (TRG) to efficiently and effectively review the Contractor's analyses. The TRG met frequently with the Contractor as the analyses were being performed. These meetings were held at the Contractor's facility in order to allow direct contact between reviewers and individuals performing the work. The TRG was also involved with all major interactions with the NRC. The significance and merit of using a peer review group in this manner is the theme of this paper. In order to present a discussion of the significance and merit of the TRG, the activities are described. The summary of the analytical approach is provided to more full understand the TRG activities

  1. Diabetic foot workshop: Improving technical and educational skills for nurses.

    Science.gov (United States)

    Aalaa, Maryam; Sanjari, Mahnaz; Shahbazi, Samimeh; Shayeganmehr, Zahra; Abooeirad, Maryam; Amini, Mohammad Reza; Adibi, Hossien; Mehrdad, Neda

    2017-01-01

    Diabetes mellitus as one of the most common metabolic disorders has some complications, one of the main ones is diabetic foot (DF). Appropriate care and education prevents 85% of diabetic foot amputations. An ideal management to prevent and treat diabetic foot necessitates a close collaboration between the health team members and the diabetic patient. Therefore, improving nurses' knowledge about DF care and advancement in the quality of care provided by the nurses could significantly improve diabetic foot prevention and management. Therefore, the aim of DF workshop was to improve technical and educational skills of the nurses to prevent and manage diabetic foot. Considering the vital role of the nurses in providing DF care, EMRI decided to conduct Diabetic foot workshop for them. The following five steps were designed for the 14 coordinating sessions in the workshop: Goals definition, deciding about attendees, location selection, creating agenda, and developing a follow-up plan. "Diabetic Foot Workshop for Nurses" provides appropriate training to DF nurses at the national level; and combining theory and practice in this workshop not only increases nurses' knowledge, but also improves their skills in the field of the diabetic foot. Providing education and care to patients by DF nurse specialists instead of general nurses could be an important output of this workshop, which may lead to DF prevention and amputation decrease in the long term.

  2. [Technical efficiency assessment of public primary care providers in the Basque Country (Spain), 2010-2013].

    Science.gov (United States)

    Cordero, José Manuel; Nuño-Solinís, Roberto; Orueta, Juan F; Polo, Cristina; Del Río-Cámara, Mario; Alonso-Morán, Edurne

    2016-01-01

    To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. 16 CFR 1401.5 - Providing performance and technical data to purchasers by labeling.

    Science.gov (United States)

    2010-01-01

    ... POINT OF PURCHASE OF PERFORMANCE AND TECHNICAL DATA § 1401.5 Providing performance and technical data to... the time of original purchase and to the first purchaser for purposes other than resale. The data... to be read and understood by ordinary individuals under normal conditions of purchase. This...

  4. Improving technical support to IAEA safeguards

    International Nuclear Information System (INIS)

    Rundquist, D.

    1986-01-01

    Changes present new safeguards challenges and require that the entire safeguards process become more efficient. A development process has evolved at the Agency that aids in matching appropriate technology to the needs, primarily through the mechanism of voluntary Member States Support Programme, which gives IAEA access to many of the worlds finest nuclear laboratories. The function of these programs is discussed in this article with particular emphasis on the Agency's co-ordination role. Besides a description of the Member States Support Programme the problems involved (coordination and communication aspects) as well as the results achieved are indicated. The support is categorized under the following headlines: 1) Information and expertise; 2) Instrumentation, methods and techniques; 3) Training; 4) Test and calibration facilities. As mentioned in the article Member States also benefit from the Support Programme. Other means of technical support such as multi-national co-operation programmes and bilateral research agreements are mentioned

  5. Performance improvement plan in customer technical services

    International Nuclear Information System (INIS)

    Lachambre, L.

    1995-01-01

    This presentation centred around the philosophy, goals, and initiatives associated with Gaz Metropolitain's performance improvement plan. Various aspects of the plan including customer surveys, new customer service policies, the creation of small working units, the decentralization of the Montreal service department, and customer-harmonized shift schedules were explored. Implementation of new service plans and contracts, the formation of improvement groups related to human resources, human resource and productivity management, leadership training, and the use of performance indicators were also explained

  6. METHOD IMPROVEMENT FOR DETERMINING THE TECHNICAL LEVEL OF CIVIL AIRCRAFT

    Directory of Open Access Journals (Sweden)

    2016-01-01

    Full Text Available Aircraft are high-tech engineering products which are characterized by a wide range of properties including the two most important groups that respectively characterize the efficiency and technical level.Improving the aircraft efficiency is an essential factor for air transport development, but the efficiency can not be fully describe the technical system, especially in forecasting and new technology requirements development. Aircraft de- signer must evaluate the prospects of a technical solution, but it’s not always possible to calculate the efficiency accuratelyat the design stage. The operator should be able to choose the most technically-advanced aircraft available in the market inorder not to let it grow obsolete quickly. This determines the need for non-economic evaluation of technical systems that can be done by assessment of their technical level.The technical level is a general index that includes a set of technical perfection indicators. Technical perfection is reflected in terms of material and energy intensity, in terms of ergonomics, safety, etc. and is achieved as a result of origi- nal design solutions, the use of new high-strength low-density materials, the introduction of advanced technological pro-cesses, calculation methods, verification, testing, etc.There is a tight connection between the product properties and its weight, because weight is the material reflection of these properties. Therefore, improvement of the product properties usually leads to an intense increase of its weight. To deal with this phenomenon is only possible with widely using scientific and technical progress results. In accordance with this, the technical perfection can be interpreted as a major component of quality that is created without the weight increase. This approach requires investment in research and testing new technical solutions.The method was developed to determine the technical level of civil long-haul aircraft which has been modified to

  7. Opening remarks: regulatory initiatives toward improved technical specifications

    International Nuclear Information System (INIS)

    Edison, G.E.

    1985-01-01

    In order to deal with the numerous problems that have evolved over the years with nuclear power plant technical specifications, the Nuclear Regulatory Commission has undertaken some initiatives for improvement: 1) new operating licenses, 2) change to existing operating reactor technical specifications, 3) a broad-scoped reconsideration of the content of technical specifications, and 4) rule changes. It is believed that reliability and risk assessment techniques can be used in conjunction with manufacturer's recommendations and engineering judgment to better define the appropriate scope and depth for technical specification resulting in focusing attention on high risk-worth systems and avoidance of plant shutdown transients both intentionally and unintentionally through provisions of technical specifications

  8. Final priority; technical assistance to improve state data capacity--National Technical Assistance Center to improve state capacity to accurately collect and report IDEA data. Final priority.

    Science.gov (United States)

    2013-05-20

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Technical Assistance to Improve State Data Capacity program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus attention on an identified national need to provide technical assistance (TA) to States to improve their capacity to meet the data collection and reporting requirements of the Individuals with Disabilities Education Act (IDEA). We intend this priority to establish a TA center to improve State capacity to accurately collect and report IDEA data (Data Center).

  9. Technical approach to improvement of SPECT images

    International Nuclear Information System (INIS)

    Fukukita, Hiroyoshi

    1985-01-01

    At present, a large number of SPECT systems are being widely used in Japan, hence, it is reasonable for us to know the physical and imaging characteristics of these SPECT devices, and also to recommend the optimum utility of SPECT systems. For this reason, a survey respect of characteristics of the commercialy available SPECT devices was carried out. In addition to this, various factors which have significant influence over SPECT image quality, such as, data acquisition matrix, reconstruction filter, γ-ray attenuation correction and daily quality control procedure, were also investigated. The materials used for this study are PET/SPECT phantom, Alderson liver phantom filled with Tc-99m solution, and either LFOV-E or ZLC-7500 interfaced to Scintipac 2400 minicomputer with 256 K byte of memory. Following are the results of this study. 1) The suitable data acquisition procedure was 128 x 128 matrix for linear sampling and approximately 64 views for angular sampling. 2) Reconstructed image using pre-processing filter with Wiener and Butterworth filters provided high quality image as compared with the Ramp filter. 3) Weighted backprojection method (WBP) proposed by Tanaka was superior to other methods, such as Sorenson method and Chang method in the object with non-uniform distribution of radionuclide. 4) It was found that uniformity correction of gamma camera and precise adjustment of the center of rotation are most important to maintain the images with a high quality. (author)

  10. RESEARCH OF PROBLEMS OF DESIGN OF COMPLEX TECHNICAL PROVIDING AND THE GENERALIZED MODEL OF THEIR DECISION

    Directory of Open Access Journals (Sweden)

    A. V. Skrypnikov

    2015-01-01

    Full Text Available Summary. In this work the general ideas of a method of V. I. Skurikhin taking into account the specified features develop and questions of the analysis and synthesis of a complex of technical means, with finishing them to the level suitable for use in engineering practice of design of information management systems are in more detail considered. In work the general system approach to the solution of questions of a choice of technical means of the information management system is created, the general technique of the sys tem analysis and synthesis of a complex of the technical means and its subsystems providing achievement of extreme value of criterion of efficiency of functioning of a technical complex of the information management system is developed. The main attention is paid to the applied party of system researches of complex technical providing, in particular, to definition of criteria of quality of functioning of a technical complex, development of methods of the analysis of information base of the information management system and definition of requirements to technical means, and also methods of structural synthesis of the main subsystems of complex technical providing. Thus, the purpose is research on the basis of system approach of complex technical providing the information management system and development of a number of methods of the analysis and the synthesis of complex technical providing suitable for use in engineering practice of design of systems. The well-known paradox of development of management information consists of that parameters of the system, and consequently, and requirements to the complex hardware, can not be strictly reasonable to development of algorithms and programs, and vice versa. The possible method of overcoming of these difficulties is prognostication of structure and parameters of complex hardware for certain management informations on the early stages of development, with subsequent clarification and

  11. 7 CFR 636.18 - Technical services provided by qualified personnel not affiliated with USDA.

    Science.gov (United States)

    2010-01-01

    ... HABITAT INCENTIVES PROGRAM § 636.18 Technical services provided by qualified personnel not affiliated with... affiliated with USDA. 636.18 Section 636.18 Agriculture Regulations of the Department of Agriculture... provided by qualified personnel not affiliated with USDA may include, but is not limited to: Conservation...

  12. Spatial Visualization ability improves with and without studying Technical Drawing.

    Science.gov (United States)

    Contreras, María José; Escrig, Rebeca; Prieto, Gerardo; Elosúa, M Rosa

    2018-03-27

    The results of several studies suggest that spatial ability can be improved through direct training with tasks similar to those integrated in the tests used to measure the ability. However, there is a greater interest in analyzing the effectiveness of indirect training such as games or of learning subjects that involve spatial processes to a certain extent. Thus, the objective of the present study was to analyze whether the indirect training in Technical Drawing improved the Spatial Visualization ability of Architecture students. For this purpose, a group of students enrolled in Fundamentals of Architecture were administered two tests, a Spatial Visualization task and an Abstract Reasoning task, at the beginning and the end of a semester, after having received training through the subjects "Technical Drawing I: Geometry and Perception" and "Projects I." The results of this group were compared with those of a control group of students enrolled in a Mathematics degree, who were also pre-post evaluated but had not received the training in Technical Drawing. The study showed a significant pre-post improvement in both, Visualization and reasoning. However, this improvement occurred in both groups, thereby concluding that this improvement was not due to indirect training. Furthermore, no significant differences were found between men and women in any of the groups or conditions. These results clarify those of an earlier study where improvement in Visualization after training in Technical Drawing was found but did not include a comparison with a control condition. The control condition has proved to be important in order to consider the limitations of the effect of Technical Drawing on said improvement.

  13. Organising, Providing and Evaluating Technical Training for Early Career Researchers: A Case Study

    Science.gov (United States)

    van Besouw, Rachel M.; Rogers, Katrine S.; Powles, Christopher J.; Papadopoulos, Timos; Ku, Emery M.

    2013-01-01

    This paper considers the importance of providing technical training opportunities for Early Career Researchers (ECRs) worldwide through the case study of a MATLAB training programme, which was proposed, organised, managed and evaluated by a team of five ECRs at the University of Southampton. The effectiveness of the programme in terms of the…

  14. 7 CFR 1466.11 - Technical services provided by qualified personnel not affiliated with USDA.

    Science.gov (United States)

    2010-01-01

    ... not affiliated with USDA. 1466.11 Section 1466.11 Agriculture Regulations of the Department of... OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM Contracts and Payments § 1466.11 Technical services provided by qualified personnel not affiliated with USDA. (a) NRCS may use the services of qualified TSPs...

  15. INVESTIGATION OF MICROPROCESSOR CURRENT PROTECTION LINES WITH IMPROVED INDICES OF TECHNICAL PERFECTION

    Directory of Open Access Journals (Sweden)

    E. V. Buloichyk

    2014-01-01

    Full Text Available Technical perfection improvement of microprocessor current protection of distribution networks lines is provided by introduction of asymmetrical fault mode determination and fault location functions in the algorithm of its functioning. As a result of computing experiment the basic indices of the technical perfection of current protection have been obtained in the paper. The paper proves high efficiency of the proposed methods that ensure selective and proper operation in the different modes of the controlled line.

  16. Technical and Scientific Support Organizations Providing Support to Regulatory Functions. Companion CD-ROM

    International Nuclear Information System (INIS)

    2018-01-01

    This publication introduces the general principles underlying the provision of technical and scientific support to a regulatory body and the characteristics of organizations providing such support. It describes the services provided to support regulatory functions as well as the associated activities and processes to maintain the needed level of expertise, state of the art tools and equipment. The publication is intended for use primarily by organizations that provide technical and scientific support in the field of nuclear and radiation safety. This also includes organizations that acquire such support, and regulatory bodies and governments, as they make decisions on the model of technical and scientific support to be developed at the national level, for example in the case of a country embarking on the development of a nuclear power programme. It is the first IAEA publication dedicated to the specific practices and challenges to be met by the technical and scientific support organizations. This CD-ROM includes the annexes to the printed publication of examples of TSOs and their interactions with key stakeholders.

  17. 34 CFR 86.302 - What are the procedures used by the Secretary for providing information or technical assistance?

    Science.gov (United States)

    2010-07-01

    ... providing information or technical assistance? 86.302 Section 86.302 Education Office of the Secretary... information or technical assistance? (a) The Secretary provides information or technical assistance to an IHE in writing, through site visits, or by other means. (b) The IHE shall inform the Secretary of any...

  18. Technical Reference Suite Addressing Challenges of Providing Assurance for Fault Management Architectural Design

    Science.gov (United States)

    Fitz, Rhonda; Whitman, Gerek

    2016-01-01

    Research into complexities of software systems Fault Management (FM) and how architectural design decisions affect safety, preservation of assets, and maintenance of desired system functionality has coalesced into a technical reference (TR) suite that advances the provision of safety and mission assurance. The NASA Independent Verification and Validation (IV&V) Program, with Software Assurance Research Program support, extracted FM architectures across the IV&V portfolio to evaluate robustness, assess visibility for validation and test, and define software assurance methods applied to the architectures and designs. This investigation spanned IV&V projects with seven different primary developers, a wide range of sizes and complexities, and encompassed Deep Space Robotic, Human Spaceflight, and Earth Orbiter mission FM architectures. The initiative continues with an expansion of the TR suite to include Launch Vehicles, adding the benefit of investigating differences intrinsic to model-based FM architectures and insight into complexities of FM within an Agile software development environment, in order to improve awareness of how nontraditional processes affect FM architectural design and system health management. The identification of particular FM architectures, visibility, and associated IV&V techniques provides a TR suite that enables greater assurance that critical software systems will adequately protect against faults and respond to adverse conditions. Additionally, the role FM has with regard to strengthened security requirements, with potential to advance overall asset protection of flight software systems, is being addressed with the development of an adverse conditions database encompassing flight software vulnerabilities. Capitalizing on the established framework, this TR suite provides assurance capability for a variety of FM architectures and varied development approaches. Research results are being disseminated across NASA, other agencies, and the

  19. Can branding by health care provider organizations drive the delivery of higher technical and service quality?

    Science.gov (United States)

    Snihurowych, Roman R; Cornelius, Felix; Amelung, Volker Eric

    2009-01-01

    Despite the widespread use of branding in nearly all other major industries, most health care service delivery organizations have not fully embraced the practices and processes of branding. Facilitating the increased and appropriate use of branding among health care delivery organizations may improve service and technical quality for patients. This article introduces the concepts of branding, as well as making the case that the use of branding may improve the quality and financial performance of organizations. The concepts of branding are reviewed, with examples from the literature used to demonstrate their potential application within health care service delivery. The role of branding for individual organizations is framed by broader implications for health care markets. Branding strategies may have a number of positive effects on health care service delivery, including improved technical and service quality. This may be achieved through more transparent and efficient consumer choice, reduced costs related to improved patient retention, and improved communication and appropriateness of care. Patient satisfaction may be directly increased as a result of branding. More research into branding could result in significant quality improvements for individual organizations, while benefiting patients and the health system as a whole.

  20. Technical Solution for Improved Safeguards/State Cooperation

    International Nuclear Information System (INIS)

    Miller, S.

    2015-01-01

    This paper will discuss an information technology solution to allow the IAEA Safeguards Department to improve cooperation with States. The solution will be a portal or hub to integrate the information, processes, and people between Safeguards and States. It will allow for two-way communication and collaboration between Safeguards staff and State representatives. This paper discusses the information security challenges inherent in building such a system. It proposes technical architectures that might allow the existing integration approach (e.g., encrypted email exchange) to be kept, while expanding it to include modern integration technologies (e.g., web services), as well explorer new collaborative web technologies. It looks at current Safeguards processes and approaches to cooperation and discusses efficiencies that could be achieved through the adoption of this technology solution. Example process areas for improvement include: a) Safeguards Agreements: States are obligated to submit data on their nuclear programme to the IAEA on a periodic basis. Declarations are received through two separate systems using encrypted email. The proposed solution would allow for enhanced exchange of declaration where States can submit any type of declaration using one system. When declarations are received and validated, an acknowledgement would automatically be sent to the State. The solution would provide the Safeguards Department the ability to ask for clarification as well as collaborate on the submitted declarations. Both the question and the response would be recorded in the system. The solution could also integrate tools allowing declarations to be added directly and validated before submission. b) Other areas that could benefit from this solution include declarations from States with small quantities protocol, facility declarations, as well as systems that support extra-budgetary funding (e.g., SPRICS). (author)

  1. Patient and provider perspectives on improving the linkage of HIV ...

    African Journals Online (AJOL)

    This study examined barriers and facilitators to the linkage of HIV-positive pregnant women from antenatal care (ANC) to long-term HIV care from patient and provider perspectives, following the implementation of a collaborative quality improvement project in Eastern Uganda. It also solicited recommendations for improving ...

  2. Improving Technical, Tactical and Psychological Preparation of Freestyle Wrestlers

    Directory of Open Access Journals (Sweden)

    Pakulin Serhij

    2016-12-01

    Full Text Available Objectives: 1 to justify the ways of improvement of training free style wrestlers to improve the results of their activities and competitive sports skills; 2 to identify the areas of improvement of psychological preparation and the structure of complex psycho-pedagogical methods for optimizing mental condition of free style wrestlers. Material and methods: The following methods were used in the study: analysis and synthesis of the scientific data of methodological literature; pedagogical supervision; survey (interview, questionnaire; analysis of freestyle wrestlers competitive activity; testing of physical and psychological fitness; pedagogical experiment; methods of mathematical and statistical analysis of research results. Results: it has been demonstrated that there is a necessity to improve technical, tactical and psychological preparation of freestyle fighters; the basic problems of the process have been defined. Conclusion: 1 the method of preparation of freestyle wrestlers has been grounded and the feasibility of its use for rapid making the best technical and tactical decisions in a competitive activity has been proved. It is proposed to include specific tactical training methods for each action and various combinations of basic actions into the coach program of wrestling; 2 the directions of improving psychological preparation and the structure of complex psychological and pedagogical methods of optimizing the mental condition of free style wrestlers are substantiated.

  3. 34 CFR 366.11 - What financial assistance does the Secretary provide for training and technical assistance?

    Science.gov (United States)

    2010-07-01

    ... for training and technical assistance? 366.11 Section 366.11 Education Regulations of the Offices of..., DEPARTMENT OF EDUCATION CENTERS FOR INDEPENDENT LIVING Training and Technical Assistance § 366.11 What financial assistance does the Secretary provide for training and technical assistance? (a) From funds, if...

  4. 34 CFR 366.10 - What agencies are eligible for assistance to provide training and technical assistance?

    Science.gov (United States)

    2010-07-01

    ... training and technical assistance? 366.10 Section 366.10 Education Regulations of the Offices of the... EDUCATION CENTERS FOR INDEPENDENT LIVING Training and Technical Assistance § 366.10 What agencies are eligible for assistance to provide training and technical assistance? Entities that have experience in the...

  5. Critical Analysis of the Quality, Readability, and Technical Aspects of Online Information Provided for Neck-Lifts.

    Science.gov (United States)

    Rayess, Hani; Zuliani, Giancarlo F; Gupta, Amar; Svider, Peter F; Folbe, Adam J; Eloy, Jean Anderson; Carron, Michael A

    2017-03-01

    grade 11 and grade 10, respectively, significantly higher than the grade 7 level recommended by the National Institutes of Health. Assessment of technical criteria demonstrated room for improvement in providing links to social media and blogs and reducing advertisements. Improving the quality and readability of online information may result in increased patient understanding, more active patient involvement, and ultimately better outcomes. Enhancing the technical aspects of websites may increase website traffic and patient volume. NA.

  6. Does teaching non-technical skills to medical students improve those skills and simulated patient outcome?

    Science.gov (United States)

    Hagemann, Vera; Herbstreit, Frank; Kehren, Clemens; Chittamadathil, Jilson; Wolfertz, Sandra; Dirkmann, Daniel; Kluge, Annette; Peters, Jürgen

    2017-03-29

    The purpose of this study is to evaluate the effects of a tailor-made, non-technical skills seminar on medical student's behaviour, attitudes, and performance during simulated patient treatment. Seventy-seven students were randomized to either a non-technical skills seminar (NTS group, n=43) or a medical seminar (control group, n=34). The human patient simulation was used as an evaluation tool. Before the seminars, all students performed the same simulated emergency scenario to provide baseline measurements. After the seminars, all students were exposed to a second scenario, and behavioural markers for evaluating their non-technical skills were rated. Furthermore, teamwork-relevant attitudes were measured before and after the scenarios, and perceived stress was measured following each simulation. All simulations were also evaluated for various medical endpoints. Non-technical skills concerning situation awareness (ptechnical skills to improve student's non-technical skills. In a next step, to improve student's handling of emergencies and patient outcomes, non-technical skills seminars should be accompanied by exercises and more broadly embedded in the medical school curriculum.

  7. Loads Providing Ancillary Services: Review of InternationalExperience-- Technical Appendix: Market Descriptions

    Energy Technology Data Exchange (ETDEWEB)

    Grayson Heffner, Charles Goldman, Kintner-Meyer, M; Kirby, Brendan

    2007-05-01

    In this study, we examine the arrangements for andexperiences of end-use loads providing ancillary services (AS) in fiveelectricity markets: Australia, the United Kingdom (UK), the Nordicmarket, and the ERCOT and PJM markets in the United States. Our objectivein undertaking this review of international experience was to identifyspecific approaches or market designs that have enabled customer loads toeffectively deliver various ancillary services (AS) products. We hopethat this report will contribute to the ongoing discussion in the U.S.and elsewhere regarding what institutional and technical developments areneeded to ensure that customer loads can meaningfully participate in allwholesale electricity markets.

  8. Non-technical skills of anaesthesia providers in Rwanda: an ethnography.

    Science.gov (United States)

    Livingston, Patricia; Zolpys, Lauren; Mukwesi, Christian; Twagirumugabe, Theogene; Whynot, Sara; MacLeod, Anna

    2014-01-01

    Patient safety depends on excellent practice of anaesthetists' non-technical skills (ANTS). The ANTS framework has been validated in developed countries but there is no literature on the practice of ANTS in low-income countries. This study examines ANTS in this unexplored context. This qualitative ethnographic study used observations of Rwandan anaesthesia providers and in-depth interviews with both North American and Rwandan anaesthesia providers to understand practice of ANTS in Rwanda. Communication is central to the practice of ANTS. Cultural factors in Rwanda, such as lack of assertiveness and discomfort taking leadership, and the strains of working in a resource-limited environment hinder the unfettered and focused communication needed for excellent anaesthesia practice. Despite the challenges, anaesthesia providers are able to coordinate activities when good communication is actively encouraged. Future teaching interventions should address leadership and communication skills through encouraging both role definition and speaking up for patient safety.

  9. How the NDA Provides Transparency and Visibility of the Technical Deliverability of the R and D Programme - 13303

    International Nuclear Information System (INIS)

    Seed, Ian; James, Paula; Brownridge, Melanie; McMinn, Mervin

    2013-01-01

    The Nuclear Decommissioning Authority (NDA) was created under the UK Energy Act 2004 to ensure the UK historic civil public sector nuclear legacy sites are decommissioned safely, securely, cost effectively and in ways that protect the environment. The delivery will involve carrying out many unique projects within a high hazard environment requiring the very highest standards in safety, security and environmental management. Unique problems require unique solutions and there is a substantial amount of research and development required for each project. The NDA's R and D strategic objective is to ensure that delivery of the NDA's mission is technically underpinned by sufficient and appropriate research and development. This drives a requirement to provide transparency and visibility of the technical deliverability of the programme through the technical baseline and accompanying research and development requirements. The NDA need to have confidence in the technical deliverability of the Site License Companies (SLCs) plans, provide overall visibility of R and D across the NDA Estate and ensure that appropriate R and D is being carried out in a timely manner. They need to identify where coordinated R and D programmes may be advantageous as a result of common needs, risks and opportunities and ensure key R and D needs across NDA are identified, prioritised and work programmes are costed and scheduled in the Lifetime Plans for individual sites and SLCs. Evidence of the Site License Company's approach and their corresponding technical underpinning programmes is achieved through submission of a number of outputs collectively known as TBuRDs (Technical Baseline and Underpinning Research and Development Requirements). This paper is a summary of the information generated by an independent review of those TBuRDs. It highlights some of the key messages, synergies and common R and D activities across the estate. It demonstrates the value of a consistent approach to collecting R

  10. Yakima Habitat Improvement Project Master Plan, Technical Report 2003.

    Energy Technology Data Exchange (ETDEWEB)

    Golder Associates, Inc.

    2003-04-22

    result of the planning effort leading to this Master Plan, a Technical Working Group (TWG) was established that represents most, if not all, fish and wildlife agencies/interests in the subbasin. This TWG met regularly throughout the planning process to provide input and review and was instrumental in the development of this plan. Preparation of this plan included the development of a quantitative prioritization process to rank 40,000 parcels within the Urban Growth Area based on the value of fish and wildlife habitat each parcel provided. Biological and physical criteria were developed and applied to all parcels through a GIS-based prioritization model. In the second-phase of the prioritization process, the TWG provided local expert knowledge and review of the properties. In selecting the most critical areas within the Urban Growth Area for protection, this project assessed the value of fish and wildlife habitat on the Yakima River. Well-developed habitat acquisition efforts (e.g., Yakima River Basin Water Enhancement Project by the Bureau of Reclamation and Yakama Nation acquisition projects) are already underway on the Yakima River mainstem. These efforts, however, face several limitations in protection of floodplain function that could be addressed through the support of the Yakima Habitat Improvement Project. This Master Plan integrates tributary habitat acquisition efforts with those ongoing on the Yakima River to best benefit fish and wildlife in the Urban Growth Area. The parcel ranking process identified 25 properties with the highest fish and wildlife value for habitat acquisition in the Yakima Urban Area. These parcels contain important fish and wildlife corridors on Ahtanum and Wide Hollow Creeks and the Naches River. The fifteen highest-ranking parcels of the 25 parcels identified were considered very high priority for protection of fish and wildlife habitat. These 15 parcels were subsequently grouped into four priority acquisition areas. This Master Plan

  11. Technical specification improvements to containment heat removal and emergency core cooling systems: Final report

    International Nuclear Information System (INIS)

    Sullivan, W.P.; Ha, C.; Pentzien, D.C.; Visweswaran, S.

    1988-07-01

    This report presents the results of an analysis for technical specification improvements to the emergency core cooling systems (ECCS) and containment heat removal systems (EPRI Research Project 2142-3). The objective of this project is to further develop a reliability- and risk-based methodology to provide improvements by considering groups of surveillance test intervals and allowed out-of-service times jointly. This was done for the technical specifications for the ECCS, containment heat removal equipment, and supporting systems of a boiling water reactor plant. The project (1) developed a methodology for optimizing groups of surveillance test intervals and allowed out-of-service times jointly, (2) applied the methodology in a case study of a specific operating plant, Hatch-2, and (3) evaluated benefits of the application. The results of the case study demonstrate that beneficial technical specification improvements can be realized with application of the methodology. By tightening a small group of sensitive surveillance test intervals (STIs) and allowed out-of-service times (AOTs), a larger group of less sensitive STIs and AOTs can be extended resulting in an overall plant operating cost improvement without reducing the plant safety. The reliability- and risk-based methodology and results from this project can be effectively applied for technical specification improvements at other operating plants

  12. Formative evaluation of a telemedicine model for delivering clinical neurophysiology services part I: utility, technical performance and service provider perspective.

    LENUS (Irish Health Repository)

    Breen, Patricia

    2010-01-01

    Formative evaluation is conducted in the early stages of system implementation to assess how it works in practice and to identify opportunities for improving technical and process performance. A formative evaluation of a teleneurophysiology service was conducted to examine its technical and sociological dimensions.

  13. 32 CFR 203.12 - Technical assistance for public participation provider qualifications.

    Science.gov (United States)

    2010-07-01

    ... waste problems. (2) Experience in making technical presentations. (3) Demonstrated writing skills. (4... 32 National Defense 2 2010-07-01 2010-07-01 false Technical assistance for public participation... THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS TECHNICAL ASSISTANCE FOR PUBLIC PARTICIPATION (TAPP...

  14. IAEA technical meeting: Assess and co-ordinate modelling needs and data providers. Summary report

    International Nuclear Information System (INIS)

    Clark, R.E.H.

    2004-05-01

    This report briefly describes the proceedings, conclusions and recommendations of the Technical Meeting to 'Assess and Co-ordinate Modelling Needs and Data Providers', held on 4-5 December 2003. Eight international experts on atomic and molecular data related to fusion energy research activities participated in the meeting. Each participant reviewed the current status of their own speciality and current lines of research as well as anticipated needs in new data for nuclear fusion energy research. Current CRPs on related topics were reviewed. In light of current research activities and anticipated data needs for fusion, a detailed set of tasks appropriate for a new CRP was developed. This meeting completely fulfilled the specified goals. (author)

  15. Improving Interdisciplinary Provider Communication Through a Unified Paging System.

    Science.gov (United States)

    Heidemann, Lauren; Petrilli, Christopher; Gupta, Ashwin; Campbell, Ian; Thompson, Maureen; Cinti, Sandro; Stewart, David A

    2016-06-01

    Interdisciplinary communication at a Veterans Affairs (VA) academic teaching hospital is largely dependent on alphanumeric paging, which has limitations as a result of one-way communication and lack of reliable physician identification. Adverse patient outcomes related to difficulty contacting the correct consulting provider in a timely manner have been reported. House officers were surveyed on the level of satisfaction with the current VA communication system and the rate of perceived adverse patient outcomes caused by potential delays within this system. Respondents were then asked to identify the ideal paging system. These results were used to develop and deploy a new Web site. A postimplementation survey was repeated 1 year later. This study was conducted as a quality improvement project. House officer satisfaction with the preintervention system was 3%. The majority used more than four modalities to identify consultants, with 59% stating that word of mouth was a typical source. The preferred mode of paging was the university hospital paging system, a Web-based program that is used at the partnering academic institution. Following integration of VA consulting services within the university hospital paging system, the level of satisfaction improved to 87%. Significant decreases were seen in perceived adverse patient outcomes (from 16% to 2%), delays in patient care (from 90% to 16%), and extended hospitalizations (from 46% to 4%). Our study demonstrates significant improvement in physician satisfaction with a newly implemented paging system that was associated with a decreased perceived number of adverse patient events and delays in care.

  16. Providing Total Quality Fundamentals: 1995 Workshops for the NASA Lewis Research Center's Technical Services Directorate

    Science.gov (United States)

    Antczak, Paul; Jacinto,Gilda; Simek, Jimmy

    1997-01-01

    The National Aeronautics and Space Administration's (NASA) agency-wide movement to cultivate a quality workplace is the basis for Lewis Research Center to implement Total Quality Fundamentals (TQF) initiatives. The Lewis Technical Services Directorate (TSD) introduced the Total Quality Fundamentals (TQF) workshops to its work force as an opportunity to introduce the concepts and principles of TQF. These workshops also provided the participants with the opportunity to dialogue with fellow TSD employees and managers. This report describes, through the perspective of the Lewis TSD TQF Coaches, how the TQF work- shop process was accomplished in TSD. It describes the structure for addressing the need, implementation process, input the TSD Coaches provided, common themes and concerns raised, conclusions, and recommendations. The Coaches concluded that these types of workshops could be the key to open the communication channels that are necessary to help everyone at Lewis understand where they fit in the organization. TQF workshops can strengthen the participant's connection with the Mission, Vision of the Center, and Vision of the Agency. Reconunendations are given based on these conclusions that can help the TSD Quality Board develop attainable measures towards a quality workplace.

  17. Using Model-Based System Engineering to Provide Artifacts for NASA Project Life-Cycle and Technical Reviews Presentation

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    This is the presentation for the AIAA Space conference in September 2017. It highlights key information from Using Model-Based Systems Engineering to Provide Artifacts for NASA Project Life-cycle and Technical Reviews paper.

  18. Improved technical specifications and related improvements to safety in commercial Nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, D.R.; Demitrack, T.; Schiele, R.; Jones, J.C. [EXCEL Services Corporation, 11921 Rockville Pike, Suite 100, Rockville, MD 20852 (United States)]. e-mail: donaldh@excelservices.com

    2004-07-01

    Many of the commercial nuclear power plants in the United States (US) have been converting a portion of the plant operating license known as the Technical Specifications (TS) in accordance with a document published by the US Nuclear Regulatory Commission (NRC). The TS prescribe commercial nuclear power plant operating requirements. There are several types of nuclear power plants in the US, based on the technology of different vendors, and there is an NRC document that supports each of the five different vendor designs. The NRC documents are known as the Improved Standard Technical Specifications (ISTS) and are contained in a separate document (NUREG series) for each one of the designs. EXCEL Services Corporation (hereinafter EXCEL) has played a major role in the development of the ISTS and in the development, licensing, and implementation of the plant specific Improved Technical Specifications (ITS) (which is based on the ISTS) for the commercial nuclear power plants in the US that have elected to make this conversion. There are currently 103 operating commercial nuclear power plants in the US and 68 of them have successfully completed the conversion to the ITS and are now operating in accordance with their plant specific ITS. The ISTS is focused mainly on safety by ensuring the commercial nuclear reactors can safely shut down and mitigate the consequences of any postulated transient and accident. It accomplishes this function by including requirements directly associated with safety in a document structured systematically and taking into account some key human factors and technical initiatives. This paper discusses the ISTS including its format, content, and detail, the history of the ISTS, the ITS development, licensing, and implementation process, the safety improvements resulting from a plant conversion to ITS, and the importance of the ITS Project to the industry. (Author)

  19. Improved technical specifications and related improvements to safety in commercial Nuclear power plants

    International Nuclear Information System (INIS)

    Hoffman, D.R.; Demitrack, T.; Schiele, R.; Jones, J.C.

    2004-01-01

    Many of the commercial nuclear power plants in the United States (US) have been converting a portion of the plant operating license known as the Technical Specifications (TS) in accordance with a document published by the US Nuclear Regulatory Commission (NRC). The TS prescribe commercial nuclear power plant operating requirements. There are several types of nuclear power plants in the US, based on the technology of different vendors, and there is an NRC document that supports each of the five different vendor designs. The NRC documents are known as the Improved Standard Technical Specifications (ISTS) and are contained in a separate document (NUREG series) for each one of the designs. EXCEL Services Corporation (hereinafter EXCEL) has played a major role in the development of the ISTS and in the development, licensing, and implementation of the plant specific Improved Technical Specifications (ITS) (which is based on the ISTS) for the commercial nuclear power plants in the US that have elected to make this conversion. There are currently 103 operating commercial nuclear power plants in the US and 68 of them have successfully completed the conversion to the ITS and are now operating in accordance with their plant specific ITS. The ISTS is focused mainly on safety by ensuring the commercial nuclear reactors can safely shut down and mitigate the consequences of any postulated transient and accident. It accomplishes this function by including requirements directly associated with safety in a document structured systematically and taking into account some key human factors and technical initiatives. This paper discusses the ISTS including its format, content, and detail, the history of the ISTS, the ITS development, licensing, and implementation process, the safety improvements resulting from a plant conversion to ITS, and the importance of the ITS Project to the industry. (Author)

  20. The power of a collaborative relationship between technical assistance providers and community prevention teams: A correlational and longitudinal study.

    Science.gov (United States)

    Chilenski, Sarah M; Perkins, Daniel F; Olson, Jonathan; Hoffman, Lesa; Feinberg, Mark E; Greenberg, Mark; Welsh, Janet; Crowley, D Max; Spoth, Richard

    2016-02-01

    Historically, effectiveness of community collaborative prevention efforts has been mixed. Consequently, research has been undertaken to better understand the factors that support their effectiveness; theory and some related empirical research suggests that the provision of technical assistance is one important supporting factor. The current study examines one aspect of technical assistance that may be important in supporting coalition effectiveness, the collaborative relationship between the technical assistance provider and site lead implementer. Four and one-half years of data were collected from technical assistance providers and prevention team members from the 14 community prevention teams involved in the PROSPER project. Spearman correlation analyses with longitudinal data show that the levels of the collaborative relationship during one phase of collaborative team functioning associated with characteristics of internal team functioning in future phases. Results suggest that community collaborative prevention work should consider the collaborative nature of the technical assistance provider - prevention community team relationship when designing and conducting technical assistance activities, and it may be important to continually assess these dynamics to support high quality implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Improving technical information use: what can be learnt from a manager's perspective?

    Science.gov (United States)

    Jacobson, C; Lisle, A; Carter, R W; Hockings, M T

    2013-07-01

    Conservation practice reportedly suffers from low use of technical information. Understanding of factors that affect the influence of technical information on management decision-making is limited. We sought to identify leverage points for improved technical information dissemination in the New South Wales Parks and Wildlife Service, Australia, given the significant recent investments in monitoring and evaluation that had been made. We did so by exploring the inter-relationships between factors affecting the influence of different information types on management decisions. Results indicate that managers have a high inclination toward adaptive behavior, given they operate in an information poor environment. The most influential types of information were those that enabled interaction between information provider and recipient (e.g., staff experience and expertise). An analysis of the concordance in individuals' responses for different information types showed that neither accessibility nor organizational expectation of use was aligned with influence on decision-making. Alignment of responses also varied by work area. Raising expectations of information use or increasing access to particular types of information is therefore unlikely to result in an increase in influence on management decision-making. Rather than focussing on matching accessibility and expected use of particular information types, our results indicate that technical information uptake is best supported through existing peer networks tailored to specific work areas.

  2. 13 CFR 120.714 - How are grants made to non-lending technical assistance providers (NTAP)?

    Science.gov (United States)

    2010-01-01

    ... entity that is not an Intermediary may apply to SBA for a grant to provide marketing, management and... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false How are grants made to non-lending technical assistance providers (NTAP)? 120.714 Section 120.714 Business Credit and Assistance SMALL BUSINESS...

  3. 75 FR 5779 - Notice Providing Agenda for Technical Conference on RTO/ISO Responsiveness

    Science.gov (United States)

    2010-02-04

    ... Conference on RTO/ISO Responsiveness January 27, 2010. California Independent System Operator Docket No. ER09.... Southwest Power Pool, Inc Docket Nos. ER09-1050-000, ER09- 1192-000. ISO New England, Inc. and New England.... Agenda--Technical Conference on RTO/ISO Responsiveness February 4, 2010 12:30 Panel 1--Stakeholder...

  4. Introduction of a fresh cadaver laboratory during the surgery clerkship improves emergency technical skills.

    Science.gov (United States)

    Nematollahi, Saman; Kaplan, Stephen J; Knapp, Christopher M; Ho, Hang; Alvarado, Jared; Viscusi, Rebecca; Adamas-Rappaport, William

    2015-08-01

    Student acquisition of technical skills during the clinical years of medical school has been steadily declining. To address this issue, the authors instituted a fresh cadaver-based Emergency Surgical Skills Laboratory (ESSL). Sixty-three medical students rotating through the third-year surgery clerkship participated in a 2-hour, fresh cadaver-based ESSL conducted during the first 2 days of the clerkship. The authors evaluated students utilizing both surgical skills and written examination before the ESSL and at 4 weeks post ESSL. Students demonstrated a mean improvement of 64% (±11) (P cadaver laboratory is an effective method to provide proficiency in emergency technical skills not acquired during the clinical years of medical school. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. 75 FR 27341 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Science.gov (United States)

    2010-05-14

    ..., ramp rates, and network topology), flexible dispatch, settlement calculations, transmission switching... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference To Discuss Increasing Market and Planning Efficiency Through Improved Software May 7, 2010. Take notice that Commission...

  6. Improving Educational Outcomes by Providing Educational Services through Mobile Technology

    OpenAIRE

    Hosam Farouk El-Sofany

    2013-01-01

    The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great co...

  7. MEDICARE: Improvements Needed in Provider Communications and Contracting Procedures

    National Research Council Canada - National Science Library

    Aronovitz, Leslie

    2001-01-01

    .... Under Medicare's fee-for-service system-which accounts for over 80 percent of program beneficiaries physicians, hospitals, and other providers submit claims to receive reimbursement for services...

  8. Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

    Science.gov (United States)

    Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C

    2013-07-23

    Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and

  9. Use of probabilistic methods for the improvement of technical specifications

    International Nuclear Information System (INIS)

    Gros, G.; Mattei, J.M.

    1987-11-01

    The technical specifications set the requirements related to the availability of equipment. In order to limit the risk when an unavailability is noticed during power operation, an allowed outage time is determined based on a fixed limit imposed on the increase of calculated core melt probability when the equipment is considered as unavailable. An example related to the main electric equipment is presented. In case of cold shutdown condition, the operations carried out lead to numerous programmed unavailabilities of equipment. For the examination of a project of technical specifications defining the necessary equipment in the diffrent phases encountered, evaluation of the increase of the core melt probability due to the unavaibilities has been made

  10. Provide good air quality for people and improve their productivity

    DEFF Research Database (Denmark)

    Fanger, Povl Ole

    2000-01-01

    Three recent independent studies have documented that the quality of indoor air has a significant and positive influence on the productivity of office workers. A combined analysis of the results of the three studies shows a significant relationship between productivity and perceived indoor air...... quality. The impact on productivity justifies a much higher indoor air quality than the minimum levels prescribed in present standards and guidelines. One way of providing air of high quality for people to breathe, without involving excessive ventilation rates and energy use, is to provide "personalized...... air" to each individual. The application of this concept is discussed....

  11. Technical concepts of further improvement of nuclear power plant safety

    International Nuclear Information System (INIS)

    Sochor, R.

    1983-01-01

    The following technical concepts are described which secure the integrity of the containment in case of an accident whose scale exceeds the so-called design basis accident: siting nuclear power plants underground which raises construction costs by 20 - 25%; completing the containment with equipment preventing the outflow of molten corium; completing the containment with emergency pressure space for discharging overpressure - this emergency space is filled with gravel which will trap approximately 50% of fission waste. (Ha)

  12. Improved Collaborative Transport Planning at Dutch Logistics Service Provider Fritom

    NARCIS (Netherlands)

    Buijs, Paul; Lopez Alvarez, Jose Alejandro; Veenstra, Marjolein; Roodbergen, Kees Jan

    2016-01-01

    We study the collaborative transport planning for two autonomous business units of Fritom, a Dutch logistics service provider. This difficult planning problem does not fit any existing type of vehicle routing problem proposed in the academic literature; therefore, we define a new problem class, the

  13. Laboratory technical services provides business opportunities for supervisory control and data acquisition systems

    International Nuclear Information System (INIS)

    Ballard, W.

    1994-01-01

    The author presents some additional information about what he considers are some really great opportunities for the business community to participate in developing the greatest scientific project in the history of mankind. Facility Engineering Services is part of Laboratory Technical Services. As part of this group, it has the responsibility to direct the construction of interim facilities, scientific labs, production process, cooling towers, cooling ponds and the operation and control of SSC Laboratory conventional support systems. These operations and controls will be accomplished through the employment of a Supervisory Control and Data Acquisition system (SCADA)

  14. Improving Educational Outcomes by Providing Educational Services through Mobile Technology

    Directory of Open Access Journals (Sweden)

    Hosam Farouk El-Sofany

    2013-01-01

    Full Text Available The use of Computers, Networks, and Internet has successfully enabled educational institutions to provide their students and instructors with various online educational services. With the recent developments in M-learning and mobile technology, further possibilities are emerging to provide such services through mobile devices such as mobile phones and PDAs. By providing the educational services using wireless and mobile technologies, the educational institutions can potentially bring great convenience to those off-campus students who do not always have time to find Internet enabled computers to get the important educational information from their academic institutions. With the mobile or M-educational services, both the students and the instructors can access the services anytime and anywhere they want. This paper discusses those M-educational services that can be moved to the mobile platform and then presents the system prototype and architecture that integrate these services into the mobile technology platform. The paper will conclude with a description of the formative evaluation of the system prototype.

  15. The use of a checklist improves anaesthesiologists' technical and non-technical performance for simulated malignant hyperthermia management.

    Science.gov (United States)

    Hardy, Jean-Baptiste; Gouin, Antoine; Damm, Cédric; Compère, Vincent; Veber, Benoît; Dureuil, Bertrand

    2018-02-01

    Anaesthesiologists may occasionally manage life-threatening operating room (OR) emergencies. Managing OR emergencies implies real-time analysis of often complicated situations, prompt medical knowledge retrieval, coordinated teamwork and effective decision making in stressful settings. Checklists are recommended to improve performance and reduce the risk of medical errors. This study aimed to assess the usefulness of the French Society of Anaesthesia and Intensive Care's (SFAR) "Malignant Hyperthermia" (MH) checklist on a simulated episode of MH crisis and management thereof by registered anesthesiologists. Twenty-four anaesthesiologists were allocated to 2 groups (checklist and control). Their technical performance in adherence with the SFAR guidelines was assessed by a 30-point score and their non-technical performance was assessed by the Anaesthetists' Non-Technical Skills (ANTS) score. Every task completion was assessed independently. Data are shown as median (first-third quartiles). Anaesthesiologists in the checklist group had higher technical performance scores (24/30 (21.5-25) vs 18/30 (15.5-19.5), P=0.002) and ANTS scores (56.5/60 (47.5-58) vs 48.5/60 (41-50.5), P=0.024). They administered the complete initial dose of dantrolene (2mg/kg) more quickly (15.7 minutes [13.9-18.3] vs 22.4 minutes [18.6-25]) than the control group (P=0.017). However, anaesthesiologists deemed the usability of the checklist to be perfectible. Registered anaesthesiologists' use of the MH checklist during a simulation session widely improved their adherence to guidelines and non-technical skills. This study strongly suggests the benefit of checklist tools for emergency management. Notwithstanding, better awareness and training for anaesthesiologists could further improve the use of this tool. Copyright © 2017 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  16. Technical needs and research opportunities provided by projected aeronautical and space systems

    Science.gov (United States)

    Noor, Ahmed K.

    1992-01-01

    The overall goal of the present task is to identify the enabling and supporting technologies for projected aeronautical and space systems. A detailed examination was made of the technical needs in the structures, dynamics and materials areas required for the realization of these systems. Also, the level of integration required with other disciplines was identified. The aeronautical systems considered cover the broad spectrum of rotorcraft; subsonic, supersonic and hypersonic aircraft; extremely high-altitude aircraft; and transatmospheric vehicles. The space systems considered include space transportation systems; spacecrafts for near-earth observation; spacecrafts for planetary and solar exploration; and large space systems. A monograph is being compiled which summarizes the results of this study. The different chapters of the monograph are being written by leading experts from governmental laboratories, industry and universities.

  17. Improving Service Quality in Technical Education: Use of Interpretive Structural Modeling

    Science.gov (United States)

    Debnath, Roma Mitra; Shankar, Ravi

    2012-01-01

    Purpose: The purpose of this paper is to identify the relevant enablers and barriers related to technical education. It seeks to critically analyze the relationship amongst them so that policy makers can focus on relevant parameters to improve the service quality of technical education. Design/methodology/approach: The present study employs the…

  18. Aligning Theme and Information Structure to Improve the Readability of Technical Writing

    Science.gov (United States)

    Moore, N. A. J.

    2006-01-01

    The readability of technical writing, and technical manuals in particular, especially for second language readers, can be noticeably improved by pairing Theme with Given and Rheme with New. This allows for faster processing of text and easier access to the "method of development" of the text. Typical Theme-Rheme patterns are described, and the…

  19. Improving Providers' Role Definitions to Decrease Overcrowding and Improve In-Hospital Cardiac Arrest Response.

    Science.gov (United States)

    Leary, Marion; Schweickert, William; Neefe, Stacie; Tsypenyuk, Boris; Falk, Scott Austin; Holena, Daniel N

    2016-07-01

    How nontechnical factors such as inadequate role definition and overcrowding affect outcomes of in-hospital cardiac arrest (IHCA) is unknown. Using a bundled intervention, we sought to improve providers' role definitions and decrease overcrowding during IHCA events. To determine if a bundled intervention consisting of a nurse/physician leadership dyad, visual cues for provider roles, and a "role check" would lead to reductions in crowding and improve perceptions of communication and team leadership. Baseline data on the number and type of IHCA providers were collected. Providers were asked to complete a postevent survey rating communication and leadership. A bundled intervention was then introduced. Data were then obtained for the subsequent IHCA events. Twenty ICHA events were captured before and 34 after the intervention. The number of physicians present at pulse checks 2 (median [interquartile range]: 6 [5-8] before vs 5 [3-6] after, P = .02) and 3 (7 [5-9] vs 4 [4-5], P = .004) decreased significantly after the intervention. The overall number of providers at the third pulse check (18 [14-22] before vs 14 [12-16] after, P = .04) also decreased after the intervention. On a 10-point Likert scale, ratings of communication (8 [7-8]) and physician leadership (8 [7-9]) did not differ significantly from before to after the intervention. Both the physician leads (90%) and patients' primary nurses (97%) were able to identify clear nurse leaders. A bundled intervention targeted at improving IHCA response led to a decrease in overcrowding at ICHA events without substantial changes in the perceptions of communication or physician leadership. ©2016 American Association of Critical-Care Nurses.

  20. Use of PSA Level 2 analysis for improving containment performance. Report of a technical committee meeting

    International Nuclear Information System (INIS)

    1998-03-01

    In order to discuss and exchange experience on different aspects of methods associated with Level 2 PSA and its applications for improving containment performance, the IAEA held a Technical Committee meeting in Vienna in December 1996. The meeting, which was attended by 26 participants from 20 Member States, provided a broad forum for discussion. The meeting addressed the issues related to the actual performance of Level 2 PSA studies as well as the insights gained from applications to improve containment performance. Particular attention was given to studies and applications for WWER type reactors, for which Level 2 work is still in its early stages, and for channel type reactors where modelling of accident progression is complex and significantly different from vessel type light water reactors. This TECDOC contains the papers presented at the meeting and the results of extensive discussions which were held in specific working groups

  1. THERMAL COMPOSITE COATINGS IMPROVING QUALITY OF TECHNICAL MEANS OF TRANSPORT

    Directory of Open Access Journals (Sweden)

    Andrzej POSMYK

    2015-06-01

    Full Text Available The paper presents the thermal properties of composite insulating material designed for producing of technical means of transport. This material can be coated on most of engineering materials. The matrix of this material is an acrylic resin ant non porous ceramic microspheres made of alumina are the reinforcing phase. Thanks to that into the spheres almost vacuum (0,13 Pa dominants and a big amount of spheres pro thickness unit is it possible to achieve low thermal conductivity. Usage of these coatings for producing of cooling cabins on vehicles let us to reduce of fuel for maintain of given temperature. Usage of these coatings in planes flying on high altitudes (temperature up to -60 allows to reduce of fuel consumption for heating. It has an important influence on transport quality and quality costs.

  2. THE PROSPECTS FOR IMPROVING THE TECHNICAL STATE OF ROLLING STOCK ON THE RAILWAYS OF UKRAINE

    Directory of Open Access Journals (Sweden)

    O. V. Ponomarenko

    2017-02-01

    Full Text Available Purpose. One of the main conditions of the effective and high-quality organization of rail hauling is availability of modern rolling stock. However, the analysis of technical condition confirms its considerable moral and physical deterioration. The main purpose of the article is search of possible ways of improvement of technical condition of the existing car fleet on the railroads of Ukraine. Methodology. The current state of a rail transport not fully meets the modern requirements. For the last decades updating of fixed assets has been provided generally at the expense of own means of the railroads and satisfied the need for capital investments only for 5-6 percent. At the same time, actually since declaration of independence of Ukraine the price growth rates for the products consumed by the railroads exceeded the fare growth rates that did not allow to update in necessary amount and to improve technical condition of the rolling stock. Findings. The article presents the analysis of freight rolling stock of Ukrainian Railways, which showed unsatisfactory condition of the cars. The railway industry today works on the old principles, which do not correspond to the modern world trends in organization of work of railway transport, contribute to the inefficiency of its functioning and impede further development, constraining the inflow of investment to this industry, hamper cooperation with private companies. Insufficient funding and imperfect system of repair and maintenance inhibit the development and reduce the competitiveness of railway transport of Ukraine. However, the implementation of strategic directions of development of the transport sector, a review of the above constraints and using the experience of advanced countries will steer the rail transport out of the crisis. Originality. The authors presented comprehensive consideration of issues to improve the car maintenance system while extending the life of their operation. Practical value

  3. The WIPP research and development program: providing the technical basis for defense waste disposal

    International Nuclear Information System (INIS)

    Hunter, Th.O.

    1983-01-01

    The Waste Isolation Pilot Plant (WIPP), located in southeastern New Mexico, is being developed by the US Department of Energy as a research and development facility to demonstrate the safe disposal of radioactive wastes from the defense programs of the United States. Underground workings are at a depth of 660 in a bedded-salt formation. Site investigations began in the early 1970s and are culminating with the completion of the Site and Preliminary Design Validation (SPDV) program in 1983 in which two shafts and several thousand feet of underground drifts are being constructed. The underground facility will be used for in situ tests and demonstrations that address technical issues associated with the disposal of transuranic and defense high-level wastes (DHLW) in bedded salt. These tests are based on several years of laboratory tests, field tests in mines, and analytical modeling studies. They primarily address repository development in bedded salt, including thermal-structural interactions plugging and sealing, and facility operations; and waste package interactions, including the effects of the waste on local rock salt and the evaluation of waste package materials. In situ testing began in the WIPP with the initiation of the SPDV program in 1981. In 1983, a major series of tests will begin to investigate the response of the rock salt without the use of any radioactivity

  4. AEL Continuous School Improvement Questionnaire. User Manual and Technical Report.

    Science.gov (United States)

    Meehan, Merrill L.; Cowley, Kimberly S.; Craig, James R.; Balow, Nancy; Childers, Robert D.

    The Continuous School Improvement Questionnaire (CSIQ) developed by the AEL helps a school staff gauge its performance on six dimensions related to continuous school improvement. Each member of the staff responds to the CSIQ individually. Although results might be used at the district or regional level, the most widely intended unit for applying…

  5. Designing a system for patients controlling providers' access to their electronic health records: organizational and technical challenges.

    Science.gov (United States)

    Leventhal, Jeremy C; Cummins, Jonathan A; Schwartz, Peter H; Martin, Douglas K; Tierney, William M

    2015-01-01

    Electronic health records (EHRs) are proliferating, and financial incentives encourage their use. Applying Fair Information Practice principles to EHRs necessitates balancing patients' rights to control their personal information with providers' data needs to deliver safe, high-quality care. We describe the technical and organizational challenges faced in capturing patients' preferences for patient-controlled EHR access and applying those preferences to an existing EHR. We established an online system for capturing patients' preferences for who could view their EHRs (listing all participating clinic providers individually and categorically-physicians, nurses, other staff) and what data to redact (none, all, or by specific categories of sensitive data or patient age). We then modified existing data-viewing software serving a state-wide health information exchange and a large urban health system and its primary care clinics to allow patients' preferences to guide data displays to providers. Patients could allow or restrict data displays to all clinicians and staff in a demonstration primary care clinic, categories of providers (physicians, nurses, others), or individual providers. They could also restrict access to all EHR data or any or all of five categories of sensitive data (mental and reproductive health, sexually transmitted diseases, HIV/AIDS, and substance abuse) and for specific patient ages. The EHR viewer displayed data via reports, data flowsheets, and coded and free text data displayed by Google-like searches. Unless patients recorded restrictions, by default all requested data were displayed to all providers. Data patients wanted restricted were not displayed, with no indication they were redacted. Technical barriers prevented redacting restricted information in free textnotes. The program allowed providers to hit a "Break the Glass" button to override patients' restrictions, recording the date, time, and next screen viewed. Establishing patient

  6. Nuclear power operating experience and technical improvement in Japan

    International Nuclear Information System (INIS)

    Toyota, M.

    1983-01-01

    LWR technology in Japan, originally introduced from the United States of America, is now almost entirely supplied domestically. During the initial stage of plant operation, electric power companies experienced various troubles such as intergranular stress corrosion cracking (IGSCC) in the piping in BWRs and steam generator (S/G) tube leaks in PWRs, which once reduced the capacity factor to about 40%. As a result of efforts to investigate the causes of the troubles and to establish countermeasures, which were applied to the plants in operation and under construction for improvement, as well as to shorten the period of regular inspection and to extend the operation cycle, the capacity factor has been improved to 60% since 1980. In 1975 an LWR improvement and standardization programme was launched to aim at improvement of reliability and availability factor and reduction of occupational radiation exposure with the development of domestic technology based on construction and operating experience. The First Phase Programme, which ran from 1975 to 1977, established countermeasures to preclude these troubles and improved workability by enlargement of the containment vessel. The Second Phase Programme followed and ran until 1981. The major steps taken during this period include the adoption of new IGSCC-resistant material and improved core design for BWRs and the improvement of fuels and S/Gs for PWRs. With these improvements, the capacity factor is now expected to reach a 75% level and occupational radiation exposure should be reduced by 50%. A Third Phase Programme will centre on the test and development programme for advanced BWRs and PWRs now under way to further improve the availability factor and reliability while also minimizing radiation exposure. (author)

  7. A MODEL FOR INTEGRATED SOFTWARE TO IMPROVE COMMUNICATION POLICY IN DENTAL TECHNICAL LABS

    Directory of Open Access Journals (Sweden)

    Minko M. Milev

    2017-06-01

    Full Text Available Introduction: Integrated marketing communications (IMC are all kinds of communications between organisations and customers, partners, other organisations and society. Aim: To develop and present an integrated software model, which can improve the effectiveness of communications in dental technical services. Material and Methods: The model of integrated software is based on recommendations of a total of 700 respondents (students of dental technology, dental physicians, dental technicians and patients of dental technical laboratories in Northeastern Bulgaria. Results and Discussion: We present the benefits of future integrated software to improve the communication policy in the dental technical laboratory that meets the needs of fast cooperation and well-built communicative network between dental physicians, dental technicians, patients and students. Conclusion: The use of integrated communications could be a powerful unified approach to improving the communication policy between all players at the market of dental technical services.

