WorldWideScience

Sample records for reported greater improvements

  1. Promoting greater Federal energy productivity [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, Mark; Dudich, Luther

    2003-03-05

    This document is a close-out report describing the work done under this DOE grant to improve Federal Energy Productivity. Over the four years covered in this document, the Alliance To Save Energy conducted liaison with the private sector through our Federal Energy Productivity Task Force. In this time, the Alliance held several successful workshops on the uses of metering in Federal facilities and other meetings. We also conducted significant research on energy efficiency, financing, facilitated studies of potential energy savings in energy intensive agencies, and undertook other tasks outlined in this report.

  2. Conservatives report, but liberals display, greater happiness.

    Science.gov (United States)

    Wojcik, Sean P; Hovasapian, Arpine; Graham, Jesse; Motyl, Matt; Ditto, Peter H

    2015-03-13

    Research suggesting that political conservatives are happier than political liberals has relied exclusively on self-report measures of subjective well-being. We show that this finding is fully mediated by conservatives' self-enhancing style of self-report (study 1; N = 1433) and then describe three studies drawing from "big data" sources to assess liberal-conservative differences in happiness-related behavior (studies 2 to 4; N = 4936). Relative to conservatives, liberals more frequently used positive emotional language in their speech and smiled more intensely and genuinely in photographs. Our results were consistent across large samples of online survey takers, U.S. politicians, Twitter users, and LinkedIn users. Our findings illustrate the nuanced relationship between political ideology, self-enhancement, and happiness and illuminate the contradictory ways that happiness differences can manifest across behavior and self-reports. Copyright © 2015, American Association for the Advancement of Science.

  3. Improving greater trochanteric reattachment with a novel cable plate system.

    Science.gov (United States)

    Baril, Yannick; Bourgeois, Yan; Brailovski, Vladimir; Duke, Kajsa; Laflamme, G Yves; Petit, Yvan

    2013-03-01

    Cable-grip systems are commonly used for greater trochanteric reattachment because they have provided the best fixation performance to date, even though they have a rather high complication rate. A novel reattachment system is proposed with the aim of improving fixation stability. It consists of a Y-shaped fixation plate combined with locking screws and superelastic cables to reduce cable loosening and limit greater trochanter movement. The novel system is compared with a commercially available reattachment system in terms of greater trochanter movement and cable tensions under different greater trochanteric abductor application angles. A factorial design of experiments was used including four independent variables: plate system, cable type, abductor application angle, and femur model. The test procedure included 50 cycles of simultaneous application of an abductor force on the greater trochanter and a hip force on the femoral head. The novel plate reduces the movements of a greater trochanter fragment within a single loading cycle up to 26%. Permanent degradation of the fixation (accumulated movement based on 50-cycle testing) is reduced up to 46%. The use of superelastic cables reduces tension loosening up to 24%. However this last improvement did not result in a significant reduction of the grater trochanter movement. The novel plate and cables present advantages over the commercially available greater trochanter reattachment system. The plate reduces movements generated by the hip abductor. The superelastic cables reduce cable loosening during cycling. Both of these positive effects could decrease the risks related to grater trochanter non-union. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  4. Greater utilization of wood residue fuels through improved financial planning

    International Nuclear Information System (INIS)

    Billings, C.D.; Ziemke, M.C.; Stanford, R.

    1991-01-01

    Recent events have focused attention on the promotion of greater utilization of biomass fuel. Considerations include the need to reduce increases in global warming and also to improve ground level air quality by limiting the use of fossil fuels. However, despite all these important environmentally related considerations, economics remains the most important factor in the decision process used to determine the feasibility of using available renewable fuels instead of more convenient fossil fuels. In many areas of the Southeast, this decision process involves choosing between wood residue fuels such as bark, sawdust and shavings and presently plentiful natural gas. The primary candidate users of wood residue fuels are industries that use large amounts of heat and electric power and are located near centers of activity in the forest products industry such as sawmills, veneer mills and furniture factories. Given that such facilities both produce wood residues and need large amounts of heat and electricity, it is understandable that these firms are often major users of wood-fired furnaces and boilers. The authors have observed that poor or incomplete financial planning by the subject firms is a major barrier to economic utilization of inexpensive and widely available renewable fuels. In this paper, the authors suggest that wider usage of improved financial planning could double the present modest annual incidence of new commercial wood-fueled installation

  5. Greater vertical spot spacing to improve femtosecond laser capsulotomy quality.

    Science.gov (United States)

    Schultz, Tim; Joachim, Stephanie C; Noristani, Rozina; Scott, Wendell; Dick, H Burkhard

    2017-03-01

    To evaluate the effect of adapted capsulotomy laser settings on the cutting quality in femtosecond laser-assisted cataract surgery. Ruhr-University Eye Clinic, Bochum, Germany. Prospective randomized case series. Eyes were treated with 1 of 2 laser settings. In Group 1, the regular standard settings were used (incisional depth 600 μm, pulse energy 4 μJ, horizontal spot spacing 5 μm, vertical spot spacing 10 μm, treatment time 1.2 seconds). In Group 2, vertical spot spacing was increased to 15 μm and the treatment time was 1.0 seconds. Light microscopy was used to evaluate the cut quality of the capsule edge. The size and number of tags (misplaced laser spots, which form a second cut of the capsule with high tear risk) were evaluated in a blinded manner. Groups were compared using the Mann-Whitney U test. The study comprised 100 eyes (50 eyes in each group). Cataract surgery was successfully completed in all eyes, and no anterior capsule tear occurred during the treatment. Histologically, significant fewer tags were observed with the new capsulotomy laser setting. The mean score for the number and size of free tags was significantly lower in this group than with the standard settings (P laser settings improved cut quality and reduced the number of tags. The modification has the potential to reduce the risk for radial capsule tears in femtosecond laser-assisted cataract surgery. With the new settings, no tags and no capsule tears were observed under the operating microscope in any eye. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  6. Greater Occipital Nerve Treatment in the Management of Spontaneous Intracranial Hypotension Headache: A Case Report.

    Science.gov (United States)

    Niraj, G; Critchley, Peter; Kodivalasa, Mahesh; Dorgham, Mohammed

    2017-06-01

    Clinical presentation of spontaneous intracranial hypotension headache (SIHH) has similarities with postdural puncture headache (PDPH). Recommended treatment for both conditions is an epidural blood patch. Successful outcomes following greater occipital nerve blocks have been reported in the management of PDPH. We present the first report of greater occipital nerve treatment in SIHH. A 40-year-old male presented with a 2-year history of daily postural headaches having a significant impact on quality of life. Magnetic resonance imaging revealed bilateral convexity subdural collections. Post gadolinium scan revealed pachymeningeal enhancement with reduced pontomesencephalic angle below 50 degrees. The patient was offered an epidural blood patch and greater occipital nerve block with corticosteroids. The patient chose occipital nerve block. The patient reported significant short-term benefit lasting 4 months. Thereafter, the patient underwent pulsed radiofrequency treatment to bilateral greater occipital nerves. He reported significant benefit lasting 10 months. Greater occipital nerve treatment may have a role in management of SIHH. © 2017 American Headache Society.

  7. Greater use of wood residue fuels through improved financial planning: a case study in Alabama

    Energy Technology Data Exchange (ETDEWEB)

    Billings, C.D.; Ziemke, M.C. (Alabama Univ., Huntsville, AL (United States). Coll. of Administrative Science); Stanford, R. (Alabama Dept. of Economic and Community Affairs, Montgomery, AL (United States))

    1993-01-01

    As the world reacts to environmental concerns relating to fossil energy usage, emphasis is again placed on greater use of renewable fuels such as wood residues. Realistically, however, decisions to utilize such fuels are based on economic factors, rather than desires to improve US energy independence and/or protect the environment. Because Alabama has a large forest products industry, state authorities have long sought to assist potential users of wood residue fuels to better use biomass fuels instead of the usual alternative: natural gas. State agency experience in promoting commercial and industrial use of wood residue fuels has shown that inadequate financial planning has often resulted in rejection of viable projects or acceptance of non-optimum projects. This paper discusses the reasons for this situation and suggests remedies for its improvement. (author)

  8. Greater Proptosis Is Not Associated With Improved Compressive Optic Neuropathy in Thyroid Eye Disease.

    Science.gov (United States)

    Nanda, Tavish; Dunbar, Kristen E; Campbell, Ashley A; Bathras, Ryan M; Kazim, Michael

    2018-05-18

    Despite the paucity of supporting data, it has generally been held that proptosis in thyroid eye disease (TED) may provide relative protection from compressive optic neuropathy (CON) by producing spontaneous decompression. The objective of this study was to investigate this phenomenon in patients with bilateral TED-CON. We retrospectively reviewed the charts of 67 patients (134 orbits) with bilateral TED-CON at Columbia-Presbyterian Medical Center. Significant asymmetric proptosis (Hertel) was defined as ≥ 2 mm. Significant asymmetric CON was defined first, as the presence of an relative afferent pupillary defect. Those without an relative afferent pupillary defect were evaluated according to the TED-CON formula y = -0.69 - 0.31 × (motility) - 0.2 × (mean deviation) - 0.02 × (color vision) as previously established for the diagnosis of TED-CON. A difference in the formula result ≥ 1.0 between eyes was considered significant. Patients were then divided into 4 groups. Forty-one of 67 patients demonstrated asymmetric CON (29 by relative afferent pupillary defect, 12 by formula). Twenty-one of 67 patients demonstrated asymmetric proptosis. Only 5 of 12 (41.6%) of the patients who had both asymmetric proptosis and asymmetric CON (group 1) showed greater proptosis in the eye with less CON. Twenty-nine patients (group 2) showed that asymmetric CON occurred despite symmetrical proptosis. Seventeen patients (group 3), showed the inverse, that asymmetric differences in proptosis occurred with symmetrical CON. Despite commonly held assumptions, our results suggest that greater proptosis is not associated with improved TED-CON. Combining groups 1 to 3-all of which demonstrated asymmetry of either proptosis, CON, or both-91.4% of patients did not show a relationship between greater proptosis and improved CON.

  9. Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

    Science.gov (United States)

    Pillai, Anilkumar; Medford, Andrew R L

    2013-01-01

    Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

  10. Torsion of the Greater Omentum Secondary to Omental Lymphangioma in a Child: A Case Report

    International Nuclear Information System (INIS)

    Mistry, Kewal Arunkumar; Iyer, Dayashankar

    2015-01-01

    Omental cyst and omental torsion both are uncommon but important causes of acute abdomen with a difficult clinical diagnosis due to nonspecific features. Here we report a case of an eight year old child with acute abdominal pain referred for USG and CT scan which revealed two cysts in greater omentum leading to secondary omental torsion. An eight year old male child presented to casualty with severe pain abdomen since 1 day. There was no history of vomiting or altered bowel habits. The patient was febrile with tachycardia on arrival. On examination rigidity and tenderness all over abdomen were present. Serum amylase was within normal range. USG and CECT abdomen were done subsequently. USG showed two well defined cystic lesions in lower abdomen with presence of some internal echogenic debris and calcified foci in their dependent part. There was also presence of omentum with a whirl of blood vessels seen along anterior abdominal wall leading to these lesions suggesting torsion. On colour Doppler the presence of blood flow within the whirl of vessels was seen. Mild amount of free fluid was also seen in the peritoneal cavity. On CECT abdomen the findings of omental cysts and torsion of greater omentum with free fluid in abdomen were confirmed. The cysts measured 60×55 and 65×55mm on CT. The patient was taken for an emergency laparotomy for indication of acute generalized peritonitis. Two large omental cysts were found in the pelvic cavity along with torsed greater omentum along with 150 ml of hemorrhagic fluid in peritoneal cavity. The cysts and twisted necrotic part of the greater omentum were excised at surgery. No postoperative complications were observed. Histopathologic examination was suggestive of lymphangioma of omentum. Lymphangioma of the omentum is an not very uncommon however acute presentation with omental torsion and infarction is an unusual entity. Optimal utilization of preoperative imaging with USG, Doppler and contrast enhanced CT scan can provide

  11. How report cards on physicians, physician groups, and hospitals can have greater impact on consumer choices.

    Science.gov (United States)

    Sinaiko, Anna D; Eastman, Diana; Rosenthal, Meredith B

    2012-03-01

    Public report cards with quality and cost information on physicians, physician groups, and hospital providers have proliferated in recent years. However, many of these report cards are difficult for consumers to interpret and have had little impact on the provider choices consumers are making. To gain a more focused understanding of why these reports cards have not been more successful and what improvements could be made, we interviewed experts and surveyed registrants at the March 2011 AHRQ National Summit on Public Reporting for Consumers in Health Care. We found broad agreement that public reporting has been disconnected from consumer decisions about providers because of weaknesses in report card content, design, and accessibility. Policy makers have an opportunity to change the landscape of public reporting by taking advantage of advances in measurement, data collection, and information technology to deliver a more consumer-centered report card. Overcoming the constraint of limited public funding, and achieving the acceptance of providers, is critical to realizing future success.

  12. Does Greater Autonomy Improve School Performance? Evidence from a Regression Discontinuity Analysis in Chicago

    Science.gov (United States)

    Steinberg, Matthew P.

    2014-01-01

    School districts throughout the United States are increasingly providing greater autonomy to local public (non-charter) school principals. In 2005-06, Chicago Public Schools initiated the Autonomous Management and Performance Schools program, granting academic, programmatic, and operational freedoms to select principals. This paper provides…

  13. Strategies to improve homing of mesenchymal stem cells for greater efficacy in stem cell therapy.

    Science.gov (United States)

    Naderi-Meshkin, Hojjat; Bahrami, Ahmad Reza; Bidkhori, Hamid Reza; Mirahmadi, Mahdi; Ahmadiankia, Naghmeh

    2015-01-01

    Stem/progenitor cell-based therapeutic approach in clinical practice has been an elusive dream in medical sciences, and improvement of stem cell homing is one of major challenges in cell therapy programs. Stem/progenitor cells have a homing response to injured tissues/organs, mediated by interactions of chemokine receptors expressed on the cells and chemokines secreted by the injured tissue. For improvement of directed homing of the cells, many techniques have been developed either to engineer stem/progenitor cells with higher amount of chemokine receptors (stem cell-based strategies) or to modulate the target tissues to release higher level of the corresponding chemokines (target tissue-based strategies). This review discusses both of these strategies involved in the improvement of stem cell homing focusing on mesenchymal stem cells as most frequent studied model in cellular therapies. © 2014 International Federation for Cell Biology.

  14. Greater Vancouver regional district air quality management plan : implementation status report

    International Nuclear Information System (INIS)

    2001-03-01

    In December 1994, an Air Quality Management Plan (AQMP) was adopted by the Greater Vancouver Regional District. The AQMP included ways to improve air quality in the region, leading to reduced emissions from commercial and industrial operations. This Plan encourages cooperation with the various communities affected to achieve clean air lifestyles and manage emissions from human activity to enhance human health and the integrity of the environment. The reduction of total emissions of the common air contaminants sulphur and nitrogen oxides, particulate matter, carbon monoxide and volatile organic compounds by 38 per cent is the stated aim of the AQMP. Five years of planning resulted in the formulation of the AQMP. The issues addressed were assigned one of four priorities as follows: priority 1 deals with ground level ozone and fine particulate, priority 2 looks at visibility, hazardous air pollutants, and global climate change, priority 3 concerns odour, carbon monoxide, sulphur dioxide, acidic deposition, and nitrogen dioxide, and priority 4 contains total suspended particulate matter and volatile organic compounds. A total of 54 Emission Reduction Measures were established, and the document reviewed them. Progress is being made in all areas. 2 tabs., 3 figs

  15. Is Greater Improvement in Early Self-Regulation Associated with Fewer Behavioral Problems Later in Childhood?

    Science.gov (United States)

    Sawyer, Alyssa C. P.; Miller-Lewis, Lauren R.; Searle, Amelia K.; Sawyer, Michael G.; Lynch, John W.

    2015-01-01

    The aim of this study was to determine whether the extent of improvement in self-regulation achieved between ages 4 and 6 years is associated with the level of behavioral problems later in childhood. Participants were 4-year-old children (n = 510) attending preschools in South Australia. Children's level of self-regulation was assessed using the…

  16. Mitigation effectiveness for improving nesting success of greater sage-grouse influenced by energy development

    Science.gov (United States)

    Kirol, Christopher P.; Sutphin, Andrew L.; Bond, Laura S.; Fuller, Mark R.; Maechtle, Thomas L.

    2015-01-01

    Sagebrush Artemisia spp. habitats being developed for oil and gas reserves are inhabited by sagebrush obligate species — including the greater sage-grouse Centrocercus urophasianus (sage-grouse) that is currently being considered for protection under the U.S. Endangered Species Act. Numerous studies suggest increasing oil and gas development may exacerbate species extinction risks. Therefore, there is a great need for effective on-site mitigation to reduce impacts to co-occurring wildlife such as sage-grouse. Nesting success is a primary factor in avian productivity and declines in nesting success are also thought to be an important contributor to population declines in sage-grouse. From 2008 to 2011 we monitored 296 nests of radio-marked female sage-grouse in a natural gas (NG) field in the Powder River Basin, Wyoming, USA, and compared nest survival in mitigated and non-mitigated development areas and relatively unaltered areas to determine if specific mitigation practices were enhancing nest survival. Nest survival was highest in relatively unaltered habitats followed by mitigated, and then non-mitigated NG areas. Reservoirs used for holding NG discharge water had the greatest support as having a direct relationship to nest survival. Within a 5-km2 area surrounding a nest, the probability of nest failure increased by about 15% for every 1.5 km increase in reservoir water edge. Reducing reservoirs was a mitigation focus and sage-grouse nesting in mitigated areas were exposed to almost half of the amount of water edge compared to those in non-mitigated areas. Further, we found that an increase in sagebrush cover was positively related to nest survival. Consequently, mitigation efforts focused on reducing reservoir construction and reducing surface disturbance, especially when the surface disturbance results in sagebrush removal, are important to enhancing sage-grouse nesting success.

  17. Preventive maintenance basis: Volume 10 -- High voltage electric motors (5 kV and greater). Final report

    International Nuclear Information System (INIS)

    Worledge, D.; Hinchcliffe, G.

    1997-07-01

    US nuclear plants are implementing preventive maintenance (PM) tasks with little documented basis beyond fundamental vendor information to support the tasks or their intervals. The Preventive Maintenance Basis project provides utilities with the technical basis for PM tasks and task intervals associated with 40 specific components such as valves, electric motors, pumps, and HVAC equipment. This report provides an overview of the PM Basis project and describes use of the PM Basis database. Volume 10 of the report provides a program of PM tasks suitable for application to high voltage (5kV and greater) electric motors in nuclear power plants. The PM tasks that are recommended provide a cost-effective way to intercept the causes and mechanisms that lead to degradation and failure. They can be used, in conjunction with material from other sources, to develop a complete PM program or to improve an existing program. Users of this information will be utility managers, supervisors, craft technicians, and training instructors responsible for developing, optimizing, or fine-tuning PM programs. Reactor Coolant Pumps motors (RCP's) are not excluded from this report in so far as good PM practices for motors of the appropriate class are concerned. However, the special auxiliary equipment normally associated with RCP's has not been included. Consequently, this report does not provide a complete PM program for RCP's. Industry and vendor programs for RCP's should be consulted for complete definition of RCP motor PM programs

  18. Improving Indonesian cinnamon (c. burmannii (Nees & t. nees) Blume) value chains for Greater Farmers Incomes

    Science.gov (United States)

    Menggala, S. R.; Damme, P. V.

    2018-03-01

    Genus Cinnamomum (Lauraceae) regroups some species whose stem bark are harvested, conditioned and traded as cinnamon in an international market. Over the centuries, the species have been domesticated so that now at least six different ones are grown in Southeast Asia countries. One of the species is Cinnamomum burmannii, also known as Korintje Cinnamon, which generates income for most smallholder farmers in Kerinci district, Jambi, Indonesia. Most cinnamon consumed in the world originates from this Korintje Cinnamon products. It is recognized for its unparalleled quality that comes with its sharp and sweet flavor, with a slightly bitter edge. However, international market requirements for product certification and quality standards make it difficult for a farmer to comply. Our research will address issues related to (improvement of) productivity, sustainability and value chains faced by cinnamon producers in Kerinci, to strengthen their product’s value chains. Smallholder farmers are very vulnerable to climate change impacts, and thus empowering the value chains of agricultural products will increase farmers resilience to climate change. The research will analyze the development of agricultural value chains, certification & standards on trade mechanism to help farmers earn a better income and future prospects.

  19. Greater-Than-Class C Low-Level Radioactive Waste Transportation Strategy report and institutional plan

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.C.; Tyacke, M.J.

    1995-01-01

    This document contains two parts. Part I, Greater-Than-Class-C Low-Level Radioactive Waste Transportation Strategy, addresses the requirements, responsibilities, and strategy to transport and receive these wastes. The strategy covers (a) transportation packaging, which includes shipping casks and waste containers; (b) transportation operations relating to the five facilities involved in transportation, i.e., waste originator, interim storage, dedicated storage, treatment, and disposal; (c) system safety and risk analysis; (d) routes; (e) emergency preparedness and response; and (o safeguards and security. A summary of strategic actions is provided at the conclusion of Part 1. Part II, Institutional Plan for Greater-Than-Class C Low-Level Radioactive Waste Packaging and Transportation, addresses the assumptions, requirements, and institutional plan elements and actions. As documented in the Strategy and Institutional Plan, the most challenging issues facing the GTCC LLW Program shipping campaign are institutional issues closely related to the strategy. How the Program addresses those issues and demonstrates to the states, local governments, and private citizens that the shipments can and will be made safely will strongly affect the success or failure of the campaign.

  20. Greater-Than-Class C Low-Level Radioactive Waste Transportation Strategy report and institutional plan

    International Nuclear Information System (INIS)

    Schmitt, R.C.; Tyacke, M.J.

    1995-01-01

    This document contains two parts. Part I, Greater-Than-Class-C Low-Level Radioactive Waste Transportation Strategy, addresses the requirements, responsibilities, and strategy to transport and receive these wastes. The strategy covers (a) transportation packaging, which includes shipping casks and waste containers; (b) transportation operations relating to the five facilities involved in transportation, i.e., waste originator, interim storage, dedicated storage, treatment, and disposal; (c) system safety and risk analysis; (d) routes; (e) emergency preparedness and response; and (o safeguards and security. A summary of strategic actions is provided at the conclusion of Part 1. Part II, Institutional Plan for Greater-Than-Class C Low-Level Radioactive Waste Packaging and Transportation, addresses the assumptions, requirements, and institutional plan elements and actions. As documented in the Strategy and Institutional Plan, the most challenging issues facing the GTCC LLW Program shipping campaign are institutional issues closely related to the strategy. How the Program addresses those issues and demonstrates to the states, local governments, and private citizens that the shipments can and will be made safely will strongly affect the success or failure of the campaign

  1. College students who have an eveningness preference report lower self-control and greater procrastination.

    Science.gov (United States)

    Digdon, Nancy L; Howell, Andrew J

    2008-11-01

    Previous research suggests a possible link between eveningness and general difficulties with self-regulation (e.g., evening types are more likely than other chronotypes to have irregular sleep schedules and social rhythms and use substances). Our study investigated the relationship between eveningness and self-regulation by using two standardized measures of self-regulation: the Self-Control Scale and the Procrastination Scale. We predicted that an eveningness preference would be associated with poorer self-control and greater procrastination than would an intermediate or morningness preference. Participants were 308 psychology students (mean age=19.92 yrs) at a small Canadian college. Students completed the self-regulation questionnaires and Morningness/Eveningness Questionnaire (MEQ) online. The mean MEQ score was 46.69 (SD=8.20), which is intermediate between morningness and eveningness. MEQ scores ranged from definite morningness to definite eveningness, but the dispersion of scores was skewed toward more eveningness. Pearson and partial correlations (controlling for age) were used to assess the relationship between MEQ score and the Self-Control Scale (global score and 5 subscale scores) and Procrastination Scale (global score). All correlations were significant. The magnitude of the effects was medium for all measures except one of the Self-Control subscales, which was small. A multiple regression analysis to predict MEQ score using the Self-Control Scale (global score), Procrastination Scale, and age as predictors indicated the Self-Control Scale was a significant predictor (accounting for 20% of the variance). A multiple regression analysis to predict MEQ scores using the five subscales of the Self-Control Scale and age as predictors showed the subscales for reliability and work ethic were significant predictors (accounting for 33% of the variance). Our study showed a relationship between eveningness and low self-control, but it did not address whether the

  2. Greater Biopsy Core Number Is Associated With Improved Biochemical Control in Patients Treated With Permanent Prostate Brachytherapy

    International Nuclear Information System (INIS)

    Bittner, Nathan; Merrick, Gregory S.; Galbreath, Robert W.; Butler, Wayne M.; Adamovich, Edward; Wallner, Kent E.

