WorldWideScience

Sample records for providing improved technical

  1. 75 FR 48273 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-08-10

    ... provisions by expanding the definition Technical Service Provider Assistance, which contained an error in the omission of ``Indian Tribe'' in the definition of Technical Service Provider. DATES: Effective Date: This amendment is effective on August 10, 2010. FOR FURTHER INFORMATION CONTACT: Angel Figueroa, Team Leader...

  2. 75 FR 6839 - Technical Service Provider Assistance

    Science.gov (United States)

    2010-02-12

    ... Conservation Service 7 CFR Part 652 RIN 0578-AA48 Technical Service Provider Assistance AGENCY: Natural... Final rule amends the Natural Resources Conservation Service (NRCS) regulations for technical service provider (TSP) provisions under the Food Security Act of 1985. The Food, Conservation, and Energy Act of...

  3. [Technical improvement of cohort constitution in administrative health databases: Providing a tool for integration and standardization of data applicable in the French National Health Insurance Database (SNIIRAM)].

    Science.gov (United States)

    Ferdynus, C; Huiart, L

    2016-09-01

    Administrative health databases such as the French National Heath Insurance Database - SNIIRAM - are a major tool to answer numerous public health research questions. However the use of such data requires complex and time-consuming data management. Our objective was to develop and make available a tool to optimize cohort constitution within administrative health databases. We developed a process to extract, transform and load (ETL) data from various heterogeneous sources in a standardized data warehouse. This data warehouse is architected as a star schema corresponding to an i2b2 star schema model. We then evaluated the performance of this ETL using data from a pharmacoepidemiology research project conducted in the SNIIRAM database. The ETL we developed comprises a set of functionalities for creating SAS scripts. Data can be integrated into a standardized data warehouse. As part of the performance assessment of this ETL, we achieved integration of a dataset from the SNIIRAM comprising more than 900 million lines in less than three hours using a desktop computer. This enables patient selection from the standardized data warehouse within seconds of the request. The ETL described in this paper provides a tool which is effective and compatible with all administrative health databases, without requiring complex database servers. This tool should simplify cohort constitution in health databases; the standardization of warehouse data facilitates collaborative work between research teams. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Risk based technique for improving technical specifications

    Energy Technology Data Exchange (ETDEWEB)

    Kim, I. S.; Jae, M. S.; Kim, B. S.; Hwang, S. W.; Kang, K. M.; Park, S. S.; Yu, Y. S. [Hanyang Univ., Seoul (Korea, Republic of)

    2001-03-15

    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.

  5. The Technical Baccalaureate: Providing Excellence in Vocational Education?

    Science.gov (United States)

    Acquah, Daniel K.; Malpass, Debra

    2017-01-01

    Proposals for a technical baccalaureate have received cross-party support in England. The technical baccalaureate is intended to deliver the necessary training to enable young people to fill the UK's skills gap in intermediate-level occupations in STEM and other sectors. This paper explores how to design and implement a high-quality technical…

  6. 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.

  7. Improving Technical Instruction Using Personality Styles.

    Science.gov (United States)

    Tomal, Daniel R.

    2003-01-01

    Incorporating personality styles into technical instruction can enhance student learning. Four personality styles based on Jung--intuitor, feeler, thinker, and doer--have implications for individualizing technical instruction. (JOW)

  8. 48 CFR 9.505-1 - Providing systems engineering and technical direction.

    Science.gov (United States)

    2010-10-01

    ... engineering and technical direction. 9.505-1 Section 9.505-1 Federal Acquisition Regulations System FEDERAL... of Interest 9.505-1 Providing systems engineering and technical direction. (a) A contractor that provides systems engineering and technical direction for a system but does not have overall contractual...

  9. Trial for Enhancing Technical Writing Skills to Improve Training Efficiency in Writing Technical Papers

    Science.gov (United States)

    Uneda, Michio; Ishikawa, Ken-Ichi

    One of the important undertakings of student in laboratory education practiced in higher educational institutions, such as universities, is the development of technical communication skills based on training in technical writing for preparing not only bachelor‧s and master‧s theses but also papers to be submitted to society journals. However, technical writing is difficult for students who are not trained in writing papers, and it might become a burden for the teaching staff. Considering this situation, we have examined methods that may enhance the technical writing skills of students and also improve the training efficiency of the teaching staff. Specifically, the methods include distributing checklists to students, providing as few corrections as possible using underlines and adding comments when correcting students‧ writings, and instructing students to exchange their writings to check each other‧s work. In this paper, we summarize and analyze the effects of practicing the above methods on the basis of the answers to a questionnaire provided by students.

  10. 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.

  11. 75 FR 5779 - Notice Providing Agenda for Technical Conference on RTO/ISO Responsiveness

    Science.gov (United States)

    2010-02-04

    ... Energy Regulatory Commission Notice Providing Agenda for Technical Conference on RTO/ISO Responsiveness.... ER09-1050-000, ER09- 1192-000. ISO New England, Inc. and New England Docket No. ER09-1051-000. Power... , (202) 502-8048. Kimberly D. Bose, Secretary. Agenda--Technical Conference on RTO/ISO Responsiveness...

  12. Improving School Accountability in California. Technical Appendices

    Science.gov (United States)

    Larsen, S. Eric; Lipscomb, Stephen; Jaquet, Karina

    2011-01-01

    This paper presents the appendices to the "Improving School Accountability in California" report. Appendices include: (1) Data and Methodology; and (2) Additional Projections. (Contains 1 table, 4 figures and 3 footnotes.) [For the main report, "Improving School Accountability in California," see ED518179.

  13. 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

  14. [Improvement in transcutaneous needle biopsy technics].

    Science.gov (United States)

    Rothenberger, K; Pensel, J

    1980-09-11

    Transcutaneous fine needle biopsy of retroperitoneal lymph nodes after lymphography minor is connected with only discomfort for the patient. It is used for clarification of a possible infestation of metastases by malignant growth, the lymphatic drainage of which is situated retroperitoneally. A new instrument for puncture is presented, the use of which permits increase in accuracy of impact and reduction of radiation exposure for both patient and examiner. These advantages are of great importance, especially in serial puncture of several lymph nodes along the lymphogenous pathway of metastases. The quality of the fluoroscopic picture is even improved by the instrument for puncture.

  15. 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

  16. 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.

  17. 16 CFR 1401.5 - Providing performance and technical data to purchasers by labeling.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Providing performance and technical data to purchasers by labeling. 1401.5 Section 1401.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... identification and warning statement may appear on a firmly affixed tag, tape, card, or sticker or similar...

  18. 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…

  19. Industry Perceptions of Industry-Based Training Provided by Technical Colleges.

    Science.gov (United States)

    Dahlgren, Judith; Stone, James R., III

    1990-01-01

    Focus groups and interviews with representatives of 36 businesses explored business and industry perceptions regarding industry-based training (IBT) provided by technical colleges. The study found that several types of programs were being used; the more successful models were personalized or standardized generic occupational training. (JOW)

  20. 16 CFR 1407.3 - Providing performance and technical data to purchasers by labeling.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Providing performance and technical data to purchasers by labeling. 1407.3 Section 1407.3 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... the portable generator that cannot be removed without the use of tools, and (B) On a location that is...

  1. 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

  2. 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.

  3. 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 technical skills and clinical knowledge, respectively. When technical skills were compared between cohorts, there were no differences observed in both pre- and post-testing (P = .08). A fresh 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.

  4. 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.

  5. 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.

  6. Technical and economic analysis of Soft Starter Providing in LV Electrical Installation

    Directory of Open Access Journals (Sweden)

    Virgil Maier

    2014-09-01

    Full Text Available The main aim of this paper is to identify the consequences magnitude of providing electronic starters, also called Soft Starters, in AC electrical motors with largest powers and the economical appreciation of this measure. Through this, it aims not only to identify the technical and economic arguments for applying more decided the provision of electronic starters, but also the limits of its application, given the great diversity of receivers rated power. Thus, it is appreciated that there is no question of applying Soft Starters for the whole power range of asynchronous motors.In context of the proposed analysis, a summary of electronic starters issues is made which may be a guide of their choice and application, facilitating the specialists access in the technical manuals of the companies producing Soft Starters.

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

    Directory of Open Access Journals (Sweden)

    Breen Patricia

    2010-09-01

    Full Text Available Abstract Background 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. Methods A teleneurophysiology service providing routine EEG investigation was established. Service use, technical performance and satisfaction of clinical neurophysiology personnel were assessed qualitatively and quantitatively. These were contrasted with a previously reported analysis of the need for teleneurophysiology, and examination of expectation and satisfaction with clinical neurophysiology services in Ireland. A preliminary cost-benefit analysis was also conducted. Results Over the course of 40 clinical sessions during 20 weeks, 142 EEG investigations were recorded and stored on a file server at a satellite centre which was 130 miles away from the host clinical neurophysiology department. Using a virtual private network, the EEGs were accessed by a consultant neurophysiologist at the host centre for interpretation. The model resulted in a 5-fold increase in access to EEG services as well as reducing average waiting times for investigation by a half. Technically the model worked well, although a temporary loss of virtual private network connectivity highlighted the need for clarity in terms of responsibility for troubleshooting and repair of equipment problems. Referral quality, communication between host and satellite centres, quality of EEG recordings, and ease of EEG review and reporting indicated that appropriate organisational processes were adopted by the service. Compared to traditional CN service delivery, the teleneurophysiology model resulted in a comparable unit cost per EEG. Conclusion Observations suggest that when traditional organisational boundaries are crossed challenges associated with the

  8. A management framework for training providers to improve skills ...

    African Journals Online (AJOL)

    Erna Kinsey

    Training providers need an internal management framework to enable them to improve workplace skills development. ... The management role of workplace training providers in the midst of the skills revolution is under ...... Benefit Analysis to determine a Return on Investment; TQM or Total. Quality Management; and PMF or ...

  9. 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.

  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. 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.

  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. The improvement of technical preparation of sprinters on the initial stage of sport training

    OpenAIRE

    Maleniuk T.V.

    2010-01-01

    Directions of perfection of technical preparation of sprinters are examined on the initial stage of the sporting training. The basic elements of technique at run are certain 100 meters. The system of criteria of estimation of technical preparedness of sprinters is developed. The certain lacks of technical preparedness are exposed. The method of improvement of technical preparation is developed and its efficiency is tested. The system of criteria of estimation of technical preparedness of spri...

  14. Improving the traffic safety culture in Kansas : technical summary.

    Science.gov (United States)

    2017-01-01

    The main objective of this research was to provide guidance to the Kansas Department of Transportation (KDOT) in establishing strategies to improve the traffic safety culture in Kansas. This was done by analyzing crash data with respect to the seven ...

  15. 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.

  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. 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.

  18. Trial for Enhancing Technical Writing Skills to Improve Training Efficiencyin Writing Technical Papers and Its Effectiveness Evaluation

    Science.gov (United States)

    Uneda, Michio; Ishikawa, Ken-Ichi

    One of the important undertakings of student in laboratory education practiced in higher educational institutions, such as universities, is the development of technical communication skills based on training in technical writing for preparing not only theses but also papers to be submitted to society journals. However, technical writing is difficult for students who study at a technical university. Moreover, it might become a burden for the teaching staff, when a teaching staff trains many students. With the background of this situation, we have examined four effective methods described in this paper from year 2006. This paper describes the effects of practicing our four methods on the basis of the answers to questionnaires provided by students in years 2006 and 2007.

  19. State “Technical Assistance Programs” for nursing home quality improvement: variations and potential implications

    Science.gov (United States)

    Li, Yue; Spector, Williams D.; Glance, Laurent G.; Mukamel, Dana B.

    2013-01-01

    Context To improve nursing home quality, many states developed “Technical Assistance Programs” that provide on-site consultation and training for nursing facility staff. Methods We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. Results As of 2010, 17 states have developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. Conclusion State “Technical Assistance Programs” for nursing homes varies in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives. PMID:23216345

  20. The improvement of technical preparation of sprinters on the initial stage of sport training

    Directory of Open Access Journals (Sweden)

    Maleniuk T.V.

    2010-05-01

    Full Text Available Directions of perfection of technical preparation of sprinters are examined on the initial stage of the sporting training. The basic elements of technique at run are certain 100 meters. The system of criteria of estimation of technical preparedness of sprinters is developed. The certain lacks of technical preparedness are exposed. The method of improvement of technical preparation is developed and its efficiency is tested. The system of criteria of estimation of technical preparedness of sprinters is developed. A general tendency is exposed to their finding on middle, above average and to high levels.

  1. Scientific advances provide opportunities to improve pediatric environmental health

    Science.gov (United States)

    Reddy, Michael M.; Reddy, Micaela B.; Reddy, Carol F.

    2004-01-01

    The health consequences of contaminants in the environment, with respect to the health of children and infants, recently have been dramatically brought to public attention by the motion pictures Erin Brockovich and A Civil Action. These productions focused public attention on the potential link between water contaminants and pediatric health, a continuing subject of public concern. As a consequence of the increasing production of new commercial chemicals, many chemicals have appeared in the scientific and public awareness as potential threats to health. These new or novel compounds eventually distribute in the environment and often are termed emerging contaminants. Gitterman and Bearer stated, "Children may serve as unwitting sentinels for society; they are often the youngest exposed to many environmental toxicants and may become the youngest in age to manifest adverse responses." The discipline of pediatric environmental health is still in its adolescence, but it will be increasingly important as new chemicals are generated and as more is learned about the health effects of chemicals already in commerce. Here, we provide an overview of recent advances in biomonitoring and environmental monitoring of environmental contaminants including emerging contaminants. Our purpose in writing this commentary is to make pediatricians aware of the current resources available for learning about pediatric environmental health and of ongoing research initiatives that provide opportunities to improve pediatric environmental health.

  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. Improvement of the Teaching of Vocational Technical Education ...

    African Journals Online (AJOL)

    Administrator

    This implies that in the absence of supervisors for schools, instructional materials should be developed for teachers of vocational-technical education to include objectives of instructions and provision for the means of attainment. The paper recommends the adoption of. Competency-based Vocational Education (CBVE) and.

  4. Recent improvements in the NASA technical report server

    Science.gov (United States)

    Maa, Ming-Hokng; Nelson, Michael L.

    1995-01-01

    The NASA Technical Report Server (NTRS), a World Wide Web (WWW) report distribution service, has been modified to allow parallel database queries, significantly decreasing user access time by an average factor of 2.3, access from clients behind firewalls and/or proxies which truncate excessively long Uniform Resource Locators (URL's), access to non-Wide Area Information Server (WAIS) databases, and compatibility with the Z39-50.3 protocol.

  5. Technical skill training improves the ability to learn.

    Science.gov (United States)

    Kurahashi, Allison M; Harvey, Adrian; MacRae, Helen; Moulton, Carol-Anne; Dubrowski, Adam

    2011-01-01

    In the initial phases of surgical training, attentional resources are monopolized by the execution of novel tasks. This consideration can result in overwhelming attentional resources, leaving few for other tasks. Practicing a technical task decreases the attentional resources required for its execution. These resources are then free for redistribution to other, clinically important tasks. This pilot study investigated how laboratory-based surgical training on a technical procedure affects concurrent acquisition of other, nontechnical information. After watching an instructional video, 16 first-year surgical residents performed a pyloroplasty procedure and were divided randomly so half received 6 trials of hands-on practice of the procedure (practice group) whereas the other did not (no practice). After 1 week, participants returned to perform the procedure on 2 tests: isolated procedural performance (transfer) and concurrent procedural and listening performance (dual). Procedural and listening performances were compared between groups using expert measures of performance (Global Rating Scale [GRS], task-specific checklist, and number of errors) and written test scores. GRS and error scores reflected greater practice group performance on both tests: transfer test (P technical task execution, thus facilitating trainees' ability to distribute attentional resources between concurrent, clinically important task performances. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. 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

    ... 34 Education 1 2010-07-01 2010-07-01 false What are the procedures used by the Secretary for providing information or technical assistance? 86.302 Section 86.302 Education Office of the Secretary, Department of Education DRUG AND ALCOHOL ABUSE PREVENTION Responses and Sanctions Issued or Imposed by the...

  7. 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

  8. Modification of the BioMedicus centrifugal pump to provide continuous irrigation for neuroendoscopy: technical note.

    Science.gov (United States)

    Koueik, Joyce; Rocque, Brandon G; Henry, Jordan; Bragg, Taryn; Paul, Jennifer; Iskandar, Bermans J

    2018-02-01

    Continuous irrigation is an important adjunct for successful intraventricular endoscopy, particularly for complex cases. It allows better visualization by washing out blood and debris, improves navigation by expanding the ventricles, and assists with tissue dissection. A method of irrigation delivery using a centrifugal pump designed originally for cardiac surgery is presented. The BioMedicus centrifugal pump has the desirable ability to deliver a continuous laminar flow of fluid that excludes air from the system. A series of modifications to the pump tubing was performed to adapt it to neuroendoscopy. Equipment testing determined flow and pressure responses at various settings and simulated clinical conditions. The pump was then studied clinically in 11 endoscopy cases and eventually used in 310 surgical cases. Modifications of the pump tubing allowed for integration with different endoscopy systems. Constant flow rates were achieved with and without surgical instruments through the working ports. Optimal flow rates ranged between 30 and 100 ml/min depending on endoscope size. Intraoperative use was well tolerated with no permanent morbidity and showed consistent flow rates, minimal air accumulation, and seamless irrigation bag replacement during prolonged surgery. Although the pump is equipped with an internal safety mechanism to protect against pressure buildup when outflow obstructions occur, equipment testing revealed that flow cessation is not instantaneous enough to protect against sudden intracranial pressure elevation. A commonly available cardiac pump system was modified to provide continuous irrigation for intraventricular endoscopy. The system alleviates the problems of inconsistent flow rates, air in the irrigation lines, and delays in changing irrigation bags, thereby optimizing patient safety and surgical efficiency. Safe use of the pump requires good ventricular outflow and, clearly, sound surgical judgment.

  9. 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...

  10. Physical Activity at Daycare: Childcare Providers' Perspectives for Improvements

    Science.gov (United States)

    Tucker, Patricia; van Zandvoort, Melissa M.; Burke, Shauna M.; Irwin, Jennifer D.

    2011-01-01

    In London, Ontario, approximately 45 percent of preschoolers are insufficiently active.With the large number of preschoolers who attend childcare (54%), and the low levels of physical activity among preschool-aged children, daycare centers may be an appropriate avenue to intervene. This study sought to collect childcare providers' suggestions for…

  11. 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

  12. A management framework for training providers to improve skills ...

    African Journals Online (AJOL)

    South Africa is in a skills revolution, launched by the Department of Labour via the Skills Development Act in 1998 and the Skills Development Levies Act in 1999. The skills revolution challenges workplace training providers through employers who pay a percentage of payroll towards skills levies and want to recover these ...

  13. Continuous School Improvement Questionnaire Field Test. Technical Report.

    Science.gov (United States)

    Wiersma, William

    The Continuous School Improvement Questionnaire (CSIQ) is a comprehensive inventory measuring educators' perceptions of factors that affect success with school improvement. A pilot test of the CSIQ was conducted in Spring 2000, one purpose of which was to reduce the length of the CSIQ. The instrument was reduced from 147 to 72 items. The pilot…

  14. 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.

  15. 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.

  16. Some administrative features for maintaining the material and technical base of medical centers providing transplant care to Russian citizens

    Directory of Open Access Journals (Sweden)

    I. I. Antoshina

    2017-01-01

    Full Text Available In this article, the authors defined the procedure for maintaining the material and technical base of medical centers providing high-tech assistance (especially, transplant care to Russian citizens. The current regulatory and methodological base determining the procedure for repairs of fixed assets is evaluated, the main issues of capital repair planning in budgetary medical centers providing high-tech medical care are considered. The innovations introduced at the present time into the legislation determining the procedure for capital repairs are defined; the applicable concepts and scope of regulation are disclosed; the procedure for the implementation of major repairs in accordance with the current regulations is considered; the key issues that make it difficult to start capital repairs of the premises in budgetary medical centers providing high-tech medical care to Russian citizens are identified. Administrative and financial discipline while ensuring the working conditions of the material and technical base has been strengthened. Considerable attention should be paid to the medium-term planning of works, preparation of technical documentation, and procurement of funds for preparatory works. Whereas it is necessary to coordinate such decisions with the Ministry of Healthcare of Russia and other governmental institutions in Russia the timing of the implementation of such projects has significantly increased.

  17. Improvement of technical preparation of elite weightlifters by variation in the magnitude of training load

    Directory of Open Access Journals (Sweden)

    Oleshko Valentin

    2016-06-01

    Full Text Available Achievement of high sports performance by elite weightlifters depends on the technical and tactical actions performed during clean and jerk that are developed under the influence of various training loads. Athletes competed in middle-weight categories have the most efficient motor actions when perform clean and jerk. The largest number of technical errors of light-weight and middle-weight categories athletes are due to violations of the dynamic structure of a movement, whereas technical errors of weightlifters competed in heavy-weight categories are related to kinematic structure of a movement. The program of improvement of technical preparedness of elite weightlifters included the performance of series of compensatory exercises in different intensity zones, and this promotes an increased realization of the technical actions of athletes during performance of clean and jerk.

  18. Information provided by diagnostic and screening tests: improving probabilities.

    Science.gov (United States)

    Weatherall, Mark

    2017-11-13

    Uncertainty in clinical encounters is inevitable and despite this uncertainty clinicians must still work with patients to make diagnostic and treatment decisions. Explicit diagnostic reasoning based on probabilities will optimise information in relation to uncertainty. In clinical diagnostic encounters, there is often pre-existing information that reflects the probability any particular patient has a disease. Diagnostic testing provides extra information that refines diagnostic probabilities. However, in general diagnostic tests will be positive in most, but not all cases of disease (sensitivity) and may not be negative in all cases of disease absence (specificity). Bayes rule is an arithmetic method of using diagnostic testing information to refine diagnostic probabilities. In this method, when probabilities are converted to odds, multiplication of the odds of disease before diagnostic testing, by the positive likelihood ratio (LR+), the sensitivity of a test divided by 1 minus the specificity refines the probability of a particular diagnosis. Similar arithmetic applies to the probability of not having a disease, where the negative likelihood ratio is the specificity divided by 1 minus the sensitivity. A useful diagnostic test is one where the LR+ is greater than 5-10. This can be clarified by creating a contingency table for hypothetical groups of patients in relation to true disease prevalence and test performance predicted by sensitivity and specificity. Most screening tests in populations with a low prevalence of disease have a very high ratio of false positive results to true positive results, which can also be illustrated by contingency tables. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  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. 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.

  1. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Samanta, P.K.; Kim, I.S. [Brookhaven National Lab., Upton, NY (United States); Vesely, W.E. [Science Applications International Corp., Dublin, OH (United States)

    1992-11-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Samanta, P.K.; Kim, I.S. (Brookhaven National Lab., Upton, NY (United States)); Vesely, W.E. (Science Applications International Corp., Dublin, OH (United States))

    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.

  4. Status and Opportunities for Improving the Consistency of Technical Reference Manuals

    Energy Technology Data Exchange (ETDEWEB)

    Jayaweera, Tina [The Cadmus Group, Walthum, MA (United States); Velonis, Aquila [The Cadmus Group, Walthum, MA (United States); Haeri, Hossein [The Cadmus Group, Walthum, MA (United States); Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schiller, Steven R. [Schiller Consulting, Inc., Piedmont, CA (United States)

    2012-05-01

    Across the United States, energy-efficiency program administrators rely on Technical Reference Manuals (TRMs) as sources for calculations and deemed savings values for specific, well-defined efficiency measures. TRMs play an important part in energy efficiency program planning by providing a common and consistent source for calculation of ex ante and often ex post savings. They thus help reduce energy-efficiency resource acquisition costs by obviating the need for extensive measurement and verification and lower performance risk for program administrators and implementation contractors. This paper considers the benefits of establishing region-wide or national TRMs and considers the challenges of such undertaking due to the difficulties in comparing energy savings across jurisdictions. We argue that greater consistency across TRMs in the approaches used to determine deemed savings values, with more transparency about assumptions, would allow better comparisons in savings estimates across jurisdictions as well as improve confidence in reported efficiency measure savings. To support this thesis, we review approaches for the calculation of savings for select measures in TRMs currently in use in 17 jurisdictions. The review reveals differences in the saving methodologies, technical assumptions, and input variables used for estimating deemed savings values. These differences are described and their implications are summarized, using four, common energy-efficiency measures as examples. Recommendations are then offered for establishing a uniform approach for determining deemed savings values.

  5. 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.

  6. 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.

  7. 76 FR 28022 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Science.gov (United States)

    2011-05-13

    ... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical Conference: Increasing Real-Time and Day- Ahead Market Efficiency Through Improved...:30 a.m. to 4:30 p.m., to discuss opportunities for increasing real-time and day-ahead market...

  8. 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.

  9. 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 .

  10. TECHNICAL NOTE: Observations on the use of a viscoelastic joint to provide noise reduced sonar domes

    Science.gov (United States)

    House, J. R.

    1997-10-01

    This paper concerns the noise and vibration advantages of an energy absorbing composite joint and its relevance to noise reduced glass reinforced polyester (GRP) sonar domes. Once installed on an operational boat, hydrodynamic flow and supporting structural induced vibrations cause the dome to vibrate, thus radiating noise and interfering with sonar sensor response. The results of a vibration transmissibility study on a GRP - steel interface are discussed as the first step in designing a composite viscoelastic joint that can act as a vibration sink to absorb flow generated and structure borne noise within GRP sonar domes. Preliminary investigations concerning the absorption of compressional waves by use of a tapered viscoelastic interlayer are discussed. It is shown that a tapered viscoelastic interlayer placed between a GRP beam and steel supporting substrate can produce a significant absorption of vibrational energy, reducing water borne radiated noise and providing a significantly quieter noise platform than conventional sonar jointing technology.

  11. 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.

  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. Improving technical preparedness of archers using directional development of their coordination skills on stage using the specialized basic training

    National Research Council Canada - National Science Library

    Antonov Sergiy; Briskin Yuriy; Perederiy Alina; Pityn Maryan; Khimenes Khrystyna; Zadorozhna Olha; Semeryak Zoryana; Svystelnyk Irina

    2017-01-01

    .... The ways of improving the technical preparedness archer at the stage of basic training specialist associated with playing rhythmic, dynamic structure and maintain stability kinematic characteristics...

  14. 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

    This paper is for the AIAA Space Conference. 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.

  15. 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.

  16. Technical Strategies to Improve Tissue Engineering of Cartilage-Carrier-Constructs

    Science.gov (United States)

    Pörtner, R.; Goepfert, C.; Wiegandt, K.; Janssen, R.; Ilinich, E.; Paetzold, H.; Eisenbarth, E.; Morlock, M.

    Technical aspects play an important role in tissue engineering. Especially an improved design of bioreactors is crucial for cultivation of artificial three-dimensional tissues in vitro. Here formation of cartilage-carrier-constructs is used to demonstrate that the quality of the tissue can be significantly improved by using optimized culture conditions (oxygen concentration, growth factor combination) as well as special bioreactor techniques to induce fluid-dynamic, hydrostatic or mechanical load during generation of cartilage.

  17. 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…

  18. Improvement of technical and tactical training of judoists at the stage of leaving high performance sport

    Directory of Open Access Journals (Sweden)

    Ananchenko Konstantin

    2016-02-01

    Full Text Available The object of the study made by the authors is the training and competition process of judoists at the stage of leaving high performance sport. The subject of the study is individual approach to organizing technical-tactical preparation of judoists-veterans as a means of improving the efficiency of the training process. The article substantiates the directions of perfection of judoists’ training activity management at the stage of leaving high performance sport

  19. 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 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 facilitating communication, as

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-02-27

    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

  1. 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.

  2. 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.

  3. TECHNICAL AND FINANCIAL ASSESSMENT OF ORGANIZATIONAL IMPROVEMENTS OF SELECTED BUSINESS ENTITIES OF FOOD CHAIN MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Małgorzata Krotowska

    2016-03-01

    Full Text Available The aim of the article was technical and economic assessment of organizational improvements and use of resources of the examined business entities within the frames of their economic activity. The measurement of economic effi ciency was done with the use of commonly accepted profi tability indices (ROE, profi t margin and RONA. The technical assessment was based on the DEA method, taking into account the model: CRS, VRS and the scale of production. The variables applied in the model w ere operating incomes, as well as expenditures, i.e. UR area, labour input, value of fi xed assets and expenditure connected with energy and materials consumption. The research results proved that there were not signifi cant diff erences between the examined groups (Z and N as far as calculated indices were concerned.

  4. Limited intervention improves technical skill in focus assessed transthoracic echocardiography among novice examiners

    Directory of Open Access Journals (Sweden)

    Frederiksen Christian

    2012-08-01

    Full Text Available Abstract Background Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation. Methods Twenty-one physicians with no previous training in FATE or echocardiography (Novices participated in the study and a reference group of three examiners with more than 10 years of experience in echocardiography (Experts was included. Novices received an initial theoretical and practical introduction (2 hours, after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation of the same two healthy volunteers from the baseline examination was performed. Results At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p = 0.005. 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4 and mean global image rating after intervention was 75.0 (CI 72.9-77.0, p = 0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9. Conclusions Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation.

  5. Limited intervention improves technical skill in focus assessed transthoracic echocardiography among novice examiners.

    Science.gov (United States)

    Frederiksen, Christian Alcaraz; Juhl-Olsen, Peter; Nielsen, Dorte Guldbrand; Eika, Berit; Sloth, Erik

    2012-08-03

    Previous studies addressing teaching and learning in point-of-care ultrasound have primarily focussed on image interpretation and not on the technical quality of the images. We hypothesized that a limited intervention of 10 supervised examinations would improve the technical skills in Focus Assessed Transthoracic Echocardiography (FATE) and that physicians with no experience in FATE would quickly adopt technical skills allowing for image quality suitable for interpretation. Twenty-one physicians with no previous training in FATE or echocardiography (Novices) participated in the study and a reference group of three examiners with more than 10 years of experience in echocardiography (Experts) was included. Novices received an initial theoretical and practical introduction (2 hours), after which baseline examinations were performed on two healthy volunteers. Subsequently all physicians were scheduled to a separate intervention day comprising ten supervised FATE examinations. For effect measurement a second examination (evaluation) of the same two healthy volunteers from the baseline examination was performed. At baseline 86% of images obtained by novices were suitable for interpretation, on evaluation this was 93% (p = 0.005). 100% of images obtained by experts were suitable for interpretation. Mean global image rating on baseline examinations was 70.2 (CI 68.0-72.4) and mean global image rating after intervention was 75.0 (CI 72.9-77.0), p = 0.0002. In comparison, mean global image rating in the expert group was 89.8 (CI 88.8-90.9). Improvement of technical skills in FATE can be achieved with a limited intervention and upon completion of intervention 93% of images achieved are suitable for clinical interpretation.

  6. 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…

  7. Lost in the rush to national reform: recommendations to improve impact on behavioral health providers in rural areas.

    Science.gov (United States)

    Semansky, Rafael; Willging, Cathleen; Ley, David J; Rylko-Bauer, Barbara

    2012-05-01

    As the United States embarks on the most ambitious national health reform since the 1960s, this article highlights the challenges faced by behavioral health agencies, providers, and clients in rural areas and presents recommendations to improve access to and quality of services. Lessons learned from five years of research on a major systems-change initiative in New Mexico illuminate potential problem areas for rural agencies under national health reform, including insufficient financial resources, shortages of trained staff, particularly clinicians with advanced credentials, and delays in adopting the latest information technology. We recommend that rural states: (1) undertake careful planning for smooth transitions; (2) provide financial resources and technical assistance to expand rural safety-net services and capacity; (3) modify the health home model for the rural context; and (4) engage in ongoing evaluation, which can help ensure the early identification and rectification of unanticipated implementation issues.

  8. 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.)

  9. 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.

  10. Technical and tactical training of qualified Volleyball players by improving attacking actions of players in different roles

    National Research Council Canada - National Science Library

    Yevgeniy Imas; Olga Borysova; Olha Shlonska; Iryna Kogut; Viktoria Marynych; Viktor Kostyukevich

    2017-01-01

    ... of competitive activity of players in the team. However, at the present stage of the game development insufficient attention is paid to improve these technical and tactical actions in the system of the game of qualified volleyball players...

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

    National Research Council Canada - National Science Library

    Kyzim, Petro; Batieieva, Nataliya

    2016-01-01

    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...

  12. 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

  13. 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%, Pskills (+7.4% vs. -2.4%, Pbasketball players during the season. However, when RSA is targeted, more specific training seems necessary. © Georg Thieme Verlag KG Stuttgart · New York.

  14. 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.

  15. Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study.

    Science.gov (United States)

    Brown, Seth A; Hayden, Theresa C; Randell, Kimberly A; Rappaport, Lara; Stevenson, Michelle D; Kim, In K

    2017-02-01

    Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements. Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data. Forty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements. Focus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care. Brown SA , Hayden TC , Randell KA , Rappaport L , Stevenson MD , Kim IK . Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20-26.

  16. 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.

  17. 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.

  18. A continuous improvement process for health providers of victims of domestic violence.

    Science.gov (United States)

    Swenson-Britt, E; Thornton, J E; Hoppe, S K; Brackley, M H

    2001-10-01

    Health care providers can play an important role in the prevention of domestic violence through established processes of identification, safety assessment, validation, documentation, and referral. In 1998 the Safe Family Project, funded by University Health System (UHS), affiliated with University of Texas Health Science Center at San Antonio, provided for a clinical review of existing services for victims of domestic violence. A subsequent review of the health system's policy and clinical practice supported the need for resources and training and for an improved care process for victims of domestic violence. THE CONTINUOUS IMPROVEMENT PROCESS (CIP) MODEL: UHS adapted the Shewhart cycle of activities popularly referred to as PDSA (plan change, do change, study results, act on results), a systematic, process-focused approach to achieving continuous and measurable improvement, as its CIP model, and it formed a process improvement team. This process led to translation of research findings into best practice guidelines for treatment of domestic violence and staff education. Significant improvements were made in the overall qualitative chart reviews, although the diagnostic coding (using ICD-9 codes and e-codes) did improve. The CIP can be replicated in other settings to improve the care of victims of domestic violence. The CIP effort is being extended to outpatient facilities, and managers have requested that the training manual be replicated and placed throughout UHS as a resource manual. Other activities are intended to improve prevention of domestic violence and intervention when it occurs.

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

    Directory of Open Access Journals (Sweden)

    Kolokoltsev M.M.

    2014-01-01

    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.

  20. 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.

  1. 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.

  2. Improving parent satisfaction: an intervention to increase neonatal parent?provider communication

    OpenAIRE

    Weiss, S; Goldlust, E; Vaucher, Y E

    2009-01-01

    Objective: The objective of the study was to assess whether a targeted intervention improved the satisfaction of neonatal parents with primary medical provider communication. Study Design: The study design was a survey assessment of parents in a neonatal intensive care unit regarding their satisfaction with physician and nurse practitioner communication. Serial cohorts were surveyed before and after an intervention, including educating providers about family communication, distributing contac...

  3. 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

  4. Real-time video communication improves provider performance in a simulated neonatal resuscitation.

    Science.gov (United States)

    Fang, Jennifer L; Carey, William A; Lang, Tara R; Lohse, Christine M; Colby, Christopher E

    2014-11-01

    To determine if a real-time audiovisual link with a neonatologist, termed video-assisted resuscitation or VAR, improves provider performance during a simulated neonatal resuscitation scenario. Using high-fidelity simulation, 46 study participants were presented with a neonatal resuscitation scenario. The control group performed independently, while the intervention group utilized VAR. Time to effective ventilation was compared using Wilcoxon rank sum tests. Providers' use of the corrective steps for ineffective ventilation per the NRP algorithm was compared using Cochran-Armitage trend tests. The time needed to establish effective ventilation was significantly reduced in the intervention group when compared to the control group (mean time 2 min 42 s versus 4 min 11 s, presuscitation scenario significantly reduces the time to establish effective ventilation and improves provider adherence to NRP guidelines. This technology may be a means for regional centers to support local providers during a neonatal emergency to improve patient safety and improve neonatal outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Communication training improves patient-centered provider behavior and screening for soldiers' mental health concerns.

    Science.gov (United States)

    Douglas, Susan R; Vides de Andrade, Ana Regina; Boyd, Stephanie; Leslie, Melanie; Webb, Lynn; Davis, Lauren; Fraine, Melissa; Frazer, Nicole L; Hargraves, Ryan; Bickman, Leonard

    2016-07-01

    To evaluate the effectiveness of patient-centered communication training for military providers who conduct post-deployment health screening. The half-day interactive workshop included simulated Soldier patients using video technology. Using a quasi-experimental design, all health care providers at four military treatment facilities were recruited for data collection during a four- to nine-day site visit (23 trained providers, 28 providers in the control group, and one provider declined to participate). All Soldiers were eligible to participate and were blinded to provider training status. Immediately after screening encounters, providers reported on their identification of mental health concerns and Soldiers reported on provider communication behaviors resulting in 1,400 matched pairs. Electronic health records were also available for 26,005 Soldiers. The workshop was found to increase (1) providers' patient-centered communication behaviors as evaluated by Soldiers; (2) provider identification of Soldier mental health concerns; and (3), related health outcomes including provision of education and referral to a confidential counseling resource. Results are promising, but with small effect sizes and study limitations, further research is warranted. A brief intensive workshop on patient-centered communication tailored to the military screening context is feasible and may improve key outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Improvement of hydrogen solubility and entrainment in hydrocracker feedstocks. Quarterly technical report, January 1, 1995--March 31, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Kabadi, V.N.