  8. Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

    Science.gov (United States)

    Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

    2015-01-01

    To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. The effect of environmental factors on technical and scale efficiency of primary health care providers in Greece

    Directory of Open Access Journals (Sweden)

    Aletras Vassilis H

    2007-11-01

    Full Text Available Abstract Background The purpose of this study was to compare technical and scale efficiency of primary care centers from the two largest Greek providers, the National Health System (NHS and the Social Security Foundation (IKA and to determine if, and how, efficiency is affected by various exogenous factors such as catchment population and location. Methods The sample comprised of 194 units (103 NHS and 91 IKA. Efficiency was measured with Data Envelopment Analysis (DEA using three inputs, -medical staff, nursing/paramedical staff, administrative/other staff- and two outputs, which were the aggregated numbers of scheduled/emergency patient visits and imaging/laboratory diagnostic tests. Facilities were categorized as small, medium and large (30,000 respectively to reflect catchment population and as urban/semi-urban or remote/island to reflect location. In a second stage analysis, technical and scale efficiency scores were regressed against facility type (NHS or IKA, size and location using multivariate Tobit regression. Results Regarding technical efficiency, IKA performed better than the NHS (84.9% vs. 70.1%, Mann-Whitney P P P = 0.103. As for scale efficiency, IKA again outperformed the NHS (89.7% vs. 85.9%, Mann-Whitney P = 0.080, but results were reversed in respect to facility size and location. Specifically, larger units performed better (96.3% vs. 90.9% vs. 75.9%, Kruskal-Wallis P P Conclusion Variations appeared to exist in the productive performance of the NHS and IKA as the two main primary care providers in Greece. These variations reflect differences in primary care organization, economical incentives, financial constraints, sociodemographic and local peculiarities. In all technical efficiency comparisons, IKA facilities appeared to outperform NHS ones irrespective of facility size or location. In respect to scale efficiency, the results were to some extent inconclusive and observed differences were mostly insignificant, although

  10. Efficiency improvements in pipeline transportation systems. Technical report, Task 3

    Energy Technology Data Exchange (ETDEWEB)

    Banks, W. F.; Horton, J. H.

    1977-01-01

    This report identifies those potential energy-conservative pipeline innovations that are most energy- and cost-effective, and formulates recommendations for the R, D, and D programs needed to exploit those opportunities. From a candidate field of over twenty classes of efficiency improvements, eight systems are recommended for pursuit. Most of these possess two highly important attributes: large potential energy savings and broad applicability outside the pipeline industry. The R, D, and D program for each improvement and the recommended immediate next step are described. The eight programs recommended for pursuit are: gas-fired combined-cycle compressor station; internally cooled internal combustion engine; methanol-coal slurry pipeline; methanol-coal slurry-fired and coal-fired engines; indirect-fired coal-burning combined-cycle pump station; fuel-cycle pump station; internal coatings in pipelines; and drag-reducing additives in liquid pipelines.

  11. The development of web program for providing RI-biomics technical information

    International Nuclear Information System (INIS)

    KI, Na Kyung; Kim, Joo Yeon; Jang, Sol Ah; Park, Tai Jin

    2014-01-01

    For designing the model of the web program, the demand survey for the technology and information has been performed for the students of the related departments, industrialists and researchers. And, the survey, such as advantages and disadvantages, for the current situations has been examined through comparison and analysis by the establishment type and operational process for the present operating web programs having the similar functions in Korea. The contents and web program for the technology and information system have been also developed by the question investigation and the expert opinions. This system for RI-Biomics has been developed by focusing the convenience for the information provision and the information search as the first constructing direction. Information has been collected by the operator in our institute and making contract with Global Trend Briefing of KISTI in Korea. The information collection in the web program has been designed as the direction regularly provided with RSS. Information has been then analyzed by constructing the expert pool provided from the advisory committee for the technology and information, and using them. The publicity for this web program has been performed by webzines and then it is noted that the publicity programs such as some events should be regularly developed when expanded and advanced to a community in future

  12. Developing and Improving Student Non-Technical Skills in IT Education: A Literature Review and Model

    Directory of Open Access Journals (Sweden)

    Marcia Hagen

    2016-06-01

    Full Text Available The purpose of this paper is to identify portions of the literature in the areas of Information Technology (IT management, skills development, and curriculum development that support the design of a holistic conceptual framework for instruction in non-technical skills within the IT higher education context. This article review provides a framework for understanding how the critical success factors related to IT and Information Systems (IS professional success is impacted by developing students’ non-technical skills. The article culminates in a holistic conceptual framework for developing non-technical skills within the IT higher education context. Implications for theory and research are provided.

  13. International Economic Association on organization of co-operative production and development of equipment and providing technical assistance in construction of nuclear power plants - ''INTERATOMENERGO''

    International Nuclear Information System (INIS)

    Mal'tsev, N.D.

    1979-01-01

    History is stated of foundation of the International Economic Association ''Interatomenergo''. Structure is given of the Association and the list of main problems to be solved by it. Project is given of the programm of co-operation in the field of scientific and technical works as well as of design and projecting works in creation of new types of equipment for nuclear power plants, in particular, creation of serial power units with improved WWER-1000 reactor. Directions are stated of activity of the Association in the field of providing assistance in construction and exploitation of nuclear power plants as well as in training of operational personnel [ru

  14. Using High-Technology Simulators to Prepare Anesthesia Providers Before Implementation of a New Electronic Health Record Module: A Technical Report.

    Science.gov (United States)

    Weintraub, Ari Y; Deutsch, Ellen S; Hales, Roberta L; Buchanan, Newton A; Rock, Whitney L; Rehman, Mohamed A

    2017-06-01

    Learning to use a new electronic anesthesia information management system can be challenging. Documenting anesthetic events, medication administration, and airway management in an unfamiliar system while simultaneously caring for a patient with the vigilance required for safe anesthesia can be distracting and risky. This technical report describes a vendor-agnostic approach to training using a high-technology manikin in a simulated clinical scenario. Training was feasible and valued by participants but required a combination of electronic and manual components. Further exploration may reveal simulated patient care training that provides the greatest benefit to participants as well as feedback to inform electronic health record improvements.

  15. Echocardiography Practice: Insights into Appropriate Clinical Use, Technical Competence and Quality Improvement Program

    Science.gov (United States)

    Kossaify, Antoine; Grollier, Gilles

    2014-01-01

    Echocardiography accounts for nearly half of all cardiac imaging techniques. It is a widely available and adaptable tool, as well as being a cost-effective and mainly a non-invasive test. In addition, echocardiography provides extensive clinical data, which is related to the presence or advent of different modalities (tissue Doppler imaging, speckle tracking imaging, three-dimensional mode, contrast echo, etc.), different approaches (transesophageal, intravascular, etc.), and different applications (ie, heart failure/resynchronization studies, ischemia/stress echo, etc.). In view of this, it is essential to conform to criteria of appropriate use and to keep standards of competence. In this study, we sought to review and discuss clinical practice of echocardiography in light of the criteria of appropriate clinical use, also we present an insight into echocardiographic technical competence and quality improvement project. PMID:24516342

  16. Safety protection and technical improvement of 60Co irradiation facilities

    International Nuclear Information System (INIS)

    Zhou Yongxing; Liang Cannan

    1993-01-01

    To ensure personal safety, some improvements has been made in the design of 60 Co irradiation compartment. The shielding door was interlocked while the 60 Co source to be lifted to the irradiation position or lowered to the shielded position. A universal change-over switch was used to cut the power supply when the source moved beyond the limits. Both γ-ray alarm and a closed-TV system were adopted. The electromagnetic attraction method was employed to shift the 60 Co source from the Pb container to the source pipe

  17. Risk-based configuration control: Application of PSA in improving technical specifications and operational safety

    International Nuclear Information System (INIS)

    Samanta, P.K.; Kim, I.S.; Vesely, W.E.

    1992-01-01

    Risk-based configuration control is the management of component configurations using a risk perspective to control risk and assure safety. A configuration, as used here, is a set of component operability statuses that define the state of a nuclear power plant. If the component configurations that have high risk implications do not occur, then the risk from the operation of nuclear power plants would be minimal. The control of component configurations, i.e., the management of component statuses, to minimize the risk from components being unavailable, becomes difficult, because the status of a standby safety system component is often not apparent unless it is tested. Controlling plant configuration from a risk-perspective can provide more direct risk control and also more operational flexibility by allowing looser controls in areas unimportant to risk. Risk-based configuration control approaches can be used to replace parts of nuclear power plant Technical Specifications. With the advances in probabilistic safety assessment (PSA) technology, such approaches to improve Technical Specifications and operational safety are feasible. In this paper, we present an analysis of configuration risks, and a framework for risk-based configuration control to achieve the desired control of risk-significant configurations during plant operation

  18. The superomedial thigh flap in scrotal reconstruction: Technical steps to improve cosmetic results

    Directory of Open Access Journals (Sweden)

    Ayat Allah Oufkir

    2013-01-01

    Full Text Available The superomedial thigh flap is a reliable and easy method for scrotal reconstruction described in 1980 and infrequently reported in the literature since its description. We used it for four patients presenting scrotal defects after Fournier′s gangrene with some technical modifications to improve the esthetic results and to facilitate the closure of the donor area. We describe the technical steps and the results.

  19. Improved Controls for Fusion RF Systems. Final technical report

    International Nuclear Information System (INIS)

    Casey, Jeffrey A.

    2011-01-01

    We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way that they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration

  20. Improved Controls for Fusion RF Systems. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Casey, Jeffrey A. [Rockfield Research Inc., Las Vegas, NV (United States)

    2011-11-08

    We have addressed the specific requirements for the integrated systems controlling an array of klystrons used for Lower Hybrid Current Drive (LHCD). The immediate goal for our design was to modernize the transmitter protection system (TPS) for LHCD on the Alcator C-Mod tokamak at the MIT Plasma Science and Fusion Center (MIT-PSFC). Working with the Alcator C-Mod team, we have upgraded the design of these controls to retrofit for improvements in performance and safety, as well as to facilitate the upcoming expansion from 12 to 16 klystrons. The longer range goals to generalize the designs in such a way that they will be of benefit to other programs within the international fusion effort was met by designing a system which was flexible enough to address all the MIT system requirements, and modular enough to adapt to a large variety of other requirements with minimal reconfiguration.

  1. THE IMPACT OF THE LEVERAGE PROVIDED BY THE FUTURES ONTHE PERFORMANCE OF TECHNICAL INDICATORS:EVIDENCEFROMTURKEY

    Directory of Open Access Journals (Sweden)

    Hakan ER

    2012-07-01

    Full Text Available Although in developed countries the futures markets have been in existence sincemid-nineteenth century, they are relatively new in the developing countries. In thelate twentieth and early twenty first century, many new futures exchanges wereestablishedin developing countries and in the majority of these newly establishedexchanges substantial growth in futures trading have been observed within a smallperiod of time. This fast growth in the futures trading volume was mainly due tothe tremendous leverage the futures provides to speculators. Thanks to futuresmargining system, by committing only a small fraction of the money needed tomaintain a position on the underlying security in the spot market, a speculator canattain a much higher return potentialby buying or selling a futures contract. Thispaper studies this effect by employing daily return data on 19 selected stockslisted continuously in IMKB-30 (Istanbul Stock Exchange 30,Turkey fromJanuary 2005 to December 2010. Populartechnical indicators are used to generatebuy and sell signals in both the spot market (Istanbul Stock Exchange and thefutures market (VOB, a fast growing derivatives exchange located in İzmir,Turkey. The profit/loss resulting from trading strategies are then calculated andcompared. The results of the study show that, although the amount invested inboth markets is the same, the profit generated from the strategies applied onfutures is significantly higher than that on spot market.A CAPM (Capital AssetPricing Model based hedge ratio is used to apply the trading strategies generated from spot market data on futures. The results show that this strategy generatessuperior returns in the futures market.

  2. 77 FR 19280 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Science.gov (United States)

    2012-03-30

    ... concerns that current system data quality might not allow for an AC optimal power flow model to be properly... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference: Increasing Real-Time and Day- Ahead Market Efficiency Through Improved Software Take notice that Commission staff will...

  3. Nevada Applied Ecology Information Center: a review of technical information support provided to the Nevada Applied Ecology Group

    International Nuclear Information System (INIS)

    Fore, C.S.; Pfuderer, H.A.

    1983-01-01

    The Nevada Applied Ecology Information Center (NAEIC) was established in January 1972 to serve the needs of the Nevada Applied Ecology Group (NAEG) by identifying, collecting, analyzing, and disseminating technical information relevant to NAEG programs. Since its inception, the NAEIC has been active in providing specialized information support to NAEG staff in the following research areas: (1) environmental aspects of the transuranics; (2) historic literature (pre-1962) on plutonium and uranium; (3) cleanup and treatment of radioactively contaminated land; (4) bioenvironmental aspects of europium and rhodium; (5) NAEG contractor reports; and (6) uptake of radioactivity by food crops

  4. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-12-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  5. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-01-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  6. The DEDUCE Guided Query tool: providing simplified access to clinical data for research and quality improvement.

    Science.gov (United States)

    Horvath, Monica M; Winfield, Stephanie; Evans, Steve; Slopek, Steve; Shang, Howard; Ferranti, Jeffrey

    2011-04-01

    In many healthcare organizations, comparative effectiveness research and quality improvement (QI) investigations are hampered by a lack of access to data created as a byproduct of patient care. Data collection often hinges upon either manual chart review or ad hoc requests to technical experts who support legacy clinical systems. In order to facilitate this needed capacity for data exploration at our institution (Duke University Health System), we have designed and deployed a robust Web application for cohort identification and data extraction--the Duke Enterprise Data Unified Content Explorer (DEDUCE). DEDUCE is envisioned as a simple, web-based environment that allows investigators access to administrative, financial, and clinical information generated during patient care. By using business intelligence tools to create a view into Duke Medicine's enterprise data warehouse, DEDUCE provides a Guided Query functionality using a wizard-like interface that lets users filter through millions of clinical records, explore aggregate reports, and, export extracts. Researchers and QI specialists can obtain detailed patient- and observation-level extracts without needing to understand structured query language or the underlying database model. Developers designing such tools must devote sufficient training and develop application safeguards to ensure that patient-centered clinical researchers understand when observation-level extracts should be used. This may mitigate the risk of data being misunderstood and consequently used in an improper fashion. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. Using Model-Based Systems Engineering To Provide Artifacts for NASA Project Life-Cycle and Technical Reviews

    Science.gov (United States)

    Parrott, Edith L.; Weiland, Karen J.

    2017-01-01

    The ability of systems engineers to use model-based systems engineering (MBSE) to generate self-consistent, up-to-date systems engineering products for project life-cycle and technical reviews is an important aspect for the continued and accelerated acceptance of MBSE. Currently, many review products are generated using labor-intensive, error-prone approaches based on documents, spreadsheets, and chart sets; a promised benefit of MBSE is that users will experience reductions in inconsistencies and errors. This work examines features of SysML that can be used to generate systems engineering products. Model elements, relationships, tables, and diagrams are identified for a large number of the typical systems engineering artifacts. A SysML system model can contain and generate most systems engineering products to a significant extent and this paper provides a guide on how to use MBSE to generate products for project life-cycle and technical reviews. The use of MBSE can reduce the schedule impact usually experienced for review preparation, as in many cases the review products can be auto-generated directly from the system model. These approaches are useful to systems engineers, project managers, review board members, and other key project stakeholders.

  8. Towards Quality Technical Vocational Education and Training (Tvet) Programmes in Nigeria: Challenges and Improvement Strategies

    Science.gov (United States)

    Ayonmike, Chinyere Shirley; Okwelle, P. Chijioke; Okeke, Benjamin Chukwumaijem

    2015-01-01

    Technical Vocational Education and Training (TVET) is widely recognized as a vital driving force for the socio-economic growth and technological development of nations. In achieving the goals and objectives of TVET in Nigeria, the quality of the programme needs to be improved and sustained. The purpose of this study is to ascertain the challenges…

  9. 78 FR 39260 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2013-07-01

    ... collaborative network of State deaf-blind TA projects. Using advances in communication and social media, the... their academic and social outcomes; empower children who are deaf-blind to engage in self-advocacy so... Improve Services and Results for Children With Disabilities--State Technical Assistance Projects To...

  10. Improving non-technical skills (teamwork) in post-partum haemorrhage: A grouped randomised trial.

    Science.gov (United States)

    Letchworth, Pippa M; Duffy, Shane P; Phillips, Dan

    2017-10-01

    To determine the effect of a decision support technology on teamwork and associated non-technical (NTS) and technical skills when teams manage post-partum haemorrhage (PPH) in the simulated environment. Multidisciplinary (MDT) maternity teams were taught how to manage post partum haemorrhage. They were randomised to the intervention: using a decision support mobile digital platform or a control group. Each team managed a post-partum simulation, which was recorded and reviewed by assessors. Primary outcome measures to assess teams NTS were the validated Global Assessment of Obstetric Team Performance (GAOTP) and Clinical Teamwork Scale (CTS). Secondary outcome measures were the 'friends and family test', technical skills, and the System Usability Scale (SUS). Sample size estimation was calculated by using 80% power 5% significance two tailed test (p1=85% p2=40%) n=34. 38 teams from August 2014-February 2016, were recruited, technical issues with failure of recording equipment meant 4 teams were excluded from teamwork analysis (1 intervention 3 control). Teamwork improved across all domains with the intervention (using a decision support mobile digital platform) p teamwork by 25% using CTS and 22% using GAOTP. Fewer technical skills were missed with the intervention (pteamwork is often cited as the cause of failures in care and we report a usable technology that assists with and improves teamwork during an emergency. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  12. EUROSAFE Forum for nuclear safety. Towards Convergence of Technical Nuclear Safety Practices in Europe. Safety Improvements - Reasons, Strategies, Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Erven, Ulrich (ed.) [Gesellschaft fuer Anlagen- und Reaktorsicherheit, GRS mbH, Schwertnergasse 1, 50667 Koeln (Germany); Cherie, Jean-Bernard (ed.) [Institut de Radioprotection et de Surete Nucleaire, IRSN, BP 17, 92262 Fontenay-aux-Roses Cedex (France); Boeck, Benoit De (ed.) [Association Vincotte Nuclear, AVN, Rue Walcourt 148, 1070 Bruxelles (Belgium)

    2005-07-01

    The EUROSAFE Forum for Nuclear Safety is part of the EUROSAFE approach, which consists of two further elements: the EUROSAFE Tribune and the EUROSAFE Web site. The general aim of EUROSAFE is to contribute to fostering the convergence of technical nuclear safety practices in a broad European context. This is done by providing technical safety and research organisations, safety authorities, power utilities, the rest of the industry and non-governmental organisations mainly from the European Union and East-European countries, and international organisations with a platform for the presentation of recent analyses and R and D in the field of nuclear safety. The goal is to share experiences, to exchange technical and scientific opinions, and to conduct debates on key issues in the fields of nuclear safety and radiation protection. The EUROSAFE Forum on 2005 focused on Safety Improvements, Reasons - Strategies - Implementation, from the point of view of the authorities, TSOs and industry. Latest work in nuclear installation safety and research, waste management, radiation safety as well as nuclear material and nuclear facilities security carried out by GRS, IRSN, AVN and their partners in the European Union, Switzerland and Eastern Europe are presented. A high level of nuclear safety is a priority for the countries of Europe. The technical safety organisations play an important role in contributing to that objective through appropriate approaches to major safety issues as part of their assessments and research activities. The challenges to nuclear safety are international. Changes in underlying technologies such as instrumentation and control, the impact of electricity market deregulation, demands for improved safety and safety management, the ageing of nuclear facilities, waste management, maintaining and improving scientific and technical knowledge, and the need for greater transparency - these are all issues where the value of an international approach is gaining

  13. EUROSAFE Forum for nuclear safety. Towards Convergence of Technical Nuclear Safety Practices in Europe. Safety Improvements - Reasons, Strategies, Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Erven, Ulrich [Gesellschaft fuer Anlagen- und Reaktorsicherheit, GRS mbH, Schwertnergasse 1, 50667 Koeln (Germany); Cherie, Jean-Bernard [Institut de Radioprotection et de Surete Nucleaire, IRSN, BP 17, 92262 Fontenay-aux-Roses Cedex (France); Boeck, Benoit De [Association Vincotte Nuclear, AVN, Rue Walcourt 148, 1070 Bruxelles (Belgium)

    2005-07-01

    The EUROSAFE Forum for Nuclear Safety is part of the EUROSAFE approach, which consists of two further elements: the EUROSAFE Tribune and the EUROSAFE Web site. The general aim of EUROSAFE is to contribute to fostering the convergence of technical nuclear safety practices in a broad European context. This is done by providing technical safety and research organisations, safety authorities, power utilities, the rest of the industry and non-governmental organisations mainly from the European Union and East-European countries, and international organisations with a platform for the presentation of recent analyses and R and D in the field of nuclear safety. The goal is to share experiences, to exchange technical and scientific opinions, and to conduct debates on key issues in the fields of nuclear safety and radiation protection. The EUROSAFE Forum on 2005 focused on Safety Improvements, Reasons - Strategies - Implementation, from the point of view of the authorities, TSOs and industry. Latest work in nuclear installation safety and research, waste management, radiation safety as well as nuclear material and nuclear facilities security carried out by GRS, IRSN, AVN and their partners in the European Union, Switzerland and Eastern Europe are presented. A high level of nuclear safety is a priority for the countries of Europe. The technical safety organisations play an important role in contributing to that objective through appropriate approaches to major safety issues as part of their assessments and research activities. The challenges to nuclear safety are international. Changes in underlying technologies such as instrumentation and control, the impact of electricity market deregulation, demands for improved safety and safety management, the ageing of nuclear facilities, waste management, maintaining and improving scientific and technical knowledge, and the need for greater transparency - these are all issues where the value of an international approach is gaining

  14. Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers.

    Science.gov (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E

    2017-06-08

    Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in

  15. Meta-Analysis as a Choice to Improve Research in Career and Technical Education

    Science.gov (United States)

    Gordon, Howard R. D.; McClain, Clifford R.; Kim, Yeonsoo; Maldonado, Cecilia

    2010-01-01

    A search of the ERIC and Academic Search Premier data bases, and a comprehensive review of literature suggest that meta-analysis is ignored by career and technical education (CTE) researchers, a situation that is regrettable but remediable. The purpose of this theoretical paper is to provide CTE researchers and consumers with procedures for…

  16. Subsurface Contaminants Focus Area (SCFA) Lead Laboratory Providing Technical Assistance to the DOE Weapons Complex in Subsurface Contamination

    International Nuclear Information System (INIS)

    Wright, J. A. Jr.; Corey, J. C.

    2002-01-01

    The Subsurface Contaminants Focus Area (SCFA), a DOE-HQ EM-50 organization, is hosted and managed at the Savannah River Site in Aiken, South Carolina. SCFA is an integrated program chartered to find technology and scientific solutions to address DOE subsurface environmental restoration problems throughout the DOE Weapons Complex. Since its inception in 1989, the SCFA program has resulted in a total of 269 deployments of 83 innovative technologies. Until recently, the primary thrust of the program has been to develop, demonstrate, and deploy those remediation technology alternatives that are solutions to technology needs identified by the DOE Sites. Over the last several years, the DOE Sites began to express a need not only for innovative technologies, but also for technical assistance. In response to this need, DOE-HQ EM-50, in collaboration with and in support of a Strategic Lab Council recommendation directed each of its Focus Areas to implement a Lead Laboratory Concept to enhance their technical capabilities. Because each Focus Area is unique as defined by the contrast in either the type of contaminants involved or the environments in which they are found, the Focus Areas were given latitude in how they set up and implemented the Lead Lab Concept. The configuration of choice for the SCFA was a Lead-Partner Lab arrangement. Savannah River Technology Center (SRTC) teamed with the SCFA as the Focus Area's Lead Laboratory. SRTC then partnered with the DOE National Laboratories to create a virtual consulting function within DOE. The National Laboratories were established to help solve the Nation's most difficult problems, drawing from a resource pool of the most talented and gifted scientists and engineers. Following that logic, SRTC, through the Lead-Partner Lab arrangement, has that same resource base to draw from to provide assistance to any SCFA DOE customer throughout the Complex. This paper briefly describes how this particular arrangement is organized and

  17. Participation in Training for Depression Care Quality Improvement: A Randomized Trial of Community Engagement or Technical Support.

    Science.gov (United States)

    Chung, Bowen; Ngo, Victoria K; Ong, Michael K; Pulido, Esmeralda; Jones, Felica; Gilmore, James; Stoker-Mtume, Norma; Johnson, Megan; Tang, Lingqi; Wells, Kenneth Brooks; Sherbourne, Cathy; Miranda, Jeanne

    2015-08-01

    Community engagement and planning (CEP) could improve dissemination of depression care quality improvement in underresourced communities, but whether its effects on provider training participation differ from those of standard technical assistance, or resources for services (RS), is unknown. This study compared program- and staff-level participation in depression care quality improvement training among programs enrolled in CEP, which trained networks of health care and social-community agencies jointly, and RS, which provided technical support to individual programs. Matched programs from health care and social-community service sectors in two communities were randomly assigned to RS or CEP. Data were from 1,622 eligible staff members from 95 enrolled programs. Primary outcomes were any staff trained (for programs) and total hours of training (for staff). Secondary staff-level outcomes were hours of training in specific depression collaborative care components. CEP programs were more likely than RS programs to participate in any training (p=.006). Within health care sectors, CEP programs were more likely than RS programs to participate in training (p=.016), but within social-community sectors, there was no difference in training by intervention. Among staff who participated in training, mean training hours were greater among CEP programs versus RS programs for any type of training (ptraining related to each component of depression care (p<.001) except medication management. CEP may be an effective strategy to promote staff participation in depression care improvement efforts in underresourced communities.

  18. Self-Study Guide for Florida VPK Provider Improvement Plan Development

    Science.gov (United States)

    Phillips, Beth M.; Mazzeo, Debbie; Smith, Kevin

    2016-01-01

    This Self-Study Guide has been developed to support Florida Voluntary Prekindergarten Providers (VPK) who are required to complete an improvement plan process (i.e., low-performing providers). The guide has sections that can be used during both the process of selecting target areas for an improvement plan and the process of implementing new or…

  19. Challenges in developing TSO to provide technical support in nuclear safety and security to Pakistan Nuclear Regulatory Authority

    International Nuclear Information System (INIS)

    Mallick, Shahid A.; Sherwani, Uzman Habib; Mehdi, M. Ammar

    2010-01-01

    This paper highlights the needs for the establishment of a technical support organization (TSO) in Pakistan Nuclear Regulatory Authority (PNRA), challenges faced during its development, application of training need assessment required for the competency development of its technical manpower and difficulties encountered after its evolution. Key issues addressed include recruitment of technical manpower and enhancing their competencies, acquisition of proper tools required for safety review and assessment, development of a sustainable education and training program consistent with the best international practices and taking the measures to get confidence of the regulatory body. (author)

  20. Technical Meeting on Fast Reactors and Related Fuel Cycle Facilities with Improved Economic Characteristics. Working Material

    International Nuclear Information System (INIS)

    2013-01-01

    In recent years, engineering oriented work, rather than basic research and development (R&D), has led to significant progress in improving the economics of innovative fast reactors and associated fuel cycle facilities, while maintaining and even enhancing the safety features of these systems. Optimization of plant size and layout, more compact designs, reduction of the amount of plant materials and the building volumes, higher operating temperatures to attain higher generating efficiencies, improvement of load factor, extended core lifetimes, high fuel burnup, etc. are good examples of achievements to date that have improved the economics of fast neutron systems. The IAEA, through its Technical Working Group on Fast Reactors (TWG-FR) and Technical Working Group on Nuclear Fuel Cycle Options and Spent Fuel Management (TWG-NFCO), devotes many of its initiatives to encouraging technical cooperation and promoting common research and technology development projects among Member States with fast reactor and advanced fuel cycle development programmes, with the general aim of catalysing and accelerating technology advances in these fields. In particular the theme of fast reactor deployment, scenarios and economics has been largely debated during the recent IAEA International Conference on Fast Reactors and Related Fuel Cycles: Safe Technologies and Sustainable Scenarios, held in Paris in March 2013. Several papers presented at this conference discussed the economics of fast reactors from different national and regional perspectives, including business cases, investment scenarios, funding mechanisms and design options that offer significant capital and energy production cost reductions. This Technical Meeting on Fast Reactors and Related Fuel Cycle Facilities with Improved Economic Characteristics addresses Member States’ expressed need for information exchange in the field, with the aim of identifying the main open issues and launching possible initiatives to help and

  1. The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.

    Science.gov (United States)

    Gutin, Sarah A; Amico, K Rivet; Hunguana, Elsa; Munguambe, António Orlando; Rose, Carol Dawson

    Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training. We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers. With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors. Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.

  2. Assessment, Problems and Ways of Improvement of Technical Regulation of Foreign Economic Activity (FEA in the World

    Directory of Open Access Journals (Sweden)

    Steblyanko Maryna D.

    2013-12-01

    Full Text Available The article analyses the state of technical regulation of FEA in the world and Ukraine and identifies main problems and ways of increase of efficiency of certification. It considers the system of technical regulation of EU and provides examples of application of technical barriers by some countries for ensuring security of goods in the domestic market. The article offers to develop a strategy of development of the national system of information provision of technical regulation and suspend transition from the system of mandatory certification to the system of assessment of correspondence with requirements of technical orders of business.

  3. Current status of light water reactor and Hitachi's technical improvements for BWR

    International Nuclear Information System (INIS)

    Miki, Minoru; Ohki, Arahiko.

    1984-01-01

    Gradual technical improvements in Japan over the years has improved the reliability of light water reactors, and has achieved the highest capacity factor level in the world. Commercial operation of Fukushima 2-2 (1,100 MW) of the Tokyo Electric Power Co. was started in February, 1984, as the first standardized BWR base plant, ushering in a new age of domestic light water reactor technology. The ABWR (1,300 MW class) has been developed as Japan's next generation light water reactor, with construction aimed at the latter half of the 1980's. Hitachi's extensive efforts range from key nuclear equipment to various related robots, directed at improving safety, reliability, and the capacity factor, while reducing radiation exposure. This paper presents an outline of Hitachi's participation in the light water reactor's improvement and standardization, and the current status of our role in the international cooperation plan for the ABWR. (author)

  4. Technical Meeting on Fast Reactors and Related Fuel Cycle Facilities with Improved Economic Characteristics. Working Material

    International Nuclear Information System (INIS)

    2013-01-01

    The objectives of the meeting were: - To identify the main issues and technical features that affect capital and energy production costs of fast reactors and related fuel cycle facilities; - To present fast reactor concepts and designs with enhanced economic characteristics, as well as innovative technical solutions (components, subsystems, etc.) that have the potential to reduce the capital costs of fast reactors and related fuel cycle facilities; - To present energy models and advanced tools for the cost assessment of innovative fast reactors and associated nuclear fuel cycles; - To discuss the results of studies and on-going R&D activities that address cost reduction and the future economic competitiveness of fast reactors; and - To identify research and technology development needs in the field, also in view of new IAEA initiatives to help and support Member States in improving the economic competitiveness of fast reactors and associated nuclear fuel cycles

  5. Technical Meeting on Fast Reactors and Related Fuel Cycle Facilities with Improved Economic Characteristics. Presentations

    International Nuclear Information System (INIS)

    2013-01-01

    The objectives of the meeting were: • To identify the main issues and technical features that affect capital and energy production costs of fast reactors and related fuel cycle facilities; • To present fast reactor concepts and designs with enhanced economic characteristics, as well as innovative technical solutions (components, subsystems, etc.) that have the potential to reduce the capital costs of fast reactors and related fuel cycle facilities; • To present energy models and advanced tools for the cost assessment of innovative fast reactors and associated nuclear fuel cycles; • To discuss the results of studies and ongoing R&D activities that address cost reduction and the future economic competitiveness of fast reactors; • To identify research and technology development needs in the field, also in view of new IAEA initiatives to help and support Member States in improving the economic competitiveness of fast reactors and associated nuclear fuel cycles

  6. Technical improvement of ATE system of Ling'ao Nuclear Power Plant Phase II

    International Nuclear Information System (INIS)

    Zhu Xingbao; Xiong Jingchuan; Liang Qiaohong

    2009-01-01

    In order to solve the problem that the content of SO 4 2- in Steam Generator significantly increased beyond the criteria after the use of the condensate treatment (ATE) system in Daya Bay Nuclear Power Plant and Ling'ao Nuclear Power Plant Phase I, technical improvement have been conducted on the sizes of the fore cation bed and the mixed bed, water distributing devices, ion exchange resins and separation facility. The effectiveness for the ion exchange of the mixed bed is improved, the resolved substance of cation resin is decreased; it is more impossible for fragments and powder which would lead high SO 4 2- content in Steam Generator. Finally, the quality of the steam-water could be improved and ensured. (authors)

  7. A technical system to improve the operational monitoring of the Zaporozhye nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Beyer, M; Carl, H; Nowak, K [Technischer Ueberwachungsverein Rheinland, Koeln (Germany). Inst. for Nuclear Engineering and Radiation Protection; Schumann, P; Seidel, A; Weiss, F P; Zschau, J

    1998-10-01

    As part of the programme implemented by the German Ministry of Environment, Nature Conservation and Reactor Safety to cooperate with the Central and Eastern European States (CEES) and the Commonwealth of Independent States (CIS) in the area of nuclear safety, a technical system to improve operational monitoring has been designed, specified and established since 1992 as a pilot project in the Zaporozhye/Ukraine nuclear power plant by Forschungszentrum Rossendorf and Technischer Ueberwachungsverein Rheinland with a significant contribution from the State Scientific and Technical Centre of the Ukrainian supervisory authority. The technical system complements existing operational checking and monitoring facilities by including modern means of information technology. It enables a continuous monitoring of the state of unit 5 in normal operation and in cases of anomalies or incidents so that when recognisable deviations from the regular plant operation occur, the Ukrainian supervisory authority can immediately inquire and if necessary impose conditions on the operator. The radiological and meteorological parameters at the nuclear power plant location are monitored to the extent necessary to assess the current radiation situation and to implement efficient emergency management measures. (orig.)

  8. A technical system to improve the operational monitoring of the Zaporozhye nuclear power plant

    International Nuclear Information System (INIS)

    Beyer, M.; Carl, H.; Nowak, K.; Schumann, P.; Seidel, A.; Weiss, F.P.; Zschau, J.

    1998-01-01

    As part of the programme implemented by the German Ministry of Environment, Nature Conservation and Reactor Safety to cooperate with the Central and Eastern European States (CEES) and the Commonwealth of Independent States (CIS) in the area of nuclear safety, a technical system to improve operational monitoring has been designed, specified and established since 1992 as a pilot project in the Zaporozhye/Ukraine nuclear power plant by Forschungszentrum Rossendorf and Technischer Ueberwachungsverein Rheinland with a significant contribution from the State Scientific and Technical Centre of the Ukrainian supervisory authority. The technical system complements existing operational checking and monitoring facilities by including modern means of information technology. It enables a continuous monitoring of the state of unit 5 in normal operation and in cases of anomalies or incidents so that when recognisable deviations from the regular plant operation occur, the Ukrainian supervisory authority can immediately inquire and if necessary impose conditions on the operator. The radiological and meteorological parameters at the nuclear power plant location are monitored to the extent necessary to assess the current radiation situation and to implement efficient emergency management measures. (orig.)

  9. TECHNICAL ASPECTS REGARDING THE IMPROVEMENT OF AEROSPACE AIR DEFENSE VECTORS’ PERFORMANCES

    Directory of Open Access Journals (Sweden)

    Vasile SANDRU

    2013-01-01

    Full Text Available Confronted with the spectacular evolution of the aircraft and other aerial vehicles, the systems destined to combat them, especially Surface-to-Air Missile Systems (SAMS, went through an accelerated loss of their performance. The financial crisis has forced an extension of the system operation even if the system is outdated. Therefore, a new modernized version has been designed. Many times, it is better to improve an existing system than to buy a new one. This article describes the diversity of SAMS’s challenges, involving a decrease in time regarding their number. The types of challenges can be divided in two categories: technical and institutional ones. The technical challenges can be also divided in two categories: deterioration of material and obsolescence. The classes of material that present interest for us are aerodynamic vector structure, propulsion, and special systems. From an institutional point of view, the main problems are: cost versus performance and cost versus the remaining lifetime (technical resource of the air defense system. The article finishes with conclusions that support the possibility and necessity of a SAMS upgrade, given the change of the threats characteristics.

  10. The Development of Technical and Vocational Education in Malaysia--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

    Science.gov (United States)

    Hee, Tieng Fok

    The economic profile of Malaysia has changed from an economy mainly based on agriculture and the production of tin ore to a more balanced economy with continuing growth in the manufacturing and industrial sectors. Educational programs need to be upgraded and improved, particularly the direction and development of technical and vocational education…

  11. Factors of Quality Improvement of the Foreign Language Teaching in Technical University

    Directory of Open Access Journals (Sweden)

    Ira R. Agasieva

    2017-03-01

    Full Text Available In the article the problem of quality of teaching and knowledge of the English language has been considered. The factors that influence the improvement of the quality of teaching and knowledge of the English language in a technical college, the use of various methods of enhancing the quality of teaching and knowledge of the English language has been analyzed. It has been distinguished the necessity of taking into account the factors such as emotional maturity of the student, the desire for success, student cognitive style, its consistency and independence.

  12. Provider perceptions of an integrated primary care quality improvement strategy: The PPAQ toolkit.

    Science.gov (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R

    2017-02-01

    The Primary Care Behavioral Health (PCBH) model of integrated primary care is challenging to implement with high fidelity. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) was designed to assess provider adherence to essential model components and has recently been adapted into a quality improvement toolkit. The aim of this pilot project was to gather preliminary feedback on providers' perceptions of the acceptability and utility of the PPAQ toolkit for making beneficial practice changes. Twelve mental health providers working in Department of Veterans Affairs integrated primary care clinics participated in semistructured interviews to gather quantitative and qualitative data. Descriptive statistics and qualitative content analysis were used to analyze data. Providers identified several positive features of the PPAQ toolkit organization and structure that resulted in high ratings of acceptability, while also identifying several toolkit components in need of modification to improve usability. Toolkit content was considered highly representative of the (PCBH) model and therefore could be used as a diagnostic self-assessment of model adherence. The toolkit was considered to be high in applicability to providers regardless of their degree of prior professional preparation or current clinical setting. Additionally, providers identified several system-level contextual factors that could impact the usefulness of the toolkit. These findings suggest that frontline mental health providers working in (PCBH) settings may be receptive to using an adherence-focused toolkit for ongoing quality improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Management of natural health products in pediatrics: a provider-focused quality improvement project.

    Science.gov (United States)

    Gutierrez, Emily; Silbert-Flagg, JoAnne; Vohra, Sunita

    2015-01-01

    The use of natural health products by pediatric patients is common, yet health care providers often do not provide management guidance. The purpose of this project was to improve management of natural health products by pediatric nurse practitioners. Pediatric nurse practitioners from large metropolitan city were recruited (n = 32). A paired pretest-posttest design was used. Study participants were engaged to improve knowledge of natural health products, and a management toolkit was created and tested. Mean knowledge scores increased from 59.19 to 76.3 (p improved with regard to patient guidance (p product use (p = .51) and drug/herb interactions (p = .35) were not significant. This investigation is the first known study to improve knowledge and management of natural health products in pediatric clinical practice. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  14. Adrenal vein sampling: substantial need for technical improvement at regional referral centres.

    Science.gov (United States)

    Elliott, Panda; Holmes, Daniel T

    2013-10-01

    Adrenal vein sampling (AVS) is the gold standard for localization of aldosterone producing adenoma. The anatomy of the right adrenal vein makes this procedure technically demanding and it may yield no clinical information if the adrenal veins are not adequately cannulated. Having frequently observed the technical failure of AVS, we undertook a review of 220 procedures in British Columbia, Canada. Subjects were retrospectively identified through the laboratory information system. The following were collected: demographics, screening aldosterone concentration and renin activity/mass, results of dynamic function tests, AVS aldosterone and cortisol results. Standard calculations were performed on AVS data and site-specific success rates were compared. The effect of adrenocorticotropin hormone (ACTH) stimulation on the selectivity index (SI) and lateralization index (LI) were explored. The overall technical success-rate of AVS procedures was only 44% in procedures where no ACTH-stimulation was used (n=200) but this rose significantly (psuccess of AVS is lower than reported elsewhere. Provided that effects on the LI are considered, the use of ACTH-stimulation during AVS assists in the identification of unilateral forms of PA. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. Better Together: Co-Location of Dental and Primary Care Provides Opportunities to Improve Oral Health.

    Science.gov (United States)

    Pourat, Nadereh; Martinez, Ana E; Crall, James J

    2015-09-01

    Community Health Centers (CHCs) are one of the principal safety-net providers of health care for low-income and uninsured populations. Co-locating dental services in primary care settings provides an opportunity to improve access to dental care. Yet this study of California CHCs that provide primary care services shows that only about one-third of them co-located primary and dental care services on-site. An additional one-third were members of multisite organizations in which at least one other site provided dental care. The remaining one-third of CHC sites had no dental care capacity. Policy options to promote co-location include requiring on-site availability of dental services, providing infrastructure funding to build and equip dental facilities, and offering financial incentives to provide dental care and recruit dental providers.

  16. Provider-Payer Partnerships as an Engine for Continuous Quality Improvement.

    Science.gov (United States)

    Balfour, Margaret E; Zinn, Tylar E; Cason, Karena; Fox, Jerimya; Morales, Myra; Berdeja, Cesar; Gray, Jay

    2018-03-01

    The authors describe a quality improvement approach in which a crisis center and a payer collaborate to improve care. Each crisis visit is considered as a potentially missed opportunity for community stabilization. Daily data on crisis visits are sent to the payer for a more up-to-date analysis of trends than is possible with financial claims data, which may lag behind services provided by up to 90 days. Using these trend data, the two organizations collaborate to identify patterns that lead to opportunities for improvement and develop multiple rapid-cycle projects for better management of services, resulting in significant decreases in readmissions and in the number of high utilizers.

  17. Quiet eye training improves surgical knot tying more than traditional technical training: a randomized controlled study.

    Science.gov (United States)

    Causer, Joe; Harvey, Adrian; Snelgrove, Ryan; Arsenault, Gina; Vickers, Joan N

    2014-08-01

    We examined the effectiveness of technical training (TT) and quiet eye training (QE) on the performance of one-handed square knot tying in surgical residents. Twenty surgical residents were randomly assigned to the 2 groups and completed pretest, training, retention, and transfer tests. Participants wore a mobile eye tracker that simultaneously recorded their gaze and hand movements. Dependent variables were knot tying performance (%), QE duration (%), number of fixations, total movement time (s), and hand movement phase time (s). The QE training group had significantly higher performance scores, a longer QE duration, fewer fixations, faster total knot tying times, and faster movement phase times compared with the TT group. The QE group maintained performance in the transfer test, whereas the TT group significantly decreased performance from retention to transfer. QE training significantly improved learning, retention, and transfer of surgical knot tying compared with a traditional technical approach. Both performance effectiveness (performance outcome) and movement efficiency (hand movement times) were improved using QE modeling, instruction, and feedback. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Small-sided game training improves aerobic capacity and technical skills in basketball players.

    Science.gov (United States)

    Delextrat, A; Martinez, A

    2014-05-01

    The aim of this study was to compare the effects of 2 training interventions based on small-sided games (SGG) and high-intensity interval training (HIT) on physical and technical performance of male junior basketball players. A secondary objective was to investigate if these effects were similar in starting and bench players. 18 players participated in a pre-testing session, 6-weeks intervention period and a post-testing session. Pre- and post-sessions involved assessments of aerobic fitness, repeated sprint ability (RSA), defensive and offensive agility, upper and lower body power, shooting and passing skills. Mixed-design analysis of variance (ANOVA) with Bonferroni corrected pairwise comparisons examined the effects of time and type of intervention on physical and technical performances. The main results showed that both interventions resulted in similar improvements in aerobic capacity (+3.4% vs. +4.1%), with greater improvements in bench players compared to starting players (+7.1% vs. +1.1%, Pbasketball players during the season. However, when RSA is targeted, more specific training seems necessary. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Capacity and readiness for quality improvement among home and community-based service providers.

    Science.gov (United States)

    Abrahamson, Kathleen; Myers, Jaclyn; Arling, Greg; Davila, Heather; Mueller, Christine; Abery, Brian; Cai, Yun

    2016-01-01

    The objective of this study was to explore home and community-based service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data were obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI. Internal resources available to support QI varied widely between participating organizations, with differences observed between smaller and larger agencies, as well as between provider types and populations served.

  20. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams

    DEFF Research Database (Denmark)

    Andersen, P.O.; Jensen, Michael Kammer; Lippert, A.

    2010-01-01

    Background: The application of non-technical skills (NTSs) in health care has previously been described in other health-care educational programmes. NTSs are behavioural principles such as leadership, task distribution and communication. The aim of this study was to identify NTSs suitable...... for improving team performance in multi-professional cardiac arrest teams, and to describe barriers to the use and implementation of such NTSs by using a qualitative method. Methods: Individual semi-structured interviews were conducted with 11 Danish Advanced Life Support instructors during the period April...... 2006 to November 2006. Interviews were focussed on barriers and recommendations for teamwork in the cardiac arrest team, optimal policy for improvement of resuscitation training and clinical practice, use of cognitive aids and adoption of European Resuscitation Council (ERC) Guidelines 2005. Interviews...

  1. A socio-technical approach for improving a Brazilian shoe manufacturing system.

    Science.gov (United States)

    Renner, J S; de M Guimarães, L B; de Oliveira, P A B

    2012-01-01

    This article presents a macroergonomic intervention in a footwear company in Rio Grande do Sul, Brazil, to improve both the quality of life of the employees and productivity by optimizing the traditional Taylor/Ford work organization. Multi-functionality and team working were implemented as means of making tasks more flexible and richer and the working hours were changed. The results showed a reduction in human and material resource costs and a consequent improvement in health and workers quality of life. Although middle managerial staff displayed strong resistance to the project and to breaking traditional production paradigms, the socio-technical system has been implemented throughout the plant and is expected to end up becoming the benchmark for other companies in the sector. Macro-ergonomics, footwear industry, organization work.

  2. Coaching and Quality Assistance in Quality Rating Improvement Systems: Approaches Used by TA Providers to Improve Quality in Early Care and Education Programs and Home-Based Settings

    Science.gov (United States)

    Smith, Sheila; Robbins, Taylor; Schneider, Will; Kreader, J. Lee; Ong, Christine

    2012-01-01

    Quality Rating Improvement Systems (QRISs) commonly offer on-site technical assistance (TA) and coaching to help early care and education settings achieve quality improvements and a higher QRIS rating. In surveys of administrators overseeing statewide QRISs, almost all states reported the use of on-site TA and coaching in both center-based and…

  3. Community Building Services Training Program: A Model Training Program to Provide Technical Training for Minority Adults in Construction, Building Maintenance,and Property Management. Final Report.

    Science.gov (United States)

    Community Building Maintenance Corp., Chicago, IL.

    A demonstration program, administered by a community based building maintenance, management, and construction corporation, was developed to provide technical training for minority adults in construction, building maintenance, and property management in the Chicago area. The program was concerned with seeking solutions to the lack of housing, job…

  4. Does service integration improve technical quality of care in low-resource settings? An evaluation of a model integrating HIV care into family planning services in Kenya.

    Science.gov (United States)

    Mutemwa, Richard; Mayhew, Susannah H; Warren, Charlotte E; Abuya, Timothy; Ndwiga, Charity; Kivunaga, Jackline

    2017-11-01

    The aim of this study was to investigate association between HIV and family planning integration and technical quality of care. The study focused on technical quality of client-provider consultation sessions. The cross-sectional study observed 366 client-provider consultation sessions and interviewed 37 health care providers in 12 public health facilities in Kenya. Multilevel random intercept and linear regression models were fitted to the matched data to investigate relationships between service integration and technical quality of care as well as associations between facility-level structural and provider factors and technical quality of care. A sensitivity analysis was performed to test for hidden bias. After adjusting for facility-level structural factors, HIV/family planning integration was found to have significant positive effect on technical quality of the consultation session, with average treatment effect 0.44 (95% CI: 0.63-0.82). Three of the 12 structural factors were significantly positively associated with technical quality of consultation session including: availability of family planning commodities (9.64; 95% CI: 5.07-14.21), adequate infrastructure (5.29; 95% CI: 2.89-7.69) and reagents (1.48; 95% CI: 1.02-1.93). Three of the nine provider factors were significantly positively associated with technical quality of consultation session: appropriate provider clinical knowledge (3.14; 95% CI: 1.92-4.36), job satisfaction (2.02; 95% CI: 1.21-2.83) and supervision (1.01; 95% CI: 0.35-1.68), while workload (-0.88; 95% CI: -1.75 to - 0.01) was negatively associated. Technical quality of the client-provider consultation session was also determined by duration of the consultation and type of clinic visit and appeared to depend on whether the clinic visit occurred early or later in the week. Integration of HIV care into family planning services can improve the technical quality of client-provider consultation sessions as measured by both health facility

  5. Improving the quality of learning discipline “Technical thermodynamics and heat exchange” at ONMU

    Science.gov (United States)

    Vasserman, A. A.; Malchevsky, V. P.

    2017-11-01

    Discipline «Technical thermodynamics and heat exchange» creates a theoretical basis for students of ship-engineering faculty of Odessa National Maritime University to learn special subjects such as: Internal Combustion Engines, Steam and Gas Turbines, Steam Boilers, Refrigerating Plants. This course forms future specialist and provides the deep understanding of essence of thermodynamic processes which run in machines and apparatus of ship. Also different kinds of heat exchange in solid, liquid and gaseous bodies which take place almost in all technological processes are considered. The quality of training ship engineers depends on the knowledge of mentioned discipline.

  6. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers.

    Science.gov (United States)

    Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C

    2013-11-04

    Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs

  7. Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers

    Science.gov (United States)

    2013-01-01

    Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff

  8. A socio-technical investigation of the smart grid: Implications for demand-side activities of electricity service providers

    Science.gov (United States)

    Corbett, Jacqueline Marie

    Enabled by advanced communication and information technologies, the smart grid represents a major transformation for the electricity sector. Vast quantities of data and two-way communications abilities create the potential for a flexible, data-driven, multi-directional supply and consumption network well equipped to meet the challenges of the next century. For electricity service providers ("utilities"), the smart grid provides opportunities for improved business practices and new business models; however, a transformation of such magnitude is not without risks. Three related studies are conducted to explore the implications of the smart grid on utilities' demand-side activities. An initial conceptual framework, based on organizational information processing theory, suggests that utilities' performance depends on the fit between the information processing requirements and capacities associated with a given demand-side activity. Using secondary data and multiple regression analyses, the first study finds, consistent with OIPT, a positive relationship between utilities' advanced meter deployments and demand-side management performance. However, it also finds that meters with only data collection capacities are associated with lower performance, suggesting the presence of information waste causing operational inefficiencies. In the second study, interviews with industry participants provide partial support for the initial conceptual model, new insights are gained with respect to information processing fit and information waste, and "big data" is identified as a central theme of the smart grid. To derive richer theoretical insights, the third study employs a grounded theory approach examining the experience of one successful utility in detail. Based on interviews and documentary data, the paradox of dynamic stability emerges as an essential enabler of utilities' performance in the smart grid environment. Within this context, the frames of opportunity, control, and data

  9. Reducing Anxiety and Improving Engagement in Health Care Providers Through an Auricular Acupuncture Intervention.

    Science.gov (United States)

    Buchanan, Teresa M; Reilly, Patricia M; Vafides, Carol; Dykes, Patricia

    Stress and anxiety are experienced by health care providers as a consequence of caregiving and may result in physical, emotional, and psychological outcomes that negatively impact work engagement. The purpose of this study was to determine whether auricular acupuncture can reduce provider anxiety and improve work engagement. Study participants received 5 auricular acupuncture sessions within a 16-week period utilizing the National Acupuncture Detoxification Association protocol for treating emotional trauma. Each participant completed the State-Trait Anxiety Inventory and the Utrecht Work Engagement Scale (UWES-9) prior to their first session and again after their fifth treatment. Significant reductions were found in state and trait anxiety (State-Trait Anxiety Inventory), as well as significant increases in the overall scores on the UWES as compared with baseline. Only the dedication subcategory of the UWES showed significant improvement. Engagement has been linked to increased productivity and well-being and improved patient and organizational outcomes. Providing effective strategies such as auricular acupuncture to support health care providers in reducing anxiety in the workplace may improve engagement.

  10. Quality Quandaries: Improving a customer value stream at a financial service provider

    NARCIS (Netherlands)

    Kuiper, A.; van de Hoef, R.; Wesseling, M.; Lameijer, B.A.; Does, R.J.M.M.

    2016-01-01

    In the wake of the financial crisis, the financial sector had to make tremendous efforts in being more transparent and cost efficient (Blom and Kuenen 2009). As a consequence, over the last decade, various financial service providers have embraced a range of methods for improving their customer

  11. IMPROVEMENT OF SYSTEMS OF TECHNICAL WATER SUPPLY WITH COOLING TOWERS FOR STEAM POWER PLANTS TECHNICAL AND ECONOMIC INDICATORS PERFECTION. Part 1

    Directory of Open Access Journals (Sweden)

    Yu. A. Zenovich-Leshkevich-Olpinskiy

    2016-01-01

    Full Text Available In order to reduce the temperature of cooling water and increase the efficiency of use of power resources the main directions of modernization of systems of technical water supply with cooling towers at steam power plants are presented. The problems of operation of irrigation systems and water distribution systems of cooling towers are reviewed. The design of heat and mass transfer devices, their shortcomings and the impact on the cooling ability of the cooling tower are also under analysis. The use of droplet heat and mass transfer device based on the lattice polypropylene virtually eliminates the shortcomings of the film and droplet-film heat and mass transfer devices of the cooling tower, increasing lifetime, and improving the reliability and efficiency of the operation of the main equipment of thermal power plants. The design of the water distribution devices of cooling towers is also considered. It is noted that the most effective are water-spattering low-pressure nozzles made of polypropylene that provides uniform dispersion of water and are of a high reliability and durability.

  12. A socio-technical approach to improving retail energy efficiency behaviours.

    Science.gov (United States)

    Christina, Sian; Waterson, Patrick; Dainty, Andrew; Daniels, Kevin

    2015-03-01

    In recent years, the UK retail sector has made a significant contribution to societal responses on carbon reduction. We provide a novel and timely examination of environmental sustainability from a systems perspective, exploring how energy-related technologies and strategies are incorporated into organisational life. We use a longitudinal case study approach, looking at behavioural energy efficiency from within one of the UK's leading retailers. Our data covers a two-year period, with qualitative data from a total of 131 participants gathered using phased interviews and focus groups. We introduce an adapted socio-technical framework approach in order to describe an existing organisational behavioural strategy to support retail energy efficiency. Our findings point to crucial socio-technical and goal-setting factors which both impede and/or enable energy efficient behaviours, these include: tensions linked to store level perception of energy management goals; an emphasis on the importance of technology for underpinning change processes; and, the need for feedback and incentives to support the completion of energy-related tasks. We also describe the evolution of a practical operational intervention designed to address issues raised in our findings. Our study provides fresh insights into how sustainable workplace behaviours can be achieved and sustained over time. Secondly, we discuss in detail a set of issues arising from goal conflict in the workplace; these include the development of a practical energy management strategy to facilitate secondary organisational goals through job redesign. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  13. Iraqi primary care system in Kurdistan region: providers' perspectives on problems and opportunities for improvement.

    Science.gov (United States)

    Shabila, Nazar P; Al-Tawil, Namir G; Al-Hadithi, Tariq S; Sondorp, Egbert; Vaughan, Kelsey

    2012-09-27

    As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers' perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq's Kurdistan region from the perspective of primary care providers. From their experience, primary care providers have a role in informing the community and

  14. Core trainee boot camp-A method for improving technical and non-technical skills of novice surgical trainees. A before and after study.

    Science.gov (United States)

    Bamford, R; Langdon, L; Rodd, C A; Eastaugh-Waring, S; Coulston, J E

    2018-04-10

    The transition to surgical training can be a stressful time for trainees and is most evident during national handover periods where new graduates start and senior trainees rotate to new programmes. During this time, patient mortality can increase and Hospital efficiency reduces. This influence is compounded by the impact of working time directives. Intensive, simulation rich training programmes or "Boot Camps" have been postulated as a solution. This article highlights the development of a surgical boot camp for novice surgical trainees and the impact this can have on training. A novel surgical boot camp was developed for all trainees within a surgical training region including nine acute NHS trusts. Participating cohort of trainees completed pre and post course questionnaires to assess technical and non-technical skills. 25 trainees attended and completed the pre and post boot camp questionnaire. Significant improvements were seen with technical skills (p = 0.0429), overall non-technical skills (p skills (p = 0.005) and outpatient skill (p = 0.002). Trainees reported significantly increased ability to assess and manage a critically unwell patient (p = 0.001) and a trauma patient (p = 0.001). 96% of trainees have utilised the skills they learnt on Boot Camp and all trainees would recommend it as an induction programme. Surgical Boot Camps offer a timely chance to develop technical and non-technical skills whilst enhancing a trainee's confidence and knowledge and reduce the patient safety impact of the handover period. Copyright © 2018. Published by Elsevier Ltd.

  15. Provider Communication, Prompts, and Feedback to Improve HPV Vaccination Rates in Resident Clinics.

    Science.gov (United States)

    Rand, Cynthia M; Schaffer, Stanley J; Dhepyasuwan, Nui; Blumkin, Aaron; Albertin, Christina; Serwint, Janet R; Darden, Paul M; Humiston, Sharon G; Mann, Keith J; Stratbucker, William; Szilagyi, Peter G

    2018-04-01

    Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics. Staff and providers in 8 resident clinics participated in a 12-month QI study. The intervention included training to strengthen provider communication about the HPV vaccine. Clinics also implemented provider prompts, received monthly performance feedback, and participated in learning collaborative calls. The primary outcome measure was eligible visits with vaccination divided by vaccine-eligible visits (captured HPV vaccination opportunities). Practices performed chart audits that were fed into monthly performance feedback on captured HPV vaccination opportunities. We used conditional logistic regression (conditioning on practice) to assess captured vaccination opportunities, with the time period of the study (before and after the QI intervention) as the independent variable. Overall, captured opportunities for HPV vaccination increased by 16.4 percentage points, from 46.9% to 63.3%. Special cause was demonstrated by centerline shift, with 8 consecutive points above the preintervention mean. On adjusted analyses, patients were more likely to receive a vaccine during, versus before, the intervention (odds ratio: 1.87; 95% confidence interval: 1.54-2.28). Captured HPV vaccination rates improved at both well-child and other visits (by 11.7 and 13.0 percentage points, respectively). A bundled intervention of provider prompts and training in communication skills plus performance feedback increased captured opportunities for HPV vaccination. Copyright © 2018 by the American Academy of Pediatrics.

  16. Improving physical health international students enrolled in a technical college in Baikal region

    Directory of Open Access Journals (Sweden)

    M.M. Kolokoltsev

    2014-02-01

    Full Text Available Purpose : to improve the physical health of foreign students enrolled in a technical college Baikal region using an extended motor mode. Material : in the experiment participated 57 students attending the training of South-East Asia, 74 - from Central Asia and 455 - Slavs, natives of the Irkutsk region. Results : it was found poor fitness and low functional performance among foreign students. For this purpose they had used advanced motoring. It included, besides training curriculum additional group activities in the form of sports, participating in sports events and guided independent study physical education. Conclusion : the end of follow foreign students involved in the extended motor mode, significantly outperform their peers engaged on normal functional parameters (heart rate, a test with 20 squats, the recovery time after exercise, dynamometry hands, breath tests, adaptive capacity as well as motor qualities.

  17. Improvement of technical purpose materials performance characteristics with the radio frequency low pressure plasma

    Science.gov (United States)

    Makhotkina, L. Yu; Khristoliubova, V. I.

    2017-11-01

    The main aim of the work is to solve the actual problem of increasing the competitiveness of tanning products by reducing the prime cost and improving the quality of finished products due to the increased durability of the working elements of tanneries. The impact of the low pressure radio frequency (RF) plasma in the processes of treating for modification of the materials for special purposes is considered in the article. The results of working elements of tanneries and the materials for special purposes sample processing by a RF low pressure plasma are described. As a result of leather materials nano structuring and nano modifying physical, mechanical and hygienic characteristics were increased. Processing of the technical purpose materials allows to increase operational performance of products and extend their lifespan.

  18. Technical integrity and continuous improvement: Key to survival beyond the nineties

    International Nuclear Information System (INIS)

    Thorogood, J.L.