    2010-01-01

    Purpose: Standard prostate biopsy schemes underestimate Gleason score in a significant percentage of cases. Extended biopsy improves diagnostic accuracy and provides more reliable prognostic information. In this study, we tested the hypothesis that greater biopsy core number should result in improved treatment outcome through better tailoring of therapy. Methods and Materials: From April 1995 to May 2006, 1,613 prostate cancer patients were treated with permanent brachytherapy. Patients were divided into five groups stratified by the number of prostate biopsy cores (≤6, 7-9, 10-12, 13-20, and >20 cores). Biochemical progression-free survival (bPFS), cause-specific survival (CSS), and overall survival (OS) were evaluated as a function of core number. Results: The median patient age was 66 years, and the median preimplant prostate-specific antigen was 6.5 ng/mL. The overall 10-year bPFS, CSS, and OS were 95.6%, 98.3%, and 78.6%, respectively. When bPFS was analyzed as a function of core number, the 10-year bPFS for patients with >20, 13-20, 10-12, 7-9 and ≤6 cores was 100%, 100%, 98.3%, 95.8%, and 93.0% (p < 0.001), respectively. When evaluated by treatment era (1995-2000 vs. 2001-2006), the number of biopsy cores remained a statistically significant predictor of bPFS. On multivariate analysis, the number of biopsy cores was predictive of bPFS but did not predict for CSS or OS. Conclusion: Greater biopsy core number was associated with a statistically significant improvement in bPFS. Comprehensive regional sampling of the prostate may enhance diagnostic accuracy compared to a standard biopsy scheme, resulting in better tailoring of therapy.

  3. OPSAID improvements and capabilities report.

    Energy Technology Data Exchange (ETDEWEB)

    Halbgewachs, Ronald D.; Chavez, Adrian R.

    2011-08-01

    Process Control System (PCS) and Industrial Control System (ICS) security is critical to our national security. But there are a number of technological, economic, and educational impediments to PCS owners implementing effective security on their systems. Sandia National Laboratories has performed the research and development of the OPSAID (Open PCS Security Architecture for Interoperable Design), a project sponsored by the US Department of Energy Office of Electricity Delivery and Energy Reliability (DOE/OE), to address this issue. OPSAID is an open-source architecture for PCS/ICS security that provides a design basis for vendors to build add-on security devices for legacy systems, while providing a path forward for the development of inherently-secure PCS elements in the future. Using standardized hardware, a proof-of-concept prototype system was also developed. This report describes the improvements and capabilities that have been added to OPSAID since an initial report was released. Testing and validation of this architecture has been conducted in another project, Lemnos Interoperable Security Project, sponsored by DOE/OE and managed by the National Energy Technology Laboratory (NETL).

  4. Olympic weightlifting and plyometric training with children provides similar or greater performance improvements than traditional resistance training.

    Science.gov (United States)

    Chaouachi, Anis; Hammami, Raouf; Kaabi, Sofiene; Chamari, Karim; Drinkwater, Eric J; Behm, David G

    2014-06-01

    A number of organizations recommend that advanced resistance training (RT) techniques can be implemented with children. The objective of this study was to evaluate the effectiveness of Olympic-style weightlifting (OWL), plyometrics, and traditional RT programs with children. Sixty-three children (10-12 years) were randomly allocated to a 12-week control OWL, plyometric, or traditional RT program. Pre- and post-training tests included body mass index (BMI), sum of skinfolds, countermovement jump (CMJ), horizontal jump, balance, 5- and 20-m sprint times, isokinetic force and power at 60 and 300° · s(-1). Magnitude-based inferences were used to analyze the likelihood of an effect having a standardized (Cohen's) effect size exceeding 0.20. All interventions were generally superior to the control group. Olympic weightlifting was >80% likely to provide substantially better improvements than plyometric training for CMJ, horizontal jump, and 5- and 20-m sprint times, whereas >75% likely to substantially exceed traditional RT for balance and isokinetic power at 300° · s(-1). Plyometric training was >78% likely to elicit substantially better training adaptations than traditional RT for balance, isokinetic force at 60 and 300° · s(-1), isokinetic power at 300° · s(-1), and 5- and 20-m sprints. Traditional RT only exceeded plyometric training for BMI and isokinetic power at 60° · s(-1). Hence, OWL and plyometrics can provide similar or greater performance adaptations for children. It is recommended that any of the 3 training modalities can be implemented under professional supervision with proper training progressions to enhance training adaptations in children.

  5. NDVI saturation adjustment: a new approach for improving cropland performance estimates in the Greater Platte River Basin, USA

    Science.gov (United States)

    Gu, Yingxin; Wylie, Bruce K.; Howard, Daniel M.; Phuyal, Khem P.; Ji, Lei

    2013-01-01

    In this study, we developed a new approach that adjusted normalized difference vegetation index (NDVI) pixel values that were near saturation to better characterize the cropland performance (CP) in the Greater Platte River Basin (GPRB), USA. The relationship between NDVI and the ratio vegetation index (RVI) at high NDVI values was investigated, and an empirical equation for estimating saturation-adjusted NDVI (NDVIsat_adjust) based on RVI was developed. A 10-year (2000–2009) NDVIsat_adjust data set was developed using 250-m 7-day composite historical eMODIS (expedited Moderate Resolution Imaging Spectroradiometer) NDVI data. The growing season averaged NDVI (GSN), which is a proxy for ecosystem performance, was estimated and long-term NDVI non-saturation- and saturation-adjusted cropland performance (CPnon_sat_adjust, CPsat_adjust) maps were produced over the GPRB. The final CP maps were validated using National Agricultural Statistics Service (NASS) crop yield data. The relationship between CPsat_adjust and the NASS average corn yield data (r = 0.78, 113 samples) is stronger than the relationship between CPnon_sat_adjust and the NASS average corn yield data (r = 0.67, 113 samples), indicating that the new CPsat_adjust map reduces the NDVI saturation effects and is in good agreement with the corn yield ground observations. Results demonstrate that the NDVI saturation adjustment approach improves the quality of the original GSN map and better depicts the actual vegetation conditions of the GPRB cropland systems.

  6. Social and institutional evaluation report for Greater-Than-Class C Low-Level Radioactive Waste Disposal

    International Nuclear Information System (INIS)

    Anderson, T.L.; Lewis, B.E.; Turner, K.H.; Rozelle, M.A.

    1993-10-01

    This report identifies and characterizes social and institutional issues that would be relevant to the siting, licensing, construction, closure, and postclosure of a Greater-Than-Class-C low-level radioactive waste (GTCC LLW) disposal facility. A historical perspective of high-level radioactive waste (HLW) and LLW disposal programs is provided as an overview of radioactive waste disposal and to support the recommendations and conclusions in the report. A characterization of each issue is provided to establish the basis for further evaluations. Where applicable, the regulatory requirements of 10 CFR 60 and 61 are incorporated in the issue characterizations. The issues are used to compare surface, intermediate depth, and deep geologic disposal alternatives. The evaluation establishes that social and institutional issues do not significantly discriminate among the disposal alternatives. Recommendations are provided for methods by which the issues could be considered throughout the lifecycle of a GTCC LLW disposal program

  7. Social and institutional evaluation report for Greater-Than-Class C Low-Level Radioactive Waste Disposal

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, T.L.; Lewis, B.E.; Turner, K.H.; Rozelle, M.A. [Dames and Moore, Denver, CO (United States)

    1993-10-01

    This report identifies and characterizes social and institutional issues that would be relevant to the siting, licensing, construction, closure, and postclosure of a Greater-Than-Class-C low-level radioactive waste (GTCC LLW) disposal facility. A historical perspective of high-level radioactive waste (HLW) and LLW disposal programs is provided as an overview of radioactive waste disposal and to support the recommendations and conclusions in the report. A characterization of each issue is provided to establish the basis for further evaluations. Where applicable, the regulatory requirements of 10 CFR 60 and 61 are incorporated in the issue characterizations. The issues are used to compare surface, intermediate depth, and deep geologic disposal alternatives. The evaluation establishes that social and institutional issues do not significantly discriminate among the disposal alternatives. Recommendations are provided for methods by which the issues could be considered throughout the lifecycle of a GTCC LLW disposal program.

  8. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report.

  9. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    International Nuclear Information System (INIS)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report

  10. Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI

    Directory of Open Access Journals (Sweden)

    Christine E. Blake

    2013-01-01

    Full Text Available Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS. Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES adults with baseline examination between 1987 and 2002 (n=19,003. Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and multivariate logistic regression. Results. Compared to men, women were more likely to be dieting (32% women; 18% men and had higher weight dissatisfaction. Men and women with greater weight dissatisfaction reported more dieting, yo-yo dieting, and snacking and consuming fewer meals, being less active, and having to eat either more or less than desired to maintain weight regardless of weight status. Those who were overweight or obese and dissatisfied with their weight had the poorest health. Conclusion. Greater satisfaction with one’s weight was associated with positive health behaviors and health outcomes in both men and women and across weight status groups.

  11. Quantifying reporting timeliness to improve outbreak control

    NARCIS (Netherlands)

    Bonačić Marinović, Axel; Swaan, Corien; van Steenbergen, Jim; Kretzschmar, MEE

    The extent to which reporting delays should be reduced to gain substantial improvement in outbreak control is unclear. We developed a model to quantitatively assess reporting timeliness. Using reporting speed data for 6 infectious diseases in the notification system in the Netherlands, we calculated

  12. Ecology of Greater Sage-Grouse in the Bi-State Planning Area Final Report, September 2007

    Science.gov (United States)

    Casazza, Michael L.; Overton, Cory T.; Farinha, Melissa A.; Torregrosa, Alicia; Fleskes, Joseph P.; Miller, Michael R.; Sedinger, James S.; Kolada, Eric J.

    2009-01-01

    Conservation efforts for greater sage-grouse (Centrocercus urophasianus), hereafter sage-grouse, are underway across the range of this species. Over 70 local working groups have been established and are implementing on-the-ground sage-grouse oriented conservation projects. Early on in this process, the California Department of Fish and Game (CDFG) recognized the need to join in these efforts and received funding from the U.S. Fish and Wildlife Service (USFWS) under the Candidate Species Conservation Program to help develop a species conservation plan for sage-grouse in the Mono County area. This conservation plan covers portions of Alpine, Mono, and Inyo counties in California and Douglas, Esmeralda, Lyon, and Mineral counties in Nevada. A concurrent effort underway through the Nevada Governor's Sage-grouse Conservation Team established Local Area Working Groups across Nevada and eastern California. The Mono County populations of sage-grouse were encompassed by the Bi-State Local Planning Area, which was comprised of six population management units (PMUs). The state agencies from California (CDFG) and Nevada (Nevada Department of Wildlife; NDOW) responsible for the management of sage-grouse agreed to utilize the process that had begun with the Nevada Governor's Team in order to develop local plans for conservation planning and implementation. Resources from the USFWS were applied to several objectives in support of the development of the Bi-State Local Area Sage-grouse Conservation Plan through a grant to the U.S. Geological Survey (USGS). Objectives included: (1) participate in the development of the Bi-State Conservation Plan, (2) compile and synthesize existing sage-grouse data, (3) document seasonal movements of sage-grouse, (4) identify habitats critical to sage-grouse, (5) determine survival rates and identify causal factors of mortality, (6) determine nest success and brood success of sage-grouse, and (7) identify sage-grouse lek sites. Progress reports

  13. Towards a greater understanding of the illicit tobacco trade in Europe: a review of the PMI funded 'Project Star' report.

    Science.gov (United States)

    Gilmore, Anna B; Rowell, Andy; Gallus, Silvano; Lugo, Alessandra; Joossens, Luk; Sims, Michelle

    2014-05-01

    Following a legal agreement with the European Union (EU), Philip Morris International (PMI) commissions a yearly report ('Project Star', PS) on the European illicit cigarette trade from KPMG, the global accountancy firm. Review of PS 2010 report. Comparison with data from independent sources including a 2010 pan-European survey (N=18,056). Within PS, data covering all 27 EU countries are entered into a model. While the model itself seems appropriate, concerns are identified with the methodologies underlying the data inputs and thus their quality: there is little transparency over methodologies; interview data underestimate legal non-domestic product partly by failing to account for legal cross-border sales; illicit cigarette estimates rely on tobacco industry empty pack surveys which may overestimate illicit; and there is an over-reliance on data supplied by PMI with inadequate external validation. Thus, PMI sales data are validated using PMI smoking prevalence estimates, yet PMI is unable to provide sales (shipment) data for the Greek islands and its prevalence estimates differ grossly from independent data. Consequently, comparisons with independent data suggest PS will tend to overestimate illicit cigarette levels particularly where cross-border shopping is frequent (Austria, Finland, France) and in Western compared with Eastern European countries. The model also provides data on the nature of the illicit cigarette market independent of seizure data suggesting that almost a quarter of the illicit cigarette market in 2010 comprised PMI's own brands compared with just 5% counterfeited PMI brands; a finding hidden in PMI's public representation of the data. PS overestimates illicit cigarette levels in some European countries and suggests PMI's supply chain control is inadequate. Its publication serves the interests of PMI over those of the EU and its member states. PS requires greater transparency, external scrutiny and use of independent data. Published by the BMJ

  14. Improved drought monitoring in the Greater Horn of Africa by combining meteorological and remote sensing based indicators

    DEFF Research Database (Denmark)

    Horion, Stéphanie Marie Anne F; Kurnik, Blaz; Barbosa, Paulo

    2010-01-01

    , and therefore to better trigger timely and appropriate actions on the field. In this study, meteorological and remote sensing based drought indicators were compared over the Greater Horn of Africa in order to better understand: (i) how they depict historical drought events ; (ii) if they could be combined...... distribution. Two remote sensing based indicators were tested: the Normalized Difference Water Index (NDWI) derived from SPOT-VEGETATION and the Global Vegetation Index (VGI) derived form MERIS. The first index is sensitive to change in leaf water content of vegetation canopies while the second is a proxy...... of the amount and vigour of vegetation. For both indexes, anomalies were estimated using available satellite archives. Cross-correlations between remote sensing based anomalies and SPI were analysed for five land covers (forest, shrubland, grassland, sparse grassland, cropland and bare soil) over different...

  15. The Greater Phenotypic Homeostasis of the Allopolyploid Coffea arabica Improved the Transcriptional Homeostasis Over that of Both Diploid Parents.

    Science.gov (United States)

    Bertrand, Benoît; Bardil, Amélie; Baraille, Hélène; Dussert, Stéphane; Doulbeau, Sylvie; Dubois, Emeric; Severac, Dany; Dereeper, Alexis; Etienne, Hervé

    2015-10-01

    Polyploidy impacts the diversity of plant species, giving rise to novel phenotypes and leading to ecological diversification. In order to observe adaptive and evolutionary capacities of polyploids, we compared the growth, primary metabolism and transcriptomic expression level in the leaves of the newly formed allotetraploid Coffea arabica species compared with its two diploid parental species (Coffea eugenioides and Coffea canephora), exposed to four thermal regimes (TRs; 18-14, 23-19, 28-24 and 33-29°C). The growth rate of the allopolyploid C. arabica was similar to that of C. canephora under the hottest TR and that of C. eugenioides under the coldest TR. For metabolite contents measured at the hottest TR, the allopolyploid showed similar behavior to C. canephora, the parent which tolerates higher growth temperatures in the natural environment. However, at the coldest TR, the allopolyploid displayed higher sucrose, raffinose and ABA contents than those of its two parents and similar linolenic acid leaf composition and Chl content to those of C. eugenioides. At the gene expression level, few differences between the allopolyploid and its parents were observed for studied genes linked to photosynthesis, respiration and the circadian clock, whereas genes linked to redox activity showed a greater capacity of the allopolyploid for homeostasis. Finally, we found that the overall transcriptional response to TRs of the allopolyploid was more homeostatic compared with its parents. This better transcriptional homeostasis of the allopolyploid C. arabica afforded a greater phenotypic homeostasis when faced with environments that are unsuited to the diploid parental species. © The Author 2015. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  16. Simultaneous administration of glucose and hyperoxic gas achieves greater improvement in tumor oxygenation than hyperoxic gas alone

    International Nuclear Information System (INIS)

    Snyder, Stacey A.; Lanzen, Jennifer L.; Braun, Rod D.; Rosner, Gary; Secomb, Timothy W.; Biaglow, John; Brizel, David M.; Dewhirst, Mark W.

    2001-01-01

    Purpose: To test the feasibility of hyperglycemic reduction of oxygen consumption combined with oxygen breathing (O 2 ), to improve tumor oxygenation. Methods and Materials: Fischer-344 rats bearing 1 cm R3230Ac flank tumors were anesthetized with Nembutal. Mean arterial pressure, heart rate, tumor blood flow ([TBF], laser Doppler flowmetry), pH, and pO 2 were measured before, during, and after glucose (1 or 4 g/kg) and/or O 2 . Results: Mean arterial pressure and heart rate were unaffected by treatment. Glucose at 1 g/kg yielded maximum blood glucose of 400 mg/dL, no change in TBF, reduced tumor pH (0.17 unit), and 3 mm Hg pO 2 rise. Glucose at 4 g/kg yielded maximum blood glucose of 900 mg/dL, pH drop of 0.6 unit, no pO 2 change, and reduced TBF (31%). Oxygen tension increased by 5 mm Hg with O 2 . Glucose (1 g/Kg) + O 2 yielded the largest change in pO 2 (27 mm Hg); this is highly significant relative to baseline or either treatment alone. The effect was positively correlated with baseline pO 2 , but 6 of 7 experiments with baseline pO 2 2 to improve tumor oxygenation. However, some cell lines are not susceptible to the Crabtree effect, and the magnitude is dependent on baseline pO 2 . Additional or alternative manipulations may be necessary to achieve more uniform improvement in pO 2

  17. Greater endurance capacity and improved dyspnoea with acute oxygen supplementation in idiopathic pulmonary fibrosis patients without resting hypoxaemia.

    Science.gov (United States)

    Dowman, Leona M; McDonald, Christine F; Bozinovski, Steven; Vlahos, Ross; Gillies, Rebecca; Pouniotis, Dodie; Hill, Catherine J; Goh, Nicole S L; Holland, Anne E

    2017-07-01

    Supplemental oxygen is commonly prescribed in patients with idiopathic pulmonary fibrosis (IPF), although its benefits have not been proven. The aims of this study were to investigate the effect of oxygen on oxidative stress, cytokine production, skeletal muscle metabolism and physiological response to exercise in IPF. Eleven participants with IPF received either oxygen, at an FiO 2 of 0.50, or compressed air for 1 h at rest and during a cycle endurance test at 85% of peak work rate. Blood samples collected at rest and during exercise were analysed for markers of oxidative stress, skeletal muscle metabolism and cytokines. The protocol was repeated a week later with the alternate intervention. Compared with air, oxygen did not adversely affect biomarker concentrations at rest and significantly improved endurance time (mean difference = 99 ± 81s, P = 0.002), dyspnoea (-1 ± 1 U, P = 0.02), systolic blood pressure (BP; -11 ± 11 mm Hg, P = 0.006), nadir oxyhaemoglobin saturation (SpO 2 ; 8 ± 6%, P = 0.001), SpO 2 at 2-min (7 ± 6%, P = 0.003) and 5-min isotimes (5 ± 3, P < 0.001) and peak exercise xanthine concentrations (-42 ± 73 µmol/L, P = 0.03). Air significantly increased IL-10 (5 ± 5 pg/mL, P = 0.04) at 2-min isotime. Thiobarbituric acid-reactive substances (TBARs), IL-6, TNF-α, creatine kinase, lactate, heart rate and fatigue did not differ between the two interventions at any time point. In patients with IPF, breathing oxygen at FiO 2 of 0.50 at rest seems safe. During exercise, oxygen improves exercise tolerance, alleviates exercise-induced hypoxaemia and reduces dyspnoea. A potential relationship between oxygen administration and improved skeletal muscle metabolism should be explored in future studies. © 2017 Asian Pacific Society of Respirology.

  18. Benchmarking for Cost Improvement. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    The US Department of Energy`s (DOE) Office of Environmental Restoration and Waste Management (EM) conducted the Benchmarking for Cost Improvement initiative with three objectives: Pilot test benchmarking as an EM cost improvement tool; identify areas for cost improvement and recommend actions to address these areas; provide a framework for future cost improvement. The benchmarking initiative featured the use of four principal methods (program classification, nationwide cost improvement survey, paired cost comparison and component benchmarking). Interested parties contributed during both the design and execution phases. The benchmarking initiative was conducted on an accelerated basis. Of necessity, it considered only a limited set of data that may not be fully representative of the diverse and complex conditions found at the many DOE installations. The initiative generated preliminary data about cost differences and it found a high degree of convergence on several issues. Based on this convergence, the report recommends cost improvement strategies and actions. This report describes the steps taken as part of the benchmarking initiative and discusses the findings and recommended actions for achieving cost improvement. The results and summary recommendations, reported below, are organized by the study objectives.

  19. A collaborative project to improve identification and management of patients with chronic kidney disease in a primary care setting in Greater Manchester.

    Science.gov (United States)

    Humphreys, John; Harvey, Gill; Coleiro, Michelle; Butler, Brook; Barclay, Anna; Gwozdziewicz, Maciek; O'Donoghue, Donal; Hegarty, Janet

    2012-08-01

    Research has demonstrated a knowledge and practice gap in the identification and management of chronic kidney disease (CKD). In 2009, published data showed that general practices in Greater Manchester had a low detection rate for CKD. A 12-month improvement collaborative, supported by an evidence-informed implementation framework and financial incentives. 19 general practices from four primary care trusts within Greater Manchester. Number of recorded patients with CKD on practice registers; percentage of patients on registers achieving nationally agreed blood pressure targets. The collaborative commenced in September 2009 and involved three joint learning sessions, interspersed with practice level rapid improvement cycles, and supported by an implementation team from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Greater Manchester. At baseline, the 19 collaborative practices had 4185 patients on their CKD registers. At final data collection in September 2010, this figure had increased by 1324 to 5509. Blood pressure improved from 34% to 74% of patients on practice registers having a recorded blood pressure within recommended guidelines. Evidence-based improvement can be implemented in practice for chronic disease management. A collaborative approach has been successful in enabling teams to test and apply changes to identify patients and improve care. The model has proved to be more successful for some practices, suggesting a need to develop more context-sensitive approaches to implementation and actively manage the factors that influence the success of the collaborative.