    1995-07-01

    The objective of this project is to determine the conditions for the hydrogen-heavy oil feed preparation so as to optimize the yield of hydrocracking reactions. Proper contacting of hydrogen with heavy oil on the catalytic bed is necessary to improve the yields of the hydrocracking reactions. It is most desirable to have the necessary amount of hydrogen available either in the dissolved or in entrained state, so that hydrogen diffusion to the reaction site does not provide rate controlling resistance to the overall rates of hydrocracking reactions. This project proposes to measure solubility and entrainment data for hydrogen in heavy oils at conditions such as in hydrocrackers, and investigate the improvement of these properties by usage of appropriate additives. Specifically, measurements will be carried out at temperatures up to 300{degrees}C and pressures up to 120 atmospheres. Correlations for solubility and entrainment kinetics will be developed from the measured data, and a method for estimating yield of hydrocracking reactions using these correlations will be suggested. Exxon Research and Engineering Company will serve as private sector collaborator providing A&T with test samples and some technical expertise that will assure successful completion of the project. Results are presented for solubility of hydrogen in hydrocarbons and in heavy petroleum fractions. Comparison with experimental data shows good agreements. It is also demonstrated that the model is easily applied to compute solubility of hydrogen in heavy petroleum fractions with fair degree of accuracy. Detailed results are presented.

  7. 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.

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

    Science.gov (United States)

    Andersen, Peter Oluf; Jensen, Michael Kammer; Lippert, Anne; Østergaard, Doris

    2010-06-01

    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. 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 and data analysis were supported by a template describing 25 NTSs derived from other educational programmes in health care. A framework with five categories relating to NTSs was identified: leadership, communication, mutual performance monitoring, maintenance of standards and guidelines and task management. Important barriers that were identified were inexperienced team leaders, task overload and hierarchic structure in the teams' inability to maintain focus on chest compressions. Interview participants pointed out that NTSs of teams could improve the treatment of cardiac arrest, but several barriers to this exist. Improving resuscitation training should include considerations regarding team leader experience, structured communication, mandatory use of cognitive aids, avoidance of task overload and mutual performance monitoring to avoid unnecessary interruptions in chest compressions. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Does Provider Self-Reporting of Etiquette Behaviors Improve Patient Experience? A Randomized Controlled Trial.

    Science.gov (United States)

    Siddiqui, Zishan; Qayyum, Rehan; Bertram, Amanda; Durkin, Nowella; Kebede, Sosena; Ponor, Lucia; Oduyebo, Ibironke; Allen, Lisa; Brotman, Daniel J

    2017-06-01

    There is a glaring lack of published evidence-based strategies to improve the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience scores on the physician domain. Strategies that have been used are resource intensive and difficult to sustain. We hypothesized that prompting providers to assess their own etiquette-based practices every 2 weeks over the course of 1 year would improve patient experience on the physician domain. Randomized controlled trial. 4 acute care hospitals. Hospitalists. Hospitalists were randomized to the study or the control arm. The study arm was prompted every 2 weeks for 12 months to report how frequently they engaged in 7 best-practice bedside etiquette behaviors. Control arm participants received similarly worded questions on quality improvement behaviors. Provider experience scores were calculated from the physician HCAHPS and Press Ganey survey provider items. Physicians reported high rates of etiquette-based behavior at baseline, and this changed modestly over the study period. Self-reported etiquette behaviors were not associated with experience scores. The difference in difference analysis of the baseline and postintervention physician experience scores between the intervention arm and the control arm was not statistically significant (P = 0.71). In this 12-month study, biweekly reflection and reporting of best-practice bedside etiquette behaviors did not result in significant improvement on physician domain experience scores. It is likely that hospitalists' self-assessment of their bedside etiquette may not reflect patient perception of these behaviors. Furthermore, hospitalists may be resistant to improvement in this area since they rate themselves highly at baseline. Journal of Hospital Medicine 2017;12:402-406.

  10. 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.

  11. Improving SPAWAR PEO C4I Organizational Alignment to Better Enable Enterprise Technical Risk Management

    Science.gov (United States)

    2017-03-01

    ENABLE ENTERPRISE TECHNICAL RISK MANAGEMENT Steven C. Crosson Civilian, Department of the Navy B.C.E., University of Delaware, 2004 M.S...Defense Acquisition University DOD Department of Defense ERM enterprise risk management ETR enterprise technical risk ETRB Enterprise Technical...emphasis that there are even graduate programs offering master’s degrees in enterprise risk management showing up at American universities such as

  12. A mindfulness course decreases burnout and improves well-being among healthcare providers.

    Science.gov (United States)

    Goodman, Matthew J; Schorling, John B

    2012-01-01

    Healthcare providers are under increasing stress and work-related burnout has become common. Mindfulness-based interventions have a potential role in decreasing stress and burnout. The purpose of this study was to determine if a continuing education course based on mindfulness-based stress reduction could decrease burnout and improve mental well-being among healthcare providers, from different professions. This was a pre-post observational study conducted in a university medical center. A total of 93 healthcare providers, including physicians from multiple specialties, nurses, psychologists, and social workers who practiced in both university and community settings, participated. The intervention was a continuing education course based on mindfulness-based stress reduction that met 2.5 hours a week for 8 weeks plus a 7-hour retreat. The classes included training in four types of formal mindfulness practices, including the body scan, mindful movement, walking meditation and sitting meditation, as well as discussion focusing on the application of mindfulness at work. The course was offered 11 times over 6 years. The main outcome measures were work-related burnout as measured by the Maslach Burnout Inventory and self-perceived mental and physical well-being as measured by the SF-12v2. Maslach Burnout Inventory scores improved significantly from before to after the course for both physicians and other healthcare providers for the Emotional Exhaustion (p burnout scores and mental well-being for a broad range of healthcare providers.

  13. 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...

  14. 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...

  15. 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.

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

    Science.gov (United States)

    Gilliam, Meredith; Krein, Sarah L; Belanger, Karen; Fowler, Karen E; Dimcheff, Derek E; Solomon, Gabriel

    2017-01-01

    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 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. PMID:28491308

  17. 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

    2016-01-01

    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

  18. 77 FR 36501 - Applications for New Awards: Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2012-06-19

    ... environments and inclusive settings that promote positive developmental and learning outcomes. Effective... State and local systems and build the capacity of providers to improve developmental and learning... early childhood programs and services through such initiatives as the Race To the Top-- Early Learning...

  19. 75 FR 27341 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Science.gov (United States)

    2010-05-14

    ... for the purposes of stimulating discussion and sharing of information about the technical aspects of... respect to energy, reserves, ramp rates, and network topology), flexible dispatch, settlement calculations... modeling aspects of these issues. We expect that participants with technical understanding of operations...

  20. 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…

  1. 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

  2. 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

  3. Interventions to improve child-parent-medical provider communication: A systematic review.

    Science.gov (United States)

    Kodjebacheva, Gergana Damianova; Sabo, Tina; Xiong, Janet

    2016-10-01

    Research related to effective communication between children/parents and medical providers is limited. To review interventions seeking to improve communication between children/parents and medical providers. The inclusion criteria were interventions in peer-reviewed articles and dissertations in English. Because of the limited availability of pediatric communication research, no restrictions were placed on the year, design, and length of follow-up of the interventions. Out of 4163 articles in the CINAHL, Cochrane, EMBASE, ERIC, MEDLINE, and PsycINFO databases, 34 met the inclusion criteria. The design, strategies, measurement tools, results, and conflicts of interest of the interventions were reviewed. Most interventions were conducted in the United States, had a small sample size, and used a pre-posttest design. Fifteen were randomized controlled trials (RCTs). The most frequent intervention strategies were role-playing sessions and seminars for medical providers. Standardized children (i.e., fictitious child patients) were frequently used to help train physicians. Most interventions improved providers' interpersonal, patient-centered interviewing skills. Interventions that targeted parents involved booklets and role-playing to encourage questions. They improved parents' satisfaction and communication. An intervention that targeted youth used a video portraying how children can communicate better with physicians. Once the children aged 5-15 years watched the video, they wrote questions for their physicians prior to the medical visit. The experimental group of children had better rapport with physicians and could recall recommendations about medications more often than the control group. More RCTs involving children as active participants are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Providing solutions to energy and environmental problems. Quarterly technical progress report, July 1, 1997--September 30, 1997

    Energy Technology Data Exchange (ETDEWEB)

    1997-10-01

    The Jointly Sponsored Research Program emphasizes technology commercialization and continues to be highly successful and supported strongly and enthusiastically by WRI`s industrial clientele. All of the available Department of Energy (USDOE) funding for each of the first seven years has been committed to projects. This report provides a description of projects and expenditures on fossil projects and environmental monitoring.

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

    Directory of Open Access Journals (Sweden)

    Fontelo Paul

    2006-11-01

    Full Text Available 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 enhancing user interactivity through client-side manipulation and management of results. Results PubMed Interact is a Web-based MEDLINE/PubMed search application built with HTML, JavaScript and PHP. It is implemented on a Windows Server 2003 with Apache 2.0.52, PHP 4.4.1 and MySQL 4.1.18. PHP scripts provide the backend engine that connects with E-Utilities and parses XML files. JavaScript manages client-side functionalities and converts Web pages into interactive platforms using dynamic HTML (DHTML, Document Object Model (DOM tree manipulation and Ajax methods. With PubMed Interact, users can limit searches with JavaScript slider bars, preview result counts, delete citations from the list, display and add related articles and create relevance lists. Many interactive features occur at client-side, which allow instant feedback without reloading or refreshing the page resulting in a more efficient user experience. Conclusion PubMed Interact is a highly interactive Web-based search application for MEDLINE/PubMed that explores recent trends in Web technologies like DOM tree manipulation and Ajax. It may become a valuable technical development for online medical search applications.

  6. Technical development of PubMed interact: an improved interface for MEDLINE/PubMed searches.

    Science.gov (United States)

    Muin, Michael; Fontelo, Paul

    2006-11-03

    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 enhancing user interactivity through client-side manipulation and management of results. PubMed Interact is a Web-based MEDLINE/PubMed search application built with HTML, JavaScript and PHP. It is implemented on a Windows Server 2003 with Apache 2.0.52, PHP 4.4.1 and MySQL 4.1.18. PHP scripts provide the backend engine that connects with E-Utilities and parses XML files. JavaScript manages client-side functionalities and converts Web pages into interactive platforms using dynamic HTML (DHTML), Document Object Model (DOM) tree manipulation and Ajax methods. With PubMed Interact, users can limit searches with JavaScript slider bars, preview result counts, delete citations from the list, display and add related articles and create relevance lists. Many interactive features occur at client-side, which allow instant feedback without reloading or refreshing the page resulting in a more efficient user experience. PubMed Interact is a highly interactive Web-based search application for MEDLINE/PubMed that explores recent trends in Web technologies like DOM tree manipulation and Ajax. It may become a valuable technical development for online medical search applications.

  7. Primary Care Provider Perceptions of Colorectal Cancer Screening Barriers: Implications for Designing Quality Improvement Interventions

    Directory of Open Access Journals (Sweden)

    Jennifer M. Weiss

    2017-01-01

    Full Text Available Aims. Colorectal cancer (CRC screening is underutilized. Increasing CRC screening rates requires interventions targeting multiple barriers at each level of the healthcare organization (patient, provider, and system. We examined groups of primary care providers (PCPs based on perceptions of screening barriers and the relationship to CRC screening rates to inform approaches for conducting barrier assessments prior to designing and implementing quality improvement interventions. Methods. We conducted a retrospective cohort study linking EHR and survey data. PCPs with complete survey responses for questions addressing CRC screening barriers were included (N=166 PCPs; 39,430 patients eligible for CRC screening. Cluster analysis identified groups of PCPs. Multivariate logistic regression estimated odds ratios and 95% confidence intervals for predictors of membership in one of the PCP groups. Results. We found two distinct groups: (1 PCPs identifying multiple barriers to CRC screening at patient, provider, and system levels (N=75 and (2 PCPs identifying no major barriers to screening (N=91. PCPs in the top half of CRC screening performance were more likely to identify multiple barriers than the bottom performers (OR, 4.14; 95% CI, 2.43–7.08. Conclusions. High-performing PCPs can more effectively identify CRC screening barriers. Targeting high-performers when conducting a barrier assessment is a novel approach to assist in designing quality improvement interventions for CRC screening.

  8. 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.

  9. 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.

    1983-01-01

    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.

  10. A Low-Literacy Asthma Action Plan to Improve Provider Asthma Counseling: A Randomized Study.

    Science.gov (United States)

    Yin, H Shonna; Gupta, Ruchi S; Tomopoulos, Suzy; Mendelsohn, Alan L; Egan, Maureen; van Schaick, Linda; Wolf, Michael S; Sanchez, Dayana C; Warren, Christopher; Encalada, Karen; Dreyer, Benard P

    2016-01-01

    The use of written asthma action plans (WAAPs) has been associated with reduced asthma-related morbidity, but there are concerns about their complexity. We developed a health literacy-informed, pictogram- and photograph-based WAAP and examined whether providers who used it, with no training, would have better asthma counseling quality compared with those who used a standard plan. Physicians at 2 academic centers randomized to use a low-literacy or standard action plan (American Academy of Allergy, Asthma and Immunology) to counsel the hypothetical parent of child with moderate persistent asthma (regimen: Flovent 110 μg 2 puffs twice daily, Singulair 5 mg daily, Albuterol 2 puffs every 4 hours as needed). Two blinded raters independently reviewed counseling transcriptions. medication instructions presented with times of day (eg, morning and night vs number of times per day) and inhaler color; spacer use recommended; need for everyday medications, even when sick, addressed; and explicit symptoms used. 119 providers were randomly assigned (61 low literacy, 58 standard). Providers who used the low-literacy plan were more likely to use times of day (eg, Flovent morning and night, 96.7% vs 51.7%, P counseling time was similar (3.9 [2.5] vs 3.8 [2.6] minutes, P = .8). Use of a low-literacy WAAP improves the quality of asthma counseling by helping providers target key issues by using recommended clear communication principles. Copyright © 2016 by the American Academy of Pediatrics.

  11. 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...

  12. 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.

  13. Smarter hospital communication: secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow.

    Science.gov (United States)

    Przybylo, Jennifer A; Wang, Ange; Loftus, Pooja; Evans, Kambria H; Chu, Isabella; Shieh, Lisa

    2014-09-01

    Though current hospital paging systems are neither efficient (callbacks disrupt workflow), nor secure (pagers are not Health Insurance Portability and Accountability Act [HIPAA]-compliant), they are routinely used to communicate patient information. Smartphone-based text messaging is a potentially more convenient and efficient mobile alternative; however, commercial cellular networks are also not secure. To determine if augmenting one-way pagers with Medigram, a secure, HIPAA-compliant group messaging (HCGM) application for smartphones, could improve hospital team communication. Eight-week prospective, cluster-randomized, controlled trial Stanford Hospital Three inpatient medicine teams used the HCGM application in addition to paging, while two inpatient medicine teams used paging only for intra-team communication. Baseline and post-study surveys were collected from 22 control and 41 HCGM team members. When compared with paging, HCGM was rated significantly (P applications improve provider perception of in-hospital communication, while providing the information security that paging and commercial cellular networks do not. © 2014 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine.

  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. 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.

  17. Using Press Ganey Provider Feedback to Improve Patient Satisfaction: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Newgard, Craig D; Fu, Rongwei; Heilman, James; Tanski, Mary; John Ma, O; Lines, Alan; Keith French, L

    2017-09-01

    The objective was to conduct a pilot randomized controlled trial to assess the feasibility, logistics, and potential effect of monthly provider funnel plot feedback reports from Press Ganey data and semiannual face-to-face coaching sessions to improve patient satisfaction scores. This was a pilot randomized controlled trial of 25 emergency medicine faculty providers in one urban academic emergency department. We enrolled full-time clinical faculty with at least 12 months of baseline Press Ganey data, who anticipated working in the ED for at least 12 additional months. Providers were randomized into intervention or control groups in a 1:1 ratio. The intervention group had an initial 20-minute meeting to introduce the funnel plot feedback tool and standardized feedback based on their baseline Press Ganey scores and then received a monthly e-mail with their individualized funnel plot depicting cumulative Press Ganey scores (compared to their baseline score and the mean score of all providers) for 12 months. The primary outcome was the difference in Press Ganey "doctor-overall" scores between treatment groups at 12 months. We used a weighted analysis of covariance model to analyze the study groups, accounting for variation in the number of surveys by provider and baseline scores. Of 36 eligible faculty, we enrolled 25 providers, 13 of whom were randomized to the intervention group and 12 to the control group. During the study period, there were 815 Press Ganey surveys returned, ranging from four to 71 surveys per provider. For the standardized overall doctor score over 12 months (primary outcome), there was no difference between the intervention and control groups (difference = 1.3 points, 95% confidence interval = -2.4 to 5.9, p = 0.47). Similarly, there was no difference between groups when evaluating the four categories of doctor-specific patient satisfaction scores from the Press Ganey survey (all p > 0.05). In this pilot trial of monthly provider funnel plot

  18. Health care provider targeted interventions to improve medication adherence: systematic review and meta-analysis

    Science.gov (United States)

    Conn, V. S.; Ruppar, T. M.; Enriquez, M.; Cooper, P. S.; Chan, K. C.

    2017-01-01

    Objective This systematic review applied meta-analytic procedures to synthesize medication adherence (also termed compliance) interventions that focus on health care providers. Design Comprehensive searching located studies testing interventions that targeted health care providers and reported patient medication adherence behavior outcomes. Search strategies included 13 computerized databases, hand searches of 57 journals, and both author and ancestry searches. Study sample, intervention characteristics, design, and outcomes were reliably coded. Standardized mean difference effect sizes were calculated using random-effects models. Heterogeneity was examined with Q and I2 statistics. Exploratory moderator analyses used meta-analytic analog of ANOVA and regression. Results Codable data were extracted from 218 reports of 151,182 subjects. The mean difference effect size was 0.233. Effect sizes for individual interventions varied from .088 to 0.301. Interventions were more effective when they included multiple strategies. Risk of bias assessment documented larger effect sizes in studies with larger samples, studies that used true control groups (as compared to attention control), and studies without intention-to-treat analyses. Conclusion Overall, this meta-analysis documented that interventions targeted to health care providers significantly improved patient medication adherence. The modest overall effect size suggests that interventions addressing multiple levels of influence on medication adherence may be necessary to achieve therapeutic outcomes. PMID:25728214

  19. Does providing extended relapse prevention bibliotherapy to problem gamblers improve outcome?

    Science.gov (United States)

    Hodgins, David C; Currie, Shawn R; el-Guebaly, Nady; Diskin, Katherine M

    2007-03-01

    Relapse rates among pathological gamblers are high with as many as 75% of gamblers returning to gambling shortly after a serious attempt to quit. The present study focused on providing a low cost, easy to access relapse prevention program to such individuals. Based on information collected in our ongoing study of the process of relapse, a series of relapse prevention booklets were developed and evaluated. Individuals who had recently quit gambling (N = 169) were recruited (through media announcements) and randomly assigned to a single mailing condition in which they received one booklet summarizing all of the relapse prevention information or a repeated mailing condition in which they received the summary booklet plus 7 additional booklets mailed to them at regular intervals over the course of a year period. Gambling involvement over the course of the 12-month follow-up period, confirmed by family or friends, was compared between the two groups. Results indicated that participants receiving the repeated mailings were more likely to meet their goal, but they did not differ from participants receiving the single mailing in frequency of gambling or extent of gambling losses. The results of this project suggest that providing extended relapse prevention bibliotherapy to problem gamblers does not improve outcome. However, providing the overview booklet may be a low cost, easy to access alternative for individuals who have quit gambling.

  20. 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

  1. Moving Beyond Blind Men and Elephants: Providing Total Estimated Annual Costs Improves Health Insurance Decision Making.

    Science.gov (United States)

    Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas; Long, Sharon K

    2017-10-01

    Health insurance is among the most important financial and health-related decisions that people make. Choosing a health insurance plan that offers sufficient risk protection is difficult, in part because total expected health care costs are not transparent. This study examines the effect of providing total costs estimates on health insurance decisions using a series of hypothetical choice experiments given to 7,648 individuals responding to the fall 2015 Health Reform Monitoring Survey. Participants were given two health scenarios presented in random order asking which of three insurance plans would best meet their needs. Half received total estimated costs, which increased the probability of choosing a cost-minimizing plan by 3.0 to 10.6 percentage points, depending on the scenario ( p < .01). With many consumers choosing or failing to switch out of plans that offer insufficient coverage, incorporating insights on consumer decision making with personalized information to estimate costs can improve the quality of health insurance choices.

  2. 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

  3. Strategies to improve effectiveness of physical activity coaching systems: Development of personas for providing tailored feedback.

    Science.gov (United States)

    Achterkamp, Reinoud; Dekker-Van Weering, Marit Gh; Evering, Richard Mh; Tabak, Monique; Timmerman, Josien G; Hermens, Hermie J; Vollenbroek-Hutten, Miriam Mr

    2016-06-27

    Mobile physical activity interventions can be improved by incorporating behavioural change theories. Relations between self-efficacy, stage of change, and physical activity are investigated, enabling development of feedback strategies that can be used to improve their effectiveness. A total of 325 healthy control participants and 82 patients wore an activity monitor. Participants completed a self-efficacy or stage of change questionnaire. Results show that higher self-efficacy is related to higher activity levels. Patients are less active than healthy controls and show a larger drop in physical activity over the day. Patients in the maintenance stage of change are more active than patients in lower stages of change, but show an equally large drop in level of physical activity. Findings suggest that coaching should at least be tailored to level of self-efficacy, stage of change, and physical activity pattern. Tailored coaching strategies are developed, which suggest that increasing self-efficacy of users is most important. Guidelines are provided. © The Author(s) 2016.

  4. Solar technical assistance provided to Forest City military communities in Hawaii for incorporation of 20-30 MW of solar energy generation to power family housing for US Navy personnel.

    Energy Technology Data Exchange (ETDEWEB)

    Dominick, Jeff (National Renewable Energy Laboratory, Golden, CO); Merrigan, Tim (National Renewable Energy Laboratory, Golden, CO); Boudra, Will (Forest City Military Communities, Honolulu, HI); Miller, Ryan (CH2M Hill, Englewood, CO); Cisneros, Gabriela (New Mexico State University, Las Cruces, NM); Rosenthal, Andrew L. (New Mexico State University, Las Cruces, NM); Kuszmaul, Scott S.; Gupta, Vipin P.

    2010-06-01

    In May 2007, Forest City Military Communities won a US Department of Energy Solar America Showcase Award. As part of this award, executives and staff from Forest City Military Communities worked side-by-side with a DOE technical assistance team to overcome technical obstacles encountered by this large-scale real estate developer and manager. This paper describes the solar technical assistance that was provided and the key solar experiences acquired by Forest City Military Communities over an 18 month period.

  5. [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.

  6. Spatial Cues Provided by Sound Improve Postural Stabilization: Evidence of a Spatial Auditory Map?

    Science.gov (United States)

    Gandemer, Lennie; Parseihian, Gaetan; Kronland-Martinet, Richard; Bourdin, Christophe

    2017-01-01

    It has long been suggested that sound plays a role in the postural control process. Few studies however have explored sound and posture interactions. The present paper focuses on the specific impact of audition on posture, seeking to determine the attributes of sound that may be useful for postural purposes. We investigated the postural sway of young, healthy blindfolded subjects in two experiments involving different static auditory environments. In the first experiment, we compared effect on sway in a simple environment built from three static sound sources in two different rooms: a normal vs. an anechoic room. In the second experiment, the same auditory environment was enriched in various ways, including the ambisonics synthesis of a immersive environment, and subjects stood on two different surfaces: a foam vs. a normal surface. The results of both experiments suggest that the spatial cues provided by sound can be used to improve postural stability. The richer the auditory environment, the better this stabilization. We interpret these results by invoking the “spatial hearing map” theory: listeners build their own mental representation of their surrounding environment, which provides them with spatial landmarks that help them to better stabilize. PMID:28694770

  7. Spatial Cues Provided by Sound Improve Postural Stabilization: Evidence of a Spatial Auditory Map?

    Science.gov (United States)

    Gandemer, Lennie; Parseihian, Gaetan; Kronland-Martinet, Richard; Bourdin, Christophe

    2017-01-01

    It has long been suggested that sound plays a role in the postural control process. Few studies however have explored sound and posture interactions. The present paper focuses on the specific impact of audition on posture, seeking to determine the attributes of sound that may be useful for postural purposes. We investigated the postural sway of young, healthy blindfolded subjects in two experiments involving different static auditory environments. In the first experiment, we compared effect on sway in a simple environment built from three static sound sources in two different rooms: a normal vs. an anechoic room. In the second experiment, the same auditory environment was enriched in various ways, including the ambisonics synthesis of a immersive environment, and subjects stood on two different surfaces: a foam vs. a normal surface. The results of both experiments suggest that the spatial cues provided by sound can be used to improve postural stability. The richer the auditory environment, the better this stabilization. We interpret these results by invoking the "spatial hearing map" theory: listeners build their own mental representation of their surrounding environment, which provides them with spatial landmarks that help them to better stabilize.

  8. Spatial Cues Provided by Sound Improve Postural Stabilization: Evidence of a Spatial Auditory Map?

    Directory of Open Access Journals (Sweden)

    Lennie Gandemer

    2017-06-01

    Full Text Available It has long been suggested that sound plays a role in the postural control process. Few studies however have explored sound and posture interactions. The present paper focuses on the specific impact of audition on posture, seeking to determine the attributes of sound that may be useful for postural purposes. We investigated the postural sway of young, healthy blindfolded subjects in two experiments involving different static auditory environments. In the first experiment, we compared effect on sway in a simple environment built from three static sound sources in two different rooms: a normal vs. an anechoic room. In the second experiment, the same auditory environment was enriched in various ways, including the ambisonics synthesis of a immersive environment, and subjects stood on two different surfaces: a foam vs. a normal surface. The results of both experiments suggest that the spatial cues provided by sound can be used to improve postural stability. The richer the auditory environment, the better this stabilization. We interpret these results by invoking the “spatial hearing map” theory: listeners build their own mental representation of their surrounding environment, which provides them with spatial landmarks that help them to better stabilize.

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

    Science.gov (United States)

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

    2009-07-01

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

  10. Do Primary Care Provider Strategies Improve Patient Participation in Colorectal Cancer Screening?

    Science.gov (United States)

    Baxter, Nancy N; Sutradhar, Rinku; Li, Qing; Daly, Corinne; Honein-AbouHaidar, Gladys N; Richardson, Devon P; Del Giudice, Lisa; Tinmouth, Jill; Paszat, Lawrence; Rabeneck, Linda

    2017-04-01

    Screening rates for colorectal cancer (CRC) remain suboptimal. The impact of provider strategies to enhance screening participation in the population is uncertain. The objective of this study was to determine the effect of provider strategies to increase screening in a single-payer system. A population-based survey was conducted in primary care providers (PCPs) linked to patients using administrative data in Ontario, Canada. Patients were due for CRC screening from April 2012 to March 2013. Patients were followed up until 31 March 2014. We determined time to become up-to-date with CRC screening. Cox proportional hazards models examined the association between PCP strategies and uptake of screening, adjusted for physician and patient factors. A total of 717 PCPs and their 147,834 rostered patients due for CRC screening were included. Most physicians employed strategies to enhance screening participation, including electronic medical record use, reminders, generation of lists, audit and feedback reports, or designating staff responsible for screening. No single strategy was strongly associated with screening. For those >1 year overdue, a systematic approach to generate lists of patients overdue for screening was weakly associated with screening uptake (hazard ratio (HR)=1.14, 95% CI: 1.03-1.26, P=0.04 >5 years overdue vs. <1 year overdue). The use of multiple PCP strategies was associated with screening participation (HR=1.27, 95% CI: 1.16-1.39, P<0.0001 for PCPs using 4-5 vs. 0-1 strategies). Practice-based strategies were self-reported. In practice, while individual PCP strategies have little effect, the use of multiple strategies to enhance screening appears to improve CRC screening uptake in patients.

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

    Science.gov (United States)

    Heijmans, Naomi; van Lieshout, Jan; Wensing, Michel

    2015-04-02

    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 using telephone interviews and postal questionnaires as modes of interest. Aiming to explore effects of choice of participation, two randomized controlled trials were performed comparing participation rates of patients provided with and without choice of participation mode, using interviews and questionnaires as participation modes. Two trials were embedded in a larger study on cardiovascular risk management in primary care. Patients with a chronic cardiovascular condition recruited for the larger study were invited to participate in an additional survey on social networks, using invitations with and without choice of participation mode. Primary outcome was participation rate. Other outcomes of interest were participation rate conditional on willingness to participate, and initial willingness to participate. In trial 1 we compared outcomes after choice of participation mode (interview or questionnaire) with invitations for participation in a telephone interview. In Trial 2 results for choice of participation mode were compared with postal questionnaires. In Trial 1 no differences were found in participation rates (65% vs 66%, p = 0.853) although conditional participation rate was highest for interviews (90% vs 72%, p choice of participation mode was provided (90% versus 73%, p choice of participation mode was provided (59% vs 46%, p choice of participation mode had benefit on participation rates compared to invitations to participate in questionnaires, but not when compared to invitations to participate in telephone interviews. Current Controlled Trials ISRCTN89237105 .

  12. 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.

  13. Development and process evaluation of improved Fischer-Tropsch slurry catalysts. Quarterly technical progress report, 1 October-31 December 1987

    Energy Technology Data Exchange (ETDEWEB)

    Withers, H.P. [Air Products and Chemicals, Inc., Allentown, PA (United States); Bukur, D.B.; Rosynek, M.P. [Texas A and M Univ., College Station, TX (United States)

    1987-12-31

    The objective of this contract is to develop a consistent technical data base on the use of iron-based catalysts in Fischer-Tropsch (FT) synthesis reactions. This data base will be developed to allow the unambiguous comparison of the performance of these catalysts with each other and with state-of-the-art iron catalyst compositions. Particular attention will be devoted to generating reproducible kinetic and selectivity data and to developing reproducible improved catalyst compositions.

  14. 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.

  15. Improving Residential Satisfaction of University Dormitories through Post-Occupancy Evaluation in China: A Socio-Technical System Approach

    Directory of Open Access Journals (Sweden)

    Yan Ning

    2016-10-01

    Full Text Available Residential satisfaction of university dormitories serves as one of the significant aspects in the framework of sustainability in higher education. This study aims to develop a framework for post-occupancy evaluation (POE of university dormitories in China grounded on the socio-technical systems approach and to identify factors contributing to students’ residential satisfaction. Two focus groups were carried out to build the socio-technical framework. A case study was undertaken to evaluate the post-occupancy status of university dormitories, and structured-questionnaire was used to collect the data. The results show that university dormitories are equipped with quality physical facilities. However, they failed to provide satisfied services and supporting infrastructure. This indicates that “hardware” could generally meet students’ requirements, while the “software” is still less competent. It is also found that the socio-technical systems approach has the feature of being embedded into the social, regulatory and geographic contexts. In order to enhance post-occupancy satisfaction, occupants’ participation would be helpful. This study contributes to the body of knowledge by presenting a socio-technical framework of POE and its embeddedness feature. Implications for research and practices are also provided.

  16. 77 FR 19280 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Science.gov (United States)

    2012-03-30

    ... stochastic unit-commitment model is used, how should day-ahead prices be calculated, given that the stochastic formulation no longer produces as part of its solution a single set of deterministic shadow prices... potentially solvable technical problem using existing computational resources if transmission operators...

  17. 78 FR 18974 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Science.gov (United States)

    2013-03-28

    ... shadow prices for power at each location? How would a stochastic day-ahead unit commitment mechanism...? If a stochastic unit-commitment model is used, how should day-ahead prices be calculated, given that... potentially solvable technical problem using existing computational resources if transmission operators...

  18. 77 FR 39226 - Applications for New Awards: Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2012-07-02

    ... Positive Behavior Support. School Psychology Review, 35(2), 245-259. Turnbull, A., Edmonson, H., Griggs, P...). Evaluation blueprint for school-wide positive behavior support. Eugene, OR: National Technical Assistance Center on Positive Behavior Interventions and Support. Retrieved from www.pbis.org/evaluation/evaluation...

  19. 76 FR 50474 - Special Demonstration Programs-National Technical Assistance Projects To Improve Employment...

    Science.gov (United States)

    2011-08-15

    ... Materials (NCRTM), the regional Technical Assistance and Continuing Education (TACE) centers, and State VR... Assistance and Continuing Education (TACE) centers to identify issues that may affect State VR agency service... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION...

  20. 78 FR 39260 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2013-07-01

    ... Rehabilitative Services, Department of Education. ACTION: Notice. Overview Information: Technical Assistance and... are supported by scientifically based research. Priority: In accordance with 34 CFR 75.105(b)(2)(v... least a portion of their day in a regular classroom in their local school (National Consortium on Deaf...

  1. 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

  2. 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

  3. 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.

  4. Clear hydro-gel, compared to ointment, provides improved eye comfort after brief surgery.

    Science.gov (United States)

    Smolle, Michaela; Keller, Christian; Pinggera, Germar; Deibl, Martina; Rieder, Josef; Lirk, Philipp

    2004-02-01

    Anesthesia impairs lid closure and decreases tear secretion and stability. Protection may, in principle, be conveyed by manual eye closure, taping the eyelids closed, and by instillation of protective substances into the conjunctival sac. Both hydro-gels and ointments are used in clinical practice. It was the objective of the present study to compare a transparent clear ocular hydro-gel (Vidisic) and a commonly used dexpanthenol and vitamin A (Oleovit) based ointment as examples of these classes of ocular lubricants in their capability to provide perioperative eye comfort. Furthermore, their bacteriostatic properties were assessed in vitro. Ninety-two consecutive patients undergoing total iv general anesthesia were randomly allocated to receive either ocular dexpanthenol ointment or a clear hydro-gel after induction of anesthesia. Subjects were assessed one hour following termination of anesthesia. Main findings were an increased incidence of foreign body sensation, adherent eyelashes and disturbance elicited by blurred vision in the ointment group as compared to clear hydro-gel (P < 0.001). Bacterial growth was significantly attenuated by the ocular hydro-gel as compared to ointment. Clear ocular hydro-gel offers improved patient comfort and decreased ocular inflammation as compared to conventional eye ointments. In addition, it decreases bacterial growth. Therefore, the use of clear ocular hydro-gel for perioperative ocular comfort is suggested.

  5. 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.

  6. 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 (panxiety, 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

  7. 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

  8. 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.

  9. Estimating the Technical Improvement of Energy Efficiency in the Automotive Industry—Stochastic and Deterministic Frontier Benchmarking Approaches

    Directory of Open Access Journals (Sweden)

    Seog-Chan Oh

    2014-09-01

    Full Text Available The car manufacturing industry, one of the largest energy consuming industries, has been making a considerable effort to improve its energy intensity by implementing energy efficiency programs, in many cases supported by government research or financial programs. While many car manufacturers claim that they have made substantial progress in energy efficiency improvement over the past years through their energy efficiency programs, the objective measurement of energy efficiency improvement has not been studied due to the lack of suitable quantitative methods. This paper proposes stochastic and deterministic frontier benchmarking models such as the stochastic frontier analysis (SFA model and the data envelopment analysis (DEA model to measure the effectiveness of energy saving initiatives in terms of the technical improvement of energy efficiency for the automotive industry, particularly vehicle assembly plants. Illustrative examples of the application of the proposed models are presented and demonstrate the overall benchmarking process to determine best practice frontier lines and to measure technical improvement based on the magnitude of frontier line shifts over time. Log likelihood ratio and Spearman rank-order correlation coefficient tests are conducted to determine the significance of the SFA model and its consistency with the DEA model. ENERGY STAR® EPI (Energy Performance Index are also calculated.

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

    Science.gov (United States)

    Cooper, Devon; Kim, JungSoo; Duderstadt, Karen; Stewart, Ray; Lin, Brent; Alkon, Abbey

    2017-01-01

    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 evaluation showed that

  11. Improving Attitudes Toward STEM By Providing Urban-Based Environmental Science Research Opportunities

    Science.gov (United States)

    Cuff, K. E.; Molinaro, M.

    2005-12-01

    Over the past decade, numerous calls have been made for the need to increase the participation of the nation's underrepresented population in science, technology, engineering, and technology (STEM) fields of endeavor. A key element in improving the less than impressive conditions that now exist with regard to this issue, is the development of effective approaches that result in positive changes in young people's attitudes toward education in general, and STEM subject matter in particular during the early stages of their intellectual development. The Environmental Science Information Technology Activities (ESITA) program provides opportunities for under-represented grades 9 - 10 students in the East San Francisco Bay Area to learn about and apply key STEM concepts and related skills. Consisting of two-year-long after school programs at community center and school-based sites, as well as a Summer Research Institute, the ESITA program engages participants in a combination of STEM content learning activities and environmental science research projects that address issues relevant to their communities. Design of the ESITA program has been informed by: 1) pilot-study data that indicated key elements necessary for ensuring high levels of participant enthusiasm and interest; 2) a conceptual framework for development of instructional materials grounded in recent research about student learning of STEM content; and 3) research about effective after school programs that present academic content. Throughout the program's two-year existence, ESITA students have participated in the following projects: investigations of the distribution of elevated lead levels in drinking water samples from Washington, D.C.; air and water quality studies in and around a popular lake situated within the nation's oldest wildlife refuge, located in downtown Oakland, California; and studies of the relationship between airborne particulate matter concentrations in Richmond, California, and activity at

  12. 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

  13. 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.

  14. 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)

  15. Bayesian species identification under the multispecies coalescent provides significant improvements to DNA barcoding analyses.