    1994-01-01

    Drilling decisions made before a rig reaches location make a significant contribution to an oil company's financial success. Of value to the company is not the ability to drill wells, but the ability to plan with confidence in the knowledge of what is possible. In spite of this, operators have tended to over-work day to day decisions about drilling out of proportion to their significance. Recognition of this fact has resulted in the present wave of contracting initiatives. A major challenge for the industry is to achieve the necessary transfer of responsibility without compromising the operator's license to operate. These changes will compel the service sector to develop a new culture of technical integrity and continuous improvement. To operate safely, measure performance and manage drilling risk, the transformation will oblige the service sector to adopt many technologies presently owned by oil companies

  19. Improvement of AEP Predictions Using Diurnal CFD Modelling with Site-Specific Stability Weightings Provided from Mesoscale Simulation

    International Nuclear Information System (INIS)

    Hristov, Y; Oxley, G; Žagar, M

    2014-01-01

    The Bolund measurement campaign, performed by Danish Technical University (DTU) Wind Energy Department (also known as RISØ), provided significant insight into wind flow modeling over complex terrain. In the blind comparison study several modelling solutions were submitted with the vast majority being steady-state Computational Fluid Dynamics (CFD) approaches with two equation k-ε turbulence closure. This approach yielded the most accurate results, and was identified as the state-of-the-art tool for wind turbine generator (WTG) micro-siting. Based on the findings from Bolund, further comparison between CFD and field measurement data has been deemed essential in order to improve simulation accuracy for turbine load and long-term Annual Energy Production (AEP) estimations. Vestas Wind Systems A/S is a major WTG original equipment manufacturer (OEM) with an installed base of over 60GW in over 70 countries accounting for 19% of the global installed base. The Vestas Performance and Diagnostic Centre (VPDC) provides online live data to more than 47GW of these turbines allowing a comprehensive comparison between modelled and real-world energy production data. In previous studies, multiple sites have been simulated with a steady neutral CFD formulation for the atmospheric surface layer (ASL), and wind resource (RSF) files have been generated as a base for long-term AEP predictions showing significant improvement over predictions performed with the industry standard linear WAsP tool. In this study, further improvements to the wind resource file generation with CFD are examined using an unsteady diurnal cycle approach with a full atmospheric boundary layer (ABL) formulation, with the unique stratifications throughout the cycle weighted according to mesoscale simulated sectorwise stability frequencies

  20. It's not hype, it's communication: Using public relations techniques to improve your technical messages

    Energy Technology Data Exchange (ETDEWEB)

    Martell, P.J.

    1990-01-01

    Technical communicators are concerned that if they employ public relations (PR) techniques, they somehow compromise their work. They believe PR equates with type. However, to those of us in the field, PR means simply how people relate. Knowing PR techniques gives one a better understanding of human factors and interactions; using the techniques improves the chances for communication to occur. If technical communications are willing to learn PR techniques, they will gain strong tools to use to strengthen their messages.

  1. A management framework for training providers to improve skills development in the workplace

    OpenAIRE

    2011-01-01

    D.Ed. A skills revolution was launched in the South African workplace by the Department of Labour in 1998. Various skills development legislation were introduced to meet international standards, redress skills imbalances, curb skills shortages and improve the general skills in the current workforce. Training providers were the drivers of workplace training, yet are now displaced by skills authorities, such as the SET As, the ETQAs and SAQA. While the custody of skills development is placed...

  2. Blood Pressure Directed Booster Trainings Improve Intensive Care Unit Provider Retention of Excellent Cardiopulmonary Resuscitation Skills.

    Science.gov (United States)

    Wolfe, Heather; Maltese, Matthew R; Niles, Dana E; Fischman, Elizabeth; Legkobitova, Veronika; Leffelman, Jessica; Berg, Robert A; Nadkarni, Vinay M; Sutton, Robert M

    2015-11-01

    Brief, intermittent cardiopulmonary resuscitation (CPR) training sessions, "Booster Trainings," improve CPR skill acquisition and short-term retention. The objective of this study was to incorporate arterial blood pressure (ABP) tracings into Booster Trainings to improve CPR skill retention. We hypothesized that ABP-directed CPR "Booster Trainings" would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining. A CPR manikin creating a realistic relationship between chest compression depth and ABP was used for training/testing. Thirty-six ICU providers were randomized to brief, bedside ABP-directed CPR manikin skill retrainings: (1) Booster Plus (ABP visible during training and testing) versus (2) Booster Alone (ABP visible only during training, not testing) versus (3) control (testing, no intervention). Subjects completed skill tests pretraining (baseline), immediately after training (acquisition), and then retention was assessed at 12 hours, 3 and 6 months. The primary outcome was retention of excellent CPR skills at 3 months. Excellent CPR was defined as systolic blood pressure of 100 mm Hg or higher and compression rate 100 to 120 per minute. Overall, 14 of 24 (58%) participants acquired excellent CPR skills after their initial training (Booster Plus 75% vs 50% Booster Alone, P = 0.21). Adjusted for age, ABP-trained providers were 5.2× more likely to perform excellent CPR after the initial training (95% confidence interval [95% CI], 1.3-21.2; P = 0.02), and to retain these skills at 12 hours (adjusted odds ratio, 4.4; 95% CI, 1.3-14.9; P = 0.018) and 3 months (adjusted odds ratio, 4.1; 95% CI, 1.2-13.9; P = 0.023) when compared to baseline performance. The ABP-directed CPR booster trainings improved ICU provider 3-month retention of excellent CPR skills without the need for interval retraining.

  3. Hyper-Realistic, Team-Centered Fleet Surgical Team Training Provides Sustained Improvements in Performance.

    Science.gov (United States)

    Hoang, Tuan N; Kang, Jeff; Siriratsivawong, Kris; LaPorta, Anthony; Heck, Amber; Ferraro, Jessica; Robinson, Douglas; Walsh, Jonathan

    2016-01-01

    The high-stress, fast-paced environment of combat casualty care relies on effective teamwork and communication which translates into quality patient care. A training course was developed for U.S. Navy Fleet Surgical Teams to address these aspects of patient care by emphasizing efficiency and appropriate patient care. An effective training course provides knowledge and skills to pass the course evaluation and sustain the knowledge and skills acquired over time. The course included classroom didactic hours, and hands-on simulation sessions. A pretest was administered before the course, a posttest upon completion, and a sustainment test 5 months following course completion. The evaluation process measured changes in patient time to disposition and critical errors made during patient care. Naval Base San Diego, with resuscitation and surgical simulations carried out within the shipboard medical spaces. United States Navy medical personnel including physicians of various specialties, corpsmen, nurses, and nurse anesthetists deploying aboard ships. Time to disposition improved significantly, 11 ± 3 minutes, from pretest to posttest, and critical errors improved by 4 ± 1 errors per encounter. From posttest to sustainment test, time to disposition increased by 3 ± 1, and critical errors decreased by 1 ± 1. This course showed value in improving teamwork and communication skills of participants, immediately upon completion of the course, and after 5 months had passed. Therefore, with ongoing sustainment activities within 6 months, this course can substantially improve trauma care provided by shipboard deployed Navy medical personnel to wounded service members. Published by Elsevier Inc.

  4. Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction

    Directory of Open Access Journals (Sweden)

    Meredith Gilliam

    2017-03-01

    Full Text Available Background: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. Objective: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. Methods: In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital. The tool facilitates completion of a comprehensive discharge summary note that is available for patients and outpatient medical providers at the time of hospital discharge. Discharge summary note availability, outpatient provider satisfaction, and time between the decision to discharge a patient and discharge note completion were all evaluated before and after implementation of the tool. Results: The percentage of discharge summary notes completed by the time of first post-discharge clinical contact improved from 43% in February 2012 to 100% in September 2012 and was maintained at 100% in 2014. A survey of 22 outpatient providers showed that 90% preferred the new summary and 86% found it comprehensive. Despite increasing required documentation, the time required to discharge a patient, from physician decision to discharge note completion, improved from 5.6 h in 2010 to 4.1 h in 2012 (p = 0.04, and to 2.8 h in 2015 (p < 0.001. Conclusion: The implementation of a novel discharge summary tool improved the timeliness and comprehensiveness of discharge information as needed for the delivery of appropriate, high-quality follow-up care, without adversely affecting the efficiency of the discharge process.

  5. Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings.

    Science.gov (United States)

    Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael

    2016-01-01

    Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.

  6. Provider and Patient Directed Financial Incentives to Improve Care and Outcomes for Patients with Diabetes

    Science.gov (United States)

    Lorincz, Ilona S.; Lawson, Brittany C. T.

    2012-01-01

    Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented. The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long term effects are lacking. In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. PMID:23225214

  7. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Directory of Open Access Journals (Sweden)

    Sheila Cyril

    Full Text Available Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services.We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia.Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers.This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD

  8. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia.

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M; Agho, Kingsley; Renzaho, Andre M N

    2016-01-01

    Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services. We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health conditions of CALD communities to ensure

  9. Technical improvements for the dynamic measurement of general scour and landslides

    Science.gov (United States)

    Chung Yang, Han; Su, Chih Chiang

    2017-04-01

    Disasters occurring near riverbeds, such as landslides, earth slides, debris flow, and general scour, are easily caused by flooding from typhoons. The occurrence of each type of disaster involves a process, so if a disaster event can be monitored in real time, hazards can be predicted, thereby enabling early warnings that could reduce the degree of loss engendered by the disaster. The study of technical improvements for the dynamic measurement of general scour and landslides could help to release these early warnings. In this study, improved wireless tracers were set up on site to ensure the feasibility of the improved measurement technology. A wireless tracer signal transmission system was simultaneously set up to avoid danger to surveyors caused by them having to be on site to take measurements. In order to understand the real-time dynamic riverbed scouring situation, after the flow path of the river was confirmed, the sites for riverbed scouring observation were established at the P30 pier of the Dajia River Bridge of National Highway No. 3, and approximately 100 m both upstream and downstream (for a total of three sites). A rainy event that caused riverbed erosion occurred in May 2015, and subsequently, Typhoons Soudelor, Goni, and Dujuan caused further erosion in the observed area. The results of the observations of several flood events revealed that wireless tracers can reflect the change in riverbed scour depth caused by typhoons and flooding in real time. The wireless tracer technique can be applied to real-time dynamic scouring observation of rivers, and these improvements in measurement technology could be helpful in preventing landslides in the future.

  10. Simulator training and non-technical factors improve laparoscopic performance among OBGYN trainees.

    Science.gov (United States)

    Ahlborg, Liv; Hedman, Leif; Nisell, Henry; Felländer-Tsai, Li; Enochsson, Lars

    2013-10-01

    To investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology. In this prospective study, trainees were randomized into three groups. The first group was allocated to proficiency-based training in the LapSimGyn(®) virtual reality simulator. The second group received additional structured mentorship during subsequent laparoscopies. The third group served as control group. At baseline an operation was performed and visuospatial ability, flow and self-efficacy were assessed. All groups subsequently performed three tubal occlusions. Self-efficacy and flow were assessed before and/or after each operation. Simulator training was conducted at the Center for Advanced Medical Simulation and Training, Karolinska University Hospital. Sterilizations were performed at each trainee's home clinic. Twenty-eight trainees/residents from 21 hospitals in Sweden were included. Visuospatial ability was tested by the Mental Rotation Test-A. Flow and self-efficacy were assessed by validated scales and questionnaires. Laparoscopic performance was measured as the duration of surgery. Visuospatial ability, self-efficacy and flow were correlated to the laparoscopic performance using Spearman's correlations. Differences between groups were analyzed by the Mann-Whitney U-test. No differences across groups were detected at baseline. Self-efficacy scores before and flow scores after the third operation were significantly higher in the trained groups. Duration of surgery was significantly shorter in the trained groups. Flow and self-efficacy correlate positively with laparoscopic performance. Simulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. 16 CFR 1406.4 - Requirements to provide performance and technical notice to prospective purchasers and purchasers.

    Science.gov (United States)

    2010-01-01

    ... recommends the use of this 2 label format in order to provide more consumer awareness of the operation and... any identification of the manufacturer, brand, model, and similar designations. At the manufacturer's...

  12. Exploring Service Providers' Perspectives in Improving Childhood Obesity Prevention among CALD Communities in Victoria, Australia

    Science.gov (United States)

    Cyril, Sheila; Green, Julie; Nicholson, Jan M.; Agho, Kingsley; Renzaho, Andre M. N.

    2016-01-01

    Background Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers’ perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities’ participation in these services. Methods We conducted a qualitative study using focus group discussions involving fifty-nine service providers from a range of services, who are involved in the health and wellbeing of children from CALD groups living in four socioeconomically disadvantaged areas in Victoria, Australia. Results Thematic analysis of the data showed three major themes including community-level barriers to CALD engagement in childhood obesity prevention services; service-level barriers to the delivery of these services; and proposed changes to current childhood obesity prevention approaches. Integrating obesity prevention messages within existing programs, better coordination between prevention and treatment services and the establishment of a childhood obesity surveillance system, were some of the important changes suggested by service providers. Conclusion This study has found that low CALD health literacy, lack of knowledge of cultural barriers among service providers and co-existing deficiencies in the structure and delivery of obesity prevention services negatively impacted the participation of CALD communities in obesity prevention services. Cultural competency training of service providers would improve their understanding of the cultural influences of childhood obesity and incorporate them into the design and development of obesity prevention initiatives. Service providers need to be educated on the pre-migratory health service experiences and health

  13. Sequencing of allotetraploid cotton (Gossypium hirsutum L. acc. TM-1) provides a resource for fiber improvement.

    Science.gov (United States)

    Zhang, Tianzhen; Hu, Yan; Jiang, Wenkai; Fang, Lei; Guan, Xueying; Chen, Jiedan; Zhang, Jinbo; Saski, Christopher A; Scheffler, Brian E; Stelly, David M; Hulse-Kemp, Amanda M; Wan, Qun; Liu, Bingliang; Liu, Chunxiao; Wang, Sen; Pan, Mengqiao; Wang, Yangkun; Wang, Dawei; Ye, Wenxue; Chang, Lijing; Zhang, Wenpan; Song, Qingxin; Kirkbride, Ryan C; Chen, Xiaoya; Dennis, Elizabeth; Llewellyn, Danny J; Peterson, Daniel G; Thaxton, Peggy; Jones, Don C; Wang, Qiong; Xu, Xiaoyang; Zhang, Hua; Wu, Huaitong; Zhou, Lei; Mei, Gaofu; Chen, Shuqi; Tian, Yue; Xiang, Dan; Li, Xinghe; Ding, Jian; Zuo, Qiyang; Tao, Linna; Liu, Yunchao; Li, Ji; Lin, Yu; Hui, Yuanyuan; Cao, Zhisheng; Cai, Caiping; Zhu, Xiefei; Jiang, Zhi; Zhou, Baoliang; Guo, Wangzhen; Li, Ruiqiang; Chen, Z Jeffrey

    2015-05-01

    Upland cotton is a model for polyploid crop domestication and transgenic improvement. Here we sequenced the allotetraploid Gossypium hirsutum L. acc. TM-1 genome by integrating whole-genome shotgun reads, bacterial artificial chromosome (BAC)-end sequences and genotype-by-sequencing genetic maps. We assembled and annotated 32,032 A-subgenome genes and 34,402 D-subgenome genes. Structural rearrangements, gene loss, disrupted genes and sequence divergence were more common in the A subgenome than in the D subgenome, suggesting asymmetric evolution. However, no genome-wide expression dominance was found between the subgenomes. Genomic signatures of selection and domestication are associated with positively selected genes (PSGs) for fiber improvement in the A subgenome and for stress tolerance in the D subgenome. This draft genome sequence provides a resource for engineering superior cotton lines.

  14. Improvement of technical training of sportswomen in rhythmic gymnastics by means of acrobatics at the stage of preliminary basic preparation

    Directory of Open Access Journals (Sweden)

    Petro Kyzim

    2016-10-01

    Full Text Available Purpose: to prove experimentally the technique of improvement of technical training of sportswomen in rhythmic gymnastics by means of acrobatics at the stage of preliminary basic preparation. Material & Methods: the following methods of the research were used: analysis and synthesis of references, pedagogical observations, pedagogical testing, pedagogical experiment, method of expert assessment (qualimetry, methods of mathematical statistics. Results: the level of technical skill of performance of pre-acrobatic elements by sportswomen of rhythmic gymnastics before carrying out the pedagogical experiment is determined. The dynamics of indicators of the level of technical preparedness of sportswomen of rhythmic gymnastics is defined. Conclusions: it is established that additional resources of acrobatics influence significantly the level of technical preparedness of sportswomen of rhythmic gymnastics at the stage of preliminary basic preparation.

  15. IMPROVEMENT OF SYSTEMS OF TECHNICAL WATER SUPPLY WITH COOLING TOWERS FOR HEAT POWER PLANTS TECHNICAL AND ECONOMIC INDICATORS PERFECTION. Part 2

    Directory of Open Access Journals (Sweden)

    Yu. A. Zenovich-Leshkevich-Olpinskiy

    2016-01-01

    Full Text Available The method of calculation of economic efficiency that can be universal and is suitable for feasibility study of modernization of irrigation and water distribution system of cooling towers has been developed. The method takes into account the effect of lower pressure exhaust steam in the condenser by lowering the temperature of the cooling water outlet of a cooling tower that aims at improvement of technical and economic indicators of heat power plants. The practical results of the modernization of irrigation and water distribution system of a cooling tower are presented. As a result, the application of new irrigation and water distribution systems of cooling towers will make it possible to increase the cooling efficiency by more than 4 оС and, therefore, to obtain the fuel savings by improving the vacuum in the turbine condensers. In addition, the available capacity of CHP in the summer period is increased. The results of the work, the experience of modernization of irrigation and water distribution systems of the Gomel CHP-2 cooling towers system, as well as the and methods of calculating of its efficiency can be disseminated for upgrading similar facilities at the power plants of the Belarusian energy system. Some measures are prosed to improve recycling systems, cooling towers and their structures; such measures might significantly improve the reliability and efficiency of technical water supply systems of heat power plants.

  16. Technologies for improving the availability and reliability of current and future water cooled nuclear power plants. Proceedings of a technical committee meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-11-01

    One of the activities of the IAEA is to provide all Member States with an international source of balanced, objective information on advanced in technology for water cooled reactors. Since the global nuclear industry has a common interest in improving plant availability and reliability to assure specific individual plant and country perspective as well as to have an image of well managed competitive industry, the IAEA held a Technical Committee Meeting on Technologies for Improving the Availability and Reliability of Current and Future Water Cooled Nuclear Power Plants in September 1997. The basic aim to was to identify, review and exchange information on international developments in technologies for achieving high availability and reliability and to suggest areas where further technical advances could contribute to improvement of performance. Designs for future plants were presented in the context of how they can accommodate both the organizational and technical means for reaching even higher levels of performance. This proceedings contains the contributed papers presented at this Meeting each with a separate abstract. Four sessions were concerned with: policies, practices and procedures for achieving high reliability and availability; improving availability and reliability through better use of today`s technologies; recent advances in technologies for improving availability and reliability; achieving high availability for new plants Refs, figs, tabs

  17. Technologies for improving the availability and reliability of current and future water cooled nuclear power plants. Proceedings of a technical committee meeting

    International Nuclear Information System (INIS)

    1998-11-01

    One of the activities of the IAEA is to provide all Member States with an international source of balanced, objective information on advanced in technology for water cooled reactors. Since the global nuclear industry has a common interest in improving plant availability and reliability to assure specific individual plant and country perspective as well as to have an image of well managed competitive industry, the IAEA held a Technical Committee Meeting on Technologies for Improving the Availability and Reliability of Current and Future Water Cooled Nuclear Power Plants in September 1997. The basic aim to was to identify, review and exchange information on international developments in technologies for achieving high availability and reliability and to suggest areas where further technical advances could contribute to improvement of performance. Designs for future plants were presented in the context of how they can accommodate both the organizational and technical means for reaching even higher levels of performance. This proceedings contains the contributed papers presented at this Meeting each with a separate abstract. Four sessions were concerned with: policies, practices and procedures for achieving high reliability and availability; improving availability and reliability through better use of today's technologies; recent advances in technologies for improving availability and reliability; achieving high availability for new plants

  18. Improving integration and coordination of funding, technical assistance, and reporting/data collection: recommendations from CDC and USAPI stakeholders.

    Science.gov (United States)

    Ka'opua, Lana Sue I; White, Susan F; Rochester, Phyllis F; Holden, Debra J

    2011-03-01

    Current US Federal funding mechanisms may foster program silos that disable sharing of resources and information across programs within a larger system of public health services. Such silos present challenges to USAPI communities where human resources, health infrastructure, and health financing are limited. Integrative and coordinated approaches have been recommended. The CDC Pacific Islands Integration and Coordination project was initiated by the CDC Division of Cancer Prevention and Control (DCPC). The project aim was to identify ways for the CDC to collaborate with the USAPI in improving CDC activities and processes related to chronic disease. This article focuses on recommendations for improving coordination and integration in three core areas of health services programming: funding, program reporting/data collection and analysis, and technical assistance. Preliminary information on challenges and issues relevant to the core areas was gathered through site visits, focus groups, key informant interviews, and other sources. This information was used by stakeholder groups from the CDC and the USAPI to develop recommendations in the core programming areas. Recommendations generated at the CDC and USAPI stakeholder meetings were prepared into a single set of recommendations and stakeholders reviewed the document for accuracy prior to its dissemination to CDC's National Center for Chronic Disease Prevention and Health Promotion programs management and staff. Key recommendations, include: (1) consideration of resources and other challenges unique to the USAPI when reviewing funding applications, (2) consideration of ways to increase flexibility in USAPI use of program funds, (3) dedication of funding and human resources for technical assistance, (4) provision of opportunities for capacity-building across programs and jurisdictions, (5) consideration of ways to more directly link program reporting with technical assistance. This project provided a unique opportunity

  19. Organization Complexity and Primary Care Providers' Perceptions of Quality Improvement Culture Within the Veterans Health Administration.

    Science.gov (United States)

    Korom-Djakovic, Danijela; Canamucio, Anne; Lempa, Michele; Yano, Elizabeth M; Long, Judith A

    2016-01-01

    This study examined how aspects of quality improvement (QI) culture changed during the introduction of the Veterans Health Administration (VHA) patient-centered medical home initiative and how they were influenced by existing organizational factors, including VHA facility complexity and practice location. A voluntary survey, measuring primary care providers' (PCPs') perspectives on QI culture at their primary care clinics, was administered in 2010 and 2012. Participants were 320 PCPs from hospital- and community-based primary care practices in Pennsylvania, West Virginia, Delaware, New Jersey, New York, and Ohio. PCPs in community-based outpatient clinics reported an improvement in established processes for QI, and communication and cooperation from 2010 to 2012. However, their peers in hospital-based clinics did not report any significant improvements in QI culture. In both years, compared with high-complexity facilities, medium- and low-complexity facilities had better scores on the scales assessing established processes for QI, and communication and cooperation. © The Author(s) 2014.

  20. Academic Detailing with Provider Audit and Feedback Improve Prescribing Quality for Older Veterans.

    Science.gov (United States)

    Vandenberg, Ann E; Echt, Katharina V; Kemp, Lawanda; McGwin, Gerald; Perkins, Molly M; Mirk, Anna K

    2018-03-01

    Suboptimal prescribing persists as a driver of poor quality care of older veterans and is associated with risk of hospitalization and emergency department visits. We adapted a successful medication management model, Integrated Management and Polypharmacy Review of Vulnerable Elders (IMPROVE), from an urban geriatric specialty clinic to rural community-based clinics that deliver primary care. The goals were to promote prescribing quality and safety for older adults, including reduced prescribing of potentially inappropriate medications (PIMs). We augmented the original model, which involved a pharmacist-led, one-on-one medication review with high-risk older veterans, to provide rural primary care providers (PCPs) and pharmacists with educational outreach through academic detailing and tools to support safe geriatric prescribing practices, as well as individual audit and feedback on prescribing practice and confidential peer benchmarking. Twenty PCPs and 4 pharmacists at 4 rural Georgia community-based outpatient clinics participated. More than 7,000 older veterans were seen in more than 20,000 PCP encounters during the 14-month intervention period. Implementation of the IMPROVE intervention reduced PIM prescribing incidence from 9.6 new medications per 100 encounters during baseline to 8.7 after the intervention (P = .009). IMPROVE reduced PIM prevalence (proportion of encounters involving veterans who were taking at least 1 PIM) from 22.6% to 16.7% (P < .001). These approaches were effective in reducing PIMs prescribed to older veterans in a rural setting and constitute a feasible model for disseminating geriatric best practices to the primary care setting. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  1. A management framework for training providers to improve workplace skills development

    Directory of Open Access Journals (Sweden)

    C. Govender

    2007-12-01

    Full Text Available Purpose: Deputy President, Ms Phumzile Mlambo-Ngcuka, says a skills revolution is necessary for South Africa’s (SA skills crisis. The SA skills revolution began with the skills legislation of 1998-9 when the Departments of Labour (DOL and Education (DOE intended a seamless, integrated approach to rapid skills development. The National Skills Development Strategy (NSDS, the Sector Education and Training Providers (SETAs, the South African Qualifications Authorities (SAQA and the National Qualifications Framework (NQF were established to drive the human resource and skills development revolutionary strategy. The purpose of this paper is to present the findings of the 2001-3 research investigating an internal management framework for training providers, employers and managers to accelerate workplace skills development. Design/Methodology/Approach: An integrated, multi-method research model was employed to gather empirical evidence on skills practices. A robust quantitative survey was conducted within 600 organisations. Simultaneously, rich, descriptive data was gathered from managers and employees using a structured qualitative interview strategy. The integrated data pool was factor analysed. The research findings, conclusion and recommended framework were reported in a PhD thesis. Findings: The research findings reveal major gaps in the effectiveness of SA training providers to radically accelerate and improve workplace skills development as per national skills legislation, implementation and management criteria. Implications: If the skills revolution in SA is to succeed, training providers especially, must become less complacent, more assertive and fully equipped when participating in the skills development arena. Originality/Value: Via this research, training providers will gain critical, reflective insight into their management framework for meeting skills legislative criteria and for managing training interventions and skills projects.

  2. Improving Technical Vocational Education and Training in the Kurdistan Region--Iraq

    Science.gov (United States)

    Constant, Louay; Culbertson, Shelly; Stasz, Cathleen; Vernez, Georges

    2014-01-01

    As Iraq's Kurdistan region develops rapidly, it is creating jobs that require a solid education and technical skills. The government has launched an ambitious reform of basic and secondary education to increase its quality and has expanded opportunities for tertiary technical and university education. But expansion of secondary vocational…

  3. Satellite provided customer premise services: A forecast of potential domestic demand through the year 2000. Volume 2: Technical report

    Science.gov (United States)

    Kratochvil, D.; Bowyer, J.; Bhushan, C.; Steinnagel, K.; Al-Kinani, G.

    1983-08-01

    The potential United States domestic telecommunications demand for satellite provided customer premises voice, data and video services through the year 2000 were forecast, so that this information on service demand would be available to aid in NASA program planning. To accomplish this overall purpose the following objectives were achieved: development of a forecast of the total domestic telecommunications demand, identification of that portion of the telecommunications demand suitable for transmission by satellite systems, identification of that portion of the satellite market addressable by Computer premises services systems, identification of that portion of the satellite market addressabble by Ka-band CPS system, and postulation of a Ka-band CPS network on a nationwide and local level. The approach employed included the use of a variety of forecasting models, a market distribution model and a network optimization model. Forecasts were developed for; 1980, 1990, and 2000; voice, data and video services; terrestrial and satellite delivery modes; and C, Ku and Ka-bands.

  4. Economic Insights into Providing Access to Improved Groundwater Sources in Remote, Low-Resource Areas

    Science.gov (United States)

    Abramson, A.; Lazarovitch, N.; Adar, E.

    2013-12-01

    Groundwater is often the most or only feasible drinking water source in remote, low-resource areas. Yet the economics of its development have not been systematically outlined. We applied CBARWI (Cost-Benefit Analysis for Remote Water Improvements), a recently developed Decision Support System, to investigate the economic, physical and management factors related to the costs and benefits of non-networked groundwater supply in remote areas. Synthetic profiles of community water services (n = 17,962), defined across 14 parameters' values and ranges relevant to remote areas, were imputed into the decision framework, and the parameter effects on economic outcomes were investigated through regression analysis (Table 1). Several approaches were included for financing the improvements, after Abramson et al, 2011: willingness-to -pay (WTP), -borrow (WTB) and -work (WTW) in community irrigation (';water-for-work'). We found that low-cost groundwater development approaches are almost 7 times more cost-effective than conventional boreholes fitted with handpumps. The costs of electric, submersible borehole pumps are comparable only when providing expanded water supplies, and off-grid communities pay significantly more for such expansions. In our model, new source construction is less cost-effective than improvement of existing wells, but necessary for expanding access to isolated households. The financing approach significantly impacts the feasibility of demand-driven cost recovery; in our investigation, benefit exceeds cost in 16, 32 and 48% of water service configurations financed by WTP, WTB and WTW, respectively. Regressions of total cost (R2 = 0.723) and net benefit under WTW (R2 = 0.829) along with analysis of output distributions indicate that parameters determining the profitability of irrigation are different from those determining costs and other measures of net benefit. These findings suggest that the cost-benefit outcomes associated with groundwater-based water

  5. Improving Science and IT Literacy by Providing Urban-Based Environmental Science Research Opportunities

    Science.gov (United States)

    Cuff, K. E.; Corazza, L.; Liang, J.

    2007-12-01

    A U.C. Berkeley-based outreach program known as Environmental Science Information Technology Activities has been in operation over the past four years. The primary aim of the program is to provide opportunities for grades 9 and 10 students in diverse East San Francisco Bay Area communities to develop deeper understandings of the nature and conduct of science, which will increase their capacity to enroll and perform successfully in science, technology, engineering, and mathematics (STEM) courses in the future. Design of the program has been informed by recent research that indicates a close relationship between educational activities that promote the perception of STEM as being relevant and the ability to foster development of deeper conceptual understandings among teens. Accordingly, ESITA includes an important student-led environmental science research project component, which provides participants with opportunities to engage in research investigations that are directly linked to relevant, real-world environmental problems and issues facing their communities. Analysis of evidence gleaned from questionnaires, interviews with participants and specific assessment/evaluation instruments indicates that ESITA program activities, including after-school meetings, summer and school year research projects, and conference preparations and presentations has provided students with high-quality inquiry science experiences that increased their knowledge of STEM and IT concepts, as well as their understanding of the nature of the scientific enterprise. In addition, the program has achieved a high degree of success in that it has: enhanced participants' intellectual self-confidence with regard to STEM; developed deeper appreciation of how scientific research can contribute to the maintenance of healthy local environments; developed a greater interest in participating in STEM-related courses of study and after school programs; and improved attitudes toward STEM. Overall

  6. Expert advice provided through telemedicine improves healing of chronic wounds: prospective cluster controlled study.

    Science.gov (United States)

    Zarchi, Kian; Haugaard, Vibeke B; Dufour, Deirdre N; Jemec, Gregor B E

    2015-03-01

    Telemedicine is widely considered as an efficient approach to manage the growing problem of chronic wounds. However, to date, there is no convincing evidence to support the clinical efficacy of telemedicine in wound management. In this prospective cluster controlled study, we tested the hypothesis that advice on wound management provided by a team of wound-care specialists through telemedicine would significantly improve the likelihood of wound healing compared with the best available conventional practice. A total of 90 chronic wound patients in home care met all study criteria and were included: 50 in the telemedicine group and 40 in the conventional group. Patients with pressure ulcers, surgical wounds, and cancer wounds were excluded. During the 1-year follow-up, complete wound healing was achieved in 35 patients (70%) in the telemedicine group compared with 18 patients (45%) in the conventional group. After adjusting for important covariates, offering advice on wound management through telemedicine was associated with significantly increased healing compared with the best available conventional practice (telemedicine vs. conventional practice: adjusted hazard ratio 2.19; 95% confidence interval: 1.15-4.17; P=0.017). This study strongly supports the use of telemedicine to connect home-care nurses to a team of wound experts in order to improve the management of chronic wounds.

  7. [A web information system for enhancing management and improving special care services provided to dependent persons].

    Science.gov (United States)

    Alvarez-Bermejo, J A; Hernández-Capel, D M; Belmonte-Ureña, L J; Roca-Piera, J

    2009-01-01

    Ensuring the quality of services provided in centres where dependent persons are seen by specialist services, by improving and enhancing how information -salary, control of tasks, patients' records, etc.- is shared between staff and carers. A web information system has been developed and experimentally deployed to accomplish this. The accuracy of the system was evaluated by assessing how confident the employees were with it rather than relying on statistical data. It was experimentally deployed since January 2009 in Asociación de Personas con Discapacidad "El Saliente" that manages several day centres in Almeria, for dependent persons over 65 years old, particularly those affected by Alzheimer' disease. Incidence data was collected during the experimental period. A total of 84% of the employees thought that the system helped to manage documents, administrative duties, etc., and 92.4% said they could attend to really important tasks because the system was responsible for alerting them of every task, such as medication timetables, checking all patients were present (to prevent an Alzheimer affected person leaving the centre) etc. During this period the incidences reported were reduced by about a 30%, although data is still partially representative. As the life expectancy of the population gets longer, these centres will increase. Providing systems such as the one presented here would be of great help for administrative duties (sensitive data protection...) as well as ensuring high quality care and attention.

  8. Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures.

    Science.gov (United States)

    Obure, Carol Dayo; Jacobs, Rowena; Guinness, Lorna; Mayhew, Susannah; Vassall, Anna

    2016-02-01

    Theoretically, integration of vertically organized services is seen as an important approach to improving the efficiency of health service delivery. However, there is a dearth of evidence on the effect of integration on the technical efficiency of health service delivery. Furthermore, where technical efficiency has been assessed, there have been few attempts to incorporate quality measures within efficiency measurement models particularly in sub-Saharan African settings. This paper investigates the technical efficiency and the determinants of technical efficiency of integrated HIV and sexual and reproductive health (SRH) services using data collected from 40 health facilities in Kenya and Swaziland for 2008/2009 and 2010/2011. Incorporating a measure of quality, we estimate the technical efficiency of health facilities and explore the effect of integration and other environmental factors on technical efficiency using a two-stage semi-parametric double bootstrap approach. The empirical results reveal a high degree of inefficiency in the health facilities studied. The mean bias corrected technical efficiency scores taking quality into consideration varied between 22% and 65% depending on the data envelopment analysis (DEA) model specification. The number of additional HIV services in the maternal and child health unit, public ownership and facility type, have a positive and significant effect on technical efficiency. However, number of additional HIV and STI services provided in the same clinical room, proportion of clinical staff to overall staff, proportion of HIV services provided, and rural location had a negative and significant effect on technical efficiency. The low estimates of technical efficiency and mixed effects of the measures of integration on efficiency challenge the notion that integration of HIV and SRH services may substantially improve the technical efficiency of health facilities. The analysis of quality and efficiency as separate dimensions of

  9. Prototype design for a predictive model to improve evacuation operations : technical report.

    Science.gov (United States)

    2011-08-01

    Mass evacuations of the Texas Gulf Coast remain a difficult challenge. These events are massive in scale, : highly complex, and entail an intricate, ever-changing conglomeration of technical and jurisdictional issues. : This project focused primarily...

  10. Technical note: Improving modeling of coagulation, curd firming, and syneresis of sheep milk.

    Science.gov (United States)

    Cipolat-Gotet, Claudio; Pazzola, Michele; Ferragina, Alessandro; Cecchinato, Alessio; Dettori, Maria L; Vacca, Giuseppe M

    2018-04-18

    The importance of milk coagulation properties for milk processing, cheese yield, and quality is widely recognized. The use of traditional coagulation traits presents several limitations for testing bovine milk and even more for sheep milk, due to its rapid coagulation and curd firming, and early syneresis of coagulum. The aim of this technical note is to test and improve model fitting for assessing coagulation, curd firming, and syneresis of sheep milk. Using milk samples from 87 Sarda ewes, we performed in duplicate lactodynamographic testing. On each of the 174 analyzed milk aliquots, using 180 observations from each aliquot (one every 15 s for 45 min after rennet addition), we compared 4 different curd firming models as a function of time (CF t , mm) using a nonlinear procedure. The most accurate and informative results were observed using a modified 4-parameter model, structured as follows: [Formula: see text] , where t is time, RCT eq (min) is the gelation time, CF P (mm) is the potential asymptotical CF at an infinite time, k CF (%/min) is the curd firming rate constant, and k SR (%/min) is the curd syneresis rate constant. To avoid nonconvergence and computational problems due to interrelations among the equation parameters, CF P was preliminarily defined as a function of maximum observed curd firmness (CF max , mm) recorded during the analysis. For this model, all the modeling equations of individual sheep milk aliquots were converging, with a negligible standard error of the estimates (coefficient of determination >0.99 for all individual sample equations). Repeatability of the modeled parameters was acceptable, also in the presence of curd syneresis during the lactodynamographic analysis. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  11. Sodium oxybate therapy provides multidimensional improvement in fibromyalgia: results of an international phase 3 trial

    Science.gov (United States)

    Spaeth, Michael; Bennett, Robert M; Benson, Beverly A; Wang, Y Grace; Lai, Chinglin; Choy, Ernest H

    2012-01-01

    Background Fibromyalgia is characterised by chronic musculoskeletal pain and multiple symptoms including fatigue, multidimensional function impairment, sleep disturbance and tenderness. Along with pain and fatigue, non-restorative sleep is a core symptom of fibromyalgia. Sodium oxybate (SXB) is thought to reduce non-restorative sleep abnormalities. This study evaluated effects of SXB on fibromyalgia-related pain and other symptoms. Methods 573 patients with fibromyalgia according to 1990 American College of Rheumatology criteria were enrolled at 108 centres in eight countries. Subjects were randomly assigned to placebo, SXB 4.5 g/night or SXB 6 g/night. The primary efficacy endpoint was the proportion of subjects with ≥30% reduction in pain visual analogue scale from baseline to treatment end. Other efficacy assessments included function, sleep quality, effect of sleep on function, fatigue, tenderness, health-related quality of life and subject's impression of change in overall wellbeing. Results Significant improvements in pain, sleep and other symptoms associated with fibromyalgia were seen in SXB treated subjects compared with placebo. The proportion of subjects with ≥30% pain reduction was 42.0% for SXB4.5 g/night (p=0.002) and 51.4% for SXB6 g/night (pQuality of sleep (Jenkins sleep scale) improved by 20% for SXB4.5 g/night (p≤0.001) and 25% for SXB6 g/night (p≤0.001) versus 0.5% for placebo. Adverse events with an incidence ≥5% and twice placebo were nausea, dizziness, vomiting, insomnia, anxiety, somnolence, fatigue, muscle spasms and peripheral oedema. Conclusion These results, combined with findings from previous phase 2 and 3 studies, provide supportive evidence that SXB therapy affordsimportant benefits across multiple symptoms in subjects with fibromyalgia. PMID:22294641

  12. Contemporary management of median arcuate ligament syndrome provides early symptom improvement

    Science.gov (United States)

    Columbo, Jesse A.; Trus, Thadeus; Nolan, Brian; Goodney, Philip; Rzucidlo, Eva; Powell, Richard; Walsh, Daniel; Stone, David

    2017-01-01

    Objective Optimal diagnosis and management of median arcuate ligament (MAL) syndrome (MALS) remains unclear in contemporary practice. The advent and evolution of laparoscopic and endovascular techniques has redirected management toward a less invasive therapeutic algorithm. This study examined our contemporary outcomes of patients treated for MALS. Methods All patients treated for MALS at Dartmouth-Hitchcock Medical Center from 2000 to 2013 were retrospectively reviewed. Demographics and comorbidities were recorded. Freedom from symptoms and freedom from reintervention were the primary end points. Return to work or school was assessed. Follow-up by clinic visits and telephone allowed quantitative comparisons among the patients. Results During the study interval, 21 patients (24% male), with a median age of 42 years, were treated for MALS. All patients complained of abdominal pain in the presence of a celiac stenosis, 16 (76%) also reported weight loss at the time of presentation, and 57% had a concomitant psychiatric history. Diagnostic imaging most commonly used included duplex ultrasound (81%), computed tomography angiography (66%), angiography (57%), and magnetic resonance angiography (5%). Fourteen patients (67%) underwent multiple diagnostic studies. All patients underwent initial laparoscopic MAL release. Seven patients (33%) underwent subsequent celiac stent placement in the setting of recurrent or unresolved symptoms with persistent celiac stenosis at a mean interval of 49 days. Two patients required surgical bypass after an endovascular intervention failed. The 6-month freedom from symptoms was 75% and freedom from reintervention was 64%. Eighteen patients (81%) reported early symptom improvement and weight gain, and 66% were able to return to work. Conclusions A multidisciplinary treatment approach using initial laparoscopic release and subsequent stent placement and bypass surgery provides symptom improvement in most patients treated for MALS. The

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

    Science.gov (United States)

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

    2015-03-01

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

  14. Correction of technical bias in clinical microarray data improves concordance with known biological information

    DEFF Research Database (Denmark)

    Eklund, Aron Charles; Szallasi, Zoltan Imre

    2008-01-01

    The performance of gene expression microarrays has been well characterized using controlled reference samples, but the performance on clinical samples remains less clear. We identified sources of technical bias affecting many genes in concert, thus causing spurious correlations in clinical data...... sets and false associations between genes and clinical variables. We developed a method to correct for technical bias in clinical microarray data, which increased concordance with known biological relationships in multiple data sets....

  15. Education as a Basic Element of Improving Professional Important Qualities of Aviation Technical Maintenance Personnel

    Directory of Open Access Journals (Sweden)

    Gorbačovs Oļegs

    2016-12-01

    Full Text Available In this article the importance of professional qualities, competence and their increase, directly dependent on the training of aviation technical maintenance personnel and determination the level of flight safety is covered. This publication analyses necessary training and requirements for aviation technical personnel involved in aircraft maintenance, as well as the requirements for aviation training organizations, defined as per Part-147, for such personnel preparation and training.

  16. Spinal Cord Stimulation Provides Pain Relief with Improved Psychosocial Function: Results from EMP3OWER.

    Science.gov (United States)

    Rosenberg, Jason; Fabi, Alain; Candido, Kenneth; Knezevic, Nick; Creamer, Michael; Carayannopoulos, Alexios; Ghodsi, Abdi; Nelson, Christopher; Bennett, Matthew

    2016-12-01

    The EMP 3 OWER™ study evaluated spinal cord stimulation (SCS) safety and efficacy and the associated changes in psychosocial and functional outcomes. Upon informed consent and IRB approval, 620 eligible subjects were enrolled prior to SCS trial evaluation and were assessed at baseline, 3, 6 and 12 months post-implant. Patient-reported pain relief (PRP), numerical rating scale (NRS), satisfaction, quality of life (QOL), and pain disability index (PDI) were assessed at all follow-up visits while the pain catastrophizing scale (PCS), short form-36 (SF-36), short form-McGill pain questionnaire version 2 (SF-MPQ-2), and the state-trait anxiety inventory (STAI) were assessed at the 6- and 12-month follow-up visits. Device and/or procedure-related adverse events were also recorded and reported. Subjects reporting a PRP ≥ 50% were considered responders. Repeated measures analysis of variance (RMANOVA) examined the changes across time for all continuous measures. A total of 401 (71%) subjects received a permanent implant. Mean (±SD) patient-reported pain relief was 59.3% (±26.2), 59.2% (±28.9), and 58.2% (±32.0) at 3, 6, and 12 months, respectively. A majority of enrolled subjects were responders at 3 (75.5%), 6 (74.7%), and 12 months (69.7%). RMANOVA revealed a statistically significant change for NRS, PCS, PDI, SF-36, SF-MPQ-2, and STAI scores. At 3 months, the majority of subjects (85.7%) were either very satisfied or satisfied with their device, with similar results at 6 and 12 months. At 3 months, the majority of subjects (73.3%) reported greatly improved or improved QOL with similar results at 6 and 12 months. Spinal cord stimulation provided pain relief and significant improvement of patient psychological and functional outcome measures. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Improving the Technology of Obtaining Technical Ethanol from Alternative Raw Materials

    Directory of Open Access Journals (Sweden)

    Sergіj Petrov

    2018-05-01

    Full Text Available The purpose of the article is to study the properties of fallen leaves as raw materials for the production of bioethanol; Improvement of the technology of recycling cellulosic raw materials into bioethanol in the most energy-efficient and ecological way. As a result of the study, it has been found out that the production of biofuels from renewable raw materials is characterized by features of innovative technology: the rapid growth of this sector of economy is accompanied by a significant increase in market share. The use of fallen leaves as raw material will eliminate the current conflict of interests associated with the use of food raw materials for the production of bioethanol, will prevent the withdrawal of resources from the sphere of food production. Significant positive factors in the production and use of biofuels are improvement of environmental conditions, reduction of the harmful effects of exhaust gases on the human body, reducing environmental pollution and, consequently, reducing morbidity and associated costs of medical care. The use of bioethanol as an ecobiopilot makes it possible to increase the octane number of fuel, and, accordingly, increase the efficiency of the engine. Thus, the use of bioethanol leads to a qualitative improvement of technical and economic indicators, which is also an indicator of innovation. The threat of reducing (exhausting non-renewable sources of energy is also the factor that necessitates the development and improvement of biofuel production technology. The relatively low profitability of biofuel production is due to the low yield of the target product and the high cost of pre-treatment of cellulose raw materials. The method of obtaining bioethanol from renewable non-demanded raw materials - fallen leaves - was improved. The technique allows to increase the bioethanol yield due to more effective hydrolysis of hard-hydrolysable polysaccharides. Further development of the study of the differences in

  18. Feedback providing improvement strategies and reflection on feedback use: Effects on students' writing motivation, process, and performance

    NARCIS (Netherlands)

    Duijnhouwer, H.; Prins, F.J.; Stokking, K.M.

    2012-01-01

    This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students’ writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the

  19. Providing Quality Therapeutics in Switzerland: Role of the Stakeholders and Recent Incentives for Further Improvements.

    Science.gov (United States)

    Besson, Marie; Samer, Caroline; Rollason, Victoria; Dayer, Pierre; Desmeules, Jules

    2015-07-01

    Quality therapeutics play an important role in Switzerland's health care and economy. Switzerland holds a key position in the world of research and development, as well as in drug production. Recently, new emphasis has been placed on promoting clinical research and maintaining Switzerland's position as a center of excellence in the field. Recent revisions to the law regarding medical trials in human research allow for better allocation of regulatory resources and simplified procedures for drugs already authorized in Switzerland. The country has its own regulatory agency, the Swiss Agency for Therapeutic Products (Swissmedic), which is a public institution of the Swiss government. Swissmedic is responsible for ensuring safety in medicines, particularly regarding authorizations and market surveillance in the sector of medicinal products and medical devices. Although the centralized authorization procedure of the European Union for medicines does not apply to Switzerland, there are mutual recognition mechanisms between the Swiss medicine regulatory authority and the European Medicines Agency. Swissmedic is also in charge of postmarketing safety and oversees the national pharmacovigilance center, which collaborates closely with the World Health Organization center in Uppsala. In addition, university hospital-based clinical pharmacologists, who are involved in basic science and clinical research, regulatory affairs, ethics committees, and pharmacovigilance, promote quality therapeutics. This article discusses the role of the various stakeholders and the recent efforts made to provide a better allocation of resources aimed at further improving quality therapeutics in Switzerland. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  20. The Importance of Providing Multiple-Channel Sections in Dredging Activities to Improve Fish Habitat Environments

    Directory of Open Access Journals (Sweden)

    Hung-Pin Chiu

    2016-01-01

    Full Text Available After Typhoon Morakot, dredging engineering was conducted while taking the safety of humans and structures into consideration, but partial stream reaches were formed in the multiple-channel sections in Cishan Stream because of anthropogenic and natural influences. This study mainly explores the distribution of each fish species in both the multiple- and single-channel sections in the Cishan Stream. Parts of the environments did not exhibit significant differences according to a one-way ANOVA comparing the multiple- and single-channel sections, but certain areas of the multiple-channel sections had more diverse habitats. Each fish species was widely distributed by non-metric multidimensional scaling in the multiple-channel sections as compared to those in the single-channel sections. In addition, according to the principal component analysis, each fish species has a preferred environment, and all of them have a wide choice of habitat environments in the multiple-channel sections. Finally, the existence of multiple-channel sections could significantly affect the existence of the fish species under consideration in this study. However, no environmental factors were found to have an influence on fish species in the single-channel sections, with the exception of Rhinogobius nantaiensis. The results show that providing multiple-channel sections in dredging activities could improve fish habitat environments.

  1. Progress in improving provincial plans for nutrition through targeted technical assistance and local advocacy in Vietnam.

    Science.gov (United States)

    Harris, Jody; Nguyen, Phuong H; To, Quyen; Frongillo, Edward A; Menon, Purnima

    2016-12-01

    Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained insufficient. Awareness of and support for nutrition improved, but some policy and legal environments were contradictory. Objectives were clearer, but use of data for planning remained inconsistent. Provinces became more proactive and creative, but remained constrained by slow approval processes and insufficient funding. Targeted assistance and local advocacy can improve decentralized planning, with success dependent on policy and programming contexts and ability to overcome constraints around capacity, investment, data use and remnants of centralized planning. We recommend strong engagement with planners at the national level to understand how to unblock major constraints; solutions must take into consideration the particular political, financial and administrative context. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  2. Interprofessional Oral Health Education Improves Knowledge, Confidence, and Practice for Pediatric Healthcare Providers

    Directory of Open Access Journals (Sweden)

    Devon Cooper

    2017-08-01

    Full Text Available Dental caries is the most prevalent chronic childhood disease in the United States. Dental caries affects the health of 60–90% of school-aged children worldwide. The prevalence of untreated early childhood dental caries is 19% for children 2–5 years of age in the U.S. Some factors that contribute to the progression of dental caries include socioeconomic status, access to dental care, and lack of anticipatory guidance. The prevalence of dental caries remains highest for children from specific ethnic or racial groups, especially those living in underserved areas where there may be limited access to a dentist. Although researchers have acknowledged the various links between oral health and overall systemic health, oral health care is not usually a component of pediatric primary health care. To address this public health crisis and oral health disparity in children, new collaborative efforts among health professionals is critical for dental disease prevention and optimal oral health. This evaluation study focused on a 10-week interprofessional practice and education (IPE course on children’s oral health involving dental, osteopathic medical, and nurse practitioner students at the University of California, San Francisco. This study’s objective was to evaluate changes in knowledge, confidence, attitude, and clinical practice in children’s oral health of the students completed the course. Thirty-one students participated in the IPE and completed demographic questionnaires and four questionnaires before and after the IPE course: (1 course content knowledge, (2 confidence, (3 attitudes, and (4 clinical practice. Results showed a statistically significant improvement in the overall knowledge of children’s oral health topics, confidence in their ability to provide oral health services, and clinical practice. There was no statistically significant difference in attitude, but there was an upward trend toward positivity. To conclude, this IPE

  3. A Framework to Improve Communication and Reliability Between Cloud Consumer and Provider in the Cloud

    OpenAIRE

    Vivek Sridhar

    2014-01-01

    Cloud services consumers demand reliable methods for choosing appropriate cloud service provider for their requirements. Number of cloud consumer is increasing day by day and so cloud providers, hence requirement for a common platform for interacting between cloud provider and cloud consumer is also on the raise. This paper introduces Cloud Providers Market Platform Dashboard. This will act as not only just cloud provider discoverability but also provide timely report to consumer on cloud ser...

  4. Flue gas conditioning for improved particle collection in electrostatic precipitators. Quarterly technical report

    Energy Technology Data Exchange (ETDEWEB)

    Durham, M.D.

    1992-04-27

    The purpose of this research program is to identify and evaluate a variety of additives capable of increasing particle cohesion which could be used for improving collection efficiency in an ESP. A three-phase screening process will be used to provide the, evaluation of many additives in a logical and cost-effective manner. The three step approach involves the following experimental setups: 1. Provide a preliminary screening in the laboratory by measuring the effects of various conditioning agents on reentrainment of flyash particles in an electric field operating at simulated flue gas conditions. 2. Evaluate the successful additives using a 100 acfm bench-scale ESP operating on actual flue gas. 3. Obtain the data required for scaling up the technology by testing the two or three most promising conditioning agents at the pilot scale.

  5. Improving the performance of solar still by using nanofluids and providing vacuum

    International Nuclear Information System (INIS)

    Kabeel, A.E.; Omara, Z.M.; Essa, F.A.

    2014-01-01

    Highlights: • Modified solar still integrated with an external condenser and used nanofluids were studied. • The results obtained that using cuprous oxide increased the distilled productivity by 133.64%. • Using the aluminum oxide–water nanofluid increased the distillate productivity of the modified still by 125.0%. - Abstract: The experimental modifications were carried out into the conventional solar still, considerably increasing the distillate water productivity. The effects of using different types of nanomaterials on the performance of solar still were studied. The investigated solid nanoparticles are the cuprous and aluminum oxides. The performance was investigated at different weight fraction concentrations of nanoparticles in the basin water with and without providing vacuum. These additions and modifications greatly improve the evaporation and condensation rates and hence the distillate yield was augmented. The research was conducted for range of concentrations starting from 0.02% to 0.2% with a step of 0.02%. The maxima productivity was obtained for using the cuprous oxide nanoparticles with a concentration of 0.2% with operating the vacuum fan. The results obtained that using cuprous oxide nanoparticles increased the distilled productivity by 133.64% and 93.87% with and without the fan respectively. On the other hand, using aluminum oxide nanoparticles enhanced the distillate by 125.0% and 88.97% with and without the fan respectively as compared to the conventional still. The estimated cost of 1.0 l of distillate are approximately 0.035$, 0.045$ when using the cuprous oxide nanomaterial with and without the fan and, as well as the aluminum oxide nanoparticles, 0.038$ and 0.051$ respectively, and for the conventional still is 0.048$

  6. Technical specification use and application

    International Nuclear Information System (INIS)

    Williamson, D.; Hoffman, D.R.

    1991-01-01

    Since early 1988 intensive efforts have been under way to produce a new and improved Standard Technical Specification. The program involves a coordinated effort between utility personnel representing each of the four nuclear steam supply system (NSSS) product lines, the NSSS vendors, and the US Nuclear Regulatory Commission (NRC). This intensive work period is actually the culmination of a decade of rhetoric about shortcomings of the existing technical specifications. Work on the improved technical specifications provided a unique forum for intense philosophical discussions between the users and enforcers of technical specifications, the outcome of which could have an impact on all licensees. Some of the more intriguing difficulties in the use and application of existing technical specifications, as well as discussions of the resolutions being applied in the improved technical specifications and the dilemmas remaining to be resolved are discussed in the paper

  7. A technical system to improve the operational monitoring of the Zaporozh'ye nuclear power plant

    International Nuclear Information System (INIS)

    Beyer, M.; Carl, H.; Schumann, P.; Seidel, A.; Weiss, F.-P.; Zschau, J.; Nowak, K.

    1997-01-01

    As part of a programme of cooperation with Central and Eastern European states, a technical system has been established for the Zaporozhe nuclear power plant, which complements existing operational checking and monitoring facilities with modern means of information technology. It makes it possible to continuously monitor the state of the units in normal operation and in cases of anomalies or incidents. The parameters selected for monitoring are listed, and the system of automatic evaluation at the power plant site is described in detail. Test operation of the technical system started in late 1995 and the industrial testing phase in mid-1996. (A.K.)

  8. Development of improved iron Fischer-Tropsch catalysts. Final technical report: Project 6464

    Energy Technology Data Exchange (ETDEWEB)

    Bukur, D.B.; Ledakowicz, S.; Koranne, M. [Texas A and M Univ., College Station, TX (United States). Dept. of Chemical Engineering] [and others

    1994-02-28

    Despite the current worldwide oil glut, the United States will ultimately require large-scale production of liquid (transportation) fuels from coal. Slurry phase Fischer Tropsch (FT) technology, with its versatile product slate, may be expected to play a major role in production of transportation fuels via indirect coal liquefaction. Texas A&M University (TAMU) with sponsorship from the US Department of Energy, Center for Energy and Mineral Resources at TAMU, Texas Higher Education Coordinating Board, and Air Products and Chemicals, Inc., has been working on development of improved iron FT catalysts and characterization of hydrodynamic parameters in two- and three-phase bubble columns with FT derived waxes. Our previous studies have provided an improved understanding of the role of promoters (Cu and K), binders (silica) and pretreatment procedures on catalyst activity, selectivity and longevity (deactivation). The objective of the present contract was to develop improved catalysts with enhanced slurry phase activity and higher selectivity to liquid fuels and wax. This was accomplished through systematic studies of the effects of pretreatment procedures and variations in catalyst composition (promoters and binders). The major accomplishments and results in each of these two main areas of research are summarized here.

  9. Optimization and improvement of the technical specifications for Santa Maria de Garona and Cofrentes nuclear power plants

    International Nuclear Information System (INIS)

    Norte Gomez, M.D.; Alcantud, F.; Hoyo, C. del

    1993-01-01

    Technical Specifications (TS) form one of the basic documents necessary for licensing nuclear power plants and are required by the Government in accordance with Article 26 of the Regulation for Nuclear and Radioactive Facilities. They contain specific plant characteristics and operating limits to provide adequate protection for the safety and health of operators and the general public. For operator actuation, TS include all the surveillance requirements and limiting operating conditions (operation at full power, startup, hot and cold shutdown, and refueling outage) of safety-related systems. They also include the conventional support systems which are necessary to keep the plant in a safe operating conditioner to bring it to safe shutdown in the event of incidents or hypothetical accidents. Because of the large volume of information contained in the TS, the NRC and American utility owners began to simplify and improve the initial standard TS, which has given way to the development of a TS Optimization Program in the USA under the auspices of the NRC. Empresarios Agrupados has been contracted by the BWR Spanish Owners' Group (GPE-BWR) to develop optimized TS for the Santa Maria de Garona and Cofrentes Nuclear Power Plants. The optimized and improved TS are simplified versions of the current ones and facilitate the work of plant operators. They help to prevent risks, and reduce the number of potential transients caused by the large number of tests required by current TS. Plant operational safety is enhanced and higher effective operation is achieved. The GPE-BWR has submitted the first part of the optimized TS with their corresponding Bases to the Spanish Nuclear Council (CSN), for comment and subsequent approval. Once the TS are approved by the Spanish Nuclear Council, the operators of the Santa Maria de Garona and Cofrentes Nuclear Power Plants will be given a training and adaptation course prior to their implementation. (author)

  10. Global policy and programme guidance on maternal nutrition: what exists, the mechanisms for providing it, and how to improve them?

    Science.gov (United States)

    Shrimpton, Roger

    2012-07-01

    Undernutrition in one form or another affects the majority of women of reproductive age in most developing countries. However, there are few or no effective programmes trying to solve maternal undernutrition problems. The purpose of the paper is to examine global policy and programme guidance mechanisms for nutrition, what their content is with regard to maternal nutrition in particular, as well as how these might be improved. Almost all countries have committed themselves politically to ensuring the right of pregnant and lactating women to good nutrition through the Convention on the Elimination of all Forms of Discrimination Against Women. Despite this, the World Health Organization (WHO) has not endorsed any policy commitments with regard to maternal nutrition. The only policy guidance coming from the various technical departments of WHO relates to the control of maternal anaemia. There is no policy or programme guidance concerning issues of maternal thinness, weight gain during pregnancy and/or low birthweight prevention. Few if any countries have maternal nutrition programmes beyond those for maternal anaemia, and most of those are not effective. The lack of importance given to maternal nutrition is related in part to a weakness of evidence, related to the difficulty of getting ethical clearance, as well as a generalised tendency to downplay the importance of those interventions found to be efficacious. No priority has been given to implementing existing policy and programme guidance for the control of maternal anaemia largely because of a lack of any dedicated funding, linked to a lack of Millennium Development Goals indicator status. This is partly due to the poor evidence base, as well as to the common belief that maternal anaemia programmes were not effective, even if efficacious. The process of providing evidence-based policy and programme guidance to member states is currently being revamped and strengthened by the Department of Nutrition for Health and

  11. THE UNIFICATION OF THE CODE LISTS PROVIDED WITHIN THE DATA MODEL ORIGINATING FROM THE INSPIRE TECHNICAL GUIDELINES AND THE ONES PROVIDED FOR GESUT DATABASES IN THE CONTEXT OF POTENTIAL EXPLOITATION IN THE MINING INDUSTRY

    Directory of Open Access Journals (Sweden)

    Andrzej ZYGMUNIAK

    2016-07-01

    Full Text Available This study is aimed at exposing differences between two data models in case of code lists values provided there. The first of them is an obligatory one for managing Geodesic Register of Utility Networks databases in Poland [9] and the second is the model originating from the Technical Guidelines issued to the INSPIRE Directive. Since the second one mentioned is the basis for managing spatial databases among European parties, correlating these two data models has an effect in easing the way of harmonizing and, in consequence, exchanging spatial data. Therefore, the study presents the possibilities of increasing compatibility between the values of the code lists concerning attributes for objects provid-ed in both models. In practice, it could lead to an increase of the competitiveness of entities managing or processing such databases and to greater involvement in scientific or research projects when it comes to the mining industry. More-over, since utility networks located on mining areas are under particular protection, the ability of making them more fitted to their own needs will make it possible for mining plants to exchange spatial data in a more efficient way.