  20. Greater adherence to a Mediterranean dietary pattern is associated with improved plasma lipid profile: the Aragon Health Workers Study cohort.

    Science.gov (United States)

    Peñalvo, José L; Oliva, Belén; Sotos-Prieto, Mercedes; Uzhova, Irina; Moreno-Franco, Belén; León-Latre, Montserrat; Ordovás, José María

    2015-04-01

    There is wide recognition of the importance of healthy eating in cardiovascular health promotion. The purpose of this study was to identify the main dietary patterns among a Spanish population, and to determine their relationship with plasma lipid profiles. A cross-sectional analysis was conducted of data from 1290 participants of the Aragon Workers Health Study cohort. Standardized protocols were used to collect clinical and biochemistry data. Diet was assessed through a food frequency questionnaire, quantifying habitual intake over the past 12 months. The main dietary patterns were identified by factor analysis. The association between adherence to dietary patterns and plasma lipid levels was assessed by linear and logistic regression. Two dietary patterns were identified: a Mediterranean dietary pattern, high in vegetables, fruits, fish, white meat, nuts, and olive oil, and a Western dietary pattern, high in red meat, fast food, dairy, and cereals. Compared with the participants in the lowest quintile of adherence to the Western dietary pattern, those in the highest quintile had 4.6 mg/dL lower high-density lipoprotein cholesterol levels (P dietary pattern had 3.3mg/dL higher high-density lipoprotein cholesterol levels (P dietary pattern is associated with improved lipid profile compared with a Western dietary pattern, which was associated with a lower odds of optimal high-density lipoprotein cholesterol levels in this population. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Error review: Can this improve reporting performance?

    International Nuclear Information System (INIS)

    Tudor, Gareth R.; Finlay, David B.

    2001-01-01

    AIM: This study aimed to assess whether error review can improve radiologists' reporting performance. MATERIALS AND METHODS: Ten Consultant Radiologists reported 50 plain radiographs, in which the diagnoses were established. Eighteen of the radiographs were normal, 32 showed an abnormality. The radiologists were shown their errors and then re-reported the series of radiographs after an interval of 4-5 months. The accuracy of the reports to the established diagnoses was assessed. Chi-square test was used to calculate the difference between the viewings. RESULTS: On re-reporting the radiographs, seven radiologists improved their accuracy score, two had a lower score and one radiologist showed no score difference. Mean accuracy pre-education was 82.2%, (range 78-92%) and post-education was 88%, (range 76-96%). Individually, two of the radiologists showed a statistically significant improvement post-education (P < 0.01,P < 0.05). Assessing the group as a whole, there was a trend for improvement post-education but this did not reach statistical significance. Assessing only the radiographs where errors were made on the initial viewing, for the group as a whole there was a 63% improvement post-education. CONCLUSION: We suggest that radiologists benefit from error review, although there was not a statistically significant improvement for the series of radiographs in total. This is partly explained by the fact that some radiologists gave incorrect responses post-education that had initially been correct, thus masking the effect of the educational intervention. Tudor, G.R. and Finlay, D.B. (2001

  2. Case Report: Anteromedial temporosphenoidal encephalocele with a clinically silent lateral bony defect in the greater wing of the sphenoid

    International Nuclear Information System (INIS)

    Pandey, Anoop Kumar

    2009-01-01

    Anteromedial temporosphenoidal encephalocele is the least common type of temporal encephalocele. It commonly presents with spontaneous cerebrospinal fluid rhinorrhea in adults. This article presents the CT cisternography and MRI findings of one such case, which also had an associated clinically silent defect in the greater wing of the sphenoid on the same side

  3. Case Report: Anteromedial temporosphenoidal encephalocele with a clinically silent lateral bony defect in the greater wing of the sphenoid

    Directory of Open Access Journals (Sweden)

    Pandey Anoop

    2009-01-01

    Full Text Available Anteromedial temporosphenoidal encephalocele is the least common type of temporal encephalocele. It commonly presents with spontaneous cerebrospinal fluid rhinorrhea in adults. This article presents the CT cisternography and MRI findings of one such case, which also had an associated clinically silent defect in the greater wing of the sphenoid on the same side.

  4. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    National Cancer Institute; Jewell, Ph.D., Scott D.; Seijo, M.S., Edward; Kelly, Ph.D., Andrea; Somiari, Ph.D., Stella; B.Chir., M.B.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., M.S., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Moore, Ph.D., Helen M.; Vaught, Ph.D., Jim; Watson, Peter

    2010-09-02

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  5. Biospecimen Reporting for Improved Study Quality

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly, Ph.D., Andrea B.; Jewell, Ph.D., Scott D.; McShane, Ph.D., Lisa M.; Clark, M.D., Douglas P.; Greenspan, M.D., Renata; Hayes, M.D., Daniel F.; Hainaut, Ph.D., Pierre; Kim, Paula; Mansfield, Ph.D., Elizabeth A.; Potapova, Ph.D., Olga; Riegman, Ph.D., Peter; Rubinstein, Ph.D., Yaffa; Seijo, M.S., Edward; Somiari, Ph.D., Stella; Chir., B; Weier, Ph.D., Heinz-Ulrich; Zhu, Ph.D., Claire; Vaught, Ph.D., Jim; Watson,M.B., Peter

    2010-12-27

    Human biospecimens are subjected to collection, processing, and storage that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research that uses human tissues, it is crucial that information on the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications on biospecimen-related research and to help reassure patient contributors and the advocacy community that their contributions are valued and respected.

  6. Biospecimen Reporting for Improved Study Quality (BRISQ)

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ph.D., Helen M.; Kelly Ph.D., Andrea; Jewell Ph.D., Scott D.; McShane Ph.D., Lisa M.; Clark M.D., Douglas P.; Greenspan M.D., Renata; Hayes M.D., Daniel F.; Hainaut Ph.D.,, Pierre; Kim, Paula; Mansfield Ph.D., Elizabeth; Potapova Ph.D., Olga; Riegman Ph.D., Peter; Rubinstein Ph.D., Yaffa; Seijo M.S., Edward; Somiari Ph.D., Stella; Watson M.B., Peter; Weier Ph.D., Heinz-Ulrich; Zhu Ph.D., Claire; Vaught Ph.D., Jim

    2011-04-26

    Human biospecimens are subject to a number of different collection, processing, and storage factors that can significantly alter their molecular composition and consistency. These biospecimen preanalytical factors, in turn, influence experimental outcomes and the ability to reproduce scientific results. Currently, the extent and type of information specific to the biospecimen preanalytical conditions reported in scientific publications and regulatory submissions varies widely. To improve the quality of research utilizing human tissues it is critical that information regarding the handling of biospecimens be reported in a thorough, accurate, and standardized manner. The Biospecimen Reporting for Improved Study Quality (BRISQ) recommendations outlined herein are intended to apply to any study in which human biospecimens are used. The purpose of reporting these details is to supply others, from researchers to regulators, with more consistent and standardized information to better evaluate, interpret, compare, and reproduce the experimental results. The BRISQ guidelines are proposed as an important and timely resource tool to strengthen communication and publications around biospecimen-related research and help reassure patient contributors and the advocacy community that the contributions are valued and respected.

  7. Improved catalyzed reporter deposition, iCARD.

    Science.gov (United States)

    Lohse, Jesper; Petersen, Kenneth Heesche; Woller, Nina Claire; Pedersen, Hans Christian; Skladtchikova, Galina; Jørgensen, Rikke Malene

    2014-06-18

    Novel reporters have been synthesized with extended hydrophilic linkers that in combination with polymerizing cross-linkers result in very efficient reporter deposition. By utilizing antibodies to stain HER2 proteins in a cell line model it is demonstrated that the method is highly specific and sensitive with virtually no background. The detection of HER2 proteins in tissue was used to visualize individual antigens as small dots visible in a microscope. Image analysis-assisted counting of fluorescent or colored dots allowed assessment of relative protein levels in tissue. Taken together, we have developed novel reporters that improve the CARD method allowing highly sensitive in situ detection of proteins in tissue. Our findings suggest that in situ protein quantification in biological samples can be performed by object recognition and enumeration of dots, rather than intensity-based fluorescent or colorimetric assays.

  8. EnergyWorks Final Report: A Better Buildings Neighborhood Program in the Five-County Greater Philadelphia Region

    Energy Technology Data Exchange (ETDEWEB)

    Gajewski, Katherine [City of Philadelphia

    2014-03-05

    This report covers the grant performance period of July 1, 2010-September 30, 2013 and discusses of the program design, outcomes and best practices as they relate to the following six areas: 1. Institutional Design and Business Model; 2. Program Design and Customer Experience; 3. Driving Demand; 4. Workforce Development; 5. Financing and Incentives; 6. Data and Evaluation.

  9. Improving the Transparency of IAEA Safeguards Reporting

    International Nuclear Information System (INIS)

    Toomey, Christopher; Hayman, Aaron M.; Wyse, Evan T.; Odlaug, Christopher S.

    2011-01-01

    In 2008, the Standing Advisory Group on Safeguards Implementation (SAGSI) indicated that the International Atomic Energy Agency's (IAEA) Safeguards Implementation Report (SIR) has not kept pace with the evolution of safeguards and provided the IAEA with a set of recommendations for improvement. The SIR is the primary mechanism for providing an overview of safeguards implementation in a given year and reporting on the annual safeguards findings and conclusions drawn by the Secretariat. As the IAEA transitions to State-level safeguards approaches, SIR reporting must adapt to reflect these evolutionary changes. This evolved report will better reflect the IAEA's transition to a more qualitative and information-driven approach, based upon State-as-a-whole considerations. This paper applies SAGSI's recommendations to the development of multiple models for an evolved SIR and finds that an SIR repurposed as a 'safeguards portal' could significantly enhance information delivery, clarity, and transparency. In addition, this paper finds that the 'portal concept' also appears to have value as a standardized information presentation and analysis platform for use by Country Officers, for continuity of knowledge purposes, and the IAEA Secretariat in the safeguards conclusion process. Accompanying this paper is a fully functional prototype of the 'portal' concept, built using commercial software and IAEA Annual Report data.

  10. Do older people with visual impairment and living alone in a rural developing country report greater difficulty in managing stairs?

    Science.gov (United States)

    Hairi, Noran N; Bulgiba, Awang; Peramalah, Devi; Mudla, Izzuna

    2013-01-01

    Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others. A population-based cross sectional study was conducted in rural Malaysia from 2007 till 2008. Seven hundred and sixty five older people aged 60 years and over underwent eye examination for visual impairment. Visual acuity criteria were used to define visual impairment. Presenting visual acuity was assessed using a standard metric Snellen Chart of E type. Difficulty in managing stairs was measured according to a question drawn from the Barthel Index which asks "do you need help in climbing stairs". Overall, the prevalence of difficulty in managing stairs among older people in our population was 135 (18.3%, 95% CI 15.7-21.2). After adjusting for important confounders the odds ratio (OR) for visual impairment and difficulty in managing stairs among older people living alone was 5.04 (95% CI 2.27, 10.62). Among older people living with others, the adjusted OR for visual impairment and difficulty in managing stairs was 3.10 (95% CI 1.52, 6.80). In a sample of older people aged 60 years and over, those living alone with visual impairment had greater difficulty in managing stairs than those living with others. Identification of these groups of older people is useful for targeting interventions. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Greater autonomy at work

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2004-01-01

    In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

  12. Year End Progress Report on Rattlesnake Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yaqi [Idaho National Lab. (INL), Idaho Falls, ID (United States); DeHart, Mark David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gleicher, Frederick Nathan [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ortensi, Javier [Idaho National Lab. (INL), Idaho Falls, ID (United States); Schunert, Sebastian [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    Rattlesnake is a MOOSE-based radiation transport application developed at INL to support modern multi-physics simulations. At the beginning of the last year, Rattlesnake was able to perform steady-state, transient and eigenvalue calculations for the multigroup radiation transport equations. Various discretization schemes, including continuous finite element method (FEM) with discrete ordinates method (SN) and spherical harmonics expansion method (PN) for the self-adjoint angular flux (SAAF) formulation, continuous FEM (CFEM) with SN for the least square (LS) formulation, diffusion approximation with CFEM and discontinuous FEM (DFEM), have been implemented. A separate toolkit, YAKXS, for multigroup cross section management was developed to support Rattlesnake calculations with feedback both from changes in the field variables, such as fuel temperature, coolant density, and etc., and in isotope inventory. The framework for doing nonlinear diffusion acceleration (NDA) within Rattlesnake has been set up, and both NDA calculations with SAAF-SN-CFEM scheme and Monte Carlo with OpenMC have been performed. It was also used for coupling BISON and RELAP-7 for the full-core multiphysics simulations. Within the last fiscal year, significant improvements have been made in Rattlesnake. Rattlesnake development was migrated into our internal GITLAB development environment at the end of year 2014. Since then total 369 merge requests has been accepted into Rattlesnake. It is noted that the MOOSE framework that Rattlesnake is based on is under continuous developments. Improvements made in MOOSE can improve the Rattlesnake. It is acknowledged that MOOSE developers spent efforts on patching Rattlesnake for the improvements made on the framework side. This report will not cover the code restructuring for better readability and modularity and documentation improvements, which we have spent tremendous effort on. It only details some of improvements in the following sections.

  13. Petro-Canada 2004 strategic overview report : building our portfolio assets for greater profitability today and tomorrow

    International Nuclear Information System (INIS)

    2004-01-01

    Financial information from Petro-Canada was presented and a review of their 2004 operations was made available for the benefit of shareholders. Petro-Canada is focused on 5 core businesses that include: North American gas; east coast oil; oil sands development; international business; and downstream operations. Highlights from 2004 for each of these core business areas were presented. In 2003, record earnings from operations and cash flows were reported at more than $1.9 billion. Upstream production of 451,100 barrels of oil equivalent per day was reported in 2004. This surpassed planned production volumes in 2004 and more than replaced reserves. Refined petroleum product sales were 56,600 cubic metres per day. Highlights for the company for 2004 include the purchase of a coalbed methane and tight bas business in the U.S. Rockies, the acquisition of unconventional land positions in Western Canada and plans to jointly develop a liquefied natural gas re-gasification terminal in Quebec. This report summarized the company's energy resource activities and presented an operations review as well as consolidated financial statements, and common share information including the accounts of Petro-Canada and its subsidiaries and the company's proportionate share of assets, liabilities, revenues, expenses and cash flows of joint ventures. Revenue and expenditure statements were summarized by source. tabs., figs

  14. Natural Recharge to the Unconfined Aquifer System on the Hanford Site from the Greater Cold Creek Watershed: Progress Report 2004

    Energy Technology Data Exchange (ETDEWEB)

    Waichler, Scott R.; Wigmosta, Mark S.; Coleman, Andre M.

    2004-09-14

    Movement of contaminants in groundwater at the Hanford Site is heavily dependent on recharge to the unconfined aquifer. As the effects of past artificial discharges dissipate, the water table is expected to return to more natural conditions, and natural recharge will become the driving force when evaluating future groundwater flow conditions and related contaminant transport. Previous work on the relationship of natural recharge to groundwater movement at the Hanford Site has focused on direct recharge from infiltrating rainfall and snowmelt within the area represented by the Sitewide Groundwater Model (SGM) domain. However, part of the groundwater recharge at Hanford is provided by flow from Greater Cold Creek watershed (GCC), a large drainage area on the western boundary of the Hanford Site that includes Cold Creek Valley, Dry Creek Valley, and the Hanford side of Rattlesnake Mountain. This study was undertaken to estimate the recharge from GCC, which is believed to enter the unconfined aquifer as both infiltrating streamflow and shallow subsurface flow. To estimate recharge, the Distributed Hydrology-Soil-Vegetation Model (DHSVM) was used to simulate a detailed water balance of GCC from 1956 to 2001 at a spatial resolution of 200~m and a temporal resolution of one hour. For estimating natural recharge to Hanford from watersheds along its western and southwestern boundaries, the most important aspects that need to be considered are 1)~distribution and relative magnitude of precipitation and evapotranspiration over the watershed, 2)~streamflow generation at upper elevations and infiltration at lower elevations during rare runoff events, and 3)~permeability of the basalt bedrock surface underlying the soil mantle.

  15. Out of sight, but not out of mind? Greater reported pain in patients who spontaneously look away during venepuncture.

    Science.gov (United States)

    Vijayan, R; Scott, G; Brownlie, W

    2015-01-01

    Various external factors can influence patients' experiences of noxious stimuli, but little is known of how patients' natural behaviour may be relevant. We ascertained how often patients spontaneously look or look away during venepuncture and associated reports of pain during a previously reported experimental randomized study. The study was conducted in the outpatient department of a U.K. district general hospital. Patients were randomized to hearing 'sharp scratch' or the verbal cue 'ready?' immediately before venepuncture. Whether patients looked or looked away during needle insertion was recorded. Patients were asked to rate their pain using a verbal numerical rating score (VNRS) and verbal response scale (VRS). One hundred ninety-two patients were included; mean age 51.7 years, 55% male. During needle insertion, 73% spontaneously looked away, whereas 27% looked. There was no significant difference in the proportion of these patients assigned to the 'sharp scratch' or 'ready?' groups, nor was there any difference in mean age or gender. For the group that looked, mean VNRS was 0.48 and VRS was 1.27, significantly less than the group that looked away (mean VNRS 0.94, p = 0.014; VRS 1.61, p = 0.002). As previously reported, pain ratings between 'sharp scratch' and 'ready?' groups were not significantly different. Almost three quarters of patients spontaneously look away during venepuncture, but their pain ratings are almost twice that of the quarter of patients who look. It is unclear why this may be, but previous experimental studies indicate that observing the body when a noxious stimulus is applied can have an analgesic effect. © 2014 European Pain Federation - EFIC®

  16. Yoga Meditation Practitioners Exhibit Greater Gray Matter Volume and Fewer Reported Cognitive Failures: Results of a Preliminary Voxel-Based Morphometric Analysis

    Directory of Open Access Journals (Sweden)

    Brett Froeliger

    2012-01-01

    Full Text Available Hatha yoga techniques, including physical postures (asanas, breathing exercises (pranayama, and meditation, involve the practice of mindfulness. In turn, yoga meditation practices may induce the state of mindfulness, which, when evoked recurrently through repeated practice, may accrue into trait or dispositional mindfulness. Putatively, these changes may be mediated by experience-dependent neuroplastic changes. Though prior studies have identified differences in gray matter volume (GMV between long-term mindfulness practitioners and controls, no studies to date have reported on whether yoga meditation is associated with GMV differences. The present study investigated GMV differences between yoga meditation practitioners (YMP and a matched control group (CG. The YMP group exhibited greater GM volume in frontal, limbic, temporal, occipital, and cerebellar regions; whereas the CG had no greater regional greater GMV. In addition, the YMP group reported significantly fewer cognitive failures on the Cognitive Failures Questionnaire (CFQ, the magnitude of which was positively correlated with GMV in numerous regions identified in the primary analysis. Lastly, GMV was positively correlated with the duration of yoga practice. Results from this preliminary study suggest that hatha yoga practice may be associated with the promotion of neuroplastic changes in executive brain systems, which may confer therapeutic benefits that accrue with repeated practice.

  17. Planning for greater confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1985-01-01

    A report that provides guidance for planning for greater-confinement disposal (GCD) of low-level radioactive waste is being prepared. The report addresses procedures for selecting a GCD technology and provides information for implementing these procedures. The focus is on GCD; planning aspects common to GCD and shallow-land burial are covered by reference. Planning procedure topics covered include regulatory requirements, waste characterization, benefit-cost-risk assessment and pathway analysis methodologies, determination of need, waste-acceptance criteria, performance objectives, and comparative assessment of attributes that support these objectives. The major technologies covered include augered shafts, deep trenches, engineered structures, hydrofracture, improved waste forms, and high-integrity containers. Descriptive information is provided, and attributes that are relevant for risk assessment and operational requirements are given. 10 refs., 3 figs., 2 tabs

  18. Facilitating SME Financing through Improved Credit Reporting

    OpenAIRE

    International Committee on Credit Reporting

    2014-01-01

    The general principles for credit reporting were issued by the World Bank in September 2011. Since then, the World Bank and the international committee on credit reporting (ICCR) have been leading efforts towards the implementation of the general principles worldwide. This report is one of the concrete outputs of the work following the general principles. It addresses one of the most signi...

  19. Student laboratory reports: an approach to improving feedback and quality

    Science.gov (United States)

    Ellingsen, Pål Gunnar; Støvneng, Jon Andreas

    2018-05-01

    We present an ongoing effort in improving the quality of laboratory reports written by first and second year physics students. The effort involves a new approach where students are given the opportunity to submit reports at intermediate deadlines, receive feedback, and then resubmit for the final deadline. In combination with a differential grading system, instead of pass/fail, the improved feedback results in higher quality reports. Improvement in the quality of the reports is visible through the grade statistics.

  20. Improving global environmental management with standard corporate reporting

    Science.gov (United States)

    Kareiva, Peter M.; McNally, Brynn W.; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-01-01

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough—also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers. PMID:26082543

  1. Improving global environmental management with standard corporate reporting.

    Science.gov (United States)

    Kareiva, Peter M; McNally, Brynn W; McCormick, Steve; Miller, Tom; Ruckelshaus, Mary

    2015-06-16

    Multinational corporations play a prominent role in shaping the environmental trajectory of the planet. The integration of environmental costs and benefits into corporate decision-making has enormous, but as yet unfulfilled, potential to promote sustainable development. To help steer business decisions toward better environmental outcomes, corporate reporting frameworks need to develop scientifically informed standards that consistently consider land use and land conversion, clean air (including greenhouse gas emissions), availability and quality of freshwater, degradation of coastal and marine habitats, and sustainable use of renewable resources such as soil, timber, and fisheries. Standardization by itself will not be enough--also required are advances in ecosystem modeling and in our understanding of critical ecological thresholds. With improving ecosystem science, the opportunity for realizing a major breakthrough in reporting corporate environmental impacts and dependencies has never been greater. Now is the time for ecologists to take advantage of an explosion of sustainability commitments from business leaders and expanding pressure for sustainable practices from shareholders, financial institutions, and consumers.

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

    International Nuclear Information System (INIS)

    Kim, Kwan Hyun

    2000-06-01

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

  3. Report focuses on improving resilience to disasters

    Science.gov (United States)

    Showstack, Randy

    2012-08-01

    “Disaster resilience is everyone's business,” states a new report that calls for a series of local and national measures to increase resilience in the face of an increasingly costly toll from natural disasters to human lives and the economy. In 2011 natural disasters were responsible for damages in the United States exceeding $55 billion, and costs could increase with more people and structures located in harm's way and with the effects of extreme events, according to the report, Disaster Resilience: A National Imperative, issued by a committee of the U.S. National Academies on 1 August. Among the recommendations is for federal government agencies to incorporate national resilience as an organizing principle to guide federal government actions and programs. The report defines resilience as “the ability to prepare and plan for, absorb, recover from, and more successfully adapt to adverse events.”

  4. Report of panel 3: Concept improvement

    International Nuclear Information System (INIS)

    Dean, S.O.; Ripin, B.H.; Batchelor, D.; Berkner, K.; Kaye, S.M.; Logan, B.G.; Marmar, E.; Navratil, G.; Ellis, W.R.; Gentle, K.W.