    Science.gov (United States)

    Yang, Ziheng; Rannala, Bruce

    2017-06-01

    DNA barcoding methods use a single locus (usually the mitochondrial COI gene) to assign unidentified specimens to known species in a library based on a genetic distance threshold that distinguishes between-species divergence from within-species diversity. Recently developed species delimitation methods based on the multispecies coalescent (MSC) model offer an alternative approach to individual assignment using either single-locus or multiloci sequence data. Here, we use simulations to demonstrate three features of an MSC method implemented in the program bpp. First, we show that with one locus, MSC can accurately assign individuals to species without the need for arbitrarily determined distance thresholds (as required for barcoding methods). We provide an example in which no single threshold or barcoding gap exists that can be used to assign all specimens without incurring high error rates. Second, we show that bpp can identify cryptic species that may be misidentified as a single species within the library, potentially improving the accuracy of barcoding libraries. Third, we show that taxon rarity does not present any particular problems for species assignments using bpp and that accurate assignments can be achieved even when only one or a few loci are available. Thus, concerns that have been raised that MSC methods may have problems analysing rare taxa (singletons) are unfounded. Currently, barcoding methods enjoy a huge computational advantage over MSC methods and may be the only approach feasible for massively large data sets, but MSC methods may offer a more stringent test for species that are tentatively assigned by barcoding. © 2017 John Wiley & Sons Ltd.

  16. Does hospital admission provide an opportunity for improving pharmacotherapy among elderly inpatients?

    Directory of Open Access Journals (Sweden)

    Daniela Oliveira de Melo

    Full Text Available ABSTRACT The purpose of the work was to assess the incidence of potential drug interactions (pDDI, major pDDI, and the use of potentially inappropriate medication (PIM at hospital admission, during hospitalization, and at discharge to evaluate whether hospital admission provides an opportunity for improving pharmacotherapy in elderly patients at a University hospital that has a clinical pharmacist. A prospective cohort study was carried out using data from the medical records of patients admitted to an internal medicine ward. All admissions and prescriptions were monitored between March and August 2006. Micromedex(r DrugReax(r and Beers Criteria 2015 were used to identify pDDI, major pDDI, and PIMs, respectively. A comparison of admission and discharge prescriptions showed the following: an increase in the proportion of patients using antithrombotic agents (76 versus 144; p<0.001, lipid modifying agents (58 versus 81; p=0.024, drugs for acid-related disorders (99 versus 152; p<0.001, and particularly omeprazole (61 versus 87; p=0.015; a decrease in the number of patients prescribed psycholeptics (73 versus 32; p<0.001 and diazepam (54 versus 13; p<0.001; and a decrease in the proportion of patients exposed to polypharmacy (16.1% versus 10.1%; p=0.025, at least one pDDI (44.5% versus 32.8%; p=0.002, major pDDI (19.9% versus 12.2%; p=0.010 or PIM (85.8% versus 51.9%; p<0.001. The conclusion is that admission to a hospital ward that has a clinical pharmacist was associated with a reduction in the number of patients exposed to polypharmacy, pDDI, major pDDI, and the use of PIMs among elderly inpatients.

  17. Providing the Answers Does Not Improve Performance on a College Final Exam

    Science.gov (United States)

    Glass, Arnold Lewis; Sinha, Neha

    2013-01-01

    In the context of an upper-level psychology course, even when students were given an opportunity to refer to text containing the answers and change their exam responses in order to improve their exam scores, their performance on these questions improved slightly or not at all. Four experiments evaluated competing explanations for the students'…

  18. Strategies to improve effectiveness of physical activity coaching systems: Development of personas for providing tailored feedback

    NARCIS (Netherlands)

    Achterkamp, Reinoud; van Weering, Marit; Evering, R.M.H.; Tabak, Monique; Timmerman, Josien; Hermens, Hermanus J.; Vollenbroek-Hutten, Miriam Marie Rosé

    2017-01-01

    Mobile physical activity interventions can be improved by incorporating behavioural change theories. Relations between self-efficacy, stage of change, and physical activity are investigated, enabling development of feedback strategies that can be used to improve their effectiveness. A total of 325

  19. Transcriptome profiling of Gossypium barbadense inoculated with Verticillium dahliae provides a resource for cotton improvement.

    Science.gov (United States)

    Zhang, Yan; Wang, Xing Fen; Ding, Ze Guo; Ma, Qing; Zhang, Gui Rong; Zhang, Shu Ling; Li, Zhi Kun; Wu, Li Qiang; Zhang, Gui Yin; Ma, Zhi Ying

    2013-09-22

    mock-/inoculated- and resistant/susceptible cotton. Our results suggest that the cotton defense response has significant transcriptional complexity and that large accumulations of defense-related transcripts may contribute to V. dahliae resistance in cotton. Therefore, these data provide a resource for cotton improvement through molecular breeding approaches. This study generated a substantial amount of cotton transcript sequences that are related to defense responses against V. dahliae. These genomics resources and knowledge of important related genes contribute to our understanding of host-pathogen interactions and the defense mechanisms utilized by G. barbadense, a non-model plant system. These tools can be applied in establishing a modern breeding program that uses marker-assisted selections and oligonucleotide arrays to identify candidate genes that can be linked to valuable agronomic traits in cotton, including disease resistance.

  20. 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...

  1. 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

  2. Technical Considerations for Improvement of USAF Operational Training, Testing and Evaluation (OTT and E)

    Science.gov (United States)

    1975-06-30

    30 JUNE 1975 q ~TECHNICAL CONSIDERA•TIONS FOR USAF OPERATIONAL TRAIIG TESTING AND EVALUATIO (TT&EI APPROVED FOR PUBLIC RELEASE: DISTRIBUTION...of this Report) Approved for Public Release - Distribution Unlimited 17. DISTRIBUTION STATEMENT (of the abstract entered In Block 20, If different...L LJ C9 - aCCa C= co =mp XE 0 a aLa C~= =b & -JA 0’-𔃺 z - -Lai’ = WE w.. _A oMac G = cm - cc0j -0, e 125 The total instrument error is a combination

  3. 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...... and data analysis were supported by a template describing 25 NTSs derived from other educational programmes in health care. Results: A framework with five categories relating to NTSs was identified: leadership, communication, mutual performance monitoring, maintenance of standards and guidelines and task...

  4. Improved criteria and comparative genomics tool provide new insights into grass paleogenomics

    National Research Council Canada - National Science Library

    Salse, Jerome; Abrouk, Michael; Murat, Florent; Quraishi, Umar Masood; Feuillet, Catherine

    2009-01-01

    ... over interpret the results of large scale comparative sequence analyses. Recently, we have established a number of improved parameters and tools to define significant relationships between genomes as a basis to develop paleogenomics studies in grasses...

  5. 78 FR 40459 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2013-07-05

    ...-wide positive behavior support. School Psychology Review, 35(2), 245-259. U.S. Department of Education... and supports that will help improve student behavior and school climate and help students with... improve behavioral and academic outcomes by improving school climate, preventing problem behavior...

  6. A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge.

    Science.gov (United States)

    Waszak, Daria L; Mitchell, Ann M; Ren, Dianxu; Fennimore, Laura A

    2017-10-27

    The opioid crisis continues to take an unprecedented number of lives and is the top cause of injury death in the United States. The emergency department is a setting where patients with pain seek care and may be prescribed an opioid, yet many patients do not receive evidence-based education about taking their opioid safely. Like many communities across the country, Allegheny County, Pennsylvania, has experienced an increased rate of opioid overdoses; from 2015-2016, the number of opioid-related overdose deaths in the county increased by 44%. This quality improvement project is the implementation of a nurse-delivered, evidence-based education initiative for patients prescribed an opioid in an emergency department. Nurses were briefly trained on opioid safety and patient education, then over 12 weeks, delivered the dual-modal (verbal and written) education with a patient teach-back to verify comprehension. Nurses who completed the project training on opioid safety and patient education had a statistically significant improvement in their knowledge. Patient satisfaction surveys showed 100% of patients reported clear understanding of how to take their pain medication, and out of the patients receiving the opioid pain education for the first time, 88.2% learned something new about how to safely take, store, or dispose of their pain medication. Improving the delivery of opioid prescription education at emergency department discharge will enhance patient knowledge and promote safety, which may help mitigate the opioid crisis by reducing the rate of opioid use disorder and accidental overdoses. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Improved Prevention Counseling by HIV Care Providers in a Multisite, Clinic-Based Intervention: Positive STEPs

    Science.gov (United States)

    Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol

    2009-01-01

    The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…

  8. Correlation between provider computer experience and accuracy of electronic anesthesia charting A pilot study and performance improvement project

    Science.gov (United States)

    2017-03-20

    Anesthesia recordkeeping: Accuracy of recall with computerized and manual entry recordkeeping. CORRELATION BETWEEN PROVIDER COMPUTER EXPERIENCE 39...Unexpected increased mortality after implementation of a CORRELATION BETWEEN PROVIDER COMPUTER EXPERIENCE 40 commercially sold computerized physician...Correlation between provider computer experience and accuracy of electronic anesthesia charting – A pilot study and performance improvement

  9. 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

  10. VISION: a regional performance improvement initiative for HIV health care providers.

    Science.gov (United States)

    Bruno, Theodore O; Hicks, Charles B; Naggie, Susanna; Wohl, David A; Albrecht, Helmut; Thielman, Nathan M; Rabin, Daniel U; Layton, Sherry; Subramaniam, Chitra; Grichnik, Katherine P; Shlien, Amanda; Weyer, Dianne

    2014-01-01

    VISION (HIV Integrated Learning ModuleS: Achieving Performance Improvement through CollaboratiON) was a regional performance improvement (PI) continuing medical education (CME) initiative designed to increase guideline-conforming practice of clinicians who manage patients with HIV infection. The 3-part activity consisted of (1) clinical practice assessment and development of an action plan for practice change, (2) completion of relevant education, and (3) reassessment. The activity did not change practitioners' performance in clinical status monitoring and in patient treatment, in large part because guidelines were being appropriately implemented at baseline as well as after the educational intervention. There was a trend toward improvement, however, in practitioner performance in the area of patient medication adherence (increased from 66% to 74%). Results observed in the VISION initiative were consistent with HIVQUAL metrics. Ongoing education in HIV is important, and VISION demonstrated performance improvement in medication adherence, a critical aspect of health care. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  11. 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

  12. 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.

  13. 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…

  14. 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

    2017-05-26

    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 skills training for laparoscopic cholecystectomy that was

  15. 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

  16. 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

  17. 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

  18. 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)

  19. 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.

  20. Valproate administered after traumatic brain injury provides neuroprotection and improves cognitive function in rats.

    Directory of Open Access Journals (Sweden)

    Pramod K Dash

    Full Text Available BACKGROUND: Traumatic brain injury (TBI initiates a complex series of neurochemical and signaling changes that lead to pathological events including neuronal hyperactivity, excessive glutamate release, inflammation, increased blood-brain barrier (BBB permeability and cerebral edema, altered gene expression, and neuronal dysfunction. It is believed that a drug combination, or a single drug acting on multiple targets, may be an effective strategy to treat TBI. Valproate, a widely used antiepileptic drug, has a number of targets including GABA transaminase, voltage-gated sodium channels, glycogen synthase kinase (GSK-3, and histone deacetylases (HDACs, and therefore may attenuate a number of TBI-associated pathologies. METHODOLOGY/PRINCIPAL FINDINGS: Using a rodent model of TBI, we tested if post-injury administration of valproate can decrease BBB permeability, reduce neural damage and improve cognitive outcome. Dose-response studies revealed that systemic administration of 400 mg/kg (i.p., but not 15, 30, 60 or 100 mg/kg, increases histone H3 and H4 acetylation, and reduces GSK-3 activity, in the hippocampus. Thirty min post-injury administration of 400 mg/kg valproate improved BBB integrity as indicated by a reduction in Evans Blue dye extravasation. Consistent with its dose response to inhibit GSK-3 and HDACs, valproate at 400 mg/kg, but not 100 mg/kg, reduced TBI-associated hippocampal dendritic damage, lessened cortical contusion volume, and improved motor function and spatial memory. These behavioral improvements were not observed when SAHA (suberoylanilide hydroxamic acid, a selective HDAC inhibitor, was administered. CONCLUSION/SIGNIFICANCE: Our findings indicate that valproate given soon after TBI can be neuroprotective. As clinically proven interventions that can be used to minimize the damage following TBI are not currently available, the findings from this report support the further testing of valproate as an acute therapeutic strategy.

  1. 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...... of scar-appearance. CONCLUSIONS: Combined superficial and deep non-ablative fractional laser-treatments induce long-term clinical and histological improvement of mature burn scars....

  2. 76 FR 30681 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2011-05-26

    ... decision-making to improve teaching and learning for students with disabilities. (e) Maintain a Web site... decision-making to improve teaching and learning for students with disabilities. In consultation with the..., documents, and other materials available for parents in both English and Spanish. (g) Use technological...

  3. The improvement of technical skill at the stage of the specialized basic preparation in fitness by means of powerlifting

    Directory of Open Access Journals (Sweden)

    Ivan Ivanov

    2015-10-01

    Full Text Available Purpose: to develop methodical recommendations of the improvement of technical skill at the stage of the specialized basic preparation in fitness by means of powerlifting. Material and Methods: masters of sports in powerlifting and candidates for the master of sports in powerlifting – members of a national team on weightlifting and powerlifting of the Kharkov area took part in the research. Methods were used: theoretical analysis and generalization, analysis of scientific literature, pedagogical supervision, pedagogical experiment, video registration method, methods of mathematical statistics. Results: we developed a number of methodical recommendations which are submitted on finishing technical skill on the basis of the analysis of technique of a performance of the competitive exercise deadlift which is made by means of the program Dartfish by highly skilled sportsmen. As a result of the experiment it is established that the gain of result was more significant in the experimental group which was engaged by the developed technique. Conclusions: it is experimentally proved that the use of computer programs of video registration allows improving qualitatively the feedback between a coach and a sportsman, optimizing the process of training of a sportsman and correction of his technique, increasing the gain of sports result

  4. Leveraging Partnerships: Families, Schools, and Providers Working Together to Improve Asthma Management.

    Science.gov (United States)

    Gleason, Melanie; Cicutto, Lisa; Haas-Howard, Christy; Raleigh, Bridget M; Szefler, Stanley J

    2016-10-01

    Asthma is one of the most common illnesses of school-aged children and can lead to both health and educational disparities. Children from low socioeconomic backgrounds and racial/ethnic minorities suffer the greatest impact. They often lack the asthma self-management skills to successfully monitor, navigate, and negotiate appropriate asthma care. School settings are a strategic point of contact for this additional support. School nurses can monitor for signs of asthma worsening, manage symptoms, provide care coordination, and reinforce self-management skills. Likewise, school-based asthma programs have the potential to reduce health and educational disparities, but it is the strong linkage to the asthma care provider that is critical to successful school-based asthma management. Healthcare providers are encouraged to establish partnerships with families through patient-centered care and schools through clear communication and care coordination to ensure asthma is well controlled so the child is in school and ready to learn.

  5. 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…

  6. What Parents Want: Does Provider Knowledge of Written Parental Expectations Improve Satisfaction in the Emergency Department?

    Science.gov (United States)

    Zoltowski, Kathleen S W; Mistry, Rakesh D; Brousseau, David C; Whitfill, Travis; Aronson, Paul L

    2016-01-01

    Satisfaction is an important measure of care quality. Interventions to improve satisfaction in the pediatric emergency department (ED) are limited, especially for patients with nonurgent conditions. Our objective was to determine if clinician knowledge of written parental expectations improves parental satisfaction for nonurgent ED visits. This randomized controlled trial was conducted in a tertiary-care pediatric ED. Parents of children presenting for nonurgent visits (Emergency Severity Index level 4 or 5) were randomized into 3 groups: 1) the intervention group completed an expectation survey on arrival, which was reviewed by the clinician, 2) the control group completed the expectation survey, which was not reviewed, and 3) the baseline group did not complete an expectation survey. At ED disposition, all groups completed a 3-item satisfaction survey, scored using 5-point Likert scales (1 = very poor, 5 = very good). The primary outcome was rating of "overall care." Secondary outcomes included likelihood of recommending the ED and staff sensitivity to concerns. Proportions were compared by chi-square test. A total of 304 subjects were enrolled. The proportion of parents rating 5 of 5 for overall care did not differ among the baseline, control, and intervention groups (74.8% vs 73.2% vs 69.2%, P = .56). The proportion of parents rating 5 of 5 also did not differ for likelihood of recommending the ED (77.7% vs 72.2% vs 70.2%, P = .45) or staff sensitivity to concerns (78.6% vs 78.4% vs 78.8%, P = .71). For nonurgent pediatric ED visits, clinician knowledge of written parental expectations does not improve parental satisfaction. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  7. IMPROVING STUDENTS’ METHODOLOGICAL AND MATHEMATICAL TRAINING TO PROVIDING CONTINUITY BETWEEN PRESCHOOL AND PRIMARY EDUCATION

    Directory of Open Access Journals (Sweden)

    Tetiana Bondarenko

    2017-04-01

    Full Text Available The article deals with the problem of implementing the principle of continuity in the mathematical education of pre-school and primary school children in terms of restarting the primary school that caused the need to update the future teachers’ training. Integration into European and world educational space actualized the problem of creating conditions for development and personal fulfillment, search for effective ways of increasing future teachers’ training quality. The article aims to examine normative support and ways of improving students’ methodological and mathematical training for realization of continuity between pre-school and primary education. At the zeroth educational level the summarized results of learning (competence are to become child's readiness to learn at primary school. At the first level it is the ability to select and search for knowledge and ways of action to solve learning problems; learning and developing through mastery of the common ways of organizing learning activities; awareness of the need to continue their education and develop individual experience knowledge. The use of ICT, including methodological web quests, blended learning in the course of improving future specialists’ methodological and mathematical training to implement continuity between preschool and primary education leads to a sense of success, develops students’ ability to self-education. In authors’ view, a perspective area of future research is the development and selection of new tasks for using methodological web quests in order to improve the future specialists’ methodological and mathematical training to implement continuity between preschool and primary education, insurance in effective conditions of organizational and methodological support of the process.

  8. Experimental evaluation of the resolution improvement provided by a silicon PET probe.

    Science.gov (United States)

    Brzeziński, K; Oliver, J F; Gillam, J; Rafecas, M; Studen, A; Grkovski, M; Kagan, H; Smith, S; Llosá, G; Lacasta, C; Clinthorne, N H

    2016-09-01

    A high-resolution PET system, which incorporates a silicon detector probe into a conventional PET scanner, has been proposed to obtain increased image quality in a limited region of interest. Detailed simulation studies have previously shown that the additional probe information improves the spatial resolution of the reconstructed image and increases lesion detectability, with no cost to other image quality measures. The current study expands on the previous work by using a laboratory prototype of the silicon PET-probe system to examine the resolution improvement in an experimental setting. Two different versions of the probe prototype were assessed, both consisting of a back-to-back pair of 1-mm thick silicon pad detectors, one arranged in 32 × 16 arrays of 1.4 mm × 1.4 mm pixels and the other in 40 × 26 arrays of 1.0 mm × 1.0 mm pixels. Each detector was read out by a set of VATAGP7 ASICs and a custom-designed data acquisition board which allowed trigger and data interfacing with the PET scanner, itself consisting of BGO block detectors segmented into 8 × 6 arrays of 6 mm × 12 mm × 30 mm crystals. Limited-angle probe data was acquired from a group of Na-22 point-like sources in order to observe the maximum resolution achievable using the probe system. Data from a Derenzo-like resolution phantom was acquired, then scaled to obtain similar statistical quality as that of previous simulation studies. In this case, images were reconstructed using measurements of the PET ring alone and with the inclusion of the probe data. Images of the Na-22 source demonstrated a resolution of 1.5 mm FWHM in the probe data, the PET ring resolution being approximately 6 mm. Profiles taken through the image of the Derenzo-like phantom showed a clear increase in spatial resolution. Improvements in peak-to-valley ratios of 50% and 38%, in the 4.8 mm and 4.0 mm phantom features respectively, were observed, while previously unresolvable 3.2 mm features were brought to light by the

  9. 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.

  10. Interdepartmental Occupational Standards for Social Service Providers and Their Role in Improving Job Performance

    Directory of Open Access Journals (Sweden)

    Zabrodin Yu.M.,

    2016-04-01

    Full Text Available The paper presents an analysis of the occupational standards development abroad and in Russia. It focuses on interdepartmental occupational standards for social service providers. While creating occupational standards for social services as an integrated industry it is advisable to consider the design of whole system and its macro-level effects in a document called “sectoral qualification framework”. It is pointed out that 1 real professional activity in social sphere has a clear humanitarian focus, and its objects are radically different population groups; 2 the complexity of the social work is often associated with the interaction between various professionals and their activity have to be interdepartmentally organized. The author identifies the factors influencing development and implementation of professional standards in different countries and consider the main strategy directions of development and application of occupational standards of education and social service providers in Russia.

  11. 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.

  12. 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.

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

    Science.gov (United States)

    2013-10-01

    medicine--a review with quality grading of articles. Medical Teacher , 21(6), 563-570. Back, A. L., Arnold, R. M., Baile, W. F., Fryer-Edwards, K. A...domain of expertise), intermediates (individuals with skills at an intermediate-stage between expert and novice such as intern or resident health care...providers), and novices (individuals with limited experience and content knowledge). Interestingly, research has demonstrated that intermediates

  14. 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

    , 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......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......, before proposing a new more comprehensive framework, which we apply to the first P4P scheme introduced for hospitals in England. We emphasise that evaluations of cost-effectiveness need to consider who the residual claimant is on any cost savings, the possibility of positive and negative spillovers...

  15. Pearl millet genome sequence provides a resource to improve agronomic traits in arid environments.

    Science.gov (United States)

    Varshney, Rajeev K; Shi, Chengcheng; Thudi, Mahendar; Mariac, Cedric; Wallace, Jason; Qi, Peng; Zhang, He; Zhao, Yusheng; Wang, Xiyin; Rathore, Abhishek; Srivastava, Rakesh K; Chitikineni, Annapurna; Fan, Guangyi; Bajaj, Prasad; Punnuri, Somashekhar; Gupta, S K; Wang, Hao; Jiang, Yong; Couderc, Marie; Katta, Mohan A V S K; Paudel, Dev R; Mungra, K D; Chen, Wenbin; Harris-Shultz, Karen R; Garg, Vanika; Desai, Neetin; Doddamani, Dadakhalandar; Kane, Ndjido Ardo; Conner, Joann A; Ghatak, Arindam; Chaturvedi, Palak; Subramaniam, Sabarinath; Yadav, Om Parkash; Berthouly-Salazar, Cécile; Hamidou, Falalou; Wang, Jianping; Liang, Xinming; Clotault, Jérémy; Upadhyaya, Hari D; Cubry, Philippe; Rhoné, Bénédicte; Gueye, Mame Codou; Sunkar, Ramanjulu; Dupuy, Christian; Sparvoli, Francesca; Cheng, Shifeng; Mahala, R S; Singh, Bharat; Yadav, Rattan S; Lyons, Eric; Datta, Swapan K; Hash, C Tom; Devos, Katrien M; Buckler, Edward; Bennetzen, Jeffrey L; Paterson, Andrew H; Ozias-Akins, Peggy; Grando, Stefania; Wang, Jun; Mohapatra, Trilochan; Weckwerth, Wolfram; Reif, Jochen C; Liu, Xin; Vigouroux, Yves; Xu, Xun

    2017-10-01

    Pearl millet [Cenchrus americanus (L.) Morrone] is a staple food for more than 90 million farmers in arid and semi-arid regions of sub-Saharan Africa, India and South Asia. We report the ∼1.79 Gb draft whole genome sequence of reference genotype Tift 23D2B1-P1-P5, which contains an estimated 38,579 genes. We highlight the substantial enrichment for wax biosynthesis genes, which may contribute to heat and drought tolerance in this crop. We resequenced and analyzed 994 pearl millet lines, enabling insights into population structure, genetic diversity and domestication. We use these resequencing data to establish marker trait associations for genomic selection, to define heterotic pools, and to predict hybrid performance. We believe that these resources should empower researchers and breeders to improve this important staple crop.

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

    Directory of Open Access Journals (Sweden)

    Christina K Barstow

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

  17. Improving continence services for older people from the service-providers' perspective: a qualitative interview study.

    Science.gov (United States)

    Orrell, Alison; McKee, Kevin; Dahlberg, Lena; Gilhooly, Mary; Parker, Stuart

    2013-07-30

    To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. 3 acute and 13 primary care National Health Service Trusts in England. 16 continence service leads in England actively treating and managing older people with UI. In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and high-quality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. Measuring to Improve: Peer and Crowd-sourced Assessments of Technical Skill with Robot-assisted Radical Prostatectomy.

    Science.gov (United States)

    Ghani, Khurshid R; Miller, David C; Linsell, Susan; Brachulis, Andrew; Lane, Brian; Sarle, Richard; Dalela, Deepansh; Menon, Mani; Comstock, Bryan; Lendvay, Thomas S; Montie, James; Peabody, James O

    2016-04-01

    Because surgical skill may be a key determinant of patient outcomes, there is growing interest in skill assessment. In the Michigan Urological Surgery Improvement Collaborative (MUSIC), we assessed whether peer and crowd-sourced (ie, layperson) video review of robot-assisted radical prostatectomy (RARP) could distinguish technical skill among practicing surgeons. A total of 76 video clips from 12 MUSIC surgeons consisted of one of four parts of RARP and underwent blinded review by MUSIC peer surgeons and prequalified crowd-sourced reviewers. Videos were rated for global skill (Global Evaluation Assessment of Robotic Skills) and procedure-specific skill (Robotic Anastomosis and Competency Evaluation). We fit linear mixed-effects models to estimate mean peer and crowd ratings for each video. Individual video ratings were aggregated to calculate surgeon skill scores. Peers (n=25) completed 351 video ratings over 15 d, whereas crowd-sourced reviewers (n=680) completed 2990 video ratings in 38 h. Surgeon global skill scores ranged from 15.8 to 21.7 (peer) and from 19.2 to 20.9 (crowd). Peer and crowd ratings demonstrated strong correlation for both global (r=0.78) and anastomosis (r=0.74) skills. The two groups consistently agreed on the rank order of lower scoring surgeons, suggesting a potential role for crowd-sourced methodology in the assessment of surgical performance. Lack of patient outcomes is a limitation and forms the basis of future study. We demonstrated the large-scale feasibility of assessing the technical skill of robotic surgeons and found that online crowd-sourced reviewers agreed with experts on the rank order of surgeons with the lowest technical skill scores. Published by Elsevier B.V.

  3. 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.

  4. Cytomegalovirus (CMV) infection and pregnancy-potential for improvements in Australasian maternity health providers' knowledge.

    Science.gov (United States)

    Shand, A W; Luk, W; Nassar, N; Hui, L; Dyer, K; Rawlinson, W

    2017-07-11

    To assess the knowledge, practice and attitudes of maternity clinicians regarding congenital cytomegalovirus (CMV). It is the most common congenital infection, and well-recognized cause of neurodevelopmental disability and hearing loss. New consensus recommendations state all pregnant women and health-care providers should be educated about congenital CMV infection and preventive measures. An email questionnaire was distributed in October 2015 to specialists, diplomates (general practitioners), and trainees of the Royal Australian New Zealand College of Obstetricians and Gynaecologists (RANZCOG), and Victorian and New South Wales midwives. 774 responded: (37.3% specialists, 17.3% diplomates, 16.8% trainees, 28.6% midwives). Clinicians had variable knowledge of fetal sequelae, transmission routes and prevention. Overall, 30.2% felt confident about discussing CMV in pregnancy: less than 10% of midwives (7.4%) and less than half of specialists (47.1%, p maternity clinicians lack confidence and knowledge about congenital CMV. Few (<10%) routinely provide advice on prevention. There is urgent need for clinical guidance and patient information to reduce the burden of disease.

  5. A feasibility study of a web-based performance improvement system for substance abuse treatment providers.

    Science.gov (United States)

    Forman, Robert; Crits-Christoph, Paul; Kaynak, Ovgü; Worley, Matt; Hantula, Donald A; Kulaga, Agatha; Rotrosen, John; Chu, Melissa; Gallop, Robert; Potter, Jennifer; Muchowski, Patrice; Brower, Kirk; Strobbe, Stephen; Magruder, Kathy; Chellis, A'Delle H; Clodfelter, Tad; Cawley, Margaret

    2007-12-01

    We report here on the feasibility of implementing a semiautomated performance improvement system-Patient Feedback (PF)-that enables real-time monitoring of patient ratings of therapeutic alliance, treatment satisfaction, and drug/alcohol use in outpatient substance abuse treatment clinics. The study was conducted in six clinics within the National Institute on Drug Abuse Clinical Trials Network. It involved a total of 39 clinicians and 6 clinic supervisors. Throughout the course of the study (consisting of five phases: training period [4 weeks], baseline [4 weeks], intervention [12 weeks], postintervention assessment [4 weeks], sustainability [1 year]), there was an overall collection rate of 75.5% of the clinic patient census. In general, the clinicians in these clinics had very positive treatment satisfaction and alliance ratings throughout the study. However, one clinic had worse drug use scores at baseline than other participating clinics and showed a decrease in self-reported drug use at postintervention. Although the implementation of the PF system proved to be feasible in actual clinical settings, further modifications of the PF system are needed to enhance any potential clinical usefulness.

  6. 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.

  7. Vitamin Variation in Capsicum Spp. Provides Opportunities to Improve Nutritional Value of Human Diets.

    Science.gov (United States)

    Kantar, Michael B; Anderson, Justin E; Lucht, Sarah A; Mercer, Kristin; Bernau, Vivian; Case, Kyle A; Le, Nina C; Frederiksen, Matthew K; DeKeyser, Haley C; Wong, Zen-Zi; Hastings, Jennifer C; Baumler, David J

    2016-01-01

    Chile peppers, native to the Americas, have spread around the world and have been integrated into the diets of many cultures. Much like their heat content, nutritional content can vary dramatically between different pepper types. In this study, a diverse set of chile pepper types were examined for nutrient content. Some pepper types were found to have high levels of vitamin A, vitamin C, or folate. Correlations between nutrient content, species, cultivation status, or geographic region were limited. Varietal selection or plant breeding offer tools to augment nutrient content in peppers. Integration of nutrient rich pepper types into diets that already include peppers could help combat nutrient deficiencies by providing a significant portion of recommended daily nutrients.

  8. Vitamin Variation in Capsicum Spp. Provides Opportunities to Improve Nutritional Value of Human Diets.

    Directory of Open Access Journals (Sweden)

    Michael B Kantar

    Full Text Available Chile peppers, native to the Americas, have spread around the world and have been integrated into the diets of many cultures. Much like their heat content, nutritional content can vary dramatically between different pepper types. In this study, a diverse set of chile pepper types were examined for nutrient content. Some pepper types were found to have high levels of vitamin A, vitamin C, or folate. Correlations between nutrient content, species, cultivation status, or geographic region were limited. Varietal selection or plant breeding offer tools to augment nutrient content in peppers. Integration of nutrient rich pepper types into diets that already include peppers could help combat nutrient deficiencies by providing a significant portion of recommended daily nutrients.

  9. Travelling abroad for aesthetic surgery: Informing healthcare practitioners and providers while improving patient safety.

    Science.gov (United States)

    Jeevan, R; Birch, J; Armstrong, A P

    2011-02-01

    Travelling abroad for surgery is a phenomenon reported internationally. It is particularly likely for aesthetic procedures not undertaken routinely by national health services. We assessed the impact of these patients presenting to the UK National Health Service (NHS) with concerns or complications on their return. All 326 UK consultant members of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) were asked to complete a short questionnaire about patients that had presented to the NHS with complications or concerns following surgery abroad. The results were subsequently presented to the Department of Health (DH). 203 (62%) UK consultant plastic surgeons responded. 76 (37%) of the 203 respondents had seen such patients in their NHS practice, most commonly following breast or abdominal procedures. A quarter underwent emergency surgery, a third out-patient treatment and a third elective surgical revision. In response to these findings, the DH clarified that NHS teams should provide emergency care to such patients but should not undertake any elective revision procedures. Travelling abroad for aesthetic surgery may reduce its cost. However, aesthetic procedures have high minor complication rates, and peri-operative travel is associated with increased risks. Fully informed consent is unlikely when patients do not meet their surgeon prior to paying and travelling for surgery, and national health services are used to provide a free safety net on their return. To help minimise the potential risks, BAPRAS has clarified the responsibilities of the NHS and is acting to better inform UK patients considering travelling abroad. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. The utility of endovascular simulation to improve technical performance and stimulate continued interest of preclinical medical students in vascular surgery.

    Science.gov (United States)

    Lee, Jason T; Qiu, Mary; Teshome, Mediget; Raghavan, Shyam S; Tedesco, Maureen M; Dalman, Ronald L

    2009-01-01

    New training paradigms in vascular surgery allow for early specialization out of medical school. Surgical simulation has emerged as an educational tool for trainees to practice procedures in a controlled environment allowing interested medical students to perform procedures without compromising patient safety. The purpose of this study is to assess the ability of a simulation-based curriculum to improve the technical performance and interest level of medical students in vascular surgery. Prospective observational cohort study of medical student performance. Academic medical center. Forty-one medical students (23 first year, 15 second year, 3 other) enrolled in a vascular surgery elective course. Students completed a survey of their interests and performed a renal stent procedure on an endovascular simulator (pretest). The curriculum consisted of didactic teaching and weekly mentored simulator sessions and concluded with a final renal stent procedure on the simulator (posttest). Objective procedural measures were determined during the pre- and posttest by the simulator, and subjective performance was graded by expert observers utilizing a structured global assessment scale. After the course, the students were surveyed as to their opinions about vascular surgery as a career option. Finally, 1 year after the course, all students were again surveyed to determine continued interest in vascular surgery. The objective and subjective criteria measured on the simulator and structured global assessment scale significantly improved from pre- to posttest in terms of performer technical skill, patient safety measures, and structured global assessments. Before beginning the course, 8.5% of the students expressed high interest in vascular surgery, and after completing the course 70% were seriously considering vascular surgery as a career option (p = 0.0001). More than 95% of the students responded that endovascular simulation increased their knowledge and interest in vascular

  11. 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

  12. 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

  13. 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

    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...

  14. 76 FR 48822 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2011-08-09

    ... previously low achievement levels, to enroll and persist in postsecondary education at higher rates than... curricula are integrated has resulted in improved student performance on standardized measures of math and... disabilities were rated at the lowest performing level when compared to their non-disabled peers (Wagner et al...

  15. Improving The Affordable Care Act: An Assessment Of Policy Options For Providing Subsidies.

    Science.gov (United States)

    Saltzman, Evan A; Eibner, Christine; Enthoven, Alain C

    2015-12-01

    A key challenge of health reform efforts is to make health insurance affordable for individuals and families who lack coverage without harming those with coverage or increasing federal spending. The Affordable Care Act (ACA) addresses this challenge in part by providing tax subsidies to qualified individuals for purchasing individual insurance and retaining tax exemptions for employer and employee contributions to the cost of premiums of employer-sponsored insurance. These tax exemptions cost approximately $250 billion annually in lost tax revenue and have been criticized for favoring higher earners and conferring preferential treatment of employer-sponsored over individual insurance. We analyzed three options for leveling the financial playing field between the two insurance markets by reallocating the value of tax benefits of employer coverage. We found that one option that uses the subsidy formula employed in the insurance Marketplaces under the ACA for both the individual and employer-sponsored insurance markets, and additionally requires the subsidy to be at least $1,250 without an upper income limit on subsidy eligibility imposed, could expand insurance coverage and reduce individual market premiums relative to the ACA with no additional federal spending. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Improved power-law estimates from multiple samples provided by millennium climate simulations

    Science.gov (United States)

    Henriksson, S. V.; Räisänen, P.; Silen, J.; Järvinen, H.; Laaksonen, A.

    2015-02-01

    Using the long annual mean temperature time series provided by millennium Earth System Model simulations and a method of discrete Fourier transform with varying starting point and length of time window together with averaging, we get good fits to power laws between two characteristic oscillatory timescales of the model climate: multidecadal (50-80 years) and El Nino (3-6 years) timescales. For global mean temperature, we fit β ˜ 0.35 in a relation S( f) ˜ f - β in a simulation without external climate forcing and β over 0.7 in a simulation with external forcing included. The power law is found both with and without external forcing despite the forcings, e.g. the volcanic forcing, not showing similar behaviour, indicating a nonlinear temperature response to time-varying forcing. We also fit a power law with β ˜ 8 to the narrow frequency range between El Nino frequencies (up to 1/(3.2 years)) and the Nyquist frequency (1/(2 years)). Also, monthly mean temperature time series are considered and a decent power-law fit for frequencies above 1/year is obtained. Regional variability in best-fit β is explored, and the impact of choosing the frequency range on the result is illustrated. When all resolved frequencies are used, land areas seem to have lower βs than ocean areas on average, but when fits are restricted to frequencies below 1/(6 years), this difference disappears, while regional differences still remain. Results compare well with measurements both for global mean temperature and for the central England temperature record.

  17. Evaluation of composite materials providing improved acoustic transmission loss for UAVs

    Science.gov (United States)

    Callicoat, Jeffrey R.