  12. Provider Profiling: A Population Health Improvement Tool for the Southeast Military Health System

    National Research Council Canada - National Science Library

    Pemberton, Phillip

    1999-01-01

    ...). Profiling with Provider Perspectives, a Primary Care Management Tool, provides the SEMHS with a standardized performance measurement system that offers feedback in a user friendly and non-threatening format...

  13. Input of Lithuanian science into nuclear safety improvement, coordination of technical support organizations

    International Nuclear Information System (INIS)

    Maksimovas, G.

    1999-01-01

    VATESI in its activities is very much supported by Lithuanian scientific and technical organizations which are doing expertise of safety analyses of Ignalina NPP. Description of these organizations is presented. Broad international cooperation and assistance programs is underway helping Lithuanians scientific organizations to build own capacity in making nuclear safety research

  14. 77 FR 36501 - Applications for New Awards: Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2012-06-19

    ... consumers on the Center's Web site, as required under paragraph (a)(1)(i) in the Technical Assistance and... components needed to support the use and sustainability of effective services and evidence-based..., guidance, implementation tools, and other materials at no cost to the consumer on: (A) Current...

  15. Providing Elementary Teachers in South Texas with Professional Development to Improve Earth Science Instruction

    Science.gov (United States)

    Borrego, H.; Ellins, K. K.

    2011-12-01

    Through three years of participation in the TeXas Earth and Space Science (TXESS) Revolution, an NSF-sponsored teacher professional development program, my knowledge of earth science, new pedagogical approaches, and confidence has improved dramatically. I have also received instructional materials and learned how to access high quality online resources and use a variety of web-based tools. In this session, I will share my experiences and report on how I used my own learning to help both teachers and students to become more earth science literate individuals. Earth Science test scores at the elementary level throughout South Texas are consistently low in comparison to other regions in the state. The majority of the teachers lack the content-knowledge, confidence, or experience to teach Earth Sciences. My TXESS Revolution experience helped me to understand the needs of these teachers and to identify teaching resources that would be useful to them. Particularly noteworthy are TERC's EarthLabs: Earth System Science and GLOBE activities. Although these Earthlab investigations are designed for high schools students, I demonstrated how they could be adapted for elementary students. As a result, I have provided professional development in the Earth Sciences to about 300 South Texas elementary teachers. TXESS Revolution has also equipped me to empower the students I teach. My students this past year presented their challenge Legacy Cycle Project to the community. The TXESS Revolution teamed up with the Texas Water Development Board to deliver training on the implementation of a new online challenged-based curriculum called the Water Exploration Legacy Cycles. This training gave me the tools to guide my students learning through authentic scientific research. To carry out their challenge, students researched an area of interest, read literature, consulted with experts in the field, consider different prospective, and presented their final products via PowerPoint, poster

  16. Evaluation and capacity building to improve precollege science and mathematics achievement in the US: 10 CFR, Part 605. Technical progress report, June--December 1992

    Energy Technology Data Exchange (ETDEWEB)

    1992-12-31

    The National Center for Improving Science Education has undertaken activities to achieve evaluation goals for DOE`s Precollege programs: develop means to determine program quality; develop means for determining the contribution of DOE precollege programs to both teacher enhancement and student achievement; provide evaluation designs and instruments and reports of program quality and impact; and strengthen both DOE`s and the Labs` capacity to do both short- and long-term planning as well as deliver effective programs and evaluation. Appendices include evaluation/technical assistance report, profiling teacher research participation and teacher development programs, teacher surveys, impact assessment design, and teacher research participation programs anecdotes for 8 labs.

  17. TECHNICAL AND ENERGY PARAMETERS IMPROVEMENT OF DIESEL LOCOMOTIVES THROUGH THE INTRODUCTION OF AUTOMATED CONTROL SYSTEMS OF A DIESEL

    Directory of Open Access Journals (Sweden)

    M. I. Kapitsa

    2015-04-01

    Full Text Available Purpose. Today the issue, connected with diesel traction remains relevant for the majority of industrial enterprises and Ukrainian railways and diesel engine continues to be the subject of extensive research and improvements. Despite the intensive process of electrification, which accompanies Railway Transport of Ukraine the last few years, diesel traction continues to play an important role both in the main and in the industrial railway traction rolling stock. Anyway, all kinds of maneuvering and chores are for locomotives, they are improved and upgraded relentlessly and hourly. This paper is focused on finding the opportunities to improve technical and energy parameters of diesels due to the development of modern control method of the fuel equipment in the diesel engine. Methodology. The proposed method increases the power of locomotives diesel engines in the range of crankshaft rotation (from idle running to maximum one. It was based on approach of mixture ignition timing up to the top «dead» center of piston position. Findings. The paper provides a brief historical background of research in the area of operating cycle in the internal combustion engine (ICE. The factors affecting the process of mixing and its quality were analyzed. The requirements for fuel feed system in to the cylinder and the «weak points» of the process were presented. A variant of the modification the fuel pump drive, which allows approaching to the regulation of fuel feed system from the other hand and to improve it was proposed. Represents a variant of embodiment of the complex system with specification of mechanical features and control circuits. The algorithm of the system operation was presented and its impact on the performance of diesel was made. Originality. The angle regulating system of fuel supply allows automating the process of fuel injection advance angle into the cylinder. Practical value. At implementation the angle regulating system of fuel supply

  18. E-KIT: An Electronic-Knowledge Information Tool for Organizing Site Information and Improving Technical Communication with Stakeholders - 13082

    International Nuclear Information System (INIS)

    Kautsky, Mark; Findlay, Richard C.; Hodges, Rex A.

    2013-01-01

    Managing technical references for projects that have long histories is hampered by the large collection of documents, each of which might contain discrete pieces of information relevant to the site conceptual model. A database application has been designed to improve the efficiency of retrieving technical information for a project. Although many databases are currently used for accessing analytical and geo-referenced data, applications designed specifically to manage technical reference material for projects are scarce. Retrieving site data from the array of available references becomes an increasingly inefficient use of labor. The electronic-Knowledge Information Tool (e-KIT) is designed as a project-level resource to access and communicate technical information. The e-KIT is a living tool that grows as new information becomes available, and its value to the project increases as the volume of site information increases. Having all references assembled in one location with complete reference citations and links to elements of the site conceptual model offers a way to enhance communication with outside groups. The published and unpublished references are incorporated into the e-KIT, while the compendium of references serves as a complete bibliography for the project. (authors)

  19. E-KIT: An Electronic-Knowledge Information Tool for Organizing Site Information and Improving Technical Communication with Stakeholders - 13082

    Energy Technology Data Exchange (ETDEWEB)

    Kautsky, Mark [U.S. Department of Energy Office of Legacy Management, 2597 Legacy Way, Grand Junction CO 81503 (United States); Findlay, Richard C.; Hodges, Rex A. [Stoller LMS Team, 2597 Legacy Way, Grand Junction CO 81503 (United States)

    2013-07-01

    Managing technical references for projects that have long histories is hampered by the large collection of documents, each of which might contain discrete pieces of information relevant to the site conceptual model. A database application has been designed to improve the efficiency of retrieving technical information for a project. Although many databases are currently used for accessing analytical and geo-referenced data, applications designed specifically to manage technical reference material for projects are scarce. Retrieving site data from the array of available references becomes an increasingly inefficient use of labor. The electronic-Knowledge Information Tool (e-KIT) is designed as a project-level resource to access and communicate technical information. The e-KIT is a living tool that grows as new information becomes available, and its value to the project increases as the volume of site information increases. Having all references assembled in one location with complete reference citations and links to elements of the site conceptual model offers a way to enhance communication with outside groups. The published and unpublished references are incorporated into the e-KIT, while the compendium of references serves as a complete bibliography for the project. (authors)

  20. THE USE OF TECHNICAL KNOWLEDGE AS DIRECTED TO THE IMPROVEMENT OF EVOLUTIONARY PROCESSES AND DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Liane Mahlmann Kipper

    2013-07-01

    Full Text Available In the current scenario of organizations Process Management aims to perform process in an organized, prioritizing actions through techniques and methods that are linked to the improvement of the organization in the market segment it operates. As a determinant for achieving goals successfully, organizational memory is all important in the management of processes, allowing all areas meet in a systemic way, crediting their information to the various organizational sectors and thus using knowledge to direct an action with a focus planning to achieve strategic organizational goal. The organizational memory can be registered through the development of a knowledge base. The work in question aims to provide a better understanding of the importance of the knowledge base in an organization, to perform appropriate actions, planning, simulating and reaching a decision through meaningful data. Soon after the development of a bibliographic research, a bibliometric study on the proposed topic was accomplished with the main events of the Brazilian scientific areas of production engineering, analyzing how the topic has been addressed by authors in the areas of Process Management and Base Knowledge. The main results so far observed the need for the implementation of knowledge-based models in systems that seek to improve the execution of processes and thus reduce failures and decision-making processes more appropriate.

  1. A Process Improvement Evaluation of Sequential Compression Device Compliance and Effects of Provider Intervention.

    Science.gov (United States)

    Beachler, Jason A; Krueger, Chad A; Johnson, Anthony E

    This process improvement study sought to evaluate the compliance in orthopaedic patients with sequential compression devices and to monitor any improvement in compliance following an educational intervention. All non-intensive care unit orthopaedic primary patients were evaluated at random times and their compliance with sequential compression devices was monitored and recorded. Following a 2-week period of data collection, an educational flyer was displayed in every patient's room and nursing staff held an in-service training event focusing on the importance of sequential compression device use in the surgical patient. Patients were then monitored, again at random, and compliance was recorded. With the addition of a simple flyer and a single in-service on the importance of mechanical compression in the surgical patient, a significant improvement in compliance was documented at the authors' institution from 28% to 59% (p < .0001).

  2. Providing Transthoracic Echocardiography Training for Intensive Care Unit Trainees: An Educational Improvement Initiative.

    Science.gov (United States)

    Kuza, Catherine M; Hanifi, M Tariq; Koç, Melissa; Stopfkuchen-Evans, Matthias

    2018-04-09

    Transthoracic echocardiography (TTE) is important in the management of critically ill patients, yet it has not been incorporated into many residency programs' curricula. Our objective is to determine if trainees undergoing a 60-minute training session on TTE have improved knowledge, ultrasound skills, and increases the utilization of TTE during their rotation in the intensive care unit (ICU). We will also compare the results of participants with prior TTE exposure to TTE-naïve trainees. Our hypothesis is that after the training, participants' will have improved knowledge and ultrasound skills compared to before training. Our secondary hypotheses are that TTE-naïve trainees will have greater improvements in knowledge scores compared to those who have had prior TTE experience and trainees will increase their use of TTE in the ICU. Single-center, prospective trial. Brigham and Women's Hospital (academic hospital). Residents and fellows rotating through the ICU, at any level of postgraduate training. Forty-two trainees participated in the study. Statistically significant improvement after training was observed for all multiple choice questions (MCQ) and practical assessments (p < 0.001). When assessing the differences in score improvement between TTE-experienced versus TTE-naïve users, mean score improvements were notably higher for TTE-naïve participants (MCQ: 28.2 ± 11.6; echo clinical: 48.6 ± 23.4) compared to TTE-experienced users (MCQ: 18.6 ± 13.5, p = 0.01; echo clinical: 38.3 ± 30.2, p = 0.04). A short didactic presentation on TTE use may be useful in teaching ICU trainees basic TTE skills and encouraging the use of bedside TTE in the ICU. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. The Efficacy of Private Sector Providers in Improving Public Educational Outcomes

    Science.gov (United States)

    Heinrich, Carolyn J.; Nisar, Hiren

    2013-01-01

    School districts required under No Child Left Behind (NCLB) to provide supplemental educational services (SES) to students in schools that are not making adequate yearly progress rely heavily on the private sector to offer choice in services. If the market does not drive out ineffective providers, students may not gain through SES participation.…

  4. A program to improve educational qualifications of reactor site technical personnel

    International Nuclear Information System (INIS)

    Christenson, J.M.; Eckart, L.E.

    1982-01-01

    The authors describe the planning and execution of a program that meets all of the Institute for Nuclear Power Operations (INPO) recommendations and Nuclear Regulatory Commission (NRC) requirements for Shift Technical Advisor (STA) education. They recall and comment these recommendations and requirements, the classification categories of the prospective candidates, indicate the courses proposed by the education program, comment the implementation of the STA program plan

  5. Improved Understanding of In Situ Chemical Oxidation. Technical Objective I: Contaminant Oxidation Kinetics Contaminant Oxidation Kinetics

    Science.gov (United States)

    2009-05-01

    methyl tert butyl ether NAPL non-aqueous phase liquid NOD natural oxidant demand •OH hydroxide radical Ox oxidant O3 ozone PCE...and persulfate; and Technical Objective 2, assess how soil properties (e.g., soil mineralogy , natural carbon content) affect oxidant mobility and...to develop a general description of kobs vs. T because there are many reactions that can contribute to the concentration of the reactive intermediate

  6. Rubisco catalytic properties of wild and domesticated relatives provide scope for improving wheat photosynthesis.

    Science.gov (United States)

    Prins, Anneke; Orr, Douglas J; Andralojc, P John; Reynolds, Matthew P; Carmo-Silva, Elizabete; Parry, Martin A J

    2016-03-01

    Rubisco is a major target for improving crop photosynthesis and yield, yet natural diversity in catalytic properties of this enzyme is poorly understood. Rubisco from 25 genotypes of the Triticeae tribe, including wild relatives of bread wheat (Triticum aestivum), were surveyed to identify superior enzymes for improving photosynthesis in this crop. In vitro Rubisco carboxylation velocity (V c), Michaelis-Menten constants for CO2 (K c) and O2 (K o) and specificity factor (S c/o) were measured at 25 and 35 °C. V c and K c correlated positively, while V c and S c/o were inversely related. Rubisco large subunit genes (rbcL) were sequenced, and predicted corresponding amino acid differences analysed in relation to the corresponding catalytic properties. The effect of replacing native wheat Rubisco with counterparts from closely related species was analysed by modelling the response of photosynthesis to varying CO2 concentrations. The model predicted that two Rubisco enzymes would increase photosynthetic performance at 25 °C while only one of these also increased photosynthesis at 35 °C. Thus, under otherwise identical conditions, catalytic variation in the Rubiscos analysed is predicted to improve photosynthetic rates at physiological CO2 concentrations. Naturally occurring Rubiscos with superior properties amongst the Triticeae tribe can be exploited to improve wheat photosynthesis and crop productivity. © The Author 2016. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  7. Providing Students with Interdisciplinary Support to Improve Their Organic Chemistry Posters

    Science.gov (United States)

    Widanski, Bozena; Thompson, Jo Ann; Foran-Mulcahy, Katie; Abafo, Amy

    2016-01-01

    A two-semester-long interdisciplinary support effort to improve student posters in organic chemistry lab is described. In the first semester, students' literature search report is supported by a workshop conducted by an Instruction Librarian. During the subsequent semester, a second workshop is presented by the Instruction Librarian, an English…

  8. Partnership working and improved service delivery: views of staff providing sexual health services.

    Science.gov (United States)

    Pow, Janette; Elliott, Lawrie; Raeside, Robert; Themessl-Huber, Markus; Claveirole, Anne

    2013-07-01

    Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provision, however, is lacking. Our aim was to assess the views of staff as to the conditions required for partnership working. This study was a cross-sectional survey of 687 staff offering sexual health education, information or support to young people in the Healthy Respect intervention area in Scotland. Views of each variable were scored and structural equation modelling was used to assess the theoretical model. Responses were received from 284 (41%) staff. Greater strength of partnership was directly associated with increasing the number of referrals. Establishing professional roles between organizations was also associated with increasing the number of referrals. Strength of partnership was indirectly associated with working more effectively with young people and this relationship depended on clear communication, trust, established professional roles and shared resources. Effective partnership working depends on a number of interdependent relationships between organizations, which act synergistically to improve organizational outcomes. Effective partnership working leads to improved service delivery though there is a need for better controlled studies which demonstrate the effect on health outcomes.

  9. Quality of provided care in vascular surgery : outcome assessment & improvement strategies

    NARCIS (Netherlands)

    Flu, Hans Christiaan

    2010-01-01

    The aim of this thesis was to evaluate the quality of care in vascular surgery in end-stage renal disease (ESRD) and peripheral arterial occlusive disease (PAOD): intermittent claudication (IC) and critical lower limb ischaemia (CLI) patients. Therefore firstly it focused on the improvement of the

  10. Improving participation rates by providing choice of participation mode: two randomized controlled trials

    NARCIS (Netherlands)

    Heijmans, N.; Lieshout, J. van; Wensing, M.J.

    2015-01-01

    BACKGROUND: Low participation rates reduce effective sample size, statistical power and can increase risk for selection bias. Previous research suggests that offering choice of participation mode can improve participation rates. However, few head-to-head trials compared choice of participation mode

  11. Provider-Initiated Patient Satisfaction Reporting Yields Improved Physician Ratings Relative to Online Rating Websites.

    Science.gov (United States)

    Ricciardi, Benjamin F; Waddell, Brad S; Nodzo, Scott R; Lange, Jeffrey; Nocon, Allina A; Amundsen, Spencer; Tarity, T David; McLawhorn, Alexander S

    2017-09-01

    Recently, providers have begun to publicly report the results of patient satisfaction surveys from their practices. However, these outcomes have never been compared with the findings of commercial online physician rating websites. The goals of the current study were to (1) compare overall patient satisfaction ratings for orthopedic surgeons derived from provider-based third-party surveys with existing commercial physician rating websites and (2) determine the association between patient ratings and provider characteristics. The authors identified 12 institutions that provided publicly available patient satisfaction outcomes derived from third-party surveys for their orthopedic surgeons as of August 2016. Orthopedic surgeons at these institutions were eligible for inclusion (N=340 surgeons). Provider characteristics were recorded from publicly available data. Four high-traffic commercial online physician rating websites were identified: Healthgrades.com, UCompareHealthCare.com, Vitals.com, and RateMDs.com. For each surgeon, overall ratings (on a scale of 1-5), total number of ratings, and percentage of negative ratings were compared between provider-initiated internal ratings and each commercial online website. Associations between baseline factors and overall physician ratings and negative ratings were assessed. Provider-initiated internal patient satisfaction ratings showed a greater number of overall patient ratings, higher overall patient satisfaction ratings, and a lower percentage of negative comments compared with commercial online physician rating websites. A greater number of years in practice had a weak association with lower internal ratings, and an academic practice setting and a location in the Northeast were protective factors for negative physician ratings. Compared with commercial online physician rating websites, provider-initiated patient satisfaction ratings of orthopedic surgeons appear to be more favorable, with greater numbers of responses

  12. Provide a model to improve the performance of intrusion detection systems in the cloud

    OpenAIRE

    Foroogh Sedighi

    2016-01-01

    High availability of tools and service providers in cloud computing and the fact that cloud computing services are provided by internet and deal with public, have caused important challenges for new computing model. Cloud computing faces problems and challenges such as user privacy, data security, data ownership, availability of services, and recovery after breaking down, performance, scalability, programmability. So far, many different methods are presented for detection of intrusion in clou...

  13. Improved Management of the Technical Interfaces Between the Hanford Tank Farm Operator and the Hanford Waste Treatment Plant - 13383

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, Garth M. [Bechtel National Inc., 2435 Stevens Center Place, Richland, Washington, 99352 (United States); Saunders, Scott A. [Washington River Protection Solutions, P.O. Box 850, Richland, Washington, 99352 (United States)

    2013-07-01

    2010-2; - Development of a set of alternatives to the current baseline that involve aspects of direct feed, feed conditioning, and design changes. The One System Technical Organization has served WTP, TOC, and DOE well in managing and resolving issues at the interface. This paper describes the organizational structure used to improve the interface and several examples of technical interface issues that have been successfully addressed by the new organization. (authors)

  14. Improved Management of the Technical Interfaces Between the Hanford Tank Farm Operator and the Hanford Waste Treatment Plant - 13383

    International Nuclear Information System (INIS)

    Duncan, Garth M.; Saunders, Scott A.

    2013-01-01

    2010-2; - Development of a set of alternatives to the current baseline that involve aspects of direct feed, feed conditioning, and design changes. The One System Technical Organization has served WTP, TOC, and DOE well in managing and resolving issues at the interface. This paper describes the organizational structure used to improve the interface and several examples of technical interface issues that have been successfully addressed by the new organization. (authors)

  15. Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers.

    Science.gov (United States)

    Boas, Samuel J; Bishop, Tara F; Ryan, Andrew M; Shih, Sarah C; Casalino, Lawrence P

    2014-07-01

    In 2009, the American Recovery and Reinvestment Act apportioned $643 million for a Health Information Technology Extension Program, which established Regional Extension Centers (RECs) to support the implementation and use of electronic health records (EHRs). Little is known, however, about how RECs should assist in EHR implementation and how they should structure ongoing support. The purpose of this paper is to describe physicians' experiences with the Primary Care Information Project (PCIP), an REC run by the New York City Department of Health and Mental Hygiene. We interviewed 17 physicians enrolled in PCIP to understand the role of the EHRon quality of care and their experience with technical assistance from PCIP. All physicians stated that they felt that the EHR improved the quality of care they delivered to their patients particularly because it helped them track patients. All the physicians found technical assistance helpful but most wanted ongoing assistance months or years after they adopted the EHR. © 2013 Published by Elsevier Inc.

  16. Job satisfaction and career commitment among Alzheimer's care providers: addressing turnover and improving staff empowerment.

    Science.gov (United States)

    Coogle, Constance L; Parham, Iris A; Rachel, Colleen A

    2011-11-01

    This study investigated the relation between job satisfaction and career commitment among 262 Alzheimer's care staff working in long-term and community-based care settings. It was anticipated that the results would suggest whether career commitment could be enhanced to positively influence job satisfaction, and conversely, if improvements in job satisfaction might contribute to a deepened sense of vocational empowerment. Participants attended dementia-specific training and completed 2 short work-related questionnaires that measured job satisfaction and career commitment. The results of stepwise regression revealed interrelations between the 2 constructs. Congruence appeared to be reciprocal with respect to the overall scale scores and the intrinsic job satisfaction measure. Unexpected relations appeared in analyses of the extrinsic job satisfaction measure and the career planning subscale. Results are indicative of the fundamental distinction between job satisfaction and career commitment. Implications for efforts to reduce turnover and improve staff empowerment are also considered.

  17. Non-ablative fractional laser provides long-term improvement of mature burn scars

    DEFF Research Database (Denmark)

    Taudorf, Elisabeth H; Danielsen, Patricia L; Paulsen, Ida F

    2015-01-01

    BACKGROUND AND OBJECTIVES: Non-ablative fractional laser-treatment is evolving for burn scars. The objective of this study was to evaluate clinical and histological long-term outcome of 1,540 nm fractional Erbium: Glass laser, targeting superficial, and deep components of mature burn scars....... MATERIALS & METHODS: Side-by-side scar-areas were randomized to untreated control or three monthly non-ablative fractional laser-treatments using superficial and extra-deep handpieces. Patient follow-up were at 1, 3, and 6 months. Primary outcome was improvement in overall scar-appearance on a modified...... of scar-appearance. CONCLUSIONS: Combined superficial and deep non-ablative fractional laser-treatments induce long-term clinical and histological improvement of mature burn scars....

  18. The improving of the heat networks operating process under the conditions of the energy efficiency providing

    Directory of Open Access Journals (Sweden)

    Blinova Tatiana

    2016-01-01

    Full Text Available Among the priorities it is important to highlight the modernization and improvement of energy efficiency of housing and communal services, as well as the transition to the principle of using the most efficient technologies used in reproduction (construction, creation of objects of municipal infrastructure and housing modernization. The main hypothesis of this study lies in the fact that in modern conditions the realization of the most important priorities of the state policy in the sphere of housing and communal services, is possible in the conditions of use of the most effective control technologies for the reproduction of thermal networks. It is possible to raise the level of information security Heat Distribution Company, and other market participants by improving business processes through the development of organizational and economic mechanism in the conditions of complex monitoring of heat network operation processes

  19. Completion plug design provides improved operational efficiency and safety while minimizing environmental risks

    Energy Technology Data Exchange (ETDEWEB)

    Dum, Frank [T.D. Williamson, Inc., Tulsa, OK (United States)

    2012-07-01

    Pipeline repair standards have been raised with recent improvements for completion plugs when used with a brand new setting tool, resulting in lower environmental risks, improved operational efficiency and safety. The design changes were originally made to serve in an offshore environment in order to minimize the diver's time in the water and simplify steps by the diver to execute pipeline repair operations in cold, dark conditions. Enhancements in the design include fewer number of fittings, plugs, o-rings and gaskets isolating the pipeline product found inside the pipe. The new design is a step toward meeting strict operational and safety standards demanded in the field of pipeline maintenance and repair. (author)

  20. A novel class of laboratory middleware. Promoting information flow and improving computerized provider order entry.

    Science.gov (United States)

    Grisson, Ricky; Kim, Ji Yeon; Brodsky, Victor; Kamis, Irina K; Singh, Balaji; Belkziz, Sidi M; Batra, Shalini; Myers, Harold J; Demyanov, Alexander; Dighe, Anand S

    2010-06-01

    A central duty of the laboratory is to inform clinicians about the availability and usefulness of laboratory testing. In this report, we describe a new class of laboratory middleware that connects the traditional clinical laboratory information system with the rest of the enterprise, facilitating information flow about testing services. We demonstrate the value of this approach in efficiently supporting an inpatient order entry application. We also show that order entry monitoring and iterative middleware updates can enhance ordering efficiency and promote improved ordering practices. Furthermore, we demonstrate the value of algorithmic approaches to improve the accuracy and completeness of laboratory test searches. We conclude with a discussion of design recommendations for middleware applications and discuss the potential role of middleware as a sharable, centralized repository of laboratory test information.

  1. Applying BI Techniques To Improve Decision Making And Provide Knowledge Based Management

    Directory of Open Access Journals (Sweden)

    Alexandra Maria Ioana FLOREA

    2015-07-01

    Full Text Available The paper focuses on BI techniques and especially data mining algorithms that can support and improve the decision making process, with applications within the financial sector. We consider the data mining techniques to be more efficient and thus we applied several techniques, supervised and unsupervised learning algorithms The case study in which these algorithms have been implemented regards the activity of a banking institution, with focus on the management of lending activities.

  2. Improving Deployment-Related Primary Care Provider Assessments of PTSD and Mental Health Conditions

    Science.gov (United States)

    2011-10-01

    Eich, P., Kiss , A., & Wossmer, B. (1998). Improving communication skills--a randomized controlled behaviorally oriented intervention study for...cases this misconduct was drug-related (Highfill-McRoy, Larson, Booth - Kewley, and Garland 2010).  Both experiencing trauma (i.e. being wounded...their data (Highfill-McRoy, Larson, Booth -Kewley, and Garland 2010). o In an article that reviewed 29 other studies on PTSD found that studies with the

  3. How do I provide leukapheresis products? Blood center experience and evidence for process improvement.

    Science.gov (United States)

    Ginzburg, Yelena; Kessler, Debra; Narici, Manlio; Caltabiano, Melinda; Rebosa, Mark; Strauss, Donna; Shaz, Beth

    2013-10-01

    The past few decades have seen a resurgence of interest in leukapheresis products to improve the survival of infected patients with neutropenia. These products have a short shelf life and require donor stimulation with dexamethasone before collection. Additionally, a system with good communications and logistical support is essential. A recent survey of blood centers in North America revealed that the majority of centers collecting leukapheresis products use steroid-stimulated donors. The survey results suggested that an analysis of the process and potential process improvement would be of interest to the transfusion medicine community. Data from 2008 to 2011 regarding donor selection, donor dexamethasone stimulation, leukapheresis collection, and correlations between potentially pertinent variables for process improvement were analyzed. Results from an analysis of cost are also included. We evaluate 432 leukapheresis donations and demonstrate correlations between 1) pre- and poststimulation white blood cell (WBC) count (pproduct granulocyte yield (pimprovement in granulocyte quality and yield can be accomplished in dexamethasone-stimulated donors, by selecting eligible donors with relatively high normal prestimulation WBC counts and/or previously good responses to dexamethasone, increasing the duration between dexamethasone stimulation and granulocyte collection, and maintaining optimal hematocrit (5%-10%) in granulocyte collections. Because the majority of surveyed blood centers collecting stimulated granulocytes use steroids alone, modifications presented here may prove useful. Further assessment of correlation between granulocyte yield and clinical outcome will await results of additional studies. © 2012 American Association of Blood Banks.

  4. An improved mixing model providing joint statistics of scalar and scalar dissipation

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, Daniel W. [Department of Energy Resources Engineering, Stanford University, Stanford, CA (United States); Jenny, Patrick [Institute of Fluid Dynamics, ETH Zurich (Switzerland)

    2008-11-15

    For the calculation of nonpremixed turbulent flames with thin reaction zones the joint probability density function (PDF) of the mixture fraction and its dissipation rate plays an important role. The corresponding PDF transport equation involves a mixing model for the closure of the molecular mixing term. Here, the parameterized scalar profile (PSP) mixing model is extended to provide the required joint statistics. Model predictions are validated using direct numerical simulation (DNS) data of a passive scalar mixing in a statistically homogeneous turbulent flow. Comparisons between the DNS and the model predictions are provided, which involve different initial scalar-field lengthscales. (author)

  5. The cost-effectiveness of using financial incentives to improve provider quality: a framework and application

    DEFF Research Database (Denmark)

    Meacock, R.; Kristensen, Søren Rud; Sutton, M.

    2014-01-01

    Despite growing adoption of pay-for-performance (P4P) programmes in health care, there is remarkably little evidence on the cost-effectiveness of such schemes. We review the limited number of previous studies and critique the frameworks adopted and the narrow range of costs and outcomes considered......, and whether performance improvement is a transitory or investment activity. Our application to the Advancing Quality initiative demonstrates that the incentive payments represented less than half of the 13m pound total programme costs. By generating approximately 5200 quality-adjusted life years and 4.4m...

  6. Technical Support Essentials Advice to Succeed in Technical Support

    CERN Document Server

    Sanchez, Andrew

    2010-01-01

    Technical Support Essentials is a book about the many facets of technical support. It attempts to provide a wide array of topics to serve as points of improvement, discussion, or simply topics that you might want to learn. The topics range from good work habits to the way technical supportgroups establish their own style of work. This book applies theories, models, and concepts synthesized from existing research in other fields-such as management, economics, leadership, and psychology-and connects them to technical support. The goal is to build on the work of others and allow their success to

  7. Use of experience for the improvement of technical specifications for operation

    International Nuclear Information System (INIS)

    Schweitz, J.P.; Seveon, J.J.

    1987-11-01

    The lessons drawn from experience led EdF to define in 1980 a national specification standard, to be applied to the first standardized series of 900 MWe units and to be adapted to the later 1300 MWe units. This document is periodically revised, every two years or so, to take into account new trends in safety thinking and lessons learnt from operating experience. In this paper we present the main developments in the field of technical specifications, particularly: the definition of rules applicable in the event of unavailability of safety-related equipment, the integration of plant unit operating feedback for specifications optimization

  8. Improved Ribosome-Footprint and mRNA Measurements Provide Insights into Dynamics and Regulation of Yeast Translation

    Science.gov (United States)

    2016-02-11

    unlimited. Improved Ribosome-Footprint and mRNA Measurements Provide Insights into Dynamics and Regulation of Yeast Translation The views, opinions and...into Dynamics and Regulation of Yeast Translation Report Title Ribosome-footprint profiling provides genome-wide snapshots of translation, but...tend to slow translation. With the improved mRNA measurements, the variation attributable to translational control in exponentially growing yeast was

  9. Editorial: Advances in healthcare provider and patient training to improve the quality and safety of patient care

    OpenAIRE

    Elizabeth M. Borycki

    2015-01-01

    This special issue of the Knowledge Management & E-Learning: An International Journal is dedicated to describing “Advances in Healthcare Provider and Patient Training to Improve the Quality and Safety of Patient Care.” Patient safety is an important and fundamental requirement of ensuring the quality of patient care. Training and education has been identified as a key to improving healthcare provider patient safety competencies especially when working with new technologies such as electronic ...

  10. Feedback Providing Improvement Strategies and Reflection on Feedback Use: Effects on Students' Writing Motivation, Process, and Performance

    Science.gov (United States)

    Duijnhouwer, Hendrien; Prins, Frans J.; Stokking, Karel M.

    2012-01-01

    This study investigated the effects of feedback providing improvement strategies and a reflection assignment on students' writing motivation, process, and performance. Students in the experimental feedback condition (n = 41) received feedback including improvement strategies, whereas students in the control feedback condition (n = 41) received…

  11. BioTapestry now provides a web application and improved drawing and layout tools.

    Science.gov (United States)

    Paquette, Suzanne M; Leinonen, Kalle; Longabaugh, William J R

    2016-01-01

    Gene regulatory networks (GRNs) control embryonic development, and to understand this process in depth, researchers need to have a detailed understanding of both the network architecture and its dynamic evolution over time and space. Interactive visualization tools better enable researchers to conceptualize, understand, and share GRN models. BioTapestry is an established application designed to fill this role, and recent enhancements released in Versions 6 and 7 have targeted two major facets of the program. First, we introduced significant improvements for network drawing and automatic layout that have now made it much easier for the user to create larger, more organized network drawings. Second, we revised the program architecture so it could continue to support the current Java desktop Editor program, while introducing a new BioTapestry GRN Viewer that runs as a JavaScript web application in a browser. We have deployed a number of GRN models using this new web application. These improvements will ensure that BioTapestry remains viable as a research tool in the face of the continuing evolution of web technologies, and as our understanding of GRN models grows.

  12. Redesigning geriatric healthcare: how cross-functional teams and process improvement provide a competitive advantage.

    Science.gov (United States)

    Andrews, B C; Kaye, J; Bowcutt, M; Campbell, J

    2001-01-01

    This study examines the consequences of adding a geriatric subacute unit to the traditional health care mix offered by a nonprofit hospital. Historically, geriatric health care offerings have been limited to either acute care units or long-term care facilities. The study's findings demonstrate that the addition of a subacute unit that is operated by an interdisciplinary team is a competitively rational move for two reasons. First, it provides a continuum of care that integrates services and departments, thereby reducing costs. Second, it provides a supportive environment for patients and their families. As a consequence patients have a higher probability of returning home than patients who are assigned to more traditional modes of care.

  13. The Otolaryngologist's Role in Providing Gender-Affirming Care: An Opportunity for Improved Education and Training.

    Science.gov (United States)

    Chaiet, Scott R; Yoshikawa, Noriko; Sturm, Angela; Flanary, Valerie; Ishman, Stacey; Streed, Carl G

    2018-06-01

    Currently, there are limited resources and training available for otolaryngologists and otolaryngology practice personnel to provide gender-affirming care for transgender or gender nonconforming patients. This unique patient population may present to our offices for gender-specific care or with complaints of the ear, nose, and throat unrelated to gender identity. Our current practice has unintentional but direct consequences on our patients care, as transgender patients often report negative experiences in the healthcare setting related to their gender identity. The absence of resources and training is also seen in other specialties. Physicians who create an environment where patients of all gender identities feel welcome can better meet their patients' health care needs. In addition, otolaryngologists can play a role in easing the gender dysphoria experienced by transgender patients. We suggest educational content should be created for and made available to otolaryngologists and office staff to provide gender-affirming care.

  14. Modifying Provider Practice To Improve Assessment of Unhealthy Weight and Lifestyle in Young Children: Translating Evidence in a Quality Improvement Initiative for At-Risk Children.

    Science.gov (United States)

    Camp, Nadine L; Robert, Rebecca C; Nash, Jessica E; Lichtenstein, Cara B; Dawes, Candice S; Kelly, Katherine Patterson

    2017-06-01

    We designed a quality improvement (QI) project to address the high prevalence of childhood overweight and obesity (OW/OB) in our patient population and the inconsistencies among primary care providers in recognizing and addressing OW/OB. We used mixed methods data collection approach to evaluate a QI project, the Childhood Healthy Behaviors Intervention (CHBI), to improve provider obesity prevention practice in two low-income, predominantly African American pediatric primary care clinics. Electronic record data were extracted from all 2-9 year well visits pre- and postintervention for frequency of appropriate diagnostic coding of OW/OB. We reviewed a random sample of records for details of health habit assessment and counseling documentation. Focused interviews were conducted to elicit provider responses regarding impressions of the intervention. The preintervention sample of records (n = 267) was extracted from 18 providers and the postsample (n = 253) from 19 providers. Providers showed improvement in the recognition of OW/OB with appropriate diagnostic coding (52% pre, 68% post), improvement in assessment of health habits informed by the habit survey (0% pre, 76% post), improvement in counseling of healthy behaviors (86% pre, 92% post), and improvement in goal setting of healthy behaviors (12% pre, 70% post). Our findings suggest that implementing a time efficient primary care intervention with brief provider training can improve provider recognition of OW/OB, as well as improve provider behavior targeted at childhood obesity prevention. This project contributes needed QI evidence on interventions to prevent and address OW/OB in primary care settings and calls for further work to strengthen implementation in similar contexts.

  15. Proceedings of a NEA/CSNI-UNIPEDE specialist meeting on improving technical specifications for nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1987-07-01

    This CSNI specialist meeting on improving technical specifications for nuclear power plants is sponsored by the OECD Nuclear Energy Agency jointly with UNIPEDE. Technical specifications for nuclear power plants are in a way a prescription which has a direct bearing on the success or failure of the particular installation, and on the success or failure of fission energy around the world. It is therefore highly important that these prescriptions are made as clear and as concise as possible and that it distinguishes requirements which are essential for public health and safety, from the many others which are less important accordingly. The conference was held in september 1987 in madrid (Spain); it is composed of about 40 papers grouped into 8 sessions: invited papers (6 papers), international survey results (1 paper), limiting conditions for operation (8 papers), maintenance and testing (4 papers), actions statements and allowed outage times (8 papers), methodology and technical justification (8 papers), future trends and alternative approaches (4 papers), and a final panel

  16. Quality and use of consumer information provided with home test kits: room for improvement.

    Science.gov (United States)

    Grispen, Janaica E J; Ickenroth, Martine H P; de Vries, Nanne K; van der Weijden, Trudy; Ronda, Gaby

    2014-10-01

    Diagnostic self-tests (tests on body materials that are initiated by consumers with the aim of diagnosing a disorder or risk factor) are becoming increasingly available. Although the pros and cons of self-testing are currently not clear, it is an existing phenomenon that is likely to gain further popularity. To examine consumers' use of and needs for information about self-testing, and to assess the quality of consumer information provided with home test kits, as perceived by consumers and as assessed using a checklist of quality criteria. A cross-sectional Internet survey among 305 self-testers assessed their use of and needs for information and their perception of the quality of consumer information provided with self-test kits. A meta-search engine was used to identify Dutch and English consumer information for home diagnostic tests available online at the time of the study. The quality of this consumer information was evaluated using a checklist of quality criteria. The consumers' information needs were in line with the most frequently used information, and the information was perceived as being of moderate to good quality. The information was mostly in agreement with clinical practice guidelines, although information on reliability and follow-up behaviour was limited. Approximately half of the instruction leaflets did not include information on the target group of the test. Although generally of moderate to good quality, some aspects of the information provided were in many cases insufficient. European legislation concerning self-tests and accompanying information needs to be adapted and adhered to more closely. © 2012 John Wiley & Sons Ltd.

  17. Improving health care strategy planning through assessment of perceptions of consumers, providers and administrators.

    Science.gov (United States)

    Scammon, D; Kennard, L

    1983-01-01

    Perceptions of consumers, health care administrators, and physicians regarding health care providers are analyzed. Ratings on 26 dimensions of health care services were obtained from members of the three participant groups using measures of image and satisfaction of both physicians in general, and of specific physicians. Discriminant analysis reveals significantly different perceptions of the health care system among the three groups of respondents. These differences suggest some changes in health care administration which could lead to increased consumer satisfaction and competitive advantages for physicians and health care institutions.

  18. Training providers on issues of race and racism improve health care equity.

    Science.gov (United States)

    Nelson, Stephen C; Prasad, Shailendra; Hackman, Heather W

    2015-05-01

    Race is an independent factor in health disparity. We developed a training module to address race, racism, and health care. A group of 19 physicians participated in our training module. Anonymous survey results before and after the training were compared using a two-sample t-test. The awareness of racism and its impact on care increased in all participants. White participants showed a decrease in self-efficacy in caring for patients of color when compared to white patients. This training was successful in deconstructing white providers' previously held beliefs about race and racism. © 2015 Wiley Periodicals, Inc.

  19. Improved fixation quality provided by a Bessel beacon in an adaptive optics system.

    Science.gov (United States)

    Lambert, Andrew J; Daly, Elizabeth M; Dainty, Christopher J

    2013-07-01

    We investigate whether a structured probe beam that creates the beacon for use in a retinal imaging adaptive optics system can provide useful side effects. In particular we investigate whether a Bessel beam that is seen by the subject as a set of concentric rings has a dampening effect on fixation variations of the subject under observation. This calming effect would allow longer periods of observation, particularly for patients with abnormal fixation. An experimental adaptive optics system developed for retinal imaging is used to monitor the fluctuations in aberrations for artificial and human subjects. The probe beam is alternated between a traditional beacon and one provided by a Bessel beam created by SLM. Time-frequency analysis is used to indicate the differences in power and time variation during fixation depending on whether the Bessel beam or the traditional beacon is employed. Comparison is made with the response for an artificial eye to discount systemic variations. Significant evidence is accrued to indicate the reduced fluctuations in fixation when the Bessel beam is employed to create the beacon. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  20. Integration of Hands-On Team Training into Existing Curriculum Improves Both Technical and Nontechnical Skills in Laparoscopic Cholecystectomy.

    Science.gov (United States)

    Caskey, Robert C; Owei, Lily; Rao, Raghavendra; Riddle, Elijah W; Brooks, Ari D; Dempsey, Daniel T; Morris, Jon B; Neylan, Christopher J; Williams, Noel N; Dumon, Kristoffel R

    Nontechnical skills are an essential component of surgical education and a major competency assessed by the ACGME milestones project. However, the optimal way to integrate nontechnical skills training into existing curricula and then objectively evaluate the outcome is still unknown. The aim of this study was to determine the effect laparoscopic team-based task training would have on the nontechnical skills needed for laparoscopic surgery. 9 PGY-1 residents underwent an established training curriculum for teaching the knowledge and technical skills involved in laparoscopic cholecystectomy. Initial training involved a didactic session, expert-led practice on a porcine model in a simulated operating room and laparoscopic skills practice on a virtual reality trainer. Residents then performed a laparoscopic cholecystectomy on the same porcine model as a preintervention test. Three to four months following this, residents were subjected to specific nontechnical skills training involving 2 simple team-based laparoscopic tasks. They then practiced a further 4 to 6 hours on the virtual reality trainer. A repeat postintervention laparoscopic cholecystectomy was then performed 3 to 4 months after nontechnical skills training. Both the preintervention and postintervention laparoscopic cholecystectomies were audiovisually recorded and then evaluated by 2 independent surgeons in a blinded fashion. Technical skills were assessed using objective structured assessment of technical skills (OSATS) and a technique specific rating scale (TRS) that we developed for laparoscopic cholecystectomy. Nontechnical skills were assessed using nontechnical skills for surgeons (NOTSS). Residents also completed a survey at the beginning and end of the training. Tertiary care, university based teaching institution. A total of 9 general surgery residents at the intern level. The mean OSATS score improved from 13.7 ± 1.24 to 26.7 ± 0.31 (p training. There was a strong correlation between OSATS and

  1. Primary healthcare providers' views on improving sexual and reproductive healthcare for adolescents in Bolivia, Ecuador, and Nicaragua

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Orozco, M.; Ibarra, M.

    2013-01-01

    Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved. Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicarag...

  2. Delaware GK-12: Improvement of Science Education in Vocational Technical High Schools Through Collaborative Learning and Coteaching

    Science.gov (United States)

    Madsen, J.; Skalak, K.; Watson, G.; Scantlebury, K.; Allen, D.; Quillen, A.

    2006-12-01

    With funding from the National Science Foundation, the University of Delaware (UD) in partnership with the New Castle County Vocational Technical School District (NCCoVoTech) in Delaware has initiated a GK-12 Program. In each of year this program, nine full time UD graduate students in the sciences, who have completed all or most of their coursework, will be selected to serve as fellows. Participation in the GK-12 program benefits the graduate fellows in many ways. In addition to gaining general insight into current issues of science education, the fellows enhance their experience as scientific researchers by directly improving their ability to effectively communicate complex quantitative and technical knowledge to an audience with multiple and diverse learning needs. In the first year of this project, fellows have been paired with high school science teachers from NCCoVoTech. These pairs, along with the principal investigators (PIs) of this program have formed a learning community that is taking this opportunity to examine and to reflect on current issues in science education while specifically addressing critical needs in teaching science in vocational technical high schools. By participating in summer workshops and follow-up meetings facilitated by the PIs, the fellows have been introduced to a number of innovative teaching strategies including problem-based learning (PBL). Fellow/teacher pairs have begun to develop and teach PBL activities that are in agreement with State of Delaware science standards and that support student learning through inquiry. Fellows also have the opportunity to engage in coteaching with their teacher partner. In this "teaching at the elbow of another", fellows will gain a better understanding of and appreciation for the complexities and nuances of teaching science in vocational technical high schools. While not taught as a stand-alone course in NCCoVoTech high schools, earth science topics are integrated into the science curriculum at

  3. A Dynamical Model of Pitch Memory Provides an Improved Basis for Implied Harmony Estimation

    Science.gov (United States)

    Kim, Ji Chul

    2017-01-01

    Tonal melody can imply vertical harmony through a sequence of tones. Current methods for automatic chord estimation commonly use chroma-based features extracted from audio signals. However, the implied harmony of unaccompanied melodies can be difficult to estimate on the basis of chroma content in the presence of frequent nonchord tones. Here we present a novel approach to automatic chord estimation based on the human perception of pitch sequences. We use cohesion and inhibition between pitches in auditory short-term memory to differentiate chord tones and nonchord tones in tonal melodies. We model short-term pitch memory as a gradient frequency neural network, which is a biologically realistic model of auditory neural processing. The model is a dynamical system consisting of a network of tonotopically tuned nonlinear oscillators driven by audio signals. The oscillators interact with each other through nonlinear resonance and lateral inhibition, and the pattern of oscillatory traces emerging from the interactions is taken as a measure of pitch salience. We test the model with a collection of unaccompanied tonal melodies to evaluate it as a feature extractor for chord estimation. We show that chord tones are selectively enhanced in the response of the model, thereby increasing the accuracy of implied harmony estimation. We also find that, like other existing features for chord estimation, the performance of the model can be improved by using segmented input signals. We discuss possible ways to expand the present model into a full chord estimation system within the dynamical systems framework. PMID:28522983

  4. A Dynamical Model of Pitch Memory Provides an Improved Basis for Implied Harmony Estimation.

    Science.gov (United States)

    Kim, Ji Chul

    2017-01-01

    Tonal melody can imply vertical harmony through a sequence of tones. Current methods for automatic chord estimation commonly use chroma-based features extracted from audio signals. However, the implied harmony of unaccompanied melodies can be difficult to estimate on the basis of chroma content in the presence of frequent nonchord tones. Here we present a novel approach to automatic chord estimation based on the human perception of pitch sequences. We use cohesion and inhibition between pitches in auditory short-term memory to differentiate chord tones and nonchord tones in tonal melodies. We model short-term pitch memory as a gradient frequency neural network, which is a biologically realistic model of auditory neural processing. The model is a dynamical system consisting of a network of tonotopically tuned nonlinear oscillators driven by audio signals. The oscillators interact with each other through nonlinear resonance and lateral inhibition, and the pattern of oscillatory traces emerging from the interactions is taken as a measure of pitch salience. We test the model with a collection of unaccompanied tonal melodies to evaluate it as a feature extractor for chord estimation. We show that chord tones are selectively enhanced in the response of the model, thereby increasing the accuracy of implied harmony estimation. We also find that, like other existing features for chord estimation, the performance of the model can be improved by using segmented input signals. We discuss possible ways to expand the present model into a full chord estimation system within the dynamical systems framework.

  5. A Dynamical Model of Pitch Memory Provides an Improved Basis for Implied Harmony Estimation

    Directory of Open Access Journals (Sweden)

    Ji Chul Kim

    2017-05-01

    Full Text Available Tonal melody can imply vertical harmony through a sequence of tones. Current methods for automatic chord estimation commonly use chroma-based features extracted from audio signals. However, the implied harmony of unaccompanied melodies can be difficult to estimate on the basis of chroma content in the presence of frequent nonchord tones. Here we present a novel approach to automatic chord estimation based on the human perception of pitch sequences. We use cohesion and inhibition between pitches in auditory short-term memory to differentiate chord tones and nonchord tones in tonal melodies. We model short-term pitch memory as a gradient frequency neural network, which is a biologically realistic model of auditory neural processing. The model is a dynamical system consisting of a network of tonotopically tuned nonlinear oscillators driven by audio signals. The oscillators interact with each other through nonlinear resonance and lateral inhibition, and the pattern of oscillatory traces emerging from the interactions is taken as a measure of pitch salience. We test the model with a collection of unaccompanied tonal melodies to evaluate it as a feature extractor for chord estimation. We show that chord tones are selectively enhanced in the response of the model, thereby increasing the accuracy of implied harmony estimation. We also find that, like other existing features for chord estimation, the performance of the model can be improved by using segmented input signals. We discuss possible ways to expand the present model into a full chord estimation system within the dynamical systems framework.

  6. From Demonstration System to Prototype: ShakeAlert Beta Users Provide Feedback to Improve Alert Delivery

    Science.gov (United States)

    Strauss, J. A.; Vinci, M.; Steele, W. P.; Allen, R. M.; Hellweg, M.

    2013-12-01

    Earthquake Early Warning (EEW) is a system that can provide a few to tens of seconds to minutes of warning prior to ground shaking at a given location. The goal and purpose of such a system is to reduce the damage, costs, and casualties resulting from an earthquake. A prototype earthquake early warning system (ShakeAlert) is in development by the UC Berkeley Seismological Laboratory, Caltech, ETH Zurich, University of Washington, and the USGS. Events are published to the UserDisplay--ShakeAlert's Java based graphical interface, which is being tested by a small group of beta users throughout California. The beta users receive earthquake alerts in real-time and are providing feedback on their experiences. For early warning alerts to be useful, people, companies, and institutions must know beforehand what actions they will perform when they receive the information. Beta user interactions allow the ShakeAlert team to discern: which alert delivery options are most effective, what changes would make the UserDisplay more useful in a pre-disaster situation, and most importantly, what actions users plan to take for various scenarios. We also collect feedback detailing costs of implementing actions and challenges within the beta user organizations, as well as anticipated benefits and savings. Thus, creating a blueprint for a fully operational system that will meet the needs of the public. New California users as well as the first group of Pacific Northwest users are slated to join the ShakeAlert beta test group in the fall of 2013.

  7. Nutritional Supplement of Hatchery Eggshell Membrane Improves Poultry Performance and Provides Resistance against Endotoxin Stress.

    Directory of Open Access Journals (Sweden)

    S K Makkar

    Full Text Available Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase

  8. [Assessment of financial performance improves the quality of healthcare provided by medical organizations].

    Science.gov (United States)

    Afek, Arnon; Meilik, Ahuva; Rotstein, Zeev

    2009-01-01

    Today, medical organizations have to contend with a highly competitive environment, an atmosphere saturated with a multitude of innovative new technologies and ever-increasing costs. The ability of these organizations to survive and to develop and expand their services mandates adoption of management guidelines based on the world of finance/commerce, adapted to make them relevant to the world of medical service. In this article the authors chose to present a management administration assessment which is a process that ensures that the management will effectively administer the organization's resources, and meet the goals set by the organization. The system demands that hospital "centers of responsibility" be defined, a management information system be set up, activities be priced, budget be defined and the expenses assessed. These processes make it possible to formulate a budget and assess any possible deviation between the budget and the actual running costs. An assessment of deviations will reveal any possible deviation of the most significant factor--efficiency. Medical organization managers, with the cooperation of the directors of the "centers of responsibility", can assess subunit activities and gain an understanding of the significance of management decisions and thus improve the quality of management, and the medical organization. The goal of this management system is not only to Lower costs and to meet the financial goals that were set; it is a tool that ensures quality. Decreasing expenditure is important in this case, but is only secondary in importance and will be a result of reducing the costs incurred by services lacking in quality.

  9. Nutritional Supplement of Hatchery Eggshell Membrane Improves Poultry Performance and Provides Resistance against Endotoxin Stress.

    Science.gov (United States)

    Makkar, S K; Rath, N C; Packialakshmi, B; Zhou, Z Y; Huff, G R; Donoghue, A M

    2016-01-01

    Eggshells are significant part of hatchery waste which consist of calcium carbonate crust, membranes, and proteins and peptides of embryonic origins along with other entrapped contaminants including microbes. We hypothesized that using this product as a nutritional additive in poultry diet may confer better immunity to the chickens in the paradigm of mammalian milk that enhances immunity. Therefore, we investigated the effect of hatchery eggshell membranes (HESM) as a short term feed supplement on growth performance and immunity of chickens under bacterial lipopolysaccharide (LPS) challenged condition. Three studies were conducted to find the effect of HESM supplement on post hatch chickens. In the first study, the chickens were fed either a control diet or diets containing 0.5% whey protein or HESM as supplement and evaluated at 5 weeks of age using growth, hematology, clinical chemistry, plasma immunoglobulins, and corticosterone as variables. The second and third studies were done to compare the effects of LPS on control and HESM fed birds at 5 weeks of age following at 4 and 24 h of treatment where the HESM was also sterilized with ethanol to deplete bacterial factors. HESM supplement caused weight gain in 2 experiments and decreased blood corticosterone concentrations. While LPS caused a significant loss in body weight at 24 h following its administration, the HESM supplemented birds showed significantly less body weight loss compared with the control fed birds. The WBC, heterophil/lymphocyte ratio, and the levels of IgG were low in chickens fed diets with HESM supplement compared with control diet group. LPS challenge increased the expression of pro-inflammatory cytokine gene IL-6 but the HESM fed birds showed its effect curtailed, also, which also, favored the up-regulation of anti-inflammatory genes compared with control diet fed chickens. Post hatch supplementation of HESM appears to improve performance, modulate immunity, and increase resistance of

  10. Dehydration protection provided by a maternal cuticle improves offspring fitness in the moss Funaria hygrometrica.

    Science.gov (United States)

    Budke, Jessica M; Goffinet, Bernard; Jones, Cynthia S

    2013-05-01

    In bryophytes the sporophyte offspring are in contact with, nourished from, and partially surrounded by the maternal gametophyte throughout their lifespan. During early development, the moss sporophyte is covered by the calyptra, a cap of maternal gametophyte tissue that has a multilayered cuticle. In this study the effects on sporophyte offspring fitness of removing the maternal calyptra cuticle, in combination with dehydration stress, is experimentally determined. Using the moss Funaria hygrometrica, calyptra cuticle waxes were removed by chemical extraction and individuals were exposed to a short-term dehydration event. Sporophytes were returned to high humidity to complete development and then aspects of sporophyte survival, development, functional morphology, and reproductive output were measured. It was found that removal of calyptra cuticle under low humidity results in significant negative impacts to moss sporophyte fitness, resulting in decreased survival, increased tissue damage, incomplete sporophyte development, more peristome malformations, and decreased reproductive output. This study represents the strongest evidence to date that the structure of the calyptra cuticle functions in dehydration protection of the immature moss sporophyte. The investment in a maternal calyptra with a multilayered cuticle increases offspring fitness and provides a functional explanation for calyptra retention across mosses. The moss calyptra may represent the earliest occurance of maternal protection via structural provisioning of a cuticle in green plants.

  11. Final Technical Report for Project 'Improving the Simulation of Arctic Clouds in CCSM3 (SGER Award)'

    International Nuclear Information System (INIS)

    Vavrus, Stephen J.

    2008-01-01

    climate model. J. Climate, 21, 5673-5687.). The article also provides a novel synthesis of surface- and satellite-based Arctic cloud observations that show how much the new freezedry parameterization improves the simulated cloud amount in high latitudes (Fig. 3). Freezedry has been incorporated into the CCSM3.5 version, in which it successfully limits the excessive polar clouds, and may be used in CCSM4. Material from this work is also appearing in a synthesis article on future Arctic cloud changes (Vavrus, D. Waliser, J. Francis, and A. Schweiger, 'Simulations of 20th and 21st century Arctic cloud amount in the global climate models assessed in the IPCC AR4', accepted in Climate Dynamics) and was used in a collaborative paper on Arctic cloud-sea ice coupling (Schweiger, A., R. Lindsay, S. Vavrus, and J. Francis, 2008: Relationships between Arctic sea ice and clouds during autumn. J. Climate, 21, 4799-4810.). This research was presented at the 2007 CCSM Annual Workshop, as well as the CCSM's 2007 Atmospheric Model Working Group and Polar Working Group Meetings. The findings were also shown at the 2007 Climate Change Prediction Program's Science Team Meeting. In addition, I served as an instructor at the International Arctic Research Center's (IARC) Summer School on Arctic Climate Modeling in Fairbanks this summer, where I presented on the challenges and techniques used in simulating polar clouds. I also contributed to the development of a new Arctic System Model by attending a workshop in Colorado this summer on this fledgling project. Finally, an outreach activity for the general public has been the development of an interactive web site ( ) that displays Arctic cloud amount in the CMIP3 climate model archive under present and future scenarios. This site allows users to make polar and global maps of a variety of climate variables to investigate the individual and ensemble-mean GCM response to greenhouse warming and the extent to which models adequately represent Arctic

  12. Technical and clinical evaluation of an improved-contrast screen-film combination for radiation therapy portal localization imaging

    International Nuclear Information System (INIS)

    Haus, Arthur G.; Dickerson, Robert E.; Huff, Kenneth E.; Monte, Suzanne; Schlager, Barbara A.; Atanas, Meri; Matloubieh, Ahmad

    1996-01-01

    Radiation Oncology Center, Highland Hospital, Rochester, NY. indicate the monitor units setting for both methods are similar. Initial clinical results indicate portal images made with the new combination are superior to those obtained with the conventional combination. The new portal images have significantly higher contrast, show clearer definition of structures, and are much easier to read. Conclusion: The prototype screen-film combination provided portal localization images with improved image quality due to significantly higher film contrast compared to the conventional commercially available combination. The prototype combination provided radiation oncologists with more detail, especially in difficult cases such as the pelvis and oblique lung. In addition the images were much easier to read and interpret. Technical factors (monitor units) were similar for both methods. The prototype film can be processed in a conventional rapid process film processor

  13. Technical improvement for the output drive unit of the reactor protection system in QNPP

    International Nuclear Information System (INIS)

    Jiang Zuyue

    1995-11-01

    For improving the reliability of the output drive unit of the reactor protection system in Qinshan NPP, the former design of this part was improved and researched on the problem appeared during the commissioning and operation under the conditions of narrow process space of cabinets and unchanged overall arrangement: (1) The output relay modules was redesigned to unify the relay specification to improve the versatility, and also to improve the pin's contact by means of welding them directly on the printed circuit boards and to make the modules detachable by connectors instead of previously non-detachable. Th modules were connected in series by both power supply line and ground line which were finally connected at same point respectively, so that other protection signals can still be output correctly when a single module is removed. (2) The relay drive circuit was also redesigned for working in on-off state instead of in amplification to minimize the power consumption. On the other hand, the CMOS buffers were taken to couple the CMOS circuits to the TTL circuits. The actuating time for the new shutdown relay was decreased from the former 35 ms to 5 ms, the actuating time for the engineered safety feature drive signal relay was decreased from 10 ms to 6 ms after the above-mentioned improvements, the reliability of the RPS is remarkably improved and a great economic benefit is obtained. (4 refs., 3 figs., 2 tabs.)