    1992-01-01

    The charge to Panel 3 was to look at the idea of concept improvements in the context of US DOE management of the magnetic fusion program. The panel suggested that if DOE were commited to the idea of concept improvement, it needed to overcome the existing impression it was not receptive to new ideas. In part the long time scale for development of fusion energy, coupled with the rate of change of scientific programs and research based on emerging knowledge, means that in general the program will be much different ten to twenty years in the future. To be able to meet this changing direction, the US program must maintain an openness to look at promising alternative ideas, spend money on developing the ideas, and consider funding some to intermediate development levels. Stellerator research was offered as one alternative to consider in light of present international work. The panel urged supporting the development of new concepts and ideas, as well as continued support for plasma physics basic research

  5. A Report Card on Continuous Quality Improvement

    Science.gov (United States)

    Blumenthal, David; Kilo, Charles M.

    1998-01-01

    Efforts to incorporate the principles of continuous quality improvement (CQI) into health care have been underway for about ten years. In order to understand the lessons of this decade of experience, senior organizational leaders and experts in the field of health care were interviewed. This select group agreed that there have been concrete accomplishments: the tactic of assigning blame for mistakes to individuals is gradually giving way to an emphasis on detecting problems with process; there is a new focus on the health care customer; and many valuable projects have been inaugurated. Nevertheless, the interviews underlined the reality that the movement has not yet made a sizable impact on the U.S. health care system. Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved. PMID:9879305

  6. Improved radioimmunotherapy of hematologic malignancies. [Final report

    Energy Technology Data Exchange (ETDEWEB)

    Press, O.W.

    1992-03-24

    This research project proposes to develop novel new approaches of improving the radioimmunodetection and radioimmunotherapy of malignancies by augmenting retention of radioimmunoconjugates by tumor cells. The approaches shown to be effective in these laboratory experiments will subsequently be incorporated into out ongoing clinical trials in patients. Specific project objectives include: to study the rates of endocytosis, intracellular routing, and metabolic degradation of radiolabeled monoclonal antibodies targeting tumor-associated antigens on human leukemia and lymphoma cells; To examine the effects of lysosomotropic amines (e.g. chloroquine, amantadine), carboxylic ionophores (monensin, nigericin), and thioamides (propylthiouracil), on the retention of radiolabeled MoAbs by tumor cells; to examine the impact of newer radioiodination techniques (tyramine cellobiose, paraiodobenzoyl) on the metabolic degradation of radioiodinated antibodies; to compare the endocytosis, intracellular routing, and degradation of radioimmunoconjugates prepared with different radionuclides ({sup 131}Iodine, {sup 111}Indium, {sup 90}Yttrium, {sup 99m}Technetium, {sup 186}Rhenium); and to examine the utility of radioimmunoconjugates targeting oncogene products for the radioimmunotherapy and radioimmunoscintigraphy of cancer.

  7. The IOM report on improving diagnosis: new concepts.

    Science.gov (United States)

    Graber, Mark L

    2015-12-01

    The IOM report 'Improving Diagnosis in Health Care' represents a major advance in summarizing the problem of diagnostic error. Three new concepts in the report will be helpful in future efforts to understand and improve the diagnostic process: a new definition of diagnostic error, a new framework for understanding the diagnostic process, and a new concept of the diagnostic 'team'. This paper highlights these new concepts and their relevance to improving diagnosis.

  8. Towards a greater understanding of the illicit tobacco trade in Europe: a review of the PMI funded ‘Project Star’ report

    Science.gov (United States)

    Gilmore, Anna B; Rowell, Andy; Gallus, Silvano; Lugo, Alessandra; Joossens, Luk; Sims, Michelle

    2014-01-01

    Background Following a legal agreement with the European Union (EU), Philip Morris International (PMI) commissions a yearly report (‘Project Star’, PS) on the European illicit cigarette trade from KPMG, the global accountancy firm. Methods Review of PS 2010 report. Comparison with data from independent sources including a 2010 pan-European survey (N=18 056). Findings Within PS, data covering all 27 EU countries are entered into a model. While the model itself seems appropriate, concerns are identified with the methodologies underlying the data inputs and thus their quality: there is little transparency over methodologies; interview data underestimate legal non-domestic product partly by failing to account for legal cross-border sales; illicit cigarette estimates rely on tobacco industry empty pack surveys which may overestimate illicit; and there is an over-reliance on data supplied by PMI with inadequate external validation. Thus, PMI sales data are validated using PMI smoking prevalence estimates, yet PMI is unable to provide sales (shipment) data for the Greek islands and its prevalence estimates differ grossly from independent data. Consequently, comparisons with independent data suggest PS will tend to overestimate illicit cigarette levels particularly where cross-border shopping is frequent (Austria, Finland, France) and in Western compared with Eastern European countries. The model also provides data on the nature of the illicit cigarette market independent of seizure data suggesting that almost a quarter of the illicit cigarette market in 2010 comprised PMI's own brands compared with just 5% counterfeited PMI brands; a finding hidden in PMI's public representation of the data. Conclusions PS overestimates illicit cigarette levels in some European countries and suggests PMI's supply chain control is inadequate. Its publication serves the interests of PMI over those of the EU and its member states. PS requires greater transparency, external scrutiny and

  9. Negative mood-induced alcohol-seeking is greater in young adults who report depression symptoms, drinking to cope, and subjective reactivity.

    Science.gov (United States)

    Hogarth, Lee; Hardy, Lorna; Mathew, Amanda R; Hitsman, Brian

    2018-04-01

    Acute negative mood powerfully motivates alcohol-seeking behavior, but it remains unclear whether sensitivity to this effect is greater in drinkers who report depression symptoms, drinking to cope, and subjective reactivity. To examine these questions, 128 young adult alcohol drinkers (ages 18-25) completed questionnaires of alcohol use disorder symptoms, depression symptoms, and drinking to cope with negative affect. Baseline alcohol choice was measured by preference to enlarge alcohol versus food thumbnail images in two-alternative forced-choice trials. Negative mood was then induced by depressive statements and music, before alcohol choice was tested. Subjective reactivity was indexed by increased sadness pre- to post-mood induction. Baseline alcohol choice correlated with alcohol dependence symptoms (p = .001), and drinking coping motives (ps ≤ .01). Mood induction increased alcohol choice and subjective sadness overall (ps choice was associated with depression symptoms (p = .007), drinking to cope (ps ≤ .03), and subjective reactivity (p = .007). The relationship between mood-induced alcohol choice and drinking to cope remained significant after covarying for other drinking motives. Furthermore, the three predictors (depression, drinking to cope, and subjective reactivity) accounted for unique variance in mood-induced alcohol choice (ps ≥ .03), and collectively accounted for 18% of the variance (p choice task as sensitive to the relative value of alcohol and acute negative mood. The findings also accord with the core prediction of negative reinforcement theory that sensitivity to the motivational impact of negative mood on alcohol-seeking behavior may be an important mechanism that links depression and alcohol dependence. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Financing mechanisms for capital improvements : interchanges, final report, March 2010.

    Science.gov (United States)

    2010-03-01

    This report examines the use of alternative local financing mechanisms for interchange and interchange area infrastructure improvements. The financing mechanisms covered include transportation impact fees, tax increment financing, value capture finan...

  11. Financing mechanisms for capital improvements : interchanges : final report.

    Science.gov (United States)

    2010-03-01

    This report examines the use of alternative local financing mechanisms for interchange and interchange area infrastructure improvements. The financing mechanisms covered include transportation impact fees, tax increment financing, value capture finan...

  12. High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

    Science.gov (United States)

    Stöggl, Thomas L.; Björklund, Glenn

    2017-01-01

    The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male (n = 33) and female (n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak): 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes. PMID:28824457

  13. Improving Manufacturing Performance in South Africa : Report of the ...

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

    1995-01-01

    Improving Manufacturing Performance in South Africa : Report of the Industrial Strategy Project. Couverture du livre Improving Manufacturing Performance in South Africa. Author(s):. Avril Joffe, David Kaplan, Raphael Kaplinsky et David Lewis. Publisher(s):. UCT Press, CRDI. January 1, 1995. ISBN: Épuisé. 264 pages.

  14. High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

    Directory of Open Access Journals (Sweden)

    Thomas L. Stöggl

    2017-08-01

    Full Text Available The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR in well-trained endurance athletes.Methods: Thirty-six male (n = 33 and female (n = 3 runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak: 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT. A maximal anaerobic running/cycling test (MART/MACT was performed prior to and following a 9-week training period.Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001 and peak lactate (P = 0.001 during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L−1 was changed (P > 0.05. Acute HRR was improved in HIIT (11.2%, P = 0.002 and POL (7.9%, P = 0.023 with no change in the HVLIT oriented control group.Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT had no effect on any performance or HRR outcomes.

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

    Science.gov (United States)

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

  16. Diagnosing and reporting of occupational diseases: a quality improvement study

    NARCIS (Netherlands)

    Spreeuwers, D.; de Boer, A. G. E. M.; Verbeek, J. H. A. M.; van Beurden, M. M.; van Dijk, F. J. H.

    2008-01-01

    AIM: To assess the need for quality improvement of diagnosing and reporting of noise-induced occupational hearing loss and occupational adjustment disorder. METHODS: Performance indicators and criteria for the quality of diagnosing and reporting were developed. Self-assessment questionnaires were

  17. Improving report writing by peer assessment using Coursera

    DEFF Research Database (Denmark)

    Christiansen, Henrik Lehrmann

    2015-01-01

    report writing. In the case of report writing active learning could include peer evaluation which is what is investigated in this paper. This paper presents a case study from the Technical University of Denmark. A course on mobile communication was redesigned to include peer evaluation as a tool......Report writing is a general engineering competence and it should therefore be part of any university engineering education to learn how to write a good report. Active leaning methods are well-known to be effective in supporting student learning; hence it should preferably also be used for teaching...... for improving report writing skills. The peer evaluation process was automated using the elearning tool Coursera. What was investigated was the improvement in report writing as well as the consistency and quality of the peer assessed grades....

  18. Improving Reports Turnaround Time: An Essential Healthcare Quality Dimension.

    Science.gov (United States)

    Khan, Mustafa; Khalid, Parwaiz; Al-Said, Youssef; Cupler, Edward; Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Turnaround time is one of the most important healthcare performance indicators. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on reducing the reports turnaround time of the neurophysiology lab from more than two weeks to only five working days for 90% of cases. The main quality improvement methodology used was the FOCUS PDCA. Using root cause analysis, Pareto analysis and qualitative survey methods, the main factors contributing to the delay of turnaround time and the suggested improvement strategies were identified and implemented, through restructuring transcriptionists daily tasks, rescheduling physicians time and alerting for new reports, engaging consultants, consistent coordination and prioritizing critical reports. After implementation; 92% of reports are verified within 5 days compared to only 6% before implementation. 7% of reports were verified in 5 days to 2 weeks and only 1% of reports needed more than 2 weeks compared to 76% before implementation.

  19. Improving ultrasound for appendicitis through standardized reporting of secondary signs.

    Science.gov (United States)

    Partain, Kristin N; Patel, Adarsh U; Travers, Curtis; Short, Heather L; Braithwaite, Kiery; Loewen, Jonathan; Heiss, Kurt F; Raval, Mehul V

    2017-08-01

    Our aim was to implement a standardized US report that included secondary signs of appendicitis (SS) to facilitate accurate diagnosis of appendicitis and decrease the use of computed tomography (CT) and admissions for observation. A multidisciplinary team implemented a quality improvement (QI) intervention in the form of a standardized US report and provided stakeholders with monthly feedback. Outcomes including report compliance, CT use, and observation admissions were compared pretemplate and posttemplate. We identified 387 patients in the pretemplate period and 483 patients in the posttemplate period. In the posttemplate period, the reporting of SS increased from 5.4% to 79.5% (pappendicitis also improved in the posttemplate period. A focused QI initiative led to high compliance rates of utilizing the standardized US report and resulted in lower CT use and fewer admissions for observation. Study of a Diagnostic Test Level of Evidence: 1. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

  1. Improving the safety of LWR power plants. Final report

    International Nuclear Information System (INIS)

    1980-04-01

    This report documents the results of the Study to identify current, potential research issues and efforts for improving the safety of Light Water Reactor (LWR) power plants. This final report describes the work accomplished, the results obtained, the problem areas, and the recommended solutions. Specifically, for each of the issues identified in this report for improving the safety of LWR power plants, a description is provided in detail of the safety significance, the current status (including information sources, status of technical knowledge, problem solution and current activities), and the suggestions for further research and development. Further, the issues are ranked for action into high, medium, and low priority with respect to primarily (a) improved safety (e.g. potential reduction in public risk and occupational exposure), and secondly (b) reduction in safety-related costs

  2. Improving Autopsy Report Turnaround Times by Implementing Lean Management Principles.

    Science.gov (United States)

    Cromwell, Susan; Chiasson, David A; Cassidy, Debra; Somers, Gino R

    2018-01-01

    The autopsy is an integral part of the service of a large academic pathology department. Timely reporting is central to providing good service and is beneficial for many stakeholders, including the families, the clinical team, the hospital, and the wider community. The current study aimed to improve hospital-consented autopsy reporting times (turnaround time, TAT) by using lean principles modified for a healthcare setting, with an aim of signing out 90% of autopsies in 90 days. An audit of current and historical TATs was performed, and a working group incorporating administrative, technical, and professional staff constructed a value stream map documenting the steps involved in constructing an autopsy report. Two areas of delay were noted: examination of the microscopy and time taken to sign-out the report after the weekly autopsy conference. Several measures were implemented to address these delays, including visual tracking using a whiteboard and individualized tracking sheets, weekly whiteboard huddles, and timelier scheduling of clinicopathologic conference rounds. All measures resulted in an improvement of TATs. In the 30 months prior to the institution of lean, 37% of autopsies (53/144) were signed out in 90 days, with a wide variation in reporting times. In the 30 months following the institution of lean, this improved to 74% (136/185) ( P lean; 63 days post-lean). The application of lean principles to autopsy sign-out workflow can significantly improve TATs and reduce variability, without changing staffing levels or significantly altering scheduling structure.

  3. The use of a proforma improves colorectal cancer pathology reporting.

    Science.gov (United States)

    Rigby, K.; Brown, S. R.; Lakin, G.; Balsitis, M.; Hosie, K. B.

    1999-01-01

    The detail and accuracy of pathological reporting for colorectal cancer is becoming increasingly recognised as important in the overall management of the patient. However, there is criticism of the variable standards of reporting. We assessed how the use of a proforma affected the completeness of reporting within one hospital. Data on all colorectal cancer patients attending one teaching hospital has been collected prospectively over a 15 month period from 1997 to 1998. The Royal College of Surgeons/Association of Coloproctology proforma lists all items considered to be essential for a complete pathological report of colorectal cancer. Its introduction in September 1997 allowed us to compare reporting before the proforma to that after. Of 54 patients, 46 (85%) had one or more items missing from their report before introduction of the proforma compared with only 8/44 (18%) patients after the proforma (P < 0.001). Circumferential resection margins and apical node status were the items most often absent, being significantly more frequently reported after the proforma (P < 0.05 and P < 0.001, respectively). There was no difference in the median number of lymph nodes harvested after proforma introduction. The introduction of the proforma has not only resulted in improvements in reporting, but has increased the dialogue between surgical oncologists and pathologists. These features should result in improved overall management of the colorectal cancer patient. PMID:10655894

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

    Directory of Open Access Journals (Sweden)

    Pedro Gabriel Melo de Barros e Silva

    2015-12-01

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

  5. Greater-confinement disposal

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Schubert, J.P.

    1989-01-01

    Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

  6. Event (error and near-miss) reporting and learning system for process improvement in radiation oncology.

    Science.gov (United States)

    Mutic, Sasa; Brame, R Scott; Oddiraju, Swetha; Parikh, Parag; Westfall, Melisa A; Hopkins, Merilee L; Medina, Angel D; Danieley, Jonathan C; Michalski, Jeff M; El Naqa, Issam M; Low, Daniel A; Wu, Bin

    2010-09-01

    evaluation of corrective measures and recognition of ineffective measures and efforts. The electronic system was relatively well accepted by personnel and resulted in minimal disruption of clinical work. Event reporting in the quarters with the fewest number of reported events, though voluntary, was almost four times greater than the most events reported in any one quarter with the paper-based system and remained consistent from the inception of the process through the date of this report. However, the acceptance was not universal, validating the need for improved education regarding reporting processes and systematic approaches to reporting culture development. Specially designed electronic event reporting systems in a radiotherapy setting can provide valuable data for process and patient safety improvement and are more effective reporting mechanisms than paper-based systems. Additional work is needed to develop methods that can more effectively utilize reported data for process improvement, including the development of standardized event taxonomy and a classification system for RT.

  7. Evaluation and review of planning for greater-confinement disposal by the Independent Peer Review Committee, July 9-10, 1985. Final report

    International Nuclear Information System (INIS)

    1985-07-01

    This evaluation and review was performed under contract by Argonne National Laboratory in support of their role for developing the ''Planning for Greater Confinement Disposal'' Document for the Low-Level Waste Management Program Office for the Department of Energy, Office of Defense Waste and Byproducts Management. The Independent Peer Review Committee was composed of 13 well-qualified and recognized experts in their fields and pertinent disciplines, collectively representing considerable expertise and experience in waste disposal operations, waste management, environmental assessment and impact analysis, and other aspects of radioactive waste disposal. The members of the Peer Review Committee, their organizations, and thier area of expertise are given in Appendix 1. The general consensus of the Independent Review Committee was that the ''Planning for Greater-Confinement Disposal'' document was reasonably comprehensive, covering nearly all topics necessary to provide a good planning guide. There is, however, a definite need to reorganize the document into two volumes with appendices and the relationship of the GCD document to other LLWMP documents needs to be clarified in the introductory volume. Specific recommendations made by the committee on the DCD document are given in Section 3.2. Recommendations by the committee that have a somewhat broader scope than just the GCD document are given in Section 3.3

  8. Structured data quality reports to improve EHR data quality.

    Science.gov (United States)

    Taggart, Jane; Liaw, Siaw-Teng; Yu, Hairong

    2015-12-01

    To examine whether a structured data quality report (SDQR) and feedback sessions with practice principals and managers improve the quality of routinely collected data in EHRs. The intervention was conducted in four general practices participating in the Fairfield neighborhood electronic Practice Based Research Network (ePBRN). Data were extracted from their clinical information systems and summarised as a SDQR to guide feedback to practice principals and managers at 0, 4, 8 and 12 months. Data quality (DQ) metrics included completeness, correctness, consistency and duplication of patient records. Information on data recording practices, data quality improvement, and utility of SDQRs was collected at the feedback sessions at the practices. The main outcome measure was change in the recording of clinical information and level of meeting Royal Australian College of General Practice (RACGP) targets. Birth date was 100% and gender 99% complete at baseline and maintained. DQ of all variables measured improved significantly (pImprovement was greatest with allergies. There was no significant change in duplicate records. SDQRs and feedback sessions support general practitioners and practice managers to focus on improving the recording of patient information. However, improved practice DQ, was not sufficient to meet RACGP targets. Randomised controlled studies are required to evaluate strategies to improve data quality and any associated improved safety and quality of care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Improving Communication of Diagnostic Radiology Findings through Structured Reporting

    Science.gov (United States)

    Panicek, David M.; Berk, Alexandra R.; Li, Yuelin; Hricak, Hedvig

    2011-01-01

    Purpose: To compare the content, clarity, and clinical usefulness of conventional (ie, free-form) and structured radiology reports of body computed tomographic (CT) scans, as evaluated by referring physicians, attending radiologists, and radiology fellows at a tertiary care cancer center. Materials and Methods: The institutional review board approved the study as a quality improvement initiative; no written consent was required. Three radiologists, three radiology fellows, three surgeons, and two medical oncologists evaluated 330 randomly selected conventional and structured radiology reports of body CT scans. For nonradiologists, reports were randomly selected from patients with diagnoses relevant to the physician’s area of specialization. Each physician read 15 reports in each format and rated both the content and clarity of each report from 1 (very dissatisfied or very confusing) to 10 (very satisfied or very clear). By using a previously published radiology report grading scale, physicians graded each report’s effectiveness in advancing the patient’s position on the clinical spectrum. Mixed-effects models were used to test differences between report types. Results: Mean content satisfaction ratings were 7.61 (95% confidence interval [CI]: 7.12, 8.16) for conventional reports and 8.33 (95% CI: 7.82, 8.86) for structured reports, and the difference was significant (P radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101913/-/DC1 PMID:21518775

  10. More features, greater connectivity.

    Science.gov (United States)

    Hunt, Sarah

    2015-09-01

    Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

  11. Greater oil investment opportunities

    International Nuclear Information System (INIS)

    Arenas, Ismael Enrique

    1997-01-01

    Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-05-01

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

  13. Umatilla River subbasin fish habitat improvement project. Annual report 1993

    International Nuclear Information System (INIS)

    Bailey, T.D.; Laws, T.S.

    1994-05-01

    This annual report is in fulfillment of contract obligations with Bonneville Power Administration which is the funding source for the Oregon Department of Fish and Wildlife's Umatilla Basin Habitat Improvement Project. Major activities undertaken during this report period included: (1) procurement of one access easement with a private landowner, (2) design, layout, and implementation of 3.36 miles of instream structure maintenance, (3) inspection and routine maintenance of 15.1 miles of fence, (4) revegetation along 3.36 miles of stream, (5) collection and summarization of physical and biological monitoring data, (6) extensive interagency coordination, and (7) environmental education activities with local high school students

  14. Public acceptance of management actions and judgments of responsibility for the wolves of the southern Greater Yellowstone Area: Report to Grand Teton National Park

    Science.gov (United States)

    Taylor, Jonathan G.; Johnson, S. Shea; Shelby, Lori B.