    With the proliferation of Unmanned Aerial Vehicles (UAVs) in civilian airspace in the near future, community noise will be a major issue of concern. Numerous studies have shown a direct link between community noise pollution (i.e., road traffic noise and airport noise) and serious health problems. There exists, therefore, a pressing need to create quiet UAVs, and this drives the need for noise-attenuating materials and structures suitable for UAV airframe fabrication. By shrouding predominant noise sources such as the engine, exhaust, and even the propeller (in the case of a ducted fan) with the airframe structure, the airframe can serve as a noise transmission barrier and substantially reduce UAV noise profiles. The present research effort is an experimental investigation of light-weight fiber-reinforced composite materials to provide high acoustic transmission loss (TL) for use in fabricating UAV airframes. A transmission loss tube acoustic test system was designed, fabricated, and validated, and extensive testing was done on numerous composite layups of interest for UAV fabrication. Composites under study included carbon fiber, fiberglass, and Kevlar fabrics as skin materials along with vinyl foam, Nomex honeycomb, and balsawood as core materials. Results from testing small 3"x3" samples in the TL tube led to the selection of four composite sandwich panels of interest for further study. Larger 36"x36" test samples of these selected layups were then fabricated and tested using a 2-room methodology. Whereas the TL tube yielded results in the stiffness-controlled region of acoustic behavior, the 2-room tests produced results in the mass-controlled region for these materials, enabling relative performance comparisons over both acoustic regimes. Recognizing that a good material for airframe fabrication should possess not only high TL, but also low weight and high stiffness, load-deflection tests were conducted and overall material performance was compared in terms of

  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. 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.

  20. 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…

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

    Energy Technology Data Exchange (ETDEWEB)

    Samanta, P.K.; Kim, I.S. (Brookhaven National Lab., Upton, NY (United States)); Vesely, W.E. (Science Applications International Corp., Columbus, OH (United States))

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Samanta, P.K.; Kim, I.S. [Brookhaven National Lab., Upton, NY (United States); Vesely, W.E. [Science Applications International Corp., Columbus, OH (United States)

    1991-12-31

    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.

  3. 78 FR 23234 - Applications for New Awards; Technical Assistance and Dissemination To Improve Services and...

    Science.gov (United States)

    2013-04-18

    ... between the parents and these entities and encouraging early resolution of disputes so that disagreements... disabilities and their parents and to provide parents with mechanisms for resolving, at the earliest point in... agencies (SEAs), local educational agencies (LEAs), schools, Part C State lead agencies, and early...

  4. Development of a Web-based educational intervention to improve cross-cultural communication among hospice providers.

    Science.gov (United States)

    Doorenbos, Ardith Z; Lindhorst, Taryn; Schim, Stephanie Myers; Van Schaik, Eileen; Demiris, George; Wechkin, Hope A; Curtis, J Randall

    2010-01-01

    In this article, the authors describe the theoretical foundation, development, and content of a Web-based educational intervention to improve cross-cultural communication about end-of-life concerns and report on the preliminary evaluation of this intervention using a qualitative study design. The data were collected with non-structured questions in a convenience sample of 21 hospice providers. Participants reported that they found the training appropriate and useful. Participants also reported finding the online delivery convenient and the interactive format valuable. Improving the quality of cross-cultural patient-provider communication can contribute to reducing disparities at end-of-life.

  5. Innovations in basic life support education for healthcare providers: improving competence in cardiopulmonary resuscitation through self-directed learning.

    Science.gov (United States)

    Cason, Carolyn L; Kardong-Edgren, Suzan; Cazzell, Mary; Behan, Deborah; Mancini, Mary Elizabeth

    2009-01-01

    Providing cardiopulmonary resuscitation is an essential competency for nurses. Nurse educators involved in staff development and continuing education spend numerous hours offering basic life support courses and conducting performance improvement activities such as mock codes. This study provides evidence that cardiopulmonary resuscitation performance skills using self-directed learning methods are as good as or, on a number of parameters, better than those achieved with a more resource- and time-intensive traditional approach.

  6. Improving the reproductive efficiency by zoo-technical methods at a dairy farm.

    Science.gov (United States)

    Tóth, F; Gábor, G; Mézes, M; Váradi, E; Ozsvári, L; Sasser, R G; Abonyi-Tóth, Zs

    2006-04-01

    This trial was conducted on a Hungarian dairy farm between July 2001 and December 2004. The objective of this work was to improve the reproductive efficiency with relatively high milk production. At the beginning of this trial blood and fodder samples were taken for checking the metabolic status of the animals in order to determine their health condition. The nutritive value of the daily ration for all groups met with the requirements of the Hungarian National Standard and almost all serum metabolic parameters differed between the milking and pregnant animals. Early pregnancy detection (by ultrasound) and ovulation synchronizing methods were introduced to optimize reproductive performance. The oestrus cycle was also checked by ultrasound and open cows were treated by the appropriate method in order to inseminate them as soon as possible. Efficiency of artificial insemination (AI) followed by a single prostaglandin F2alpha (PGF2alpha) and Ovsynch treatment was similar (30.8% and 29%) and less effective than AI after natural heat detection (37.1%). Provsynch (Pre-synch followed by Ovsynch) was the most effective ovulation synchronization method (conception rate=42.6%; pmilk production increased between 2002 and 2004 by approximately 600 kg per cow, the calving period decreased by 20 days and the number of AIs per pregnancy was also improved (0.8 AI per conception). These findings are really beneficial economically because the decrease in the calving interval returns profit for the dairy farms; one open day costs euro2.5/cow. Economical analysis showed a high profit ratio from the reproductive 'investment' on this farm. Every invested euro yielded approximately euro10.

  7. Mild coal pretreatment to improve liquefaction reactivity. Final technical report, September 1990--February 1994

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R.L.; Shams, K.G.

    1994-07-01

    Recent research efforts in direct coal liquefaction are focused on lowering the level of reaction severity, identification and determination of the causes of retrogressive reactions, and improving the economics of the process. Ambient pretreatment of coals using methanol and a trace amount of hydrochloric acid was extensively studied in connection with low severity coal liquefaction. Ambient pretreatment of eight Argonne coals using methanol/HCl improved THF-soluble conversions 24.5 wt % (maf basis) for Wyodak subbituminous coal and 28.4 wt % for Beulah-Zap lignite with an average increase of 14.9 wt % for the eight Argonne coals at 623 K (350{degrees}C) reaction temperature and 30 minutes reaction time. Optimal pretreatment conditions were determined using Wyodak and Illinois No. 6 coals. Acid concentration was the most important pretreatment variable studied; liquefaction reactivity increased with increasing acid concentration up to 2 vol %. The FTIR spectra of treated and untreated Wyodak coal samples demonstrated formation of carboxylic functional groups during pretreatment, a result of divalent (Ca, Mg) cationic bridge destruction. The extent of liquefaction reactivity directly correlated with the amount of calcium removed during pretreatment, and results from calcium ``addback`` experiments supported the observation that calcium adversely affected coal reactivity at low severity reaction conditions. Model compound studies using benzyl phenyl ether demonstrated that calcium cations catalyzed retrogressive reactions, inhibited hydrogenation reactions at low severity reaction conditions, and were more active at higher reaction temperatures. Based on kinetic data, mechanisms for hydrogenation-based inhibition and base-catalyzed retrogressive reactions are proposed. The base-catalyzed retrogressive reactions are shown to occur via a hydrogen abstraction mechanism where hydrogenation inhibition reactions are shown to take place via a surface quenching mechanism.

  8. 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

  9. Effects of computer-aided clinical decision support systems in improving antibiotic prescribing by primary care providers: a systematic review.

    Science.gov (United States)

    Holstiege, Jakob; Mathes, Tim; Pieper, Dawid

    2015-01-01

    To assess the effectiveness of computer-aided clinical decision support systems (CDSS) in improving antibiotic prescribing in primary care. A literature search utilizing Medline (via PubMed) and Embase (via Embase) was conducted up to November 2013. Randomized controlled trials (RCTs) and cluster randomized trials (CRTs) that evaluated the effects of CDSS aiming at improving antibiotic prescribing practice in an ambulatory primary care setting were included for review. Two investigators independently extracted data about study design and quality, participant characteristics, interventions, and outcomes. Seven studies (4 CRTs, 3 RCTs) met our inclusion criteria. All studies were performed in the USA. Proportions of eligible patient visits that triggered CDSS use varied substantially between intervention arms of studies (range 2.8-62.8%). Five out of seven trials showed marginal to moderate statistically significant effects of CDSS in improving antibiotic prescribing behavior. CDSS that automatically provided decision support were more likely to improve prescribing practice in contrast to systems that had to be actively initiated by healthcare providers. CDSS show promising effectiveness in improving antibiotic prescribing behavior in primary care. Magnitude of effects compared to no intervention, appeared to be similar to other moderately effective single interventions directed at primary care providers. Additional research is warranted to determine CDSS characteristics crucial to triggering high adoption by providers as a perquisite of clinically relevant improvement of antibiotic prescribing. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.

  10. 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).

  11. Dissemination Approaches to Participating Primary Care Providers in a Quality Improvement Program Addressing Opioid Use in Central Appalachia.

    Science.gov (United States)

    Cardarelli, Roberto; Workman, Charlotte Sue; Weatherford, Sarah; Whanger, Stacey; King, Dana E

    2017-06-01

    Practice-based research networks (PBRNs) have been described as new clinical laboratories for primary care research and dissemination. PBRNs, however, have struggled to disseminate research results in a meaningful way to participating providers and clinics. The Central Appalachia Inter-Professional Pain Education Collaborative was developed to work with PBRN clinics using quality improvement methods, deliver statewide continuing education activities to address the issue of opioid use in patients with chronic pain, and develop a multimodal mechanism to disseminate project results to clinics and participating providers. Successful change in the delivery of chronic pain care was dependent on the clinic's commitment to a team-based, patient-centered approach. Statistically significant improvements were shown in 10 of 16 process measures, and 80% of the participants agreed that the quality improvement process activity increased their knowledge and would improve their performance in managing patients with chronic pain, as well as patient outcomes in their practice. The Central Appalachia Inter-Professional Pain Education Collaborative project used an extensive and innovative dissemination plan under the rubric of "continual dissemination." Unlike traditional dissemination efforts that focus on summary presentations, this initiative used a continual dissemination approach that updated participants quarterly through multiple means throughout the project, which improved engagement in the project.

  12. 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

  13. Letter to Editor: Electronic Medical Record, Step toward Improving the Quality of Healthcare Services and Treatment Provided to Patients

    Directory of Open Access Journals (Sweden)

    Elahe Gozali

    2014-04-01

    Full Text Available Information technology can increase the quality of medical care and is a target for many of the pioneers in the development of clinical or medical information. Electronic medical record (EMR, one of such technologies, is a well-known and valuable system to access patient information in hospitals. Electronic medical records which are used for the purpose of providing basic health care are available through a network of computers. All units of the hospital such as examination room, conference room, emergency, patient care units, nursing stations, operating rooms, recovery units, laboratory, radiology, pharmacy and medical records should have access to it. Among its advantages are improved quality of care provided to patients, better organized information, improvement in the timeliness of the process, accuracy and completeness of documentation, patient access to electronic copies of records, prevention of medication errors and allergies, reduced medical errors, immediate access to information in different places, decision support technology and improvement in the process of doing . S urely the use of electronic medical records has created a new dimension to patient care and clinical practice and will provide a comprehensive system to support people in the community and enhance the quality of services provided to them.

  14. Improving health worker performance of abortion services: an assessment of post-training support to providers in India, Nepal and Nigeria.

    Science.gov (United States)

    Benson, Janie; Healy, Joan; Dijkerman, Sally; Andersen, Kathryn

    2017-11-21

    Health worker performance has been the focus of numerous interventions and evaluation studies in low- and middle-income countries. Few have examined changes in individual provider performance with an intervention encompassing post-training support contacts to improve their clinical practice and resolve programmatic problems. This paper reports the results of an intervention with 3471 abortion providers in India, Nepal and Nigeria. Following abortion care training, providers received in-person visits and virtual contacts by a clinical and programmatic support team for a 12-month period, designed to address their individual practice issues. The intervention also included technical assistance to and upgrades in facilities where the providers worked. Quantitative measures to assess provider performance were established, including: 1) Increase in service provision; 2) Consistent service provision; 3) Provision of high quality of care through use of World Health Organization-recommended uterine evacuation technologies, management of pain and provision of post-abortion contraception; and 4) Post-abortion contraception method mix. Descriptive univariate analysis was conducted, followed by examination of the bivariate relationships between all independent variables and the four dependent performance outcome variables by calculating unadjusted odds ratios, by country and overall. Finally, multivariate logistic regression was performed for each outcome. Providers received an average of 5.7 contacts. Sixty-two percent and 46% of providers met measures for consistent service provision and quality of care, respectively. Fewer providers achieved an increased number of services (24%). Forty-six percent provided an appropriate postabortion contraceptive mix to clients. Most providers met the quality components for use of WHO-recommended abortion methods and provision of pain management. Factors significantly associated with achievement of all measures were providers working in

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

    Science.gov (United States)

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

    2017-01-01

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

  16. An Evaluation of Family-Centered Rounds in the PICU: Room for Improvement Suggested by Families and Providers.

    Science.gov (United States)

    Levin, Amanda B; Fisher, Kiondra R; Cato, Krista D; Zurca, Adrian D; October, Tessie W

    2015-11-01

    To identify areas for improvement in family-centered rounds from both the family and provider perspectives. Prospective, cross-sectional mixed-methods study, including an objective measure (direct observation of family-centered rounds) and subjective measures (surveys of English-speaking families and providers) of family-centered rounds. PICU in a single, tertiary children's hospital. Families of children admitted to the PICU, physicians, and nurses. None. Two hundred thirty-two family-centered round encounters were observed over a 10-week period. Family-centered round encounters averaged 10.5 minutes per child. Multivariable regression analysis revealed that family presence was independently associated with length of family-centered rounds (p family talk time accounting for an average of 25 seconds (4%) of the encounter. Non-English-speaking families were less likely to attend family-centered rounds compared with English-speaking families even when physically present at the patient's bedside (p families and providers agreed that family-centered rounds keep the family informed and reported positive statements about family presence on family-centered rounds; however, PICU fellows did not agree that families provided pertinent information and nurses reported that family presence limited patient discussions. The primary advice families offered providers to improve family-centered rounds was to be more considerate and courteous, including accommodating family schedules, minimizing distractions, and limiting computer viewing. Family presence increased the length of family-centered rounds despite a small percentage of time spoken by families, suggesting longer rounds are due to changes in provider behavior when families are present. Also, non-English-speaking families may need more support to be able to attend and benefit from family-centered rounds. Lastly, in an era of full family-centered rounds acceptance, families and most providers, except fellows, report benefit

  17. 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.

  18. 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.

  19. 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.

  20. Do Lower Target Temperatures or Prolonged Cooling Provide Improved Outcomes for Comatose Survivors of Cardiac Arrest Treated With Hypothermia?

    Science.gov (United States)

    Kagawa, Eisuke; Dote, Keigo; Kato, Masaya; Sasaki, Shota; Oda, Noboru; Nakano, Yoshinori; Miura, Katsuya; Inoue, Ichiro; Kihara, Yasuki

    2015-09-21

    Optimal protocols for targeted temperature management are still unclear. This study investigated whether lower target temperatures and/or prolonged cooling could provide improved outcomes in comatose survivors of cardiac arrest. This observational study was conducted using the prospectively collected targeted temperature management database in Hiroshima, Japan. Between September 2003 and September 2014, 237 patients treated with TTM after cardiac arrest were enrolled in this study. The target temperatures and durations were assigned by the treating physicians regardless of the patients' conditions. Favorable outcomes were defined as a cerebral performance category scale of 1 or 2 at the 90-day follow-up time point. The rate of favorable outcomes were similar between the patients whose protocols of target temperature were 28 hours and target temperatures <34°C were associated with more frequent lethal arrhythmia, pneumonia, and/or bleedings. Prolonged durations of cooling and rewarming ≥28 hours may not improve outcomes and may increase complications. Further studies are necessary to assess the hypothesis that target temperatures <34°C provide improved outcomes in patients treated with extracorporeal cardiopulmonary resuscitation. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  1. Mobile technology intervention to improve care coordination between HIV and substance use treatment providers: development, training, and evaluation protocol.

    Science.gov (United States)

    Claborn, Kasey; Becker, Sara; Ramsey, Susan; Rich, Josiah; Friedmann, Peter D

    2017-03-14

    People living with HIV (PLWH) with a substance use disorder (SUD) tend to receive inadequate medical care in part because of a siloed healthcare system in which HIV and substance use services are delivered separately. Ideal treatment requires an interdisciplinary, team-based coordinated care approach, but many structural and systemic barriers impede the integration of HIV and SUD services. The current protocol describes the development and preliminary evaluation of a care coordination intervention (CCI), consisting of a tablet-based mobile platform for HIV and SUD treatment providers, an interagency communication protocol, and a training protocol. We hypothesize that HIV and SUD treatment providers will find the CCI to be acceptable, and that after receipt of the CCI, providers will: exhibit higher retention in dual care among patients, report increased frequency and quality of communication, and report increased rates of relational coordination. A three phase approach is used to refine and evaluate the CCI. Phase 1 consists of in-depth qualitative interviews with 8 key stakeholders as well as clinical audits of participating HIV and SUD treatment agencies. Phase 2 contains functionality testing of the mobile platform with frontline HIV and SUD treatment providers, followed by refinement of the CCI. Phase 3 consists of a pre-, post-test trial with 30 SUD and 30 HIV treatment providers. Data will be collected at the provider, organization, and patient levels. Providers will complete assessments at baseline, immediately post-training, and at 1-, 3-, and 6-months post-training. Organizational data will be collected at baseline, 1-, 3-, and 6-months post training, while patient data will be collected at baseline and 6-months post training. This study will develop and evaluate a CCI consisting of a tablet-based mobile platform for treatment providers, an interagency communication protocol, and a training protocol as a means of improving the integration of care for PLWH

  2. 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

  3. 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.

  4. Which level of evidence does the US National Toxicology Program provide? Statistical considerations using the Technical Report 578 on Ginkgo biloba as an example.

    Science.gov (United States)

    Gaus, Wilhelm

    2014-09-02

    The US National Toxicology Program (NTP) is assessed by a statistician. In the NTP-program groups of rodents are fed for a certain period of time with different doses of the substance that is being investigated. Then the animals are sacrificed and all organs are examined pathologically. Such an investigation facilitates many statistical tests. Technical Report TR 578 on Ginkgo biloba is used as an example. More than 4800 statistical tests are possible with the investigations performed. Due to a thought experiment we expect >240 false significant tests. In actuality, 209 significant pathological findings were reported. The readers of Toxicology Letters should carefully distinguish between confirmative and explorative statistics. A confirmative interpretation of a significant test rejects the null-hypothesis and delivers "statistical proof". It is only allowed if (i) a precise hypothesis was established independently from the data used for the test and (ii) the computed p-values are adjusted for multiple testing if more than one test was performed. Otherwise an explorative interpretation generates a hypothesis. We conclude that NTP-reports - including TR 578 on Ginkgo biloba - deliver explorative statistics, i.e. they generate hypotheses, but do not prove them. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  5. Discordant indigenous and provider frames explain challenges in improving access to arthritis care: a qualitative study using constructivist grounded theory.

    Science.gov (United States)

    Thurston, Wilfreda E; Coupal, Stephanie; Jones, C Allyson; Crowshoe, Lynden F J; Marshall, Deborah A; Homik, Joanne; Barnabe, Cheryl

    2014-06-11

    Access to health services is a determinant of population health and is known to be reduced for a variety of specialist services for Indigenous populations in Canada. With arthritis being the most common chronic condition experienced by Indigenous populations and causing high levels of disability, it is critical to resolve access disparities through an understanding of barriers and facilitators to care. The objective of this study was to inform future health services reform by investigating health care access from the perspective of Aboriginal people with arthritis and health professionals. Using constructivist grounded theory methodology we investigated Indigenous peoples' experiences in accessing arthritis care through the reports of 16 patients and 15 healthcare providers in Alberta, Canada. Semi-structured interviews were conducted between July 2012 and February 2013 and transcribed verbatim. The patient and provider data were first analyzed separately by two team members then brought together to form a framework. The framework was refined through further analysis following the multidisciplinary research team's discussions. Once the framework was developed, reports on the patient and provider data were shared with each participant group independently and participants were interviewed to assess validity of the summary. In the resulting theoretical framework Indigenous participants framed their experience with arthritis as 'toughing it out' and spoke of racism encountered in the healthcare setting as a deterrent to pursuing care. Healthcare providers were frustrated by high disease severity and missed appointments, and framed Indigenous patients as lacking 'buy-in'. Constraints imposed by complex healthcare systems contributed to tensions between Indigenous peoples and providers. Low specialist care utilization rates among Indigenous people cannot be attributed to cultural and social preferences. Further, the assumptions made by providers lead to stereotyping and

  6. 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.

  7. 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

  8. Providing supplemental milk to piglets preweaning improves the growth but not survival of gilt progeny compared with sow progeny.

    Science.gov (United States)

    Miller, Y J; Collins, A M; Smits, R J; Thomson, P C; Holyoake, P K

    2012-12-01

    Gilt progeny have lighter weaning weights and greater postweaning medication and mortality rates compared with the progeny of older parity sows. Because weaning weight has been positively correlated with postweaning survival, this study aimed to determine whether the provision of supplemental milk preweaning could improve weaning weight and subsequent weights as well as postweaning survival of gilt progeny. The study was replicated in summer and winter as the effects of supplemental milk were expected to vary with season. The progeny of 80 gilts (parity 0) and 80 sows (parity 2 to 5) were allocated to both treatments: with or without supplemental milk in these 2 seasons with 5 sheds/season. Litter size was standardized (10 to 11 piglets) and each piglet was weighed at birth, d 21, weaning (4 wk), and 10 wk of age. Medications and mortalities were recorded both preweaning and postweaning. Pigs were housed within treatment groups postweaning, and ADFI and G:F were measured. Gilt progeny were 200 g lighter at birth in both replicates (P gilt and sow progeny by 800 g in summer (P gilts or sows (P > 0.05). Supplemental milk disappearance (the daily difference between the volume of milk provided and the residue left in the drinker) was greater in summer than winter (by 130 mL/piglet d(-1); P gilt progeny reached or exceeded that of nonsupplemented sow progeny. Gilt progeny had greater postweaning mortality (2.6%) and medication rates (6.2%) than sow progeny (1 and 2.2%, respectively; both P Gilt progeny also had less postweaning ADFI than sow progeny in winter (528 and 636 g, respectively; P 0.05). The hypothesis that supplemental milk provision did increase gilt progeny weaning weight was supported (especially in summer) but the supplementation had no effect on postweaning weights and survival. Efforts to improve gilt progeny postweaning growth and survival need to be aimed at improving health and immunity, not just weaning weight.

  9. 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 Technical Skills as a reliable, basic tool to standardize the evaluation of technical skills in general surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. 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.

  11. Development and process evaluation of improved Fischer-Tropsch slurry catalysts. Sixth quarterly technical progress report, 1 January--31 March 1988

    Energy Technology Data Exchange (ETDEWEB)

    Withers, H.P. [Air Products and Chemicals, Inc., Allentown, PA (United States); Bukur, D.B.; Rosynek, M.P. [Texas A and M Univ., College Station, TX (United States)

    1988-12-31

    The objective of this contract is to develop a consistent technical data base on the use of iron-based catalysts in Fischer-Tropsch (FT) synthesis reactions. This data base will be developed to allow the unambiguous comparison of the performance of these catalysts with each other and with state-of-the-art iron catalyst comparisons. Particular attention will be devoted to generating reproducible kinetic and selectivity data and to developing reproducible improved catalyst compositions.

  12. New approaches to provide feedback from nuclear and covariance data adjustment for effective improvement of evaluated nuclear data files

    Energy Technology Data Exchange (ETDEWEB)

    Palmiotti, Giuseppe; Salvatores, Massimo; Hursin, Mathieu; Kodeli, Ivo; Gabrielli, Fabrizio; Hummel, Andrew

    2016-11-01

    A critical examination of the role of uncertainty assessment, target accuracies, role of integral experiment for validation and, consequently, of data adjustments methods is underway since several years at OECD-NEA, the objective being to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and experimentalists in order to improve without ambiguities the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications and to meet new requirements and constraints for innovative reactor and fuel cycle system design. An approach will be described that expands as much as possible the use in the adjustment procedure of selected integral experiments that provide information on “elementary” phenomena, on separated individual physics effects related to specific isotopes or on specific energy ranges. An application to a large experimental data base has been performed and the results are discussed in the perspective of new evaluation projects like the CIELO initiative.

  13. New approaches to provide feedback from nuclear and covariance data adjustment for effective improvement of evaluated nuclear data files

    Science.gov (United States)

    Palmiotti, Giuseppe; Salvatores, Massimo; Hursin, Mathieu; Kodeli, Ivo; Gabrielli, Fabrizio; Hummel, Andrew

    2017-09-01

    A critical examination of the role of uncertainty assessment, target accuracies, role of integral experiment for validation and, consequently, of data adjustments methods is underway since several years at OECD-NEA, the objective being to provide criteria and practical approaches to use effectively the results of sensitivity analyses and cross section adjustments for feedback to evaluators and experimentalists in order to improve without ambiguities the knowledge of neutron cross sections, uncertainties, and correlations to be used in a wide range of applications and to meet new requirements and constraints for innovative reactor and fuel cycle system design. An approach will be described that expands as much as possible the use in the adjustment procedure of selected integral experiments that provide information on "elementary" phenomena, on separated individual physics effects related to specific isotopes or on specific energy ranges. An application to a large experimental data base has been performed and the results are discussed in the perspective of new evaluation projects like the CIELO initiative.

  14. Improvement of reading speed after providing of low vision aids in patients with age-related macular degeneration.

    Science.gov (United States)

    Nguyen, Nhung Xuan; Weismann, Malte; Trauzettel-Klosinski, Susanne

    2009-11-01

    Age-related macular degeneration (AMD) is the most common cause of severe visual impairment, including loss of reading ability, among elderly persons in developed countries. The aim of the present study was to evaluate reading ability before and after providing of appropriate low vision aids. Five hundred and thirty patients with different stages of AMD (age 82 +/- 8 years) were included in this retrospective study. All patients underwent a standardized ophthalmological examination including evaluation of magnification requirement and careful providing of low vision aids. Before and after the provision of low vision aids, reading speed [words per minute (wpm)] was evaluated using standardized reading texts. For the whole group, the average best-corrected distance visual acuity of the better eye was 0.18 +/- 0.15, with 69% of patients having visual acuity of 0.1 (20/200) or better. The mean magnification requirement was 7.4 +/- 6.3-fold (range 2-25). Visual rehabilitation was achieved with optical visual aids in 58% of patients, whereas 42% of patients needed electronically closed-circuit TV systems. Mean reading speed was 20 +/- 33 wpm before and increased significantly to 72 +/- 35 (p reading speed before (0.4 +/- 3.8 versus 20 +/- 28 wpm, p reading speed compared to patients with visual acuity of 0.1 or better following rehabilitation (p read; in contrast, reading ability was achieved in 94% of patients after the provision of low vision aids for the whole group. Our results indicate the great value of low vision rehabilitation through adequate providing of vision aids for the improvement of reading ability, with a highly significant increase of reading speed without training of eccentric viewing in patients with retained central fixation. The prompt implementation of low vision aids in patients with macular degeneration will help them to maintain and regain their reading ability, which can lead to an increase in independence, communication, mental agility and

  15. Can a mobile app improve the quality of patient care provided by trainee doctors? Analysis of trainees' case reports.

    Science.gov (United States)

    Webb, Katie; Bullock, Alison; Dimond, Rebecca; Stacey, Mark

    2016-09-21

    To explore how a medical textbook app ('iDoc') supports newly qualified doctors in providing high-quality patient care. The iDoc project, funded by the Wales Deanery, provides new doctors with an app which gives access to key medical textbooks. Participants' submitted case reports describing self-reported accounts of specific instances of app use. The size of the data set enabled analysis of a subsample of 'complex' case reports. Of the 568 case reports submitted by Foundation Year 1s (F1s)/Year 2s (F2s), 142 (25%) detailed instances of diagnostic decision-making and were identified as 'complex'. We analysed these data against the Quality Improvement (QI) Framework using thematic content analysis. Clinical settings across Wales, UK. Newly qualified doctors (2012-2014; n=114), F1 and F2. The iDoc app, powered by Dr Companion software, provided newly qualified doctors in Wales with a selection of key medical textbooks via individuals' personal smartphone. Doctors' use of the iDoc app supported 5 of the 6 QI elements: efficiency, timeliness, effectiveness, safety and patient-centredness. None of the case reports were coded to the equity element. Efficiency was the element which attracted the highest number of case report references. We propose that the QI Framework should be expanding to include 'learning' as a 7th element. Access to key medical textbooks via an app provides trusted and valuable support to newly qualified doctors during a period of transition. On the basis of these doctors' self-reported accounts, our evidence indicates that the use of the app enhances efficiency, effectiveness and timeliness of patient-care in addition consolidating a safe, patient-centred approach. We propose that there is scope to extend the QI Framework by incorporating 'learning' as a 7th element in recognition of the relationship between providing high-quality care through educational engagement. Published by the BMJ Publishing Group Limited. For permission to use (where not

  16. 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.

  17. 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…

  18. 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

  19. Improving Curriculum Development Practices in a Technical Vocational Community College: Examining Effects of a Professional Development Arrangement for Middle Managers

    Science.gov (United States)

    Albashiry, Nabeel M.; Voogt, Joke M.; Pieters, Jules M.

    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 professional development arrangement (PDA), with such a…

  20. The Hispanic Clinic for Pediatric Surgery: A model to improve parent-provider communication for Hispanic pediatric surgery patients.

    Science.gov (United States)

    Jaramillo, Joshua; Snyder, Elizabeth; Dunlap, Jonathan L; Wright, Robert; Mendoza, Fernando; Bruzoni, Matias

    2016-04-01

    preference for, and value of language concordant care. Language discordant participants reported that they desired to ask more questions but were limited by a language barrier (p=0.001). In a pediatric surgery clinic, language concordant care increases the number of patient-asked questions during a clinical visit and improves communication suggesting that discordant care is a potential source of disparities in access to information. Future efforts should focus on expanding access to language concordant providers in other surgery subspecialties as a step towards limiting disparities in surgical care for all patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. 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.

  2. 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.

  3. 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

  4. A framework for community ownership of a text messaging programme to improve adherence to antiretroviral therapy and client-provider communication: a mixed methods study.

    Science.gov (United States)

    Mbuagbaw, Lawrence; Bonono-Momnougui, Renee-Cecile; Thabane, Lehana; Kouanfack, Charles; Smieja, Marek; Ongolo-Zogo, Pierre

    2014-09-26

    Mobile phone text messaging has been shown to improve adherence to antiretroviral therapy and to improve communication between patients and health care workers. It is unclear which strategies are most appropriate for scaling up text messaging programmes. We sought to investigate acceptability and readiness for ownership (community members designing, sending and receiving text messages) of a text message programme among a community of clients living with human immunodeficiency virus (HIV) in Yaoundé, Cameroon and to develop a framework for implementation. We used the mixed-methods sequential exploratory design. In the qualitative strand we conducted 7 focus group discussions (57 participants) to elicit themes related to acceptability and readiness. In the quantitative strand we explored the generalizability of these themes in a survey of 420 clients. Qualitative and quantitative data were merged to generate meta-inferences. Both qualitative and quantitative strands showed high levels of acceptability and readiness despite low rates of participation in other community-led projects. In the qualitative strand, compared to the quantitative strand, more potential service users were willing to pay for a text messaging service, preferred participation of health personnel in managing the project and preferred that the project be based in the hospital rather than in the community. Some of the limitations identified to implementing a community-owned project were lack of management skills in the community, financial, technical and literacy challenges. Participants who were willing to pay were more likely to find the project acceptable and expressed positive feelings about community readiness to own a text messaging project. Community ownership of a text messaging programme is acceptable to the community of clients at the Yaoundé Central Hospital. Our framework for implementation includes components for community members who take on roles as services users (demonstrating

  5. Improvement of Operations and Maintenance Techniques Program. Literature Review and Technical Evaluation of Sediment Resuspension during Dredging

    Science.gov (United States)

    1991-01-01

    Dredging and Marine Construction, Ports and Dredging, Hydro Delft, Land and Water Interna- tional, and Dock and Harbour Authority. Efforts were made...transparency, visibility, clarity, opacity, color, and suspended solids. In older literature, the word " siltation " has been used in place of turbidity quite...Conditions of Grab Dredger on Turbidity," In Japanese, Technical Note No. 257, Port and Harbour Research Institute, Kurihama, Japan, pp 1-29. Koma, H. 1978

  6. 78 FR 27963 - Reliability Technical Conference; Notice of Technical Conference

    Science.gov (United States)

    2013-05-13

    ... Energy Regulatory Commission Reliability Technical Conference; Notice of Technical Conference Take notice that the Federal Energy Regulatory Commission will hold a Technical Conference on Tuesday, July 9, 2013... to the webcast. The Capitol Connection provides technical support for webcasts and offers the option...

  7. Technical Note: Using a high finesse optical resonator to provide a long light path for differential optical absorption spectroscopy: CE-DOAS

    Directory of Open Access Journals (Sweden)

    J. Meinen

    2010-04-01

    Full Text Available Cavity enhanced methods in absorption spectroscopy have seen a considerable increase in popularity during the past decade. Especially Cavity Enhanced Absorption Spectroscopy (CEAS established itself in atmospheric trace gas detection by providing tens of kilometers of effective light path length using a cavity as short as 1 m. In this paper we report on the construction and testing of a compact and power efficient light emitting diode based broadband Cavity Enhanced Differential Optical Absorption Spectrometer (CE-DOAS for in situ observation of atmospheric NO3. This device combines the small size of the cavity with the advantages of the DOAS approach in terms of sensitivity, specificity and insensivity to intensity fluctuations of the light source. In particular, no selective removal of the analyte (here NO3 is necessary for calibration of the instrument if appropriate corrections are applied to the CEAS theory. Therefore the CE-DOAS technique can – in principle – measure any gas detectable by DOAS. We will discuss the advantages of using a light emitting diode (LED as light source particularly the precautions which have to be considered for the use of LEDs with a broad wavelength range. The instrument was tested in the lab by detecting NO3 formed by mixing of NO2 and O3 in air. It was then compared to other trace gas detection techniques in an intercomparison campaign in the atmosphere simulation chamber SAPHIR at Forschungszentrum Jülich at NO3 concentrations as low as 6.3 ppt.

  8. [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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

    OpenAIRE

    Barnett, Tony; Hoang, Ha; Stuart, Jackie; Crocombe, Len

    2015-01-01

    Objectives 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. Design Qualitative study with semistructured interviews and thematic analysis. Setting Four remote communities in outback Queensland, Australia. Participants 35 primary care providers who had experie...

  13. 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.

  14. 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/

  15. 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.

  16. 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.

  17. Defense Logistics Agency Aviation Can Improve its Processes to Obtain Restitution From Contractors That Provide Defective Spare Parts

    Science.gov (United States)

    2016-02-23

    Spare Parts Report No. DODIG-2016-052 Mission Our mission is to provide independent, relevant, and timely oversight of the Department of Defense that...its Processes to Obtain Restitution From Contractors That Provide Defective Spare Parts DODIG-2016-052 (Project No. D2015-D000AG-0107.000) │ i Visit...from contractors that provided defective spare parts . This is the second in a series of audits on product quality deficiency reports processed by

  18. 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.

  19. 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...

  20. 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.

  1. 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...

  2. Improving adequacy of hemodialysis in Northern California ESRD patients: a final project report. Provider Participants and Medical Review Board of the TransPacific Renal Network.

    Science.gov (United States)

    Brown, J; Josephson, M

    2000-10-01

    with a KT/V below the national benchmark. Only 9% (n = 8) of the 113 providers had a variance in post-BUN sampling methodologies that could be related to the clinical measure of adequacy. In Phase II, a random selection of 12 providers with data below US and Network standards was made for an intensive assessment. A total of 217 patient records were reviewed from a population of 1,027. In addition to comparison of baseline data, each facility was assessed for barriers to achieving adequacy outcomes. The number of problems was extensive and specific to each facility; however, a common reoccurring theme in the majority of events was the lack of supporting documentation for changes to the plan of care when variances occur. The most common occurrences were incorrect blood flow and dialysate flow with no supporting documentation on record for the prescription not being met. In Phase III, Network interventions for facilities not meeting US and Network standards for adequacy as measured by URR and KT/V included required quarterly reporting on their facility-specific quality improvement programs for adequacy. In addition the 12 facilities that participated in the intensive assessment had additional interventions that included an educational "tool box" focused on documentation, legal implications of charting, and general medical records management, and an educational program to review information to be shared with facility staff. All on-site facilities reported ongoing quality improvement programs. In some facilities they did provide a focus on processes and not only a measurement of an indicator. All facilities reported a team concept of some type used in their program. Although there were similarities in the facilities, each facility presented with a unique combination of barriers. In addition to a large patient-to-RN ratio, the lack of technical education for the unlicensed assistive personnel on processes and outcomes appears to play a significant role in the achievement of

  3. 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

  4. A strategy to improve skills in pharmaceutical supply management in East Africa: the regional technical resource collaboration for pharmaceutical management.

    Science.gov (United States)

    Matowe, Lloyd; Waako, Paul; Adome, Richard Odoi; Kibwage, Isaac; Minzi, Omary; Bienvenu, Emile

    2008-12-23

    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. 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. 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 effectiveness of a novel skills-building approach for

  5. 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

  6. Development of an Educational Video to Improve Patient Knowledge and Communication with Their Healthcare Providers about Colorectal Cancer Screening

    Science.gov (United States)

    Katz, Mira L.; Heaner, Sarah; Reiter, Paul; van Putten, Julie; Murray, Lee; McDougle, Leon; Cegala, Donald J.; Post, Douglas; David, Prabu; Slater, Michael; Paskett, Electra D.