  14. An innovative fuel design concept for improved light water reactor performance and safety. Final technical report

    International Nuclear Information System (INIS)

    Tulenko, J.S.; Connell, R.G.

    1995-07-01

    Light water reactor (LWR) fuel performance is limited by thermal and mechanical constraints associated with the design, fabrication, and operation of fuel in a nuclear reactor. The purpose of this research was to explore a technique for extending fuel performance by thermally bonding LWR fuel with a non-alkaline liquid metal alloy. Current LWR fuel rod designs consist of enriched uranium oxide (UO 2 ) fuel pellets enclosed in a zirconium alloy cylindrical clad. The space between the pellets and the clad is filled by an inert gas. Due to the thermal conductivity of the gas, the gas space thermally insulates the fuel pellets from the reactor coolant outside the fuel rod, elevating the fuel temperatures. Filling the gap between the fuel and clad with a high conductivity liquid metal thermally bonds the fuel to the cladding, and eliminates the large temperature change across the gap, while preserving the expansion and pellet loading capabilities. The resultant lower fuel temperature directly impacts fuel performance limit margins and also core transient performance. The application of liquid bonding techniques to LWR fuel was explored for the purposes of increasing LWR fuel performance and safety. A modified version of the ESCORE fuel performance code (ESBOND) has been developed under the program to analyze the in-reactor performance of the liquid metal bonded fuel. An assessment of the technical feasibility of this concept for LWR fuel is presented, including the results of research into materials compatibility testing and the predicted lifetime performance of Liquid Metal Bonded LWR fuel

  15. Technical skill improvement with surgical preparatory courses: What advantages are reflected in residency?

    Science.gov (United States)

    Green, Courtney A; Huang, Emily; Zhao, Nina W; O'Sullivan, Patricia S; Kim, Edward; Chern, Hueylan

    2017-11-01

    Sustainability of skill acquisition gained from graduating medical student (GMS) preparatory courses remains uncertain. GMS skills were assessed before (T1) and after a preparatory course (T2) and then again 2 (T3) and 4 (T4) months into residency and compared to surgical interns without such a course. In April, GMS took the preparatory course. In July-August all interns participated in a basic skills curriculum. Learners completed four technical exercises pre/post each course. Three surgeons scored performances. GMS scores were compared across the 4 time points. Control interns were compared at T3 and T4. Thirty-two interns completed all pre/post course assessments (T3 and T4); seven of those were GMSs. GMS scores increased from 74.5%(T1) to 94.2%(T2) (p starting residency compared to control interns (T3, 89.08% vs 65.03%, p start. Without such course, interns require a steep learning curve. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Potential contribution of microbial communities in technical ceramics for the improvement of rheological properties

    Science.gov (United States)

    Moreira, Bernardino; Miller, Ana Z.; Santos, Ricardo; Monteiro, Sílvia; Dias, Diamantino; Neves, Orquídia; Dionísio, Amélia; Saiz-Jimenez, Cesareo

    2014-05-01

    Several bacterial and fungal species naturally occurring in ceramic raw materials used in construction, such as Aspergillus, Penicillium and Aureobasidium, are known to produce exopolysaccharides (EPS). These polymers excreted by the cells are of widespread occurrence and may confer unique and potentially interesting properties with potential industrial uses, such as viscosity control, gelation, and flocculation, during ceramic manufacturing. In this study, the microbial communities present in clay raw materials were identified by both cultural methods and DNA-based molecular techniques in order to appraise their potential contribution to enhance the performance of technical ceramics through the use of EPS. Mineralogical identification by X- Ray Diffraction (XRD) and Fourier Transform Infrared (FTIR) spectroscopy of the clay raw materials, as well as characterization of rheological properties of ceramic slips were also performed. Microbial EPS production and its introduction into ceramic slips will be then carried out in order to evaluate their effects on the rheological properties of the ceramic slips, powders and conformed bodies. Some positive aspects related to the use of EPS are: reduction of the environmental impact caused by synthetic organic additives, reduction of production costs, as well as the costs related with operator protection systems, gaseous effluent treatments, complex landfill, among others.

  17. Dynamic CT perfusion imaging of the myocardium: a technical note on improvement of image quality.

    Directory of Open Access Journals (Sweden)

    Daniela Muenzel

    Full Text Available OBJECTIVE: To improve image and diagnostic quality in dynamic CT myocardial perfusion imaging (MPI by using motion compensation and a spatio-temporal filter. METHODS: Dynamic CT MPI was performed using a 256-slice multidetector computed tomography scanner (MDCT. Data from two different patients-with and without myocardial perfusion defects-were evaluated to illustrate potential improvements for MPI (institutional review board approved. Three datasets for each patient were generated: (i original data (ii motion compensated data and (iii motion compensated data with spatio-temporal filtering performed. In addition to the visual assessment of the tomographic slices, noise and contrast-to-noise-ratio (CNR were measured for all data. Perfusion analysis was performed using time-density curves with regions-of-interest (ROI placed in normal and hypoperfused myocardium. Precision in definition of normal and hypoperfused areas was determined in corresponding coloured perfusion maps. RESULTS: The use of motion compensation followed by spatio-temporal filtering resulted in better alignment of the cardiac volumes over time leading to a more consistent perfusion quantification and improved detection of the extend of perfusion defects. Additionally image noise was reduced by 78.5%, with CNR improvements by a factor of 4.7. The average effective radiation dose estimate was 7.1±1.1 mSv. CONCLUSION: The use of motion compensation and spatio-temporal smoothing will result in improved quantification of dynamic CT MPI using a latest generation CT scanner.

  18. A Qualitative Study of Multidisciplinary Providers' Experiences With the Transfer Process for Injured Children and Ideas for Improvement.

    Science.gov (United States)

    Gawel, Marcie; Emerson, Beth; Giuliano, John S; Rosenberg, Alana; Minges, Karl E; Feder, Shelli; Violano, Pina; Morrell, Patricia; Petersen, Judy; Christison-Lagay, Emily; Auerbach, Marc

    2018-02-01

    Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn. Participants (n = 34) included interprofessional providers from sending facilities, transport teams, and receiving facilities. Using the constant comparative method, a multidisciplinary team coded transcripts and collectively refined codes to generate recurrent themes across interviews until theoretical saturation was achieved. Participants reported that the transfer process for injured children is complex, stressful, and necessitates collaboration. The transfer process was perceived to involve numerous interrelated components, including professions, disciplines, and institutions. The 5 themes identified as areas to improve this transfer process included 1) Creation of a unified standard operating procedure that crosses institutions/teams, 2) Enhancing 'shared sense making' of all providers, 3) Improving provider confidence, expertise, and skills in caring for pediatric trauma transfer cases, 4) Addressing organization and environmental factors that may impede/delay transfer, and 5) Fostering institutional and personal relationships. Efforts to improve the transfer process for injured children should be guided by the experiences of and input from multidisciplinary frontline emergency providers.

  19. Technical Network

    CERN Multimedia

    2007-01-01

    In order to optimize the management of the Technical Network (TN), to ease the understanding and purpose of devices connected to the TN, and to improve security incident handling, the Technical Network Administrators and the CNIC WG have asked IT/CS to verify the "description" and "tag" fields of devices connected to the TN. Therefore, persons responsible for systems connected to the TN will receive email notifications from IT/CS asking them to add the corresponding information in the network database. Thank you very much for your cooperation. The Technical Network Administrators & the CNIC WG

  20. Technical Network

    CERN Multimedia

    2007-01-01

    In order to optimise the management of the Technical Network (TN), to facilitate understanding of the purpose of devices connected to the TN and to improve security incident handling, the Technical Network Administrators and the CNIC WG have asked IT/CS to verify the "description" and "tag" fields of devices connected to the TN. Therefore, persons responsible for systems connected to the TN will receive e-mails from IT/CS asking them to add the corresponding information in the network database at "network-cern-ch". Thank you very much for your cooperation. The Technical Network Administrators & the CNIC WG

  1. Technical Support of Performance Improvement for Resistance Welding Using Zr-4 Endcap and Endplate

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Soo Sung

    2008-10-15

    The proper welding process for Zircaloy-4 endplate of PHWR and DUPIC fuel bundle assembly is considered important in respect to the soundness of weldment and the improvement of the performance of nuclear fuel bundle during the operation in reactor. The Zircaloy-4 endplate of PHWR and DUPIC fuel bundles are welded by the projection joint type, connecting the endcaps of fuel elements. Therefore, the purpose of this projection joint is to improve the welding quality of torque strength and welding deformation and to apply the commercial productions for the endplate welding of PHWR and DUPIC nuclear fuel bundle assembly.

  2. Improved Structure and Fabrication of Large, High-Power KHPS Rotors - Final Scientific/Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Corren, Dean [Verdant Power, Inc.; Colby, Jonathan [Verdant Power, Inc.; Adonizio, Mary Ann [Verdant Power, Inc.

    2013-01-29

    Verdant Power, Inc, working in partnership with the National Renewable Energy Laboratory (NREL), Sandia National Laboratories (SNL), and the University of Minnesota St. Anthony Falls Laboratory (SAFL), among other partners, used evolving Computational Fluid Dynamics (CFD) and Finite Element Analysis (FEA) models and techniques to improve the structure and fabrication of large, high-power composite Kinetic Hydropower System (KHPS) rotor blades. The objectives of the project were to: design; analyze; develop for manufacture and fabricate; and thoroughly test, in the lab and at full scale in the water, the improved KHPS rotor blade.

  3. Improving measurement quality assurance for photon irradiations at Department of Energy facilities. Final technical report

    International Nuclear Information System (INIS)

    1996-01-01

    For radiation-instrument calibration to be generally acceptable throughout the US, direct or indirect traceability to a primary standard is required. In most instances, one of the primary standards established at NIST is employed for this purpose. The Department of Energy Laboratory Accreditation Program (DOELAP) is an example of a program employing dosimetry based on the NIST primary photon-, beta particle- and neutron-dosimetry standards. The NIST primary dosimetry standards for bremsstrahlung were first established in the 1950s. They have been updated since then on several occasions. In the 1970s, Technical Committee 85 of the International Standards Organization (ISO) started its work on establishing sets of internationally acceptable, well-characterized photon beams for the calibration of radiation-protection instruments. It is the intent of this paper to make a detailed comparison between the current NIST and the most up-to-date ISO techniques. At present, 41 bremsstrahlung techniques are specified in ISO 4037 while NIST supports a total of 32 techniques. Given the existing equivalences, it makes sense to try to extend the NIST techniques to cover more of the ISO Narrow Spectrum and High Air-Kerma Rate Series. These extensions will also allow the possibility for use of ISO beam techniques in future revisions of the DOELAP standard, which has been suggested by DOE. To this end, NIST was funded by DOE to procure material and make adaptations to the existing NIST x-ray calibration ranges to allow NIST to have the capability of producing all the ISO bremsstrahlung techniques. The following sections describe the steps that were taken to achieve this

  4. How do technical improvements change radiographers' practice – A practice theory perspective

    International Nuclear Information System (INIS)

    Lundvall, L.-L.; Abrandt-Dahlgren, M.; Wirell, S.

    2015-01-01

    Introduction: The two plane imaging techniques are gradually being replaced by multidimensional imaging. How it affects radiographers' professional practice has not been investigated. Aim: To explore how technical development affects the relations between different actors and their actions in the practice of Computer Tomography. Method: A qualitative design with data collection by open interviews (n = 8) and open observations (n = 10) of radiographers during their work with Computer Tomography. Data was first analyzed inductively resulting in seven codes. Secondly abduction was carried out by interpreting the content in the codes with a practice theory. This resulted in four themes. Result: First theme: Changed materiality makes the practical action easier. The actual image production has become practically easier. Second theme: Changed machines cause conflict between the arrangements of the work and the patients' needs. The time for the machine to carry out image production is easy to foresee, but information about the patient's individual status and needs is missing and this leads to difficulties in giving individual planned care. Third theme: Changing materiality prefigure learning. The different apparatus in use and the continuously changing methods of image production is co-constitutive of the practitioners' activities and learning. Fourth theme: Radiography is arranged for patient safety in relation to radiation doses and medical security risks. But the radiographers, who meet the patients, have to check the accuracy of the planned examination in relation to the clinical observed information about patient safety risks with the examination. - Highlights: • The arrangements of CT practice make it difficult to achieve individual planned care. • Continuously learning has become an essential part of radiographers' practice. • Radiographers' planning of each examination is important for secure patient safety

  5. 76 FR 48822 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2011-08-09

    ... high school can prepare students, including those with previously low achievement levels, to enroll and... improved student performance on standardized measures of math and literacy achievement (Pearson, Sawyer... level when compared to their non-disabled peers (Wagner et al, 2006). Researchers have identified...

  6. Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

    Science.gov (United States)

    Pietz, Victoria Lynn

    2014-01-01

    Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

  7. Training Sessions and Materials Present Ways to Improve System Efficiency: OIT Technical Assistance Fact Sheet: Training

    International Nuclear Information System (INIS)

    Ericksen, E.

    1999-01-01

    Interested in learning about innovative ways to improve the efficiency of your plant's steam, electric motor, and compressed air systems? This US Department of Energy Office of Industrial Technologies fact sheet offers information regarding training sessions, teleconferences, and various training materials to teach you and your company ways to reduce energy use, save money, and reduce waste and pollution through system optimization

  8. Technical development of PubMed Interact: an improved interface for MEDLINE/PubMed searches

    OpenAIRE

    Muin, Michael; Fontelo, Paul

    2006-01-01

    Abstract Background The project aims to create an alternative search interface for MEDLINE/PubMed that may provide assistance to the novice user and added convenience to the advanced user. An earlier version of the project was the 'Slider Interface for MEDLINE/PubMed searches' (SLIM) which provided JavaScript slider bars to control search parameters. In this new version, recent developments in Web-based technologies were implemented. These changes may prove to be even more valuable in enhanci...

  9. Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial

    NARCIS (Netherlands)

    Vlemmix, Floortje; Rosman, Ageeth N.; Rijnders, Marlies E.; Beuckens, Antje; Opmeer, Brent C.; Mol, Ben W. J.; Kok, Marjolein; Fleuren, Margot A. H.

    2015-01-01

    To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Cluster randomized controlled trial. Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands. Singleton breech

  10. Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial

    NARCIS (Netherlands)

    Vlemmix, F.; Rosman, A.N.; Rijnders, M.E.; Beuckens, A.; Opmeer, B.C.; Mol, B.W.J.; Kok, M.; Fleuren, M.A.H.

    2015-01-01

    Onjective: To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Design: Cluster randomized controlled trial.Setting: Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the

  11. A case study of the counterpart technical support policy to improve rural health services in Beijing

    Science.gov (United States)

    2012-01-01

    Background There is, globally, an often observed inequality in the health services available in urban and rural areas. One strategy to overcome the inequality is to require urban doctors to spend time in rural hospitals. This approach was adopted by the Beijing Municipality (population of 20.19 million) to improve rural health services, but the approach has never been systematically evaluated. Methods Drawing upon 1.6 million cases from 24 participating hospitals in Beijing (13 urban and 11 rural hospitals) from before and after the implementation of the policy, changes in the rural–urban hospital performance gap were examined. Hospital performance was assessed using changes in six indices over-time: Diagnosis Related Groups quantity, case-mix index (CMI), cost expenditure index (CEI), time expenditure index (TEI), and mortality rates of low- and high-risk diseases. Results Significant reductions in rural–urban gaps were observed in DRGs quantity and mortality rates for both high- and low-risk diseases. These results signify improvements of rural hospitals in terms of medical safety, and capacity to treat emergency cases and more diverse illnesses. No changes in the rural–urban gap in CMI were observed. Post-implementation, cost and time efficiencies worsened for the rural hospitals but improved for urban hospitals, leading to a widening rural–urban gap in hospital efficiency. Conclusions The strategy for reducing urban–rural gaps in health services adopted, by the Beijing Municipality shows some promise. Gains were not consistent, however, across all performance indicators, and further improvements will need to be tried and evaluated. PMID:23272703

  12. Technical improvement to prevent DNA degradation of Leptospira spp. in pulsed field gel electrophoresis.

    Science.gov (United States)

    Ribeiro, R L; Machry, L; Brazil, J M V; Ramos, T M V; Avelar, K E S; Pereira, M M

    2009-08-01

    Leptospirosis is a public health problem. Infection with pathogenic Leptospira occurs by exposure to many environments and is traditionally associated with occupational risk activities. Pulsed-field gel electrophoresis was used to investigate the epidemiological relatedness among Leptospira isolates. However, analysis by PFGE yielded inconclusive data as a result of extensive DNA degradation. This degradation can be significantly reduced by the inclusion of thiourea in the electrophoresis buffer, improving the analysis of DNA banding patterns.

  13. Narrative review of provider behavior in primary care behavioral health: How process data can inform quality improvement.

    Science.gov (United States)

    Beehler, Gregory P; Lilienthal, Kaitlin R; Possemato, Kyle; Johnson, Emily M; King, Paul R; Shepardson, Robyn L; Vair, Christina L; Reyner, Jacqueline; Funderburk, Jennifer S; Maisto, Stephen A; Wray, Laura O

    2017-09-01

    Primary care behavioral health (PCBH) is a population-based approach to delivering mental and behavioral health care in the primary care setting. Implementation of the PCBH model varies across practice settings, which can impact how PCBH providers deliver services to patients and in turn may predict a variety of important outcomes. This article aims to characterize PCBH provider engagement in key processes of integrated care as demonstrated in results from empirical studies of real-world clinical practice. For this narrative review of published studies on PCBH provider engagement in processes of care, PubMed and PsycINFO databases were searched from January 1990 through May 2016 to identify relevant articles. Provider adherence to the brief, time-limited treatment model appears suboptimal. Common mental health conditions, such as depression, were often the primary focus of provider attention, with less consistent emphasis on behavioral medicine concerns. Whereas providers regularly conducted qualitative functional assessments with patients, routine use of standardized measures was low. Engagement in interprofessional collaboration with the primary care team was also low, but engagement in behaviors that fostered therapeutic relationships was high. This review identified several strengths and weaknesses of typical PCBH provider practices. Results are discussed in relation to their value as areas for future quality improvement initiatives that can improve PCBH service delivery and, ultimately, patient outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Risk-based configuration control: Application of PRA in improving technical specifications and operational safety

    International Nuclear Information System (INIS)

    Samanta, P.K.; Kim, I.S.; Vesely, W.E.

    1991-01-01

    The objective of risk-based configuration control is to detect and control plant configurations form a risk perspective. The configurations of particular interest involve components which are down during power operation. Controlling plant configurations from a risk-perspective can provide more direct risk control and also more operational flexibility by allowing looser control in areas unimportant to risk

  15. 78 FR 18974 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Science.gov (United States)

    2013-03-28

    ...) Stochastic modeling for unit commitment and operating reserves: Given the difficulty in formulating and... transmission operators optimize only a small number of transmission switch positions. It is less clear whether... advances made since last year's conference and provide context for any proposals or presentations on best...

  16. Tools for Schools: Filtration for Improved Air Quality. Technical Services Bulletin.

    Science.gov (United States)

    2001

    This product bulletin addresses air pollution control in educational facilities to enhance educational performance, provides air quality recommendations for schools, and examines the filtration needs of various school areas. The types of air particles typically present are highlighted, and the use of proper filtration to control gases and vapors…

  17. Fuel Element Technical Manual

    Energy Technology Data Exchange (ETDEWEB)

    Burley, H.H. [ed.

    1956-08-01

    It is the purpose of the Fuel Element Technical Manual to Provide a single document describing the fabrication processes used in the manufacture of the fuel element as well as the technical bases for these processes. The manual will be instrumental in the indoctrination of personnel new to the field and will provide a single data reference for all personnel involved in the design or manufacture of the fuel element. The material contained in this manual was assembled by members of the Engineering Department and the Manufacturing Department at the Hanford Atomic Products Operation between the dates October, 1955 and June, 1956. Arrangement of the manual. The manual is divided into six parts: Part I--introduction; Part II--technical bases; Part III--process; Part IV--plant and equipment; Part V--process control and improvement; and VI--safety.

  18. Technical Perspective on Using Information Demand Pattern in a Collaborative Recommendation System for Improving E-Mail Communication

    Directory of Open Access Journals (Sweden)

    Dirk Stamer

    2015-04-01

    Full Text Available Today e-mail communication information is widely used in organizations to distribute information. The increasing volume of received e-mails hinders an efficient work. It becomes more and more difficult to identify relevant e-mails inside this enormous volume of information. This work presents a solution in a multi-user environment by improving an established e-mail client extension based on information demand pattern with a recommendation system. The contributions of this work are (1 the concept and implementation of the solution for a single-user environment using information demand pattern, (2 the concept and architecture to use the solution in a multi-user environment (3 a detailed technical description about the proposed solutions.

  19. Editorial: Advances in healthcare provider and patient training to improve the quality and safety of patient care

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Borycki

    2015-09-01

    Full Text Available This special issue of the Knowledge Management & E-Learning: An International Journal is dedicated to describing “Advances in Healthcare Provider and Patient Training to Improve the Quality and Safety of Patient Care.” Patient safety is an important and fundamental requirement of ensuring the quality of patient care. Training and education has been identified as a key to improving healthcare provider patient safety competencies especially when working with new technologies such as electronic health records and mobile health applications. Such technologies can be harnessed to improve patient safety; however, if not used properly they can negatively impact on patient safety. In this issue we focus on advances in training that can improve patient safety and the optimal use of new technologies in healthcare. For example, use of clinical simulations and online computer based training can be employed both to facilitate learning about new clinical discoveries as well as to integrate technology into day to day healthcare practices. In this issue we are publishing papers that describe advances in healthcare provider and patient training to improve patient safety as it relates to the use of educational technologies, health information technology and on-line health resources. In addition, in the special issue we describe new approaches to training and patient safety including, online communities, clinical simulations, on-the-job training, computer based training and health information systems that educate about and support safer patient care in real-time (i.e. when health professionals are providing care to patients. These educational and technological initiatives can be aimed at health professionals (i.e. students and those who are currently working in the field. The outcomes of this work are significant as they lead to safer care for patients and their family members. The issue has both theoretical and applied papers that describe advances in patient

  20. The Development of Technical and Vocational Education in India--A Case Study in Quality Improvement. Case Studies on Technical and Vocational Education in Asia and the Pacific.

    Science.gov (United States)

    Mishra, Arun K.

    Education has a place of high priority on India's development agenda. The technical/vocational education (TVE) system is multisectoral with each ministry responsible for labor force development in that sector. The TVE programs in the formal education system are either state delivered or financed. The higher secondary vocational education program…

  1. Structured training on the da Vinci Skills Simulator leads to improvement in technical performance of robotic novices.

    Science.gov (United States)

    Walliczek-Dworschak, U; Mandapathil, M; Förtsch, A; Teymoortash, A; Dworschak, P; Werner, J A; Güldner, C

    2017-02-01

    The increasing use of minimally invasive techniques such as robotic-assisted devices raises the question of how to acquire robotic surgery skills. The da Vinci Skills Simulator has been demonstrated to be an effective training tool in previous reports. To date, little data are available on how to acquire proficiency through simulator training. We investigated the outcome of a structured training programme for robotic surgical skills by robotic novices. This prospective study was conducted from January to December 2013 using the da Vinci Skills Simulator. Twenty participants, all robotic novices, were enrolled in a 4-week training curriculum. After a brief introduction to the simulator system, three consecutive repetitions of five selected exercises (Match Board 1, 2, 3 and Ring and Rail 1, 2) were performed in a defined order on days 1, 8, 15 and 22. On day 22, one repetition of a previously unpractised more advanced module (Needle Targeting) was also performed. After completion of each study day, the overall performance, time to completion, economy in motion, instrument collisions, excessive instrument force, instruments out of view, master workspace range and number of drops were analysed. Comparing the first and final repetition, overall score and time needed to complete all exercises, economy of motion and instrument collisions were significantly improved in nearly all exercises. Regarding the new exercise, a positive training effect could be demonstrated. While its overall entry score was significantly higher, the time to completion and economy of motion were significantly lower than the scores on the first repetition of the previous 5 exercises. It could be shown that training on the da Vinci Skills Simulator led to an improvement in technical performance of robotic novices. With regard to a new exercise, the training had a positive effect on the technical performance. © 2016 John Wiley & Sons Ltd.

  2. Improving timeliness and efficiency in the referral process for safety net providers: application of the Lean Six Sigma methodology.

    Science.gov (United States)

    Deckard, Gloria J; Borkowski, Nancy; Diaz, Deisell; Sanchez, Carlos; Boisette, Serge A

    2010-01-01

    Designated primary care clinics largely serve low-income and uninsured patients who present a disproportionate number of chronic illnesses and face great difficulty in obtaining the medical care they need, particularly the access to specialty physicians. With limited capacity for providing specialty care, these primary care clinics generally refer patients to safety net hospitals' specialty ambulatory care clinics. A large public safety net health system successfully improved the effectiveness and efficiency of the specialty clinic referral process through application of Lean Six Sigma, an advanced process-improvement methodology and set of tools driven by statistics and engineering concepts.

  3. Validation of detailed thermal hydraulic models used for LMR safety and for improvement of technical specifications

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, F.E.

    1995-12-31

    Detailed steady-state and transient coolant temperatures and flow rates from an operating reactor have been used to validate the multiple pin model in the SASSYS-1 liquid metal reactor systems analysis code. This multiple pin capability can be used for explicit calculations of axial and lateral temperature distributions within individual subassemblies. Thermocouples at a number of axial locations and in a number of different coolant sub-channels m the XXO9 instrumented subassembly in the EBR-II reactor provided temperature data from the Shutdown Heat Removal Test (SHRT) series. Flow meter data for XXO9 and for the overall system are also available from these tests. Results of consistent SASSYS-1 multiple pin analyses for both the SHRT-45 loss-of-flow-without-scram-test and the S14RT-17 protected loss-of-flow test agree well with the experimental data, providing validation of the SASSYS-1 code over a wide range of conditions.

  4. Identification of Technical Requirement for Improving Quality of Local Online Food Delivery Service in Yogyakarta

    OpenAIRE

    Elvandari, , Cecilia Desvita Ratna; Sukartiko, Anggoro Cahyo; Nugrahini, Arita Dewi

    2017-01-01

    Increased internet usage and fast-paced consumer’s demands have created business opportunities, including online food delivery services. However, competition with similar national-scale businesses allegedly contributed to the decline in the number of XYZ company orders, one of the food-delivery service providers in Yogyakarta. Therefore, this study aimed to identify the need’s attributes of the daring food delivery service consumers, to find out the service-quality satisfaction level, and to ...

  5. Scientific/Technical Report: Improvement in compensation and crystal growth of cadmium zinc telluride radiation detectors

    International Nuclear Information System (INIS)

    Kelvin G. Lynn; Kelly A. Jones

    2007-01-01

    was a single crystal except on the edges. We consider that single crystals are necessary but are not yet the key to the best radiation response. Starting this with very few changes we were unable to reproduce the single crystal in CG40. (4) CZT defect characterization--Upgraded defect characterization techniques and tools were implemented as well improving the cutting process to reduce damage. An automated thermoelectric effect spectroscopy (TEES) and thermally stimulated current (TSC) machine was modified and tested.. Infrared transmission microscopy was improved to better analyze the role of these inclusions. These three devices improved defect analysis capabilities and helped produce a presentation

  6. Improving artificial breeding of cattle in Africa. Guidelines and recommendations. A manual prepared under the framework of an IAEA technical cooperation regional AFRA project on increasing and improving milk and meat production

    International Nuclear Information System (INIS)

    2005-04-01

    The International Atomic Energy Agency (IAEA) and the African Co-operative Agreement for Research, Development and Training Related to Nuclear Science and Technology (AFRA), with technical support from the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, implemented a technical cooperation project entitled Improving and Increasing Milk and Meat Production. The objectives of this project were to be achieved by (a) assessing the performance of existing artificial insemination (AI) programmes for small-scale dairy farmers and identifying constraints; (b) formulating and assisting in the implementation of remedial measures including appropriate strategies; (c) establishing sustainable routine non-pregnancy diagnosis (N-PD) and related services to farmers; and (d) harmonizing managerial and field practices and sharing of expertise within the region. The radioimmunoassay (RIA) for measurement of progesterone in milk and blood of cattle and use of the computer database AIDA (Artificial Insemination Database Application) are important components of an integrated approach to these activities. The project commenced in 1999 and, in addition to other national and regional activities, two meetings were held specifically to address objective (d) above: - Task Force Meeting on Training of Artificial Insemination (AI) Technicians, Field Assessment of Fertility and Database Management, November 1999 in Pretoria, South Africa. - Task Force Meeting to Harmonize Procedures for Selection and Management of AI Bulls and Use of Semen Technology in African Countries, May 2001 in Arusha, Tanzania. The meeting in Tanzania provided a comprehensive overview of the current practices being adopted for selection and management of AI bulls and use of semen technology in five African countries, and compared these with international practices. It also provided an opportunity for participants to discuss technical issues related to provision of improved breeding services to

  7. Technical improvement and development of automatic detection method for genomic mutation

    International Nuclear Information System (INIS)

    Yamada, Kiyomi; Takai, Setsuo; Togashi, Chikako; Itami, Jun

    1999-01-01

    Fluorescent in situ hybridization (FISH) method was improved to estimate the dose of radiation exposure. Cleavage of DNA molecules in lymphocyte was used as the detection parameter and the procedures for preparation of samples suitable for atomic force microscopy and laser microscopy were developed. When ordinal primers on the market were used for PCR, the products were generally too small (about 200 b.p.) for detection by FISH method. Therefore, dATP and biotin-labeled dUTP were linked to its 3'-end by treatment with TdT for 2 hours, resulting that the mean length of PCR products was ca. 1.5 Kb. After hybridization using this prove, signal amplification was carried out according to biotin-avidin detection method. Thus, fluorescent signals on chromosomes could be easily detected. When three primers, D6S105, D6S291 and D6S282 were used as primer, fluorescent signal was detectable at 3 sites on chromatin fiber. These results indicate that this method is available for the analysis of cleavage of chromosomes. However, the backgrounds were much varied depending on the way to wash the preparation after incubation with fluorescent particle to form biotin-avidin binding. Therefore, further improvement of this method was necessary to apply in practice. When chromosomes 13, 14 and 15 from lymphocytes exposed to X-ray were used as test samples, it was demonstrated that radio-sensitivity was variable depending on the contents of R band in each chromosome. (M.N.)

  8. Technical Note: Improving the VMERGE treatment planning algorithm for rotational radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Gaddy, Melissa R., E-mail: mrgaddy@ncsu.edu; Papp, Dávid, E-mail: dpapp@ncsu.edu [Department of Mathematics, North Carolina State University, Raleigh, North Carolina 27695-8205 (United States)

    2016-07-15

    Purpose: The authors revisit the VMERGE treatment planning algorithm by Craft et al. [“Multicriteria VMAT optimization,” Med. Phys. 39, 686–696 (2012)] for arc therapy planning and propose two changes to the method that are aimed at improving the achieved trade-off between treatment time and plan quality at little additional planning time cost, while retaining other desirable properties of the original algorithm. Methods: The original VMERGE algorithm first computes an “ideal,” high quality but also highly time consuming treatment plan that irradiates the patient from all possible angles in a fine angular grid with a highly modulated beam and then makes this plan deliverable within practical treatment time by an iterative fluence map merging and sequencing algorithm. We propose two changes to this method. First, we regularize the ideal plan obtained in the first step by adding an explicit constraint on treatment time. Second, we propose a different merging criterion that comprises of identifying and merging adjacent maps whose merging results in the least degradation of radiation dose. Results: The effect of both suggested modifications is evaluated individually and jointly on clinical prostate and paraspinal cases. Details of the two cases are reported. Conclusions: In the authors’ computational study they found that both proposed modifications, especially the regularization, yield noticeably improved treatment plans for the same treatment times than what can be obtained using the original VMERGE method. The resulting plans match the quality of 20-beam step-and-shoot IMRT plans with a delivery time of approximately 2 min.

  9. Consumers' Interest In Provider Ratings Grows, And Improved Report Cards And Other Steps Could Accelerate Their Use.

    Science.gov (United States)

    Findlay, Steven D

    2016-04-01

    Encouraging patients and consumers to use data and other information in choosing health care providers is an important way to enhance patient engagement and improve the quality of care. The growing use of technology, including smart phones and near-ubiquitous Internet access, provides consumers with easy access to websites that collect and report assessments and ratings of providers, primarily physicians and hospitals. In addition to new technology, recent laws and changes in society and the delivery of care are laying the foundation for greater use by consumers of provider performance report cards. Such use could be accelerated if the shortcomings of current report card efforts were addressed. Recommendations include making online report cards easier to use and more understandable, engaging, substantive, and relevant to consumers' health and medical concerns and choices. Project HOPE—The People-to-People Health Foundation, Inc.

  10. Production-Based Education Model for Improving Technical and Vocational Teachers Ability

    Science.gov (United States)

    Saputro, H.; Suharno; Widiastuti, I.; Harjanto, B.

    2018-02-01

    The vocational high schools (SMK) in Surakarta have applied the Production-Based Education (PBE) in order to improve the student skills. On the other hand, the implementation of PBE model is needed the professional teachers who have the skill qualifications in the production and learning. This study focuses on strengthening of teacher’s behavior related to the implementation of PBE model at vocational high schools in Surakarta, especially on teacher’s Organizational Citizenship Behavior. This research conducted based on the observational research method that employed 134 teachers of SMK Warga Surakarta as respondents. The data of teachers OCB were analyzed by using the descriptive analysis. The result showed that the PBE model had strengthened the teachers OCB at SMK Warga Surakarta. The measurements of OCB level of SMK teachers had shown the high (H) level and some of the teachers’ OCB characters show very high (VH) levels such as altruism and civic virtue. OCB or “good soldier syndrome” could be manifested by the teacher’s interaction at school such as loyalty, volunteering and helping others. Therefore, teacher’s OCB behavior became important due to the organizational effectiveness at vocational high school (SMK).

  11. Technical Improvement and Application of Hydrodynamic Gene Delivery in Study of Liver Diseases

    Directory of Open Access Journals (Sweden)

    Mei Huang

    2017-08-01

    Full Text Available Development of an safe and efficient in vivo gene delivery method is indispensable for molecular biology research and the progress in the following gene therapy. Over the past few years, hydrodynamic gene delivery (HGD with naked DNA has drawn increasing interest in both research and potential clinic applications due to its high efficiency and low risk in triggering immune responses and carcinogenesis in comparison to viral vectors. This method, involving intravenous injection (i.v. of massive DNA in a short duration, gives a transient but high in vivo gene expression especially in the liver of small animals. In addition to DNA, it has also been shown to deliver other substance such as RNA, proteins, synthetic small compounds and even viruses in vivo. Given its ability to robustly mimic in vivo hepatitis B virus (HBV production in liver, HGD has become a fundamental and important technology on HBV studies in our group and many other groups. Recently, there have been interesting reports about the applications and further improvement of this technology in other liver research. Here, we review the principle, safety, current application and development of hydrodynamic delivery in liver disease studies, and discuss its future prospects, clinical potential and challenges.

  12. The impact of a quality-improvement package on reproductive health services delivered by private providers in Uganda.

    Science.gov (United States)

    Agha, Sohail

    2010-09-01

    This study assesses the effectiveness of a quality-improvement (QI) package designed to enable small-scale commercial reproductive health (RH) service providers to improve the services they offer. The study was conducted among midwives who are members of the Uganda Private Midwives Association. A pretest-post-test quasi-experimental panel study design was used wherein midwife clinics were allocated to two experimental groups and one control group. Baseline and follow-up measurements of structural and process attributes of quality were taken at the clinics by means of a facility inventory, interviews with midwives, and observations of client-provider interactions. Nearly 70 percent of the midwives who were trained to use the package reported that it was easy to use. Among clinics in which midwives received training in the use of the self-assessment tool and in developing action plans, structural and process attributes of quality improved only among those clinics in which the midwives' supervisors received training in finding solutions to the problems identified through self-assessments. The QI package may be implemented with small-scale private providers of RH services who are part of a professional association, network, or franchise that supervises their performance.

  13. Dual energy CTA of the supraaortic arteries: Technical improvements with a novel dual source CT system

    International Nuclear Information System (INIS)

    Lell, Michael M.; Hinkmann, Fabian; Nkenke, Emeka; Schmidt, Bernhard; Seidensticker, Peter; Kalender, Willi A.; Uder, Michael; Achenbach, Stephan

    2010-01-01

    Objectives: Computed tomography angiography (CTA) is a well-accepted imaging modality to evaluate the supraaortic vessels. Initial reports have suggested that dual energy CTA (DE-CTA) can enhance diagnosis by creating bone-free data sets, which can be visualized in 3D, but a number of limitations of this technique have also been addressed. We sought to describe the performance of DE-CTA of the supraaortic vessels with a novel dual source CT system with special emphasis on image quality and post-processing related artifacts. Materials and methods: Thirty-three patients underwent carotid CT angiography on a second generation dual source CT system. Simultaneous acquisitions of 100 and 140 kV data sets in arterial phase were performed. Two examiners evaluated overall bone suppression with a 3-point scale (1 = poor; 3 = excellent) and image quality regarding integrity of the vessel lumen of different vessel segments (n = 26) with a 5-point scale (1 = poor; 5 = excellent), CTA source data served as the reference. Results: Excellent bone suppression could be achieved in the head and neck. Only minor bone remnants occurred, mean score for bone removal was 2.9. Mean score for vessel integrity was 4.3. Eight hundred fifty-seven vessel segments could be evaluated. Six hundred thirty-five segments (74%) showed no lumen alteration, 65 segments (7.6%) lumen alterations 10% resulting in a total luminal reduction 50%, and 113 segments (13.2%) showed a gap in the vessel course (100% total lumen reduction). Artificial gaps of the vessel lumen occurred in 28 vessel segments due to artifacts caused by dental hardware and in all but one (65) ophthalmic arteries. Conclusions: Excellent bone suppression could be achieved, DE imaging with 100 and 140 kV lead to improved image quality and vessel integrity in the shoulder region than previously reported. The ophthalmic artery still cannot be adequately visualized.

  14. Implementation of client versus care-provider strategies to improve external cephalic version rates: a cluster randomized controlled trial.

    Science.gov (United States)

    Vlemmix, Floortje; Rosman, Ageeth N; Rijnders, Marlies E; Beuckens, Antje; Opmeer, Brent C; Mol, Ben W J; Kok, Marjolein; Fleuren, Margot A H

    2015-05-01

    To determine the effectiveness of a client or care-provider strategy to improve the implementation of external cephalic version. Cluster randomized controlled trial. Twenty-five clusters; hospitals and their referring midwifery practices randomly selected in the Netherlands. Singleton breech presentation from 32 weeks of gestation onwards. We randomized clusters to a client strategy (written information leaflets and decision aid), a care-provider strategy (1-day counseling course focused on knowledge and counseling skills), a combined client and care-provider strategy and care-as-usual strategy. We performed an intention-to-treat analysis. Rate of external cephalic version in various strategies. Secondary outcomes were the percentage of women counseled and opting for a version attempt. The overall implementation rate of external cephalic version was 72% (1169 of 1613 eligible clients) with a range between clusters of 8-95%. Neither the client strategy (OR 0.8, 95% CI 0.4-1.5) nor the care-provider strategy (OR 1.2, 95% CI 0.6-2.3) showed significant improvements. Results were comparable when we limited the analysis to those women who were actually offered intervention (OR 0.6, 95% CI 0.3-1.4 and OR 2.0, 95% CI 0.7-4.5). Neither a client nor a care-provider strategy improved the external cephalic version implementation rate for breech presentation, neither with regard to the number of version attempts offered nor the number of women accepting the procedure. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Dual energy CTA of the supraaortic arteries: Technical improvements with a novel dual source CT system

    Energy Technology Data Exchange (ETDEWEB)

    Lell, Michael M., E-mail: Michael.lell@uk-erlangen.de [Department of Radiology, University Erlangen, Maximiliansplatz 1, 91054 Erlangen (Germany); Hinkmann, Fabian [Department of Radiology, University Erlangen, Maximiliansplatz 1, 91054 Erlangen (Germany); Nkenke, Emeka [Department of Maxillofacial Surgery, University Erlangen (Germany); Schmidt, Bernhard [Bayer-Schering Healthcare, Berlin (Germany); Seidensticker, Peter [Siemens Healthcare, CT-Division, Forchheim (Germany); Kalender, Willi A. [Institute of Medical Physics, University Erlangen (Germany); Uder, Michael [Department of Radiology, University Erlangen, Maximiliansplatz 1, 91054 Erlangen (Germany); Achenbach, Stephan [Department of Cardiology, University Erlangen (Germany)

    2010-11-15

    Objectives: Computed tomography angiography (CTA) is a well-accepted imaging modality to evaluate the supraaortic vessels. Initial reports have suggested that dual energy CTA (DE-CTA) can enhance diagnosis by creating bone-free data sets, which can be visualized in 3D, but a number of limitations of this technique have also been addressed. We sought to describe the performance of DE-CTA of the supraaortic vessels with a novel dual source CT system with special emphasis on image quality and post-processing related artifacts. Materials and methods: Thirty-three patients underwent carotid CT angiography on a second generation dual source CT system. Simultaneous acquisitions of 100 and 140 kV data sets in arterial phase were performed. Two examiners evaluated overall bone suppression with a 3-point scale (1 = poor; 3 = excellent) and image quality regarding integrity of the vessel lumen of different vessel segments (n = 26) with a 5-point scale (1 = poor; 5 = excellent), CTA source data served as the reference. Results: Excellent bone suppression could be achieved in the head and neck. Only minor bone remnants occurred, mean score for bone removal was 2.9. Mean score for vessel integrity was 4.3. Eight hundred fifty-seven vessel segments could be evaluated. Six hundred thirty-five segments (74%) showed no lumen alteration, 65 segments (7.6%) lumen alterations <10%, 27 segments (3.1%) lumen alterations >10% resulting in a total luminal reduction <50%, 17 segments (2%) lumen alterations of more than 10% resulting in a total luminal reduction >50%, and 113 segments (13.2%) showed a gap in the vessel course (100% total lumen reduction). Artificial gaps of the vessel lumen occurred in 28 vessel segments due to artifacts caused by dental hardware and in all but one (65) ophthalmic arteries. Conclusions: Excellent bone suppression could be achieved, DE imaging with 100 and 140 kV lead to improved image quality and vessel integrity in the shoulder region than previously

  16. A continuous quality improvement intervention to improve the effectiveness of community health workers providing care to mothers and children: a cluster randomised controlled trial in South Africa.

    Science.gov (United States)

    Horwood, Christiane; Butler, Lisa; Barker, Pierre; Phakathi, Sifiso; Haskins, Lyn; Grant, Merridy; Mntambo, Ntokozo; Rollins, Nigel

    2017-06-13

    Community health workers (CHWs) play key roles in delivering health programmes in many countries worldwide. CHW programmes can improve coverage of maternal and child health services for the most disadvantaged and remote communities, leading to substantial benefits for mothers and children. However, there is limited evidence of effective mentoring and supervision approaches for CHWs. This is a cluster randomised controlled trial to investigate the effectiveness of a continuous quality improvement (CQI) intervention amongst CHWs providing home-based education and support to pregnant women and mothers. Thirty CHW supervisors were randomly allocated to intervention (n = 15) and control (n = 15) arms. Four CHWs were randomly selected from those routinely supported by each supervisor (n = 60 per arm). In the intervention arm, these four CHWs and their supervisor formed a quality improvement team. Intervention CHWs received a 2-week training in WHO Community Case Management followed by CQI mentoring for 12 months (preceded by 3 months lead-in to establish QI processes). Baseline and follow-up surveys were conducted with mothers of infants Improved training and CQI-based mentoring of CHWs can improve quantity and quality of CHW-mother interactions at household level, leading to improvements in mothers' knowledge and infant feeding practices. ClinicalTrials.Gov NCT01774136.

  17. Training of technical staff and technical staff managers

    International Nuclear Information System (INIS)

    Moody, G.F.

    1991-01-01

    The purpose of Technical Staff and Technical Staff Managers training is to provide job skills enhancement to individuals selected to fill key technical positions within a nuclear utility. This training is unique in that unlike other training programs accredited by the National Academy for Nuclear Training, it does not lead to specific task qualification. The problems encountered when determining the student population and curriculum are a direct result of this major difference. Major problems encountered are determining who should attend the training, what amount of training is necessary and sufficient, and how to obtain the best feedback in order to effect substantive program improvements. These topics will be explored and possible solutions discussed

  18. Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers.

    Science.gov (United States)

    Porter, Laura S; Pollak, Kathryn I; Farrell, David; Cooper, Meredith; Arnold, Robert M; Jeffreys, Amy S; Tulsky, James A

    2015-10-01

    Patients often struggle to express their emotional concerns to their oncology providers and may therefore experience unmet needs. This paper describes the development and implementation of an online program that teaches patients how to communicate their emotions to their oncology providers. The intervention was developed by a multidisciplinary team consisting of palliative care physicians, psychologists, and an intervention software developer and included input from patients. It incorporated elements of Social Cognitive Theory and validated cognitive behavioral strategies for communication skills training. Strategies to increase intervention adherence were implemented midway through the study. The intervention consists of four interactive, online modules to teach patients strategies for expressing emotional concerns to their providers and asking for support. In addition to skill-building, the intervention was designed to raise patients' expectations that expressing emotional concerns to providers would be helpful, to enhance their self-efficacy for doing so, and to help them overcome barriers to having these conversations. After implementing strategies to improve adherence, usage rates increased from 47 to 64 %. This intervention addresses an unmet educational need for patients with advanced cancer. Strategies to increase adherence led to improvements in usage rates in this population of older patients. We are currently evaluating the intervention in a randomized clinical trial to determine its efficacy in increasing patient expression of emotional concerns and requests for support. If successful, this intervention could serve as a model for future online patient education programs.

  19. Improving sexual health communication between older women and their providers: how the integrative model of behavioral prediction can help.

    Science.gov (United States)

    Hughes, Anne K; Rostant, Ola S; Curran, Paul G

    2014-07-01

    Talking about sexual health can be a challenge for some older women. This project was initiated to identify key factors that improve communication between aging women and their primary care providers. A sample of women (aged 60+) completed an online survey regarding their intent to communicate with a provider about sexual health. Using the integrative model of behavioral prediction as a guide, the survey instrument captured data on attitudes, perceived norms, self-efficacy, and intent to communicate with a provider about sexual health. Data were analyzed using structural equation modeling. Self-efficacy and perceived norms were the most important factors predicting intent to communicate for this sample of women. Intent did not vary with race, but mean scores of the predictors of intent varied for African American and White women. Results can guide practice and intervention with ethnically diverse older women who may be struggling to communicate about their sexual health concerns. © The Author(s) 2013.

  20. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.

    2001-07-15

    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  1. Improving maternal and neonatal departments in high and low resource settings: the opinion of local health providers.

    Science.gov (United States)

    Trevisanuto, Daniele; Bavuusuren, Bayasgalantai; Wickramasinghe, Chandani S; Dharmaratne, Saminda M; Doglioni, Nicoletta; Giordan, Alessia; Zanardo, Vincenzo; Carlo, Waldemar A

    2011-10-01

    We compared local health caregivers' opinions regarding the priority areas for improving the maternal and neonatal departments in low and high resource countries. Personnel involved in maternal and neonatal care operating in level III, teaching hospitals in four countries (Sri Lanka, Mongolia, USA, and Italy) were asked to fill out an anonymous, written questionnaire. The questionnaire was completed by 1112 out of 1265 (87.9%) participants. "Personnel's education" was classified as the first most important intervention by health providers working in high (49.0%) as well as in low (29.9%) resource countries, respectively. Improvement in salary, equipment, internet access, and organizational protocols were considered as the most important interventions by a significantly larger percentage of personnel from low resource countries in comparison with those from high resource countries. Health providers from high resource countries considered organizational aspects (to define specific roles and responsibilities) as a priority more frequently than their colleagues from low resource countries. Although education of personnel was valued as the highest priority for improving maternal and neonatal departments there are substantial differences in priorities associated with the working setting. Local caregivers' opinion may contribute to better design interventions in settings with high or limited resources.

  2. Career Technical Education Pathways Initiative Annual Report

    Science.gov (United States)

    California Community Colleges, Chancellor's Office, 2014

    2014-01-01

    California's education system--the largest in the United States--is an essential resource for ensuring strong economic growth in the state. The Career Technical Education Pathways Initiative (the Initiative) became law in 2005 with Senate Bills 70 and 1133 and provided more than $380 million over eight years to improve career technical education…

  3. Variable effectiveness of stepwise implementation of nudge-type interventions to improve provider compliance with intraoperative low tidal volume ventilation.

    Science.gov (United States)

    O'Reilly-Shah, Vikas N; Easton, George S; Jabaley, Craig S; Lynde, Grant C

    2018-05-18

    Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system. Dashboards were emailed to providers four times over the course of the 9-month study. Additionally, the default setting on anaesthesia machines for tidal volume was decreased from 700 mL to 400 mL. Data on surgical cases performed between 1 September 2016 and 31 May 2017 were examined for compliance with LPV. The impact of the interventions was assessed via pairwise logistic regression analysis corrected for multiple comparisons. A total of 14 793 anaesthesia records were analysed. Absolute compliance rates increased from 59.3% to 87.8%preintervention to postintervention. Introduction of attending physician dashboards resulted in a 41% increase in the odds of compliance (OR 1.41, 95% CI 1.17 to 1.69, p=0.002). Subsequently, the addition of advanced practice provider and resident dashboards lead to an additional 93% increase in the odds of compliance (OR 1.93, 95% CI 1.52 to 2.46, p<0.001). Lastly, modifying ventilator defaults led to a 376% increase in the odds of compliance (OR 3.76, 95% CI 3.1 to 4.57, p<0.001). Audit and feedback tools in conjunction with default changes improve provider compliance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise

  4. Water balance and fertigation for crop improvement in West Asia. Results of a technical co-operation project

    International Nuclear Information System (INIS)

    2002-01-01

    Mediterranean countries have a severe shortage of water resources for agricultural, municipal and industrial purposes. This situation is aggravated daily due to the rapidly increasing population in the area. Agriculture is the biggest consumer of water with about 80% of the renewable resource used for irrigation. Traditional irrigation methods are highly inefficient: only about one-third of the applied water is actually transpired by the crops. Clearly, there is great scope for improved irrigation management. Intensification of agricultural production to meet growing market demand requires the simultaneous application of irrigation water and fertilizers. Application of fertilizer in drip irrigation (fertigation) is an effective way to promote efficient use of these scarce and expensive resources. There is widespread interest in Mediterranean countries in fertigation. Nevertheless, information on the form and concentration of the nutrients required for different crops is presently inadequate. Moreover, the low fertilizer recoveries due to extensive fertilization practiced during the last few decades have created serious agricultural and environmental problems. High nitrate concentrations in groundwater and deterioration of some important quality parameters of agricultural products are the main concerns. Recognizing the potential role of nuclear techniques in identifying improved water and fertilizer management practices, the IAEA implemented two regional technical co-operation projects during the period 1995-2000 with eight participating countries from the West Asia region: The Islamic Republic of Iran, Jordan, Lebanon, Saudi Arabia, the Syria Arab Republic, Turkey, United Arab Emirates and Yemen. The main objective was to establish water balance and fertigation practices using nuclear techniques, with a view to improving crop production in arid and semi-arid zones. The projects aimed to compare the following parameters under conventional fertilizer and water

  5. Public-private partnerships to improve primary healthcare surgeries: clarifying assumptions about the role of private provider activities.

    Science.gov (United States)

    Mudyarabikwa, Oliver; Tobi, Patrick; Regmi, Krishna

    2017-07-01

    Aim To examine assumptions about public-private partnership (PPP) activities and their role in improving public procurement of primary healthcare surgeries. PPPs were developed to improve the quality of care and patient satisfaction. However, evidence of their effectiveness in delivering health benefits is limited. A qualitative study design was employed. A total of 25 interviews with public sector staff (n=23) and private sector managers (n=2) were conducted to understand their interpretations of assumptions in the activities of private investors and service contractors participating in Local Improvement Finance Trust (LIFT) partnerships. Realist evaluation principles were applied in the data analysis to interpret the findings. Six thematic areas of assumed health benefits were identified: (i) quality improvement; (ii) improved risk management; (iii) reduced procurement costs; (iv) increased efficiency; (v) community involvement; and (vi) sustainable investment. Primary Care Trusts that chose to procure their surgeries through LIFT were expected to support its implementation by providing an environment conducive for the private participants to achieve these benefits. Private participant activities were found to be based on a range of explicit and tacit assumptions perceived helpful in achieving government objectives for LIFT. The success of PPPs depended upon private participants' (i) capacity to assess how PPP assumptions added value to their activities, (ii) effectiveness in interpreting assumptions in their expected activities, and (iii) preparedness to align their business principles to government objectives for PPPs. They risked missing some of the expected benefits because of some factors constraining realization of the assumptions. The ways in which private participants preferred to carry out their activities also influenced the extent to which expected benefits were achieved. Giving more discretion to public than private participants over critical

  6. Technical report writing

    Science.gov (United States)

    Vidoli, Carol A.

    1992-01-01

    This manual covers the fundamentals of organizing, writing, and reviewing NASA technical reports. It was written to improve the writing skills of LeRC technical authors and the overall quality of their reports.

  7. AMS: technical improvements

    International Nuclear Information System (INIS)

    Balsley, D.; Farwell, G.W.; Fauska, H.; Grootes, P.M.; Leach, D.D.; Schmidt, F.H.

    1984-01-01

    Last year the authors reported progress on two systems of normalization of the rare isotope beam (particle counting rate, 14 C or 10 Be) against the stable isotope beam or beams (/sup 12,13/C or 9 Be ion current). In the concurrent monitoring method, the abundant isotope (e.g., 12 C) is monitored at the low-energy end of the accelerator while the rare isotope (e.g., 14 C) is monitored simultaneously following acceleration and high-energy ion analysis. In the sequential transmission method, the rare and abundant isotopic ion beams are alternated by adjustment of the entire set of accelerator parameters. The recent advent of a two-level, nuclear-magnetic-resonance-controlled isotope alternation system has greatly enhanced the effectiveness of the sequential transmission method and the authors experienced little difficulty taking data on carbon from tree-ring segments with about +/ 12% accuracy for a single measurement

  8. The main requirements for research work against the challenges of "Industry - 4.0" and the analysis of ongoing work in improving the state of the material and technical base and improving the level of training of young engineers

    Directory of Open Access Journals (Sweden)

    Р. С. Турманидзе

    2017-12-01

    Full Text Available The work analyzes theoretical and practical results obtained after each of the first three world scientific - technical revolution, appreciated their role in the development of humanity, and improve the level of industry in different sectors of the economy. More discussed in detail situation on the threshold of the fourth scientific - technical revolution "industry-4". It is proved crucial in accelerating these processes, the level of training of young engineering staff and suggestions, some ideas and solutions to these problems on the example of the Georgian Technical University.

  9. Consumer Health Informatics: The Application of ICT in Improving Patient-Provider Partnership for a Better Health Care.

    Science.gov (United States)

    Abaidoo, Benjamin; Larweh, Benjamin Teye

    2014-01-01

    There is a growing interest concerning the potential of ICT solutions that are customized to consumers. This emerging discipline referred to as consumer health informatics (CHI) plays a major role in providing information to patients and the public, and facilitates the promotion of self-management. The concept of CHI has emerged out of the desire of most patients to shoulder responsibilities regarding their health and a growing desire of health practitioners to fully appreciate the potential of the patient. To describe the role of ICT in improving the patient-provider partnership in consumer health informatics. Systematic reviewing of literature, identification of reference sources and formulation of search strategies and manual search regarding the significance of developed CHI applications in healthcare delivery. New consumer health IT applications have been developed to be used on a variety of different platforms, including the Web, messaging systems, PDAs, and cell phones. These applications assists patients with self-management through reminders and prompts, delivery of real-time data on a patient's health condition to patients and providers, web-based communication and personal electronic health information. New tools are being developed for the purposes of providing information to patients and the public which has enhanced decision making in health matters and an avenue for clinicians and consumers to exchange health information for personal and public use. This calls for corroboration among healthcare organizations, governments and the ICT industry to develop new research and IT innovations which are tailored to the health needs of the consumer.

  10. Development and Operation of the nuclear technology program for improving the public acceptance by providing the right information

    International Nuclear Information System (INIS)

    Lee, Juwoon; Kang, Mincheol; Min, Sangky; Yi, Jongmin; Yi, Yunyoung

    2013-11-01

    This detailed assignment conducted to improve the communication efficiency through the operation of differentiated programs to accomplish 'Establishment of knowledge diffusion system for improvement of Nuclear understanding', which is the purpose of the general assignment. We developed the programs on each social opinion leader groups by providing the right information on nuclear(radiation) technology, and had a forum for providing the right information on each social groups. Also, Consisted the consultant group, which participates humanities and social sciences, civic group, science teachers, the press, national assembly workers. Technology PR was performed 4 times, which is 1 time more than the original plan of 4 times. In the theme of affection of radiation, we broadened the vision of various fields which enabled to approach in general for the PR program. We Induced a positive reaction from the participants in political areas which coexistent of uncertain expectation and difficult vision of nuclear and radiation, by sharing the development possibility in relation with potential values of radiation industry and other industries and delivering accurate information, not a fragmentary knowledge, but in general. We hope that this results will contribute to establishing the effective nuclear knowledge diffusion program system

  11. Development and Operation of the nuclear technology program for improving the public acceptance by providing the right information

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Juwoon; Kang, Mincheol; Min, Sangky; Yi, Jongmin; Yi, Yunyoung

    2013-11-15

    This detailed assignment conducted to improve the communication efficiency through the operation of differentiated programs to accomplish 'Establishment of knowledge diffusion system for improvement of Nuclear understanding', which is the purpose of the general assignment. We developed the programs on each social opinion leader groups by providing the right information on nuclear(radiation) technology, and had a forum for providing the right information on each social groups. Also, Consisted the consultant group, which participates humanities and social sciences, civic group, science teachers, the press, national assembly workers. Technology PR was performed 4 times, which is 1 time more than the original plan of 4 times. In the theme of affection of radiation, we broadened the vision of various fields which enabled to approach in general for the PR program. We Induced a positive reaction from the participants in political areas which coexistent of uncertain expectation and difficult vision of nuclear and radiation, by sharing the development possibility in relation with potential values of radiation industry and other industries and delivering accurate information, not a fragmentary knowledge, but in general. We hope that this results will contribute to establishing the effective nuclear knowledge diffusion program system.

  12. Advances in fuel pellet technology for improved performance at high burnup. Proceedings of a Technical Committee meeting

    International Nuclear Information System (INIS)

    1998-08-01

    The IAEA has recently completed two co-ordinated Research Programmes (CRPs) on The Development of Computer Models for Fuel Element Behaviour in Water Reactors, and on Fuel Modelling at Extended Burnup. Through these CRPs it became evident that there was a need to obtain data on fuel behaviour at high burnup. Data related o thermal behaviour, fission gas release and pellet to clad mechanical interaction were obtained and presented at the Technical Committee Meeting on Advances in Fuel Pellet Technology for Improved Performance at High Burnup which was recommended by the International Working Group on Fuel Performance and Technology (IWGFPT). The 34 papers from 10 countries are published in this proceedings and presented by a separate abstract. The papers were grouped in 6 sessions. First two sessions covered the fabrication of both UO 2 fuel and additives and MOX fuel. Sessions 3 and 4 covered the thermal behaviour of both types of fuel. The remaining two sessions dealt with fission gas release and the mechanical aspects of pellet to clad interaction

  13. Improving powerlifters’ technical preparedness at initial training stage using a device for remote control of competitive exercises technique

    Directory of Open Access Journals (Sweden)

    А. Власов

    2016-12-01

    Full Text Available The objective is to improve powerlifters’ technical preparedness at the initial training stage using a device for remote control of the competitive exercises technique. Materials and methods. The study relied on the following methods used: theoretical analysis and collation of data of scientific and methodological literature and internet; pedagogical observation; pedagogical experiment; methods of mathematical statistics. Results. We have designed an algorithmic structure for teaching squats with a barbell on shoulders in powerlifting and a device for remote control of the competitive exercises technique. We used the pedagogical experiment and pedagogical observation of the competitive activity to reveal reliable deviations (p > 0.05 in the number of mistakes made by the athletes of the reference and experimental groups during the competitive activity. The reference group powerlifters made the mistake “no straight angle between the knee and the hip joints when performing the third stage” twelve times, while the experimental group athletes — seven times. Conclusions. The results obtained allow to maintain that the experimental group athletes have more rationally mastered the competitive exercises technique and made fewer mistakes compared to the control group powerlifters. This confirms the effectiveness of the designed algorithmic structure for teaching squats with a barbell on shoulders.