    2005-01-01

    Introduction Wolves of Grand Teton National Park and the Greater Yellowstone Area Gray wolves (Canis lupus) appeared in Grand Teton National Park (GRTE) in October of 1998, two years after being reintroduced to Yellowstone National Park (YNP). Since that time, five packs have been within the GRTE borders - Gros Ventre Pack, Nez Perce Pack, Yellowstone Delta Pack, Teton Pack, and Green River Pack (Table 1). Wolves in the Greater Yellowstone Area are increasing and spreading out geographically (USFWS and others, 2004). This dispersion was demonstrated recently by the death of a 2-year-old female wolf from the Swan Lake pack on I-70 in Colorado (June 7, 2004; http://mountain-prairie.USFWS.gov/pressrel /04-43.htm). The organization of wolf packs in the GYA is dynamic and highly structured. In 2003, for example, a wolf from the Teton Pack joined with the Green River Pack, and several young wolves left the Teton Pack and moved south (USFWS and others, 2004). Pack size (averaging five to ten members) is dependent on hunting efficiency, which depends on prey size, type, and density. Each pack defends home ranges of several hundred square miles. The social structure of the pack is based on a breeding pair (an alpha male and female). Other wolves in the pack can be categorized as betas (males and/or females second in rank to the alphas), subordinates, pups, and occasional omegas (outcasts). Because generally only the alpha pair breeds, subordinate wolves of reproductive age must disperse from their packs and form new associations in order to breed. (http://www.nps.gov/grte/wolf/biolo.htm). The reintroduced wolves are classified by the U.S. Fish and Wildlife Service (USFWS) as "nonessential experimental" under section 10(j) of the Endangered Species Act. The recovery criteria for the GYA wolves were met in 2002 for removing the wolves from the Endangered Species List (30 or more breeding pairs). Currently, the USFWS manages wolf populations in the GYA until delisting occurs

  15. Anesthesia report card - a customizable tool for performance improvement.

    Science.gov (United States)

    Peccora, Christian D; Gimlich, Robert; Cornell, Richard P; Vacanti, Charles A; Ehrenfeld, Jesse M; Urman, Richard D

    2014-09-01

    Measuring and providing performance feedback to physicians has gained momentum not only as a way to comply with regulatory requirements, but also as a way to improve patient care. Measurement of structural, process, and outcome metrics in a reliable, evidence-based, specialty-specific manner maximizes the probability of improving physician performance. The manner in which feedback is provided influences whether the measurement tool will be successful in changing behavior. We created an innovative reporting tool template for anesthesiology practitioners designed to provide detailed, continuous feedback covering many aspects of clinical practice. The literature regarding quality metric measurement and feedback strategies was examined to design a reporting tool that could provide high quality information and result in improved performance of clinical and academic tasks. A committee of department leaders and information technology professionals was tasked with determining the measurement criteria and infrastructure needed to generate these reports. Data was collected in a systematic, unbiased manner, and reports were populated with information from multiple databases and software systems. Feedback would be based on frequently updated information and allow for analysis of historical performance as well as comparison amongst peers. A template for an anesthesia report card was created. Categories included compliance, credentialing and qualifications, education, clinical and operating room responsibilities, and academic achievements. Physicians were able to choose to be evaluated in some of the categories and had to meet a minimum number of criteria within each category. This allowed for customization to each practitioner's practice. Criteria were derived from the measures of academic and clinical proficiency, as well as quality metrics. Criteria were objective measures and data gathering was often automated. Reports could be generated that were updated daily and provided

  16. Planning for greater-confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1984-01-01

    This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objectives and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 references

  17. Planning for greater-confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1984-01-01

    This contribution is a progress report for preparation of a document that will summarize procedures and technical information needed to plan for and implement greater-confinement disposal (GCD) of low-level radioactive waste. Selection of a site and a facility design (Phase I), and construction, operation, and extended care (Phase II) will be covered in the document. This progress report is limited to Phase I. Phase I includes determination of the need for GCD, design alternatives, and selection of a site and facility design. Alternative designs considered are augered shafts, deep trenches, engineered structures, high-integrity containers, hydrofracture, and improved waste form. Design considerations and specifications, performance elements, cost elements, and comparative advantages and disadvantages of the different designs are covered. Procedures are discussed for establishing overall performance objecties and waste-acceptance criteria, and for comparative assessment of the performance and cost of the different alternatives. 16 refs

  18. Structured reporting platform improves CAD-RADS assessment.

    Science.gov (United States)

    Szilveszter, Bálint; Kolossváry, Márton; Karády, Júlia; Jermendy, Ádám L; Károlyi, Mihály; Panajotu, Alexisz; Bagyura, Zsolt; Vecsey-Nagy, Milán; Cury, Ricardo C; Leipsic, Jonathon A; Merkely, Béla; Maurovich-Horvat, Pál

    2017-11-01

    Structured reporting in cardiac imaging is strongly encouraged to improve quality through consistency. The Coronary Artery Disease - Reporting and Data System (CAD-RADS) was recently introduced to facilitate interdisciplinary communication of coronary CT angiography (CTA) results. We aimed to assess the agreement between manual and automated CAD-RADS classification using a structured reporting platform. Five readers prospectively interpreted 500 coronary CT angiographies using a structured reporting platform that automatically calculates the CAD-RADS score based on stenosis and plaque parameters manually entered by the reader. In addition, all readers manually assessed CAD-RADS blinded to the automatically derived results, which was used as the reference standard. We evaluated factors influencing reader performance including CAD-RADS training, clinical load, time of the day and level of expertise. Total agreement between manual and automated classification was 80.2%. Agreement in stenosis categories was 86.7%, whereas the agreement in modifiers was 95.8% for "N", 96.8% for "S", 95.6% for "V" and 99.4% for "G". Agreement for V improved after CAD-RADS training (p = 0.047). Time of the day and clinical load did not influence reader performance (p > 0.05 both). Less experienced readers had a higher total agreement as compared to more experienced readers (87.0% vs 78.0%, respectively; p = 0.011). Even though automated CAD-RADS classification uses data filled in by the readers, it outperforms manual classification by preventing human errors. Structured reporting platforms with automated calculation of the CAD-RADS score might improve data quality and support standardization of clinical decision making. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  19. Figures in clinical trial reports: current practice & scope for improvement.

    Science.gov (United States)

    Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

    2007-11-19

    Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  20. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  1. Improving patient safety in radiotherapy through error reporting and analysis

    International Nuclear Information System (INIS)

    Findlay, Ú.; Best, H.; Ottrey, M.

    2016-01-01

    Aim: To improve patient safety in radiotherapy (RT) through the analysis and publication of radiotherapy errors and near misses (RTE). Materials and methods: RTE are submitted on a voluntary basis by NHS RT departments throughout the UK to the National Reporting and Learning System (NRLS) or directly to Public Health England (PHE). RTE are analysed by PHE staff using frequency trend analysis based on the classification and pathway coding from Towards Safer Radiotherapy (TSRT). PHE in conjunction with the Patient Safety in Radiotherapy Steering Group publish learning from these events, on a triannual and summarised on a biennial basis, so their occurrence might be mitigated. Results: Since the introduction of this initiative in 2010, over 30,000 (RTE) reports have been submitted. The number of RTE reported in each biennial cycle has grown, ranging from 680 (2010) to 12,691 (2016) RTE. The vast majority of the RTE reported are lower level events, thus not affecting the outcome of patient care. Of the level 1 and 2 incidents reported, it is known the majority of them affected only one fraction of a course of treatment. This means that corrective action could be taken over the remaining treatment fractions so the incident did not have a significant impact on the patient or the outcome of their treatment. Analysis of the RTE reports demonstrates that generation of error is not confined to one professional group or to any particular point in the pathway. It also indicates that the pattern of errors is replicated across service providers in the UK. Conclusion: Use of the terminology, classification and coding of TSRT, together with implementation of the national voluntary reporting system described within this report, allows clinical departments to compare their local analysis to the national picture. Further opportunities to improve learning from this dataset must be exploited through development of the analysis and development of proactive risk management strategies

  2. A new safety event reporting system improves physician reporting in the surgical intensive care unit.

    Science.gov (United States)

    Schuerer, Douglas J E; Nast, Patricia A; Harris, Carolyn B; Krauss, Melissa J; Jones, Rebecca M; Boyle, Walter A; Buchman, Timothy G; Coopersmith, Craig M; Dunagan, W Claiborne; Fraser, Victoria J

    2006-06-01

    Medical errors are common, and physicians have notably been poor medical error reporters. In the SICU, reporting was generally poor and reporting by physicians was virtually nonexistent. This study was designed to observe changes in error reporting in an SICU when a new card-based system (SAFE) was introduced. Before implementation of the SAFE reporting system, education was given to all SICU healthcare providers. The SAFE system was introduced into the SICU for a 9-month period from March 2003 through November 2003, to replace an underused online system. Data were collected from the SAFE card reports and the online reporting systems during introduction, removal, and reimplementation of these cards. Reporting rates were calculated as number of reported events per 1,000 patient days. Reporting rates increased from 19 to 51 reports per 1,000 patient days after the SAFE cards were introduced into the ICU (preporting increased most, rising from 0.3 to 5.8 reports per 1,000 patient days; nursing reporting also increased from 18 to 39 reports per 1,000 patient days (both preporting declined to 0 reports per 1,000 patient days (p=0.01) and rose to 8.1 (p=0.001) when the cards were returned, similar to nursing results. A higher proportion of physician reports were events that caused harm compared with no effect (p reporting system, combined with appropriate education, improved overall reporting in the SICU, especially among physician providers. Nurses were more likely to use reporting systems than were physicians. Physician reports were more likely to be of events that caused harm.

  3. Can technology improve intershift report? What the research reveals.

    Science.gov (United States)

    Strople, Bernadette; Ottani, Patricia

    2006-01-01

    Shift report is a multifaceted process that serves to provide nurses with vital patient information to facilitate clinical decisions and patient care planning. A shift report also provides nurses with a forum for functions, such as patient problem solving and collaboration. The authors conducted a literature review, which indicates that current methodologies used to collect and convey patient information are ineffective and may contribute to negative patient outcomes. Data incongruence, legal implications, time constraints augmented by the nursing shortage, and the financial impact of shift report are also addressed. The literature reveals significant rationale for pioneering new and innovative methods of shift-to-shift communication. In the report To Err is Human: Building a Safe Health System, the Institute of Medicine attributes the deaths of up to 98,000 hospitalized Americans to medical errors, including communication failures [Institute of Medicine. (1999). To err is human: Building a safe health system. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. As a result, government policy makers and health care agencies have focused their attention on determining the root cause of errors to identify preventative measures, including the use of information technology [Institute of Medicine. (2004). Keeping patients safe: Transforming the work environment of nurses. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. Under these premises, the authors examined the process of nursing shift report and how it impacts patient outcomes. The use of computer technology and wireless modes of communication is explored as a means of improving the shift report process and, subsequently, health care outcomes and patient safety.

  4. Improving plant bioaccumulation science through consistent reporting of experimental data.

    Science.gov (United States)

    Fantke, Peter; Arnot, Jon A; Doucette, William J

    2016-10-01

    Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent data collection and reporting requirements, the information generated is often less useful than it could be for direct applications in chemical assessments and for model development and refinement. We review existing testing guidelines, common data reporting practices, and provide recommendations for revising testing guidelines and reporting requirements to improve bioaccumulation knowledge and models. This analysis provides a list of experimental parameters that will help to develop high quality datasets and support modeling tools for assessing bioaccumulation of organic chemicals in plants and ultimately addressing uncertainty in ecological and human health risk assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Special report. New products that improve officer performance, safety.

    Science.gov (United States)

    1991-12-01

    The need for products that improve performance of security officers is counterbalanced these days by budgetary constraints. While this may limit major investments in security systems and personnel, less costly improvements or innovations might be worth considering. In this report, we will discuss four advances that may be valuable not only in hospital security, but in other industries as well. One of them, a smoke filter, was originally developed for the hotel industry. Another, a drug detection device, may replace the use of undercover agents or drug-sniffing' dogs in certain circumstances. The third new product is an economical patrol vehicle for parking facilities which might replace more costly vehicles such as golf carts or cars. The fourth product, a roving CCTV camera, is actually being tested at a Midwest medical center and may allow you to monitor areas of parking garages with cameras instead of officers on patrol.

  6. 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.

  7. Final report on improved N15 analyser NOI-6e

    International Nuclear Information System (INIS)

    Meier, G.; Hollenthoner, S.

    1985-05-01

    This report gives a general view of the computerized NOI-6e nitrogen analyzer. The construction of the new prototype is described. The new version of the N15 analyzer together with the microcomputer program which has been developed improves the convenience of operation and also has high reliability. Many practical test measurements have been made. The most important result is the remarkable reduction of the standard deviation σsub(x): a standard deviation of less than 0.5% is achieved. We have not found such a low standard deviation in descriptions of similar analyzers which use emission spectroscopy

  8. DTU International Energy Report 2012: Energy efficiency improvements

    DEFF Research Database (Denmark)

    Increased energy efficiency can reduce global CO2 emissions over the period to 2050 with up to 25%. On the top of that large profits can be gained for very little investment. Energy efficiency improvements can save investment in new energy infrastructure, cut fuel costs, increase competitiveness...... and increase consumer welfare. Thus, it is natural for DTU International Energy Report 2012 to take up this issue and analyze the global, regional and national challenges in exploiting energy efficiency and promote research and development in energy efficiency....

  9. Improving cancer treatment with cyclotron produced radionuclides. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.; Finn, R.D.

    1993-11-01

    This report describes our continuing long term goal of promoting nuclear medicine applications by improving the scientific basis for tumor diagnosis, treatment and treatment follow-up based on the use of cyclotron produced radiotracers in oncology. The program includes 3 interactive components: Radiochemistry/Cyclotron; Pharmacology; and Immunology. An essential strategy is as follows: novel radionuclides and radiotracers developed in the Radiochemistry/Cyclotron section will be employed in the Pharmacology and Immunology sections during the next year. The development of novel radionuclides and tracers is of course useful in and of itself, but their utility is greatly enhanced by the interaction with the immunology and pharmacology components of the program.

  10. 2003 Stewardship progress report : committed to continuous improvement

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-12-01

    The stewardship initiative is a mandatory requirement for members of the Canadian Association of Petroleum Producers (CAPP). It involves performance management and benchmarking, voluntary audits and verification, as well as training and improved communication inside and outside the industry. This fourth annual progress report describes the environment, health, safety and socio-economic stewardship initiative. This report presents an aggregate of industry performance. Stewardship of Excellence awards were presented in 2003, celebrating outstanding performance by members who demonstrated their commitment to responsible development and continuous improvement within a business framework. The awards were presented in three categories, namely environment, health and safety, and socio-economic. Northrock Resources was presented with the award in the environment category for its voluntary waste gas reduction. The health and safety recognition went to Burlington Resources Canada Ltd. for superior office ergonomics, while the award in the socio-economic category was presented to Suncor Energy Inc. for Aboriginal business development. A brief overview of the achievements of each of these three companies was presented. tabs., figs.

  11. Using Patient-Reported Information to Improve Clinical Practice.

    Science.gov (United States)

    Schlesinger, Mark; Grob, Rachel; Shaller, Dale

    2015-12-01

    To assess what is known about the relationship between patient experience measures and incentives designed to improve care, and to identify how public policy and medical practices can promote patient-valued outcomes in health systems with strong financial incentives. Existing literature (gray and peer-reviewed) on measuring patient experience and patient-reported outcomes, identified from Medline and Cochrane databases; evaluations of pay-for-performance programs in the United States, Europe, and the Commonwealth countries. We analyzed (1) studies of pay-for-performance, to identify those including metrics for patient experience, and (2) studies of patient experience and of patient-reported outcomes to identify evidence of influence on clinical practice, whether through public reporting or private reporting to clinicians. First, we identify four forms of "patient-reported information" (PRI), each with distinctive roles shaping clinical practice: (1) patient-reported outcomes measuring self-assessed physical and mental well-being, (2) surveys of patient experience with clinicians and staff, (3) narrative accounts describing encounters with clinicians in patients' own words, and (4) complaints/grievances signaling patients' distress when treatment or outcomes fall short of expectations. Because these forms vary in crucial ways, each must be distinctively measured, deployed, and linked with financial incentives. Second, although the literature linking incentives to patients experience is limited, implementing pay-for-performance systems appears to threaten certain patient-valued aspects of health care. But incentives can be made compatible with the outcomes patients value if: (a) a sufficient portion of incentives is tied to patient-reported outcomes and experiences, (b) incentivized forms of PRI are complemented by other forms of patient feedback, and (c) health care organizations assist clinicians to interpret and respond to PRI. Finally, we identify roles for the

  12. A Small Decrease in Rubisco Content by Individual Suppression of RBCS Genes Leads to Improvement of Photosynthesis and Greater Biomass Production in Rice Under Conditions of Elevated CO2.

    Science.gov (United States)

    Kanno, Keiichi; Suzuki, Yuji; Makino, Amane

    2017-03-01

    Rubisco limits photosynthesis at low CO2 concentrations ([CO2]), but does not limit it at elevated [CO2]. This means that the amount of Rubisco is excessive for photosynthesis at elevated [CO2]. Therefore, we examined whether a small decrease in Rubisco content by individual suppression of the RBCS multigene family leads to increases in photosynthesis and biomass production at elevated [CO2] in rice (Oryza sativa L.). Our previous studies indicated that the individual suppression of RBCS decreased Rubisco content in rice by 10-25%. Three lines of BC2F2 progeny were selected from transgenic plants with individual suppression of OsRBCS2, 3 and 5. Rubisco content in the selected lines was 71-90% that of wild-type plants. These three transgenic lines showed lower rates of CO2 assimilation at low [CO2] (28 Pa) but higher rates of CO2 assimilation at elevated [CO2] (120 Pa). Similarly, the biomass production and relative growth rate (RGR) of the two lines were also smaller at low [CO2] but greater than that of wild-type plants at elevated [CO2]. This greater RGR was caused by the higher net assimilation rate (NAR). When the nitrogen use efficiency (NUE) for the NAR was estimated by dividing the NAR by whole-plant leaf N content, the NUE for NAR at elevated [CO2] was higher in these two lines. Thus, a small decrease in Rubisco content leads to improvements of photosynthesis and greater biomass production in rice under conditions of elevated CO2. © The Author 2017. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  13. A call to improve sampling methodology and reporting in young novice driver research.

    Science.gov (United States)

    Scott-Parker, B; Senserrick, T

    2017-02-01

    Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field. 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/.

  14. INTERIM REPORT IMPROVED METHODS FOR INCORPORATING RISK IN DECISION MAKING

    Energy Technology Data Exchange (ETDEWEB)

    Clausen, M. J.; Fraley, D. W.; Denning, R. S.

    1980-08-01

    This paper reports observations and preliminary investigations in the first phase of a research program covering methodologies for making safety-related decisions. The objective has been to gain insight into NRC perceptions of the value of formal decision methods, their possible applications, and how risk is, or may be, incorporated in decision making. The perception of formal decision making techniques, held by various decision makers, and what may be done to improve them, were explored through interviews with NRC staff. An initial survey of decision making methods, an assessment of the applicability of formal methods vis-a-vis the available information, and a review of methods of incorporating risk and uncertainty have also been conducted.

  15. Organising a manuscript reporting quality improvement or patient safety research.

    Science.gov (United States)

    Holzmueller, Christine G; Pronovost, Peter J

    2013-09-01

    Peer-reviewed publication plays important roles in disseminating research findings, developing generalisable knowledge and garnering recognition for authors and institutions. Nonetheless, many bemoan the whole manuscript writing process, intimidated by the arbitrary and somewhat opaque conventions. This paper offers practical advice about organising and writing a manuscript reporting quality improvement or patient safety research for submission to a peer-reviewed journal. Each section of the paper discusses a specific manuscript component-from title, abstract and each section of the manuscript body, through to reference list and tables and figures-explaining key principles, offering content organisation tips and providing an example of how this section may read. The paper also offers a checklist of common mistakes to avoid in a manuscript.

  16. Innovative improvements of thermal response tests - Final report

    Energy Technology Data Exchange (ETDEWEB)

    Poppei, J.; Schwarz, R. [AF-Colenco Ltd, Baden (Switzerland); Peron, H.; Silvani, C; Steinmann, G.; Laloui, L. [Swiss Federal Institute of Technology, Laboratoire de Mecanique des Sols, Lausanne (Switzerland); Wagner, R.; Lochbuehler, T.; Rohner, E. [Geowatt AG, Zuerich (Switzerland)

    2008-12-15

    This illustrated final report for Swiss Federal Office of Energy (SFOE) takes a look at innovative improvements to thermal response tests that are used to investigate the thermo-physical properties of the ground for the purpose of dimensioning borehole heat exchangers. Recent technical developments in the borehole investigation tools area provide a promising prerequisite for improved estimates of thermal conductivity. A mini-module developed at the Swiss Federal Institute of Technology EPFL which is suitable for fast and flexible thermal response testing is discussed as is a wireless miniature data logger for continuous temperature recordings in borehole heat exchangers up to a depth of 350 m. This allows high-resolution vertical temperature profiling in boreholes. International state-of-the-art methods are reviewed. The adaptations to the analytical methods necessary for the effective application of these tools are discussed and numerical methods available are looked at. The testing of the methods developed and their results are discussed, as is the influence of ground-water flow.

  17. Statistical reviewers improve reporting in biomedical articles: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Erik Cobo

    2007-03-01

    Full Text Available Although peer review is widely considered to be the most credible way of selecting manuscripts and improving the quality of accepted papers in scientific journals, there is little evidence to support its use. Our aim was to estimate the effects on manuscript quality of either adding a statistical peer reviewer or suggesting the use of checklists such as CONSORT or STARD to clinical reviewers or both.Interventions were defined as 1 the addition of a statistical reviewer to the clinical peer review process, and 2 suggesting reporting guidelines to reviewers; with "no statistical expert" and "no checklist" as controls. The two interventions were crossed in a 2x2 balanced factorial design including original research articles consecutively selected, between May 2004 and March 2005, by the Medicina Clinica (Barc editorial committee. We randomized manuscripts to minimize differences in terms of baseline quality and type of study (intervention, longitudinal, cross-sectional, others. Sample-size calculations indicated that 100 papers provide an 80% power to test a 55% standardized difference. We specified the main outcome as the increment in quality of papers as measured on the Goodman Scale. Two blinded evaluators rated the quality of manuscripts at initial submission and final post peer review version. Of the 327 manuscripts submitted to the journal, 131 were accepted for further review, and 129 were randomized. Of those, 14 that were lost to follow-up showed no differences in initial quality to the followed-up papers. Hence, 115 were included in the main analysis, with 16 rejected for publication after peer review. 21 (18.3% of the 115 included papers were interventions, 46 (40.0% were longitudinal designs, 28 (24.3% cross-sectional and 20 (17.4% others. The 16 (13.9% rejected papers had a significantly lower initial score on the overall Goodman scale than accepted papers (difference 15.0, 95% CI: 4.6-24.4. The effect of suggesting a guideline to the

  18. Using crowdsourcing to prioritize bicycle network improvements : final report.

    Science.gov (United States)

    2016-04-01

    Effort to improve the bicycle route network using crowdsourced data is a powerful means : of incorporating citizens in infrastructure improvement decisions, which will improve : livability by maximizing the benefit of the bicycle infrastructure fundi...

  19. Improving brightness and photostability of green and red fluorescent proteins for live cell imaging and FRET reporting

    OpenAIRE

    Bajar, Bryce T.; Wang, Emily S.; Lam, Amy J.; Kim, Bongjae B.; Jacobs, Conor L.; Howe, Elizabeth S.; Davidson, Michael W.; Lin, Michael Z.; Chu, Jun

    2016-01-01

    Many genetically encoded biosensors use F?rster resonance energy transfer (FRET) to dynamically report biomolecular activities. While pairs of cyan and yellow fluorescent proteins (FPs) are most commonly used as FRET partner fluorophores, respectively, green and red FPs offer distinct advantages for FRET, such as greater spectral separation, less phototoxicity, and lower autofluorescence. We previously developed the green-red FRET pair Clover and mRuby2, which improves responsiveness in intra...

  20. Does physiotherapy based on the Bobath concept, in conjunction with a task practice, achieve greater improvement in walking ability in people with stroke compared to physiotherapy focused on structured task practice alone?: a pilot randomized controlled trial.

    Science.gov (United States)

    Brock, Kim; Haase, Gerlinde; Rothacher, Gerhard; Cotton, Susan

    2011-10-01

    To compare the short-term effects of two physiotherapy approaches for improving ability to walk in different environments following stroke: (i) interventions based on the Bobath concept, in conjunction with task practice, compared to (ii) structured task practice alone. Randomized controlled trial. Two rehabilitation centres Participants: Twenty-six participants between four and 20 weeks post-stroke, able to walk with supervision indoors. Both groups received six one-hour physiotherapy sessions over a two-week period. One group received physiotherapy based on the Bobath concept, including one hour of structured task practice. The other group received six hours of structured task practice. The primary outcome was an adapted six-minute walk test, incorporating a step, ramp and uneven surface. Secondary measures were gait velocity and the Berg Balance Scale. Measures were assessed before and after the intervention period. Following the intervention, there was no significant difference in improvement between the two groups for the adapted six-minute walk test (89.9 (standard deviation (SD) 73.1) m Bobath versus 41 (40.7) m task practice, P = 0.07). However, walking velocity showed significantly greater increases in the Bobath group (26.2 (SD 17.2) m/min versus 9.9 (SD = 12.9) m/min, P = 0.01). No significant differences between groups were recorded for the Berg Balance Scale (P = 0.2). This pilot study indicates short-term benefit for using interventions based on the Bobath concept for improving walking velocity in people with stroke. A sample size of 32 participants per group is required for a definitive study.