    2009-01-01

    Background: Low rates of colorectal cancer (CRC) screening persist due to individual, provider, and system level barriers. Purpose: To develop and obtain initial feedback about a CRC screening educational video from community members and medical professionals. Methods: Focus groups of patients were conducted prior to the development of the CRC…

  7. Scientific and Technical English.

    Science.gov (United States)

    Vaclavik, Jaroslav

    Technical English differs from everyday English because of the specialized contexts in which it is used and because of the specialized interests of scientists and engineers. This text provides exercises in technical and scientific exposition in the following fields: mathematics, physics, temperature effects, mechanics, dynamics, conservation of…

  8. 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.

  9. 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…

  10. Conceptualisation of socio-technical integrated information technology solutions to improve incident reporting through Maslow's hierarchy of needs: a qualitative study of junior doctors.

    Science.gov (United States)

    Yee, Kwang Chien

    2007-01-01

    Medical errors are common, especially within the acute healthcare delivery. The identification of systemic factors associated with adverse events and the construction of models to improve the safety of the healthcare system seems straightforward, this process has been proven to be much more difficult in the realism of medical practice due to the failure of the incident reporting system to capture the essential information, especially from the perspective of junior doctors. The failure of incidence reporting system has been related to the lack of socio-technical consideration for both system designs and system implementations. The main reason of non-reporting can be conceptualised through the motivation psychology model: Maslow's hierarchy of needs; in order to achieve a change in the socio-cultural domain for incident reporting. This paper presents a qualitative research methodology approach to generate contextual-rich insights into the socio-cultural and technological factors of incident reporting among junior doctors. The research illuminates the guiding principles for future socio-technical integrated information communication technology designs and implementations. Using Maslow's hierarchy of needs as the conceptual framework, the guiding principles aim to design electronic incident reporting systems which will motivate junior doctors to participate in the process. This research paper aims to make a significant contribution to the fields of socio-technical systems and medical errors management. The design and implementation of the new incident reporting system has great potential to motivate junior doctors to change the culture of incident reporting and to work towards a safer future healthcare system.

  11. 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

  12. 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.

  13. 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

    House dust mite (HDM) allergy represents a highly prevalent inhalant allergy, and exposure to HDM allergens results in allergic rhinitis with persistent symptoms that may not be adequately controlled with available allergy pharmacotherapy. Allergy immunotherapy constitutes a complementary treatment...... option targeting the underlying immunological mechanisms of allergic disease and represents the only treatment with a potential for disease modification and long-term efficacy. As traditional allergy immunotherapy delivered by subcutaneous injection of specific HDM allergens involves a time......-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...

  14. Reorganizing small animal gross anatomy: improving the faculty and student experience and incorporating non-technical competency development.

    Science.gov (United States)

    Sprunger, Leslie K; Smith, Tamara L

    2005-01-01

    The organization of the small animal gross anatomy course at Washington State University's College of Veterinary Medicine was modified in several ways over a two-year period. These modifications were motivated in part by the need to accommodate a larger number of students, but also by our desire to make more efficient use of faculty and student time as well as physical resources and to give our students opportunities to develop non-technical competencies such as communication and teamwork skills. The four major changes were (1) increasing dissection group size, (2) assigning specimens to dissection groups on a rotating basis, (3) reducing the amount of dissection time relative to time spent studying prepared specimens, and (4) introducing ''transition reviews,'' a limited form of peer teaching meant to emphasize peer interaction and communication skills rather than conveyance of specific and detailed subject matter. This article describes the details of these changes and evaluates their effectiveness based on faculty assessments, results from surveys of participating students, and comparison of examination performance and formal end-of-course student evaluations before and after reorganization of the course. Increasing the dissection group size and reducing per-student dissection time did not adversely affect student performance and were viewed at least neutrally or favorably by most students. Notably, the rotation of specimens and the transition reviews elicited strongly favorable responses from a large majority of students and had several beneficial effects of which students may not have been aware but which were apparent to participating faculty. Overall, the changes were well received by both faculty and students and were, in our view, of sufficient value that this course organization plan would be used regardless of class size.

  15. Improving correctional healthcare providers' ability to care for transgender patients: Development and evaluation of a theory-driven cultural and clinical competence intervention.

    Science.gov (United States)

    White Hughto, Jaclyn M; Clark, Kirsty A; Altice, Frederick L; Reisner, Sari L; Kershaw, Trace S; Pachankis, John E

    2017-12-01

    Correctional healthcare providers' limited cultural and clinical competence to care for transgender patients represents a barrier to care for incarcerated transgender individuals. The present study aimed to adapt, deliver, and evaluate a transgender cultural and clinical competence intervention for correctional healthcare providers. In the summer of 2016, a theoretically-informed, group-based intervention to improve transgender cultural and clinical competence was delivered to 34 correctional healthcare providers in New England. A confidential survey assessed providers' cultural and clinical competence to care for transgender patients, self-efficacy to provide hormone therapy, subjective norms related to transgender care, and willingness to provide gender-affirming care to transgender patients before and after (immediately and 3-months) the intervention. Linear mixed effects regression models were fit to assess change in study outcomes over time. Qualitative exit interviews assessed feasibility and acceptability of the intervention. Providers' willingness to provide gender-affirming care improved immediately post-intervention (β = 0.38; SE = 0.41, p cultural competence (χ2 = 22.49; p cultural and clinical competence, self-efficacy, subjective norms, and willingness to provide gender-affirming care to transgender patients. Continued efforts should be made to train correctional healthcare providers in culturally and clinically competent gender-affirming care in order to improve the health of incarcerated transgender people. Future efficacy testing of this intervention is warranted. Copyright © 2017. Published by Elsevier Ltd.

  16. 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

  17. 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.

  18. 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

    2015-12-10

    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.

  19. 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

  20. 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…

  1. 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.

  2. 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.

  3. Semiconductor light-emitting devices having concave microstructures providing improved light extraction efficiency and method for producing same

    Science.gov (United States)

    Tansu, Nelson; Gilchrist, James F; Ee, Yik-Khoon; Kumnorkaew, Pisist

    2013-11-19

    A conventional semiconductor LED is modified to include a microlens layer over its light-emitting surface. The LED may have an active layer including at least one quantum well layer of InGaN and GaN. The microlens layer includes a plurality of concave microstructures that cause light rays emanating from the LED to diffuse outwardly, leading to an increase in the light extraction efficiency of the LED. The concave microstructures may be arranged in a substantially uniform array, such as a close-packed hexagonal array. The microlens layer is preferably constructed of curable material, such as polydimethylsiloxane (PDMS), and is formed by soft-lithography imprinting by contacting fluid material of the microlens layer with a template bearing a monolayer of homogeneous microsphere crystals, to cause concave impressions, and then curing the material to fix the concave microstructures in the microlens layer and provide relatively uniform surface roughness.

  4. An assessment of a traffic monitoring system for a major traffic generator to improve regional planning : technical report.

    Science.gov (United States)

    2009-09-01

    The opening of a major traffic generator in the San Antonio area provided an opportunity to develop and : implement an extensive traffic monitoring system to analyze local, area, and regional traffic impacts from the : generator. Researchers reviewed...

  5. Technical and tactical training of qualified Volleyball players by improving attacking actions of players in different roles

    National Research Council Canada - National Science Library

    Yevgeniy Imas; Olga Borysova; Olha Shlonska; Iryna Kogut; Viktoria Marynych; Viktor Kostyukevich

    2017-01-01

    Introduction. One of the major trends in the development of modern volleyball is the use of attacking actions from the back line of the playing court and force service in the jump that provides high efficiency...

  6. Computerised provider order entry combined with clinical decision support systems to improve medication safety: a narrative review.

    Science.gov (United States)

    Ranji, Sumant R; Rennke, Stephanie; Wachter, Robert M

    2014-09-01

    Adverse drug events (ADEs) are a major cause of morbidity in hospitalised and ambulatory patients. Computerised provider order entry (CPOE) combined with clinical decision support systems (CDSS) are being widely implemented with the goal of preventing ADEs, but the effectiveness of these systems remains unclear. We searched the specialised database Agency for Healthcare Research and Quality (AHRQ) Patient Safety Net to identify reviews of the effect of CPOE combined with CDSS on ADE rates in inpatient and outpatient settings. We included systematic and narrative reviews published since 2008 and controlled clinical trials published since 2012. We included five systematic reviews, one narrative review and two controlled trials. The existing literature consists mostly of studies of homegrown systems conducted in the inpatient setting. CPOE+CDSS was consistently reported to reduce prescribing errors, but does not appear to prevent clinical ADEs in either the inpatient or outpatient setting. Implementation of CPOE+CDSS profoundly changes staff workflow, and often leads to unintended consequences and new safety issues (such as alert fatigue) which limit the system's safety effects. CPOE+CDSS does not appear to reliably prevent clinical ADEs. Despite more widespread implementation over the past decade, it remains a work in progress. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. 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.

  8. 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.

  9. Patient Perception of Enough Time Spent With Provider Is a Mechanism for Improving Women Veterans' Experiences With VA Outpatient Health Care.

    Science.gov (United States)

    Trentalange, Mark; Bielawski, Mark; Murphy, Terrence E; Lessard, Katarzyna; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Gaetano, Vera; Haskell, Sally; Bastian, Lori A

    2016-12-01

    We postulated that associations between two specific provider characteristics, class (nurse practitioner relative to physician) and primary care providers who are proficient and interested in women's health (designated women's provider relative to nondesignated) and overall satisfaction with provider, were mediated through women veterans' perception of enough time spent with the provider. A national patient experience survey was administered to 7,620 women veterans. Multivariable models of overall patient satisfaction with provider were compared with and without the proposed mediator. A structural equation model (SEM) of the mediation of the two provider characteristics was also evaluated. Without the mediator, associations of provider class and designation with overall patient satisfaction were significant. With the proposed mediator, these associations became nonsignificant. An SEM showed that the majority (>80%) of the positive associations between provider class and designation and the outcome were exerted through patient perception of enough time spent with provider. Higher ratings of overall satisfaction with provider exhibited by nurse practitioners and designated women's health providers were exerted through patient perception of enough time spent with provider. Future research should examine what elements of provider training can be developed to improve provider-patient communication and patient satisfaction with their health care. © The Author(s) 2016.

  10. 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

  11. 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.

  12. 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 general domains, performance was significantly better for all domains by self-assessment (P < .05 for all domains) and in 4 domains by expert assessment (P < .04 for all domains other than 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.

  13. Patient and provider perspectives on improving the linkage of HIV-positive pregnant women to long-term HIV care and treatment in eastern Uganda.

    Science.gov (United States)

    Saleem, Haneefa; Kyeyagalire, Robert; Lunsford, Sarah Smith

    2014-01-01

    Despite strong evidence that antiretroviral therapy (ART) reduces the risk of mother-to-child transmission of HIV and improves the health of HIV-positive mothers, many HIV-positive pregnant women do not enrol into long-term HIV care and treatment. 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 linkages to HIV care. Structured interviews were conducted with 11 health providers and 48 HIV-positive mothers enrolled in HIV care. Facilitators to linking HIV-positive pregnant women to long-term HIV care identified included support from expert clients, escorted referrals, same-day HIV care registration, and coordination between ANC and HIV services. Barriers reported included shortages in HIV testing kits and fear of social, physical and medical consequences. Participants recommended integration of ANC and HIV services, reduction in waiting times, HIV counselling by expert clients, and community-based approaches for improving linkages to HIV care. Linking HIV-positive pregnant women to HIV care can be improved through deliberate implementation of quality improvement interventions in facilities to address barriers to access and provide stronger support and community mobilisation.

  14. 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.

  15. 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

  16. Technical note: Relating functional group measurements to carbon types for improved model-measurement comparisons of organic aerosol composition

    Science.gov (United States)

    Takahama, Satoshi; Ruggeri, Giulia

    2017-04-01

    Functional group (FG) analysis provides a means by which functionalization in organic aerosol can be attributed to the abundances of its underlying molecular structures. However, performing this attribution requires additional, unobserved details about the molecular mixture to provide constraints in the estimation process. We present an approach for conceptualizing FG measurements of organic aerosol in terms of its functionalized carbon atoms. This reformulation facilitates estimation of mass recovery and biases in popular carbon-centric metrics that describe the extent of functionalization (such as oxygen to carbon ratio, organic mass to organic carbon mass ratio, and mean carbon oxidation state) for any given set of molecules and FGs analyzed. Furthermore, this approach allows development of parameterizations to more precisely estimate the organic carbon content from measured FG abundance. We use simulated photooxidation products of α-pinene secondary organic aerosol previously reported by Ruggeri et al. (2016) and FG measurements by Fourier transform infrared (FT-IR) spectroscopy in chamber experiments by Sax et al. (2005) to infer the relationships among molecular composition, FG composition, and metrics of organic aerosol functionalization. We find that for this simulated system, ˜ 80 % of the carbon atoms should be detected by FGs for which calibration models are commonly developed, and ˜ 7 % of the carbon atoms are undetectable by FT-IR analysis because they are not associated with vibrational modes in the infrared. Estimated biases due to undetected carbon fraction for these simulations are used to make adjustments in these carbon-centric metrics such that model-measurement differences are framed in terms of unmeasured heteroatoms (e.g., in hydroperoxide and nitrate groups for the case studied in this demonstration). The formality of this method provides framework for extending FG analysis to not only model-measurement but also instrument

  17. Tell Us™: A Web-Based Tool for Improving Communication Among Patients, Families, and Providers in Hospice and Palliative Care Through Systematic Data Specification, Collection, and Use

    Science.gov (United States)

    Dy, Sydney M.; Roy, Jayashree; Ott, Geoffrey E.; McHale, Michael; Kennedy, Christine; Kutner, Jean S.; Tien, Allen

    2015-01-01

    Context Routine electronic patient-reported outcome collection in patients with advanced disease could improve communication among patients, caregivers and providers and improve the timeliness of identifying problems and effectiveness of follow-up. Objective To develop a web-based tool to collect symptoms and need data and provide feedback to hospice and palliative care patients, caregivers and providers. Methods We developed Tell Us™ based on an existing pure web technology platform, the Medical Decision Logic, Inc. (“mdlogix”) Health Science Process Framework (HSPF™). The software development process included eliciting information on systems and needs and mapping care processes with three diverse hospices, and soliciting ideas for the software from clinicians and researchers. We developed a prototype software product, incorporated the hospices’ processes, assessment questions, and educational materials, and refined the product with feedback from other hospice and palliative care professionals. Results Tell Us includes modules for authoring and deploying clinical queries and completion schedules; for enrolling clinical sites and patients for patients and/or families to complete assigned assessments on a scheduled basis; and for providers to view patient-reported data. Tell Us provides customizable automated provider e-mail alerts based on patient responses (such as uncontrolled symptoms or need for medication refills) and provides educational materials targeted to patient needs. Conclusions This web-based toolset may be useful for improving communication between hospice and palliative care patients, caregivers, and providers and proactive patient management. Future research will involve integrating the software into care and evaluating its feasibility and use for data collection, patient education, and improving outcomes. PMID:21458214

  18. Technical improvement of the TBP (tubulin-based polymorphism) method for plant species detection, based on capillary electrophoresis.

    Science.gov (United States)

    Gavazzi, Floriana; Casazza, Anna Paola; Depedro, Claudia; Mastromauro, Francesco; Breviario, Diego

    2012-09-01

    Nowadays, feed and food safety and traceability are of primary importance. Hence, a correct labeling of the different products is highly desirable in general, but mandatory for those people who are suffering from eating disorders and food allergies. Among the technologies that have been developed for feed and food analysis, the patented tubulin-based polymorphism (TBP) method emerges as an easy, versatile, and inexpensive diagnostic tool. Initially used to fingerprint different plant species and varieties, TBP was then successfully applied to trace species in mixtures of plant origin such as commercial feeds. TBP is a DNA-based molecular marker, that makes use of PCR for the selective amplification of plant β-tubulin introns. Amplified fragments are then separated by PAGE and visualized by silver staining. We have now developed an improved version of TBP. Based on capillary electrophoresis and fluorescence detection, it makes the method automatic, more sensible, reproducible, and faster. Compared to the classic TBP, this new version allows to obtain a better data resolution and an easier interpretation of the results, clearing the way to large-scale feed/food diagnostics. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Technical modifications for improving the success rate of PEG tube placement in patients with head and neck cancer.

    Science.gov (United States)

    Taller, A; Horvath, E; Iliás, L; Kótai, Z; Simig, M; Elö, J; Harsányi, L

    2001-11-01

    Patients with head and neck cancer (HNC) benefit from nutritional support by means of PEG tubes, but endoscopy may be impossible when there is partial or complete trismus and/or stenosis or occlusion of the upper aerodigestive tract. PEG tubes were placed in 277 patients with HNC. Oral insertion of an endoscope into the esophagus was impossible in 27 patients. Transnasal endoscopy was performed (n = 4). In the cases of high-grade tumor obstruction, the endoscope was introduced into the esophagus through a straight laryngoscope (n = 9). When upper aerodigestive tract occlusion was present, endoscopy with PEG placement was successfully performed during surgery by means of the opened pharynx after tumor resection (n = 12). In 25 of the 27 cases PEG tubes could be placed by using the above alternative techniques. There were no immediate complications, and no complications occurred within 30 days of PEG placement. Transnasal, straight laryngoscopic, or intraoperative open endoscopy can improve the success rate for PEG tube placement in patients with HNC.

  20. Technical note: Boundary layer height determination from lidar for improving air pollution episode modeling: development of new algorithm and evaluation

    Science.gov (United States)

    Yang, Ting; Wang, Zifa; Zhang, Wei; Gbaguidi, Alex; Sugimoto, Nobuo; Wang, Xiquan; Matsui, Ichiro; Sun, Yele

    2017-05-01

    Predicting air pollution events in the low atmosphere over megacities requires a thorough understanding of the tropospheric dynamics and chemical processes, involving, notably, continuous and accurate determination of the boundary layer height (BLH). Through intensive observations experimented over Beijing (China) and an exhaustive evaluation of existing algorithms applied to the BLH determination, persistent critical limitations are noticed, in particular during polluted episodes. Basically, under weak thermal convection with high aerosol loading, none of the retrieval algorithms is able to fully capture the diurnal cycle of the BLH due to insufficient vertical mixing of pollutants in the boundary layer associated with the impact of gravity waves on the tropospheric structure. Consequently, a new approach based on gravity wave theory (the cubic root gradient method: CRGM) is developed to overcome such weakness and accurately reproduce the fluctuations of the BLH under various atmospheric pollution conditions. Comprehensive evaluation of CRGM highlights its high performance in determining BLH from lidar. In comparison with the existing retrieval algorithms, CRGM potentially reduces related computational uncertainties and errors from BLH determination (strong increase of correlation coefficient from 0.44 to 0.91 and significant decreases of the root mean square error from 643 to 142 m). Such a newly developed technique is undoubtedly expected to contribute to improving the accuracy of air quality modeling and forecasting systems.

  1. Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists

    NARCIS (Netherlands)

    Timmers, L.; Boons, C.C.; Verbrugghe, M.; Bemt, B.J.F van den; Hecke, A. Van; Hugtenburg, J.G.

    2017-01-01

    BACKGROUND: Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the

  2. 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

  3. Flue gas conditioning for improved particle collection in electrostatic precipitators. Quarterly technical progress report, October 1--December 31, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Durham, M.D.

    1993-01-15

    It is concluded that the laboratory tests should be conducted at high levels of SO{sub 3} such that the resulting resistivity is in the range of 10{sup 7}--10{sup 8} ohm-cm. There are several reasons leading to this conclusion. At SO{sub 3} concentrations of 30 ppM and greater, the curves for both dew point and resistivity are relatively flat so that changes in gas phase SO{sub 3} will have minimal impact on particle characteristics. In addition, the electrostatic forces are relatively flat in this range so that changes in flue gas conditions will that result in a change in resistivity by up to two orders of magnitude will have little effect on the magnitude of reentrainment. Finally, at the very low resistivity conditions, reentrainment will be the highest. Since the purpose of the laboratory resistivity tests is to determine the relative ability of the various additives to reduce resistivity, the greater the reentrainment, the easier it will be to measure an improvement. Tests were conducted by first operating at baseline conditions with no additives and then repeating the test with additives. The data collected during each test includes the resistivity of the material, thickness of the collected dust layer, and subjective indications of the dust characteristics. The candidate additives were from the polymer group, cellulose derivatives, starches and gums, and oils. No waxes or synthetic compounds have been tested to date in the laboratory apparatus. Of the seventeen additives tested, eight appeared to have a positive impact on either the ash layer thickness or the physical appearance of the dust layer. Excessive deposits on the discharge electrode resulted during injection of some of the additives. Three of the additives resulted in significant deposits in the injection chamber. The build up on the electrode was interpreted as a positive indicator of increase particle adhesion. The initial observations and comments for the eight additives are listed in Table 1.

  4. Technical Note: Improved total atmospheric water vapour amount determination from near-infrared filter measurements with sun photometers

    Directory of Open Access Journals (Sweden)

    F. Mavromatakis

    2007-09-01

    Full Text Available In this work we explore the effect of the contribution of the solar spectrum to the recorded signal in wavelengths outside the typical 940-nm filter's bandwidth. We employ gaussian-shaped filters as well as actual filter transmission curves, mainly AERONET data, to study the implications imposed by the non-zero out-of-band contribution to the coefficients used to derive precipitable water from the measured water vapour band transmittance. Published parameterized transmittance functions are applied to the data to determine the filter coefficients. We also introduce an improved, three-parameter, fitting function that can describe the theoretical data accurately, with significantly less residual effects than with the existing functions. The moderate-resolution SMARTS radiative transfer code is used to predict the incident spectrum outside the filter bandpass for different atmospheres, solar geometries and aerosol optical depths. The high-resolution LBLRTM radiative transfer code is used to calculate the water vapour transmittance in the 940-nm band. The absolute level of the out-of-band transmittance has been chosen to range from 10−6 to 10−4, and typical response curves of commercially available silicon photodiodes are included into the calculations.

    It is shown that if the out-of-band transmittance effect is neglected, as is generally the case, then the derived columnar water vapour is mainly underestimated by a few percents. The actual error depends on the specific out-of-band transmittance, optical air mass of observation and water vapour amount. Further investigations will use experimental data from field campaigns to validate these findings.

  5. Technical note: High-performing swine herds improved their reproductive performance differently from ordinary herds for five years.

    Science.gov (United States)

    Koketsu, Y

    2007-11-01

    The objectives of this study were to determine changes in herd productivity and the performance of female pigs over time in commercial swine herds. Annual measurement data from 1999 to 2003 were obtained from the record files of 113 herds in Japan. Two groups were formed according to the 25th percentile of pigs weaned/mated females per year (PWMFY) in 2003; the 2 groups were high-performing herds (those constituting the top 25%) and the remaining ordinary herds. The effects of group based on PWMFY in 2003, year, and the group x year interaction on repeated measures between 1999 and 2003 were analyzed by using mixed-effects models. A regression analysis was also used to compare key measurements in productivity between the 2 groups, with years as a continuous variable. Variance components were obtained to determine herd repeatability of PWMFY for the 2 herd groups. The average female inventory increased from 290 +/- 31 to 355 +/- 42 females for these 5 yr. The PWMFY also changed from 20.9 +/- 0.21 to 21.2 +/- 0.30 pigs. An interaction between year and group was detected (P pigs each year, whereas the ordinary herds did not increase. The number of pigs weaned per sow increased by 0.07 +/- 0.02 pigs each year in high-performing herds and increased by 0.03 +/- 0.01 pigs each year in ordinary herds. In high-performing herds, for each year, the percentage of sows mated by 7 d after weaning increased by 0.92 +/- 0.25%, the percentage of reserviced females decreased by 0.63 +/- 0.26%, and culling rate increased by 1.53 +/- 0.50%. Repeatability of PWMFY for high-performing herds and ordinary herds was 28.8 and 54.0%, respectively. This study shows that productivity in high-performing herds was improved compared with that of ordinary herds.

  6. Porcine liver decellularization under oscillating pressure conditions: a technical refinement to improve the homogeneity of the decellularization process.

    Science.gov (United States)

    Struecker, Benjamin; Hillebrandt, Karl Herbert; Voitl, Robert; Butter, Antje; Schmuck, Rosa B; Reutzel-Selke, Anja; Geisel, Dominik; Joehrens, Korinna; Pickerodt, Philipp A; Raschzok, Nathanael; Puhl, Gero; Neuhaus, Peter; Pratschke, Johann; Sauer, Igor M

    2015-03-01

    vascular (portal vein and hepatic artery) and biliary framework. In summary, the presented protocol for pig liver decellularization is quick (7 h) and effective. The application of oscillating pressure conditions improves the homogeneity of perfusion and thus the outcome of the decellularization process.

  7. Simulated Conversations With Virtual Humans to Improve Patient-Provider Communication and Reduce Unnecessary Prescriptions for Antibiotics: A Repeated Measure Pilot Study.

    Science.gov (United States)

    Schoenthaler, Antoinette; Albright, Glenn; Hibbard, Judith; Goldman, Ron

    2017-04-19

    Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics. However, most patients and providers do not feel prepared to engage in such challenging conversations. The aim of this pilot study was to assess the ability of a brief 15-min simulated role-play conversation with virtual humans to serve as a preliminary step to help health care providers and patients practice, and learn how to engage in effective conversations about antibiotics overuse. A total of 69 participants (35 providers and 34 patients) completed the simulation once in one sitting. A pre-post repeated measures design was used to assess changes in patients' and providers' self-reported communication behaviors, activation, and preparedness, intention, and confidence to effectively communicate in the patient-provider encounter. Changes in patients' knowledge and beliefs regarding antibiotic use were also evaluated. Patients experienced a short-term positive improvement in beliefs about appropriate antibiotic use for infection (F1,30=14.10, P=.001). Knowledge scores regarding the correct uses of antibiotics improved immediately postsimulation, but decreased at the 1-month follow-up (F1,30=31.16, Pchange in patient activation and shared decision-making (SDM) scores in the total sample of patients (P>.10) Patients with lower levels of activation exhibited positive, short-term benefits in increased intent and confidence to discuss their needs

  8. Magnetic resonance-derived circumferential strain provides a superior and incremental assessment of improvement in contractile function in patients early after ST-segment elevation myocardial infarction.

    Science.gov (United States)

    Wong, Dennis T L; Leong, Darryl P; Weightman, Michael J; Richardson, James D; Dundon, Benjamin K; Psaltis, Peter J; Leung, Michael C H; Meredith, Ian T; Worthley, Matthew I; Worthley, Stephen G

    2014-06-01

    We evaluate whether circumferential strain derived from grid-tagged CMR is a better method for assessing improvement in segmental contractile function after STEMI compared to late gadolinium enhancement (LGE). STEMI patients post primary PCI underwent baseline CMR (day 3) and follow-up (day 90). Cine, grid-tagged and LGE images were acquired. Baseline LGE infarct hyperenhancement was categorised as ≤25 %, 26-50 %, 51-75 % and >75 % hyperenhancement. The segmental baseline circumferential strain (CS) and circumferential strain rate (CSR) were calculated from grid-tagged images. Segments demonstrating an improvement in wall motion of ≥1 grade compared to baseline were regarded as having improved segmental contractile-function. Forty-five patients (aged 58 ± 12 years) and 179 infarct segments were analysed. A baseline CS cutoff of -5 % had sensitivity of 89 % and specificity of 70 % for detection of improvement in segmental-contractile-function. On receiver-operating characteristic analysis for predicting improvement in contractile function, AUC for baseline CS (0.82) compared favourably to LGE hyperenhancement (0.68), MVO (0.67) and baseline-CSR (0.74). On comparison of AUCs, baseline CS was superior to LGE hyperenhancement and MVO in predicting improvement in contractile function (P improvement in segmental contractile function (P improvement in segmental contractile function, providing incremental value when added to LGE hyperenhancement and MVO following STEMI. Baseline CS predicts contractile function recovery better than LGE and MVO following STEMI. Baseline CS predicts contractile function recovery better than baseline CSR following STEMI. Baseline CS provides incremental value to LGE and MVO following STEMI.

  9. 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...

  10. 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

  11. 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...

  12. Improving the quality of paediatric malaria diagnosis and treatment by rural providers in Myanmar: an evaluation of a training and support intervention.

    Science.gov (United States)

    Aung, Tin; Longfield, Kim; Aye, Nyo Me; San, Aung Kyaw; Sutton, Thea S; Montagu, Dominic

    2015-10-09

    This study evaluates the effectiveness of a training programme for improving the diagnostic and treatment quality of the most complex service offered by Sun Primary Health (SPH) providers, paediatric malaria. The study further assesses whether any quality improvements were sustained over the following 12 months. The study took place in 13 townships in central Myanmar between January 2011 and October 2012. A total of 251 community health workers were recruited and trained in the provision of paediatric and adult malaria diagnosis and treatment; 197 were surveyed in all three rounds: baseline, 6 and 12 months. Townships were selected based on a lack of alterative sources of medical care, averaging 20 km from government or private professional health care treatment facilities. Seventy percent of recruits were assistant nurse midwives or had other basic health training; the rest had no health training experience. Recruits were evaluated on their ability to properly diagnosis and treat a simulated 5-year-old patient using a previously validated method known as Observed Simulated Patient. A trained observer scored SPH providers on a scale of 1-100, based on WHO and Myanmar MOH established best practices. During a pilot test, 20 established private physicians operating in malaria-endemic areas of Myanmar scored an average of 70/100. Average quality scores of newly recruited SPH providers prior to training (baseline) were 12/100. Six months after training, average quality scores were 48/100. This increase was statistically significant (p training, providers were retested and average quality scores were 45/100 (R3-R1, p training programme was able to improve the quality of paediatric malaria care significantly, and to maintain that improvement over time. Quality of care remains lower than that of trained physicians; however, SPH providers operate in rural areas where no trained physicians operate. More research is needed to establish acceptable and achievable levels of

  13. Efficiency and technical change in the Western Australian wheatbelt

    OpenAIRE

    Cattle, Nathan; White, Benedict

    2007-01-01

    The production performance of wheatbelt farms in Western Australia is analysed to determine whether potential to exploit scale economies and improve technical efficiency has driven the trend towards increased farm size. An input-orientated stochastic frontier model is used to estimate technical efficiency and scale economies using an unbalanced panel dataset provided by BankWest for the period 1995/1996 to 2005/2006. Differences in the relative efficiency of farms are explored by the simultan...

  14. Social media: opportunities for quality improvement and lessons for providers-a networked model for patient-centered care through digital engagement.

    Science.gov (United States)

    Bornkessel, Alexandra; Furberg, Robert; Lefebvre, R Craig

    2014-07-01

    Social media brings a new dimension to health care for patients, providers, and their support networks. Increasing evidence demonstrates that patients who are more actively involved in their healthcare experience have better health outcomes and incur lower costs. In the field of cardiology, social media are proposed as innovative tools for the education and update of clinicians, physicians, nurses, and medical students. This article reviews the use of social media by healthcare providers and patients and proposes a model of "networked care" that integrates the use of digital social networks and platforms by both patients and providers and offers recommendations for providers to optimize their use and understanding of social media for quality improvement.

  15. Patients' and providers' perspectives of a polypill strategy to improve cardiovascular prevention in Australian primary health care: a qualitative study set within a pragmatic randomized, controlled trial.

    Science.gov (United States)

    Liu, Hueiming; Massi, Luciana; Laba, Tracey-Lea; Peiris, David; Usherwood, Tim; Patel, Anushka; Cass, Alan; Eades, Anne-Marie; Redfern, Julie; Hayman, Noel; Howard, Kirsten; Brien, Jo-anne; Jan, Stephen

    2015-05-01

    This study explores health provider and patient attitudes toward the use of a cardiovascular polypill as a health service strategy to improve cardiovascular prevention. In-depth, semistructured interviews (n=94) were conducted with health providers and patients from Australian general practice, Aboriginal community-controlled and government-run Indigenous Health Services participating in a pragmatic randomized controlled trial evaluating a polypill-based strategy for high-risk primary and secondary cardiovascular disease prevention. Interview topics included polypill strategy acceptability, factors affecting adherence, and trial implementation. Transcribed interview data were analyzed thematically and interpretively. Polypill patients commented frequently on cost-savings, ease, and convenience of a daily-dosing pill. Most providers considered a polypill strategy to facilitate improved patient medication use. Indigenous Health Services providers and indigenous patients thought the strategy acceptable and beneficial for indigenous patients given the high disease burden. Providers noted the inflexibility of the fixed dose regimen, with dosages sometimes inappropriate for patients with complex management considerations. Future polypill formulations with varied strengths and classes of medications may overcome this barrier. Many providers suggested the polypill strategy, in its current formulations, might be more suited to high-risk primary prevention patients. The polypill strategy was generally acceptable to patients and providers in cardiovascular prevention. Limitations to provider acceptability of this particular polypill were revealed, as was a perception it might be more suitable for high-risk primary prevention patients, though future combinations could facilitate its use in secondary prevention. Participants suggested a polypill-based strategy as particularly appropriate for lowering the high cardiovascular burden in indigenous populations. URL: http

  16. 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.

  17. 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

  18. 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.

  19. 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 training level. Although the magnitude of improvement was comparable, the mean compliance score was highest in year 2 at 81% (year 1: 72% [P = 0.019] and year 3: 70% [P = 0.002]). Fellows expressed a high degree of satisfaction with the educational intervention and emphasized the value in reviewing the conceptual 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.

  20. 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

  1. Final technical report DOE award DE-SC0007206 Improving CESM Efficiency to Study Variable C:N:P Stoichiometry in the Oceans

    Energy Technology Data Exchange (ETDEWEB)

    Primeau, Francois William [Univ. of California, Irvine, CA (United States)

    2016-02-11

    This report lists the accomplishments of the project, which includes: (1) analysis of inorganic nutrient concentration data as well as suspended particulate organic matter data in the ocean to demonstrate that the carbon to nitrogen to phosphorus ratios (C:N:P) of biological uptake and export vary on large spatial scales, (2) the development of a new computationally efficient method for simulating biogeochemical tracers in earth system models, (3) the application of the method to help calibrate an improved representation of dissolved organic matter in the ocean that includes variable C:N:P stoichiometry. This research is important because biological uptake of carbon and nutrients in the upper ocean and export by sinking particles and downward mixing of dissolved organic matter helps maintain a vertical gradient in the carbon dioxide concentration in the ocean. This gradient is key to understanding the partitioning of CO2 between the ocean and the atmosphere. The final report lists seven peer reviewed scientific publications, one Ph.D. thesis, one technical report and two papers in preparation.

  2. 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 %.

  3. 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

  4. 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.

  5. 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....

  6. 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...

  7. 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.

  8. Research in Technical Communication. A Bibliographic Sourcebook.

    Science.gov (United States)

    Moran, Michael G., Ed.; Journet, Debra, Ed.

    The essays in this volume enunciate the pressing need for a theoretical framework for the study of technical communication. The first part of the volume provides an overview of extensive ways to study technical communication. Subsequent chapters discuss humanistic approaches to technical communication, the history of technical communication,…

  9. Use of a Tablet-Based Risk Assessment Program to Improve Health Counseling and Patient-Provider Relationships in a Federally Qualified Health Center.

    Science.gov (United States)

    Diaz, Vanessa A; Mainous, Arch G; Gavin, Jennifer K; Player, Marty S; Wright, Robert U

    2016-09-01

    This study evaluates the impact of an interactive, tablet-based lifestyle behavior questionnaire prior to a patient's primary care visit on counseling for health behaviors and patient-provider relationships. Using a quasi-experimental design at 2 federally qualified health centers, adults aged 18 to 35 years were asked to complete a tablet-based assessment about nutrition, physical activity, weight, smoking status, and alcohol use to identify unhealthy behaviors and their desire to discuss them with their provider. In the intervention group, participants were more likely to trust their providers (83% vs 71%, P = .0427) and feel that their provider cared about their health (80% vs 68%, P = .0468). Overweight/obese individuals were more likely to discuss weight loss with their doctor (59% vs 33%, P = .0088). Integrating information technology into primary care to encourage providers to discuss lifestyle issues and promote a positive patient-provider relationship may help improve the health promotion in primary care practices. © The Author(s) 2015.