  14. IAEA coordinated research project on improvement of technical measures to detect and respond to illicit trafficking of nuclear and other radioactive materials

    International Nuclear Information System (INIS)

    Abedin-Zadeh, R.; Abou-Zahra, A.; Weiss, B.

    2002-01-01

    Full text: Monitoring to detect the illicit trafficking of nuclear and other radioactive materials includes screening vehicles, cargo and individuals at borders to 1) detect smuggling of these materials; 2) locate, measure and characterize the source of radiation; and 3) fully characterize any confiscated material. Currently available instruments used for the field measurements are not optimized for this purpose and may not detect shielded plutonium and highly enriched uranium. Confiscated radioactive materials need to be characterized with macro- and microanalysis techniques to fully understand the significance of the material and to provide credible evidence in the event of prosecution of the traffickers. Although most States have national laboratories capable to determine the basic characteristics of such material, only a few member States have the sophisticated analytical capability necessary to perform proper forensics analysis. The coordinated research project on 'Improvement of Technical Measures to Detect and Respond to Illicit Trafficking of Nuclear and other Radioactive Materials' has been established to: Improve the detection capability and performance of hand-held and portable isotope measurement devices, including the technical and functional specifications for such devices; standardize procedures to examine suspicious packages and to assess the hazard of confiscated material; and develop recommendations and guidelines for establishing a system to provide nuclear forensics support to member States for the characterization of seized nuclear material. Related to the nuclear forensics support, it should be noted that with the inception of the Agency's nuclear security programme in 1995, the IAEA has offered the services of its laboratories in Seibersdorf and associated laboratories to assist States in analysing confiscated nuclear materials. Since 1993 the IAEA has received reports of over 300 cases of smuggling of nuclear and other radioactive materials

  15. Continuous Quality Improvement in a University Setting: The Case of the Department of Vocational and Technical Education at the University of Minnesota.

    Science.gov (United States)

    Copa, George H.

    1993-01-01

    Discusses the application of continuous quality improvement principles in the Department of Vocational and Technical Education at the University of Minnesota. Reviews the processes that the department incorporated to implement this program and lists future steps and categories of action. (Author)

  16. Improving the technical preparation of football players on the basis of the control of discriminative characteristics when performing combinations of techniques during a game

    Directory of Open Access Journals (Sweden)

    Mitova Olena

    2016-06-01

    Full Text Available The paper examines the issue of improving the technical preparation of football players during initial basic training. A special attention is paid to the development and experimental substantiation of the methods of technical preparation of young football players in an annual cycle at the stage of initial basic training on the basis of the control of discriminative characteristics when performing inseparable combinations of techniques during a game. An attempt was made to uncover the underlying causes of a low technical preparedness of football players at different stages of multi-year training and to implement an integrated scientific approach to improvement of the process of technical preparation of 10-11 years old football players in an annual cycle at the stage of initial basic training on the basis of the control of discriminative characteristics when performing inseparable combinations of techniques during competitive activity, along with the peculiarities of psychophysical condition and a level of development of physical qualities. This approach in teaching technical skills will be of interest to specialists and coaches in football, since the pedagogical experiment has determined the effectiveness of the developed methodology.

  17. Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture.

    Science.gov (United States)

    Livingood, William C; Peden, Angela H; Shah, Gulzar H; Marshall, Nandi A; Gonzalez, Ketty M; Toal, Russell B; Alexander, Dayna S; Wright, Alesha R; Woodhouse, Lynn D

    2015-07-31

    Public health agencies in the USA are increasingly challenged to adopt Quality Improvement (QI) strategies to enhance performance. Many of the functional and structural barriers to effective use of QI can be found in the organizational culture of public health agencies. The purpose of this study was to assess the impact of public health practice based research network (PBRN) evaluation and technical assistance for QI interventions on the organizational culture of public health agencies in Georgia, USA. An online survey of key informants in Georgia's districts and county health departments was used to compare perceptions of characteristics of organizational QI culture between PBRN supported QI districts and non-PBRN supported districts before and after the QI interventions. The primary outcomes of concern were number and percentage of reported increases in characteristics of QI culture as measured by key informant responses to items assessing organizational QI practices from a validated instrument on QI Collaboratives. Survey results were analyzed using Multi-level Mixed Effects Logistic Model, which accounts for clustering/nesting. Increases in QI organizational culture were consistent for all 10- items on a QI organizational culture survey related to: leadership support, use of data, on-going QI, and team collaboration. Statistically significant odds ratios were calculated for differences in increased QI organizational culture between PBRN-QI supported districts compared to Non-PBRN supported districts for 5 of the 10 items, after adjusting for District clustering of county health departments. Agency culture, considered by many QI experts as the main goal of QI, is different than use of specific QI methods, such as Plan-Do-Study-Act (PDSA) cycles or root-cause analyses. The specific use of a QI method does not necessarily reflect culture change. Attempts to measure QI culture are newly emerging. This study documented significant improvements in characteristics of

  18. Technical endoscopy

    International Nuclear Information System (INIS)

    Cavalar, K.O.

    1988-01-01

    A survey is provided on different versions of endoscopes, taking into account the new developments of video endoscopy. With a variety of practical examples it is shown that technical tests using endoscopy are a demanding task for nondestructive testing, whose requirements can only be met on a customized basis. (orig./HP) [de

  19. POSSIBILITY OF IMPROVING EXISTING STANDARDS AND METHODOLOGIES FOR AUDITING INFORMATION SYSTEMS TO PROVIDE E-GOVERNMENT SERVICES

    Directory of Open Access Journals (Sweden)

    Евгений Геннадьевич Панкратов

    2014-03-01

    Full Text Available This article analyzes the existing methods of e-government systems audit, their shortcomings are examined.  The approaches to improve existing techniques and adapt them to the specific characteristics of e-government systems are suggested. The paper describes the methodology, providing possibilities of integrated assessment of information systems. This methodology uses systems maturity models and can be used in the construction of e-government rankings, as well as in the audit of their implementation process. Maturity models are based on COBIT, COSO methodologies and models of e-government, developed by the relevant committee of the UN. The methodology was tested during the audit of information systems involved in the payment of temporary disability benefits. The audit was carried out during analysis of the outcome of the pilot project for the abolition of the principle of crediting payments for disability benefits.DOI: http://dx.doi.org/10.12731/2218-7405-2014-2-5

  20. Omega-3 polyunsaturated fatty acids provided during embryonic development improve the growth performance and welfare of Muscovy ducks (Cairina moschata).

    Science.gov (United States)

    Baéza, E; Chartrin, P; Bordeau, T; Lessire, M; Thoby, J M; Gigaud, V; Blanchet, M; Alinier, A; Leterrier, C

    2017-09-01

    The welfare of ducks can be affected by unwanted behaviors such as excessive reactivity and feather pecking. Providing long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) during gestation and early life has been shown to improve the brain development and function of human and rodent offspring. The aim of this study was to test whether the pecking behavior of Muscovy ducks during rearing could be reduced by providing LC n-3 PUFA during embryonic and/or post-hatching development of ducklings. Enrichment of eggs, and consequently embryos, with LC n-3 PUFA was achieved by feeding female ducks (n-3F) a diet containing docosahexaenoic (DHA) and linolenic acids (microalgae and linseed oil). A control group of female ducks (CF) was fed a diet containing linoleic acid (soybean oil). Offspring from both groups were fed starter and grower diets enriched with DHA and linolenic acid or only linoleic acid, resulting in four treatment groups with 48 ducklings in each. Several behavioral tests were performed between 1 and 3 weeks of age to analyze the adaptation ability of ducklings. The growth performance, time budget, social interactions, feather growth, and pecking behavior of ducklings were recorded regularly during the rearing period. No significant interaction between maternal and duckling feeding was found. Ducklings from n-3F ducks had a higher body weight at day 0, 28, and 56, a lower feed conversion ratio during the growth period, and lower reactivity to stress than ducklings from CF ducks. Ducklings from n-3F ducks also exhibited a significantly reduced feather pecking frequency at 49 and 56 days of age and for the whole rearing period. Moreover, consumption of diets enriched with n-3 PUFA during the starter and grower post-hatching periods significantly improved the tibia mineralization of ducklings and the fatty acid composition of thigh muscles at 84 days of age by increasing the n-3 FA content. © 2017 Poultry Science Association Inc.

  1. Improvement of beef cattle genetics provided increasing sustainability of beef cattle production and protein consumption in Thailand

    Energy Technology Data Exchange (ETDEWEB)

    Boonyanuwat, K. [Beef Cattle Research and Development Group, Division of Animal Husbandry, Department of Livestock Development, Bangkok (Thailand)], E-mail: kalayabo@yahoo.com; Sirisom, P [Tak Livestock Breeding and Research Center, Meung (Thailand); Putharatanung, A [Nongkwang Livestock Research and Breeding Center, Photharam (Thailand)

    2009-07-01

    .00%. They were the smallest size. Farmers raised them by main of grass-fed and some added with concentrate. Meat quality from this group was the lowest. The meat texture of this group is the most firm. It was suitable for Thai food cooking. Meat from this group was used to make meatball and Thai food. The second group was around 38.50%. They were fattening 3-6 month. Meat from this group was medium quality. Farmers fed them with grass, agricultural by product, and concentrate. Meat from this group was used for general Thai food and steak cooking. The third and forth group were around 20.00%. In this group, it was added with other beef cattle: Kampangsaen and Ponyangkhum beef cattle. They were fed higher concentrate, up to 90% of concentrate in the last month of fattening. They were fattening 6-12 month. Farmers fed them following feeding plan of cooperative, so they had the greatest ADG and % carcass. Quality of meat from this group was the best, most tender. Meat from this group was used for steak and shabushabu. Meat from this group had quality the same as import meat. Some of them were better than import meat. It was tenderer. The fifth group was less than 0.5%. They were on experiment to establish new breed by DLD. This group was optimized for Thai farmers, small size and low mature age. Meat from this group had the most tenderness and marbling. Meat from this group had more quality than import meat. It was used for steak and shabushabu. Farmers could earn money from beef cattle raising occupation. Beef cattle genetic improvement provided sustainable productivity, profitability, quality of products, and sustained economic growth in rural Thailand. Beef meat production would be the mainly red meat production and provided protein sources for consumer in Thailand. (author)

  2. Frontline health workers as brokers: provider perceptions, experiences and mitigating strategies to improve access to essential medicines in South Africa.

    Science.gov (United States)

    Magadzire, Bvudzai Priscilla; Budden, Ashwin; Ward, Kim; Jeffery, Roger; Sanders, David

    2014-11-05

    Front-line health providers have a unique role as brokers (patient advocates) between the health system and patients in ensuring access to medicines (ATM). ATM is a fundamental component of health systems. This paper examines in a South African context supply- and demand- ATM barriers from the provider perspective using a five dimensional framework: availability (fit between existing resources and clients' needs); accessibility (fit between physical location of healthcare and location of clients); accommodation (fit between the organisation of services and clients' practical circumstances); acceptability (fit between clients' and providers' mutual expectations and appropriateness of care) and affordability (fit between cost of care and ability to pay). This cross-sectional, qualitative study uses semi-structured interviews with nurses, pharmacy personnel and doctors. Thirty-six providers were purposively recruited from six public sector Community Health Centres in two districts in the Eastern Cape Province representing both rural and urban settings. Content analysis combined structured coding and grounded theory approaches. Finally, the five dimensional framework was applied to illustrate the interconnected facets of the issue. Factors perceived to affect ATM were identified. Availability of medicines was hampered by logistical bottlenecks in the medicines supply chain; poor public transport networks affected accessibility. Organization of disease programmes meshed poorly with the needs of patients with comorbidities and circular migrants who move between provinces searching for economic opportunities, proximity to services such as social grants and shopping centres influenced where patients obtain medicines. Acceptability was affected by, for example, HIV related stigma leading patients to seek distant services. Travel costs exacerbated by the interplay of several ATM barriers influenced affordability. Providers play a brokerage role by adopting flexible

  3. Technical Assistance Plan (TAP)

    Science.gov (United States)

    A Technical Assistance Plan (TAP) enables community groups to retain the services of an independent technical advisor and to provide resources for a community group to help inform other community members about site decisions.

  4. Olympic weightlifting and plyometric training with children provides similar or greater performance improvements than traditional resistance training.

    Science.gov (United States)

    Chaouachi, Anis; Hammami, Raouf; Kaabi, Sofiene; Chamari, Karim; Drinkwater, Eric J; Behm, David G

    2014-06-01

    A number of organizations recommend that advanced resistance training (RT) techniques can be implemented with children. The objective of this study was to evaluate the effectiveness of Olympic-style weightlifting (OWL), plyometrics, and traditional RT programs with children. Sixty-three children (10-12 years) were randomly allocated to a 12-week control OWL, plyometric, or traditional RT program. Pre- and post-training tests included body mass index (BMI), sum of skinfolds, countermovement jump (CMJ), horizontal jump, balance, 5- and 20-m sprint times, isokinetic force and power at 60 and 300° · s(-1). Magnitude-based inferences were used to analyze the likelihood of an effect having a standardized (Cohen's) effect size exceeding 0.20. All interventions were generally superior to the control group. Olympic weightlifting was >80% likely to provide substantially better improvements than plyometric training for CMJ, horizontal jump, and 5- and 20-m sprint times, whereas >75% likely to substantially exceed traditional RT for balance and isokinetic power at 300° · s(-1). Plyometric training was >78% likely to elicit substantially better training adaptations than traditional RT for balance, isokinetic force at 60 and 300° · s(-1), isokinetic power at 300° · s(-1), and 5- and 20-m sprints. Traditional RT only exceeded plyometric training for BMI and isokinetic power at 60° · s(-1). Hence, OWL and plyometrics can provide similar or greater performance adaptations for children. It is recommended that any of the 3 training modalities can be implemented under professional supervision with proper training progressions to enhance training adaptations in children.

  5. The New York Adequacy Study: "Determining the Cost of Providing All Children in New York an Adequate Education." Volume 1: Final Report [and] Volume 2: Technical Appendices

    Science.gov (United States)

    Chambers, Jay G.; Parrish, Thomas B.; Levin, Jesse D.; Smith, James R.; Guthrie, James W.; Seder, Rich C.; Taylor, Lori

    2004-01-01

    What is the cost of providing all New York public school students a full opportunity to meet the Regents Learning Standards? This report presents the results of a fifteen-month project undertaken jointly by American Institutes for Research (AIR) and Management Analysis and Planning, Inc. (MAP) to answer this question. This is a "costing…

  6. 25 CFR 1000.68 - May non-BIA bureaus provide technical assistance to a Tribe/Consortium in drafting its planning...

    Science.gov (United States)

    2010-04-01

    ... Financial Assistance for Planning and Negotiation Grants for Non-BIA Programs Eligibility and Application... Tribe/Consortium in drafting its planning grant application? 1000.68 Section 1000.68 Indians OFFICE OF... planning grant application? Yes, upon request from the Tribe/Consortium, a non-BIA bureau may provide...

  7. Improving communication when seeking informed consent: a randomised controlled study of a computer-based method for providing information to prospective clinical trial participants.

    Science.gov (United States)

    Karunaratne, Asuntha S; Korenman, Stanley G; Thomas, Samantha L; Myles, Paul S; Komesaroff, Paul A

    2010-04-05

    To assess the efficacy, with respect to participant understanding of information, of a computer-based approach to communication about complex, technical issues that commonly arise when seeking informed consent for clinical research trials. An open, randomised controlled study of 60 patients with diabetes mellitus, aged 27-70 years, recruited between August 2006 and October 2007 from the Department of Diabetes and Endocrinology at the Alfred Hospital and Baker IDI Heart and Diabetes Institute, Melbourne. Participants were asked to read information about a mock study via a computer-based presentation (n = 30) or a conventional paper-based information statement (n = 30). The computer-based presentation contained visual aids, including diagrams, video, hyperlinks and quiz pages. Understanding of information as assessed by quantitative and qualitative means. Assessment scores used to measure level of understanding were significantly higher in the group that completed the computer-based task than the group that completed the paper-based task (82% v 73%; P = 0.005). More participants in the group that completed the computer-based task expressed interest in taking part in the mock study (23 v 17 participants; P = 0.01). Most participants from both groups preferred the idea of a computer-based presentation to the paper-based statement (21 in the computer-based task group, 18 in the paper-based task group). A computer-based method of providing information may help overcome existing deficiencies in communication about clinical research, and may reduce costs and improve efficiency in recruiting participants for clinical trials.

  8. Bariatric Surgery Prior to Total Joint Arthroplasty May Not Provide Dramatic Improvements In Post Arthroplasty Surgical Outcomes

    Science.gov (United States)

    Paxton, Elizabeth W.; Fisher, David; Li, Robert A.; Barber, Thomas C.; Singh, Jasvinder A.

    2014-01-01

    This study compared the total joint arthroplasty (TJA) surgical outcomes of patients who had bariatric surgery prior to TJA to TJA patients who were candidates but did not have bariatric surgery. Patients were retrospectively grouped into: Group 1 (n=69), those with bariatric surgery >2 years prior to TJA, Group 2 (n=102), those with surgery within 2 years of TJA, and Group 3 (n=11,032), those without bariatric surgery. In Group 1, 2.9% (95%CI 0.0–6.9%) had complications within 1 year compared to 5.9% (95%CI 1.3–10.4%) in Group 2, and 4.1% (95%CI 3.8–4.5%) in Group 3. 90-day readmission (7.2%, 95%CI 1.1–13.4%) and revision density (3.4/100 years of observation) was highest in Group 1. Bariatric surgery prior to TJA may not provide dramatic improvements in post-operative TJA surgical outcomes. PMID:24674730

  9. Parallel experimental design and multivariate analysis provides efficient screening of cell culture media supplements to improve biosimilar product quality.

    Science.gov (United States)

    Brühlmann, David; Sokolov, Michael; Butté, Alessandro; Sauer, Markus; Hemberger, Jürgen; Souquet, Jonathan; Broly, Hervé; Jordan, Martin

    2017-07-01

    Rational and high-throughput optimization of mammalian cell culture media has a great potential to modulate recombinant protein product quality. We present a process design method based on parallel design-of-experiment (DoE) of CHO fed-batch cultures in 96-deepwell plates to modulate monoclonal antibody (mAb) glycosylation using medium supplements. To reduce the risk of losing valuable information in an intricate joint screening, 17 compounds were separated into five different groups, considering their mode of biological action. The concentration ranges of the medium supplements were defined according to information encountered in the literature and in-house experience. The screening experiments produced wide glycosylation pattern ranges. Multivariate analysis including principal component analysis and decision trees was used to select the best performing glycosylation modulators. Subsequent D-optimal quadratic design with four factors (three promising compounds and temperature shift) in shake tubes confirmed the outcome of the selection process and provided a solid basis for sequential process development at a larger scale. The glycosylation profile with respect to the specifications for biosimilarity was greatly improved in shake tube experiments: 75% of the conditions were equally close or closer to the specifications for biosimilarity than the best 25% in 96-deepwell plates. Biotechnol. Bioeng. 2017;114: 1448-1458. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  10. Does routine psychosocial screening improve referral to psychosocial care providers and patient-radiotherapist communication? A cluster randomized controlled trial.

    Science.gov (United States)

    Braeken, Anna P B M; Lechner, Lilian; Eekers, Daniëlle B P; Houben, Ruud M A; van Gils, Francis C J M; Ambergen, Ton; Kempen, Gertrudis I J M

    2013-11-01

    This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication. A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention. Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (Pcommunication. Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients. Psychosocial screening can be enhanced by effective radiotherapist-patient communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Modeling the Ecosystem Services Provided by Trees in Urban Ecosystems: Using Biome-BGC to Improve i-Tree Eco

    Science.gov (United States)

    Brown, Molly E.; McGroddy, Megan; Spence, Caitlin; Flake, Leah; Sarfraz, Amna; Nowak, David J.; Milesi, Cristina

    2012-01-01

    As the world becomes increasingly urban, the need to quantify the effect of trees in urban environments on energy usage, air pollution, local climate and nutrient run-off has increased. By identifying, quantifying and valuing the ecological activity that provides services in urban areas, stronger policies and improved quality of life for urban residents can be obtained. Here we focus on two radically different models that can be used to characterize urban forests. The i-Tree Eco model (formerly UFORE model) quantifies ecosystem services (e.g., air pollution removal, carbon storage) and values derived from urban trees based on field measurements of trees and local ancillary data sets. Biome-BGC (Biome BioGeoChemistry) is used to simulate the fluxes and storage of carbon, water, and nitrogen in natural environments. This paper compares i-Tree Eco's methods to those of Biome-BGC, which estimates the fluxes and storage of energy, carbon, water and nitrogen for vegetation and soil components of the ecosystem. We describe the two models and their differences in the way they calculate similar properties, with a focus on carbon and nitrogen. Finally, we discuss the implications of further integration of these two communities for land managers such as those in Maryland.

  12. Improving of technical characteristics of launch vehicles with liquid rocket engines using active onboard de-orbiting systems

    Science.gov (United States)

    Trushlyakov, V.; Shatrov, Ya.

    2017-09-01

    In this paper, the analysis of technical requirements (TR) for the development of modern space launch vehicles (LV) with main liquid rocket engines (LRE) is fulfilled in relation to the anthropogenic impact decreasing. Factual technical characteristics on the example of a promising type of rocket ;Soyuz-2.1.v.; are analyzed. Meeting the TR in relation to anthropogenic impact decrease based on the conventional design approach and the content of the onboard system does not prove to be efficient and leads to depreciation of the initial technical characteristics obtained at the first design stage if these requirements are not included. In this concern, it is shown that the implementation of additional active onboard de-orbiting system (AODS) of worked-off stages (WS) into the onboard LV stages systems allows to meet the TR related to the LV environmental characteristics, including fire-explosion safety. In some cases, the orbital payload mass increases.

  13. Crowd-sourced assessment of technical skills: an opportunity for improvement in the assessment of laparoscopic surgical skills.

    Science.gov (United States)

    Deal, Shanley B; Lendvay, Thomas S; Haque, Mohamad I; Brand, Timothy; Comstock, Bryan; Warren, Justin; Alseidi, Adnan

    2016-02-01

    Objective, unbiased assessment of surgical skills remains a challenge in surgical education. We sought to evaluate the feasibility and reliability of Crowd-Sourced Assessment of Technical Skills. Seven volunteer general surgery interns were given time for training and then testing, on laparoscopic peg transfer, precision cutting, and intracorporeal knot-tying. Six faculty experts (FEs) and 203 Amazon.com Mechanical Turk crowd workers (CWs) evaluated 21 deidentified video clips using the Global Objective Assessment of Laparoscopic Skills validated rating instrument. Within 19 hours and 15 minutes we received 662 eligible ratings from 203 CWs and 126 ratings from 6 FEs over 10 days. FE video ratings were of borderline internal consistency (Krippendorff's alpha = .55). FE ratings were highly correlated with CW ratings (Pearson's correlation coefficient = .78, P Assessment of Technical Skills as a reliable, basic tool to standardize the evaluation of technical skills in general surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Opportunities for improved diabetes care among patients of safety net practices: a safety net providers' strategic alliance study.

    Science.gov (United States)

    Reichsman, Ann; Werner, James; Cella, Peggi; Bobiak, Sarah; Stange, Kurt C

    2009-01-01

    To identify barriers and opportunities for quality diabetes care in safety net practices. In 3 federally qualified health centers and 1 free clinic, 19 primary care clinicians profiled patient and visit characteristics and quality of care measures for 181 consecutive visits by adult type 2 diabetic patients. Open-ended questions assessed patient and clinician perception of barriers to diabetes care and patient report of enabling factors. A multidisciplinary team identified themes from open-ended responses. Logistic regression analyses assessed the association of the identified barriers/enablers with 2 measures of quality care: glycosylated hemoglobin and prophylactic aspirin use. Ranked barriers noted by patients included adherence (40%), financial/insurance (23%), and psychosocial (13%) factors. Clinicians ranked systemic factors, including financial/ insurance (32%) and cultural/psychosocial (29%) factors, as important to adherence (29%) in determining quality diabetes care. Patients reported dietary and medical adherence (37%) and family/health care worker support (17%) as helpful factors. Among 175 patients with available data, glycosylated hemoglobin levels were associated with patient report of financial/insurance factors both as a barrier when visits and medications were unaffordable and as an opportunity when free or low-cost medications and services were provided. Patients' adherence with aspirin prophylaxis was strongly associated with African American race, prior prescription of aspirin and distribution of aspirin at the practice site (p<.001). Patients were less likely than clinicians to identify systemic and contextual factors contributing to poor diabetes care. From the front line's perspective, enabling patient self-management and systemic support is a target for improving diabetes care in safety net practices.

  15. Sun protection provided by regulation school uniforms in Australian schools: an opportunity to improve personal sun protection during childhood.

    Science.gov (United States)

    Turner, Denise; Harrison, Simone L

    2014-01-01

    Childhood sun exposure is linked to excessive pigmented mole development and melanoma risk. Clothing provides a physical barrier, protecting skin from ultraviolet radiation (UVR). Extending sleeves to elbow length and shorts to knee length has been shown to significantly reduce mole acquisition in preschoolers from tropical Queensland. We used publicly available uniform images and guidelines from primary schools in Townsville (latitude 19.25°S, n = 43 schools), Cairns (16.87°S, n = 46) and the Atherton Tablelands (17.26°S, n = 23) in tropical Australia to objectively determine the body surface proportion covered by regulation school uniforms. Uniforms of nongovernment, large (≥800 students), urban, educationally advantaged schools with comprehensive sun protection policies covered more skin than those of government schools (63.2% vs 62.0%; P schools (63.4% vs 62.3%; P = 0.009), rural (62.7% vs 61.9%; P = 0.002) and educationally disadvantaged schools (62.8% vs 62.3%; P school uniforms covered identical body surface proportions (62.4%, P = 0.084). Although wearing regulation school uniforms is mandatory at most Australian primary schools, this opportunity to improve children's sun protection is largely overlooked. Recent evidence suggests that even encouraging minor alterations to school uniforms (e.g. slightly longer sleeves/dresses/skirts/shorts) to increase skin coverage may reduce mole acquisition and melanoma risk, especially in high-risk populations. © 2014 The American Society of Photobiology.

  16. Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement.

    Science.gov (United States)

    Powell, Arfon G M T; Paterson-Brown, Simon; Drummond, Gordon B

    2014-02-20

    Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as "too esoteric", the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and "fitness for purpose", and avoid omission of vital knowledge.

  17. Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Ben Mathews

    Full Text Available Early childhood care and education providers (CCPs work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control. Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93; large effect size 0.95, p < 0.001; the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22; negligible effect size 0.03, p = 0.684. Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05. Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior.US National Institutes of Health NCT02225301.

  18. Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial.

    Science.gov (United States)

    Mathews, Ben; Yang, Chengwu; Lehman, Erik B; Mincemoyer, Claudia; Verdiglione, Nicole; Levi, Benjamin H

    2017-01-01

    Early childhood care and education providers (CCPs) work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control). Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93); large effect size 0.95, p < 0.001); the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22); negligible effect size 0.03, p = 0.684). Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05). Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior. US National Institutes of Health NCT02225301.

  19. EnviroTRADE: A technical perspective on the development of an information system providing data on environmental technologies and needs worldwide

    International Nuclear Information System (INIS)

    Harrington, M.W.; Harlan, C.P.

    1992-01-01

    In support of the US Department of Energy's commitment to the remediation of waste sites throughout its complex, the DOE has recognized that it can accelerate its technology development efforts and leverage the expenditure of available funds through an international cooperation among government entities, private industry, and educational institutions. To support the technology transfer of environmental information, the DOE has sponsored the development of EnviroTRADE - an international information system that will facilitate the exchange of environmental restoration and waste management technologies worldwide. The system will contain profiles on both environmental restoration / waste management needs and foreign / domestic technologies. Users will be able to identify matches between worldwide needs and available or emerging technologies. Where matches between needs and existing technologies are not found, the system will identify the potential for development of new and innovative technologies to address environmental problems. EnviroTRADE will also provide general information on international environmental restoration and waste management organizations, sites, activities, and contacts

  20. Do Mathematics and Reading Competencies Integrated into Career and Technical Education Courses Improve High School Student State Assessment Scores?

    Science.gov (United States)

    Pierce, Kristin B.; Hernandez, Victor M.

    2015-01-01

    A quasi experimental study tested a contextual teaching and learning model for integrating reading and mathematics competencies through 13 introductory career and technical education (CTE) courses. The treatment group consisted of students in the 13 introductory courses taught by the CTE teachers who designed the units and the control group…

  1. Improving Forsyth Technical Community College's Ability to Develop and Maintain Partnerships: Leveraging Technology to Develop Partnerships

    Science.gov (United States)

    Murdock, Alan K.

    2017-01-01

    Forsyth Technical Community College (FTCC) face a shortage of funding to meet the demands of students, faculty, staff and businesses. Through this practitioner research, the utilization of the college's current customer relationship management (CRM) database advanced. By leveraging technology, the researcher assisted the college in meeting the…

  2. Improving curriculum development practices in a technical vocational community college: examining effects of a professional development arrangement for middle managers

    NARCIS (Netherlands)

    Albashiry, Nabeel; Voogt, Joke; Pieters, Julius Marie

    2015-01-01

    Learning about curriculum development is critical for middle managers of technical vocational institutions in order to assume curriculum leadership in maintaining and enhancing the quality and relevance of their educational programs. This case study reports on the design and effects of a

  3. Non-dental primary care providers' views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study.

    Science.gov (United States)

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-10-29

    To investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways in which oral health and oral health services could be improved for their communities. Qualitative study with semistructured interviews and thematic analysis. Four remote communities in outback Queensland, Australia. 35 primary care providers who had experience in providing oral health advice to patients and four dental care providers who had provided oral health services to patients from the four communities. In the absence of a resident dentist, rural and remote residents did present to non-dental primary care providers with oral health problems such as toothache, abscess, oral/gum infection and sore mouth for treatment and advice. Themes emerged from the interview data around communication challenges and strategies to improve oral health. Although, non-dental care providers commonly advised patients to see a dentist, they rarely communicated with the dentist in the nearest regional town. Participants proposed that oral health could be improved by: enabling access to dental practitioners, educating communities on preventive oral healthcare, and building the skills and knowledge base of non-dental primary care providers in the field of oral health. Prevention is a cornerstone to better oral health in rural and remote communities as well as in more urbanised communities. Strategies to improve the provision of dental services by either visiting or resident dental practitioners should include scope to provide community-based oral health promotion activities, and to engage more closely with other primary care service providers in these small communities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. An Experimental Investigation of Improving Human Problem-Solving Performance by Guiding Attention and Adaptively Providing Details on Information Displays

    National Research Council Canada - National Science Library

    Narayanan, N. H

    2007-01-01

    .... Results showed that various display strategies for augmenting information presented based on knowledge about both the viewer's gaze patterns and the problem solving procedure he or she is employing could indeed improve problem-solving performance.

  5. [Digital electroencephalography in brain death diagnostics : Technical requirements and results of a survey on the compatibility with medical guidelines of digital EEG systems from providers in Germany].

    Science.gov (United States)

    Walter, U; Noachtar, S; Hinrichs, H

    2018-02-01

    The guidelines of the German Medical Association and the German Society for Clinical Neurophysiology and Functional Imaging (DGKN) require a high procedural and technical standard for electroencephalography (EEG) as an ancillary method for diagnosing the irreversible cessation of brain function (brain death). Nowadays, digital EEG systems are increasingly being applied in hospitals. So far it is unclear to what extent the digital EEG systems currently marketed in Germany meet the guidelines for diagnosing brain death. In the present article, the technical und safety-related requirements for digital EEG systems and the EEG documentation for diagnosing brain death are described in detail. On behalf of the DGKN, the authors sent out a questionnaire to all identified distributors of digital EEG systems in Germany with respect to the following technical demands: repeated recording of the calibration signals during an ongoing EEG recording, repeated recording of all electrode impedances during an ongoing EEG recording, assessability of intrasystem noise and galvanic isolation of measurement earthing from earthing conductor (floating input). For 15 of the identified 20 different digital EEG systems the specifications were provided by the distributors (among them all distributors based in Germany). All of these EEG systems are provided with a galvanic isolation (floating input). The internal noise can be tested with all systems; however, some systems do not allow repeated recording of the calibration signals and/or the electrode impedances during an ongoing EEG recording. The majority but not all of the currently available digital EEG systems offered for clinical use are eligible for use in brain death diagnostics as per German guidelines.

  6. A 'special effort' to provide improved sounding and cloud-motion wind data for FGGE. [First GARP Global Experiment

    Science.gov (United States)

    Greaves, J. R.; Dimego, G.; Smith, W. L.; Suomi, V. E.

    1979-01-01

    Enhancement and editing of high-density cloud motion wind assessments and research satellite soundings have been necessary to improve the quality of data used in The Global Weather Experiment. Editing operations are conducted by a man-computer interactive data access system. Editing will focus on such inputs as non-US satellite data, NOAA operational sounding and wind data sets, wind data from the Indian Ocean satellite, dropwindsonde data, and tropical mesoscale wind data. Improved techniques for deriving cloud heights and higher resolution sounding in meteorologically active areas are principal parts of the data enhancement program.

  7. Effectiveness of Provider and Community Interventions to Improve Treatment of Uncomplicated Malaria in Nigeria: A Cluster Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Obinna Onwujekwe

    Full Text Available The World Health Organization recommends that malaria be confirmed by parasitological diagnosis before treatment using Artemisinin-based Combination Therapy (ACT. Despite this, many health workers in malaria endemic countries continue to diagnose malaria based on symptoms alone. This study evaluates interventions to help bridge this gap between guidelines and provider practice. A stratified cluster-randomized trial in 42 communities in Enugu state compared 3 scenarios: Rapid Diagnostic Tests (RDTs with basic instruction (control; RDTs with provider training (provider arm; and RDTs with provider training plus a school-based community intervention (provider-school arm. The primary outcome was the proportion of patients treated according to guidelines, a composite indicator requiring patients to be tested for malaria and given treatment consistent with the test result. The primary outcome was evaluated among 4946 (93% of the 5311 patients invited to participate. A total of 40 communities (12 in control, 14 per intervention arm were included in the analysis. There was no evidence of differences between the three arms in terms of our composite indicator (p = 0.36: stratified risk difference was 14% (95% CI -8.3%, 35.8%; p = 0.26 in the provider arm and 1% (95% CI -21.1%, 22.9%; p = 0.19 in the provider-school arm, compared with control. The level of testing was low across all arms (34% in control; 48% provider arm; 37% provider-school arm; p = 0.47. Presumptive treatment of uncomplicated malaria remains an ingrained behaviour that is difficult to change. With or without extensive supporting interventions, levels of testing in this study remained critically low. Governments and researchers must continue to explore alternative ways of encouraging providers to deliver appropriate treatment and avoid the misuse of valuable medicines.ClinicalTrials.gov NCT01350752.

  8. 75 FR 6839 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-02-12

    ... underserved groups have participated in USDA programs at parity with other producers. Extrapolating from.... TSP applies to all persons equally regardless of race, color, national origin, gender, sex, or...

  9. Providing Technical Expertise for Effective Contract Management

    Science.gov (United States)

    2011-04-12

    back to both the finance leg and the contracting leg . In order to avoid a conflict of interest or give the impression of 4 any improprieties...each leg of this triad is separate. It is this reason and those already mentioned that the COR is the responsibility of the requiring activity and...A. Fulghum, DoD Logistician Optimistic About Afghanistan (Aviation Week’s DTI , January 27, 2010) as reported on military.com, accessed on 15 February

  10. Technologies for improving current and future light water reactor operation and maintenance: Development on the basis of experience. Proceedings of a technical committee meeting

    International Nuclear Information System (INIS)

    2000-09-01

    experienced in nuclear power plant operation and maintenance. Worldwide, the average energy availability factor has increased from approximately 70 percent in 1989 to 79 percent' in 1998, with some utilities achieving significantly higher values. This is being achieved through integrated programmes, including personnel training and quality assurance, from improvements implemented in plant systems and components, and from improvements in outage duration for maintenance, refuelling, and other scheduled shutdowns, as well as forced outages. International co-operation is a key role in this success. The various programmes of the World Association of Nuclear Operators (WANO) to exchange information and encourage communication of experience, and the activities of the IAEA including projects in nuclear power plant performance assessment and feedback, effective quality management, and information exchange meetings on technology advances, are important examples of international co-operation to improve the performance of nuclear power plants. This IAEA Technical Committee meeting (TCM) was convened to provide a forum for information exchange on technologies for improving plant operation and maintenance which can contribute to enhanced economic competitiveness of LWRs, and on on-going or planned technology development expected to achieve further improvements. Information exchange of recent positive experience on development and/or implementation of technologies that have resulted in reduced operation and maintenance costs of LWRs, and information on on-going or planned activities, was strongly encouraged

  11. Technologies for improving current and future light water reactor operation and maintenance: Development on the basis of experience. Proceedings of a technical committee meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-09-01

    experienced in nuclear power plant operation and maintenance. Worldwide, the average energy availability factor has increased from approximately 70 percent in 1989 to 79 percent' in 1998, with some utilities achieving significantly higher values. This is being achieved through integrated programmes, including personnel training and quality assurance, from improvements implemented in plant systems and components, and from improvements in outage duration for maintenance, refuelling, and other scheduled shutdowns, as well as forced outages. International co-operation is a key role in this success. The various programmes of the World Association of Nuclear Operators (WANO) to exchange information and encourage communication of experience, and the activities of the IAEA including projects in nuclear power plant performance assessment and feedback, effective quality management, and information exchange meetings on technology advances, are important examples of international co-operation to improve the performance of nuclear power plants. This IAEA Technical Committee meeting (TCM) was convened to provide a forum for information exchange on technologies for improving plant operation and maintenance which can contribute to enhanced economic competitiveness of LWRs, and on on-going or planned technology development expected to achieve further improvements. Information exchange of recent positive experience on development and/or implementation of technologies that have resulted in reduced operation and maintenance costs of LWRs, and information on on-going or planned activities, was strongly encouraged.

  12. SQ house dust mite (HDM) SLIT-tablet provides clinical improvement in HDM-induced allergic rhinitis

    DEFF Research Database (Denmark)

    Klimek, Ludger; Mosbech, Holger; Zieglmayer, Petra

    2016-01-01

    -consuming treatment regimen and a risk of systemic adverse reactions, sublingually administered allergy immunotherapy (SLIT) has been investigated as a more convenient treatment option with similar levels of efficacy and an improved safety profile that allows for at-home daily administration. In this Drug Profile, we...

  13. Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging

    International Nuclear Information System (INIS)

    Michalak, Gregory; Grimes, Joshua; Fletcher, Joel; Yu, Lifeng; Leng, Shuai; McCollough, Cynthia; Halaweish, Ahmed

    2016-01-01

    Purpose: The purpose of this study was to evaluate, over a wide range of phantom sizes, CT number stability achieved using two techniques for generating dual-energy computed tomography (DECT) virtual monoenergetic images. Methods: Water phantoms ranging in lateral diameter from 15 to 50 cm and containing a CT number test object were scanned on a DSCT scanner using both single-energy (SE) and dual-energy (DE) techniques. The SE tube potentials were 70, 80, 90, 100, 110, 120, 130, 140, and 150 kV; the DE tube potential pairs were 80/140, 70/150Sn, 80/150Sn, 90/150Sn, and 100/150Sn kV (Sn denotes that the 150 kV beam was filtered with a 0.6 mm tin filter). Virtual monoenergetic images at energies ranging from 40 to 140 keV were produced from the DECT data using two algorithms, monoenergetic (mono) and monoenergetic plus (mono+). Particularly in large phantoms, water CT number errors and/or artifacts were observed; thus, datasets with water CT numbers outside ±10 HU or with noticeable artifacts were excluded from the study. CT numbers were measured to determine CT number stability across all phantom sizes. Results: Data exclusions were generally limited to cases when a SE or DE technique with a tube potential of less than 90 kV was used to scan a phantom larger than 30 cm. The 90/150Sn DE technique provided the most accurate water background over the large range of phantom sizes evaluated. Mono and mono+ provided equally improved CT number stability as a function of phantom size compared to SE; the average deviation in CT number was only 1.4% using 40 keV and 1.8% using 70 keV, while SE had an average deviation of 11.8%. Conclusions: The authors’ report demonstrates, across all phantom sizes, the improvement in CT number stability achieved with mono and mono+ relative to SE

  14. Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Michalak, Gregory; Grimes, Joshua; Fletcher, Joel; Yu, Lifeng; Leng, Shuai; McCollough, Cynthia, E-mail: mccollough.cynthia@mayo.edu [Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905 (United States); Halaweish, Ahmed [Siemens Medical Solutions, Malvern, Pennsylvania 19355 (United States)

    2016-01-15

    Purpose: The purpose of this study was to evaluate, over a wide range of phantom sizes, CT number stability achieved using two techniques for generating dual-energy computed tomography (DECT) virtual monoenergetic images. Methods: Water phantoms ranging in lateral diameter from 15 to 50 cm and containing a CT number test object were scanned on a DSCT scanner using both single-energy (SE) and dual-energy (DE) techniques. The SE tube potentials were 70, 80, 90, 100, 110, 120, 130, 140, and 150 kV; the DE tube potential pairs were 80/140, 70/150Sn, 80/150Sn, 90/150Sn, and 100/150Sn kV (Sn denotes that the 150 kV beam was filtered with a 0.6 mm tin filter). Virtual monoenergetic images at energies ranging from 40 to 140 keV were produced from the DECT data using two algorithms, monoenergetic (mono) and monoenergetic plus (mono+). Particularly in large phantoms, water CT number errors and/or artifacts were observed; thus, datasets with water CT numbers outside ±10 HU or with noticeable artifacts were excluded from the study. CT numbers were measured to determine CT number stability across all phantom sizes. Results: Data exclusions were generally limited to cases when a SE or DE technique with a tube potential of less than 90 kV was used to scan a phantom larger than 30 cm. The 90/150Sn DE technique provided the most accurate water background over the large range of phantom sizes evaluated. Mono and mono+ provided equally improved CT number stability as a function of phantom size compared to SE; the average deviation in CT number was only 1.4% using 40 keV and 1.8% using 70 keV, while SE had an average deviation of 11.8%. Conclusions: The authors’ report demonstrates, across all phantom sizes, the improvement in CT number stability achieved with mono and mono+ relative to SE.

  15. Improving a health information system for real-time data entries: An action research project using socio-technical systems theory.

    Science.gov (United States)

    Adaba, Godfried Bakiyem; Kebebew, Yohannes

    2018-03-01

    This paper presents the findings of an action research (AR) project to improve a health information system (HIS) at the Operating Theater Department (OTD) of a National Health Service (NHS) hospital in South East England, the UK. Informed by socio-technical systems (STS) theory, AR was used to design an intervention to enhance an existing patient administration system (PAS) to enable data entries in real time while contributing to the literature. The study analyzed qualitative data collected through interviews, participant observations, and document reviews. The study found that the design of the PAS was unsuitable to the work of the three units of the OTD. Based on the diagnoses and STS theory, the project developed and implemented a successful intervention to enhance the legacy system for data entries in real time. The study demonstrates the value of AR from a socio-technical perspective for improving existing systems in healthcare settings. The steps adopted in this study could be applied to improve similar systems. A follow-up study will be essential to assess the sustainability of the improved system.

  16. Improving the United States airline industry's capacity to provide safe and dignified services to travelers with disabilities: focus group findings.

    Science.gov (United States)

    McCarthy, Michael J

    2011-01-01

    As a component of a training development project for intercity air travel providers, we investigated the capacity of the airline industry to meet the needs of travelers with disabilities by exploring: (1) the level of sensitivity among personnel to travelers' needs, (2) training currently provided, (3) areas in which additional training might be beneficial, and (4) organisational/systems-level commitment to dignified assistance to all travelers. Forty-four airline/vendor employees participated in nine focus groups in four US cities. Groups were audio recorded and transcribed. A grounded-theory approach was used to develop a coding system which was then applied to transcripts to identify themes. Factors influencing capacity grouped broadly into four areas: characteristics of the job/system, characteristics of current training, characteristics of providers themselves, and characteristics of travelers. At an interpersonal level, providers were empathetic and desired to provide dignified services. They lacked training and adequate equipment in some cases, however, and organisational commitment varied between companies. Traveler characteristics were also shown to impact service delivery. Results are promising but additional regulatory and organisational policies are needed to ensure quality services. Providers and consumers of intercity air travel services may benefit from the findings and recommendations of this study.

  17. Improving the non-technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™).

    Science.gov (United States)

    Cant, Robyn P; Porter, Joanne E; Cooper, Simon J; Roberts, Kate; Wilson, Ian; Gartside, Christopher

    2016-12-01

    This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  18. Improving support for parents of children with hearing loss: provider training on use of targeted communication strategies.

    Science.gov (United States)

    Muñoz, Karen; Nelson, Lauri; Blaiser, Kristina; Price, Tanner; Twohig, Michael

    2015-02-01

    When proper protocols are followed, children who are identified with a permanent hearing loss early in life have opportunities to develop language on par with their typical hearing peers. Young children with hearing loss are dependent on their parents to manage intervention during early years critical to their development, and parents' ability to effectively integrate recommendations in daily life is foundational for intervention success. Audiologists and early intervention professionals not only need to provide current evidence-based services, but also must address parents' emotional and learning needs related to their child's hearing loss. This study explored practice patterns related to education and support provided to parents of children with hearing loss and the influence of an in-service training on provider attitudes. This study used a prepost design with a self-report questionnaire to identify practice patterns related to communication skills and support used by providers when working with parents of children with hearing loss. A total of 45 participants (21 professionals and 24 graduate students) currently working with children completed the pretraining questionnaire, and 29 participants (13 professionals and 16 graduate students) completed the postquestionnaire. Data were collected using an online questionnaire before the training and 1 mo after training. Descriptive analyses were done to identify trends, and paired-samples t-tests were used to determine changes pretraining to posttraining. Findings revealed that professionals most frequently teach skills to mothers (91%) and infrequently teach skills to fathers (19%) and other caregivers (10%). Professionals reported frequently collaborating with other intervention providers (76%) and infrequently collaborating with primary care physicians (19%). One-third of the professionals reported addressing symptoms of depression and anxiety as an interfering factor with the ability to implement management

  19. An improved estimator for the hydration of fat-free mass from in vivo measurements subject to additive technical errors

    International Nuclear Information System (INIS)

    Kinnamon, Daniel D; Ludwig, David A; Lipshultz, Steven E; Miller, Tracie L; Lipsitz, Stuart R

    2010-01-01

    The hydration of fat-free mass, or hydration fraction (HF), is often defined as a constant body composition parameter in a two-compartment model and then estimated from in vivo measurements. We showed that the widely used estimator for the HF parameter in this model, the mean of the ratios of measured total body water (TBW) to fat-free mass (FFM) in individual subjects, can be inaccurate in the presence of additive technical errors. We then proposed a new instrumental variables estimator that accurately estimates the HF parameter in the presence of such errors. In Monte Carlo simulations, the mean of the ratios of TBW to FFM was an inaccurate estimator of the HF parameter, and inferences based on it had actual type I error rates more than 13 times the nominal 0.05 level under certain conditions. The instrumental variables estimator was accurate and maintained an actual type I error rate close to the nominal level in all simulations. When estimating and performing inference on the HF parameter, the proposed instrumental variables estimator should yield accurate estimates and correct inferences in the presence of additive technical errors, but the mean of the ratios of TBW to FFM in individual subjects may not

  20. A cell-free scaffold-based cartilage repair provides improved function hyaline-like repair at one year.

    Science.gov (United States)

    Siclari, Alberto; Mascaro, Gennaro; Gentili, Chiara; Cancedda, Ranieri; Boux, Eugenio

    2012-03-01

    Bone marrow stimulation techniques in cartilage repair such as drilling are limited by the formation of fibrous to hyaline-like repair tissue. It has been suggested such techniques can be enhanced by covering the defect with scaffolds. We present an innovative approach using a polyglycolic acid (PGA)-hyaluronan scaffold with platelet-rich-plasma (PRP) in drilling. We asked whether (1) PRP immersed in a cell-free PGA-hyaluronan scaffold improves patient-reported 1-year outcomes for the Knee injury and Osteoarthritis Score (KOOS), and (2) implantation of the scaffold in combination with bone marrow stimulation leads to the formation of hyaline-like cartilage repair tissue. We reviewed 52 patients who had arthroscopic implantation of the PGA-hyaluronan scaffold immersed with PRP in articular cartilage defects of the knee pretreated with Pridie drilling. Patients were assessed by KOOS. At 9 months followup, histologic staining was performed in specimens obtained from five patients to assess the repair tissue quality. The KOOS subscores improved for pain (55 to 91), symptoms (57 to 88), activities of daily living (69 to 86), sports and recreation (36 to 70), and quality of life (38 to 73). The histologic evaluation showed a homogeneous hyaline-like cartilage repair tissue. The cell-free PGA-hyaluronan scaffold combined with PRP leads to cartilage repair and improved patient-reported outcomes (KOOS) during 12 months of followup. Histologic sections showed morphologic features of hyaline-like repair tissue. Long-term followup is needed to determine if the cartilage repair tissue is durable. Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

  1. The Healthcare Improvement Scotland evidence note rapid review process: providing timely, reliable evidence to inform imperative decisions on healthcare.

    Science.gov (United States)

    McIntosh, Heather M; Calvert, Julie; Macpherson, Karen J; Thompson, Lorna

    2016-06-01

    Rapid review has become widely adopted by health technology assessment agencies in response to demand for evidence-based information to support imperative decisions. Concern about the credibility of rapid reviews and the reliability of their findings has prompted a call for wider publication of their methods. In publishing this overview of the accredited rapid review process developed by Healthcare Improvement Scotland, we aim to raise awareness of our methods and advance the discourse on best practice. Healthcare Improvement Scotland produces rapid reviews called evidence notes using a process that has achieved external accreditation through the National Institute for Health and Care Excellence. Key components include a structured approach to topic selection, initial scoping, considered stakeholder involvement, streamlined systematic review, internal quality assurance, external peer review and updating. The process was introduced in 2010 and continues to be refined over time in response to user feedback and operational experience. Decision-makers value the responsiveness of the process and perceive it as being a credible source of unbiased evidence-based information supporting advice for NHSScotland. Many agencies undertaking rapid reviews are striving to balance efficiency with methodological rigour. We agree that there is a need for methodological guidance and that it should be informed by better understanding of current approaches and the consequences of different approaches to streamlining systematic review methods. Greater transparency in the reporting of rapid review methods is essential to enable that to happen.

  2. Enhancing the relationship and improving communication between adolescents and their health care providers: a school based intervention by medical students.

    Science.gov (United States)

    Towle, Angela; Godolphin, William; Van Staalduinen, Samantha

    2006-08-01

    To develop, implement and evaluate a workshop to help adolescents develop independent and active relationships with their physicians. A needs-assessment survey informed the development of a workshop delivered by medical student volunteers and incorporated into the career and personal planning curriculum of high schools in Vancouver, Canada. Over a 6-year period, 64 workshops were delivered by 181 medical students to 1651 high school students in six schools. The workshop is acceptable, do-able, effective and sustainable, characteristics that arise from the mutual benefits to all the groups involved: the medical school, the school board, the medical students, the high school teachers and students. The workshop provides a model for providing health care education to adolescents in the community. Teaching adolescents the importance of good doctor-patient communication encourages them to take ongoing responsibility for their health care and is an alternative route to direct health care education.

  3. Study of technical and economic methods for improving anthracite washing. Estudio de las posibilidades tecnico-economicas de la mejora del lavado de carbones de antracita

    Energy Technology Data Exchange (ETDEWEB)

    1988-10-01

    This project was conceived and financed by Ocicarbon in order to help improve methods for washing indigenous anthracite with the aim of maximising its economic and energy benefits. The project has been carried out jointly by the National Institute for Coal and its subsidiaries, Francisco Pintado Fe, and ENADIMSA (Adaro Mining Research). The article summarises the programme of work and the results obtained. The project was divided into three phases: selection; technical analysis of the plant; and a basic engineering and feasibility study. 4 tabs.

  4. Appearance traits in fish farming: progress from classical genetics to genomics, providing insight into current and potential genetic improvement

    Directory of Open Access Journals (Sweden)

    Nelson eColihueque

    2014-08-01

    Full Text Available Appearance traits in fish, those external body characteristics that influence consumer acceptance at point of sale, have come to the forefront of commercial fish farming, as culture profitability is closely linked to management of these traits. Appearance traits comprise mainly body shape and skin pigmentation. Analysis of the genetic basis of these traits in different fish reveals significant genetic variation within populations, indicating potential for their genetic improvement. Work into ascertaining the minor or major genes underlying appearance traits for commercial fish is emerging, with substantial progress in model fish in terms of identifying genes that control body shape and skin colors. In this review, we describe research progress to date, especially with regard to commercial fish, and discuss genomic findings in model fish in order to better address the genetic basis of the traits. Given that appearance traits are important in commercial fish, the genomic information related to this issue promises to accelerate the selection process in coming years.

  5. Appearance traits in fish farming: progress from classical genetics to genomics, providing insight into current and potential genetic improvement

    Science.gov (United States)

    Colihueque, Nelson; Araneda, Cristian

    2014-01-01

    Appearance traits in fish, those external body characteristics that influence consumer acceptance at point of sale, have come to the forefront of commercial fish farming, as culture profitability is closely linked to management of these traits. Appearance traits comprise mainly body shape and skin pigmentation. Analysis of the genetic basis of these traits in different fish reveals significant genetic variation within populations, indicating potential for their genetic improvement. Work into ascertaining the minor or major genes underlying appearance traits for commercial fish is emerging, with substantial progress in model fish in terms of identifying genes that control body shape and skin colors. In this review, we describe research progress to date, especially with regard to commercial fish, and discuss genomic findings in model fish in order to better address the genetic basis of the traits. Given that appearance traits are important in commercial fish, the genomic information related to this issue promises to accelerate the selection process in coming years. PMID:25140172

  6. Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

    Science.gov (United States)

    McCarthy, Melissa L; Ding, Ru; Roderer, Nancy K; Steinwachs, Donald M; Ortmann, Melinda J; Pham, Julius Cong; Bessman, Edward S; Kelen, Gabor D; Atha, Walter; Retezar, Rodica; Bessman, Sara C; Zeger, Scott L

    2013-09-01

    We determine whether prescription information or services improve the medication adherence of emergency department (ED) patients. Adult patients treated at one of 3 EDs between November 2010 and September 2011 and prescribed an antibiotic, central nervous system, gastrointestinal, cardiac, or respiratory drug at discharge were eligible. Subjects were randomly assigned to usual care or one of 3 prescription information or services intervention groups: (1) practical services to reduce barriers to prescription filling (practical prescription information or services); (2) consumer drug information from MedlinePlus (MedlinePlus prescription information or services); or (3) both services and information (combination prescription information or services). Self-reported medication adherence, measured by primary adherence (prescription filling) and persistence (receiving medicine as prescribed) rates, was determined during a telephone interview 1 week postdischarge. Of the 3,940 subjects enrolled and randomly allocated to treatment, 86% (N=3,386) completed the follow-up interview. Overall, primary adherence was 88% and persistence was 48%. Across the sites, primary adherence and persistence did not differ significantly between usual care and the prescription information or services groups. However, at site C, subjects who received the practical prescription information or services (odds ratio [OR]=2.4; 95% confidence interval [CI] 1.4 to 4.3) or combination prescription information or services (OR=1.8; 95% CI 1.1 to 3.1) were more likely to fill their prescription compared with usual care. Among subjects prescribed a drug that treats an underlying condition, subjects who received the practical prescription information or services were more likely to fill their prescription (OR=1.8; 95% CI 1.0 to 3.1) compared with subjects who received usual care. Prescription filling and receiving medications as prescribed was not meaningfully improved by offering patients patient

  7. Improving the action requirements of technical specifications: A risk-comparison of continued operation and plant shutdown

    Energy Technology Data Exchange (ETDEWEB)

    Kim, I.S.; Samanta, P.K. [Brookhaven National Lab., Upton, NY (United States); Mankamo, T.

    1995-04-01

    When the systems needed to remove decay heat are inoperable or degraded, the risk of shutting down the plant may be comparable to, or even higher than, that of continuing power operation with the equipment inoperable while giving priority to repairs. This concern arises because the plant may not have sufficient capability for removing decay heat during the shutdown. However, Technical Specifications (TSs) often require {open_quotes}immediate{close_quotes} shutdown of the plant. In this paper, we present risk-based analyses of the various operational policy alternatives available in such situations, with an example application to the standby service water (SSW) system of a BWR. These analyses can be used to define risk-effective requirements for those standby safety systems under discussion.

  8. Improving the action requirements of technical specifications: A risk-comparison of continued operation and plant shutdown

    International Nuclear Information System (INIS)

    Kim, I.S.; Samanta, P.K.

    1994-01-01

    When the systems needed to remove decay heat are inoperable or degraded, the risk of shutting down the plant may be comparable to, or even higher than, that of continuing power operation with the equipment inoperable while giving priority to repairs. This concern arises because the plant may not have sufficient capability for removing decay heat during the shutdown. However, Technical Specifications (TSs) often require ''immediate'' shutdown of the plant. In this paper, the authors present risk-based analyses of the various operational policy alternatives available in such situations, with an example application to the standby service water (SSW) system of a BWR. These analyses can be used to define risk-effective requirements for those standby safety systems under discussion

  9. Order no 000040/M/DIRCAB/PRN from December 03,2014 provides for composition, assignments and modes of the working of the technical and scientist advice consultative of the high Nigerian Autority of the Atomic Energy

    International Nuclear Information System (INIS)

    Saidou, Sidibe

    2014-01-01

    this Order provides for composition, assignments and modes of the working of the technical and scientist advice consultative of the high Nigerian Autority of the Atomic Energy, this consultative advice composed of forty member and a president (president of HANEA) and a reporter (general secretary of HANEA) is placed under the authority of the HANEA. It constitutes a national committee of nuclear security, to this title it orients the activities and assure the follow-up: - of the built-in plan of national nuclear security (IAEA-NIGER) - the plan of the stake doesn't work of the resolution 1540 (ONU-NIGER) - of strategies for the attenuation of chemical and biologic nuclear risk NRBC [fr

  10. Functionalized bioengineered spider silk spheres improve nuclease resistance and activity of oligonucleotide therapeutics providing a strategy for cancer treatment.

    Science.gov (United States)

    Kozlowska, Anna Karolina; Florczak, Anna; Smialek, Maciej; Dondajewska, Ewelina; Mackiewicz, Andrzej; Kortylewski, Marcin; Dams-Kozlowska, Hanna

    2017-09-01

    Cell-selective delivery and sensitivity to serum nucleases remain major hurdles to the clinical application of RNA-based oligonucleotide therapeutics, such as siRNA. Spider silk shows great potential as a biomaterial due to its biocompatibility and biodegradability. Self-assembling properties of silk proteins allow for processing into several different morphologies such as fibers, scaffolds, films, hydrogels, capsules and spheres. Moreover, bioengineering of spider silk protein sequences can functionalize silk by adding peptide moieties with specific features including binding or cell recognition domains. We demonstrated that modification of silk protein by adding the nucleic acid binding domain enabled the development of a novel oligonucleotide delivery system that can be utilized to improve pharmacokinetics of RNA-based therapeutics, such as CpG-siRNA. The MS2 bioengineered silk was functionalized with poly-lysine domain (KN) to generate hybrid silk MS2KN. CpG-siRNA efficiently bound to MS2KN in contrary to control MS2. Both MS2KN complexes and spheres protected CpG-siRNA from degradation by serum nucleases. CpG-siRNA molecules encapsulated into MS2KN spheres were efficiently internalized and processed by TLR9-positive macrophages. Importantly, CpG-STAT3siRNA loaded in silk spheres showed delayed and extended target gene silencing compared to naked oligonucleotides. The prolonged Stat3 silencing resulted in the more pronounced downregulation of interleukin 6 (IL-6), a proinflammatory cytokine and upstream activator of STAT3, which limits the efficacy of TLR9 immunostimulation. Our results demonstrate the feasibility of using spider silk spheres as a carrier of therapeutic nucleic acids. Moreover, the modified kinetic and activity of the CpG-STAT3siRNA embedded into silk spheres is likely to improve immunotherapeutic effects in vivo. We demonstrated that modification of silk protein by adding the nucleic acid binding domain enabled the development of a novel

  11. The geographic distribution of eye care providers in the United States: Implications for a national strategy to improve vision health.