  1. Butterfly valves: greater use in power plants

    International Nuclear Information System (INIS)

    McCoy, M.

    1975-01-01

    Improvements in butterfly valves, particularly in the areas of automatic control and leak tightness are described. The use of butterfly valves in nuclear power plants is discussed. These uses include service in component cooling, containment cooling, and containment isolation. The outlook for further improvements and greater uses is examined. (U.S.)

  2. Improving energy audit process and report outcomes through planning initiatives

    Science.gov (United States)

    Sprau Coulter, Tabitha L.

    Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first

  3. Structured reporting of MRI of the shoulder - improvement of report quality?

    Energy Technology Data Exchange (ETDEWEB)

    Gassenmaier, Sebastian; Armbruster, Marco; Sommer, Wieland H.; Sommer, Nora N. [Ludwig-Maximilians-University (LMU), Department of Clinical Radiology, Munich (Germany); Haasters, Florian [Schoen Klinik Muenchen Harlaching, Department of Knee, Hip and Shoulder Surgery, Munich (Germany); Ludwig-Maximilians-University (LMU), Department of General, Trauma and Reconstructive Surgery, Munich (Germany); Helfen, Tobias [Ludwig-Maximilians-University (LMU), Department of General, Trauma and Reconstructive Surgery, Munich (Germany); Henzler, Thomas [University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, Heidelberg (Germany); Alibek, Sedat [Ambulatory Health Care Center Radiology and Nuclear Medicine, Fuerth (Germany); Friedrich-Alexander University, Department of Diagnostic Radiology, Erlangen-Nuremberg (Germany); Pfoerringer, Dominik [Klinikum rechts der Isar, Technical University of Munich, Department of Trauma Surgery, Munich (Germany)

    2017-10-15

    To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. (orig.)

  4. Structured reporting of MRI of the shoulder - improvement of report quality?

    International Nuclear Information System (INIS)

    Gassenmaier, Sebastian; Armbruster, Marco; Sommer, Wieland H.; Sommer, Nora N.; Haasters, Florian; Helfen, Tobias; Henzler, Thomas; Alibek, Sedat; Pfoerringer, Dominik

    2017-01-01

    To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. (orig.)

  5. Conceptual design report -- Gasification Product Improvement Facility (GPIF)

    Energy Technology Data Exchange (ETDEWEB)

    Sadowski, R.S.; Skinner, W.H.; House, L.S.; Duck, R.R. [CRS Sirrine Engineers, Inc., Greenville, SC (United States); Lisauskas, R.A.; Dixit, V.J. [Riley Stoker Corp., Worcester, MA (United States); Morgan, M.E.; Johnson, S.A. [PSI Technology Co., Andover, MA (United States). PowerServe Div.; Boni, A.A. [PSI-Environmental Instruments Corp., Andover, MA (United States)

    1994-09-01

    The problems heretofore with coal gasification and IGCC concepts have been their high cost and historical poor performance of fixed-bed gasifiers, particularly on caking coals. The Gasification Product Improvement Facility (GPIF) project is being developed to solve these problems through the development of a novel coal gasification invention which incorporates pyrolysis (carbonization) with gasification (fixed-bed). It employs a pyrolyzer (carbonizer) to avoid sticky coal agglomeration caused in the conventional process of gradually heating coal through the 400 F to 900 F range. In so doing, the coal is rapidly heated sufficiently such that the coal tar exists in gaseous form rather than as a liquid. Gaseous tars are then thermally cracked prior to the completion of the gasification process. During the subsequent endothermic gasification reactions, volatilized alkali can become chemically bound to aluminosilicates in (or added to) the ash. To reduce NH{sub 3} and HCN from fuel born nitrogen, steam injection is minimized, and residual nitrogen compounds are partially chemically reduced in the cracking stage in the upper gasifier region. Assuming testing confirms successful deployment of all these integrated processes, future IGCC applications will be much simplified, require significantly less mechanical components, and will likely achieve the $1,000/kWe commercialized system cost goal of the GPIF project. This report describes the process and its operation, design of the plant and equipment, site requirements, and the cost and schedule. 23 refs., 45 figs., 23 tabs.

  6. Accounting for failures may improve precision: evidence supporting improved validity of self-reported condom use.

    Science.gov (United States)

    Crosby, Richard; Salazar, Laura F; DiClemente, Ralph J; Yarber, William L; Caliendo, Angela M; Staples-Horne, Michelle

    2005-08-01

    To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens. Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted. The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71-3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13-11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms. Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.

  7. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  8. Programme Reporting Standards (PRS for improving the reporting of sexual, reproductive, maternal, newborn, child and adolescent health programmes

    Directory of Open Access Journals (Sweden)

    Anna E. Kågesten

    2017-08-01

    , collaborative process, including methods to incorporate input from SRMNCAH stakeholders. The World Health Organization will develop a document that explains the items in greater detail, and will also apply the PRS to on-going initiatives. We welcome continuous input from the field, while it is being used, to improve its relevance and usefulness.

  9. Embedded Sensors and Controls to Improve Component Performance and Reliability Conceptual Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Kisner, R.; Melin, A.; Burress, T.; Fugate, D.; Holcomb, D.; Wilgen, J.; Miller, J.; Wilson, D.; Silva, P.; Whitlow, L.; Peretz, F.

    2012-09-15

    The objective of this project is to demonstrate improved reliability and increased performance made possible by deeply embedding instrumentation and controls (I&C) in nuclear power plant (NPP) components and systems. The project is employing a highly instrumented canned rotor, magnetic bearing, fluoride salt pump as its I&C technology demonstration platform. I&C is intimately part of the basic millisecond-by-millisecond functioning of the system; treating I&C as an integral part of the system design is innovative and will allow significant improvement in capabilities and performance. As systems become more complex and greater performance is required, traditional I&C design techniques become inadequate and more advanced I&C needs to be applied. New I&C techniques enable optimal and reliable performance and tolerance of noise and uncertainties in the system rather than merely monitoring quasistable performance. Traditionally, I&C has been incorporated in NPP components after the design is nearly complete; adequate performance was obtained through over-design. By incorporating I&C at the beginning of the design phase, the control system can provide superior performance and reliability and enable designs that are otherwise impossible. This report describes the progress and status of the project and provides a conceptual design overview for the platform to demonstrate the performance and reliability improvements enabled by advanced embedded I&C.

  10. Waste management in Greater Vancouver

    Energy Technology Data Exchange (ETDEWEB)

    Carrusca, K. [Greater Vancouver Regional District, Burnaby, BC (Canada); Richter, R. [Montenay Inc., Vancouver, BC (Canada)]|[Veolia Environmental Services, Vancouver, BC (Canada)

    2006-07-01

    An outline of the Greater Vancouver Regional District (GVRD) waste-to-energy program was presented. The GVRD has an annual budget for solid waste management of $90 million. Energy recovery revenues from solid waste currently exceed $10 million. Over 1,660,00 tonnes of GVRD waste is recycled, and another 280,000 tonnes is converted from waste to energy. The GVRD waste-to-energy facility combines state-of-the-art combustion and air pollution control, and has processed over 5 million tonnes of municipal solid waste since it opened in 1988. Its central location minimizes haul distance, and it was originally sited to utilize steam through sales to a recycle paper mill. The facility has won several awards, including the Solid Waste Association of North America award for best facility in 1990. The facility focuses on continual improvement, and has installed a carbon injection system; an ammonia injection system; a flyash stabilization system; and heat capacity upgrades in addition to conducting continuous waste composition studies. Continuous air emissions monitoring is also conducted at the plant, which produces a very small percentage of the total air emissions in metropolitan Vancouver. The GVRD is now seeking options for the management of a further 500,000 tonnes per year of solid waste, and has received 23 submissions from a range of waste energy technologies which are now being evaluated. It was concluded that waste-to-energy plants can be located in densely populated metropolitan areas and provide a local disposal solution as well as a source of renewable energy. Other GVRD waste reduction policies were also reviewed. refs., tabs., figs.

  11. Using Organization Development To Improve School Climate. Report No. 17.

    Science.gov (United States)

    Gottfredson, Gary D.; Gottfredson, Denise C.

    This paper presents and illustrates some principles for organizational development approaches to improving school climate. It discusses a specific structure for facilitating school improvement entitled Program Development Evaluation, and it illustrates the use of school climate assessments for school diagnosis and the evaluation of improvement…

  12. Case Report: Improved Homonymous Hemianopia with Hyperbaric Oxygen Therapy

    Science.gov (United States)

    2017-06-29

    in the visual fields was noted at 13 treatments, but approximately 50% improvement was demonstrated in the right eye after 30 treatments with less...significant objective improvement of a fixed neurologic deficit following an ischemic brain injury. Various hypotheses exist regarding the recovery of

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

    Science.gov (United States)

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

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

  14. Matrix Summaries Improve Research Reports: Secondary Analyses Using Published Literature

    Science.gov (United States)

    Zientek, Linda Reichwein; Thompson, Bruce

    2009-01-01

    Correlation matrices and standard deviations are the building blocks of many of the commonly conducted analyses in published research, and AERA and APA reporting standards recommend their inclusion when reporting research results. The authors argue that the inclusion of correlation/covariance matrices, standard deviations, and means can enhance…

  15. Improving Numeracy and Literacy: Evaluation Report and Executive Summary

    Science.gov (United States)

    Worth, Jack; Sizmur, Juliet; Ager, Rob; Styles, Ben

    2015-01-01

    The project, "Oxford Improving Numeracy and Literacy Programme," was delivered by Oxford University Department of Education. This evaluation tested two different initiatives with Year 2 children: "Mathematics and Reasoning" and "Literacy and Morphemes." The "Mathematics and Reasoning" programme aimed to…

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

    Energy Technology Data Exchange (ETDEWEB)

    Perry, D.R.

    1978-09-01

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

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

    International Nuclear Information System (INIS)

    Perry, D.R.

    1978-09-01

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

  18. A Novel Reporting System to Improve Accuracy in Appendicitis Imaging

    Science.gov (United States)

    Godwin, Benjamin D.; Drake, Frederick T.; Simianu, Vlad V.; Shriki, Jabi E.; Hippe, Daniel S.; Dighe, Manjiri; Bastawrous, Sarah; Cuevas, Carlos; Flum, David; Bhargava, Puneet

    2015-01-01

    OBJECTIVE The purpose of this study was to ascertain if standardized radiologic reporting for appendicitis imaging increases diagnostic accuracy. MATERIALS AND METHODS We developed a standardized appendicitis reporting system that includes objective imaging findings common in appendicitis and a certainty score ranging from 1 (definitely not appendicitis) through 5 (definitely appendicitis). Four radiologists retrospectively reviewed the preoperative CT scans of 96 appendectomy patients using our reporting system. The presence of appendicitis-specific imaging findings and certainty scores were compared with final pathology. These comparisons were summarized using odds ratios (ORs) and the AUC. RESULTS The appendix was visualized on CT in 89 patients, of whom 71 (80%) had pathologically proven appendicitis. Imaging findings associated with appendicitis included appendiceal diameter (odds ratio [OR] = 14 [> 10 vs appendicitis. In this initially indeterminate group, using the standardized reporting system, radiologists assigned higher certainty scores (4 or 5) in 21 of the 28 patients with appendicitis (75%) and lower scores (1 or 2) in five of the seven patients without appendicitis (71%) (AUC = 0.90; p = 0.001). CONCLUSION Standardized reporting and grading of objective imaging findings correlated well with postoperative pathology and may decrease the number of CT findings reported as indeterminate for appendicitis. Prospective evaluation of this reporting system on a cohort of patients with clinically suspected appendicitis is currently under way. PMID:26001230

  19. Invited review: Recommendations for reporting intervention studies on reproductive performance in dairy cattle: Improving design, analysis, and interpretation of research on reproduction.

    Science.gov (United States)

    Lean, Ian J; Lucy, Matthew C; McNamara, John P; Bradford, Barry J; Block, Elliot; Thomson, Jennifer M; Morton, John M; Celi, Pietro; Rabiee, Ahmad R; Santos, José E P; Thatcher, William W; LeBlanc, Stephen J

    2016-01-01

    Abundant evidence from the medical, veterinary, and animal science literature demonstrates that there is substantial room for improvement of the clarity, completeness, and accuracy of reporting of intervention studies. More rigorous reporting guidelines are needed to improve the quality of data available for use in comparisons of outcomes (or meta-analyses) of multiple studies. Because of the diversity of factors that affect reproduction and the complexity of interactions between these, a systematic approach is required to design, conduct, and analyze basic and applied studies of dairy cattle reproduction. Greater consistency, clarity, completeness, and correctness of design and reporting will improve the value of each report and allow for greater depth of evaluation in meta-analyses. Each of these benefits will improve understanding and application of current knowledge and better identify questions that require additional modeling or primary research. The proposed guidelines and checklist will aid in the design, conduct, analysis, and reporting of intervention studies. We propose an adaptation of the REFLECT (Reporting Guidelines for Randomized Controlled Trials for Livestock and Food Safety) statement to provide guidelines and a checklist specific to reporting intervention studies in dairy cattle reproduction. Furthermore, we provide recommendations that will assist investigators to produce studies with greater internal and external validity that can more often be included in systematic reviews and global meta-analyses. Such studies will also assist the development of models to describe the physiology of reproduction. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  20. Improved Barriers to Turbine Engine Fragments: Final Annual Report

    National Research Council Canada - National Science Library

    Shockey, Donald

    2002-01-01

    This final annual technical report describes the progress rnade during year 4 of the SPI International Phase II effort to develop a computational capability for designing lightweight fragment barriers...

  1. Chemical Weapons Improved Response Program. 2000 Summary Report

    National Research Council Canada - National Science Library

    2000-01-01

    The purpose of this summary report is to inform members of the first responder and emergency management communities about the on-going activities, initiatives, and lessons learned from the Chemical...

  2. Report: Improvements Needed in Key EPA Information System Security Practices

    Science.gov (United States)

    Report #10-P-0146, June 15, 2010. Williams Adley found that EPA program offices lacked evidence that they planned and executed tests of information system security controls as required by federal requirements.

  3. Report: EPA Needs to Improve Continuity of Operations Planning

    Science.gov (United States)

    Report #10-P-0017, October 27, 2009. EPA has limited assurance that it can successfully maintain continuity of operations and execute its mission essential functions during a significant national event such as a pandemic influenza outbreak.

  4. Agencies Need Improved Financial Data Reporting for Private Security Contractors

    National Research Council Canada - National Science Library

    Warren, David R; Bianco, Michael A; Nasser, Waheed; Kusman, Richard R; Shafer, James; Venner, Jason; Walls, Lovell Q; Wright, Samson J

    2008-01-01

    .... The objective of this report was to determine the extent to which federal agencies have systematically captured financial data for private security services in Iraq since 2003, and to identify...

  5. Improving user-insurance communication on accident reports

    OpenAIRE

    Fardoun, Habib Moussa; Alghazzawi, Daniyal M.; Paules Ciprés, Antonio

    2014-01-01

    This paper presents an easy to use methodology and system for insurance companies targeting at managing traffic accidents reports process. The main objective is to facilitate and accelerate the process of creating and finalizing the necessary accident reports in cases without mortal victims involved. The diverse entities participating in the process from the moment an accident occurs until the related final actions needed are included. Nowadays, this market is limited to the consulting platfo...

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

    Science.gov (United States)

    Findlay, Steven D

    2016-04-01

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

  7. Improved patient-reported health impact of multiple sclerosis

    DEFF Research Database (Denmark)

    Macdonell, Richard; Nagels, Guy; Laplaud, David-Axel

    2016-01-01

    BACKGROUND: Multiple sclerosis (MS) is a debilitating disease that negatively impacts patients' lives. OBJECTIVE: ENABLE assessed the effect of long-term prolonged-release (PR) fampridine (dalfampridine extended release in the United States) treatment on patient-perceived health impact in patients...... with MS with walking impairment. METHODS: ENABLE was a 48-week, open-label, Phase 4 study of PR-fampridine 10 mg twice daily. Patients who showed any improvement in Timed 25-Foot Walk walking speed at weeks 2 and 4 and any improvement in 12-item MS Walking Scale score at week 4 remained on treatment....... The primary endpoint was change from baseline in 36-Item Short-Form Health Survey (SF-36) physical component summary (PCS) score. RESULTS: At week 4, 707/901 (78.5%) patients met the criteria to remain on treatment. Patients on treatment demonstrated significant and clinically meaningful improvements in SF-36...

  8. IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    William M. Bond; Salih Ersayin

    2007-03-30

    This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency of individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern

  9. DOD Financial Management: Greater Visibility Needed to Better Assess Audit Readiness for Property, Plant, and Equipment

    Science.gov (United States)

    2016-05-01

    with U.S. generally accepted accounting principles and establish and maintain effective internal control over financial reporting and compliance with... Accountability Office Highlights of GAO-16-383, a report to congressional committees May 2016 DOD FINANCIAL MANAGEMENT Greater Visibility... Accounting Standards Advisory Board FIAR Financial Improvement and Audit Readiness IUS internal-use software NDAA National Defense Authorization Act

  10. Improving Employability Skills, Enriching Our Economy. Case Study Report

    Science.gov (United States)

    National Foundation for Educational Research, 2015

    2015-01-01

    This report has been produced by four organisations--the National Foundation for Educational Research, South East Strategic Leaders, London Councils and the London Enterprise Panel. It is based on research into how secondary schools, colleges, SMEs (small and medium-sized enterprises) and micro-businesses in London and the South East work together…

  11. The effect of the SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines on reporting standards in the quality improvement literature: a before-and-after study.

    Science.gov (United States)

    Howell, Victoria; Schwartz, Amanda Eva; O'Leary, James Daniel; Mc Donnell, Conor

    2015-06-01

    The SQUIRE (Standards of QUality Improvement Reporting Excellence) guidelines were developed to improve the reporting of quality improvement (QI) projects. The effect of the guidelines on the completeness of reporting in the QI literature is unknown. Our primary objective was to determine if the completeness of reporting in the QI literature has been improved[OUP_CE13] since the introduction of the SQUIRE guidelines. We performed a before-and-after evaluation of QI articles selected from four prominent journals of healthcare quality. Twenty-five articles published in each of two time periods (2006-2008 and 2010-2011) were confirmed to be QI projects using a standardised definition and were independently evaluated by two investigators as an interim evaluation of a planned larger sample. Articles were assessed using 50 statements of the SQUIRE guidelines, and the overall change in the completeness of reporting between the two groups was determined. The value of pimprovement observed in the completeness of reporting of QI projects after the publication of the SQUIRE guidelines, and the study was stopped early. There is potential for improvement in reporting standards, particularly for those guideline items or statements specific to QI projects. 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.

  12. Fort St. Vrain improvement program plan. Draft final report

    International Nuclear Information System (INIS)

    1980-03-01

    The restraints are described which inhibit the Fort St. Vrain (FSV) Nuclear Power Station, a high temperature gas cooled reactor (HTGR) plant, from achieving full power operation with high availability. The actions necessary to overcome these restraints are outlined. The restraints originated from problems in both hardware related and institutional areas. The report summarizes what has been accomplished, what is currently being done, and what should be done to resolve the problems

  13. Genetic Test Reporting and Counseling for Melanoma Risk in Minors May Improve Sun Protection Without Inducing Distress.

    Science.gov (United States)

    Stump, Tammy K; Aspinwall, Lisa G; Kohlmann, Wendy; Champine, Marjan; Hauglid, Jamie; Wu, Yelena P; Scott, Emily; Cassidy, Pamela; Leachman, Sancy A

    2018-01-19

    Genetic testing of minors is advised only for conditions in which benefits of early intervention outweigh potential psychological harms. This study investigated whether genetic counseling and test reporting for the CDKN2A/p16 mutation, which confers highly elevated melanoma risk, improved sun protection without inducing distress. Eighteen minors (M age  = 12.4, SD = 1.9) from melanoma-prone families completed measures of protective behavior and distress at baseline, 1 week (distress only), 1 month, and 1 year following test disclosure. Participants and their mothers were individually interviewed on the psychological and behavioral impact of genetic testing 1 month and 1 year post-disclosure. Carriers (n = 9) and noncarriers (n = 9) reported significantly fewer sunburns and a greater proportion reported sun protection adherence between baseline and 1 year post-disclosure; results did not vary by mutation status. Anxiety symptoms remained low post-disclosure, while depressive symptoms and cancer worry decreased. Child and parent interviews corroborated these findings. Mothers indicated that genetic testing was beneficial (100%) because it promoted risk awareness (90.9%) and sun protection (81.8%) without making their children scared (89.9%); several noted their child's greater independent practice of sun protection (45.4%). In this small initial study, minors undergoing CDKN2A/p16 genetic testing reported behavioral improvements and consistently low distress, suggesting such testing may be safely implemented early in life, allowing greater opportunity for risk-reducing lifestyle changes.

  14. Improving the Efficient of Ernie Turner Center. Final Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Fredeen, Amy

    2011-03-21

    The objective of this project was to complete the specifications and drawings for a variable speed kitchen exhaust system and the boiler heating system which when implemented will improve the heating efficiency of the building. The design work was focused in two key areas: kitchen ventilation and heating for the Ernie Turner Center building (ETC). RSA completed design work and issued a set of 100% drawings. RSA also worked with a cost estimator to put together a detailed cost estimate for the project. The design components are summarized.

  15. [Financial incentives in improving healthcare quality. SESPAS Report 2012].

    Science.gov (United States)

    Eirea Eiras, Carlos; Ortún Rubio, Vicente

    2012-03-01

    We address the contribution of financial incentives linked to pay for performance (P4P) to improving the quality of care. The situation of P4P is analyzed internationally and in the distinct health services in Spain. The participation of P4P in wage compensation and the effects of the current economic crisis on these incentives is discussed. We review the results of recent studies to clarify the role of these incentive models and assess possible orientations and new proposals. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. How can the use of data within the immunisation programme be increased in order to improve data quality and ensure greater accountability in the health system? A protocol for implementation science study.

    Science.gov (United States)

    Tilahun, Binyam; Teklu, Alemayehu; Mancuso, Arielle; Abebaw, Zeleke; Dessie, Kassahun; Zegeye, Desalegn

    2018-05-03

    Immunisation remains one of the most important and cost-effective interventions to reduce vaccine-preventable child morbidity, disability and mortality. Health programmes like the Expanded Program of Immunization rely on complex decision-making and strong local level evidence is important to effectively and efficiently utilise limited resources. Lack of data use for decision-making at each level of the health system remains the main challenge in most developing countries. While there is much evidence on data quality and how to improve it, there is a lack of sufficient evidence on why the use of data for decision-making at each level of the health system is low. Herein, we describe a comprehensive implementation science study that will be conducted to identify organisational, technical and individual level factors affecting local data use at each level of the Ethiopian health system. We will apply a mixed methods approach using key informant interviews and document reviews. The qualitative data will be gathered through key informant interviews using a semi-structured guide with open- and closed-ended questions with four categories of respondents, namely decision-makers, data producers, data users and community representatives at the federal, regional, zonal, woreda and community levels of the health system. The document review will be conducted on selected reports and feedback documented at different levels of the health system. Data will be collected from July 2017 to March 2018. Descriptive statistics will be analysed for the quantitative study using SPSS version 20 software and thematic content analysis will be performed for the qualitative part using NVivo software. Appropriate and timely use of health and health-related information for decision-making is an essential element in the process of transforming the health sector. The findings of the study will inform stakeholders at different levels on the institutionalisation of evidence-based practice in

  17. Natural Propagation and Habitat Improvement, Volume 1, Oregon, 1986 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Stuart, Amy

    1987-01-01

    This report describes activities implemented for fisheries habitat improvement work on priority drainages in the Clackamas and Hood River sub-basins. Separate abstracts have been prepared for the reports on individual projects. (ACR)

  18. Management Report: Improvements Needed in IRS's Accounting Procedures and Internal Controls

    National Research Council Canada - National Science Library

    2002-01-01

    ... with requirements of the Federal Financial Management Improvement Act of 1996. A separate report on the implementation status of recommendations from our prior IRS financial audits and related financial management reports will be issued shortly...