  10. An Evidence-Based Alcohol Screening, Brief Intervention and Referral to Treatment (SBIRT) Curriculum for Emergency Department (ED) Providers Improves Skills and Utilization

    Science.gov (United States)

    Bernstein, Edward; Bernstein, Judith; Feldman, James; Fernandez, William; Hagan, Melissa; Mitchell, Patricia; Safi, Clara; Woolard, Robert; Mello, Mike; Baird, Janette; Lee, Cristina; Bazargan-Hejazi, Shahrzad; Broderick, Kerry; LaPerrier, Kathryn A.; Kellermann, Arthur; Wald, Marlena M.; Taylor, Robert E.; Walton, Kim; Grant-Ervin, Michelle; Rollinson, Denise; Edwards, David; Chan, Theodore; Davis, Dan; Marshall, Jean Buchanan; Aseltine, Robert; James, Amy; Abu-Hasaballah, Khamis; Schilling, Elizabeth; Baumann, Brigitte M.; Boudreaux, Edwin D.; Maio, Ronald; Cunningham, Rebecca; Murrell, Teresa; Doezema, David; Bauer, Michael J.; Anglin, Deirdre; Eliassen, Adriana; Martin, Marcus; Pines, Jesse; Buchanan, Leslie; Turner, James; D'Onofrio, Gail; Degutis, Linda C.; Owens, Patricia

    2014-01-01

    SUMMARY Objective Emergency Departments (EDs) offer an opportunity to improve the care of patients with at-risk and dependent drinking by teaching staff to screen, perform brief intervention and refer to treatment (SBIRT). We describe here the implementation at 14 Academic EDs of a structured SBIRT curriculum to determine if this learning experience improves provider beliefs and practices. Methods ED faculty, residents, nurses, physician extenders, social workers, and Emergency Medical Technicians (EMTs) were surveyed prior to participating in either a two hour interactive workshops with case simulations, or a web-based program (www.ed.bmc.org/sbirt). A pre-post repeated measures design assessed changes in provider beliefs and practices at three and 12 months post-exposure. Results Among 402 ED providers, 74% reported < 10 hours of prior professional alcohol-related education and 78% had < 2 hours exposure in the previous year. At 3-month follow-up, scores for self-reported confidence in ability, responsibility to intervene, and actual utilization of SBIRT skills all improved significantly over baseline. Gains decreased somewhat at 12 months, but remained above baseline. Length of time in practice was positively associated with SBIRT utilization, controlling for gender, race and type of profession. Persistent barriers included time limitations and lack of referral resources. Conclusions ED providers respond favorably to SBIRT. Changes in utilization were substantial at three months post-exposure to a standardized curriculum, but less apparent after 12 months. Booster sessions, trained assistants and infrastructure supports may be needed to sustain changes over the longer term. PMID:18077305

  11. Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions

    Directory of Open Access Journals (Sweden)

    Smarth Carole

    2006-04-01

    Full Text Available Abstract Background Despite awareness of inequities in health care quality, little is known about strategies that could improve the quality of healthcare for ethnic minority populations. We conducted a systematic literature review and analysis to synthesize the findings of controlled studies evaluating interventions targeted at health care providers to improve health care quality or reduce disparities in care for racial/ethnic minorities. Methods We performed electronic and hand searches from 1980 through June 2003 to identify randomized controlled trials or concurrent controlled trials. Reviewers abstracted data from studies to determine study characteristics, results, and quality. We graded the strength of the evidence as excellent, good, fair or poor using predetermined criteria. The main outcome measures were evidence of effectiveness and cost of strategies to improve health care quality or reduce disparities in care for racial/ethnic minorities. Results Twenty-seven studies met criteria for review. Almost all (n = 26 took place in the primary care setting, and most (n = 19 focused on improving provision of preventive services. Only two studies were designed specifically to meet the needs of racial/ethnic minority patients. All 10 studies that used a provider reminder system for provision of standardized services (mostly preventive reported favorable outcomes. The following quality improvement strategies demonstrated favorable results but were used in a small number of studies: bypassing the physician to offer preventive services directly to patients (2 of 2 studies favorable, provider education alone (2 of 2 studies favorable, use of a structured questionnaire to assess adolescent health behaviors (1 of 1 study favorable, and use of remote simultaneous translation (1 of 1 study favorable. Interventions employing more than one main strategy were used in 9 studies with inconsistent results. There were limited data on the costs of these

  12. 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

  13. 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

  14. Assessment of the impact of quality improvement interventions on the quality of sick child care provided by Health Extension Workers in Ethiopia.

    Science.gov (United States)

    Miller, Nathan P; Amouzou, Agbessi; Hazel, Elizabeth; Legesse, Hailemariam; Degefie, Tedbabe; Tafesse, Mengistu; Black, Robert E; Bryce, Jennifer

    2016-12-01

    Ethiopia has scaled up integrated community case management of childhood illness (iCCM), including several interventions to improve the performance of Health Extension Workers (HEWs). We assessed associations between interventions to improve iCCM quality of care and the observed quality of care among HEWs. We assessed iCCM implementation strength and quality of care provided by HEWs in Ethiopia. Multivariate logistic regression analyses were performed to assess associations between interventions to improve iCCM quality of care and correct management of iCCM illnesses. Children who were managed by an HEW who had attended a performance review and clinical mentoring meeting (PRCMM) had 8.3 (95% confidence interval (CI) 2.34-29.51) times the odds of being correctly managed, compared to children managed by an HEW who did not attend a PRCMM. Management by an HEW who received follow-up training also significantly increased the odds of correct management (odds ratio (OR) = 2.09, 95% CI 1.05-4.18). Supervision on iCCM (OR = 0.63, 95% CI 0.23-1.72) did not significantly affect the odds of receiving correct care. These results suggest PRCMM and follow-up training were effective interventions, while implementation of supportive supervision needs to be reviewed to improve impact.

  15. 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)

  16. 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.

  17. Creating a “Wellness Pathway” between health care providers and community-based organizations to improve the health of older adults

    Directory of Open Access Journals (Sweden)

    Maria A. Han, MD, MSHPM

    2015-12-01

    Full Text Available To effectively manage the health of older high-risk patients, health care organizations need to adopt strategies that go beyond the doctor's office and into patients' homes and communities. Community-based organizations (CBOs are important underutilized partners in activating and providing the resources necessary to deliver coordinated, culturally-tailored services to older individuals. This paper describes the process and preliminary results of creating and implementing a “Wellness Pathway” to improve the health of older individuals by coordinating care between health care providers and CBOs, such as senior centers. The Wellness Pathway provides a mechanism whereby health care providers refer patients to programs at the senior center, and senior center staff members refer patients for urgent or primary care services at the health care provider organization. The aim of the project was to determine whether the creation of the Wellness Pathway through the health care provider and CBO education and engagement is feasible and to identify challenges in scalability. During the 6 month study period, 25 patients were referred through the Wellness Pathway, and six patients acted on the referral. Stakeholders at both organizations were interviewed to obtain detailed information regarding their experiences with, and perceptions of, the Wellness Pathway. Patients and providers who participated in the pilot believe that it has the potential to positively impact the health of older patients and is worth continuing. The primary challenges that arose in the implementation of the Wellness Pathway resulted from inadequate levels of health care provider and staff engagement and from lagging patient recruitment.

  18. Understanding integrated mental health care in "real-world" primary care settings: What matters to health care providers and clients for evaluation and improvement?

    Science.gov (United States)

    Ion, Allyson; Sunderji, Nadiya; Jansz, Gwen; Ghavam-Rassoul, Abbas

    2017-09-01

    The integration of mental health specialists into primary care has been widely advocated to deliver evidence-based mental health care to a defined population while improving access, clinical outcomes, and cost efficiency. Integrated care has been infrequently and inconsistently translated into real-world settings; as a result, the key individual components of effective integrated care remain unclear. This article reports findings from a qualitative study that explored provider and client experiences of integrated care. We conducted in-depth interviews with integrated care providers (n = 13) and clients (n = 9) to understand their perspectives and experiences of integrated care including recommended areas for quality measurement and improvement. The authors used qualitative content and reflexive thematic analytic approaches to synthesize the interview data. Clients and integrated care providers agreed regarding the overarching concepts of the what, how, and why of integrated care including co-location of care; continuity of care; team composition and functioning; client centeredness; and comprehensive care for individuals and populations. Providers and clients proposed a number of dimensions that could be the focus for quality measurement and evaluation, illuminating what is needed for successful context-sensitive spreading and scaling of integrated care interventions. With a mounting gap between the empirical support for integrated care approaches and the implementation of these models, there is a need to clarify the aims of integrated care and the key ingredients required for widespread implementation outside of research settings. This study has important implications for future integrated care research, and health care provider and client engagement in the quality movement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. A study of new referrals to a menopause clinic and their initial outcomes: how can we improve the service we provide?

    Science.gov (United States)

    Liddiard, Andrea; Bain, Christine

    2010-09-01

    This retrospective case-note study was performed to examine the ways in which an already established menopause clinic could improve service to its patients. The management of 151 patients was examined. Most were referred by their general practitioner and the most common reason for referral was to seek an alternative to hormone replacement therapy (HRT). The consultant saw 17% of the patients, and with the trainee was most likely to discharge the patient. Better information on alternatives to HRT, more consultant input and better use of telephone consultation for follow-up would enhance the service provided by the menopause clinic.

  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 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...

  2. 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...

  3. Supporting adherence to oral anticancer agents: clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists.

    Science.gov (United States)

    Timmers, Lonneke; Boons, Christel C L M; Verbrugghe, Mathieu; van den Bemt, Bart J F; Van Hecke, Ann; Hugtenburg, Jacqueline G

    2017-02-10

    Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the management of medication adherence. A cross-sectional, observational study among HCPs in (haemato-)oncology settings in Belgium and the Netherlands was conducted in 2014 using a composite questionnaire. A total of 47 care activities were listed and categorised into eight domains. HCPs were also asked about their perceptions of adherence management on the items: insight into adherence, patients' communication, capability to influence, knowledge of consequences and insight into causes. Validated questionnaires were used to assess beliefs about medication (BMQ) and shared decision making (SDM-Q-doc). In total, 208 HCPs (29% male) participated; 107 from 51 Dutch and 101 from 26 Belgian hospitals. Though a wide range of activities were reported, certain domains concerning medication adherence management received less attention. Activities related to patient knowledge and adverse event management were reported most frequently, whereas activities aimed at patient's self-efficacy and medication adherence during ongoing use were frequently missed. The care provided differed between professions and by country. Belgian physicians reported more activities than Dutch physicians, whereas Dutch nurses and pharmacists reported more activities than Belgian colleagues. The perceptions of medication adherence management were related to the level of care provided by HCPs. SDM and BMQ outcomes were not related to the care provided. Enhancing the awareness and perceptions of medication adherence management of HCPs is likely to have a positive effect on care quality. Care can be improved by addressing medication adherence more directly e.g., by questioning patients about (expected) barriers and discussing

  4. 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...

  5. Integration of Provider, Pharmacy, and Patient-Reported Data to Improve Medication Adherence for Type 2 Diabetes: A Controlled Before-After Pilot Study.

    Science.gov (United States)

    Dixon, Brian E; Alzeer, Abdullah H; Phillips, Erin O'Kelly; Marrero, David G

    2016-02-08

    Patients with diabetes often have poor adherence to using medications as prescribed. The reasons why, however, are not well understood. Furthermore, most health care delivery processes do not routinely assess medication adherence or the factors that contribute to poor adherence. The objective of the study was to assess the feasibility of an integrated informatics approach to aggregating and displaying clinically relevant data with the potential to identify issues that may interfere with appropriate medication utilization and facilitate patient-provider communication during clinical encounters about strategies to improve medication use. We developed a clinical dashboard within an electronic health record (EHR) system that uses data from three sources: the medical record, pharmacy claims, and a patient portal. Next, we implemented the dashboard into three community health centers. Health care providers (n=15) and patients with diabetes (n=96) were enrolled in a before-after pilot to test the system's impact on medication adherence and clinical outcomes. To measure adherence, we calculated the proportion of days covered using pharmacy claims. Demographic, laboratory, and visit data from the EHR were analyzed using pairwise t tests. Perceived barriers to adherence were self-reported by patients. Providers were surveyed about their use and perceptions of the clinical dashboard. Adherence significantly and meaningfully improved (improvements ranged from 6%-20%) consistently across diabetes as well as cardiovascular drug classes. Clinical outcomes, including HbA1c, blood pressure, lipid control, and emergency department utilization remained unchanged. Only a quarter of patients (n=24) logged into the patient portal and completed psychosocial questionnaires about their barriers to taking medications. Integrated approaches using advanced EHR, clinical decision support, and patient-controlled technologies show promise for improving appropriate medication use and supporting

  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. Mechanical engineering department technical review

    Energy Technology Data Exchange (ETDEWEB)

    Carr, R.B. Denney, R.M. (eds.)

    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.

  8. 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

  9. Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis

    Directory of Open Access Journals (Sweden)

    Okumura LM

    2016-09-01

    Full Text Available Background: Computerized Provider Order Entry (CPOE and Clinical Decision Support System (CDSS help practitioners to choose evidence-based decisions, regarding patients’ needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. Objective: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing. Methods: This is a cross-sectional study that compared two different scenarios: one prior CPOE/CDSS versus after software implementation. We conducted twelve years of data analysis (3 years prior and 9 years after CDSS implementation, where main outcomes from this study included: cefazolin Defined Daily Doses/100 bed-days (DDD, crude costs and product of costs-DDD (cost-DDD/100 bed-days. We applied a Spearman rho non-parametric test to assess the reduction of cefazolin consumption through the years. Results: In twelve years, 84,383 vials of cefazolin were dispensed and represented 38.89 DDD/100 bed-days or USD 44,722.99. Surgical wards were the largest drug prescribers and comprised >95% of our studied sample. While in 2002, there were 6.31 DDD/100 bed-days, 9 years later there was a reduction to 2.15 (p<0.05. In a scenario without CDSS, the hospital would have consumed 75.72 DDD/100 bed-days, which is equivalent to USD 116 998.07. It is estimated that CDSS provided USD 50,433.39 of cost savings. Conclusion: The implementation of a CPOE/CDSS helped to improve prophylactic cefazolin use by reducing its consumption and estimated direct costs.

  10. 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

  11. 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

  12. A novel fed-batch based cultivation method provides high cell-density and improves yield of soluble recombinant proteins in shaken cultures

    Science.gov (United States)

    2010-01-01

    Background Cultivations for recombinant protein production in shake flasks should provide high cell densities, high protein productivity per cell and good protein quality. The methods described in laboratory handbooks often fail to reach these goals due to oxygen depletion, lack of pH control and the necessity to use low induction cell densities. In this article we describe the impact of a novel enzymatically controlled fed-batch cultivation technology on recombinant protein production in Escherichia coli in simple shaken cultures. Results The enzymatic glucose release system together with a well-balanced combination of mineral salts and complex medium additives provided high cell densities, high protein yields and a considerably improved proportion of soluble proteins in harvested cells. The cultivation method consists of three steps: 1) controlled growth by glucose-limited fed-batch to OD600 ~10, 2) addition of growth boosters together with an inducer providing efficient protein synthesis within a 3 to 6 hours period, and 3) a slow growth period (16 to 21 hours) during which the recombinant protein is slowly synthesized and folded. Cell densities corresponding to 10 to 15 g l-1 cell dry weight could be achieved with the developed technique. In comparison to standard cultures in LB, Terrific Broth and mineral salt medium, we typically achieved over 10-fold higher volumetric yields of soluble recombinant proteins. Conclusions We have demonstrated that by applying the novel EnBase® Flo cultivation system in shaken cultures high cell densities can be obtained without impairing the productivity per cell. Especially the yield of soluble (correctly folded) proteins was significantly improved in comparison to commonly used LB, Terrific Broth or mineral salt media. This improvement is thought to result from a well controlled physiological state during the whole process. The higher volumetric yields enable the use of lower culture volumes and can thus significantly reduce

  13. Final Technical Report

    International Development Research Centre (IDRC) Digital Library (Canada)

    Tommy Ngai

    2014-03-31

    Mar 31, 2014 ... capacity building activities) to upgrade the technical and management capacities of governments and NGOs .... Furthermore, as described in the original proposal, CAWST provided practical perspectives in ..... when a funder or manager refuses to include important and central issues in the evaluation.

  14. Specific features of the structure of a technical and tactical arsenal of Non-Olympic single combats of an impact type and a way of its improvement

    Directory of Open Access Journals (Sweden)

    Volodymyr Ashanin

    2015-02-01

    Full Text Available Purpose: identify key differences in technical operations and tactical combat potential ways to implement popular athletes in combat shock type, applying for entry into the Olympic Games. Material and Methods: distinctions of sports technique and tactics in duels in karate, taekwondo, kickboxing and Thai boxing were estimated by the expert group. The arsenal of technical and tactical actions of sportsmen was analyzed at competitions of various levels. Results: essential distinctions in competitive exercises, estimated criteria of refereeing, the structure and the arsenal of the applied sports technique and tactics are revealed in chosen for the research types of impact single combats. Conclusions: essential differences in the technical - tactical arsenal of the studied types of impact single combats which are shown in the topography of zones allowed for drawing, the structure of attacking and protective actions, and also tactical stylistics of carrying out duels.

  15. 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 ...

  16. 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 ...

  17. 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...

  18. Care coordination between specialty care and primary care: a focus group study of provider perspectives on strong practices and improvement opportunities

    Directory of Open Access Journals (Sweden)

    Kim B

    2015-01-01

    Full Text Available Bo Kim,1,2 Michelle A Lucatorto,3 Kara Hawthorne,4 Janis Hersh,5 Raquel Myers,6 A Rani Elwy,1,7 Glenn D Graham81Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial VA Hospital, Bedford, 2Department of Psychiatry, Harvard Medical School, Boston, MA, 3Office of Nursing Services, Department of Veterans Affairs, 4Chief Business Office, Purchased Care, Washington, DC, 5New England Veterans Engineering Resource Center, Boston, MA, 6SJ Quinney College of Law, University of Utah, Salt Lake City, UT, 7Department of Health Policy and Management, Boston University School of Public Health, Boston, MA, 8Specialty Care Services (10P4E, Department of Veterans Affairs, Washington, DC, USAAbstract: Care coordination between the specialty care provider (SCP and the primary care provider (PCP is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1 what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2 how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts

  19. Health service provider education and/or training in infant male circumcision to improve short- and long-term morbidity outcomes: protocol for systematic review.

    Science.gov (United States)

    Gyan, Thomas; Strobel, Natalie; McAuley, Kimberley; Shannon, Caitlin; Newton, Sam; Tawiah-Agyemang, Charlotte; Amenga-Etego, Seeba; Owusu-Agyei, Seth; Forbes, David; Edmond, Karen

    2016-03-01

    There has been an expansion of circumcision services in Africa as part of a long-term HIV prevention strategy. However, the effect of infant male circumcision on morbidity and mortality still remains unclear. Acute morbidities associated with circumcision include pain, bleeding, swelling, infection, tetanus or inadequate skin removal. Scale-up of circumcision services could lead to a rise in these associated morbidities that could have significant impact on health service delivery and the safety of infants. Multidisciplinary training programmes have been developed to improve skills of health service providers, but very little is known about the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. This review aims to evaluate the effectiveness of health service provider education and/or training for infant male circumcision on short- and long-term morbidity outcomes. The review will include studies comparing health service providers who have received education and/or training to improve their skills for infant male circumcision with those who have not received education and/or training. Randomised controlled trials (RCTs) and cluster RCTs will be included. The outcomes of interest are short-term morbidities of the male infant including pain, infection, tetanus, bleeding, excess skin removal, glans amputation and fistula. Long-term morbidities include urinary tract infection (UTI), HIV infection and abnormalities of urination. Databases such as MEDLINE (OVID), PsycINFO (OVID), EMBASE (OVID), CINAHL, Cochrane Library (including CENTRAL and DARE), WHO databases and reference list of papers will be searched for relevant articles. Study selection, data extraction and synthesis and risk of bias assessment using the Cochrane risk of bias assessment tool will be conducted. We will calculate the pooled estimates of the difference in means and risk ratios using random effects models. If

  20. 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.

  1. 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.

  2. Hyaluronic Acid Filler Injections Under the Metatarsal Heads Provide a Significant and Long-Lasting Improvement in Metatarsalgia From Wearing High-Heeled Shoes.

    Science.gov (United States)

    Foumenteze, Jean Paul; Simpson, Helen; Kerrouche, Nabil

    2018-01-22

    Metatarsalgia is a common overuse injury that may be caused by wearing high-heeled shoes. To evaluate the decrease in metatarsalgia using a hyaluronic acid dermal filler. A 6-month, open study was conducted in 15 subjects with metatarsalgia because of regularly wearing high-heeled shoes. Hyaluronic acid (20 mg/mL) with lidocaine hydrochloride (3 mg/mL) was injected under the metatarsal heads at baseline. Pain (on a 0-10 scale) under the metatarsal heads when walking in high heels was recorded in a weekly subject diary. At 6 months after injections, 5 subjects (33.3%) reported no metatarsalgia pain. For subjects with pain, they were able to wear high heels for significantly longer than before the injections (7.2 hours at 6 months vs 3.4 hours at baseline). Significant improvements from baseline were observed at Month 6 for time to onset of pain (3.5 hours longer), time between onset of pain and intolerable pain (1.9 hours longer), and pain sensation (-2.2 grades at onset and -3.8 grades at shoe removal). No adverse events were reported. Injection of hyaluronic acid filler to the forefeet provided a significant effective, long-lasting, and well-tolerated improvement in metatarsalgia because of wearing high-heeled shoes.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  3. KSC Technical Capabilities Website

    Science.gov (United States)

    Nufer, Brian; Bursian, Henry; Brown, Laurette L.

    2010-01-01

    This document is the website pages that review the technical capabilities that the Kennedy Space Center (KSC) has for partnership opportunities. The purpose of this information is to make prospective customers aware of the capabilities and provide an opportunity to form relationships with the experts at KSC. The technical capabilities fall into these areas: (1) Ground Operations and Processing Services, (2) Design and Analysis Solutions, (3) Command and Control Systems / Services, (4) Materials and Processes, (5) Research and Technology Development and (6) Laboratories, Shops and Test Facilities.

  4. The Digital technical documentation handbook

    CERN Document Server

    Schultz, Susan I; Kavanagh, Frank X; Morse, Marjorie J

    1993-01-01

    The Digital Technical Documentation Handbook describes the process of developing and producing technical user information at Digital Equipment Corporation. * Discusses techniques for making user information _more effective * Covers the draft and reviewprocess, the production and distribution of printed and electronic media, archiving, indexing, testing for usability, and many other topics * Provides quality assurance checklists, contains a glossary and a bibliography of resources for technicalcommunicators

  5. 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

  6. 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

  7. 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

    Introduction 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. Objective To share knowledge and experience between an international center of excellence in pediatric cardiac surgery and a related program in Brazil. Methods 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. Results Professionals specialized in care provided to the mentioned population had the opportunity to share to the knowledge conveyed. Conclusion 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. PMID:24896168

  8. 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.

  9. Positive Student Attitudes Toward CTE (Career and Technical Education)

    Science.gov (United States)

    Gaunt, Dave; Palmer, Louann Bierlein

    2005-01-01

    Previous research has indicated that Career and Technical Education (CTE) has an image problem due to the perception that it provides poor quality education for the worst students, but little research has been done to ascertain how national, state, and local efforts to improve this image might be paying off. This paper reports the results of a…

  10. 2011 Residential Energy Efficiency Technical Update Meeting Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2011-11-01

    This report provides an overview of the U.S. Department of Energy Building America program's Summer 2011 Residential Energy Efficiency Technical Update Meeting. This meeting was held on August 9-11, 2011, in Denver, Colorado, and brought together more than 290 professionals representing organizations with a vested interest in energy efficiency improvements in residential buildings.

  11. The Application of Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis for Managing Vocational and Technical Education (VTE) Programmes for Improved Efficiency in Nigeria

    Science.gov (United States)

    Adepoju, T. L.; Famade, Olu Adesola

    2010-01-01

    This paper reviews the current status of vocational and technical education programmes (VTE) in Nigeria and the major innovations of the Nigerian Government in the recent times in the sector vis-a-vis the demands of the modern world for vocational and technological development. It therefore, proposes a paradigm shift in the operation of VTE…

  12. The Quest for Continuous Improvement: A Qualitative Study on Diffusion of Outcomes Assessment among Career and Technical Education Faculty Members at Rocky Mountain States Community Colleges

    Science.gov (United States)

    McFarlane, Michele

    2012-01-01

    The following qualitative multicase study presents an examination of outcomes assessment adoption as it relates to Career and Technical Education faculty at community colleges and outlines recommendations for postsecondary education administration as they introduce innovations to faculty members. The purpose of this investigation was to explore…

  13. Orientaciones Tecnicas para el Mejoramiento de la Administracion Educacional--Necesidades, Posibilidades y Perspectivas (Technical Guidelines on the Improvement of Educational Administration--Needs, Possibilities, and Perspectives).

    Science.gov (United States)

    Valle, Victor M.

    The success of development programs in educational systems is dependent, to a large extent, on the quality and relevancy of their management. Many worthwhile, well conceived and planned educational reforms have failed due to poor management. Therefore, both ministries of education and international organizations of technical cooperation have…

  14. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    Tuesday 30 March TECHNICAL TRAINING SEMINAR From 9:00 to 12:00 and from 13:00 to 16:00 hrs - Council Chamber, Salle B, Salle des Pas Perdus National Instruments (NI) on Tour 2004 Claudia Jüngel, Evrem Yarkin, Joel Clerc, Hervé Baour / NATIONAL INSTRUMENTS The special event NI on Tour 2004, run in Germany, Austria and Switzerland, will be at CERN on March 30. Technical seminars and free introductory courses will be offered all day long in the Council Chamber, Salle B, and Salle des Pas Perdus (buildings 61 and 503). Technical conferences: 09:00 - 12:00 Data acquisition systems on PCs. Industrial measurement and control techniques. 13:00 - 16:00 Advanced LabVIEW software and PXI instrumentation. Measuring instruments and system components for teststand automation. Introductory courses: 09:00 - 12:00 DIAdem: Data analysis and presentation 13:00 - 16:00 Data acquisition with LabVIEW Language: English and French Free special seminar. Registration is recommended with National Instruments Switzerland (please sp...

  15. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    Tuesday 30 March TECHNICAL TRAINING SEMINAR From 9:00 to 12:00 and from 13:00 to 16:00 hrs - Council Chamber, Salle B, Salle des Pas Perdus National Instruments (NI) on Tour 2004 Claudia Jüngel, Evrem Yarkin, Joel Clerc, Hervé Baour / NATIONAL INSTRUMENTS The special event NI on Tour 2004, run in Germany, Austria and Switzerland, will be at CERN on March 30. Technical seminars and free introductory courses will be offered all day long in the Council Chamber, Salle B, and Salle des Pas Perdus (buildings 61 and 503). Technical conferences: 09:00 - 12:00 Data acquisition systems on PCs. Industrial measurement and control techniques. 13:00 - 16:00 Advanced LabVIEW software and PXI instrumentation. Measuring instruments and system components for teststand automation. Introductory courses: 09:00 - 12:00 DIAdem: Data analysis and presentation 13:00 - 16:00 Data acquisition with LabVIEW Language: English and French Free special seminar. Registration is recommended with National Instruments Swi...

  16. 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.

  17. 34 CFR 200.40 - Technical assistance.

    Science.gov (United States)

    2010-07-01

    ... Programs Operated by Local Educational Agencies Lea and School Improvement § 200.40 Technical assistance. (a) An LEA that identifies a school for improvement under § 200.32 must ensure that the school receives technical assistance as the school develops and implements its improvement plan under § 200.41 and...

  18. The technical writer's handbook writing with style and clarity

    CERN Document Server

    Young, Matt

    2002-01-01

    "The Technical Writer's Handbook" is by a practising scientist who screens hundreds of manuscripts each year. It is directed at scientists, engineers and others who want to improve their writing and communication. It teaches that technical writing, although it has its own special requirements, is no different from ordinary writing and should be written with short, clear sentences and in the active voice. Divided into two parts, the first part is an introduction to technical and report writing and provides a sort of prescription for writing and organizing technical papers of all kinds. The second part is written in dictionary format and contains entries on grammar, style, and organization, as well as entries on topics such as common errors, resume writing, metric units, jargon, conference proceedings, figures, tables and slides. A comprehensive list of cross-references reveals related topics quickly and easily.

  19. 48 CFR 227.7102-2 - Rights in technical data.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Rights in technical data... Technical Data 227.7102-2 Rights in technical data. (a) The clause at 252.227-7015, Technical Data—Commercial Items, provides the Government specific license rights in technical data pertaining to commercial...

  20. 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

  1. Calcium and cholecalciferol supplementation provides no added benefit to nutritional counseling to improve bone mineral density in survivors of childhood acute lymphoblastic leukemia (ALL).

    Science.gov (United States)

    Kaste, S C; Qi, A; Smith, K; Surprise, H; Lovorn, E; Boyett, J; Ferry, R J; Relling, M V; Shurtleff, S A; Pui, C H; Carbone, L; Hudson, M M; Ness, K K

    2014-05-01

    We sought to improve lumbar spine bone mineral density (LS-BMD) in long-term survivors of childhood acute lymphoblastic leukemia (ALL) using calcium and cholecalciferol supplementation. This double-blind, placebo-controlled trial randomized 275 participants (median age, 17 [9-36.1] years) with age- and gender-specific LS-BMD Z-scores <0 to receive nutritional counseling with supplementation of 1,000 mg/day calcium and 800 International Unit cholecalciferol or placebo for 2 years. The primary outcome was change in LS-BMD assessed by quantitative computerized tomography (QCT) at 24 months. Linear regression models were employed to identify the baseline risk factors for low LS-BMD and to compare LS-BMD outcomes. Pre-randomization LS-BMD below the mean was associated with male gender (P = 0.0024), White race (P = 0.0003), lower body mass index (P < 0.0001), and cumulative glucocorticoid doses of ≥ 5,000 mg (P = 0.0012). One hundred eighty-eight (68%) participants completed the study; 77% adhered to the intervention. Mean LS-BMD change did not differ between survivors randomized to supplements (0.33 ± 0.57) or placebo (0.28 ± 0.56). Participants aged 9-13 years and those 22-35 years had the greatest mean increases in LS-BMD (0.50 ± 0.66 and 0.37 ± 0.23, respectively). Vitamin D insufficiency (serum 25[OH]D <30 ng/ml) found in 296 (75%), was not associated with LS-BMD outcomes (P = 0.78). Cholecalciferol and calcium supplementation provides no added benefit to nutritional counseling for improving LS-BMD among adolescent and young adult survivors of ALL (93% of whom had LS-BMD Z-scores above the mean at study entry). © 2014 Wiley Periodicals, Inc.

  2. Health care providers' use and knowledge of the Edmonton Symptom Assessment System (ESAS): is there a need to improve information and training?

    Science.gov (United States)

    Carli Buttenschoen, Daniela; Stephan, Jarad; Watanabe, Sharon; Nekolaichuk, Cheryl

    2014-01-01

    The ESAS is a clinical symptom assessment tool developed for patients receiving palliative care for pain and symptom control. Recent studies have indicated that patients have difficulty understanding terminology and correct use of the ESAS, and that they appreciate the presence of a health care provider (HCP) to assist with ESAS completion. As appropriate assessment translates into effective treatment, it is important that HCPs have a good understanding of the tool. The purpose of this study was to assess HCPs' use, knowledge, and training needs of the ESAS. One hundred ninety-three HCPs in palliative care and chronic pain, who used the ESAS, were invited to participate in a survey. The response rate was 43 % (n = 83), with 62 % nurses, 26 % physicians, and 12 % other specialties. Most participants were palliative care specialists (79 %). The majority (77 %) had a good understanding of the ESAS terms. Knowledge problems included distinguishing tiredness and drowsiness (25 %), interpreting shortness of breath as a combination of subjective and objective symptoms (19 %), not indicating current symptom level (14 %), and reverse scoring of well-being (13 %) and appetite (9 %). Reported challenges were misinterpretation of some ESAS terms, assessing patients with impaired communication, and lack of time and reliability of caregiver assessments. Participants offered suggestions regarding how their knowledge and use of the ESAS could be improved. Suggestions for improving ESAS administration and training were to include term definitions and examples of how to ask about terms that might be challenging for patients. Furthermore, initial and ongoing training sessions might help to clarify issues with the tool.

  3. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball and W. Zeuner

    2013-01-01

    For the reporting period, the CMS common systems and infrastructure worked well, without failures that caused significant data losses. One more disconnection of the magnet cold box occurred in the shadow of interruptions in data taking, caused by a series of technical faults. The recognition during 2012 that re-connection can only safely be done at around 2 T implies a minimum magnet recovery time of 12 hours and raises serious concerns about the number of ramping cycles of the magnet these incidents cause. This has triggered studies of how to make the cryo-system of the magnet more robust against failures. The proton-proton run ended just before the end-of-year CERN closure, during which CASTOR was installed on the negative end of CMS and both ZDC calorimeters were installed in TAN absorbers the LHC tunnel, in preparation for the heavy-ion run. The installation of CASTOR was an excellent “engineering test” of procedures for working in an activated environment. Despite some technical pr...

  4. TECHNICAL COORDINATION

    CERN Multimedia

    Austin Ball

    Summary of progress since last CMS week. Ten years of construction work have been completed. CMS is closed, in very close to the ideal low luminosity configuration, and performed well in the first tests with LHC beam. Behind this encouraging news is the story of a summer of intense commitment by many teams (from the collaboration and 3 CERN departments) working together, against the clock and despite many minor setbacks, to ensure that the experiment was ready to play a leading role in the excitement of September 10. Following beampipe bakeout and refill with pure neon, a magnificent effort by the ECAL group and the pt 5 technical crew made it possible to install and commission all 4 ECAL endcap Dees before the end of August. In the shadow of this activity, the barrel and forward pixel trackers and part of the beam monitoring were installed within the vac tank. The pt 5 technical teams then succeeded in safely removing the 20t installation tables and their support blocks from beneath the already installed ...

  5. Interventions to improve the self-management support health professionals provide for people with progressive neurological conditions: protocol for a realist synthesis.

    Science.gov (United States)

    Davies, Freya; Wood, Fiona; Bullock, Alison; Wallace, Carolyn; Edwards, Adrian

    2017-03-20

    Supporting self-management among people with long-term conditions is recognised as an important component of healthcare. Progressive neurological conditions (PNCs), for example, Parkinson's disease and multiple sclerosis are associated with problems such as fatigue and cognitive impairment which may make self-management more challenging. Health professionals may need to develop specific skills in order to provide effective self-management support for these patients. The review aims to develop explanatory theories about how health professional-targeted interventions to improve self-management support provision for people with PNCs operate in different circumstances. A realist synthesis of the evidence is proposed. There are 2 priority questions for the review to address. These relate to the role of a shared concept of self-management support within the healthcare team, and the need to tailor the support provided to the requirements of people with PNCs. Key stakeholders will be involved throughout the process. The initial search strategy uses terms relating to (1) self-management, (2) health professionals and (3) PNCs. Searching, data extraction and synthesis will occur in parallel. Studies will be prioritised for inclusion based on anticipated contribution to generating explanatory theories. Key informant interviews are planned to direct supplementary searches and help further refine the theories developed. Results will be expressed in the form of context-mechanism-outcome configurations. Publication guidelines on realist synthesis will be followed. The results will be published in a peer-reviewed journal and made available to organisations involved in the provision of health professional training. 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/.

  6. Cilostazol Improves Proangiogenesis Functions in Human Early Endothelial Progenitor Cells through the Stromal Cell-Derived Factor System and Hybrid Therapy Provides a Synergistic Effect In Vivo.

    Science.gov (United States)

    Tseng, Shih-Ya; Chao, Ting-Hsing; Li, Yi-Heng; Cho, Chung-Lung

    2016-01-01

    This study investigated the effect of cilostazol on proangiogenesis functions in human early endothelial progenitor cells (EPCs) in vitro and the therapeutic implication of hybrid therapy with cilostazol and human early EPCs in vivo. Cilostazol significantly increased colony-forming units and enhanced differentiation of EPCs toward endothelial lineage. Treatments resulted in antiapoptotic effects and stimulated proliferation and migration and in vitro vascular tube formation through activation of stromal cell-derived factor-1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4)/phosphatidylinositol-3 kinase (PI3K)/Akt signaling pathway. Blood flow recovery and capillary density in murine ischemic hindlimbs were significantly improved in cilostazol-treated, human early EPCs-treated, and cotreatment groups. The effects were attenuated with SDF-1α inhibition. Plasma SDF-1α levels were significantly higher in 3 active treatment groups after surgery, with greatest effects observed in hybrid therapy. The angiogenic effects of transplanted EPCs pretreated with cilostazol ex vivo were superior to untreated EPCs using in vivo Matrigel assay. Implanted EPCs were incorporated into the capillary, with pretreatment or cotreatment with cilostazol resulting in enhanced effects. Taken together, cilostazol promotes a large number of proangiogenic functions in human early EPCs through activation of SDF-1/CXCR4/PI3K/Akt signaling, and hybrid therapy provides a synergistic effect in vivo. Cotreatment may be beneficial in ischemic disease.

  7. 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.

  8. PVMaT improvements in the manufacturing of the PVI Powergrid{trademark}: Final technical report, 27 October 1997--31 October 1998

    Energy Technology Data Exchange (ETDEWEB)

    Kaminar, N.R.; Alexander, T.; Amaya, J.; Bottenberg, W.R.; Carrie, P.; Chen, K.; Hobden, P.; Lawyer, G.; Zimmermann, J.; Sherring, C.

    1999-10-20

    Photovoltaics International, LLC (PVI), is improving the manufacturing of the Powergrid{trademark} under the Photovoltaic Manufacturing Technology (PVMaT) program in five basic areas: development of an advanced, state-of-the-art lens extrusion system; development of an advanced, state-of-the-art module side extrusion system; development of a second generation automated receiver assembly station; development of low-cost roll-formed steel panel frame members; and development of an automated module assembly process with low usage of volatile organic compounds and hazardous materials. The results of the program were as follows: (1) Manufacturing improvements have led to dramatic improvements in performance, quality, durability and cost. (2) The first ever ethylene vinyl acetate encapsulation system for photovoltaic concentrators was developed, thereby eliminating volatile organic compounds and hazardous materials in the encapsulation process. (3) An in-house extrusion system was developed that produces the highest quality cell assemblies at low labor cost. (4) An advanced automated cell assembly station was developed that produces quality cell assemblies at low labor cost. (5) Solvents have been eliminated in the module assembly eliminating volatile organic compounds and hazardous materials. (6) Roll formed steel panel frame members have been introduced to production that have dramatically reduced cost. (7) A snap-together module assembly has been developed that provides low-cost field assembly of components and thereby also greatly reduced shipping cost. The Powergrid has the potential to be very low cost in the short term. The PVI PVMaT program should allow PVI to reach the cost goals set by the company. This, in turn, will allow PVI to become a substantial player in the PV market and will allow the DOE goals of increased application of PV to become a reality.