    Science.gov (United States)

    Gibson, Diane M

    2015-04-01

    To describe the patterns of local eye care provider availability in the US. Data from 2011 on the number of ophthalmologists and optometrists in each of the 3143 counties in the US were drawn from the Area Health Resources File. Population-weighted quartiles of the county-level number of ophthalmologists per capita and the county-level number of optometrists per capita were defined. Descriptive statistics were calculated and a cross tabulation of quartiles of ophthalmologist availability and quartiles of optometrist availability was conducted for all the counties in the US and for the set of counties in each region of the US. 24.0% of US counties had no ophthalmologists or optometrists. 60.7% of counties in the US were in one of the lower two quartiles of both ophthalmologist availability and optometrist availability, and 24.1% of counties were in one of the lower two quartiles of ophthalmologist availability but in one of the upper two quartiles of optometrist availability. Public health interventions that are effective in a context of limited local eye care provider availability or that are able to leverage optometrist availability effectively in areas with limited ophthalmologist availability could be of widespread use in the US. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Combined DNA, toxicological and heavy metal analyses provides an auditing toolkit to improve pharmacovigilance of traditional Chinese medicine (TCM)

    Science.gov (United States)

    Coghlan, Megan L.; Maker, Garth; Crighton, Elly; Haile, James; Murray, Dáithí C.; White, Nicole E.; Byard, Roger W.; Bellgard, Matthew I.; Mullaney, Ian; Trengove, Robert; Allcock, Richard J. N.; Nash, Christine; Hoban, Claire; Jarrett, Kevin; Edwards, Ross; Musgrave, Ian F.; Bunce, Michael

    2015-12-01

    Globally, there has been an increase in the use of herbal remedies including traditional Chinese medicine (TCM). There is a perception that products are natural, safe and effectively regulated, however, regulatory agencies are hampered by a lack of a toolkit to audit ingredient lists, adulterants and constituent active compounds. Here, for the first time, a multidisciplinary approach to assessing the molecular content of 26 TCMs is described. Next generation DNA sequencing is combined with toxicological and heavy metal screening by separation techniques and mass spectrometry (MS) to provide a comprehensive audit. Genetic analysis revealed that 50% of samples contained DNA of undeclared plant or animal taxa, including an endangered species of Panthera (snow leopard). In 50% of the TCMs, an undeclared pharmaceutical agent was detected including warfarin, dexamethasone, diclofenac, cyproheptadine and paracetamol. Mass spectrometry revealed heavy metals including arsenic, lead and cadmium, one with a level of arsenic >10 times the acceptable limit. The study showed 92% of the TCMs examined were found to have some form of contamination and/or substitution. This study demonstrates that a combination of molecular methodologies can provide an effective means by which to audit complementary and alternative medicines.

  13. Providing education on evidence-based practice improved knowledge but did not change behaviour: a before and after study

    Directory of Open Access Journals (Sweden)

    Lovarini Meryl

    2005-12-01

    Full Text Available Abstract Background Many health professionals lack the skills to find and appraise published research. This lack of skills and associated knowledge needs to be addressed, and practice habits need to change, for evidence-based practice to occur. The aim of this before and after study was to evaluate the effect of a multifaceted intervention on the knowledge, skills, attitudes and behaviour of allied health professionals. Methods 114 self-selected occupational therapists were recruited. The intervention included a 2-day workshop combined with outreach support for eight months. Support involved email and telephone contact and a workplace visit. Measures were collected at baseline, post-workshop, and eight months later. The primary outcome was knowledge, measured using the Adapted Fresno Test of Evidence-Based Practice (total score 0 to 156. Secondary outcomes were attitude to evidence-based practice (% reporting improved skills and confidence; % reporting barriers, and behaviour measured using an activity diary (% engaging/not engaging in search and appraisal activities, and assignment completion. Results Post-workshop, there were significant gains in knowledge which were maintained at follow-up. The mean difference in the Adapted Fresno Test total score was 20.6 points (95% CI, 15.6 to 25.5. The change from post-workshop to follow-up was small and non-significant (mean difference 1.2 points, 95% CI, -6.0 to 8.5. Fewer participants reported lack of searching and appraisal skills as barriers to evidence-based practice over time (searching = 61%, 53%, 24%; appraisal 60%, 65%, 41%. These differences were statistically significant (p = 0.0001 and 0.010 respectively. Behaviour changed little. Pre-workshop, 6% engaged in critical appraisal increasing to 18% post-workshop and 18% at follow-up. Nearly two thirds (60% were not reading any research literature at follow-up. Twenty-three participants (20.2% completed their assignment. Conclusion Evidence

  14. Time Matters: Increasing the Efficiency of Antarctic Marine Geology and Paleoceanography Expeditions by Providing Improved Sediment Chronology

    Science.gov (United States)

    Rosenheim, B. E.; Domack, E. W.; Shevenell, A.; Subt, C.

    2015-12-01

    To maximize the areal extent of Antarctic sedimentary records of past deglaciation, it is necessary to ensure more sediment cores can be adequately dated. Antarctic margin sediment is challenging to date due to the lack of preserved calcium carbonate, but the records contained in these sediments readily recount the history of deglaciation. Recent and continued development of new chronological methods for Antarctic margin sediments have allowed better use of the efforts of marine geological coring expeditions to the region. The development of Ramped PyrOx radiocarbon dating has allowed us to 1. improve dates in deglacial sediments where no carbonate is preserved, 2. date glacial sediments lying below the tills marking the last glaciation, and 3. compile core chronologies into a regional framework of ice shelf collapse that has eluded many marine geology campaigns over the last few decades. These advances in a fundamental aspect of geological sciences will put the U.S. and international community on a better foothold to interpret the past as it relates to our warming future. We will present these advances in chronology as well as the science that is enabled by them, while arguing that the future of Antarctic marine science also depends on investments in shore-based technologies that come at a relatively low cost.

  15. Draft genome sequence of Cicer reticulatum L., the wild progenitor of chickpea provides a resource for agronomic trait improvement.

    Science.gov (United States)

    Gupta, Sonal; Nawaz, Kashif; Parween, Sabiha; Roy, Riti; Sahu, Kamlesh; Kumar Pole, Anil; Khandal, Hitaishi; Srivastava, Rishi; Kumar Parida, Swarup; Chattopadhyay, Debasis

    2017-02-01

    Cicer reticulatum L. is the wild progenitor of the fourth most important legume crop chickpea (C. arietinum L.). We assembled short-read sequences into 416 Mb draft genome of C. reticulatum and anchored 78% (327 Mb) of this assembly to eight linkage groups. Genome annotation predicted 25,680 protein-coding genes covering more than 90% of predicted gene space. The genome assembly shared a substantial synteny and conservation of gene orders with the genome of the model legume Medicago truncatula. Resistance gene homologs of wild and domesticated chickpeas showed high sequence homology and conserved synteny. Comparison of gene sequences and nucleotide diversity using 66 wild and domesticated chickpea accessions suggested that the desi type chickpea was genetically closer to the wild species than the kabuli type. Comparative analyses predicted gene flow between the wild and the cultivated species during domestication. Molecular diversity and population genetic structure determination using 15,096 genome-wide single nucleotide polymorphisms revealed an admixed domestication pattern among cultivated (desi and kabuli) and wild chickpea accessions belonging to three population groups reflecting significant influence of parentage or geographical origin for their cultivar-specific population classification. The assembly and the polymorphic sequence resources presented here would facilitate the study of chickpea domestication and targeted use of wild Cicer germplasms for agronomic trait improvement in chickpea. © The Author 2016. Published by Oxford University Press on behalf of Kazusa DNA Research Institute.

  16. Technical writing versus technical writing

    Science.gov (United States)

    Dillingham, J. W.

    1981-01-01

    Two terms, two job categories, 'technical writer' and 'technical author' are discussed in terms of industrial and business requirements and standards. A distinction between 'technical writing' and technical 'writing' is made. The term 'technical editor' is also considered. Problems inherent in the design of programs to prepare and train students for these jobs are discussed. A closer alliance between industry and academia is suggested as a means of preparing students with competent technical communication skills (especially writing and editing skills) and good technical skills.

  17. From disability to ability: comprehensive rehabilitation providing a holistic functional improvement in a child with neglected neural tube defect.

    Science.gov (United States)

    Mishra, Kriti; Siddharth, V

    2017-09-25

    Neural Tube defects are one of the most common congenital disorders, presenting in a paediatric rehabilitation set-up. With its wide spectrum of clinical presentation and possible complications, the condition can significantly impact an individual's functional capacity and quality of life. The condition also affects the family of the child leaving them with a lifelong impairment to cope up with. Through this 16-year-old child, we shed light on the effects of providing rehabilitation, even at a later stage and its benefits. We also get a glimpse of difficulties in availing rehabilitation services in developing countries and the need to reach out many more neglected children like him with good functional abilities. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

    Science.gov (United States)

    Steele, Joseph R; Schomer, Don F

    2009-07-01

    Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

  19. Formative evaluation of the STAR intervention: improving teachers' ability to provide psychosocial support for vulnerable individuals in the school community.

    Science.gov (United States)

    Ferreira, Ronél; Ebersöhn, Liesel

    2011-04-01

    The article describes the pilot phase of a participatory reflection and action (PRA) study. The longitudinal investigation explores teachers' ability to provide psychosocial support within the context of HIV/AIDS following an asset-based intervention. The study ensued from our desire to understand and contribute to knowledge about the changed roles of teachers due to adversity in the community, specifically in relation to HIV/AIDS and education. The supportive teachers, assets and resilience (STAR) intervention was facilitated from November 2003 to October 2005 and consisted of the research team undertaking nine field visits and facilitating 20 intervention sessions (2-3 hours each), and 12 post-intervention research visits have been conducted to date. Ten female teachers were selected for participation through random purposeful sampling at a primary school in an informal settlement outside Port Elizabeth, South Africa. Data-generation included PRA activities, observation, informal interactive interviews, and focus group discussions. The data were analysed by means of inductive thematic analysis. We found that the teachers did not view vulnerability as being related to children or HIV/AIDS in isolation, but rather that their psychosocial support to children and the school community was inclusive across a spectrum of vulnerabilities and services. We argue that teachers who are inclined to provide such support will fulfil this role irrespective of understanding policy or receiving training. We contend that teachers are well-positioned to manage school-based psychosocial support in order to create relevant and caring spaces for vulnerable individuals in the school community.

  20. Incorporating technology buying behaviour into UK-based long term domestic stock energy models to provide improved policy analysis

    International Nuclear Information System (INIS)

    Lee, Timothy; Yao, Runming

    2013-01-01

    The UK has a target for an 80% reduction in CO 2 emissions by 2050 from a 1990 base. Domestic energy use accounts for around 30% of total emissions. This paper presents a comprehensive review of existing models and modelling techniques and indicates how they might be improved by considering individual buying behaviour. Macro (top-down) and micro (bottom-up) models have been reviewed and analysed. It is found that bottom-up models can project technology diffusion due to their higher resolution. The weakness of existing bottom-up models at capturing individual green technology buying behaviour has been identified. Consequently, Markov chains, neural networks and agent-based modelling are proposed as possible methods to incorporate buying behaviour within a domestic energy forecast model. Among the three methods, agent-based models are found to be the most promising, although a successful agent approach requires large amounts of input data. A prototype agent-based model has been developed and tested, which demonstrates the feasibility of an agent approach. This model shows that an agent-based approach is promising as a means to predict the effectiveness of various policy measures. - Highlights: ► Long term energy models are reviewed with a focus on UK domestic stock models. ► Existing models are found weak in modelling green technology buying behaviour. ► Agent models, Markov chains and neural networks are considered as solutions. ► Agent-based modelling (ABM) is found to be the most promising approach. ► A prototype ABM is developed and testing indicates a lot of potential.

  1. Time Delay Mechanical-noise Cancellation (TDMC) to Provide Order of Magnitude Improvements in Radio Science Observations

    Science.gov (United States)

    Atkinson, D. H.; Babuscia, A.; Lazio, J.; Asmar, S.

    2017-12-01

    Many Radio Science investigations, including the determinations of planetary masses, measurements of planetary atmospheres, studies of the solar wind, and solar system tests of relativistic gravity, rely heavily on precision Doppler tracking. Recent and currently proposed missions such as VERITAS, Bepi Colombo, Juno have shown that the largest error source in the precision Doppler tracking data is noise in the Doppler system. This noise is attributed to un-modeled motions of the ground antenna's phase center and is commonly referred to as "antenna mechanical noise." Attempting to reduce this mechanical noise has proven difficult since the deep space communications antennas utilize large steel structures that are already optimized for mechanical stability. Armstrong et al. (2008) have demonstrated the Time Delay Mechanical-noise Cancellation (TDMC) concept using Goldstone DSN antennas (70 m & 34 m) and the Cassinispacecraft to show that the mechanical noise of the 70 m antenna could be suppressed when two-way Doppler tracking from the 70 m antenna and the receive-only Doppler data from the smaller, stiffer 34 m antenna were combined with suitable delays. The proof-of-concept confirmed that the mechanical noise in the final Doppler observable was reduced to that of the stiffer, more stable antenna. Caltech's Owens Valley Radio Observatory (OVRO) near Bishop, CA now has six 10.4 m diameter antennas, a consequence of the closure of Combined Array for Research in Millimeter Astronomy (CARMA). In principle, a 10 m antenna can lead to an order-of-magnitude improvement for the mechanical noise correction, as the smaller dish offers better mechanical stability compared to a DSN 34-m antenna. These antennas also have existing Ka-band receiving systems, and preliminary discussions with the OVRO staff suggest that much of the existing signal path could be used for Radio Science observations.

  2. Innovative PCM-desiccant packet to provide dry microclimate and improve performance of cooling vest in hot environment

    International Nuclear Information System (INIS)

    Itani, Mariam; Ghaddar, Nesreen; Ghali, Kamel

    2017-01-01

    Highlights: • A PCM and desiccant packet is proposed for use in personal cooling vest to keep dry air next to skin. • A PCM-Desiccant model for clothed heated wet cylinder is developed and validated experimentally. • The microclimate air temperature was 0.6 °C higher in PCM-Desiccant case compared to PCM-only case. • Microclimate humidity content decreased due to desiccant from 21.23 to 19.74 g/kg dry air. • PCM melted fraction increased due to desiccant from 0.24 to 0.5. - Abstract: A novel combination of phase change material (PCM) and a solid desiccant layer is proposed for the aim of maintaining dry cool microclimate air adjacent to wet warm skin and hence improve PCM performance in cooling vests used in hot humid environment. A fabric-PCM-Desiccant model is developed to predict the temperature and moisture content of the microclimate air layer in the presence of a PCM-Desiccant packet. The developed model is validated through experiments conducted on a wet clothed heated cylinder for the two cases of using (i) a PCM only packet and (ii) a PCM-Desiccant packet. Microclimate air temperatures and humidity content as well as PCM and desiccant temperatures were measured experimentally and were compared with predicted values by the fabric-PCM-Desiccant model. Good agreement was attained with a maximum relative error of 7% in measured temperatures. A decrease is observed in the humidity content of the microclimate air in the presence of the solid desiccant from 21.23 g/kg dry air to 19.74 g/kg dry air and an increase in the melted fraction of the PCM at the end of the experiment from 0.24 to 0.5.

  3. Evaluating the impact of healthcare provider training to improve tuberculosis management: a systematic review of methods and outcome indicators used.

    Science.gov (United States)

    Wu, Shishi; Roychowdhury, Imara; Khan, Mishal

    2017-03-01

    Developing human resources capacity is vital for tuberculosis (TB) control in low- and middle-income countries. Although investments in TB healthcare provider (HCP) training programmes have increased, it is unclear whether these are robustly evaluated. The objective of this systematic review was to synthesize the methods and outcome indicators used to assess TB HCP training programmes. A systematic scoping review of publications reporting on evaluations of training programmes for TB HCPs - including doctors, nurses, paramedics, and lay health workers - was conducted through a search in three electronic databases, Google Scholar, and five websites of non-profit organizations. Data on the study location, population trained, outcomes assessed, and evaluation approach were extracted. After screening 499 unique publications, 21 were eligible for inclusion in the analysis. The majority of evaluations were conducted in Africa. The most common evaluation methods were a review of patient records (n=8, 38%) and post-training interview with trainees (n=7, 33%). In terms of outcomes, more than half of the studies (n=12, 57%) evaluated knowledge acquisition of trainees, with only six (29%) assessing on-the-job behaviour change. Even though more funds have been invested in TB HCP training, publications from robust evaluations assessing the impact on quality of care and behaviour change are limited. Copyright © 2016. Published by Elsevier Ltd.

  4. Estimation and improvement of the RF government plan for providing the sustainable social-economic development of Russia in 2016

    Directory of Open Access Journals (Sweden)

    Dmitriy V. Manushin

    2016-09-01

    interestfree loans for initial setting of personal farms for the citizens who have received free land from the state to intensify the work in the field of infrastructure projects implementation to solve organizational problems of state management of society and the economy etc. Practical significance implementation of the proposed measures will improve the crisis management in the Russian macroeconomics.

  5. Polar Bears or People?: How Framing Can Provide a Useful Analytic Tool to Understand & Improve Climate Change Communication in Classrooms

    Science.gov (United States)

    Busch, K. C.

    2014-12-01

    study indicates that framing may be a useful theory for investigating how climate change is taught and learned in classrooms. In addition, suggestions are made for how to develop effective professional development for teachers to improve their communication of climate change.

  6. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball and W. Zeuner

    2011-01-01

      Operational experience 2011 CMS is approaching the end of a very successful year of operation. Proton- proton running ended in the late afternoon of 30th October with a stunning 5.73 fb–1 delivered by LHC, of which CMS recorded 5.22 fb–1. During heavy-ion operation, which continues until 7th December, both the accelerator and the CMS detector have also performed very well. Despite the encouraging overall reliability of technical operation, several infrastructure failures which occurred since the last Bulletin are worthy of mention, with one leading for the first time to significant data-loss. On 10th July, a CERN-wide power failure brought down essentially all services including the magnet, due to an MCS setting being left in “manual” after the recent technical stop, but there was no significant damage and the detector was operational before the LHC, despite a slow and tortuous recovery (one of several indications this year that there is room for improve...

  7. A strategy to improve skills in pharmaceutical supply management in East Africa: the regional technical resource collaboration for pharmaceutical management

    Directory of Open Access Journals (Sweden)

    Minzi Omary

    2008-12-01

    Full Text Available Abstract Background International initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the President's Emergency Plan for AIDS Relief and the President's Malaria Initiative have significantly increased availability and access to medicines in some parts of the developing world. Despite this, however, skills remain limited on quantifying needs for medications and ordering, receiving and storing medications appropriately; recording medications inventories accurately; distributing medications for use appropriately; and advising patients on how to use medications appropriately. The Regional Technical Resource Collaboration for Pharmaceutical Management (RTRC has been established to help address the problem of skills shortage in pharmaceutical management in East Africa. Methods The initiative brings together academic institutions from four East African countries to participate in skills-building activities in pharmaceutical supply management. The initiative targeted the institutions' ability to conduct assessments of pharmaceutical supply management systems and to develop and implement effective skills-building programmes for pharmaceutical supply chain management. Results Over a two-year period, the RTRC succeeded in conducting assessments of pharmaceutical supply management systems and practices in Kenya, Rwanda, Tanzania and Uganda. In 2006, the RTRC participated in a materials-development workshop in Kampala, Uganda, and contributed to the development of comprehensive HIV/AIDS pharmaceutical management training materials; these materials are now widely available in all four countries. In Tanzania and Uganda the RTRC has been involved with the training of health care workers in HIV/AIDS pharmaceutical management. In Kenya, Tanzania and Uganda the RTRC has been conducting operations research to find solutions to their countries' skills-shortage problems. Some of the interventions tested include applying and evaluating the

  8. Logistic quantile regression provides improved estimates for bounded avian counts: A case study of California Spotted Owl fledgling production

    Science.gov (United States)

    Cade, Brian S.; Noon, Barry R.; Scherer, Rick D.; Keane, John J.

    2017-01-01

    Counts of avian fledglings, nestlings, or clutch size that are bounded below by zero and above by some small integer form a discrete random variable distribution that is not approximated well by conventional parametric count distributions such as the Poisson or negative binomial. We developed a logistic quantile regression model to provide estimates of the empirical conditional distribution of a bounded discrete random variable. The logistic quantile regression model requires that counts are randomly jittered to a continuous random variable, logit transformed to bound them between specified lower and upper values, then estimated in conventional linear quantile regression, repeating the 3 steps and averaging estimates. Back-transformation to the original discrete scale relies on the fact that quantiles are equivariant to monotonic transformations. We demonstrate this statistical procedure by modeling 20 years of California Spotted Owl fledgling production (0−3 per territory) on the Lassen National Forest, California, USA, as related to climate, demographic, and landscape habitat characteristics at territories. Spotted Owl fledgling counts increased nonlinearly with decreasing precipitation in the early nesting period, in the winter prior to nesting, and in the prior growing season; with increasing minimum temperatures in the early nesting period; with adult compared to subadult parents; when there was no fledgling production in the prior year; and when percentage of the landscape surrounding nesting sites (202 ha) with trees ≥25 m height increased. Changes in production were primarily driven by changes in the proportion of territories with 2 or 3 fledglings. Average variances of the discrete cumulative distributions of the estimated fledgling counts indicated that temporal changes in climate and parent age class explained 18% of the annual variance in owl fledgling production, which was 34% of the total variance. Prior fledgling production explained as much of

  9. Improving Depression Care for Adults With Serious Mental Illness in Underresourced Areas: Community Coalitions Versus Technical Support.

    Science.gov (United States)

    Castillo, Enrico G; Shaner, Roderick; Tang, Lingqi; Chung, Bowen; Jones, Felica; Whittington, Yolanda; Miranda, Jeanne; Wells, Kenneth B

    2018-02-01

    Community Partners in Care (CPIC) was a group-randomized study of two approaches to implementing expanded collaborative depression care: Community Engagement and Planning (CEP), a coalition approach, and Resources for Services (RS), a technical assistance approach. Collaborative care networks in both arms involved health care and other agencies in five service sectors. This study examined six- and 12-month outcomes for CPIC participants with serious mental illness. This secondary analysis focused on low-income CPIC participants from racial-ethnic minority groups with serious mental illness in underresourced Los Angeles communities (N=504). Serious mental illness was defined as self-reported severe depression (≥20 on the Patient Health Questionnaire-8) at baseline or a lifetime history of bipolar disorder or psychosis. Logistic and Poisson regression with multiple imputation and response weights, controlling for covariates, was used to model intervention effects. Among CPIC participants, 50% had serious mental illness. Among those with serious mental illness, CEP relative to RS reduced the likelihood of poor mental health-related quality of life (OR=.62, 95% CI=.41-.95) but not depression (primary outcomes); reduced the likelihood of having homelessness risk factors and behavioral health hospitalizations; increased the likelihood of mental wellness; reduced specialty mental health medication and counseling visits; and increased faith-based depression visits (each pmental health-related quality of life and some social outcomes for adults with serious mental illness, although no evidence was found for long-term effects in this subsample.

  10. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball and W. Zeuner

    2010-01-01

    Overview Once again, the bulk of this article reviews the intense activity of a recently completed shutdown, which, although quite unforeseeable until a few weeks before it started, proved by its success that our often advertised capability to conduct major maintenance within a two month period is real. Although safely completed, on-time to remarkable precision, the activity was not without incident, and highlighted our dependence on many experienced, specialist teams and their precise choreography. Even after the yoke was safely closed, magnet re-commissioning and beampipe pumpdown showed new and thought-provoking behaviour. The struggle to maintain adequate technical resources will be a pre-occupation over the coming months, in parallel with the start of truly sustained operation, for which various procedures are still being put in place. Planning for future shutdowns must now become a high priority, with many working groups and task forces already in existence to prepare infrastructure improvements and to...

  11. Does Problem-Based Learning Improve Problem Solving Skills?--A Study among Business Undergraduates at Malaysian Premier Technical University

    Science.gov (United States)

    Kadir, Z. Abdul; Abdullah, N. H.; Anthony, E.; Salleh, B. Mohd; Kamarulzaman, R.

    2016-01-01

    Problem-based Learning (PBL) approach has been widely used in various disciplines since it is claimed to improve students' soft skills. However, empirical supports on the effect of PBL on problem solving skills have been lacking and anecdotal in nature. This study aimed to determine the effect of PBL approach on students' problem solving skills…

  12. A cost-effectiveness analysis of provider interventions to improve health worker practice in providing treatment for uncomplicated malaria in Cameroon: a study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Wiseman Virginia

    2012-01-01

    Full Text Available Abstract Background Governments and donors all over Africa are searching for sustainable, affordable and cost-effective ways to improve the quality of malaria case management. Widespread deficiencies have been reported in the prescribing and counselling practices of health care providers treating febrile patients in both public and private health facilities. Cameroon is no exception with low levels of adherence to national guidelines, the frequent selection of non-recommended antimalarials and the use of incorrect dosages. This study evaluates the effectiveness and cost-effectiveness of introducing two different provider training packages, alongside rapid diagnostic tests (RDTs, designed to equip providers with the knowledge and practical skills needed to effectively diagnose and treat febrile patients. The overall aim is to target antimalarial treatment better and to facilitate optimal use of malaria treatment guidelines. Methods/Design A 3-arm stratified, cluster randomized trial will be conducted to assess whether introducing RDTs with provider training (basic or enhanced is more cost-effective than current practice without RDTs, and whether there is a difference in the cost effectiveness of the provider training interventions. The primary outcome is the proportion of patients attending facilities that report a fever or suspected malaria and receive treatment according to malaria guidelines. This will be measured by surveying patients (or caregivers as they exit public and mission health facilities. Cost-effectiveness will be presented in terms of the primary outcome and a range of secondary outcomes, including changes in provider knowledge. Costs will be estimated from a societal and provider perspective using standard economic evaluation methodologies. Trial Registration ClinicalTrials.gov: NCT00981877

  13. Improved technical performance of a multifunctional prehospital telemedicine system between the research phase and the routine use phase - an observational study.

    Science.gov (United States)

    Felzen, Marc; Brokmann, Jörg C; Beckers, Stefan K; Czaplik, Michael; Hirsch, Frederik; Tamm, Miriam; Rossaint, Rolf; Bergrath, Sebastian

    2017-04-01

    Introduction Telemedical concepts in emergency medical services (EMS) lead to improved process times and patient outcomes, but their technical performance has thus far been insufficient; nevertheless, the concept was transferred into EMS routine care in Aachen, Germany. This study evaluated the system's technical performance and compared it to a precursor system. Methods The telemedicine system was implemented on seven ambulances and a teleconsultation centre staffed with experienced EMS physicians was established in April 2014. Telemedical applications included mobile vital data, 12-lead, picture transmission and video streaming from inside the ambulances. The tele-EMS physician filled in a questionnaire regarding the technical performance of the applications, background noise and assessed clinical values of the transmitted pictures and videos after each mission between 15 May 2014-15 October 2014. Results Teleconsultation was established during 539 emergency cases. In 83% of the cases ( n = 447), only the paramedics and the tele-EMS physician were involved. Transmission success rates ranged from 98% (audio connection) to 93% (12-lead electrocardiogram (ECG) transmission). All functionalities, except video transmission, were significantly better than the pilot project ( p < 0.05). Severe background noise was detected to a lesser extent ( p = 0.0004) and the clinical value of the pictures and videos were considered significantly more valuable. Discussion The multifunctional system is now sufficient for routine use and is the most reliable mobile emergency telemedicine system compared to other published projects. Dropouts were due to user errors and network coverage problems. These findings enable widespread use of this system in the future, reducing the critical time intervals until medical therapy is started.

  14. Photovoltaic Manufacturing Cost and Throughput Improvements for Thin Film CIGS-Based Modules: Final Technical Report, July 1998 -- September 2001

    Energy Technology Data Exchange (ETDEWEB)

    Britt, J.

    2002-04-01

    This report describes the marked improvements made of the production line under the PVMaT program: successfully developed a high-speed, all-laser, monolithic integration process for CIGS-based modules on polyimide substrates; exceeded PVMaT goals for scribing rate and total interconnect width; developed robust, well-controlled techniques for selective scribing; improved CIGS evaporation sources to allow uniform, controllable delivery; completed foundation required to integrate higher CIGS deposition rates into the production line; developed well-controlled Se delivery system to minimize Se consumption; successfully integrated the parallel-detector spectroscope ellipsometer (PDSE) into a production CIGS deposition chamber; collected useful, in-situ data with PDSE; validated the performance of the X-ray fluorescometry (XRF) sensor in the production CIGS deposition chamber; and successfully incorporated the XRF sensor into the control architecture of the production CIGS deposition chamber .

  15. Analysis of strategies for improving uranium utilization in pressurized water reactors. Annual technical progress report for FY 1980

    International Nuclear Information System (INIS)

    Sefcik, J.A.; Driscoll, M.J.; Lanning, D.D.

    1981-01-01

    Systematic procedures have been devised and applied to evaluate core design and fuel management strategies for improving uranium utilization in Pressurized Water Reactors operated on a once-through fuel cycle. A principal objective has been the evaluation of suggested improvements on a self-consistent basis, allowing for concurrent changes in dependent variables such as core leakage and batch power histories, which might otherwise obscure the sometimes subtle effects of interest. Two levels of evaluation have been devised: a simple but accurate analytic model based on the observed linear variations in assembly reactivity as a function of burnup; and a numerical approach, embodied in a computer program, which relaxes this assumption and combines it with empirical prescriptions for assembly (or batch) power as a function of reactivity, and core leakage as a function of peripheral assembly power. State-of-the-art physics methods, such as PDQ-7, were used to verify and supplement these techniques

  16. RBMK nuclear reactors: Proposals for instrumentation and control improvements to enhanced safety and availability. IEC technical report of type 3. Working material

    International Nuclear Information System (INIS)

    1995-01-01

    The present material presents a CD+V draft report ''RBMK nuclear reactors: Proposals for instrumentation and control improvements to enhance safety and availability'' prepared by the Joint IEC/IAEA team during 1993-1995. Experience has demonstrated the need to improve the safety instrumentation of the RBMK type reactors using well proven modern technology. The working group identified the upgrades and changes of the highest priority based on the evaluation of the RBMK systems and the events where the instrumentation was found to be inadequate for safe operation. The subjects discussed in this document were not selected on a systematic basis but were selected by the IEC and IAEA experts as considered to be appropriate to the activities of the IEC and for which technical experience was available. The items identified therefore do not reflect any ranking of the safety issues or any priority or impact on safety of any of the measures were they to be implemented. Many important safety issued and areas where physical measures are required to improve safety have been omitted and indeed not even acknowledged in this document. The recommendations presented in the document differ from those normally produced by the IEC in the form of standards as they are of a transitory nature and some have already been overtaken by the continuing process of improvements to plant safety. Figs and tabs

  17. The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia

    DEFF Research Database (Denmark)

    Pinder, Margeret; Conteh, Lesong; Jeffries, David

    2016-01-01

    ) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. Methods/design A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide...

  18. Using a quality improvement model to enhance providers' performance in maternal and newborn health care : a post-only intervention and comparison design

    NARCIS (Netherlands)

    Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle

    2017-01-01

    Background: The Standards Based Management and Recognition (SBM-R (R)) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine

  19. Technical Study on Improvement of Endurance Capability of Limit Short-circuit Current of Charge Control SMART Meter

    Science.gov (United States)

    Li, W. W.; Du, Z. Z.; Yuan, R. m.; Xiong, D. Z.; Shi, E. W.; Lu, G. N.; Dai, Z. Y.; Chen, X. Q.; Jiang, Z. Y.; Lv, Y. G.

    2017-10-01

    Smart meter represents the development direction of energy-saving smart grid in the future. The load switch, one of the core parts of smart meter, should be of high reliability, safety and endurance capability of limit short-circuit current. For this reason, this paper discusses the quick simulation of relationship between attraction and counterforce of load switch without iteration, establishes dual response surface model of attraction and counterforce and optimizes the design scheme of load switch for charge control smart meter, thus increasing electromagnetic attraction and spring counterforce. In this way, this paper puts forward a method to improve the withstand capacity of limit short-circuit current.

  20. Improved technical efficiency and exogenous factors in transportation demand for energy: An application of structural time series analysis to South Korean data

    International Nuclear Information System (INIS)

    Sa'ad, Suleiman

    2010-01-01

    This paper stresses the importance of incorporating the effects of improved technical efficiency and exogenous factors when estimating energy demand functions. Using annual time series data for the period 1973-2007 in the STSM (structural time series model) developed by Harvey et al. the paper estimates price and income elasticities of demand for energy as well as the annual growth of the stochastic trend at the end of the estimation period. The results of the study reveal a long-run income elasticity of 1.37 and a price elasticity of -0.19. In addition, the underlying trend is generally stochastic and negatively sloping during the greater part of the estimation period. Finally, the estimated result from the structural time series is compared with the results from the Johansen Cointegration. These results suggest that income is the dominant factor in energy consumption. In addition, the coefficient of linear trend is negative, supporting the results from the STSM.

  1. Improved technical efficiency and exogenous factors in transportation demand for energy: An application of structural time series analysis to South Korean data

    Energy Technology Data Exchange (ETDEWEB)

    Sa' ad, Suleiman [Surrey Centre for Energy Economics (SEEC), University of Surrey, Guildford (United Kingdom)

    2010-07-15

    This paper stresses the importance of incorporating the effects of improved technical efficiency and exogenous factors when estimating energy demand functions. Using annual time series data for the period 1973-2007 in the STSM (structural time series model) developed by Harvey et al. the paper estimates price and income elasticities of demand for energy as well as the annual growth of the stochastic trend at the end of the estimation period. The results of the study reveal a long-run income elasticity of 1.37 and a price elasticity of -0.19. In addition, the underlying trend is generally stochastic and negatively sloping during the greater part of the estimation period. Finally, the estimated result from the structural time series is compared with the results from the Johansen Cointegration. These results suggest that income is the dominant factor in energy consumption. In addition, the coefficient of linear trend is negative, supporting the results from the STSM. (author)

  2. A structured self-directed basic skills curriculum results in improved technical performance in the absence of expert faculty teaching.

    Science.gov (United States)

    Wright, Andrew S; McKenzie, Jill; Tsigonis, Abraham; Jensen, Aaron R; Figueredo, Edgar J; Kim, Sara; Horvath, Karen

    2012-06-01

    We developed a novel curriculum teaching 20 open surgical skills in 5 general domains (instrument handling, knot tying, simple wound closure, advanced wound closure, and hemostasis). The curriculum includes online didactics, skills practice, and defined performance metrics, but is entirely self-guided with no expert oversight or teaching. Subjects included first- and second-year medical students (n = 9). Subjects first viewed a demonstration video depicting proper technique. The pretest was video-recorded performance of each skill. Subjects then completed the self-guided skills curriculum at their own pace, returning for posttesting once they met defined self-assessment criteria. Performance was evaluated through both self-assessment and blinded video review by 2 expert reviewers using previously validated scales. After completion of the curriculum, performance improved significantly by both self-assessment (3,754 ± 1,742 to 6,496 ± 1,337; P performance was significantly better for all domains by self-assessment (P instrument handling). Completion of a self-guided basic surgical skills curriculum allows novice learners to significantly improve performance in basic open surgical skills, without traditional expert teaching. This curriculum is useful for medical students and incoming junior residents. Copyright © 2012 Mosby, Inc. All rights reserved.

  3. Improved Bone Graft Method for Upper Cervical Surgery with Posterior Approach: Technical Description and Report of 52 Cases.

    Science.gov (United States)

    Wang, Yong-Li; Wang, Xiang-Yang

    2018-02-21

    We sought to report a minimum 12 months' follow-up results of our improved bone graft method for upper cervical surgery with the posterior approach. Among 52 consecutive cases, odontoid nonunion occurred in 33 patients, atlantoaxial instability in 11 patients, and occipitocervical deformity in 8 patients who underwent posterior C1-C2 transarticular screw/screw-rod internal fixation (41 cases) and occipitocervical fusion (11 cases) with the improved bone graft technique. Each surgical procedure was performed by the same senior spine surgeon. We took lateral cervical standing roentgenograms before surgery and immediately after surgery. Then we conducted craniocerebral computed tomography examination with reconstruction at 3, 6, 12, and 24 months and annually thereafter. The postoperative follow-up times are about 12-38 months. All cases showed satisfactory screw fixation by radiographic examination, and there were no postoperative neurologic complications. One case had postoperative retropharyngeal infection after the transoral release and posterior reduction by pedicle screw instrumentation. All patients got solid fusions, and no pseudarthrosis occurred. All cases had solid fusions at the 3-month follow-up. Good bone graft bed, enough bone graft material, solid local fixation, and effective bone graft method are prerequisites for a successful bone graft. By analyzing postoperative follow-up in the consecutive cases in this study, our bone graft method describing a new bone graft structure is a reliable posterior fusion technique. It is worth considering, and further research is needed. Copyright © 2018. Published by Elsevier Inc.

  4. Assessing Students' Technical Skill Attainment

    Science.gov (United States)

    Jorgensen, Haley

    2010-01-01

    The Wisconsin Technical College System (WTCS) is working to comply with the Carl D. Perkins Career and Technical Education Improvement Act of 2006 (Perkins) to ensure that its graduates have mastered the technical skills needed by business and industry. The legislation requires that each state identify and approve program assessment strategies…

  5. Improved technical success and radiation safety of adrenal vein sampling using rapid, semi-quantitative point-of-care cortisol measurement.

    Science.gov (United States)

    Page, Michael M; Taranto, Mario; Ramsay, Duncan; van Schie, Greg; Glendenning, Paul; Gillett, Melissa J; Vasikaran, Samuel D

    2018-01-01

    Objective Primary aldosteronism is a curable cause of hypertension which can be treated surgically or medically depending on the findings of adrenal vein sampling studies. Adrenal vein sampling studies are technically demanding with a high failure rate in many centres. The use of intraprocedural cortisol measurement could improve the success rates of adrenal vein sampling but may be impracticable due to cost and effects on procedural duration. Design Retrospective review of the results of adrenal vein sampling procedures since commencement of point-of-care cortisol measurement using a novel single-use semi-quantitative measuring device for cortisol, the adrenal vein sampling Accuracy Kit. Success rate and complications of adrenal vein sampling procedures before and after use of the adrenal vein sampling Accuracy Kit. Routine use of the adrenal vein sampling Accuracy Kit device for intraprocedural measurement of cortisol commenced in 2016. Results Technical success rate of adrenal vein sampling increased from 63% of 99 procedures to 90% of 48 procedures ( P = 0.0007) after implementation of the adrenal vein sampling Accuracy Kit. Failure of right adrenal vein cannulation was the main reason for an unsuccessful study. Radiation dose decreased from 34.2 Gy.cm 2 (interquartile range, 15.8-85.9) to 15.7 Gy.cm 2 (6.9-47.3) ( P = 0.009). No complications were noted, and implementation costs were minimal. Conclusions Point-of-care cortisol measurement during adrenal vein sampling improved cannulation success rates and reduced radiation exposure. The use of the adrenal vein sampling Accuracy Kit is now standard practice at our centre.

  6. Advanced Direct-Drive Generator for Improved Availability of Oscillating Wave Surge Converter Power Generation Systems Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Englebretson, Steven [ABB Inc., Cary, NC (United States); Ouyang, Wen [ABB Inc., Cary, NC (United States); Tschida, Colin [ABB Inc., Cary, NC (United States); Carr, Joseph [ABB Inc., Cary, NC (United States); Ramanan, V.R. [ABB Inc., Cary, NC (United States); Johnson, Matthew [Texas A& M Univ., College Station, TX (United States); Gardner, Matthew [Texas A& M Univ., College Station, TX (United States); Toliyat, Hamid [Texas A& M Univ., College Station, TX (United States); Staby, Bill [Resolute Marine Energy, Inc., Boston, MA (United States); Chertok, Allan [Resolute Marine Energy, Inc., Boston, MA (United States); Hazra, Samir [ABB Inc., Cary, NC (United States); Bhattacharya, Subhashish [ABB Inc., Cary, NC (United States)

    2017-05-13

    This report summarizes the activities conducted under the DOE-EERE funded project DE-EE0006400, where ABB Inc. (ABB), in collaboration with Texas A&M’s Advanced Electric Machines & Power Electronics (EMPE) Lab and Resolute Marine Energy (RME) designed, derisked, developed, and demonstrated a novel magnetically geared electrical generator for direct-drive, low-speed, high torque MHK applications The project objective was to investigate a novel and compact direct-drive electric generator and its system aspects that would enable elimination of hydraulic components in the Power Take-Off (PTO) of a Marine and Hydrokinetic (MHK) system with an oscillating wave surge converter (OWSC), thereby improving the availability of the MHK system. The scope of this project was limited to the development and dry lab demonstration of a low speed generator to enable future direct drive MHK systems.

  7. Research and development of improved efficiency small steam turbines (IESST). Technical progress report, Phase I, 16 April-31 December 1979

    Energy Technology Data Exchange (ETDEWEB)

    Choate, D.M.; Tuttle, A.H.

    1980-01-01

    Product Statistical Bulletins of the National Electrical Manufacturers Association (NEMA) and Turbodyne's shipment records over a 10-y period were researched to determine quantities installed and to define general parameters of design. Engineering studies were conducted to determine the optimum turbine design to meet the defined design parameters. Two conceptual designs plus an added variation of one design were completed together with designs of gearing required to provide speeds compatible with driven equipment speeds. The calculated performance of the recommended design and currently available small steam turbines were compared and a life cycle cost analysis was conducted to determine the economic competitiveness of the new design.

  8. Who recognises technical standards in TTIP?

    NARCIS (Netherlands)

    Purnhagen, K.

    2018-01-01

    Current political discussions on the relationship of technical standards to the Transatlantic, Trade and Investment Partnership (TTIP) concern the question whether TTIP can provide a transatlantic level playing field for technical standards, and whether this will negatively affect technical

  9. Imagining Technicities

    DEFF Research Database (Denmark)

    Liboriussen, Bjarke; Plesner, Ursula

    2011-01-01

    to the elements of taste and skill. In the final analysis those references were synthesized as five imagined technicities: the architect, the engineer, the client, the Chinese, and the Virtual World native. Because technicities are often assumed and rarely discussed as actants who influence practice, their role......, this article focuses on innovative uses of virtual worlds in architecture. We interviewed architects, industrial designers and other practitioners. Conceptually supported by an understanding of technicity found in Cultural Studies, the interviews were then coded with a focus on interviewees’ references...... in cooperation and development of ICTs seems to pass unnoticed. However, since they are aligned into ICTs, technicities impact innovation....

  10. INDOT Technical Training Plan

    Science.gov (United States)

    2012-04-01

    The study provides the background documents necessary for the development of a Technical Training Plan and makes recommendations : for the content and structure of such a plan for the District Operations, Operations, Capital Program Management, and E...

  11. Technical note: Rapid image-based field methods improve the quantification of termite mound structures and greenhouse-gas fluxes

    Directory of Open Access Journals (Sweden)

    P. A. Nauer

    2018-06-01

    Full Text Available Termite mounds (TMs mediate biogeochemical processes with global relevance, such as turnover of the important greenhouse gas methane (CH4. However, the complex internal and external morphology of TMs impede an accurate quantitative description. Here we present two novel field methods, photogrammetry (PG and cross-sectional image analysis, to quantify TM external and internal mound structure of 29 TMs of three termite species. Photogrammetry was used to measure epigeal volume (VE, surface area (AE and mound basal area (AB by reconstructing 3-D models from digital photographs, and compared against a water-displacement method and the conventional approach of approximating TMs by simple geometric shapes. To describe TM internal structure, we introduce TM macro- and micro-porosity (θM and θμ, the volume fractions of macroscopic chambers, and microscopic pores in the wall material, respectively. Macro-porosity was estimated using image analysis of single TM cross sections, and compared against full X-ray computer tomography (CT scans of 17 TMs. For these TMs we present complete pore fractions to assess species-specific differences in internal structure. The PG method yielded VE nearly identical to a water-displacement method, while approximation of TMs by simple geometric shapes led to errors of 4–200 %. Likewise, using PG substantially improved the accuracy of CH4 emission estimates by 10–50 %. Comprehensive CT scanning revealed that investigated TMs have species-specific ranges of θM and θμ, but similar total porosity. Image analysis of single TM cross sections produced good estimates of θM for species with thick walls and evenly distributed chambers. The new image-based methods allow rapid and accurate quantitative characterisation of TMs to answer ecological, physiological and biogeochemical questions. The PG method should be applied when measuring greenhouse-gas emissions from TMs to avoid large errors from inadequate shape

  12. Unregulated provider perceptions of audit and feedback reports in long-term care: cross-sectional survey findings from a quality improvement intervention.

    Science.gov (United States)

    Fraser, Kimberly D; O'Rourke, Hannah M; Baylon, Melba Andrea B; Boström, Anne-Marie; Sales, Anne E

    2013-02-13

    Audit with feedback is a moderately effective approach for improving professional practice in other health care settings. Although unregulated caregivers give the majority of direct care in long-term care settings, little is known about how they understand and perceive feedback reports because unregulated providers have not been directly targeted to receive audit with feedback in quality improvement interventions in long-term care. The purpose of this paper is to describe unregulated care providers' perceptions of usefulness of a feedback report in four Canadian long-term care facilities. We delivered monthly feedback reports to unregulated care providers for 13 months in 2009-2010. The feedback reports described a unit's performance in relation to falls, depression, and pain as compared to eight other units in the study. Follow-up surveys captured participant perceptions of the feedback report. We conducted descriptive analyses of the variables related to participant perceptions and multivariable logistic regression to assess the association between perceived usefulness of the feedback report and a set of independent variables. The vast majority (80%) of unregulated care providers (n = 171) who responded said they understood the reports. Those who discussed the report with others and were interested in other forms of data were more likely to find the feedback report useful for making changes in resident care. This work suggests that unregulated care providers can understand and feel positively about using audit with feedback reports to make changes to resident care. Further research should explore ways to promote fuller engagement of unregulated care providers in decision-making to improve quality of care in long-term care settings.

  13. Implementation of provider-based electronic medical records and improvement of the quality of data in a large HIV program in Sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Barbara Castelnuovo

    Full Text Available INTRODUCTION: Starting in June 2010 the Infectious Diseases Institute (IDI clinic (a large urban HIV out-patient facility switched to provider-based Electronic Medical Records (EMR from paper EMR entered in the database by data-entry clerks. Standardized clinics forms were eliminated but providers still fill free text clinical notes in physical patients' files. The objective of this study was to compare the rate of errors in the database before and after the introduction of the provider-based EMR. METHODS AND FINDINGS: Data in the database pre and post provider-based EMR was compared with the information in the patients' files and classified as correct, incorrect, and missing. We calculated the proportion of incorrect, missing and total error for key variables (toxicities, opportunistic infections, reasons for treatment change and interruption. Proportions of total errors were compared using chi-square test. A survey of the users of the EMR was also conducted. We compared data from 2,382 visits (from 100 individuals of a retrospective validation conducted in 2007 with 34,957 visits (from 10,920 individuals of a prospective validation conducted in April-August 2011. The total proportion of errors decreased from 66.5% in 2007 to 2.1% in 2011 for opportunistic infections, from 51.9% to 3.5% for ART toxicity, from 82.8% to 12.5% for reasons for ART interruption and from 94.1% to 0.9% for reasons for ART switch (all P<0.0001. The survey showed that 83% of the providers agreed that provider-based EMR led to improvement of clinical care, 80% reported improved access to patients' records, and 80% appreciated the automation of providers' tasks. CONCLUSIONS: The introduction of provider-based EMR improved the quality of data collected with a significant reduction in missing and incorrect information. The majority of providers and clients expressed satisfaction with the new system. We recommend the use of provider-based EMR in large HIV programs in Sub

  14. Reconciling patient and provider priorities for improving the care of critically ill patients: A consensus method and qualitative analysis of decision making.

    Science.gov (United States)

    McKenzie, Emily; Potestio, Melissa L; Boyd, Jamie M; Niven, Daniel J; Brundin-Mather, Rebecca; Bagshaw, Sean M; Stelfox, Henry T

    2017-12-01

    Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list. We employed a modified Delphi process with a diverse group of panellists to reconcile priorities for improving care of critically ill patients in the intensive care unit (ICU). Proceedings were audio-recorded, transcribed and analysed using qualitative content analysis to explore the decision-making process for establishing consensus. Nine panellists including three providers, three decision makers and three family members of previously critically ill patients. Panellists rated and revised 28 priorities over three rounds of review and reached consensus on the "Top 5" priorities for quality improvement: transition of patient care from ICU to hospital ward; family presence and effective communication; delirium screening and management; early mobilization; and transition of patient care between ICU providers. Four themes were identified as important for establishing consensus: storytelling (sharing personal experiences), amalgamating priorities (negotiating priority scope), considering evaluation criteria and having a priority champion. Our study demonstrates the feasibility of incorporating families of patients into a multistakeholder prioritization exercise. The approach described can be used to guide consensus building and reconcile priorities of diverse stakeholder groups. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  15. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

    Science.gov (United States)

    Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

    2018-01-01

    Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving

  16. Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

    Science.gov (United States)

    Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

    2018-01-01

    Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and

  17. Online Training in Specific Meditation Practices Improves Gratitude, Well-Being, Self-Compassion, and Confidence in Providing Compassionate Care Among Health Professionals.

    Science.gov (United States)

    Rao, Nisha; Kemper, Kathi J

    2016-04-06

    Mind-body practices that intentionally generate positive emotion could improve health professionals' well-being and compassion. However, the feasibility and impact of clinician training in these practices is unknown. Data were analyzed from 3 online modules offered to health professionals: (a) Gratitude, (b) Positive Word, and (c) Loving-kindness/Compassion meditation. Pairedttests were used to assess pre- to posttraining changes in gratitude (Gratitude Questionnaire), well-being (World Health Organization Well-Being Index), self-compassion (Neff's Self-Compassion Scale), and confidence in providing compassionate care (Confidence in Providing Calm, Compassionate Care Scale). The 177 enrollees included diverse practitioners (nurses, physicians, social workers, and others). Training was associated with statistically significant improvements in gratitude (38.3 ± 4.6 to 39.5 ± 3.3), well-being (16.4 ± 4.0 to 17.9 ± 4.2), self-compassion (39.5 ± 8.1 to 43.1 ± 7.6), and confidence in providing compassionate care (73.3 ± 16.4 to 80.9 ± 13.8;Pgratitude, well-being, self-compassion, and confidence in providing compassionate care. © The Author(s) 2016.

  18. Routine training is not enough: structured training in family planning and abortion improves residents' competency scores and intentions to provide abortion after graduation more than ad hoc training.

    Science.gov (United States)

    Macisaac, Laura; Vickery, Zevidah

    2012-03-01

    Abortion provision remains threatened by the paucity of physicians trained to provide them. Lack of training during residency has been cited by obstetrician and gynecologist (ob-gyn) physicians as a reason for not including abortion in their practice. We administered surveys on interest, competency and intention to provide abortions to two groups of ob-gyn residents: one experiencing a new comprehensive and structured family planning rotation, and another group at our affiliate hospital's residency program receiving "ad hoc" training during their routine gynecology rotations. Surveys were anonymous and blinded to investigator. The structured family planning rotation group compared to the ad hoc group reported significantly increased competency score using a Likert scale in manual vacuum aspiration (MVA) (4.5 vs. 1; p=.003) and had a higher proportion reporting intent to provide office MVA postresidency (100% vs. 39%; p=.01) and being trained to 22.5 weeks' vs. 12 weeks' gestation (p=.005). In bivariate analysis, competency in MVA was associated with higher intentions to provide MVA after residency (p=.007). A structured rotation in family planning and abortion for obstetrics/gynecology residents results in increases in competency and intentions to provide abortion, and an association between the two. In-hospital structured training proved to be superior to ad hoc training in our affiliate institution in improving competency and intention to provide abortion after residency. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Tendências curriculares nas escola de formação técnica para o SUS Curricular trends in the schools providing technical training for the SUS

    Directory of Open Access Journals (Sweden)

    Isabel Brasil Pereira

    2004-03-01

    Full Text Available Este artigo mapeia e analisa tendências curriculares das escolas de educação profissional em nível técnico para o Sistema Único de Saúde (SUS. Trata-se de, mediante resgate da literatura sobre currículo, analisar a organização, a seleção e a hierarquização de conhecimentos, fatores que estão articulados às lutas entre projetos educacionais. É significativo para o estudo o fato de que a educação profissional é chamada a responder às questões advindas do mundo do trabalho. Neste sentido, recuperam-se contradições existentes no campo educacional, como a idéia de que, por um lado, é verdade que 'a experiência ensina', consistindo em ponto significativo para a aprendizagem, mas que, por outro, é necessário fazer a crítica na fé incomensurável na experiência cotidiana como um processo que, por si só, garante a aprendizagem qualificada.This article outlines and analyses the curricular trends in the schools providing professional technical education for the Brazilian Health System's workers (Sistema Único de Saúde - SUS. With the help of a close survey of the literature on curricula, it analyses the organization, selection and hierarchical gradation of knowledge, all of which are connected with the struggle between educational projects. For the study, the fact that professional education is called to respond to the issues originating in the labour world is highly significant. In this sense, we attempted to rescue the contradictions existing in the educational field, such as, for instance, the idea that, even if it is true that "experience is the best teacher" and an important stage in the learning process, it is also important to criticize an exaggerated faith on the everyday experience and the presumption that experience can, by itself, provide qualified learning.

  20. Providing Our Fellows in Training with Education on Inflammatory Bowel Disease Health Maintenance to Improve the Quality of Care in Our Health Care System.

    Science.gov (United States)

    Lee, Ann Joo; Kraemer, Dale F; Smotherman, Carmen; Eid, Emely

    2016-01-01

    Inflammatory bowel disease (IBD) quality measures were established in an effort to standardize IBD health care. Despite effort to improve clinical performance, considerable variations in practice still exist. To further improve IBD health care, we propose incorporating an in-service educational session on IBD health maintenance to provide trainees with increasing awareness and knowledge on IBD management. Fifty electronic medical charts were randomly selected, and the level of quality documentation was assessed for 15 core IBD quality measures. Data were reported as the percentage of charts meeting audit criteria (compliance score). Fellows then attended an in-service educational session to review IBD quality measures and reinforce practice expectations. A second audit was then performed on an additional 50 patient charts to determine whether documentation practices improved after the educational session. We found a positive correlation between an in-service educational session and fellows' compliance with IBD health maintenance. Overall, the fellows' compliance score increased by 18% (before intervention, 65%; after intervention, 83%; P bases for IBD health maintenance. Incorporating a standard curriculum on IBD health maintenance provides fellows in training with increased awareness and guidance on managing the unique preventive care needs of patients with IBD.

  1. Unifying Water Data Sources: How the CUAHSI Water Data Center is Enabling and Improving Access to a Growing Catalog of over 100 Data Providers

    Science.gov (United States)

    Pollak, J.; Berry, K.; Couch, A.; Arrigo, J.; Hooper, R. P.

    2013-12-01

    Scientific data about water are collected and distributed by numerous sources which can differ tremendously in scale. As competition for water resources increases, increasing access to and understanding of information about water will be critical. The mission of the new CUAHSI Water Data Center (WDC) is to provide those researchers who collect data a medium to publish their datasets and give those wanting to discover data the proper tools to efficiently find the data that they seek. These tools include standards-based data publication, data discovery tools based upon faceted and telescoping search, and a data analysis tool HydroDesktop that downloads and unifies data in standardized formats. The CUAHSI Hydrologic Information System (HIS) is a community developed and open source system for sharing water data. As a federated, web service oriented system it enables data publication for a diverse user population including scientific investigators (Research Coordination Networks, Critical Zone Observatories), government agencies (USGS, NASA, EPA), and citizen scientists (watershed associations). HydroDesktop is an end user application for data consumption in this system that the WDC supports. This application can be used for finding, downloading, and analyzing data from the HIS. It provides a GIS interface that allows users to incorporate spatial data that are not accessible via HIS, simple analysis tools to facilitate graphing and visualization, tools to export data to common file types, and provides an extensible architecture that developers can build upon. HydroDesktop, however, is just one example of a data access client for HIS. The web service oriented architecture enables data access by an unlimited number of clients provided they can consume the web services used in HIS. One such example developed at the WDC is the 'Faceted Search Client', which capitalizes upon exploratory search concepts to improve accuracy and precision during search. We highlight such

  2. Using a quality improvement model to enhance providers' performance in maternal and newborn health care: a post-only intervention and comparison design.

    Science.gov (United States)

    Ayalew, Firew; Eyassu, Gizachew; Seyoum, Negash; van Roosmalen, Jos; Bazant, Eva; Kim, Young Mi; Tekleberhan, Alemnesh; Gibson, Hannah; Daniel, Ephrem; Stekelenburg, Jelle

    2017-04-12

    The Standards Based Management and Recognition (SBM-R © ) approach to quality improvement has been implemented in Ethiopia to strengthen routine maternal and newborn health (MNH) services. This evaluation assessed the effect of the intervention on MNH providers' performance of routine antenatal care (ANC), uncomplicated labor and delivery and immediate postnatal care (PNC) services. A post-only evaluation design was conducted at three hospitals and eight health centers implementing SBM-R and the same number of comparison health facilities. Structured checklists were used to observe MNH providers' performance on ANC (236 provider-client interactions), uncomplicated labor and delivery (226 provider-client interactions), and immediate PNC services in the six hours after delivery (232 provider-client interactions); observations were divided equally between intervention and comparison groups. Main outcomes were provider performance scores, calculated as the percentage of essential tasks in each service area completed by providers. Multilevel analysis was used to calculate adjusted mean percentage performance scores and standard errors to compare intervention and comparison groups. There was no statistically significant difference between intervention and comparison facilities in overall mean performance scores for ANC services (63.4% at intervention facilities versus 61.0% at comparison facilities, p = 0.650) or in any specific ANC skill area. MNH providers' overall mean performance score for uncomplicated labor and delivery care was 11.9 percentage points higher in the intervention than in the comparison group (77.5% versus 65.6%; p = 0.002). Overall mean performance scores for immediate PNC were 22.2 percentage points higher at intervention than at comparison facilities (72.8% versus 50.6%; p = 0.001); and there was a significant difference of 22 percentage points between intervention and comparison facilities for each PNC skill area: care for the newborn

  3. Quasi-Monopoly Status of a Non-for-Profit Reference Terminology Provider - An Exemplary Approach on Transparency Improvement Regarding Licensing.

    Science.gov (United States)

    Dewenter, Heike; Thun, Sylvia

    2018-01-01

    As the reference terminology SNOMED CT is gaining in significance and seems without alternative in interoperable Electronic Health Records, the holder of its intellectual property, the non-for-profit organization SNOMED International has achieved a quasi-monopoly status as a provider. We examine the current dealing with corporate transparency regarding SNOMED CT licensing together with policy recommendations derived from the research project ASSESS CT, in the context of collaboration with Standardization Organizations. In addition, transparency improvement is proposed based on the economic Principal-Agent-Theory, assuming SNOMED CT Licensees as principals. In this paper we introduce improvement measures with regard to increase transparency in the licensing process addressing to the reference terminology users and especially the terminology provider. The aim is to present strategies towards transparency, with the intent to remove barriers concerning indecisive organization stakeholders and users of a license and fee-based terminology solutions, as well as to overcome resentments connected to the quasi-monopoly status of the provider.

  4. Can Economic Model Transparency Improve Provider Interpretation of Cost-effectiveness Analysis? Evaluating Tradeoffs Presented by the Second Panel on Cost-effectiveness in Health and Medicine.