  19. IMPROVING THE REPORTING OF THERAPEUTIC EXERCISE INTERVENTIONS IN REHABILITATION RESEARCH.

    Science.gov (United States)

    Page, Phil; Hoogenboom, Barb; Voight, Michael

    2017-04-01

    The foundation of evidence-based practice lies in clinical research, which is based on the utilization of the scientific method. The scientific method requires that all details of the experiment be provided in publications to support replication of the study in order to evaluate and validate the results. More importantly, clinical research can only be translated into practice when researchers provide explicit details of the study. Too often, rehabilitation exercise intervention studies lack the appropriate detail to allow clinicians to replicate the exercise protocol in their patient populations. Therefore, the purpose of this clinical commentary is to provide guidelines for optimal reporting of therapeutic exercise interventions in rehabilitation research. 5.

  20. Improved nuclear gage development - phase i and ii. Interim report

    International Nuclear Information System (INIS)

    Chan, E.L.; Champion, F.C.; Castanon, D.R.; Chang, J.C.; Hannon, J.B.

    1976-09-01

    This report contains Phase I and II of an investigation covering the design and construction of a prototype nuclear-moisture-density backscatter gage. Gage development was based upon the analysis of several factors which affect gage performance. This research indicated that the prototype gage measurements are approximately equivalent to measurements obtained by a commercial transmission gage. The implication of this research finding concerns the qualification of the backscatter test method as a valid, reliable, and expedient procedure for determining in-situ soil conditions

  1. Research work for improving LWR safety. 1991 annual report

    International Nuclear Information System (INIS)

    1992-08-01

    The work performed in 1991 for the PNS project centers on various phenomena of severe fuel damage and on selected aspects of a core meltdown accident, relating to aerosol behaviour and filter engineering, and to methods of assessing and minimizing the radiological impacts of a reactor accident. One paper included in this annual report summarizes the evaluation of experiments carried out in 1990 at the Wuerenlingen PROTEUS reactor. The 1991 task programme of the project for the first time included research into extreme load conditions affecting the containment in a core meltdown accident; first results are given of the experiments performed. (orig./DG) [de

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

    International Nuclear Information System (INIS)

    Casey, Jeffrey A.

    2011-01-01

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

  3. Improving plant bioaccumulation science through consistent reporting of experimental data

    DEFF Research Database (Denmark)

    Fantke, Peter; Arnot, Jon A.; Doucette, William J.

    2016-01-01

    Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new...... experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never......-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent...

  4. 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.

  5. Valve-stem-packing improvement study. Final report

    International Nuclear Information System (INIS)

    Adey, C.W.; Klein, J.J.

    1982-08-01

    By employing questionnaires and face-to-face interviews with valve and valve packing manufacturers, as well as nuclear plant personnel, an understanding of valve stem packing leakage problems from each of the three viewpoints was developed. This information, in-house experience, and available technical literature were used to develop specific recommendations for valve manufacturers, valve packing manufacturers, and nuclear plant valve users. It was generally recommended that each these groups make better use of graphite packing. The questionnaires and interviews indicated that increased usage of graphite packing over the last few years has reduced the incidence of valve packing problems. To confirm this, a survey of Licensee Event Reports (LERs) from 1972 to 1980 was undertaken using the keywords Valve and Packing. A statistical analysis of the LER data confirms that the adoption of graphite packing has significantly reduced valve stem leakage

  6. Simultaneous bilateral isolated greater trochanter fracture

    Directory of Open Access Journals (Sweden)

    Maruti Kambali

    2013-01-01

    Full Text Available A 48-year-old woman sustained simultaneous isolated bilateral greater trochanteric fracture, following a road traffic accident. The patient presented to us 1 month after the injury. She presented with complaints of pain in the left hip and inability to walk. Roentgenograms revealed displaced comminuted bilateral greater trochanter fractures. The fracture of the left greater trochanter was reduced and fixed internally using the tension band wiring technique. The greater trochanter fracture on the right side was asymptomatic and was managed conservatively. The patient regained full range of motion and use of her hips after a postoperative follow-up of 6 months. Isolated fractures of the greater trochanter are unusual injuries. Because of their relative rarity and the unsettled controversy regarding their etiology and pathogenesis, several methods of treatment have been advocated. Furthermore, the reports of this particular type of injury are not plentiful and the average textbook coverage afforded to this entity is limited. In our study we discuss the mechanism of injury and the various treatment options available.

  7. Quality improvement in depression care in the Netherlands: the Depression Breakthrough Collaborative. A quality improvement report.

    NARCIS (Netherlands)

    Franx, G.C.; Meeuwissen, J.A.; Sinnema, H.; Spijker, J.; Huyser, J.; Wensing, M.J.P.; Lange, J.

    2009-01-01

    BACKGROUND: Improving the healthcare for patients with depression is a priority health policy across the world. Roughly, two major problems can be identified in daily practice: (1) the content of care is often not completely consistent with recommendations in guidelines and (2) the organization of

  8. Final Scientific Report - "Improved Fuel Efficiency from Nanocomposite Tire Tread"

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Andrew Myers

    2005-12-30

    Rolling resistance, a measure of the energy lost as a tire rotates while moving, is a significant source of power and fuel loss. Recently, low rolling resistant tires have been formulated by adding silica to tire tread. These "Green Tires" (so named from the environmental advantages of lower emissions and improved fuel economy) have seen some commercial success in Europe, where high fuel prices and performance drive tire selection. Unfortunately, the higher costs of the silica and a more complicated manufacturing process have prevented significant commercialization - and the resulting fuel savings - in the U.S. In this project, TDA Research, Inc. (TDA) prepared an inexpensive alternative to silica that leads to tire components with lower rolling resistance. These new tire composite materials were processed with traditional rubber processing equipment. We prepared specially designed nanoparticle additives, based on a high purity, inorganic mineral whose surface can be easily modified for compatibility with tire tread formulations. Our nanocomposites decreased energy losses to hysteresis, the loss of energy from the compression and relaxation of an elastic material, by nearly 20% compared to a blank SBR sample. We also demonstrated better performance than a leading silica product, with easier production of our final rubber nanocomposite.

  9. Foundations for Improvements to Passive Detection Systems - Final Report

    International Nuclear Information System (INIS)

    Labov, S E; Pleasance, L; Sokkappa, P; Craig, W; Chapline, G; Frank, M; Gronberg, J; Jernigan, J G; Johnson, S; Kammeraad, J; Lange, D; Meyer, A; Nelson, K; Pohl, B; Wright, D; Wurtz, R

    2004-01-01

    This project explores the scientific foundation and approach for improving passive detection systems for plutonium and highly enriched uranium in real applications. Sources of gamma-ray radiation of interest were chosen to represent a range of national security threats, naturally occurring radioactive materials, industrial and medical radiation sources, and natural background radiation. The gamma-ray flux emerging from these sources, which include unclassified criticality experiment configurations as surrogates for nuclear weapons, were modeled in detail. The performance of several types of gamma-ray imaging systems using Compton scattering were modeled and compared. A mechanism was created to model the combine sources and background emissions and have the simulated radiation ''scene'' impinge on a model of a detector. These modeling tools are now being used in various projects to optimize detector performance and model detector sensitivity in complex measuring environments. This study also developed several automated algorithms for isotope identification from gamma-ray spectra and compared these to each other and to algorithms already in use. Verification testing indicates that these alternative isotope identification algorithms produced less false positive and false negative results than the ''GADRAS'' algorithms currently in use. In addition to these algorithms that used binned spectra, a new approach to isotope identification using ''event mode'' analysis was developed. Finally, a technique using muons to detect nuclear material was explored

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

    Energy Technology Data Exchange (ETDEWEB)

    Golder Associates, Inc.

    2003-04-22

    The Yakima Urban Growth Area (UGA) is a developing and growing urban area in south-central Washington. Despite increased development, the Yakima River and its tributaries within the UGA continue to support threatened populations of summer steelhead and bull trout as well as a variety of non-listed salmonid species. In order to provide for the maintenance and recovery of these species, while successfully planning for the continued growth and development within the UGA, the City of Yakima has undertaken the Yakima Habitat Improvement Project. The overall goal of the project is to maintain, preserve, and restore functioning fish and wildlife habitat within and immediately surrounding the Yakima UGA over the long term. Acquisition and protection of the fish and wildlife habitat associated with key properties in the UGA will prevent future subdivision along riparian corridors, reduce further degradation or removal of riparian habitat, and maintain or enhance the long term condition of aquatic habitat. By placing these properties in long-term protection, the threat of development from continued growth in the urban area will be removed. To most effectively implement the multi-year habitat acquisition and protection effort, the City has developed this Master Plan. The Master Plan provides the structure and guidance for future habitat acquisition and restoration activities to be performed within the Yakima Urban Area. The development of this Master Plan also supports several Reasonable and Prudent Alternatives (RPAs) of the NOAA Fisheries 2000 Biological Opinion (BiOp), as well as the Water Investment Action Agenda for the Yakima Basin, local planning efforts, and the Columbia Basin Fish and Wildlife Authority's 2000 Fish and Wildlife Program. This Master Plan also provides the framework for coordination of the Yakima Habitat Improvement Project with other fish and wildlife habitat acquisition and protection activities currently being implemented in the area. As a

  11. Global hydrobelts: improved reporting scale for water-related issues?

    Science.gov (United States)

    Meybeck, M.; Kummu, M.; Dürr, H. H.

    2012-08-01

    Questions related to water such as its availability, water needs or stress, or management, are mapped at various resolutions at the global scale. They are reported at many scales, mostly along political or continental boundaries. As such, they ignore the fundamental heterogeneity of the hydroclimate and the natural boundaries of the river basins. Here, we describe the continental landmasses according to eight global-scale hydrobelts strictly limited by river basins, defined at a 30' (0.5°) resolution. The belts were defined and delineated, based primarily on the annual average temperature (T) and runoff (q), to maximise interbelt differences and minimise intrabelt variability. The belts were further divided into 29 hydroregions based on continental limits. This new global puzzle defines homogeneous and near-contiguous entities with similar hydrological and thermal regimes, glacial and postglacial basin histories, endorheism distribution and sensitivity to climate variations. The Mid-Latitude, Dry and Subtropical belts have northern and southern analogues and a general symmetry can be observed for T and q between them. The Boreal and Equatorial belts are unique. The hydroregions (median size 4.7 Mkm2) contrast strongly, with the average q ranging between 6 and 1393 mm yr-1 and the average T between -9.7 and +26.3 °C. Unlike the hydroclimate, the population density between the North and South belts and between the continents varies greatly, resulting in pronounced differences between the belts with analogues in both hemispheres. The population density ranges from 0.7 to 0.8 p km-2 for the North American Boreal and some Australian hydroregions to 280 p km-2 for the Asian part of the Northern Mid-Latitude belt. The combination of population densities and hydroclimate features results in very specific expressions of water-related characteristics in each of the 29 hydroregions. Our initial tests suggest that hydrobelt and hydroregion divisions are often more

  12. Improving brightness and photostability of green and red fluorescent proteins for live cell imaging and FRET reporting.

    Science.gov (United States)

    Bajar, Bryce T; Wang, Emily S; Lam, Amy J; Kim, Bongjae B; Jacobs, Conor L; Howe, Elizabeth S; Davidson, Michael W; Lin, Michael Z; Chu, Jun

    2016-02-16

    Many genetically encoded biosensors use Förster resonance energy transfer (FRET) to dynamically report biomolecular activities. While pairs of cyan and yellow fluorescent proteins (FPs) are most commonly used as FRET partner fluorophores, respectively, green and red FPs offer distinct advantages for FRET, such as greater spectral separation, less phototoxicity, and lower autofluorescence. We previously developed the green-red FRET pair Clover and mRuby2, which improves responsiveness in intramolecular FRET reporters with different designs. Here we report the engineering of brighter and more photostable variants, mClover3 and mRuby3. mClover3 improves photostability by 60% and mRuby3 by 200% over the previous generation of fluorophores. Notably, mRuby3 is also 35% brighter than mRuby2, making it both the brightest and most photostable monomeric red FP yet characterized. Furthermore, we developed a standardized methodology for assessing FP performance in mammalian cells as stand-alone markers and as FRET partners. We found that mClover3 or mRuby3 expression in mammalian cells provides the highest fluorescence signals of all jellyfish GFP or coral RFP derivatives, respectively. Finally, using mClover3 and mRuby3, we engineered an improved version of the CaMKIIα reporter Camuiα with a larger response amplitude.

  13. Does improvement in maternal attachment representations predict greater maternal sensitivity, child attachment security and lower rates of relapse to substance use? A second test of Mothering from the Inside Out treatment mechanisms.

    Science.gov (United States)

    Suchman, Nancy E; DeCoste, Cindy; Borelli, Jessica L; McMahon, Thomas J

    2018-02-01

    In this study, we replicated a rigorous test of the proposed mechanisms of change associated with Mothering from the Inside out (MIO), an evidence-based parenting therapy that aims to enhance maternal reflective functioning and mental representations of caregiving in mothers enrolled in addiction treatment and caring for young children. First, using data from 84 mothers who enrolled in our second randomized controlled trial, we examined whether therapist fidelity to core MIO treatment components predicted improvement in maternal reflective functioning and mental representations of caregiving, even after taking fidelity to non-MIO components into account. Next, we examined whether improvement in directly targeted outcomes (e.g., maternal mentalizing and mental representations of caregiving) led to improvements in the indirectly targeted outcome of maternal caregiving sensitivity, even after controlling for other plausible competing mechanisms (e.g., improvement in maternal psychiatric distress and substance use). Third, we examined whether improvement in targeted parenting outcomes (e.g., maternal mentalizing, mental representations of caregiving and caregiving sensitivity) was associated in improvement in child attachment status, even after controlling for competing mechanisms (e.g., improvement in maternal psychiatric distress and substance use). Finally, we examined whether improvement in maternal mentalizing and caregiving representations was associated with a reduction in relapse to substance use. Support was found for the first three tests of mechanisms but not the fourth. Implications for future research and intervention development are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Widely Assumed but Thinly Tested: Do Employee Volunteers' Self-Reported Skill Improvements Reflect the Nature of Their Volunteering Experiences?

    Science.gov (United States)

    Jones, David A

    2016-01-01

    An increasing number of companies use corporate volunteering programs (CVPs) to support and coordinate their employees' efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers' self-reported skill development reflects the characteristics of the volunteers and their volunteering experiences. Study participants were 74 employee volunteers who completed a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit's records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of 10 work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were moderated by the employee volunteers' self-efficacy about improving their work

  15. Widely Assumed but Thinly Tested: Do Employee Volunteers' Self-Reported Skill Improvements Reflect the Nature of Their Volunteering Experiences?

    Science.gov (United States)

    Jones, David A.

    2016-01-01

    An increasing number of companies use corporate volunteering programs (CVPs) to support and coordinate their employees' efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers' self-reported skill development reflects the characteristics of the volunteers and their volunteering experiences. Study participants were 74 employee volunteers who completed a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit's records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of 10 work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were moderated by the employee volunteers' self-efficacy about improving their work

  16. Nutrition Report Cards: an opportunity to improve school lunch selection.

    Directory of Open Access Journals (Sweden)

    Brian Wansink

    Full Text Available OBJECTIVE: To explore the feasibility and implementation efficiency of Nutritional Report Cards (NRCs in helping children make healthier food choices at school. METHODS: Pilot testing was conducted in a rural New York school district (K-12. Over a five-week period, 27 parents received a weekly e-mail containing a NRC listing how many meal components (fruits, vegetables, starches, milk, snacks, and a-la-carte foods their child selected. We analyzed choices of students in the NRC group vs. the control group, both prior to and during the intervention period. Point-of-sale system data for a-la-carte items was analyzed using Generalized Least Squares regressions with clustered standard errors. RESULTS: NRCs encouraged more home conversations about nutrition and more awareness of food selections. Despite the small sample, the NRC was associated with reduced selection of some items, such as the percentage of those selecting cookies which decreased from 14.3 to 6.5 percent. Additionally, despite requiring new keys on the check-out registers to generate the NRC, checkout times increased by only 0.16 seconds per transaction, and compiling and sending the NRCs required a total weekly investment of 30 minutes of staff time. CONCLUSIONS: This test of concept suggests that NRCs are a feasible and inexpensive tool to guide children towards healthier choices.

  17. Quantify and improve PEM fuel cell durability. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Grahl-Madsen, L.; Odgaard, M.; Munksgaard Nielsen, R. (IRD Fuel Cell A/S, Svendborg (Denmark)); Li, Q.; Jensen, Jens Oluf (Technical Univ. of Denmark, Dept. of Chemistry, Kgs. Lyngby (Denmark)); Andersen, Shuang Ma; Speder, J.; Skou, E. (Syddansk Univ. (SDU), Odense (Denmark))

    2010-07-01

    The aim of the present project is to systematically quantify and improve the durability of the PEM FC including the following three PEM FC variants: LT PEM FC, DMFC, and HT PEM FC. Different factors influencing dissolution properties of noble metal catalyst platinum and platinum-ruthenium alloy has been studied. The dissolution was found to increase by increasing the CV cycle upper potential limit, number of potential cycles, solution acidity, oxygen partial pressure, involvement of chloride, and temperature. Ruthenium was found to deteriorate ten (10) times faster than platinum catalyst; and carbon supported catalyst (Pt: 20%, Ru: up to 100%) deteriorate ten (10) times faster than non-supported catalyst (Pt: 2%, Ru: 30%) at the same condition. Loss of sulphonic acid groups and fluoride from perfluorinated sulfonic acid membrane was confirmed by different techniques, which locally leads to loss of acidity, and consequently enhances dissolution of noble metal catalyst. Degradation of Nafion ionomer in the electrode was enhanced by noble metal catalyst and the thermal decomposition properties has synergetic effect with carbon degradation. Hydrophobicity of GDL and electrode on GDL were found to degrade e.g. radical attack, oxidation, and physical wear out. The very top micro surface structure turned out to be responsible for wetting property after chemical ageing. Optimal catalyst and ionomer ratio is also reflected in contact angle value, which can be understood in terms of catalyst/carbon - ionomer affinity and layered structure. Long-term tested and 'virgin' LT PEM MEAs have been characterised with respect to SEM, TEM, EDS, and XRD. Both failed and well-functioning MEAs have been characterised. The Post Mortem analysis has shown and quantified degradation mechanisms like catalyst growth and carbon corrosion. Furthermore, the effect of fuel starvation was shown by pronounced Ru-catalyst band within the membrane. The catalyst coarsening observed after

  18. [Autoerotic fatalities in Greater Dusseldorf].

    Science.gov (United States)

    Hartung, Benno; Hellen, Florence; Borchard, Nora; Huckenbeck, Wolfgang

    2011-01-01

    Autoerotic fatalities in the Greater Dusseldorf area correspond to the relevant medicolegal literature. Our results included exclusively young to middle-aged, usually single men who were found dead in their city apartments. Clothing and devices used showed a great variety. Women's or fetish clothing and complex shackling or hanging devices were disproportionately frequent. In most cases, death occurred due to hanging or ligature strangulation. There was no increased incidence of underlying psychiatric disorders. In most of the deceased no or at least no remarkable alcohol intoxication was found. Occasionally, it may be difficult to reliably differentiate autoerotic accidents, accidents occurring in connection with practices of bondage & discipline, dominance & submission (BDSM) from natural death, suicide or homicide.

  19. An educational approach to improve outcomes in acute kidney injury (AKI): report of a quality improvement project.

    Science.gov (United States)

    Xu, Gang; Baines, Richard; Westacott, Rachel; Selby, Nick; Carr, Susan

    2014-03-20

    To assess the impact of a quality improvement project that used a multifaceted educational intervention on how to improve clinician's knowledge, confidence and awareness of acute kidney injury (AKI). 2 large acute teaching hospitals in England, serving a combined population of over 1.5 million people. All secondary care clinicians working in the clinical areas were targeted, with a specific focus on clinicians working in acute admission areas. A multifaceted educational intervention consisting of traditional didactic lectures, case-based teaching in small groups and an interactive web-based learning resource. We assessed clinicians' knowledge of AKI and their self-reported clinical behaviour using an interactive questionnaire before and after the educational intervention. Secondary outcome measures included clinical audit of patient notes before and after the intervention. 26% of clinicians reported that they were aware of local AKI guidelines in the preintervention questionnaire compared to 64% in the follow-up questionnaire (χ²=60.2, pquality improvement project utilising a multifaceted educational intervention improved awareness of AKI as demonstrated by changes in the clinician's self-reported management of patients with AKI. Elements of the project have been sustained beyond the project period, and demonstrate the power of quality improvement projects to help initiate changes in practice. Our findings are limited by confounding factors and highlight the need to carry out formal randomised studies to determine the impact of educational initiatives in the clinical setting.

  20. Counterfeit Parts: DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk

    Science.gov (United States)

    2016-02-01

    agencies and contractors we met with stated that they have encountered counterfeit parts less frequently in the DOD supply chain , in part, because...the DOD supply chain as a method to prevent further counterfeiting.22 DOD and industry officials noted that timely reporting of...COUNTERFEIT PARTS DOD Needs to Improve Reporting and Oversight to Reduce Supply Chain Risk Report to Congressional Committees

  1. AMCP Partnership Forum: Improving Quality, Value, and Outcomes with Patient-Reported Outcomes.

    Science.gov (United States)

    2018-03-01

    manufacturers should engage key stakeholders early and throughout the drug development process to ensure the most valid and representative PROs and patient populations will be included. To streamline the PRO collection process, participants suggested engaging pharmacists and other providers who may have more frequent interaction with patients. Participants also recommended that PRO collection and analysis should use common technology platforms, streamline components of clinician care to reduce workflow, and be integrated with claims data to provider payers a better understanding of patient health in real time. Finally, additional work should be done to develop patient-reported outcome measures that contain relevant measures for all healthcare stakeholders. While significant challenges remain in PRO development and adoption, participants agreed that greater use can only be achieved through collaboration and patient-centered care. The AMCP Partnership Forum titled "Improving Quality, Value, and Outcomes with Patient-Reported Outcomes" and the development of this proceedings report were supported by Amgen, Boehringer Ingelheim Pharmaceuticals, Genentech, GlaxoSmithKline, Novartis Pharmaceuticals, Novo Nordisk, Precision for Value, Premier, Sanofi, Takeda Pharmaceuticals USA, and Xcenda.

  2. Reporting Guidelines and Checklists Improve the Reliability and Rigor of Research Reports.

    Science.gov (United States)

    Abbott, J Haxby

    2016-03-01

    The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) requires the use of robust research reporting guidelines for all research report submissions, including the newly adopted RECORD (REporting of studies Conducted using Observational Routinely-collected health Data) statement. We remind authors submitting research to JOSPT to identify the appropriate guideline and checklist for their study design, and to submit a completely and accurately completed checklist with their manuscript. J Orthop Sports Phys Ther 2016;46(3):130. doi:10.2519/jospt.2016.0105.