  9. 1996 DOE technical standards program workshop: Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    The workshop theme is `The Strategic Standardization Initiative - A Technology Exchange and Global Competitiveness Challenge for DOE.` The workshop goal is to inform the DOE technical standards community of strategic standardization activities taking place in the Department, other Government agencies, standards developing organizations, and industry. Individuals working on technical standards will be challenged to improve cooperation and communications with the involved organizations in response to the initiative. Workshop sessions include presentations by representatives from various Government agencies that focus on coordination among and participation of Government personnel in the voluntary standards process; reports by standards organizations, industry, and DOE representatives on current technology exchange programs; and how the road ahead appears for `information superhighway` standardization. Another session highlights successful standardization case studies selected from several sites across the DOE complex. The workshop concludes with a panel discussion on the goals and objectives of the DOE Technical Standards Program as envisioned by senior DOE management. The annual workshop on technical standards has proven to be an effective medium for communicating information related to standards throughout the DOE community. Technical standards are used to transfer technology and standardize work processes to produce consistent, acceptable results. They provide a practical solution to the Department`s challenge to protect the environment and the health and safety of the public and workers during all facility operations. Through standards, the technologies of industries and governments worldwide are available to DOE. The DOE Technical Standards Program, a Department-wide effort that crosscuts all organizations and disciplines, links the Department to those technologies.

  10. Improved estimates of separation distances to prevent unacceptable damage to nuclear power plant structures from hydrogen detonation for gaseous hydrogen storage. Technical report

    Energy Technology Data Exchange (ETDEWEB)

    1994-05-01

    This report provides new estimates of separation distances for nuclear power plant gaseous hydrogen storage facilities. Unacceptable damage to plant structures from hydrogen detonations will be prevented by having hydrogen storage facilities meet separation distance criteria recommended in this report. The revised standoff distances are based on improved calculations on hydrogen gas cloud detonations and structural analysis of reinforced concrete structures. Also, the results presented in this study do not depend upon equivalencing a hydrogen detonation to an equivalent TNT detonation. The static and stagnation pressures, wave velocity, and the shock wave impulse delivered to wall surfaces were computed for several different size hydrogen explosions. Separation distance equations were developed and were used to compute the minimum separation distance for six different wall cases and for seven detonating volumes (from 1.59 to 79.67 lbm of hydrogen). These improved calculation results were compared to previous calculations. The ratio between the separation distance predicted in this report versus that predicted for hydrogen detonation in previous calculations varies from 0 to approximately 4. Thus, the separation distances results from the previous calculations can be either overconservative or unconservative depending upon the set of hydrogen detonation parameters that are used. Consequently, it is concluded that the hydrogen-to-TNT detonation equivalency utilized in previous calculations should no longer be used.

  11. Improving First Aid Management of Epilepsy by Trainee Teachers of the Federal College of Education (Technical), Akoka - Lagos, South West Nigeria--Can Health Education have an Effect?

    Science.gov (United States)

    Eze, Christian N; Ebuehi, Olufunke M

    2013-01-01

    lt is estimated that epilepsy affects approximately 50 million people worldwide and about 40 million of them live in developing countries. Studies have indicated high rates of poor knowledge, negative attitude and poor first aid management skills of students with epilepsy among practicing teachers. However, there is paucity of such studies on trainee teachers to ascertain any similarities or differences (if any) and the effect of educational interventions. To determine the effect of a health education intervention on trainee teachers' knowledge, attitude and first aid management of epilepsy. The effect of a health education intervention in first aid management of epilepsy was assessed among 226 trainee teachers, attending the Federal College of Education (Technical), Akoka. This was done using a quasi-experimental study design. Data were analyzed using the SPSS version 15. The respondents had a median age of 22 years with a range of 18 to 56 years. The majority of them were females (68.6%), single (79.2%), Christians (81.9%), Yoruba (70.4%) and in first year (100 level) of their study (69.9%). The highest proportion was from the Accounting department (46.0%). A consistent increase in responses to items on knowledge, attitude and first aid management of epileptic seizure items from baseline to post-intervention was observed. For instance, the proportion of responses that epileptic seizures originate from the brain significantly (p = 0.025) increased from 62.5% at baseline to 74.1% after intervention. Generally, slightly more than two-fifths (44.2%) and about two thirds (61.9%) of the respondents were observed to have poor knowledge and negative attitude to epilepsy respectively at baseline. Overall, giving health education on epilepsy led to a reduction in the proportion of respondents with poor knowledge by 15.5% (increase of good knowledge by 29.6%), decrease of negative attitude by 16.4% and increase of good first aid management skill by 25.0%. The knowledge

  12. RAID-S Technical Overview: Raid 4 and 5-Compliant Hardware and Software Functionality Improves Data Availability Through Use of XOR-Capable Disks in an Integrated Cached Disk Array

    Science.gov (United States)

    Quinn, Brett

    1996-01-01

    The purpose of this paper is to provide a technical description of redundant array of independent disks - Symmetrix (RAID-S). It is intended to give the reader an understanding of how RAID-S is architected and implemented in the EMC Symmetrix 3000/5000 series integrated cached disk array. Topics include RAID-S taxonomy, configuration considerations, operational characteristics, performance, and implementation guidelines.

  13. Engineering Technical Support Center (ETSC)

    Science.gov (United States)

    ETSC is EPA’s technical support and resource centers responsible for providing specialized scientific and engineering support to decision-makers in the Agency’s ten regional offices, states, communities, and local businesses.

  14. Technical Service Agreement (TSA) | FNLCR

    Science.gov (United States)

    Frederick National Laboratory for Cancer Research (FNLCR) scientists provide services and solutions to collaborators through the Technical Services Program, whose portfolio includes more than 200 collaborations with more than 80 partners. FNLCR’s u

  15. S-Chip Technical Assistance

    Data.gov (United States)

    U.S. Department of Health & Human Services — The page will provide access to reports and other published products designed to assist states with complicated S-Chip technical issues. The reports and products...

  16. Improvement of the defrosting process for air-cooled evaporators - Phase 3: technical implementation, laboratory tests and field trials; Verbesserung des Abtauens bei luftbeaufschlagten Verdampfern. Phase 3: technische Umsetzung, Labor- und Feldversuche

    Energy Technology Data Exchange (ETDEWEB)

    Ehrbar, M.; Bertsch, S.; Schwendener, S. [NTB Interstaatliche Hochschule fuer Technik Buchs, Buchs (Switzerland); Hubacher, P.; Bernal, C.; Hubacher, B. [Hubacher Engineering, Engelburg (Switzerland)

    2005-07-01

    This final report for the Swiss Federal Office of Energy (SFOE) reviews the results of the third phase of a project that involved the examination of the technical possibilities of decreasing energy consumption during defrosting of heat pump evaporators. The five topics looked at include defrosting at temperatures above 2 {sup o}C using the unit's fan, defrosting with ambient air from the room where the evaporator is located, defrosting using stored heat, optimised hot-gas defrosting and 'natural' defrosting during the time when the system is not running. The authors state that many improvements can be obtained with only moderate technical measures being taken and at low cost.

  17. Proper interpretation of chronic toxicity studies and their statistics: A critique of "Which level of evidence does the US National Toxicology Program provide? Statistical considerations using the Technical Report 578 on Ginkgo biloba as an example".

    Science.gov (United States)

    Kissling, Grace E; Haseman, Joseph K; Zeiger, Errol

    2015-09-02

    A recent article by Gaus (2014) demonstrates a serious misunderstanding of the NTP's statistical analysis and interpretation of rodent carcinogenicity data as reported in Technical Report 578 (Ginkgo biloba) (NTP, 2013), as well as a failure to acknowledge the abundant literature on false positive rates in rodent carcinogenicity studies. The NTP reported Ginkgo biloba extract to be carcinogenic in mice and rats. Gaus claims that, in this study, 4800 statistical comparisons were possible, and that 209 of them were statistically significant (pGinkgo biloba extract cannot be definitively established. However, his assumptions and calculations are flawed since he incorrectly assumes that the NTP uses no correction for multiple comparisons, and that significance tests for discrete data operate at exactly the nominal level. He also misrepresents the NTP's decision making process, overstates the number of statistical comparisons made, and ignores the fact that the mouse liver tumor effects were so striking (e.g., p<0.0000000000001) that it is virtually impossible that they could be false positive outcomes. Gaus' conclusion that such obvious responses merely "generate a hypothesis" rather than demonstrate a real carcinogenic effect has no scientific credibility. Moreover, his claims regarding the high frequency of false positive outcomes in carcinogenicity studies are misleading because of his methodological misconceptions and errors. Published by Elsevier Ireland Ltd.

  18. Technical presentation

    CERN Multimedia

    FP Department

    2009-01-01

    07 April 2009 Technical presentation by Leuze Electronics: 14.00 – 15.00, Main Building, Room 61-1-017 (Room A) Photoelectric sensors, data identification and transmission systems, image processing systems. We at Leuze Electronics are "the sensor people": we have been specialising in optoelectronic sensors and safety technology for accident prevention for over 40 years. Our dedicated staff are all highly customer oriented. Customers of Leuze Electronics can always rely on one thing – on us! •\tFounded in 1963 •\t740 employees •\t115 MEUR turnover •\t20 subsidiaries •\t3 production facilities in southern Germany Product groups: •\tPhotoelectric sensors •\tIdentification and measurements •\tSafety devices

  19. Technical presentation

    CERN Multimedia

    FI Department

    2008-01-01

    RADIOSPARES, the leading catalogue distributor of components (electronic, electrical, automation, etc.) and industrial supplies will be at CERN on Friday 3 October 2008 (Main Building, Room B, from 9.00 a.m. to 3.00 p.m.) to introduce its new 2008/2009 catalogue. This will be the opportunity for us to present our complete range of products in more detail: 400 000 part numbers available on our web site (Radiospares France, RS International, extended range of components from other manufacturers); our new services: quotations, search for products not included in the catalogue, SBP products (Small Batch Production: packaging in quantities adapted to customers’ requirements); partnership with our focus manufacturers; demonstration of the on-line purchasing tool implemented on our web site in conjunction with CERN. RADIOSPARES will be accompanied by representatives of FLUKE and TYCO ELECTRONICS, who will make presentations, demonstrate materials and answer any technical questio...

  20. Technical presentation

    CERN Multimedia

    GS Department

    2010-01-01

    10 March 2010 DYNEOS 10:00 – 12:00 - Main Building, Room B, 61-1-009 Dyneos AG is active in the fields of photonics, laser and high-precision positioning. Our highly qualified engineer team has more than 30 years of experience in electro-optical solutions sales. The engineers are supported by a technical and administrative team. We are focused on the Swiss market and represent six suppliers (Coherent, PI Physik Instrumente, SIOS, Nanonics Imaging, APE, Ekspla) in order to give a qualified sales and service support to our customers. Our products are dedicated to the research field as well as to industry. In addition to standard catalog products, we offer custom designs to fulfill the specific needs of OEM customers or specific applications.

  1. Technical Training: Technical Training Seminar

    CERN Multimedia

    2004-01-01

    TECHNICAL TRAINING Monique Duval tel. 74924 technical.training@cern.ch Tuesday 3 February 2004 From 09:00 to 13:30 - Training Centre Auditorium - bldg. 593, room 11 USB (Universal Serial Bus) CYPRESS Seminar Claudia Colombini, Field Application Engineer CYPRESS ActiveComp Electronic GmbH D-85077 MANCHING, Germany As a pioneer in USB, CYPRESS sets the standard for cost-effective solutions without sacrificing functionality, performance or reliability. Having shipped over 200 million USB devices, Cypress is the undisputed market leader and demonstrates unmatched USB expertise. With the industry's broadest selection of USB solutions, Cypress has the right silicon, software and support for every USB application, from Low-speed to High-Speed and USB On-The-Go (OTG). 9:00 - 10:30 Overview of USB systems. USB CYPRESS product overview. Peripherals: Low Speed, Full Speed, High Speed (1.1 and 2.0). Hub Solutions, Embedded Host Solutions, On-The-Go (OTG) and wireless USB. USB Development Tools (first part) 10:30 -...

  2. 48 CFR 12.211 - Technical data.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Technical data. 12.211... ACQUISITION OF COMMERCIAL ITEMS Special Requirements for the Acquisition of Commercial Items 12.211 Technical data. Except as provided by agency-specific statutes, the Government shall acquire only the technical...

  3. Pea p68, a DEAD-box helicase, provides salinity stress tolerance in transgenic tobacco by reducing oxidative stress and improving photosynthesis machinery.

    Science.gov (United States)

    Tuteja, Narendra; Banu, Mst Sufara Akhter; Huda, Kazi Md Kamrul; Gill, Sarvajeet Singh; Jain, Parul; Pham, Xuan Hoi; Tuteja, Renu

    2014-01-01

    The DEAD-box helicases are required mostly in all aspects of RNA and DNA metabolism and they play a significant role in various abiotic stresses, including salinity. The p68 is an important member of the DEAD-box proteins family and, in animal system, it is involved in RNA metabolism including pre-RNA processing and splicing. In plant system, it has not been well characterized. Here we report the cloning and characterization of p68 from pea (Pisum sativum) and its novel function in salinity stress tolerance in plant. The pea p68 protein self-interacts and is localized in the cytosol as well as the surrounding of cell nucleus. The transcript of pea p68 is upregulated in response to high salinity stress in pea. Overexpression of p68 driven by constitutive cauliflower mosaic virus-35S promoter in tobacco transgenic plants confers enhanced tolerances to salinity stress by improving the growth, photosynthesis and antioxidant machinery. Under stress treatment, pea p68 overexpressing tobacco accumulated higher K+ and lower Na+ level than the wild-type plants. Reactive oxygen species (ROS) accumulation was remarkably regulated by the overexpression of pea p68 under salinity stress conditions, as shown from TBARS content, electrolyte leakage, hydrogen peroxide accumulation and 8-OHdG content and antioxidant enzyme activities. To the best of our knowledge this is the first direct report, which provides the novel function of pea p68 helicase in salinity stress tolerance. The results suggest that p68 can also be exploited for engineering abiotic stress tolerance in crop plants of economic importance.

  4. Plantation forestry under global warming: hybrid poplars with improved thermotolerance provide new insights on the in vivo function of small heat shock protein chaperones.

    Science.gov (United States)

    Merino, Irene; Contreras, Angela; Jing, Zhong-Ping; Gallardo, Fernando; Cánovas, Francisco M; Gómez, Luis

    2014-02-01

    Climate-driven heat stress is a key factor affecting forest plantation yields. While its effects are expected to worsen during this century, breeding more tolerant genotypes has proven elusive. We report here a substantial and durable increase in the thermotolerance of hybrid poplar (Populus tremula×Populus alba) through overexpression of a major small heat shock protein (sHSP) with convenient features. Experimental evidence was obtained linking protective effects in the transgenic events with the unique chaperone activity of sHSPs. In addition, significant positive correlations were observed between phenotype strength and heterologous sHSP accumulation. The remarkable baseline levels of transgene product (up to 1.8% of total leaf protein) have not been reported in analogous studies with herbaceous species. As judged by protein analyses, such an accumulation is not matched either by endogenous sHSPs in both heat-stressed poplar plants and field-grown adult trees. Quantitative real time-polymerase chain reaction analyses supported these observations and allowed us to identify the poplar members most responsive to heat stress. Interestingly, sHSP overaccumulation was not associated with pleiotropic effects that might decrease yields. The poplar lines developed here also outperformed controls under in vitro and ex vitro culture conditions (callus biomass, shoot production, and ex vitro survival), even in the absence of thermal stress. These results reinforce the feasibility of improving valuable genotypes for plantation forestry, a field where in vitro recalcitrance, long breeding cycles, and other practical factors constrain conventional genetic approaches. They also provide new insights into the biological functions of the least understood family of heat shock protein chaperones.

  5. Plantation Forestry under Global Warming: Hybrid Poplars with Improved Thermotolerance Provide New Insights on the in Vivo Function of Small Heat Shock Protein Chaperones1[C][W

    Science.gov (United States)

    Merino, Irene; Contreras, Angela; Jing, Zhong-Ping; Gallardo, Fernando; Cánovas, Francisco M.; Gómez, Luis

    2014-01-01

    Climate-driven heat stress is a key factor affecting forest plantation yields. While its effects are expected to worsen during this century, breeding more tolerant genotypes has proven elusive. We report here a substantial and durable increase in the thermotolerance of hybrid poplar (Populus tremula × Populus alba) through overexpression of a major small heat shock protein (sHSP) with convenient features. Experimental evidence was obtained linking protective effects in the transgenic events with the unique chaperone activity of sHSPs. In addition, significant positive correlations were observed between phenotype strength and heterologous sHSP accumulation. The remarkable baseline levels of transgene product (up to 1.8% of total leaf protein) have not been reported in analogous studies with herbaceous species. As judged by protein analyses, such an accumulation is not matched either by endogenous sHSPs in both heat-stressed poplar plants and field-grown adult trees. Quantitative real time-polymerase chain reaction analyses supported these observations and allowed us to identify the poplar members most responsive to heat stress. Interestingly, sHSP overaccumulation was not associated with pleiotropic effects that might decrease yields. The poplar lines developed here also outperformed controls under in vitro and ex vitro culture conditions (callus biomass, shoot production, and ex vitro survival), even in the absence of thermal stress. These results reinforce the feasibility of improving valuable genotypes for plantation forestry, a field where in vitro recalcitrance, long breeding cycles, and other practical factors constrain conventional genetic approaches. They also provide new insights into the biological functions of the least understood family of heat shock protein chaperones. PMID:24306533

  6. Pea p68, a DEAD-box helicase, provides salinity stress tolerance in transgenic tobacco by reducing oxidative stress and improving photosynthesis machinery.

    Directory of Open Access Journals (Sweden)

    Narendra Tuteja

    Full Text Available BACKGROUND: The DEAD-box helicases are required mostly in all aspects of RNA and DNA metabolism and they play a significant role in various abiotic stresses, including salinity. The p68 is an important member of the DEAD-box proteins family and, in animal system, it is involved in RNA metabolism including pre-RNA processing and splicing. In plant system, it has not been well characterized. Here we report the cloning and characterization of p68 from pea (Pisum sativum and its novel function in salinity stress tolerance in plant. RESULTS: The pea p68 protein self-interacts and is localized in the cytosol as well as the surrounding of cell nucleus. The transcript of pea p68 is upregulated in response to high salinity stress in pea. Overexpression of p68 driven by constitutive cauliflower mosaic virus-35S promoter in tobacco transgenic plants confers enhanced tolerances to salinity stress by improving the growth, photosynthesis and antioxidant machinery. Under stress treatment, pea p68 overexpressing tobacco accumulated higher K+ and lower Na+ level than the wild-type plants. Reactive oxygen species (ROS accumulation was remarkably regulated by the overexpression of pea p68 under salinity stress conditions, as shown from TBARS content, electrolyte leakage, hydrogen peroxide accumulation and 8-OHdG content and antioxidant enzyme activities. CONCLUSIONS: To the best of our knowledge this is the first direct report, which provides the novel function of pea p68 helicase in salinity stress tolerance. The results suggest that p68 can also be exploited for engineering abiotic stress tolerance in crop plants of economic importance.

  7. Pea p68, a DEAD-Box Helicase, Provides Salinity Stress Tolerance in Transgenic Tobacco by Reducing Oxidative Stress and Improving Photosynthesis Machinery

    Science.gov (United States)

    Tuteja, Narendra; Banu, Mst. Sufara Akhter; Huda, Kazi Md. Kamrul; Gill, Sarvajeet Singh; Jain, Parul; Pham, Xuan Hoi; Tuteja, Renu

    2014-01-01

    Background The DEAD-box helicases are required mostly in all aspects of RNA and DNA metabolism and they play a significant role in various abiotic stresses, including salinity. The p68 is an important member of the DEAD-box proteins family and, in animal system, it is involved in RNA metabolism including pre-RNA processing and splicing. In plant system, it has not been well characterized. Here we report the cloning and characterization of p68 from pea (Pisum sativum) and its novel function in salinity stress tolerance in plant. Results The pea p68 protein self-interacts and is localized in the cytosol as well as the surrounding of cell nucleus. The transcript of pea p68 is upregulated in response to high salinity stress in pea. Overexpression of p68 driven by constitutive cauliflower mosaic virus-35S promoter in tobacco transgenic plants confers enhanced tolerances to salinity stress by improving the growth, photosynthesis and antioxidant machinery. Under stress treatment, pea p68 overexpressing tobacco accumulated higher K+ and lower Na+ level than the wild-type plants. Reactive oxygen species (ROS) accumulation was remarkably regulated by the overexpression of pea p68 under salinity stress conditions, as shown from TBARS content, electrolyte leakage, hydrogen peroxide accumulation and 8-OHdG content and antioxidant enzyme activities. Conclusions To the best of our knowledge this is the first direct report, which provides the novel function of pea p68 helicase in salinity stress tolerance. The results suggest that p68 can also be exploited for engineering abiotic stress tolerance in crop plants of economic importance. PMID:24879307

  8. Independent technical review, handbook

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    Purpose Provide an independent engineering review of the major projects being funded by the Department of Energy, Office of Environmental Restoration and Waste Management. The independent engineering review will address questions of whether the engineering practice is sufficiently developed to a point where a major project can be executed without significant technical problems. The independent review will focus on questions related to: (1) Adequacy of development of the technical base of understanding; (2) Status of development and availability of technology among the various alternatives; (3) Status and availability of the industrial infrastructure to support project design, equipment fabrication, facility construction, and process and program/project operation; (4) Adequacy of the design effort to provide a sound foundation to support execution of project; (5) Ability of the organization to fully integrate the system, and direct, manage, and control the execution of a complex major project.

  9. Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Maxwell, Mike, J., P.E.

    2012-08-30

    The STI product is the Final Technical Report from ReliOn, Inc. for contract award DE-EE0000487: Recovery Act PEM Fuel Cell Systems Providing Emergency Reserve and Backup Power. The program covered the turnkey deployment of 431 ReliOn fuel cell systems at 189 individual sites for AT&T and PG&E with ReliOn functioning as the primary equipment supplier and the project manager. The Final Technical Report provides an executive level summary, a comparison of the actual accomplishments vs. the goals and objectives of the project, as well as a summary of the project activity from the contract award date of August 1, 2009 through the contract expiration date of December 31, 2011. Two photos are included in the body of the report which show hydrogen storage and bulk hydrogen refueling technologies developed as a result of this program.

  10. Evaluating the effectiveness of case method instruction in technical communication

    Science.gov (United States)

    Feinberg, S. G.

    1981-01-01

    The effectiveness of the case method as an instructional technique in improving technical writing was evaluated. The development of a self-report instrument that attempts to measure changes in attitude toward technical communication and the presentation results change are the purpose of this paper. Standards for developing a case set forth by Goldstein and Couture, were used to design an evaluation instrument to measure the effect instruction on student attitude toward technical communication. This self-report instrument is based on model developed and tested by Daly and Miller who studied writer attitude and apprehension toward writing. It was the most important objective of any evaluation is to provide information for improving the program.

  11. DENSO Technical Communication Education

    Science.gov (United States)

    Isogai, Emiko; Suzuki, Takamasa

    We developed technical communication education from beginning to managerial levels to enhance communication skills necessary for engineers. The courses in this program progressed from theory to hands-on training and discussion, providing an opportunity for fact-finding and problem-solving. After the courses were completed, the engineers applied what they had learned on the job. The courses proved to be useful, satisfying participating engineers.

  12. Bioethics for Technical Experts

    Science.gov (United States)

    Asano, Shigetaka

    Along with rapidly expanding applications of life science and technology, technical experts have been implicated more and more often with ethical, social, and legal problems than before. It should be noted that in this background there are scientific and social uncertainty elements which are inevitable during the progress of life science in addition to the historically-established social unreliability to scientists and engineers. In order to solve these problems, therefore, we should establish the social governance with ‘relief’ and ‘reliance’ which enables for both citizens and engineers to share the awareness of the issues, to design social orders and criterions based on hypothetical sense of values for bioethics, to carry out practical use management of each subject carefully, and to improve the sense of values from hypothetical to universal. Concerning these measures, the technical experts can learn many things from the present performance in the medical field.

  13. Genome-wide scan for seed composition provides insights into the improvement of soybean quality and the impacts of domestication and modern breeding

    Science.gov (United States)

    Soybean (Glycine max (L.) Merrill) is a world-widely grown major crop rich in both protein and oil. Improvement of seed nutrients has long been one of the most important breeding objectives in soybean. To better understand the genetic architecture of the traits for improvement, we conducted genome-w...

  14. Protocol for project IMPACT (improving millions hearts for provider and community transformation): a quasi-experimental evaluation of an integrated electronic health record and community health worker intervention study to improve hypertension management among South Asian patients.

    Science.gov (United States)

    Lopez, Priscilla M; Zanowiak, Jennifer; Goldfeld, Keith; Wyka, Katarzyna; Masoud, Ahmad; Beane, Susan; Kumar, Rashi; Laughlin, Phoebe; Trinh-Shevrin, Chau; Thorpe, Lorna; Islam, Nadia

    2017-12-06

    The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building upon this initiative, we present the protocol and preliminary results of a research study, Project IMPACT, designed to fill this gap in knowledge. Project IMPACT is a stepped wedge quasi-experimental study designed to test the feasibility, adoption, and impact of integrating CHW-led health coaching with electronic health record (EHR)-based interventions to improve hypertension control among South Asian patients in New York City primary care practices. EHR intervention components include the training and implementation of hypertension-specific registry reports, alerts, and order sets. Fidelity to the EHR intervention is assessed by collecting the type, frequency, and utilization of intervention components for each practice. CHW intervention components consist of health coaching sessions on hypertension and related risk factors for uncontrolled hypertensive patients. The outcome, hypertension control (Project IMPACT builds upon the evidence base of the effectiveness of CHW and Million Hearts® initiatives and proposes a unique integration of provider-based EHR and community-based CHW interventions. The project informs the effectiveness of these interventions in team-based care approaches, thereby, helping to develop relevant sustainability

  15. Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Joseph Junker; Greg Wheeler

    2007-02-26

    Since 1986 the Oregon State University Industrial Assessment Center (OSU IAC) has worked to increase the energy efficiency, productivity, sustainability, and competitiveness of US manufacturers; provide engineering students an education not available in the classroom; keep engineering faculty in contact with technology and challenges in Northwest industry; and reduce dependence on nonrenewable energy resources, both imported and domestic. Project Objective: Over the duration of this project (2002-2006), the OSU IAC worked to directly support and influence industrial decisions primarily regarding energy but also regarding sustainability and profitability through: Assessments & Follow-up: The OSU IAC performed 111 Industrial Assessments in Oregon, Washington, Idaho and Nevada to help industry identify and implement opportunities to increase energy efficiency, productivity, sustainability, and competitiveness Workshops Seminars Forums Etc: OSU IAC staff worked with regional peers to offer appropriate workshops and trainings as opportunities availed themselves. Graduating Excellent Energy Aware Professional Alumni: As technically capable, skilled written and verbal communicators, our alumni contributed to OSU IAC influence from their positions within industry, consulting organizations, utilities, and governmental and non governmental agencies. Tool Development: Analysis tools and guides originated at the OSU IAC extended our reach. The center continually worked to develop computer based analysis tools, evaluation checklists, analysis guide sheets for internal use and general sharing with industry, energy, and other professionals to assist them in efforts to improve US Industry. Impact: Over 20 years of activity the OSU IAC has typically performed 25 Industrial Assessments a year. On average, each year of 25 assessments has resulted in implemented projects that saved industry a total of: 25.3 TBTU in annual energy and $4.5 Million annually, with an average investment

  16. Bubbles, shocks and elementary technical trading strategies

    Science.gov (United States)

    Fry, John

    2014-01-01

    In this paper we provide a unifying framework for a set of seemingly disparate models for bubbles, shocks and elementary technical trading strategies in financial markets. Markets operate by balancing intrinsic levels of risk and return. This seemingly simple observation is commonly over-looked by academics and practitioners alike. Our model shares its origins in statistical physics with others. However, under our approach, changes in market regime can be explicitly shown to represent a phase transition from random to deterministic behaviour in prices. This structure leads to an improved physical and econometric model. We develop models for bubbles, shocks and elementary technical trading strategies. The list of empirical applications is both interesting and topical and includes real-estate bubbles and the on-going Eurozone crisis. We close by comparing the results of our model with purely qualitative findings from the finance literature.

  17. TECHNICAL COORDINATION

    CERN Multimedia

    Austin Ball

    2013-01-01

      Since the last report, much visible progress has been made, as the LS1 programme approaches the halfway point. From early October, technical and safety shift-crew have been present around the clock, allowing detectors to stay switched on overnight, ensuring that safety systems are operational and instructions for non-expert shift-crew are clear. LS1 progress Throughout the summer, whilst the solenoid vacuum tank and YB0 surfaces were accessible, an extensive installation programme took place to prepare for Tracker colder operation and the PLT installation, in 2014, the Phase 1 Pixel Tracker installation, in 2016–’17, and the HCAL Phase 1 upgrade completion, ending in LS2. This included pipework for N2 or dry air to flush the Tracker bulkhead region, many sensors to monitor temperature and dew point in the Tracker and its service channels, heating wires outside the Tracker cooling bundles, supports for the new vacuum-jacketed, concentric, CO2 Pixel cooling lines, the PLT cool...

  18. TECHNICAL COORDINATION

    CERN Multimedia

    A. Ball and W. Zeuner

    2012-01-01

      UXC + detectors As explained in detail in the November 2011 bulletin, the bellows unit at −18.5 m from the CMS interaction point was identified as a prime candidate for the regularly occurring pressure spikes which occasionally led to sustained severe background conditions in 2011, affecting dead time and data quality. Similar regions in LHC with vacuum instabilities were observed to be close to bellows, which radiography showed to have distorted RF-fingers — on removal, they proved to have been severely overheated. The plans for the Year-End Technical Stop were adapted to prioritise radiography of the bellows at 16 m to 18 m either end of CMS. Excellent work by the beam pipe, survey and heavy mechanical teams allowed the X-rays to be taken as planned on 20th December, showing that the bellow at −18.5m had an obvious non-conformity. The RF-fingers were found inside the end of the opposing flared pipe instead of outside. In addition, the overlap between fingers and...

  19. Provider documentation of patient education: a lean investigation

    Directory of Open Access Journals (Sweden)

    Jean P. Shipman, MSLS, AHIP, FMLA

    2016-11-01

    Full Text Available Purpose: The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU requirements. Methods: Thirty-eight patient-provider interactions in two health care outpatient clinics were observed. Results: Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR materials, while available, have technical access barriers. Conclusions: Providers’ EHR skills and knowledge levels contribute to non-standardized patient education delivery.

  20. Science Translational Medicine – improving human health care worldwide by providing an interdisciplinary forum for idea exchange between basic scientists and clinical research practitioners

    Directory of Open Access Journals (Sweden)

    Forsythe, Katherine

    2010-09-01

    Full Text Available Science Translational Medicine’s mission is to improve human health care worldwide by providing a forum for communication and interdisciplinary idea exchange between basic scientists and clinical research practitioners from all relevant established and emerging disciplines. The weekly journal debuted in October 2009 and is published by the American Association for the Advancement of Science (AAAS, the publisher of Science and Science Signaling. The journal features peer-reviewed research articles, perspectives and commentary, and is guided by an international Advisory Board, led by Chief Scientific Adviser, Elias A. Zerhouni, M.D., former Director of the National Institutes of Health, and Senior Scientific Adviser, Elazer R. Edelman, M.D., Ph.D., Thomas D. and Virginia W. Cabot Professor of Health Sciences and Technology, Massachusetts Institute of Technology. The Science Translational Medicine editorial team is led by Katrina L. Kelner, Ph.D., AAAS. A profound transition is required for the science of translational medicine. Despite 50 years of advances in our fundamental understanding of human biology and the emergence of powerful new technologies, the rapid transformation of this knowledge into effective health measures is not keeping pace with the challenges of global health care. Creative experimental approaches, novel technologies, and new ways of conducting scientific explorations at the interface of established and emerging disciplines are now required to an unprecedented degree if real progress is to be made. To aid in this reinvention, Science and AAAS have created a new interdisciplinary journal, Science Translational Medicine. The following interview exemplefies the pioneering content found in Science Translational Medicine. It is an excerpt from a Podcast interview with Dr. Samuel Broder, former director of the National Cancer Institute and current Chief Medical Officer at Celera. The Podcast was produced in tangent with Dr

  1. Do clinical decision-support reminders for medical providers improve isoniazid preventative therapy prescription rates among HIV-positive adults? Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Green, Eric P; Catalani, Caricia; Diero, Lameck; Carter, E Jane; Gardner, Adrian; Ndwiga, Charity; Keny, Aggrey; Owiti, Philip; Israelski, Dennis; Biondich, Paul

    2015-04-09

    This document describes a research protocol for a study designed to estimate the impact of implementing a reminder system for medical providers on the use of isoniazid preventative therapy (IPT) for adults living with HIV in western Kenya. People living with HIV have a 5% to 10% annual risk of developing active tuberculosis (TB) once infected with TB bacilli, compared to a 5% lifetime risk in HIV-negative people with latent TB infection. Moreover, people living with HIV have a 20-fold higher risk of dying from TB. A growing body of literature suggests that IPT reduces overall TB incidence and is therefore of considerable benefit to patients and the larger community. However, in 2009, of the estimated 33 million people living with HIV, only 1.7 million (5%) were screened for TB, and about 85,000 (0.2%) were offered IPT. This study will examine the use of clinical decision-support reminders to improve rates of initiation of preventative treatment in a TB/HIV co-morbid population living in a TB endemic area. This will be a pragmatic, parallel-group, cluster-randomized superiority trial with a 1:1 allocation to treatment ratio. For the trial, 20 public medical facilities that use clinical summary sheets generated from an electronic medical records system will participate as clusters. All HIV-positive adult patients who complete an initial encounter at a study cluster and at least one return encounter during the study period will be included in the study cohort. The primary endpoint will be IPT prescription at 3 months post the initial encounter. We will conduct both individual-level and cluster-level analyses. Due to the nature of the intervention, the trial will not be blinded. This study will contribute to the growing evidence base for the use of electronic health interventions in low-resource settings to promote high-quality clinical care, health system optimization and positive patient outcomes. Trial registration ClinicalTrials.gov NCT01934309, registered 29

  2. A Multicomponent Intervention to Improve Primary Care Provider Adherence to Chronic Opioid Therapy Guidelines and Reduce Opioid Misuse: A Cluster Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Lasser, Karen E; Shanahan, Christopher; Parker, Victoria; Beers, Donna; Xuan, Ziming; Heymann, Orlaith; Lange, Allison; Liebschutz, Jane M

    2016-01-01

    Prescription opioid misuse is a significant public health problem as well as a patient safety concern. Primary care providers (PCPs) are the leading prescribers of opioids for chronic pain, yet few PCPs follow standard practice guidelines regarding assessment and monitoring. This cluster randomized controlled trial will determine whether four implementation strategies; nurse care management, use of a patient registry, academic detailing, and electronic tools, will increase PCP adherence to chronic opioid therapy guidelines and reduce opioid misuse among patients, relative to electronic tools alone. The implementation strategies and intervention content are based on the chronic care model. We include 53 PCPs from three Boston-area community health centers and one urban safety-net hospital-based primary care practice who have at least four patients meeting the following inclusion criteria: 1) age≥18; 2) one or more completed visits to the primary care practice in the past year; 3) long-term opioid treatment defined as three or more opioid prescriptions written at least 21days apart within 6months and 4) an inpatient or outpatient ICD-9-CM diagnosis for musculoskeletal or neuropathic pain. We consider PCPs to be study subjects, and obtained a waiver of informed consent for patients because the study is promoting an established standard of care. We enrolled participants (PCPs) from December 2012 through March 2015. PCPs were randomized to receive the intervention, which includes four components: 1) nurse care management, 2) use of a patient registry, 3) academic detailing, and 4) electronic tools, or a control condition, which includes only the use of the electronic tools. The intervention PCPs receive the services of a nurse-managed registry for planning individual patient care and conducting population-based care for patients receiving opioids for chronic pain. In academic detailing visits, trained co-investigators provide intervention PCPs with individualized

  3. Primer Control System Cyber Security Framework and Technical Metrics

    Energy Technology Data Exchange (ETDEWEB)

    Wayne F. Boyer; Miles A. McQueen

    2008-05-01

    The Department of Homeland Security National Cyber Security Division supported development of a control system cyber security framework and a set of technical metrics to aid owner-operators in tracking control systems security. The framework defines seven relevant cyber security dimensions and provides the foundation for thinking about control system security. Based on the developed security framework, a set of ten technical metrics are recommended that allow control systems owner-operators to track improvements or degradations in their individual control systems security posture.

  4. How can information systems provide support to nurses’ hand hygiene performance? Using gamification and indoor location to improve hand hygiene awareness and reduce hospital infections

    National Research Council Canada - National Science Library

    Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; da Silva, Miguel Mira; Lapão, Luís Velez

    2017-01-01

    .... To raise awareness regarding hand hygiene compliance, individual behaviour change and performance optimization, we aimed to develop a gamification solution that collects data and provides real-time...

  5. Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 1: state of the art.