    Science.gov (United States)

    Padula, William V; McQueen, Robert Brett; Pronovost, Peter J

    2017-11-01

    The Second Panel on Cost-Effectiveness in Health and Medicine convened on December 7, 2016 at the National Academy of Medicine to disseminate their recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses (CEAs). Following its summary, panel proceedings included lengthy discussions including the field's struggle to disseminate findings efficiently through peer-reviewed literature to target audiences. With editors of several medical and outcomes research journals in attendance, there was consensus that findings of cost-effectiveness analyses do not effectively reach other researchers or health care providers. The audience members suggested several solutions including providing additional training to clinicians in cost-effectiveness research and requiring that cost-effectiveness models are made publicly available. However, there remains the questions of whether making economic modelers' work open-access through journals is fair under the defense that these models remain one's own intellectual property, or whether journals can properly manage the peer-review process specifically for cost-effectiveness analyses. In this article, we elaborate on these issues and provide some suggested solutions that may increase the dissemination and application of cost-effectiveness literature to reach its intended audiences and ultimately benefit the patient. Ultimately, it is our combined view as economic modelers and clinicians that cost-effectiveness results need to reach the clinician to improve the efficiency of medical practice, but that open-access models do not improve clinician access or interpretation of the economics of medicine.

  5. Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files. SG39 meeting, December 2015

    International Nuclear Information System (INIS)

    Cabellos, Oscar; De Saint Jean, Cyrille; Hursin, Mathieu; Pelloni, Sandro; Ivanov, Evgeny; Kodeli, Ivan; Leconte, Pierre; Palmiotti, Giuseppe; Salvatores, Massimo; Sobes, Vladimir; Yokoyama, Kenji

    2015-12-01

    The aim of WPEC subgroup 39 'Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files' is to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and differential measurement experimentalists in order to improve the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications. This document is the proceedings of the fifth formal Subgroup 39 meeting held at the Institute Curie, Paris, France, on 4 December 2015. It comprises a Summary Record of the meeting, and all the available presentations (slides) given by the participants: A - Sensitivity methods: - 1: Short update on deliverables (K. Yokoyama); - 2: Does one shot Bayesian is equivalent to successive update? Bayesian inference: some matrix linear algebra (C. De Saint Jean); - 3: Progress in Methodology (G. Palmiotti); - SG39-3: Use of PIA approach. Possible application to neutron propagation experiments (S. Pelloni); - 4: Update on sensitivity coefficient methods (E. Ivanov); - 5: Stress test for U-235 fission (H. Wu); - 6: Methods and approaches development at ORNL for providing feedback from integral benchmark experiments for improvement of nuclear data files (V. Sobes); B - Integral experiments: - 7a: Update on SEG analysis (G. Palmiotti); - 7b:Status of MANTRA (G. Palmiotti); - 7c: Possible new experiments at NRAD (G. Palmiotti); - 8: B-eff experiments (I. Kodeli); - 9: On going CEA activities related to dedicated integral experiments for nuclear date validation in the Fast energy range (P. Leconte); - 10: PROTEUS Experiments: an update (M. Hursin); - 11: Short updates on neutron propagation experiments, STEK, CIELO status (O. Cabellos)

  6. ERLN Technical Support for Labs

    Science.gov (United States)

    The Environmental Response Laboratory Network provides policies and guidance on lab and data requirements, Standardized Analytical Methods, and technical support for water and radiological sampling and analysis

  7. The Use of Adsorbent Materials of Improving the Characteristics of Polluted Soils, Part 1 Phytoremediation of Soils Polluted with Oil Products, Cultivated with Technical Plants

    Directory of Open Access Journals (Sweden)

    Smaranda Masu

    2015-10-01

    Full Text Available In this study are presented in pot experimental variants regarding alternatives to improve the characteristics of soils polluted with 74.12 ± 3.50 g·kg-1 D.M. total petroleum hydrocarbon (TPH in order to apply the phytoremediation process using technical plants from the common flax (Linum usitatissimum. The harmful effects of TPH polluted soils to plants was reduced by using fly ash from thermal plant as temporary adsorbent of non-polar pollutants, petroleum products. The increase of water retention capacity of the soil was achieved by treatments with indigenous volcanic tuff. The lack of nutrients, based on N and P in soils contaminated with TPH rich in C compounds are completed using sewage sludge anaerobically stabilized. The use of appropriate amounts of fly ash and fertilizer agents in the presence of volcanic tuff caused the formation of strong networks of roots and rich harvests of plants, stems and seeds from the treated soil. The TPH reduction efficiency of TPH polluted soils treated with fly ash (TPH soil: fly ash ratio 12:1 wt. / wt. and anaerobically stabilized sewage sludge respectively indigenous volcanic tuff during one vegetative cycle of crops was in the range of 56.2 - 63.25 %.

  8. Toward an evidence-based system for innovation support for implementing innovations with quality: tools, training, technical assistance, and quality assurance/quality improvement.

    Science.gov (United States)

    Wandersman, Abraham; Chien, Victoria H; Katz, Jason

    2012-12-01

    An individual or organization that sets out to implement an innovation (e.g., a new technology, program, or policy) generally requires support. In the Interactive Systems Framework for Dissemination and Implementation, a Support System should work with Delivery Systems (national, state and/or local entities such as health and human service organizations, community-based organizations, schools) to enhance their capacity for quality implementation of innovations. The literature on the Support System [corrected] has been underresearched and under-developedThis article begins to conceptualize theory, research, and action for an evidence-based system for innovation support (EBSIS). EBSIS describes key priorities for strengthening the science and practice of support. The major goal of EBSIS is to enhance the research and practice of support in order to build capacity in the Delivery System for implementing innovations with quality, and thereby, help the Delivery System achieve outcomes. EBSIS is guided by a logic model that includes four key support components: tools, training, technical assistance, and quality assurance/quality improvement. EBSIS uses the Getting To Outcomes approach to accountability to aid the identification and synthesis of concepts, tools, and evidence for support. We conclude with some discussion of the current status of EBSIS and possible next steps, including the development of collaborative researcher-practitioner-funder-consumer partnerships to accelerate accumulation of knowledge on the Support System.

  9. Towards safer roads : non-technical measures to improve road safety. Paper presented at the seminar `Black spots' in Wisla, Poland, April, 15-20, 1996.

    NARCIS (Netherlands)

    Goldenbeld, C. & Noordzij, P.C.

    1996-01-01

    This paper discusses engineering, education and enforcement in relation to hazardous road situations. If a high risk road or road site has been identified, the question is which selection of technical and non-technical measures should be taken to prevent or reduce the danger. The main argument is

  10. Technical noise supplement : TeNS : a technical supplement to the Traffic Noise Analysis Protocol.

    Science.gov (United States)

    1998-10-01

    The purpose of this Technical Noise Supplement (TeNS) is to provide technical background : information on transportation-related noise in general and highway traffic noise in : particular. It is designed to elaborate on technical concepts and procedu...

  11. Medical Care Provided Under California's Workers' Compensation Program: Effects of the Reforms and Additional Opportunities to Improve the Quality and Efficiency of Care.

    Science.gov (United States)

    Wynn, Barbara O; Timbie, Justin W; Sorbero, Melony E

    2011-01-01

    Since 2004, significant changes have been made to the California workers' compensation (WC) system. The Commission on Health and Safety and Workers' Compensation (CHSWC) asked the RAND Corporation to examine the impact that these changes have on the medical care provided to injured workers. This study synthesizes findings from interviews and available information regarding the implementation of the changes affecting WC medical care and identifies areas in which additional changes might increase the quality and efficiency of care delivered under the WC system. To improve incentives for efficiently providing medically appropriate care, California should revise its fee schedule allowances for services provided by hospitals to inpatients, freestanding ambulatory surgery centers, and physicians, create nonmonetary incentives for providing medically appropriate care in the medical provider network (MPN) context through more-selective contracting with providers and reducing medical review requirements for high-performing physicians; reduce incentives for inappropriate prescribing practices by curtailing in-office physician dispensing; and implement pharmacy benefit network regulations. To increase accountability for performance, California should revise the MPN certification process to place accountability for meeting MPN standards on the entity contracting with the physician network; strengthen Division of Workers' Compensation (DWC) authorities to provide intermediate sanctions for failure to comply with MPN requirements; and modify the Labor Code to remove payers and MPNs from the definition of individually identifiable data so that performance on key measures can be publicly available. To facilitate monitoring and oversight, California should provide DWC with more flexibility to add needed data elements to medical data reporting and provide penalties for a claim administrator failing to comply with the data-reporting requirements; require that medical cost

  12. Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers

    Science.gov (United States)

    Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D

    2017-01-01

    Introduction In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Methods and analysis Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. Ethics and dissemination The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement

  13. Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files. SG39 meeting, May 2015

    International Nuclear Information System (INIS)

    Wang, Wenming; Yokoyama, Kenji; Kim, Do Heon; Kodeli, Ivan-Alexander; Hursin, Mathieu; Pelloni, Sandro; Palmiotti, Giuseppe; Salvatores, Massimo; Touran, Nicholas; Cabellos De Francisco, Oscar; )

    2015-05-01

    The aim of WPEC subgroup 39 'Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files' is to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and differential measurement experimentalists in order to improve the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications. This document is the proceedings of the fourth Subgroup meeting, held at the NEA, Issy-les-Moulineaux, France, on 19-20 May 2015. It comprises a Summary Record of the meeting, two papers on deliverables and all the available presentations (slides) given by the participants: 1 - Status of Deliverables: '1. Methodology' (K. Yokoyama); 2 - Status of Deliverables: '2. Comments on covariance data' (K. Yokoyama); 3 - PROTEUS HCLWR Experiments (M. Hursin); 4 - Preliminary UQ Efforts for TWR Design (N. Touran); 5 - Potential use of beta-eff and other benchmark for adjustment (I. Kodeli); 6 - k_e_f_f uncertainties for a simple case of Am"2"4"1 using different codes and evaluated files (I. Kodeli); 7 - k_e_f_f uncertainties for a simple case of Am"2"4"1 using TSUNAMI (O. Cabellos); 8 - REWIND: Ranking Experiments by Weighting to Improve Nuclear Data (G. Palmiotti); 9 - Recent analysis on NUDUNA/MOCABA applications to reactor physics parameters (E. Castro); 10 - INL exploratory study for SEG (A. Hummel); 11 - The Development of Nuclear Data Adjustment Code at CNDC (H. Wu); 12 - SG39 Perspectives (M. Salvatores). A list of issues and actions conclude the document

  14. Facial primer provides immediate and long-term improvements in mild-to-moderate facial hyperpigmentation and fine lines associated with photoaging

    Directory of Open Access Journals (Sweden)

    Roberts WE

    2015-09-01

    Full Text Available Wendy E Roberts,1 Lily I Jiang,2 James H Herndon Jr3 1Generational and Cosmetic Dermatology, Rancho Mirage, CA, 2Thomas J Stephens and Associates, Richardson, 3Dermatology Center of Dallas, Dallas, TX, USA Background: Photoaged skin results from various environmental factors, most importantly chronic sun exposure. Dyschromia and fine lines/wrinkles are common clinical manifestations of photodamaged skin. Purpose: This single-center clinical trial was conducted to assess the efficacy and tolerability of a new multifunctional facial primer (camouflage, broad-spectrum SPF 50, and a treatment for hyperpigmentation when used by females with mild-to-moderate facial hyperpigmentation and fine lines due to photoaging over a course of 12 weeks. Patients and methods: Subjects were provided test material (Even Up-Clinical Pigment Perfector and supporting products to use on their face and neck. Products were used according to specific application instructions. Clinical grading for efficacy and tolerability assessments were performed by an expert grader at baseline, baseline (post-application primer, week 4, week 8, week 12, and week 12 (post-application primer. Standardized digital photographs were taken, and self-assessment questionnaires were conducted. Results: Twenty-eight female subjects completed the 12-week trial. The facial primer improved scores for the appearance of hyperpigmentation and other photoaging parameters immediately after the first application. The treatment also showed a progressive improvement in the clinical assessment of hyperpigmentation and other photoaging parameters over the 12-week trial. These long-term benefits can be attributed to an improvement in the underlying skin condition. The facial primer was well tolerated. Subject questionnaires showed that the product was highly rated at all visits. Conclusion: The facial primer was shown to be effective and well tolerated for immediate and long-term improvement in the appearance

  15. 'Gotta be sit down and worked out together': views of Aboriginal caregivers and service providers on ways to improve dementia care for Aboriginal Australians.

    Science.gov (United States)

    Smith, Kate; Flicker, Leon; Shadforth, Geraldine; Carroll, Emily; Ralph, Naomi; Atkinson, David; Lindeman, Melissa; Schaper, Frank; Lautenschlager, Nicola T; LoGiudice, Dina

    2011-01-01

    Dementia is five-fold more prevalent among Aboriginal than non-Aboriginal Australians. Despite this, the quality of care available to people living with dementia in remote Aboriginal communities is poor. The objective of this study was to determine ways to overcome factors affecting the successful delivery of services to Aboriginal people with dementia living in remote communities, and to their families and communities. This qualitative research took place in the Kimberley Region of Western Australia. Data collection occurred in three stages: (1) interviews with service providers to identify the services available; (2) interviews with the caregivers of Aboriginal people living with dementia and community-based care workers; and (3) focus groups with community representatives and community care staff. Each stage was concluded when no new themes emerged. At each stage the transcribed information was analysed and joint interpretation identified common themes. In total, 42 service providers, 31 caregivers and community-based care workers were interviewed and 3 focus groups were conducted. Obstacles to accessing quality care were mentioned and recommendations on ways to improve care were made. The key themes that emerged were caregiver role, perspectives of dementia, community and culturally-appropriate care, workforce, education and training, issues affecting remote communities and service issues. Detailed information on how each theme affects the successful delivery of dementia care is provided. These research findings indicate that people living with dementia and their caregivers in remote Aboriginal communities are struggling to cope. They are requesting and require better community care. Implementing a culturally safe model of dementia care for remote Aboriginal communities that encompasses the recommendations made and builds on the strengths of the communities could potentially deliver the required improvements to dementia care for this population.

  16. Ex-vivo release of Pipeline Embolization Device polytetrafluoroethylene (PTFE) sleeves for improved distal landing zone accuracy in-vivo: A technical note.

    Science.gov (United States)

    Griessenauer, Christoph J; Gupta, Raghav; Moore, Justin; Thomas, Ajith J; Ogilvy, Christopher S

    2016-12-01

    Distal landing zone accuracy is critical in some intracranial aneurysms treated with the Pipeline Embolization Device (PED), and delayed opening of the distal end of the device can complicate the procedure. Here, we report a technical nuance that facilitates accurate placement of the distal end of the PED by ex-vivo, pre-implantation release of the PED Flex polytetrafluoroethylene (PTFE) sleeves. The PED Flex is partially pushed out of the introducer sheath ex-vivo, pre-implantation until the distal PED opens entirely and the PTFE sleeves are located distal to the device. Without inverting the PTFE sleeves, the PED is carefully pulled back into the introducer sheath placing the PTFE sleeves inside the device. The PED is loaded into the microcatheter and advanced toward the site of implantation. When the PED is initially deployed and pushed out of the microcatheter, it opens immediately and provides an anchor for the remainder of the deployment process. We present a video (supplementary material) that illustrates the technique along with an illustrative case. Ex-vivo, pre-implantation release of the PTFE sleeves is an option in aneurysm treatment where distal landing accuracy is critical. Even without the protection of the PTFE sleeves, our clinical observation shows that the PED can be advanced safely through the microcatheter in selected cases. © The Author(s) 2016.

  17. New usable technical specifications

    International Nuclear Information System (INIS)

    Webster, S.A.; Tomasi, L.T.; Bernier, R.A.

    1989-01-01

    After 2 yr of preparation, 1988 finally saw the nuclear industry writing operator-oriented technical specifications. This effort is a continuation of previous efforts to develop improved and usable standard technical specifications (STSs), and is being conducted by the four nuclear steam supply system vendor owners' groups under the auspices of the Nuclear Management Resources Council. Each participant is currently preparing a set of improved STSs based on a writer's guide that was developed through a combined industry effort. In May of 1987, a Human Factors Improvements to Technical Specifications (HFITS) task group was formed to prepare a writer's guide for improved, industrywide STSs. This task group was composed of two representatives from each owners' group, one with a human factors background and one with some operations background. Two documents were prepared in 6 months, a human factors report laying the groundwork for the considerations to go into technical specifications and a writer's guide for their preparation. This paper reports on the application of this writer's guide to the writing of improved STS

  18. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  19. Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files. SG39 meeting, November 2014

    International Nuclear Information System (INIS)

    Aufiero, Manuele; Ivanov, Evgeny; Hoefer, Axel; Yokoyama, Kenji; Da Cruz, Dirceu Ferreira; KODELI, Ivan-Alexander; Hursin, Mathieu; Pelloni, Sandro; Palmiotti, Giuseppe; Salvatores, Massimo; Barnes, Andrew; Cabellos De Francisco, Oscar; ); Ivanova, Tatiana; )

    2014-11-01

    The aim of WPEC subgroup 39 'Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files' is to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and differential measurement experimentalists in order to improve the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications. This document is the proceedings of the third formal Subgroup meeting held at the NEA, Issy-les-Moulineaux, France, on 27-28 November 2014. It comprises a Summary Record of the meeting and all the available presentations (slides) given by the participants: A - Sensitivity methods: 1 - Perturbation/sensitivity calculations with Serpent (M. Aufiero); 2 - Comparison of deterministic and Monte Carlo sensitivity analysis of SNEAK-7A and FLATTOP-Pu Benchmarks (I. Kodeli); B - Integral experiments: 1 - PROTEUS experiments: selected experiments sensitivity profiles and availability, (M. Hursin, M. Salvatores - PROTEUS Experiments, HCLWR configurations); 2 - SINBAD Benchmark Database and FNS/JAEA Liquid Oxygen TOF Experiment Analysis (I. Kodeli); 3 - STEK experiment Opportunity for Validation of Fission Products Nuclear Data (D. Da Cruz); 4 - SEG (tailored adjoint flux shapes) (M. Savatores - comments) 5 - IPPE transmission experiments (Fe, 238 U) (T. Ivanova); 6 - RPI semi-integral (Fe, 238 U) (G. Palmiotti - comments); 7 - New experiments, e.g. in connection with the new NSC Expert Group on 'Improvement of Integral Experiments Data for Minor Actinide Management' (G. Palmiotti - Some comments from the Expert Group) 8 - Additional PSI adjustment studies accounting for nonlinearity (S. Pelloni); 9 - Adjustment methodology issues (G. Palmiotti); C - Am-241 and fission product issues: 1 - Am-241 validation for criticality-safety calculations (A. Barnes - Visio

  20. OSH technical reference manual

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    In an evaluation of the Department of Energy (DOE) Occupational Safety and Health programs for government-owned contractor-operated (GOCO) activities, the Department of Labor`s Occupational Safety and Health Administration (OSHA) recommended a technical information exchange program. The intent was to share written safety and health programs, plans, training manuals, and materials within the entire DOE community. The OSH Technical Reference (OTR) helps support the secretary`s response to the OSHA finding by providing a one-stop resource and referral for technical information that relates to safe operations and practice. It also serves as a technical information exchange tool to reference DOE-wide materials pertinent to specific safety topics and, with some modification, as a training aid. The OTR bridges the gap between general safety documents and very specific requirements documents. It is tailored to the DOE community and incorporates DOE field experience.

  1. Socio-technical Betwixtness

    DEFF Research Database (Denmark)

    Bossen, Claus

    2017-01-01

    the intrinsically social and technical interwovenness of design, and the necessity of including affected people and stakeholders in the design process. This betwixtness of socio-technical design is demonstrated by the analysis of two IT systems for healthcare: a foundational model for electronic healthcare records......This chapter focusses on two challenges for socio-technical design: Having to choose between different rationales for design, and the adequate understanding and depiction of the work to be redesigned. These two challenges betwixt the otherwise strong tenets of socio-technical design of pointing out......, and an IT system organizing hospital porters’ work. The conceptual background for the analysis of the cases is provided by a short introduction to different rationales for organizational design, and by pointing to the differences between a linear, rationalistic versus an interactional depiction of work....

  2. Technical report writing today

    CERN Document Server

    Riordan, Daniel G

    2014-01-01

    "Technical Report Writing Today" provides thorough coverage of technical writing basics, techniques, and applications. Through a practical focus with varied examples and exercises, students internalize the skills necessary to produce clear and effective documents and reports. Project worksheets help students organize their thoughts and prepare for assignments, and focus boxes highlight key information and recent developments in technical communication. Extensive individual and collaborative exercises expose students to different kinds of technical writing problems and solutions. Annotated student examples - more than 100 in all - illustrate different writing styles and approaches to problems. Numerous short and long examples throughout the text demonstrate solutions for handling writing assignments in current career situations. The four-color artwork in the chapter on creating visuals keeps pace with contemporary workplace capabilities. The Tenth Edition offers the latest information on using electronic resum...

  3. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments

    Directory of Open Access Journals (Sweden)

    Noortgate Nele

    2009-12-01

    Full Text Available Abstract Background The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. Methods A cross-sectional mail survey was sent to all acute hospitals (67 main campuses in Flanders (Belgium. The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. Results The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%. While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%. More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Conclusions Most Flemish acute hospitals have developed a policy on end-of-life practices

  4. Policies to improve end-of-life decisions in Flemish hospitals: communication, training of health care providers and use of quality assessments.

    Science.gov (United States)

    D'Haene, Ina; Vander Stichele, Robert H; Pasman, H Roeline W; Noortgate, Nele Van den; Bilsen, Johan; Mortier, Freddy; Deliens, Luc

    2009-12-30

    The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-life. Implementation of policies through quality assessments, communication and the training and education of health care providers is equally important in improving actual end-of-life practice. The aim of the present study is to report on the existence and nature of end-of-life policy implementation activities in Flemish acute hospitals. A cross-sectional mail survey was sent to all acute hospitals (67 main campuses) in Flanders (Belgium). The questionnaire asked about hospital characteristics, the prevalence of policies on five types of end-of-life decisions: euthanasia, palliative sedation, alleviation of symptoms with possible life-shortening effect, do-not-resuscitate decision, and withdrawing or withholding of treatment, the internal and external communication of these policies, training and education on aspects of end-of-life care, and quality assessments of end-of-life care on patient and family level. The response rate was 55%. Results show that in 2007 written policies on most types of end-of-life decisions were widespread in acute hospitals (euthanasia: 97%, do-not-resuscitate decisions: 98%, palliative sedation: 79%). While standard communication of these policies to health care providers was between 71% and 91%, it was much lower to patients and/or family (between 17% and 50%). More than 60% of institutions trained and educated their caregivers in different aspects on end-of-life care. Assessment of the quality of these different aspects at patient and family level occurred in 25% to 61% of these hospitals. Most Flemish acute hospitals have developed a policy on end-of-life practices. However, communication, training and the education of health care

  5. Tanzanian farmers' knowledge and attitudes to GM biotechnology and the potential use of GM crops to provide improved levels of food security. A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Herron Caroline M

    2010-07-01

    believe use of GM biotechnology is an appropriate way in which to tackle issues of food security, provide improved health and drive development.

  6. Tanzanian farmers' knowledge and attitudes to GM biotechnology and the potential use of GM crops to provide improved levels of food security. A Qualitative Study.

    Science.gov (United States)

    Lewis, Christopher P; Newell, James N; Herron, Caroline M; Nawabu, Haidari

    2010-07-12

    to tackle issues of food security, provide improved health and drive development.

  7. Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files. SG39 meeting, November 2013

    International Nuclear Information System (INIS)

    De Saint Jean, C.; Dupont, E.; ); Dyrda, J.; Hursin, M.; Pelloni, S.; Ishikawa, M.; Ivanov, E.; Ivanova, T.; Kim, D.H.; Ee, Y.O.; Kodeli, I.; Leal, L.; Leichtle, D.; Palmiotti, G.; Salvatores, M.; Pronyaev, V.; Simakov, S.; )

    2013-11-01

    The aim of WPEC subgroup 39 'Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files' is to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and differential measurement experimentalists in order to improve the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications. This document is the proceedings of the first formal Subgroup 39 meeting held at the NEA, Issy-les-Moulineaux, France, on 28-29 November 2013. It comprises a Summary Record of the meeting and all the available presentations (slides) given by the participants: A - Recent data adjustments performances and trends: 1 - Recommendations from ADJ2010 adjustment (M. Ishikawa); 2 - Feedback on CIELO isotopes from ENDF/B-VII.0 adjustment (G. Palmiotti); 3 - Sensitivity and uncertainty results on FLATTOP-Pu (I. Kodeli); 4 - SG33 benchmark: Comparative adjustment results (S. Pelloni) 5 - Integral benchmarks for data assimilation: selection of a consistent set and establishment of integral correlations (E. Ivanov); 6 - PROTEUS experimental data (M. Hursin); 7 - Additional information on High Conversion Light Water Reactor (HCLWR aka FDWR-II) experiments (14 January 2014); 8 - Data assimilation of benchmark experiments for homogenous thermal/epithermal uranium systems (J. Dyrda); B - Methodology issues: 1 - Adjustment methodology issues (G. Palmiotti); 2 - Marginalisation, methodology issues and nuclear data parameter adjustment (C. De Saint Jean); 3 - Nuclear data parameter adjustment (G. Palmiotti). A list of issues and actions conclude the document

  8. Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files. SG39 meeting, December 2016

    International Nuclear Information System (INIS)

    Cabellos, Oscar; ); PELLONI, Sandro; Ivanov, Evgeny; Sobes, Vladimir; Fukushima, M.; Yokoyama, Kenji; Palmiotti, Giuseppe; Kodeli, Ivo

    2016-12-01

    The aim of WPEC subgroup 39 'Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files' is to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and differential measurement experimentalists in order to improve the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications. This document is the proceedings of the eighth Subgroup 39 meeting, held at the OECD NEA, Boulogne-Billancourt, France, on 1-2 December 2016. It comprises all the available presentations (slides) given by the participants: A - Presentations: Welcome and actions review (Oscar CABELLOS); B - Methods: - Detailed comparison of Progressive Incremental Adjustment (PIA) sequence results involving adjustments of spectral indices and coolant density effects on the basis of the SG33 benchmark (Sandro PELLONI); - ND assessment alternatives: Validation matrix vs XS adjustment (Evgeny IVANOV); - Implementation of Resonance Parameter Sensitivity Coefficients Calculation in CE TSUNAMI-3D (Vladimir SOBES); C - Experiment analysis, sensitivity calculations and benchmarks: - Benchmark tests of ENDF/B-VIII.0 beta 1 using sodium void reactivity worth of FCA-XXVII-1 assembly (M. FUKUSHIMA, Kenji YOKOYAMA); D - Adjustments: - Cross-section adjustment based on JENDL-4.0 using new experiments on the basis of the SG33 benchmark (Kenji YOKOYAMA); - Comparison of adjustment trends with the Cielo evaluation (Sandro PELLONI); - Expanded adjustment in support of CIELO initiative (Giuseppe PALMIOTTI); - First preliminary results of the adjustment exercise using ASPIS Fe88 and SNEAK-7A/7B k_e_f_f and b_e_f_f benchmarks (Ivo KODELI); E - Future actions, deliverables: - Discussion on future of SG39 and possible new subgroup (Giuseppe PALMIOTTI); - WPEC sub-group proposal: Investigation of Covariance Data in

  9. Building a 'data repository' for heterogenous technical research communities through collaborations

    NARCIS (Netherlands)

    Rombouts, J.; Princic, A.

    2010-01-01

    The paper describes the project ‘3TU.Datacentrum’, an initiative of the libraries of the three Dutch Technical Universities. Its aim is to build a data curation facility for the improvement of data management, providing data curation services for data producers of the Technical Universities and

  10. Improving opioid safety practices in primary care: protocol for the development and evaluation of a multifaceted, theory-informed pilot intervention for healthcare providers.

    Science.gov (United States)

    Leece, Pamela; Buchman, Daniel Z; Hamilton, Michael; Timmings, Caitlyn; Shantharam, Yalnee; Moore, Julia; Furlan, Andrea D

    2017-04-26

    In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians. The intervention uses practical educational and self-assessment tools to provide prescribers with feedback on their current knowledge and practices, and resources to improve their practice. The evaluation approach uses a pretest and post-test design and includes both quantitative and qualitative methods at baseline and 6 months. We will recruit a purposive sample of approximately 10 family physicians in Ontario from diverse practice settings, who currently treat patients with long-term opioid therapy for chronic pain. Quantitative data will be analysed using basic descriptive statistics, and qualitative data will be analysed using the Framework Method. The University Health Network Research Ethics Board approved this study. Dissemination plan includes publications, conference presentations and brief stakeholder reports. This evidence-informed, theory-driven intervention has implications for national application of opioid quality improvement tools in primary care settings. We are engaging experts and end users in advisory and stakeholder roles throughout our project to increase its national relevance, application and sustainability. The performance measures could be used as the basis for health system quality improvement indicators to monitor opioid prescribing. Additionally, the

  11. Peer-driven quality improvement among health workers and traditional birth attendants in Sierra Leone: linkages between providers' organizational skills and relationships.

    Science.gov (United States)

    Higgins-Steele, Ariel; Waller, Kathryn; Fotso, Jean Christophe; Vesel, Linda

    2015-01-01

    Sierra Leone has among the poorest maternal and child health indicators in the world and investments in public health have been predominately to increase demand for services, with fewer initiatives targeting supply side factors that influence health workers' work environment. This paper uses data from the Quality Circles project in a rural district of Sierra Leone to achieve three objectives. First, we examine the effect of the intervention on organizational skills and relationships among coworkers as well as between health workers and traditional birth attendants. Second, we examine whether changes in organizational skills are associated with changes in relationships among and between formal and informal health providers and between health providers and clients. Third, we aim to further understand these changes through the perspectives of health workers and traditional birth attendants. The Quality Circles project was implemented in Kailahun District in the Eastern province of Sierra Leone from August 2011 to June 2013, with adjacent Tonkolili District serving as the control site. Using a mixed-methods approach, the evaluation included a quantitative survey, in-depth interviews and focus group discussions with health workers and traditional birth attendants. Mean values of the variables of interest were compared across sub-populations, and correlation analyses were performed between changes in organizational skills and changes in relationships. The results demonstrate that the Quality Circles intervention had positive effects on organizational skills and relationships. Furthermore, improvements in all organizational skill variables - problem-solving, strategizing and negotiation skills - were strongly associated with a change in the overall relationship variable. The Quality Circles approach has the potential to support health workers to improve their organizational skills and relationships, which in turn can contribute to improving the interpersonal dimensions of

  12. Materials Technical Team Roadmap

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-08-01

    Roadmap identifying the efforts of the Materials Technical Team (MTT) to focus primarily on reducing the mass of structural systems such as the body and chassis in light-duty vehicles (including passenger cars and light trucks) which enables improved vehicle efficiency regardless of the vehicle size or propulsion system employed.

  13. Technical Writing in Hydrogeology.

    Science.gov (United States)

    Tinker, John R., Jr.

    1986-01-01

    A project for Writing Across the Curriculum at the University of Wisconsin-Eau Claire is described as a method to relate the process of writing to the process of learning hydrology. The project focuses on an actual groundwater contamination case and is designed to improve the technical writing skills of students. (JN)

  14. Information technology implementing globalization on strategies for quality care provided to children submitted to cardiac surgery: International Quality Improvement Collaborative Program--IQIC.

    Science.gov (United States)

    Sciarra, Adilia Maria Pires; Croti, Ulisses Alexandre; Batigalia, Fernando

    2014-01-01

    Congenital heart diseases are the world's most common major birth defect, affecting one in every 120 children. Ninety percent of these children are born in areas where appropriate medical care is inadequate or unavailable. To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. The strategy used by the program was based on long-term technological and educational support models used in that center, contributing to the creation and implementation of new programs. The Telemedicine platform was used for real-time monthly broadcast of themes. A chat software was used for interaction between participating members and the group from the center of excellence. Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. It was possible to observe that the technological resources that implement the globalization of human knowledge were effective in the dissemination and improvement of the team regarding the care provided to children with congenital heart diseases.

  15. A Customized Quantitative PCR MicroRNA Panel Provides a Technically Robust Context for Studying Neurodegenerative Disease Biomarkers and Indicates a High Correlation Between Cerebrospinal Fluid and Choroid Plexus MicroRNA Expression.

    Science.gov (United States)

    Wang, Wang-Xia; Fardo, David W; Jicha, Gregory A; Nelson, Peter T

    2017-12-01

    MicroRNA (miRNA) expression varies in association with different tissue types and in diseases. Having been found in body fluids including blood and cerebrospinal fluid (CSF), miRNAs constitute potential biomarkers. CSF miRNAs have been proposed as biomarkers for neurodegenerative diseases; however, there is a lack of consensus about the best candidate miRNA biomarkers and there has been variability in results from different research centers, perhaps due to technical factors. Here, we sought to optimize technical parameters for CSF miRNA studies. We examined different RNA isolation methods and performed miRNA expression profiling with TaqMan® miRNA Arrays. More specifically, we developed a customized CSF-miRNA low-density array (TLDA) panel that contains 47 targets: miRNAs shown previously to be relevant to neurodegenerative disease, miRNAs that are abundant in CSF, data normalizers, and controls for potential blood and tissue contamination. The advantages of using this CSF-miRNA TLDA panel include specificity, sensitivity, fast processing and data analysis, and cost effectiveness. We optimized technical parameters for this assay. Further, the TLDA panel can be tailored to other specific purposes. We tested whether the profile of miRNAs in the CSF resembled miRNAs isolated from brain tissue (hippocampus or cerebellum), blood, or the choroid plexus. We found that the CSF miRNA expression profile most closely resembles that of choroid plexus tissue, underscoring the potential importance of choroid plexus-derived signaling through CSF miRNAs. In summary, the TLDA miRNA array panel will enable evaluation and discovery of CSF miRNA biomarkers and can potentially be utilized in clinical diagnosis and disease stage monitoring.

  16. Introducing standardized “readbacks” to improve patient safety in surgery: a prospective survey in 92 providers at a public safety-net hospital

    Directory of Open Access Journals (Sweden)

    Prabhakar Hari

    2012-06-01

    Full Text Available Abstract Background Communication breakdowns represent the main root cause of preventable complications which lead to harm to surgical patients. Standardized readbacks have been successfully implemented as a main pillar of professional aviation safety for decades, to ensure a safe closed-loop communication between air traffic control and individual pilots. The present study was designed to determine the perception of staff in perioperative services regarding the role of standardized readbacks for improving patient safety in surgery at a single public safety-net hospital and level 1 trauma center. Methods A 12-item questionnaire was sent to 180 providers in perioperative services at Denver Health Medical Center. The survey was designed to determine the individual participants’ perception of (1 appropriateness of current readback processes; (2 willingness to attend a future training module on this topic; (3 specific scenarios in which readbacks may be effective; and (4 perceived major barriers to the implementation of standardized readbacks. Survey results were compared between departments (surgery versus anesthesia and between specific staff roles (attending or midlevel provider, resident physician, nursing staff, using non-parametric tests. Results The response rate to the survey was 50.1 % (n = 92. Respondents overwhelmingly recognized the role of readbacks in reducing communication errors and improving patient safety. There was a strong agreement among respondents to support participation in a readbacks training program. There was no difference in the responses between the surgery and anesthesia departments. There was a statistically significant difference in the healthcare providers willingness to attend a short training module on readbacks (p  The main challenge for respondents, which emanated from their responses, appeared to relate to determining the ideal scenarios in which readbacks may be most appropriately used. Overall

  17. Technical Note

    African Journals Online (AJOL)

    Administratör

    In this report on four patients, we did not use any of these techniques. The existence and the site of the fistulas was clearly demonstrated using basic but important preoperative detailed assessment and two intraoperative findings. The preoperative referral note that indicated the site of technical difficulty during the previous ...

  18. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball

    2010-01-01

    Operational Experience At the end of the first full-year running period of LHC, CMS is established as a reliable, robust and mature experiment. In particular common systems and infrastructure faults accounted for <0.6 % CMS downtime during LHC pp physics. Technical operation throughout the entire year was rather smooth, the main faults requiring UXC access being sub-detector power systems and rack-cooling turbines. All such problems were corrected during scheduled technical stops, in the shadow of tunnel access needed by the LHC, or in negotiated accesses or access extensions. Nevertheless, the number of necessary accesses to the UXC averaged more than one per week and the technical stops were inevitably packed with work packages, typically 30 being executed within a few days, placing a high load on the coordination and area management teams. It is an appropriate moment for CMS Technical Coordination to thank all those in many CERN departments and in the Collaboration, who were involved in CMS techni...

  19. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball

    2010-01-01

    Operational Experience Since the closure of the detector in February, the technical operation of CMS has been quite smooth and reliable. Some minor interventions in UXC were required to cure failures of power supplies, fans, readout boards and rack cooling connections, but all these failures were repaired in scheduled technical stops or parasitically during access dedicated to fixing LHC technical problems. The only occasion when CMS had to request an access between fills was to search for the source of an alarm from the leak-detection cables mounted in the DT racks. After a few minutes of diagnostic search, a leaking air-purge was found. Replacement was complete within 2 hours. This incident demonstrated once more the value of these leak detection cables; the system will be further extended (during the end of year technical stop) to cover more racks in UXC and the floor beneath the detector. The magnet has also been operating reliably and reacted correctly to the 14s power cut on 29 May (see below). In or...

  20. Productivity Measurement Of Technical Institute

    Directory of Open Access Journals (Sweden)

    Miss.Pooja Yadav

    2015-05-01

    Full Text Available Abstract The increasing concern over globalization between other things has made the achievement of lifetime skills vital for all classes of people. Achievement of such skills can be developed from technical education programs in the advance of any nation. Skill gaining provides knowledge and inculcates the approaches that are essential for arrival and progress into an occupation. When skills are developed in any occupation it will provide and improve the standard of living with the cover beside poverty thereby behind national development. This paper observes sampling distribution and moving average concept that how technical education can generate the required skills the significance of skill acquisition its roles benefits and sustainability in national development. It also mentions among others that government should look into and improve productivity that can encourage skill achievement for the youths. The solutions are divided the sampling box into few group before stacking up workstation and use table and some other wood product. Cost reduction for each solution was intended and the solution with highest cost decrease is chosen to increase the productivity of the college.

  1. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    TECHNICAL TRAINING Monique Duval tel. 74924 technical.training@cern.ch Monday 9 February 2004 From 10:00 to 12:00 - IT Auditorium - bldg. 31, 3rd floor ANSOFT High-Frequency Seminar David Prestaux, Application Engineer, ANSOFT F-78535 BUC, France This Technical Training seminar will present two Ansoft application products: Ansoft HFSS and Ansoft Designer. Ansoft HFSS makes use of the Finite Element Method (FEM) to calculate field solutions from first principles. It can accurately predict all high-frequency behaviours such as dispersion, mode conversion, and losses due to materials and radiation. Ansoft Designer is a suite of design tools to fully integrate high-frequency, physics-based electromagnetic simulations into a seamless system-level simulation environment. Ansoft Designer uses a simple interface to give complete control over every design task, by a method allowing multiple solvers, Solver on Demand. • Introduction • Overview of the Ansoft Total solution • Ansoft HFSS 9...

  2. Head Start Impact Study. Technical Report

    Science.gov (United States)

    Puma, Michael; Bell, Stephen; Cook, Ronna; Heid, Camilla; Shapiro, Gary; Broene, Pam; Jenkins, Frank; Fletcher, Philip; Quinn, Liz; Friedman, Janet; Ciarico, Janet; Rohacek, Monica; Adams, Gina; Spier, Elizabeth

    2010-01-01

    This Technical Report is designed to provide technical detail to support the analysis and findings presented in the "Head Start Impact Study Final Report" (U.S. Department of Health and Human Services, January 2010). Chapter 1 provides an overview of the Head Start Impact Study and its findings. Chapter 2 provides technical information on the…

  3. Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 2: methodological quality and effects.

    Science.gov (United States)

    Johansen, Monika Alise; Berntsen, Gro K Rosvold; Schuster, Tibor; Henriksen, Eva; Horsch, Alexander

    2012-10-03

    We conducted in two parts a systematic review of randomized controlled trials (RCTs) on electronic symptom reporting between patients and providers to improve health care service quality. Part 1 reviewed the typology of patient groups, health service innovations, and research targets. Four innovation categories were identified: consultation support, monitoring with clinician support, self-management with clinician support, and therapy. To assess the methodological quality of the RCTs, and summarize effects and benefits from the methodologically best studies. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles between 1990 and November 2011. Risk of bias and feasibility were judged according to the Cochrane recommendation, and theoretical evidence and preclinical testing were evaluated according to the Framework for Design and Evaluation of Complex Interventions to Improve Health. Three authors assessed the risk of bias and two authors extracted the effect data independently. Disagreement regarding bias assessment, extraction, and interpretation of results were resolved by consensus discussions. Of 642 records identified, we included 32 articles representing 29 studies. No articles fulfilled all quality requirements. All interventions were feasible to implement in a real-life setting, and theoretical evidence was provided for almost all studies. However, preclinical testing was reported in only a third of the articles. We judged three-quarters of the articles to have low risk for random sequence allocation and approximately half of the articles to have low risk for the following biases: allocation concealment, incomplete outcome data, and selective reporting. Slightly more than one fifth of the articles were judged as low risk for blinding of outcome assessment. Only 1 article had low risk of bias for blinding of participants and personnel. We excluded 12

  4. Whiteboard Use in Labor and Delivery: A Tool to Improve Patient Knowledge of the Name of the Delivery Provider and Satisfaction with Care.

    Science.gov (United States)

    Pimentel, Verónica Maria; Sun, Mengyang; Bernstein, Peter S; Ferzli, Myriam; Kim, Mimi; Goffman, Dena

    2018-04-01

    Introduction The impact of whiteboard use in labor rooms has not previously been studied. This quality improvement study aimed to evaluate patient knowledge of their delivering physician's name and the change in patient satisfaction after the implementation of a whiteboard in labor rooms. Methods A multidisciplinary team designed a dry-erase whiteboard prompting care providers to record their names, roles and patient care information. A questionnaire was administered to patients before and after the whiteboard implementation. Patients who had a planned cesarean or vaginal birth within 1 h of admission were excluded. Categorical variables were compared using Chi square and Fisher's exact tests. A multivariable logistic regression was performed to control for confounders. Results 191 patients completed the questionnaires. Although patients were not randomized, the pre-and post-intervention groups were similar. Post-intervention, we found a significant increase in recalling the delivery resident's name [21/101 (20.8%) vs. 33/90 (36.7%), p = 0.016] and a non-significant increase in recalling the name of the attending and nurse [19/101 (18.8%) vs. 23/90 (25.6%), p = 0.296; 46/101 (45.5%) vs. 53/90 (58.9%), p = 0.082]. Post-intervention, patient satisfaction with care was significantly higher [83/101 (82.2%) vs. 83/89 (93.3%), p = 0.028]. Knowledge of the delivery resident's name was associated with higher patient satisfaction [115/137 (84%) vs. 51/53 (96%), p = 0.03] and attendance of the postpartum care visit [50.4% (69/137) vs. 64.8% (35/54), p = 0.049]. Discussion The use of a well-designed whiteboard increases laboring patients' knowledge of their delivery physician's name and may improve patient satisfaction with care on Labor and Delivery.

  5. Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files. SG39 meeting, May 2014

    International Nuclear Information System (INIS)

    Aliberti, G.; Archier, P.; Dunn, M.; Dupont, E.; Hill, I.; ); Garcia, A.; Hursin, M.; Pelloni, S.; Ivanova, T.; Kodeli, I.; Palmiotti, G.; Salvatores, M.; Touran, N.; Wenming, Wang; Yokoyama, K.

    2014-05-01

    The aim of WPEC subgroup 39 'Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files' is to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and differential measurement experimentalists in order to improve the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications. This document is the proceedings of the second Subgroup meeting, held at the NEA, Issy-les-Moulineaux, France, on 13 May 2014. It comprises a Summary Record of the meeting and all the available presentations (slides) given by the participants: A - Welcome: Review of actions (M. Salvatores); B - Inter-comparison of sensitivity coefficients: 1 - Sensitivity Computation with Monte Carlo Methods (T. Ivanova); 2 - Sensitivity analysis of FLATTOP-Pu (I. Kodeli); 3 - Sensitivity coefficients by means of SERPENT-2 (S. Pelloni); 4 - Demonstration - Database for ICSBEP (DICE) and Database and Analysis Tool for IRPhE (IDAT) (I. Hill); C - Specific new experiments: 1 - PROTEUS FDWR-II (HCLWR) program summary (M. Hursin); 2 - STEK and SEG Experiments, M. Salvatores 3 - Experiments related to "2"3"5U, "2"3"8U, "5"6Fe and "2"3Na, G. Palmiotti); 4 - Validation of Iron Cross Sections against ASPIS Experiments (JEF/DOC-420) (I. Kodeli); 5 - Benchmark analysis of Iron Cross-sections (EFFDOC-1221) (I. Kodeli 6 - Integral Beta-effective Measurements (K. Yokoyama on behalf of M. Ishikawa); D - Adjustment results: 1 - Impacts of Covariance Data and Interpretation of Adjustment Trends of ADJ2010, (K. Yokoyama); 2 - Revised Recommendations from ADJ2010 Adjustment (K. Yokoyama); 3 - Comparisons and Discussions on Adjustment trends from JEFF (CEA) (P. Archier); 4 - Feedback on CIELO Isotopes from ENDF/B-VII.0 Adjustment (G. Palmiotti); 5 - Demonstration - Plot comparisons of participants' results (E

  6. Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Eggeman, Tim [ZeaChem Inc., Lakewood, CO (United States); O' Neill, Brian [ZeaChem Inc., Lakewood, CO (United States)

    2016-08-17

    from wood breakdown products, resulting in a non-viable process from an economic point of view. Later runs with the Chem Frac unit switched to a configuration that used dilute acid pretreatment followed by enzymatic hydrolysis. This change improved yield, increased sugar concentrations, and improved fermentability of sugars. The Hydrogenolysis unit met or exceeded all expectations with respect to unit capacity, technical performance, and economic performance. The US DOE funds for the project were provided through the American Recovery and Reinvestment Act of 2009. In addition to the scientific/technical merit of the project, this project benefited the public through the creation of approximately 75 onsite direct construction-related jobs, 25 direct on-going operations-related jobs, plus numerous indirect jobs, and thus was well aligned with the goals of the American Recovery and Reinvestment Act of 2009.

  7. Improving artificial breeding of cattle and buffalo in Asia. Guidelines and recommendations. A manual prepared under the framework of an IAEA Technical Cooperation Regional RCA Project on 'Improving Animal Productivity and Reproductive Efficiency', with technical support of the Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture

    International Nuclear Information System (INIS)

    2005-11-01

    The International Atomic Energy Agency (IAEA) and the Regional Cooperative Agreement for Asia and the Pacific Region (RCA), with technical support of the Joint FAO/IAEA Programme of Nuclear Techniques in Food and Agriculture, implemented a Technical Cooperation (TC) project entitled Improving Animal Productivity and Reproductive Efficiency. The dual objectives of this project are (a) strengthening and extending the field applications of Urea Molasses Multinutrient Blocks (UMMB) and other feed supplementation strategies, and (b) monitoring and improving the reproductive management and fertility of smallholder dairy cattle subjected to Artificial Insemination (AI). The radioimmunoassay (RIA) for measurement of progesterone in milk and use of the computer database AIDA (Artificial Insemination Database Application) play important roles in the success of the latter objective. The first meeting to plan project activities was held in January 1999 in Yangon, Myanmar and the second meeting to review progress and develop further work plans was held in February 2000 in Kuala Lumpur, Malaysia. The latter meeting concluded that the procedures currently used by different Asian countries for evaluation of breeding bulls should be standardized and unified protocols developed for ensuring quality control of semen during processing, storage and field use. It was recommended that this should be accomplished through a regional workshop of national consultants. A workshop of national consultants from 10 RCA Member States was therefore held in April 2002 in Faisalabad, Pakistan, to consider and discuss the following aspects and arrive at a consensus on the best procedures and practices to be adopted to suit conditions and needs in developing countries of Asia: - Selection, management and health control of AI bulls; - Semen technologies from collection through processing to storage; - Delivery and follow-up of field AI services to farmers The IAEA has also supported a similar project in

  8. Transgenic tobacco plants with improved cyanobacterial Rubisco expression but no extra assembly factors grow at near wild-type rates if provided with elevated CO2.

    Science.gov (United States)

    Occhialini, Alessandro; Lin, Myat T; Andralojc, P John; Hanson, Maureen R; Parry, Martin A J

    2016-01-01

    Introducing a carbon-concentrating mechanism and a faster Rubisco enzyme from cyanobacteria into higher plant chloroplasts may improve photosynthetic performance by increasing the rate of CO2 fixation while decreasing losses caused by photorespiration. We previously demonstrated that tobacco plants grow photoautotrophically using Rubisco from Synechococcus elongatus, although the plants exhibited considerably slower growth than wild-type and required supplementary CO2 . Because of concerns that vascular plant assembly factors may not be adequate for assembly of a cyanobacterial Rubisco, prior transgenic plants included the cyanobacterial chaperone RbcX or the carboxysomal protein CcmM35. Here we show that neither RbcX nor CcmM35 is needed for assembly of active cyanobacterial Rubisco. Furthermore, by altering the gene regulatory sequences on the Rubisco transgenes, cyanobacterial Rubisco expression was enhanced and the transgenic plants grew at near wild-type growth rates, although still requiring elevated CO2 . We performed detailed kinetic characterization of the enzymes produced with and without the RbcX and CcmM35 cyanobacterial proteins. These transgenic plants exhibit photosynthetic characteristics that confirm the predicted benefits of introduction of non-native forms of Rubisco with higher carboxylation rate constants in vascular plants and the potential nitrogen-use efficiency that may be achieved provided that adequate CO2 is available near the enzyme. © 2015 The Authors The Plant Journal © 2015 John Wiley & Sons Ltd.

  9. Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships.

    Science.gov (United States)

    MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve

    2017-11-28

    Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

  10. A new immuno- dystrophin-deficient model, the NSG-mdx4Cv mouse, provides evidence for functional improvement following allogeneic satellite cell transplantation

    Science.gov (United States)

    Arpke, Robert W.; Darabi, Radbod; Mader, Tara L.; Zhang, Yu; Toyama, Akira; Lonetree, Cara-lin; Nash, Nardina; Lowe, Dawn A.; Perlingeiro, Rita C.R.; Kyba, Michael

    2013-01-01

    Transplantation of a myogenic cell population into an immunodeficient recipient is an excellent way of assessing the in vivo muscle-generating capacity of that cell population. To facilitate both allogeneic and xenogeneic transplantations of muscle-forming cells in mice we have developed a novel immunodeficient muscular dystrophy model, the NSG-mdx4Cv mouse. The IL2Rg mutation, which is linked to the Dmd gene on the X chromosome, simultaneously depletes NK cells and suppresses thymic lymphomas, issues that limit the utility of the SCID/mdx model. The NSG-mdx4Cv mouse presents a muscular dystrophy of similar severity to the conventional mdx mouse. We show that this animal supports robust engraftment of both pig and dog muscle mononuclear cells. The question of whether satellite cells prospectively isolated by flow cytometry can confer a functional benefit upon transplantation has been controversial. Using allogeneic Pax7-ZsGreen donors and NSG-mdx4Cv recipients, we demonstrate definitively that as few as 900 FACS-isolated satellite cells can provide functional regeneration in vivo, in the form of an increased mean maximal force-generation capacity in cell-transplanted muscles, compared to a sham-injected control group. These studies highlight the potency of satellite cells to improve muscle function, and the utility of the NSG-mdx4Cv model for studies on muscle regeneration and Duchenne muscular dystrophy therapy. PMID:23606600

  11. Mechanical engineering department technical review

    International Nuclear Information System (INIS)

    Carr, R.B.; Denney, R.M.

    1981-01-01

    The Mechanical Engineering Department Technical Review is published to: (1) inform the readers of various technical activities within the department, (2) promote exchange of ideas, and (3) give credit to the personnel who are achieving the results. The report is formatted into two parts: technical acievements and publication abstracts. The first is divided into eight sections, one for each division in the department providing the reader with the names of the personnel and the division accomplishing the work

  12. Mechanical Engineering Department. Technical review

    Energy Technology Data Exchange (ETDEWEB)

    Simecka, W.B.; Condouris, R.A.; Talaber, C. (eds.)

    1980-01-01

    The Mechanical Engineering Department Technical Review is published to (1) inform the readers of various technical activities within the Department, (2) promote exchange of ideas, and (3) give credit to the personnel who are achieving the results. The report is formatted into two parts: technical achievements and publication abstracts. The first is divided into eight sections, one for each Division in the Department providing the reader with the names of the personnel and the Division accomplishing the work.

  13. Mechanical Engineering Department. Technical review

    International Nuclear Information System (INIS)

    Simecka, W.B.; Condouris, R.A.; Talaber, C.

    1980-01-01

    The Mechanical Engineering Department Technical Review is published to (1) inform the readers of various technical activities within the Department, (2) promote exchange of ideas, and (3) give credit to the personnel who are achieving the results. The report is formatted into two parts: technical achievements and publication abstracts. The first is divided into eight sections, one for each Division in the Department providing the reader with the names of the personnel and the Division accomplishing the work

  14. Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files. SG39 meeting, May 2016

    International Nuclear Information System (INIS)

    Herman, Michal Wladyslaw; Cabellos De Francisco, Oscar; Beck, Bret; Ignatyuk, Anatoly V.; Palmiotti, Giuseppe; Grudzevich, Oleg T.; Salvatores, Massimo; Chadwick, Mark; Pelloni, Sandro; Diez De La Obra, Carlos Javier; Wu, Haicheng; Sobes, Vladimir; Rearden, Bradley T.; Yokoyama, Kenji; Hursin, Mathieu; Penttila, Heikki; Kodeli, Ivan-Alexander; Plevnik, Lucijan; Plompen, Arjan; Gabrielli, Fabrizio; Leal, Luiz Carlos; Aufiero, Manuele; Fiorito, Luca; Hummel, Andrew; Siefman, Daniel; Leconte, Pierre

    2016-05-01

    The aim of WPEC subgroup 39 'Methods and approaches to provide feedback from nuclear and covariance data adjustment for improvement of nuclear data files' is to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and differential measurement experimentalists in order to improve the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications. WPEC subgroup 40-CIELO (Collaborative International Evaluated Library Organization) provides a new working paradigm to facilitate evaluated nuclear reaction data advances. It brings together experts from across the international nuclear reaction data community to identify and document discrepancies among existing evaluated data libraries, measured data, and model calculation interpretations, and aims to make progress in reconciling these discrepancies to create more accurate ENDF-formatted files. SG40-CIELO focusses on 6 important isotopes: "1H, "1"6O, "5"6Fe, "2"3"5","2"3"8U, "2"3"9Pu. This document is the proceedings of the seventh formal Subgroup 39 meeting and of the Joint SG39+SG40 Session held at the NEA, OECD Conference Center, Paris, France on 10-11 May 2016. It comprises a Summary Record of the meeting, and all the available presentations (slides) given by the participants: A - Welcome and actions review (Oscar CABELLOS); B - Methods: - XGPT: uncertainty propagation and data assimilation from continuous energy covariance matrix and resonance parameters covariances (Manuele AUFIERO); - Optimal experiment utilization (REWINDing PIA), (G. Palmiotti); C - Experiment analysis, sensitivity calculations and benchmarks: - Tripoli-4 analysis of SEG experiments (Andrew HUMMEL); - Tripoli-4 analysis of BERENICE experiments (P. DUFAY, Cyrille DE SAINT JEAN); - Preparation of sensitivities of k-eff, beta-eff and shielding benchmarks for adjustment exercise (Ivo KODELI); - SA and

  15. Optimization and improvement of the technical specifications for Santa Maria de Garona and Cofrentes nuclear power plants; Optimizacion y mejora de las especificaciones tecnicas de funcionamiento para las centrales de Santa Maria de Garona y Cofrentes

    Energy Technology Data Exchange (ETDEWEB)

    Norte Gomez, M D [Empresarios Agrupados, A.I.E., Madrid (Spain); Alcantud, F [Iberdrola C.N., Cofrentes, (Spain); Hoyo, C del [Nuclenor C.N., Santa Maria de Garona (Spain)

    1993-12-15

    Technical Specifications (TS) form one of the basic documents necessary for licensing nuclear power plants and are required by the Government in accordance with Article 26 of the Regulation for Nuclear and Radioactive Facilities. They contain specific plant characteristics and operating limits to provide adequate protection for the safety and health of operators and the general public. For operator actuation, TS include all the surveillance requirements and limiting operating conditions (operation at full power, startup, hot and cold shutdown, and refueling outage) of safety-related systems. They also include the conventional support systems which are necessary to keep the plant in a safe operating conditioner to bring it to safe shutdown in the event of incidents or hypothetical accidents. Because of the large volume of information contained in the TS, the NRC and American utility owners began to simplify and improve the initial standard TS, which has given way to the development of a TS Optimization Program in the USA under the auspices of the NRC. Empresarios Agrupados has been contracted by the BWR Spanish Owners' Group (GPE-BWR) to develop optimized TS for the Santa Maria de Garona and Cofrentes Nuclear Power Plants. The optimized and improved TS are simplified versions of the current ones and facilitate the work of plant operators. They help to prevent risks, and reduce the number of potential transients caused by the large number of tests required by current TS. Plant operational safety is enhanced and higher effective operation is achieved. The GPE-BWR has submitted the first part of the optimized TS with their corresponding Bases to the Spanish Nuclear Council (CSN), for comment and subsequent approval. Once the TS are approved by the Spanish Nuclear Council, the operators of the Santa Maria de Garona and Cofrentes Nuclear Power Plants will be given a training and adaptation course prior to their implementation. (author)

  16. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball

    Overview From a technical perspective, CMS has been in “beam operation” state since 6th November. The detector is fully closed with all components operational and the magnetic field is normally at the nominal 3.8T. The UXC cavern is normally closed with the radiation veto set. Access to UXC is now only possible during downtimes of LHC. Such accesses must be carefully planned, documented and carried out in agreement with CMS Technical Coordination, Experimental Area Management, LHC programme coordination and the CCC. Material flow in and out of UXC is now strictly controlled. Access to USC remains possible at any time, although, for safety reasons, it is necessary to register with the shift crew in the control room before going down.It is obligatory for all material leaving UXC to pass through the underground buffer zone for RP scanning, database entry and appropriate labeling for traceability. Technical coordination (notably Stephane Bally and Christoph Schaefer), the shift crew and run ...

  17. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball and W. Zeuner

    2011-01-01

    In this report we will review the main achievements of the Technical Stop and the progress of several centrally-managed projects to support CMS operation and maintenance and prepare the way for upgrades. Overview of the extended Technical Stop  The principal objectives of the extended Technical Stop affecting the detector itself were the installation of the TOTEM T1 telescopes on both ends, the readjustment of the alignment link-disk in YE-2, the replacement of the light-guide sleeves for all PMs of both HFs, and some repairs on TOTEM T2 and CASTOR. The most significant tasks were, however, concentrated on the supporting infrastructure. A detailed line-by-line leak search was performed in the C6F14 cooling system of the Tracker, followed by the installation of variable-frequency drives on the pump motors of the SS1 and SS2 tracker cooling plants to reduce pressure transients during start-up. In the electrical system, larger harmonic filters were installed in ...

  18. Assessment and the feasibility of improving the artificial lighting system in technical services workshop located in the Fourth South Pars Gas Refinery

    Directory of Open Access Journals (Sweden)

    masoud shafiee motlagh

    2015-09-01

    Full Text Available Background & Objectives: Desirable and ergonomic lighting in the workplaces has a significant impact on the visual effects and improve the efficiency and productivity of employees. This study aims to evaluate the lighting system and feasibility of improving the artificial lighting system for comfort lighting in the workshop of the Fourth South Pars Gas Refinery. Methods: In this descriptive-analytical study, the environmental conditions of the studied workshop were evaluated and the illuminance was measured in both day and night times at 216 points. Based on lighting measurements, a site map was provided. Further, based on current conditions of the workshop, illuminance was estimated using DIALux 4.12 lighting calculations software. In regard to the national recommended limits for industrial lighting and the current luminaires, the different practical, accessible and low cost solutions were presented. Using the mentioned software, the share of each proposed solutions for improving workshop lighting were estimated. Results: The results showed that illuminance of the workshop in day and night times were equal to 197±71.5lx and 160±50.6 lx, respectively. The same results were also acquired by software calculations. Based on the results, lighting system was considered as undesirable lighting system along with need to modifications. Workshop lighting can increase between 260 lx to 405 lx through employing the proposed solutions based on the software predictions. Conclusion: The results confirmed that the low cost and simple solutions can significantly be improved the ergonomic and comfort lighting in the workplace. The use of the specialized tools calculations by experts and designers can be also facilitated the conducting feasibility reliable.