    Science.gov (United States)

    Johansen, Monika Alise; Henriksen, Eva; Horsch, Alexander; Schuster, Tibor; Berntsen, Gro K Rosvold

    2012-10-03

    Over the last two decades, the number of studies on electronic symptom reporting has increased greatly. However, the field is very heterogeneous: the choices of patient groups, health service innovations, and research targets seem to involve a broad range of foci. To move the field forward, it is necessary to build on work that has been done and direct further research to the areas holding most promise. Therefore, we conducted a comprehensive review of randomized controlled trials (RCTs) focusing on electronic communication between patient and provider to improve health care service quality, presented in two parts. Part 2 investigates the methodological quality and effects of the RCTs, and demonstrates some promising benefits of electronic symptom reporting. To give a comprehensive overview of the most mature part of this emerging field regarding (1) patient groups, (2) health service innovations, and (3) research targets relevant to electronic symptom reporting. We searched Medline, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and IEEE Xplore for original studies presented in English-language articles published from 1990 to November 2011. Inclusion criteria were RCTs of interventions where patients or parents reported health information electronically to the health care system for health care purposes and were given feedback. Of 642 records identified, we included 32 articles representing 29 studies. The included articles were published from 2002, with 24 published during the last 5 years. The following five patient groups were represented: respiratory and lung diseases (12 studies), cancer (6), psychiatry (6), cardiovascular (3), and diabetes (1). In addition to these, 1 study had a mix of three groups. All included studies, except 1, focused on long-term conditions. We identified four categories of health service innovations: consultation support (7 studies), monitoring with clinician support (12), self-management with clinician support (9

  6. Technical interventions to increase adenoma detection rate in colonoscopy.

    Science.gov (United States)

    Rondonotti, Emanuele; Andrealli, Alida; Amato, Arnaldo; Paggi, Silvia; Conti, Clara Benedetta; Spinzi, Giancarlo; Radaelli, Franco

    2016-12-01

    Adenoma detection rate (ADR) is the most robust colonoscopy quality metric and clinical studies have adopted it as the ideal method to assess the impact of technical interventions. Areas covered: We reviewed papers focusing on the impact of colonoscopy technical issues on ADR, including withdrawal time and technique, second evaluation of the right colon, patient positional changes, gastrointestinal assistant participation during colonoscopy, water-aided technique, optimization of bowel preparation and antispasmodic administration. Expert commentary: Overall, technical interventions are inexpensive, available worldwide and easy to implement. Some of them, such as the adoption of split dose regimen and slow scope withdrawal to allow a careful inspection, have been demonstrated to significantly improve ADR. Emerging data support the use of water-exchange colonoscopy. According to published studies, other technical interventions seem to provide only marginal benefit to ADR. Unfortunately, the available evidence has methodological limitations, such as small sample sizes, the inclusion of expert endoscopists only and the evaluation of single technical interventions. Additionally, larger studies are needed to clarify whether these interventions might have a higher benefit on low adenoma detectors and whether the implementation of a bundle of them, instead of a single technical maneuver, might have a greater impact on ADR.

  7. Results from a clinical yoga program for veterans: yoga via telehealth provides comparable satisfaction and health improvements to in-person yoga.

    Science.gov (United States)

    Schulz-Heik, R Jay; Meyer, Hilary; Mahoney, Louise; Stanton, Michael V; Cho, Rachael H; Moore-Downing, Danae P; Avery, Timothy J; Lazzeroni, Laura C; Varni, Joanne M; Collery, Linda Martin; Bayley, Peter J

    2017-04-04

    Yoga is increasingly popular, though little data regarding its implementation in healthcare settings is available. Similarly, telehealth is being utilized more frequently to increase access to healthcare; however we know of no research on the acceptability or effectiveness of yoga delivered through telehealth. Therefore, we evaluated the feasibility, acceptability, and patient-reported effectiveness of a clinical yoga program at a Veterans Affairs Medical Center and assessed whether these outcomes differed between those participating in-person and those participating via telehealth. Veterans who attended a yoga class at the VA Palo Alto Health Care System were invited to complete an anonymous program evaluation survey. 64 Veterans completed the survey. Participants reported high satisfaction with the classes and the instructors. More than 80% of participants who endorsed a problem with pain, energy level, depression, or anxiety reported improvement in these symptoms. Those who participated via telehealth did not differ from those who participated in-person in any measure of satisfaction, overall improvement (p = .40), or improvement in any of 16 specific health problems. Delivering yoga to a wide range of patients within a healthcare setting appears to be feasible and acceptable, both when delivered in-person and via telehealth. Patients in this clinical yoga program reported high levels of satisfaction and improvement in multiple problem areas. This preliminary evidence for the effectiveness of a clinical yoga program complements prior evidence for the efficacy of yoga and supports the use of yoga in healthcare settings.

  8. Improved multiple-locus variable-number tandem-repeat assay for Staphylococcus aureus genotyping, providing a highly informative technique together with strong phylogenetic value

    NARCIS (Netherlands)

    Pourcel, Christine; Hormigos, Katia; Onteniente, Lucie; Sakwinska, Olga; Deurenberg, Ruud H; Vergnaud, Gilles

    2009-01-01

    We describe an improved multiple-locus variable-number tandem-repeat (VNTR) analysis (MLVA) scheme for genotyping Staphylococcus aureus. We compare its performance to those of multilocus sequence typing (MLST) and spa typing in a survey of 309 strains. This collection includes 87 epidemic

  9. Non-ablative fractional laser provides long-term improvement of mature burn scars--a randomized controlled trial with histological assessment.

    Science.gov (United States)

    Taudorf, Elisabeth H; Danielsen, Patricia L; Paulsen, Ida F; Togsverd-Bo, Katrine; Dierickx, Christine; Paasch, Uwe; Haedersdal, Merete

    2015-02-01

    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. 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-Patient-and-Observer-Scar-Assessment-Scale (mPOSAS, 1 = "normal skin", 10 = "worst imaginable scar"). Secondary outcomes included histology, patient satisfaction (0-10), patient-assessed improvement, and safety. Study was completed by 17 of 20 randomized patients with normotrophic (n = 11), hypertrophic (n = 5) or atrophic (n = 1) scars. Scar-appearance improved from laser-treatments (P ablative fractional laser-treatments induce long-term clinical and histological improvement of mature burn scars. © 2014 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Friedenberg, Joan E.

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

  11. Establishing a 1991 Veterans Research Network to Improve Characterization of Gulf War Illness and Provide a National Resource for Veterans and Investigators

    Science.gov (United States)

    2016-11-01

    data will be used to optimize a GWI case definition, based on current symptoms, and to provide insights concerning rates of other medical conditions... questionnaires by mail or online, and to participate in the 1991 Veterans Research and Information Network (91VetNet), a national research and information...be used to update and optimize a GWI case definition, based on veterans’ current health status, and to provide important insights concerning rates of

  12. Wall-based measurement features provides an improved IVUS coronary artery risk assessment when fused with plaque texture-based features during machine learning paradigm.

    Science.gov (United States)

    Banchhor, Sumit K; Londhe, Narendra D; Araki, Tadashi; Saba, Luca; Radeva, Petia; Laird, John R; Suri, Jasjit S

    2017-12-01

    Planning of percutaneous interventional procedures involves a pre-screening and risk stratification of the coronary artery disease. Current screening tools use stand-alone plaque texture-based features and therefore lack the ability to stratify the risk. This IRB approved study presents a novel strategy for coronary artery disease risk stratification using an amalgamation of IVUS plaque texture-based and wall-based measurement features. Due to common genetic plaque makeup, carotid plaque burden was chosen as a gold standard for risk labels during training-phase of machine learning (ML) paradigm. Cross-validation protocol was adopted to compute the accuracy of the ML framework. A set of 59 plaque texture-based features was padded with six wall-based measurement features to show the improvement in stratification accuracy. The ML system was executed using principle component analysis-based framework for dimensionality reduction and uses support vector machine classifier for training and testing-phases. The ML system produced a stratification accuracy of 91.28%, demonstrating an improvement of 5.69% when wall-based measurement features were combined with plaque texture-based features. The fused system showed an improvement in mean sensitivity, specificity, positive predictive value, and area under the curve by: 6.39%, 4.59%, 3.31% and 5.48%, respectively when compared to the stand-alone system. While meeting the stability criteria of 5%, the ML system also showed a high average feature retaining power and mean reliability of 89.32% and 98.24%, respectively. The ML system showed an improvement in risk stratification accuracy when the wall-based measurement features were fused with the plaque texture-based features. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Assessment and the feasibility of improving the artificial lighting system in technical services workshop located in the Fourth South Pars Gas Refinery

    OpenAIRE

    masoud shafiee motlagh; Mohsen Aliabadi; Reza Shahidi; Amin Kahani

    2015-01-01

    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 illum...

  14. Does a combined technical and didactical training program improve the acceptance of student tutors in the dissection course? A prospective controlled randomized study.

    Science.gov (United States)

    Shiozawa, Thomas; Hirt, Bernhard; Celebi, Nora; Werner, Anne; Weyrich, Peter; Lammerding-Koeppel, Maria

    2010-12-20

    student tutors in the dissection course are expected to meet high demands on their job. We developed a combined technical and didactical training on the basis of literature review and needs assessment. The three-week training program comprised dissection as well as presentation techniques, group dynamics and activating teaching methods. A randomized, controlled, single-blind study was set up to test whether there is a difference between the tutee's perception of the tutor competences, comparing trained and untrained tutors. a total of 10 trained and 10 untrained tutors (control group) were enlisted in the study. The acceptance of the training program was measured with a questionnaire (11 items, 5-point Likert scale) where the tutees rated the competences of the tutors. The tutees were assigned randomly to their tutor and blinded to his/her training. the tutees assessed the trained tutors better in all categories compared to the untrained tutors. A significantly better score (pcompetencies, is well accepted by the tutees and tutors. 2010 Elsevier GmbH. All rights reserved.

  15. The improvement of near-term CdTe processing and product capabilities and establishment of next-generation CdTe technology. Annual technical progress report, September 1, 1995--August 31, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Kester, J.; Albright, S. [Golden Photon, Inc., CO (United States)

    1997-07-01

    The potential of photovoltaics to become a major global business enterprise still lingers outside the limits of industrial capabilities. For the Cadmium Sulfide/Cadmium Telluride (CdS/CdTe) system this potential has continued to focus on improvements in efficiency, stability, and cost reduction. This triad is the primary objective of the present subcontract with NREL entitled {open_quotes}The Improvement of Near-term CdTe Processing and Product Capabilities & Establishment of Next Generation CdTe Technology{close_quotes}. This subcontract represents an intermediate stage of NREL`s plan to assist the growth of the photovoltaic industry in overcoming the scientific and technical barriers to commercialization. This report outlines the progress that has been made during the period of August 1995 through August 1996. The objectives of this subcontract are to improve processing methods, quantify and understand efficiency improvement mechanisms, meet life-testing goals, and address cadmium safety concerns. Task and subtask goals are defined to meet these objectives in specific areas. The approach to fulfilling the subcontract goals is through a balanced plan of process improvement and mechanism identification. These are carried out and continued through monitoring under various long term and accelerated stress conditions. GPI maintains an on-going awareness of all safety related issues, can in particular, those involving cadmium.

  16. Technical infrastructure monitoring at CERN

    CERN Document Server

    Stowisek, Jan; Suwalska, Anna

    2006-01-01

    The Technical Infrastructure Monitoring system (TIM) is used to monitor and control CERN's technical services from the CERN Control Centre (CCC). The system's primary function is to provide CCC operators with reliable real-time information about the state of the laboratory's extensive and widely distributed technical infrastructure. TIM is also used to monitor all general services required for the operation of CERN's accelerator complex and the experiments. A flexible data acquisition mechanism allows TIM to interface with a wide range of technically diverse installations, using industry standard protocols wherever possible and custom designed solutions where needed. The complexity of the data processing logic, including persistence, logging, alarm handling, command execution and the evaluation of datadriven business rules is encapsulated in the system's business layer. Users benefit from a suite of advanced graphical applications adapted to operations (synoptic views, alarm consoles, data analysis tools etc....

  17. 2011 PERFORMANCE ASSESSMENT COMMUNITY OF PRACTICE TECHNICAL EXCHANGE - SUMMARY

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, R.

    2011-12-30

    The Performance Assessment Community of Practice (PA CoP) was developed in 2008 to improve consistency and quality in the preparation of performance assessments (PAs) and risk assessments across the Department of Energy (DOE) Complex. The term, PA, is used to represent all of these modeling applications in this report. The PA CoP goals are to foster the exchange of information among PA practitioners and to share lessons learned from PAs conducted for DOE, commercial disposal facilities, and international entities. Technical exchanges and workshops are a cornerstone of PA CoP activities. Previous technical exchanges have addressed Engineered Barriers (2009 - http://www.cresp.org/education/workshops/pacop/), the Advanced Simulation Capability for Environmental Management and the Cementitious Barriers Partnership (2010 - http://srnl.doe.gov/copexchange/links.htm). Each technical exchange also includes summary presentations regarding activities at DOE, the Nuclear Regulatory Commission (NRC) and other organizations (e.g., International Atomic Energy Agency (IAEA)) as well as a number of presentations from selected sites to provide insight and perspective from on-going modeling activities. Through the deployment of PA Assistance Teams, the PA CoP has also been engaged in the development of new PAs across the DOE Complex. As a way of improving consistency in the preparation of new PAs, the teams provide technical advice and share experiences, noteworthy practices, and lessons learned from previous Low-Level Waste Disposal Facility Federal Review Group (LFRG) reviews. Teams have provided support for PAs at Hanford, Idaho, Paducah and Portsmouth. The third annual PA CoP Technical Exchange was held on May 25-26, 2011 in Atlanta, GA. The PA CoP Steering Committee Meeting held its first meeting on May 24 prior to the Technical Exchange. Decision making using models and software quality assurance were the topical emphasis for the exchange. A new feature at the 2011 technical

  18. SU-E-T-170: Characterization of the Location, Extent, and Proximity to Critical Structures of Target Volumes Provides Detail for Improved Outcome Predictions Among Pancreatic Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Z; Moore, J; Rosati, L; Mian, O; Narang, A; Herman, J; McNutt, T [Johns Hopkins University, Baltimore, MD (United States)

    2015-06-15

    Purpose: In radiotherapy, size, location and proximity of the target to critical structures influence treatment decisions. It has been shown that proximity of the target predicts dosimetric sparing of critical structures. In addition to dosimetry, precise location of disease has further implications such as tumor invasion, or proximity to major arteries that inhibit surgery. Knowledge of which patients can be converted to surgical candidates by radiation may have high impact on future treat/no-treat decisions. We propose a method to improve our characterization of the location of pancreatic cancer and treatment volume extent with respect to nearby arteries with the goal of developing features to improve clinical predictions and decisions. Methods: Oncospace is a local learning health system that systematically captures clinical outcomes and all aspects of radiotherapy treatment plans, including overlap volume histograms (OVH) – a measure of spatial relationships between two structures. Minimum and maximum distances of PTV and OARs based on OVH, PTV volume, anatomic location by ICD-9 code, and surgical outcome were queried. Normalized distance to center from the left and right kidney was calculated to indicate tumor location and laterality. Distance to critical arteries (celiac, superior mesenteric, common hepatic) is validated by surgical status (borderline resectable, locally advanced converted to resectable). Results: There were 205 pancreas stereotactic body radiotherapy patients treated from 2009–2015 queried. Location/laterality of tumor based on kidney OVH show strong trends between location by OVH and by ICD-9. Compared to the locally advanced group, the borderline resectable group showed larger geometrical distance from critical arteries (p=0.03). Conclusion: Our platform enabled analysis of shape/size-location relationships. These data suggest that PTV volume and attention to distance between PTVs and surrounding OARs and major arteries may be

  19. Logistic quantile regression provides improved estimates for bounded avian counts: a case study of California Spotted Owl fledgling production

    Science.gov (United States)

    Brian S. Cade; Barry R. Noon; Rick D. Scherer; John J. Keane

    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...

  20. VIRTEx project aims to promote long term health and improve social care. Virtual extra care project develops the potential of telehealthcare to provide community-based care.

    Science.gov (United States)

    Sadler, Steve

    2009-03-01

    Funded by the Technology Strategy Boards Assisted Living Innovation Platform, the VIRTEx project aims to develop the potential of telehealthcare to provide community-based care and increased social activity, inclusion and support for the growing number of people with long-term needs.

  1. Improvements in access to malaria treatment in Tanzania after switch to artemisinin combination therapy and the introduction of accredited drug dispensing outlets - a provider perspective

    Directory of Open Access Journals (Sweden)

    Dillip Angel

    2010-06-01

    Full Text Available Abstract Background To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO was created in Tanzania. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP to artemether-lumefantrine (ALu in 2007. Subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on access to malaria treatment was studied in rural Tanzania. Methods The study was carried out in the villages of Kilombero and Ulanga Demographic Surveillance System (DSS and in Ifakara town. Data collection consisted of: 1 yearly censuses of shops selling drugs; 2 collection of monthly data on availability of anti-malarials in public health facilities; and 3 retail audits to measure anti-malarial sales volumes in all public, mission and private outlets. The data were complemented with DSS population data. Results Between 2004 and 2008 access to malaria treatment greatly improved and the number of anti-malarial treatment doses dispensed increased by 78%. Particular improvements were observed in the availability (from 0.24 shops per 1,000 people in 2004 to 0.39 in 2008 and accessibility (from 71% of households within 5 km of a shop in 2004 to 87% in 2008 of drug shops. Despite no improvements in affordability this resulted in an increase of the market share from 49% of anti-malarial sales 2005 to 59% in 2008. The change of treatment policy from SP to ALu led to severe stock-outs of SP in health facilities in the months leading up to the introduction of ALu (only 40% months in stock, but these were compensated by the wide availability of SP in shops. After the introduction of ALu stock levels of the drug were relatively high in public health facilities (over 80% months in stock, but the drug could only be found in 30% of drug shops and in no general shops. This resulted in a low overall utilization of the drug (19% of all anti

  2. Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Aristos Aristidou Natureworks); Robert Kean (NatureWorks); Tom Schechinger (IronHorse Farms, Mat); Stuart Birrell (Iowa State); Jill Euken (Wallace Foundation & Iowa State)

    2007-10-01

    /storage/transportation equipment and the processor would build and operate the plant. Pilot fermentation studies demonstrated dramatic improvements in yields and rates with optimization of batch fermentor parameters. Demonstrated yields and rates are approaching those necessary for profitable commercial operation for production of ethanol or lactic acid. The ability of the biocatalyst to adapt to biomass hydrolysate (both biomass sugars and toxins in the hydrolysate) was demonstrated and points towards ultimate successful commercialization of the technology. However, some of this work will need to be repeated and possibly extended to adapt the final selected biocatalyst for the specific commercial hydrolysate composition. The path from corn stover in the farm field to final products, involves a number of steps. Each of these steps has options, problems, and uncertainties; thus creating a very complex multidimensional obstacle to successful commercial development. Through the tasks of this project, the technical and commercial uncertainties of many of these steps have been addressed; thus providing for a clearer understanding of paths forward and commercial viability of a corn stover-based biorefinery.

  3. Active assistive forced exercise provides long-term improvement to gait velocity and stride length in patients bilaterally affected by Parkinson's disease.

    Science.gov (United States)

    Stuckenschneider, T; Helmich, I; Raabe-Oetker, A; Froböse, I; Feodoroff, B

    2015-10-01

    Forced exercise training presents a valid method of improving symptoms of Parkinson's disease such as rigor, dyskinesia and gait dysfunctions. Brain imaging data suggest that use of active assistive forced exercise could improve Parkinsonian symptoms more effectively than passive assistive forced exercise. However, the long-term effects of active versus passive assistive forced exercise on the symptoms of Parkinson's disease are unknown. Here, 24 patients showing bilateral effects of Parkinson's disease underwent a 12 week intervention of either passive or active assistive forced exercise. We analyzed tremor scores, gait patterns, and scores on the Unified Parkinson's Disease Rating Scale-III from three timepoints--before beginning the intervention, upon completion of the intervention, and twelve weeks after completion of the intervention. Participation in both passive and active assistive forced exercise increased gait velocity (0.5 km/h), swing phase (2%), monopedal stance phase (2%), elongated stride length (11 cm) and decreased double stance phase (4%). However, with participation in active assistive forced exercise, postural and kinetic tremor were also reduced and gait velocity and stride length were increased long-term. Given these findings, we conclude that future treatment for patients bilaterally affected by Parkinson's disease should carefully consider the type of assistive forced exercise intervention to be used. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Critical analysis of India's National Mission on Medicinal Plants (NMMP in providing access to quality botanical drugs to improve public health

    Directory of Open Access Journals (Sweden)

    Rahi Jain

    2015-01-01

    Full Text Available Drugs play an important role in improving health of the population. Medicinal plants help in addressing the health issues of a large section of the population – especially the low and middle-income people. However, there are some concerns about the supply, efficacy and safety in using them. This study reviews India's major initiative toward medicinal plants namely, the National Mission on Medicinal Plants to meet medicinal plants challenges. The study analyzed the mission's probable shortcomings due to its design and operational details. This study used “content analysis” approach for analysis of mission's publicly available documents, viz. “Operational guidelines” and its two amendments. The study identified prevalent 28 shortcomings in the original document related to clarity of the document; accountability, transparency and stakeholders' representation. These challenges were partially addressed in two amendments, which indicate persistence of shortcomings in design and operational details. The mission can help in improving and strengthening the Ayurveda, Yoga, Unani, Siddha and Homeopathy program by addressing those shortcomings.

  5. Concept and development of a discharge alert filter for abnormal laboratory values coupled with computerized provider order entry: a tool for quality improvement and hospital risk management.

    Science.gov (United States)

    Mathew, George; Kho, Abel; Dexter, Paul; Bloodworth, Nathaniel; Fantz, Corinne; Spell, Nathan; LaBorde, David V

    2012-06-01

    To develop a clinical decision support system activated at the time of discharge to reduce potentially inappropriate discharges from unidentified or unaddressed abnormal laboratory values. We identified 106 laboratory tests for possible inclusion in the discharge alert filter. We selected 7 labs as widely available, commonly obtained, and associated with high risk for potential morbidity or mortality within abnormal ranges. We identified trigger thresholds at levels that would capture significant laboratory abnormalities while avoiding excessive flag generation because of laboratory results that minimally deviate outside the normal reference range. We selected sodium (>155 or 6 mEq/dL) phosphorous (11,000 cells/mm with a rise of 20% or more between the 2 most recent results), and international normalized ratio greater than 4. A discharge alert filter that reliably and effectively identifies patients that may be discharged in unsafe situations because of unaddressed critical laboratory values can improve patient safety at discharge and potentially reduce the incidence of costly litigation. Further research is needed to validate whether the proposed discharge alert filter is effective at improving patient safety at discharge.

  6. Where does the cod come from? Panels of gene‐associated markers provide vastly improved origin assignment in Atlantic cod (Gadus morhua)

    DEFF Research Database (Denmark)

    Eg Nielsen, Einar; Hansen, Jakob Hemmer; Taylor, Martin

    2012-01-01

    Methods for determining the geographical origin of individual fish are in high demand for fighting illegal, unreported, and unregulated (IUU) fishing and for independent control of catch certificates and “eco‐labels”. Hitherto, genetic origin assignment of marine fish has been hampered by the gen...... relevant for controlling illegal fishing, ecolabels, and fisheries management. Our results demonstrate how application of gene‐associated markers will probably revolutionize origin assignment in cod by providing faster, cheaper, and more reliable tools for origin assignment...

  7. Final Technical Report

    Energy Technology Data Exchange (ETDEWEB)

    Sobecky, Patricia A; Taillefert, Martial

    2013-03-29

    This final technical report describes results and findings from a research project to examine the role of microbial phosphohydrolase enzymes in naturally occurring subsurface microorganisms for the purpose of promoting the immobilization of the radionuclide uranium through the production of insoluble uranium phosphate minerals. The research project investigated the microbial mechanisms and the physical and chemical processes promoting uranium biomineralization and sequestration in oxygenated subsurface soils. Uranium biomineralization under aerobic conditions can provide a secondary biobarrier strategy to immobilize radionuclides should the metal precipitates formed by microbial dissimilatory mechanisms remobilize due to a change in redox state.

  8. Synbiotic supplementation promotes improvement of chronic diarrhea of unknown etiology in patient with chronic kidney disease and provides better outcomes in dialysis

    Science.gov (United States)

    Alvarenga Borges, Natalia; Elias Farage, Najla; Faria Barros, Amanda; Carvalho Ferreira, Dennis; Fouque, Denis; Mafra, Denise

    2016-02-16

    Chronic kidney disease (CKD) patients often have gastrointestinal symptoms which may result in malnutrition and a negative impact on their quality of life. Modulation of the gut microbiota can be a strategy to promote host health and homeostasis. The authors present a case of chronic diarrhea in a hemodialysis (HD) patient with an unknown etiology. After about one year and several failed interventions, synbiotic therapy was performed. The diarrhea episodes ceased after three months of daily supplementation and both biochemical and nutritional parameters improved. Synbyotic therapy promoted clinical benefits in this patient. Therefore, this simple therapy may be a promising alternative in CKD and it should be tested in larger studies.

  9. Pomegranate extract and exercise provide additive benefits on improvement of immune function by inhibiting inflammation and oxidative stress in high-fat-diet-induced obesity in rats.

    Science.gov (United States)

    Zhao, Fei; Pang, Wentao; Zhang, Ziyi; Zhao, Jialong; Wang, Xin; Liu, Ye; Wang, Xun; Feng, Zhihui; Zhang, Yong; Sun, Wenyan; Liu, Jiankang

    2016-06-01

    Obesity is reported to be associated with immune dysfunction and a state of low-grade, chronic inflammation. Either pomegranate extract (PomE) or exercise (Ex) has been shown to have antiobesity, anti-inflammatory and antioxidant effects. Nevertheless, no study has addressed the additive benefits of PomE and Ex on the restoration of obesity-induced immune defects. The present work aims to study the effect of PomE and Ex as a combined intervention on immune function and the underlying mechanism involved in inflammation and oxidative stress in rats with high-fat-diet (HFD)-induced obesity. Our results demonstrate that the combination of PomE and Ex showed additive benefits on inhibition of HFD-induced body weight increase and improvement of HFD-induced immune dysfunction, including (a) attenuating the abnormality of histomorphology of the spleen, (b) increasing the ratio of the CD4+:CD8+ T cell subpopulations in splenocytes and peripheral blood mononuclear cells (PBMC), (c) inhibition of apoptosis in splenocytes and PBMC, (d) normalizing peritoneal macrophage phenotypes and (e) restoring immunomodulating factors in serum. We also find that immune dysfunction in HFD-fed rats was associated with increased inflammatory cytokine secretion and oxidative stress biomarkers, and that the combination of PomE and Ex effectively inhibited the inflammatory response and decreased oxidative damage. The effect of PomE and Ex as a combined intervention is greater than the effect of either PomE or Ex alone, showing that PomE and Ex may be additively effective in improving immune function in HFD-fed rats by inhibiting inflammation and decreasing oxidative stress. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Design mentoring tool : [technical summary].

    Science.gov (United States)

    2011-01-01

    In 2004 a design engineer on-line mentoring tool was developed and implemented The purpose of the tool was to assist senior engineers mentoring new engineers to the INDOT design process and improve their technical competency. This approach saves seni...

  11. Gigabit Ethernet: A Technical Assessment.

    Science.gov (United States)

    Axner, David

    1997-01-01

    Describes gigabit ethernet for LAN (local area network) technology that will expand ethernet bandwidth. Technical details are discussed, including protocol stacks, optical fiber, deployment strategy for performance improvement, ATM (Asynchronous Transfer Mode), real-time protocol, reserve reservation protocol, and standards. (LRW)

  12. Technical note

    DEFF Research Database (Denmark)

    Hermansen, Jonas S; Fonslet, Jesper; Søndergaard, Lasse R

    2017-01-01

    PURPOSE: To provide a faster and more intuitive way of designing shielding for PET facilities, while still relying on the principles of the AAPM 108 Taskforce guidelines, as well as illustrating the calculation output using dose maps that are easily evaluated. METHODS: A graphical user interface...... was developed, implementing an inverse AAPM method, wherein radiation sources and shield barriers are manually defined. Simulations are calculated using a user defined control mesh grid. DoseMapper simulations were verified against manual calculations using the AAPM guidelines, as well as compared with in......-situ dose rate measurements using four different dosemeters. RESULTS: DoseMapper simulations were virtually identical to manual calculations using AAPM guidelines, with a maximum relative error of

  13. Effects of long-term coal supply contracts on technology adoption and improvements in the mining of coal. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Walton, D.R.; Hawkins, S.A.; Webb, P.F.; Kauffman, P.W.

    1979-08-01

    The relationship between long-term coal supply contracts and the adoption of new technology in the coal mining industry is a complex one. From this study certain conclusions can be drawn. New technologies and improvements in the mining of coal can be logically categorized into three areas: evolutionary technology, transitional technology, or innovative technology. Evolutionary improvements in technology can be categorized as improvements, or increased production capacities, in existing equipment. Transitional technology involves the adoption of existing or proven technologies into new conditions, or, proceeding from one technology type to a newer type for the same function. Innovative technology includes equipment, concepts, and systems not readily available, or untried, in the existing mining environment (seam conditions, etc.). Technology adoption is an economic decision. This point was repeatedly emphasized by industry representatives contacted during the study. The long-term coal supply contract influences the decision to adopt new technology and mining improvements in several ways depending on the technology type (i.e., evolutionary, transitional, or innovative), and also the coal supplier type (i.e., captive or independent producer). Several examples of the adoption of new technologies in mines under long-term coal supply contracts are discussed. (LTN)

  14. 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

    Background In malaria-endemic areas, residents of modern houses have less malaria than those living in traditional houses. This study will determine if modern housing provides incremental protection against clinical malaria over the current best practice of long-lasting insecticidal nets (LLINs...... at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection, parasite density, and the prevalence of anemia. Exposure to malaria parasites will be assessed using light traps, followed by detection of Anopheles gambiae species and sporozoite infection. Ancillary...

  15. Comparison of Traditional and Innovative Techniques to Solve Technical Challenges

    Science.gov (United States)

    Perchonok, Michele

    2011-01-01

    This slide presentation reviews the use of traditional and innovative techniques to solve technical challenges in food storage technology. The planning for a mission to Mars is underway, and the food storage technology improvements requires that improvements be made. This new technology is required, because current food storage technology is inadequate,refrigerators or freezers are not available for food preservation, and that a shelf life of 5 years is expected. A 10 year effort to improve food packaging technology has not enhanced significantly food packaging capabilities. Two innovation techniques were attempted InnoCentive and Yet2.com and have provided good results, and are still under due diligence for solver verification.

  16. Does additional support provided through e-mail or SMS in a Web-based Social Marketing program improve children's food consumption? A Randomized Controlled Trial.

    Science.gov (United States)

    Rangelov, Natalie; Della Bella, Sara; Marques-Vidal, Pedro; Suggs, L Suzanne

    2018-02-16

    The FAN Social Marketing program was developed to improve dietary and physical activity habits of families with children in Ticino, Switzerland. The aim of this study was to examine if the effects of the program on children's food intake differed by intervention group. Effects of the FAN program were tested through a Randomized Controlled Trial. The program lasted 8 weeks, during which participants received tailored communication about nutrition and physical activity. Families were randomly allocated to one of three groups, where the parent received the intervention by the Web (G1), Web + e-mail (G2) or Web + SMS (G3). Children in all groups received tailored print letters by post. Children's food consumption was assessed at baseline and immediate post intervention using a 7-day food diary. Generalized linear mixed models with child as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects were used to test the impact of the intervention. Analyses were conducted with a sample of 608 children. After participating in FAN the marginal means of daily consumption of fruit changed from 0.95 to 1.12 in G1, from 0.82 to 0.94 in G2, and from 0.93 to 1.18 in G3. The margins of the daily consumption of sweets decreased in each group (1.67 to 1.56 in G1, 1.71 to 1.49 in G2, and 1.72 to 1.62 in G3). The change in vegetable consumption observed from pre to post intervention in G3 (from 1.13 to 1.21) was significantly different from that observed in G1 (from 1.21 to 1.17). A well-designed Web-based Social Marketing intervention complemented with print letters can help improve children's consumption of water, fruit, soft drinks, and sweets. The use of SMS to support greater behavior change, in addition to Web-based communication, resulted only in a small significant positive change for vegetables, while the use of e-mail in addition to Web did not result in any significant difference. The trial was retrospectively registered in the

  17. Alfalfa (Medicago sativa L./maize (Zea mays L. intercropping provides a feasible way to improve yield and economic incomes in farming and pastoral areas of northeast China.

    Directory of Open Access Journals (Sweden)

    Baoru Sun

    Full Text Available Given the growing challenges to food and eco-environmental security as well as sustainable development of animal husbandry in the farming and pastoral areas of northeast China, it is crucial to identify advantageous intercropping modes and some constraints limiting its popularization. In order to assess the performance of various intercropping modes of maize and alfalfa, a field experiment was conducted in a completely randomized block design with five treatments: maize monoculture in even rows, maize monoculture in alternating wide and narrow rows, alfalfa monoculture, maize intercropped with one row of alfalfa in wide rows and maize intercropped with two rows of alfalfa in wide rows. Results demonstrate that maize monoculture in alternating wide and narrow rows performed best for light transmission, grain yield and output value, compared to in even rows. When intercropped, maize intercropped with one row of alfalfa in wide rows was identified as the optimal strategy and the largely complementary ecological niches of alfalfa and maize were shown to account for the intercropping advantages, optimizing resource utilization and improving yield and economic incomes. These findings suggest that alfalfa/maize intercropping has obvious advantages over monoculture and is applicable to the farming and pastoral areas of northeast China.

  18. Alfalfa (Medicago sativa L.)/maize (Zea mays L.) intercropping provides a feasible way to improve yield and economic incomes in farming and pastoral areas of northeast China.

    Science.gov (United States)

    Sun, Baoru; Peng, Yi; Yang, Hongyu; Li, Zhijian; Gao, Yingzhi; Wang, Chao; Yan, Yuli; Liu, Yanmei

    2014-01-01

    Given the growing challenges to food and eco-environmental security as well as sustainable development of animal husbandry in the farming and pastoral areas of northeast China, it is crucial to identify advantageous intercropping modes and some constraints limiting its popularization. In order to assess the performance of various intercropping modes of maize and alfalfa, a field experiment was conducted in a completely randomized block design with five treatments: maize monoculture in even rows, maize monoculture in alternating wide and narrow rows, alfalfa monoculture, maize intercropped with one row of alfalfa in wide rows and maize intercropped with two rows of alfalfa in wide rows. Results demonstrate that maize monoculture in alternating wide and narrow rows performed best for light transmission, grain yield and output value, compared to in even rows. When intercropped, maize intercropped with one row of alfalfa in wide rows was identified as the optimal strategy and the largely complementary ecological niches of alfalfa and maize were shown to account for the intercropping advantages, optimizing resource utilization and improving yield and economic incomes. These findings suggest that alfalfa/maize intercropping has obvious advantages over monoculture and is applicable to the farming and pastoral areas of northeast China.

  19. Systemic injection of AAV9-GDNF provides modest functional improvements in the SOD1(G93A) ALS rat but has adverse side effects.

    Science.gov (United States)

    Thomsen, G M; Alkaslasi, M; Vit, J-P; Lawless, G; Godoy, M; Gowing, G; Shelest, O; Svendsen, C N

    2017-04-01

    Injecting proteins into the central nervous system that stimulate neuronal growth can lead to beneficial effects in animal models of disease. In particular, glial cell line-derived neurotrophic factor (GDNF) has shown promise in animal and cell models of Parkinson's disease, Huntington's disease and amyotrophic lateral sclerosis (ALS). Here, systemic AAV9-GDNF was delivered via tail vein injections to young rats to determine whether this could be a safe and functional strategy to treat the SOD1(G93A) rat model of ALS and, therefore, translated to a therapy for ALS patients. We found that GDNF administration in this manner resulted in modest functional improvement, whereby grip strength was maintained for longer and the onset of forelimb paralysis was delayed compared to non-treated rats. This did not, however, translate into an extension in survival. In addition, ALS rats receiving GDNF exhibited slower weight gain, reduced activity levels and decreased working memory. Collectively, these results confirm that caution should be applied when applying growth factors such as GDNF systemically to multiple tissues.

  20. Co-inoculating ruminal content neither provides active hydrolytic microbes nor improves methanization of ¹³C-cellulose in batch digesters.

    Science.gov (United States)

    Chapleur, Olivier; Bize, Ariane; Serain, Thibaut; Mazéas, Laurent; Bouchez, Théodore

    2014-03-01

    Cellulose hydrolysis often limits the kinetics and efficiency of anaerobic degradation in industrial digesters. In animal digestive systems, specialized microorganisms enable cellulose biodegradation at significantly higher rates. This study aims to assess the potential of ruminal microbial communities to settle and to express their cellulolytic properties in anaerobic digesters. Cellulose-degrading batch incubations were co-inoculated with municipal solid waste digester sludge and ruminal content. ¹³C-labeled cellulose degradation was described over time with Gas Chromatography-Combustion-Isotope Ratio Mass Spectrometry. Results were linked to the identification of the microorganisms assimilating ¹³C and to the monitoring of their relative dynamics. Cellulose degradation in co-inoculated incubations was efficient but not significantly improved. Transient disturbances in degradation pathways occurred, as revealed by propionate accumulation. Automated Ribosomal Intergenic Spacer Analysis dynamics and pyrosequencing revealed that expected classes of Bacteria and Archaea were active and degraded cellulose. However, despite the favorable co-inoculation conditions, molecular tools also revealed that no ruminal species settled in the bioreactors. Other specific parameters were probably needed for this to happen. This study shows that exploiting the rumen's cellulolytic properties in anaerobic digesters is not straightforward. Co-inoculation can only be successful if ruminal microorganisms manage to thrive in the anaerobic digester and outcompete native microorganisms, which requires specific nutritional and environmental parameters, and a meticulous reproduction of the selection pressure encountered in the rumen. © 2013 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.