  3. Practicing more retrieval routes leads to greater memory retention.

    Science.gov (United States)

    Zheng, Jun; Zhang, Wei; Li, Tongtong; Liu, Zhaomin; Luo, Liang

    2016-09-01

    A wealth of research has shown that retrieval practice plays a significant role in improving memory retention. The current study focused on one simple yet rarely examined question: would repeated retrieval using two different retrieval routes or using the same retrieval route twice lead to greater long-term memory retention? Participants elaborately learned 22 Japanese-Chinese translation word pairs using two different mediators. Half an hour after the initial study phase, the participants completed two retrieval sessions using either one mediator (Tm1Tm1) or two different mediators (Tm1Tm2). On the final test, which was performed 1week after the retrieval practice phase, the participants received only the cue with a request to report the mediator (M1 or M2) followed by the target (Experiment 1) or only the mediator (M1 or M2) with a request to report the target (Experiment 2). The results of Experiment 1 indicated that the participants who practiced under the Tm1Tm2 condition exhibited greater target retention than those who practiced under the Tm1Tm1 condition. This difference in performance was due to the significant disadvantage in mediator retrieval and decoding of the unpracticed mediator under the Tm1Tm1 condition. Although mediators were provided to participants on the final test in Experiment 2, decoding of the unpracticed mediators remained less effective than decoding of the practiced mediators. We conclude that practicing multiple retrieval routes leads to greater memory retention than focusing on a single retrieval route. Thus, increasing retrieval variability during repeated retrieval practice indeed significantly improves long-term retention in a delay test. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Natural Propagation and Habitat Improvement, Volume I, Oregon, 1984 Final and Annual Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Rod

    1986-02-01

    This volume contains reports on habitat improvement and fisheries enhancement projects conducted in the following subbasins: (1) Clackamas River; (2) Hood River; :(3) Deschutes River; (4) John Day River; (5) Umatilla River; and (6) Grande Ronde River. (ACR)

  5. Report: Agency-Wide Application of Region 7 NPDES Program Process Improvements Could Increase EPA Efficiency

    Science.gov (United States)

    Report #11-P-0315, July 6, 2011. Although Region 7 NPDES Kaizen event participants continued to follow up on the commitments and action items identified, no single authority was responsible for tracking the process improvement outcomes.

  6. Report: EPA Needs to Improve Management Practices to Ensure a Successful Customer Technology Solutions Project

    Science.gov (United States)

    Report #10-P-0194, August 23, 2010. Although EPA indicated it could avoid spending more than $115.4 million over 8.5 years by consolidating the desktop computing environment, improved management practices are needed.

  7. Report: Improved Management Practices Needed to Increase Use of Exchange Network

    Science.gov (United States)

    Report #2007-P-00030, August 20, 2007. EPA established a partnership with the Exchange Network’s governance bodies to assist them with accomplishing Network initiatives, more improvements are needed to ensure Network partners fully utilize the Network.

  8. Motivators and barriers to using patient experience reports for performance improvement

    NARCIS (Netherlands)

    Geissler, K.H.; Friedberg, M.W.; SteelFisher, G.K.; Schneider, E.C.

    2013-01-01

    Increasingly, patient experience surveys are available to provide performance feedback to physician groups. However, limited published literature addresses factors influencing use of these reports for performance improvement. To address this gap, we conducted semistructured interviews with leaders

  9. Report: Office of Research and Development Needs to Improve Its Method of Measuring Administrative Savings

    Science.gov (United States)

    Report #11-P-0333, July 14, 2011. ORD’s efforts to reduce its administrative costs are noteworthy, but ORD needs to improve its measurement mechanism for assessing the effectiveness of its initiatives to reduce administrative costs.

  10. Nuclear Weapons Sustainment: Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency

    Science.gov (United States)

    2015-12-01

    Enhance Transparency Report to Congressional Committees December 2015 GAO-16-23 United States Government Accountability Office United...SUSTAINMENT Improvements Made to Budget Estimates Report, but Opportunities Remain to Further Enhance Transparency Why GAO Did This Study DOD and DOE are...modernization plans and (2) complete, transparent information on the methodologies used to develop those estimates. GAO analyzed the departments

  11. Improving Bioscience Research Reporting: The ARRIVE Guidelines for Reporting Animal Research

    Directory of Open Access Journals (Sweden)

    Carol Kilkenny

    2014-02-01

    Full Text Available In the last decade the number of bioscience journals has increased enormously, with many filling specialised niches reflecting new disciplines and technologies. The emergence of open-access journals has revolutionised the publication process, maximising the availability of research data. Nevertheless, a wealth of evidence shows that across many areas, the reporting of biomedical research is often inadequate, leading to the view that even if the science is sound, in many cases the publications themselves are not “fit for purpose”, meaning that incomplete reporting of relevant information effectively renders many publications of limited value as instruments to inform policy or clinical and scientific practice [1–21]. A recent review of clinical research showed that there is considerable cumulative waste of financial resources at all stages of the research process, including as a result of publications that are unusable due to poor reporting [22]. It is unlikely that this issue is confined to clinical research [2–14,16–20].

  12. Setting the Greater Mekong Subregion - Development Analysis ...

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

    The funding will support the first stage of a two-stage research program in ... Inclusive development in basic education and health in Cambodia : final report ... New website will help record vital life events to improve access to services for all.

  13. Report from SG 1.1: improving the performance of existing gas storages

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This report aims to identify underlying trends for improvements in the underground gas storage (UGS) industry. It highlights best practices and state-of-the-art technology used in operating gas storages. The core conclusions of this report are based on a survey, which was sent out to the member countries. A reply was received from 15 countries, represented by 22 companies/institutions, including more than 100 gas storage sites. This response represents some 30% of the total estimated world storage working volume. In the survey operators were asked to report on the following issues: - measures implemented to improve the performance, - current priorities for improvements, - most important drivers for improvement, - techniques used to analyze performance, - techniques used to optimize storage performance, - software packages used, - technology used for reservoir management, wells and surface facilities, - safety and environment. (author)

  14. Does enhanced regulation improve EIA report quality? Lessons from South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Sandham, L.A., E-mail: luke.sandham@nwu.ac.za [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa); Heerden, A.J. van [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa); Jones, C.E. [School of Environment and Development, University of Manchester, Oxford Road, Manchester, M13 9PL (United Kingdom); Retief, F.P.; Morrison-Saunders, A.N. [Environmental Assessment Research Group, School of Geo and Spatial Sciences, North-West University, Private Bag X6001, Potchefstroom, 2520 (South Africa)

    2013-01-15

    Recently, various EIA systems have been subjected to system review processes with a view to improve performance. Many of these reviews resulted in some form of legislative reform. The South African Environmental Impact Assessment (EIA) regulations were modified in 2006 with the express intent to improve EIA effectiveness. In order to evaluate to what extent the desired outcome was achieved, the quality of EIA reports produced under the 2006 regulations was investigated for comparative analysis with the preceding regime. A sample of EIA reports from the two legislative regimes was reviewed using an adapted version of a well established method known colloquially as the 'Lee and Colley' review package. Despite some improvements in certain aspects, overall report quality has decreased slightly from the 1997 EIA regime. It therefore appears that the modifications to the regulations, often heralded as the solution to improvements in performance have not resulted in improved quality of EIA reports. - Highlights: Black-Right-Pointing-Pointer EIA regulations in South Africa were revised and became more comprehensive in 2006. Black-Right-Pointing-Pointer The report quality of a sample of EIAs was reviewed using the Lee and Colley review package. Black-Right-Pointing-Pointer Report quality showed a slight decline from the previous regulatory regime. Black-Right-Pointing-Pointer EIA good practice needs flexibility rather than over-detailed regulation.

  15. Does enhanced regulation improve EIA report quality? Lessons from South Africa

    International Nuclear Information System (INIS)

    Sandham, L.A.; Heerden, A.J. van; Jones, C.E.; Retief, F.P.; Morrison-Saunders, A.N.

    2013-01-01

    Recently, various EIA systems have been subjected to system review processes with a view to improve performance. Many of these reviews resulted in some form of legislative reform. The South African Environmental Impact Assessment (EIA) regulations were modified in 2006 with the express intent to improve EIA effectiveness. In order to evaluate to what extent the desired outcome was achieved, the quality of EIA reports produced under the 2006 regulations was investigated for comparative analysis with the preceding regime. A sample of EIA reports from the two legislative regimes was reviewed using an adapted version of a well established method known colloquially as the “Lee and Colley” review package. Despite some improvements in certain aspects, overall report quality has decreased slightly from the 1997 EIA regime. It therefore appears that the modifications to the regulations, often heralded as the solution to improvements in performance have not resulted in improved quality of EIA reports. - Highlights: ► EIA regulations in South Africa were revised and became more comprehensive in 2006. ► The report quality of a sample of EIAs was reviewed using the Lee and Colley review package. ► Report quality showed a slight decline from the previous regulatory regime. ► EIA good practice needs flexibility rather than over-detailed regulation.

  16. Diabetes technology: improving care, improving patient-reported outcomes and preventing complications in young people with Type 1 diabetes.

    Science.gov (United States)

    Prahalad, P; Tanenbaum, M; Hood, K; Maahs, D M

    2018-04-01

    With the evolution of diabetes technology, those living with Type 1 diabetes are given a wider arsenal of tools with which to achieve glycaemic control and improve patient-reported outcomes. Furthermore, the use of these technologies may help reduce the risk of acute complications, such as severe hypoglycaemia and diabetic ketoacidosis, as well as long-term macro- and microvascular complications. In addition, diabetes technology can have a beneficial impact on psychosocial health by reducing the burden of diabetes. Unfortunately, diabetes goals are often unmet and people with Type 1 diabetes too frequently experience acute and long-term complications of this condition, in addition to often having less than ideal psychosocial outcomes. Increasing realization of the importance of patient-reported outcomes is leading to diabetes care delivery becoming more patient-centred. Diabetes technology in the form of medical devices, digital health and big data analytics have the potential to improve clinical care and psychosocial support, resulting in lower rates of acute and chronic complications, decreased burden of diabetes care, and improved quality of life. © 2018 Diabetes UK.

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

    Science.gov (United States)

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

    2017-06-01

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

  18. Peer-Assisted Analysis of Resident Feedback Improves Clinical Teaching: A Case Report.

    Science.gov (United States)

    Mai, Christine L; Baker, Keith

    2017-07-01

    Anesthesiologists play an important role in educating future clinicians. Yet few residency programs incorporate teaching skills into faculty development. Consequently, many anesthesiologists have limited training to supervise and educate residents. In turn, these attendings may receive negative feedback and poor evaluations from residents without a means to effectively improve. Peer-assisted teaching between faculty members may serve as a strategy to improve teaching skills. We report a case of peer-assisted analysis of resident feedback to identify specific areas of concern that were targeted for improvement. This approach resulted in improved teaching scores and feedback for the faculty member.

  19. Widely Assumed but Thinly Tested: Do Employee Volunteers’ Self-Reported Skill Improvements Reflect the Nature of their Volunteering Experience?

    Directory of Open Access Journals (Sweden)

    David Allen Jones

    2016-04-01

    Full Text Available An increasing number of companies use corporate volunteering programs (CVPs to support and coordinate their employees’ efforts to serve their communities. Among the most frequently touted benefits of such programs to sponsoring companies and employee volunteers alike is the opportunities they provide for employees to develop tangible work-related skills through their volunteering activities. Evidence for skill development through volunteering, however, is mostly limited to the expressed beliefs of corporate leaders and employee volunteers. This study was designed to contribute to this largely anecdotal literature by testing hypotheses about the extent to which employee volunteers’ self-reported skill development reflects the characteristics of the volunteers and their volunteering experience. Study participants were 74 employees who volunteered a few hours of their time once a week for ten weeks in a service apprenticeship managed by a U.S.-based nonprofit called Citizen Schools that partners with middle schools to extend the learning day with a combination of academic support, enrichment, and youth development activities. Data were obtained via the nonprofit’s records, and surveys completed by employee volunteers before and after their service experience, including measures used to assess self-reported improvements in each of ten work-related skills: communicating performance expectations, leadership, mentorship, motivating others, project management, providing performance feedback, public speaking and presenting, speaking clearly, teamwork, and time management. Support was found for several hypothesized effects suggesting that employees who practiced specific skills more often during their volunteering experience reported greater improvements in those skills. Improvements in some skills were higher among employee volunteers who completed a greater number of pre-volunteering preparation courses, and the effects of preparation courses were

  20. Structured pathology reporting improves the macroscopic assessment of rectal tumour resection specimens.

    Science.gov (United States)

    King, Simon; Dimech, Margaret; Johnstone, Susan

    2016-06-01

    We examined whether introduction of a structured macroscopic reporting template for rectal tumour resection specimens improved the completeness and efficiency in collecting key macroscopic data elements. Fifty free text (narrative) macroscopic reports retrieved from 2012 to 2014 were compared with 50 structured macroscopic reports from 2013 to 2015, all of which were generated at John Hunter Hospital, Newcastle, NSW. The six standard macroscopic data elements examined in this study were reported in all 50 anatomical pathology reports using a structured macroscopic reporting dictation template. Free text reports demonstrated significantly impaired data collection when recording intactness of mesorectum (p<0.001), relationship to anterior peritoneal reflection (p=0.028) and distance of tumour to the non-peritonealised circumferential margin (p<0.001). The number of words used was also significantly (p<0.001) reduced using pre-formatted structured reports compared to free text reports. The introduction of a structured reporting dictation template improves data collection and may reduce the subsequent administrative burden when macroscopically evaluating rectal resections. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  1. Commercial Integrated Heat Pump with Thermal Storage --Demonstrate Greater than 50% Average Annual Energy Savings, Compared with Baseline Heat Pump and Water Heater (Go/No-Go) FY16 4th Quarter Milestone Report

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Bo [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Baxter, Van D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rice, C. Keith [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Abu-Heiba, Ahmad [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-03-01

    For this study, we authored a new air source integrated heat pump (AS-IHP) model in EnergyPlus, and conducted building energy simulations to demonstrate greater than 50% average energy savings, in comparison to a baseline heat pump with electric water heater, over 10 US cities, based on the EnergyPlus quick-service restaurant template building. We also assessed water heating energy saving potentials using ASIHP versus gas heating, and pointed out climate zones where AS-IHPs are promising.

  2. Kauffman Teen Survey. An Annual Report on Teen Health Behaviors: Use of Alcohol, Tobacco, and Other Drugs among 8th-, 10th-, and 12th-Grade Students in Greater Kansas City, 1991-92 to 2000-01.

    Science.gov (United States)

    Ewing Marion Kauffman Foundation, Kansas City, MO.

    The Ewing Marion Kauffman Foundation began surveying Kansas City area teens during the 1984-85 school year. The Kauffman Teen Survey now addresses two sets of issues for teens. Teen Health Behaviors, addressed in this report, have been a focus of the survey since its inception. The report focuses on teen use of alcohol, tobacco, and other drugs in…

  3. Critical evaluation as an aid to improved report writing: a case study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-05-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents. They were given opportunities to practise using the framework both through exemplars and through evaluating the work of their peers. They also carried out self-assessment. The authors' analysis of this novel approach shows that most students responded well to it and benefited from it. Lessons are drawn from this work for others who wish to improve their students' report writing skills.

  4. Greater Sudbury fuel efficient driving handbook

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-12-15

    Reducing the amount of fuel that people use for personal driving saves money, improves local air quality, and reduces personal contributions to climate change. This handbook was developed to be used as a tool for a fuel efficient driving pilot program in Greater Sudbury in 2009-2010. Specifically, the purpose of the handbook was to provide greater Sudbury drivers with information on how to drive and maintain their personal vehicles in order to maximize fuel efficiency. The handbook also provides tips for purchasing fuel efficient vehicles. It outlines the benefits of fuel maximization, with particular reference to reducing contributions to climate change; reducing emissions of air pollutants; safe driving; and money savings. Some tips for efficient driving are to avoid aggressive driving; use cruise control; plan trips; and remove excess weight. Tips for efficient winter driving are to avoid idling to warm up the engine; use a block heater; remove snow and ice; use snow tires; and check tire pressure. The importance of car maintenance and tire pressure was emphasized. The handbook also explains how fuel consumption ratings are developed by vehicle manufacturers. refs., figs.

  5. Greater confinement disposal of radioactive wastes

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

    1985-01-01

    Low-level radioactive waste (LLW) includes a broad spectrum of different radionuclide concentrations, half-lives, and hazards. Standard shallow-land burial practice can provide adequate protection of public health and safety for most LLW. A small volume fraction (approx. 1%) containing most of the activity inventory (approx. 90%) requires specific measures known as greater-confinement disposal (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics

  6. How do aggregated patient-reported outcome measures data stimulate health care improvement? A realist synthesis

    Science.gov (United States)

    Dalkin, Sonia; Gibbons, Elizabeth; Wright, Judy; Valderas, Jose Maria; Meads, David; Black, Nick

    2017-01-01

    Objectives Internationally, there has been considerable debate about the role of data in supporting quality improvement in health care. Our objective was to understand how, why and in what circumstances the feedback of aggregated patient-reported outcome measures data improved patient care. Methods We conducted a realist synthesis. We identified three main programme theories underlying the use of patient-reported outcome measures as a quality improvement strategy and expressed them as nine ‘if then’ propositions. We identified international evidence to test these propositions through searches of electronic databases and citation tracking, and supplemented our synthesis with evidence from similar forms of performance data. We synthesized this evidence through comparing the mechanisms and impact of patient-reported outcome measures and other performance data on quality improvement in different contexts. Results Three programme theories were identified: supporting patient choice, improving accountability and enabling providers to compare their performance with others. Relevant contextual factors were extent of public disclosure, use of financial incentives, perceived credibility of the data and the practicality of the results. Available evidence suggests that patients or their agents rarely use any published performance data when selecting a provider. The perceived motivation behind public reporting is an important determinant of how providers respond. When clinicians perceived that performance indicators were not credible but were incentivized to collect them, gaming or manipulation of data occurred. Outcome data do not provide information on the cause of poor care: providers needed to integrate and interpret patient-reported outcome measures and other outcome data in the context of other data. Lack of timeliness of performance data constrains their impact. Conclusions Although there is only limited research evidence to support some widely held theories of how

  7. Peer pressure and public reporting within healthcare setting: improving accountability and health care quality in hospitals.

    Science.gov (United States)

    Specchia, Maria Lucia; Veneziano, Maria Assunta; Cadeddu, Chiara; Ferriero, Anna Maria; Capizzi, Silvio; Ricciardi, Walter

    2012-01-01

    In the last few years, the need of public reporting of health outcomes has acquired a great importance. The public release of performance results could be a tool for improving health care quality and many attempts have been made in order to introduce public reporting programs within the health care context at different levels. It would be necessary to promote the introduction of a standardized set of outcome and performance measures in order to improve quality of health care services and to make health care providers aware of the importance of transparency and accountability.

  8. Model-driven approach to data collection and reporting for quality improvement.

    Science.gov (United States)

    Curcin, Vasa; Woodcock, Thomas; Poots, Alan J; Majeed, Azeem; Bell, Derek

    2014-12-01

    Continuous data collection and analysis have been shown essential to achieving improvement in healthcare. However, the data required for local improvement initiatives are often not readily available from hospital Electronic Health Record (EHR) systems or not routinely collected. Furthermore, improvement teams are often restricted in time and funding thus requiring inexpensive and rapid tools to support their work. Hence, the informatics challenge in healthcare local improvement initiatives consists of providing a mechanism for rapid modelling of the local domain by non-informatics experts, including performance metric definitions, and grounded in established improvement techniques. We investigate the feasibility of a model-driven software approach to address this challenge, whereby an improvement model designed by a team is used to automatically generate required electronic data collection instruments and reporting tools. To that goal, we have designed a generic Improvement Data Model (IDM) to capture the data items and quality measures relevant to the project, and constructed Web Improvement Support in Healthcare (WISH), a prototype tool that takes user-generated IDM models and creates a data schema, data collection web interfaces, and a set of live reports, based on Statistical Process Control (SPC) for use by improvement teams. The software has been successfully used in over 50 improvement projects, with more than 700 users. We present in detail the experiences of one of those initiatives, Chronic Obstructive Pulmonary Disease project in Northwest London hospitals. The specific challenges of improvement in healthcare are analysed and the benefits and limitations of the approach are discussed. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Design report on SCDAP/RELAP5 model improvements - debris bed and molten pool behavior

    International Nuclear Information System (INIS)

    Allison, C.M.; Rempe, J.L.; Chavez, S.A.

    1994-11-01

    The SCDAP/RELAP5/MOD3 computer code is designed to describe the overall reactor coolant system thermal-hydraulic response, core damage progression, and in combination with VICTORIA, fission product release and transport during severe accidents. Improvements for existing debris bed and molten pool models in the SCDAP/RELAP5/MOD3.1 code are described in this report. Model improvements to address (a) debris bed formation, heating, and melting; (b) molten pool formation and growth; and (c) molten pool crust failure are discussed. Relevant data, existing models, proposed modeling changes, and the anticipated impact of the changes are discussed. Recommendations for the assessment of improved models are provided

  10. Monitoring and research on the Bi-State Distinct Population Segment of greater sage-grouse (Centrocercus urophasianus) in the Pine Nut Mountains, California and Nevada—Study progress report, 2011–15

    Science.gov (United States)

    Coates, Peter S.; Andrle, Katie M.; Ziegler, Pilar T.; Casazza, Michael L.

    2016-09-29

    The Bi-State distinct population segment (DPS) of greater sage-grouse (Centrocercus urophasianus) that occurs along the Nevada–California border was proposed for listing as threatened under the Endangered Species Act (ESA) by the U.S. Fish and Wildlife Service (FWS) in October 2013. However, in April 2015, the FWS determined that the Bi-State DPS no longer required protection under the ESA and withdrew the proposed rule to list the Bi-State DPS (U.S. Fish and Wildlife Service, 2015). The Bi-State DPS occupies portions of Alpine, Mono, and Inyo Counties in California, and Douglas, Esmeralda, Lyon, Carson City, and Mineral Counties in Nevada. Unique threats facing this population include geographic isolation, expansion of single-leaf pinyon (Pinus monophylla) and Utah juniper (Juniperus osteosperma), anthropogenic activities, and recent changes in predator communities. Estimating population vital rates, identifying seasonal habitat, quantifying threats, and identifying movement patterns are important first steps in developing effective sage-grouse management and conservation plans. During 2011–15, we radio- and Global Positioning System (GPS)-marked (2012–14 only) 44, 47, 17, 9, and 3 sage-grouse, respectively, for a total of 120, in the Pine Nut Mountains Population Management Unit (PMU). No change in lek attendance was detected at Mill Canyon (maximum=18 males) between 2011 and 2012; however, 1 male was observed in 2014 and no males were observed in 2013 and 2015. Males were observed near Bald Mountain in 2013, making it the first year this lek was observed to be active during the study period. Males were observed at a new site in the Buckskin Range in 2014 during trapping efforts and again observed during surveys in 2015. Findings indicate that pinyon-juniper is avoided by sage-grouse during every life stage. Nesting females selected increased sagebrush cover, sagebrush height, and understory horizontal cover, and brood-rearing females selected similar areas

  11. Communicating the Improvements Developed from Critical Incident Reports is an Essential Part of CIRS.

    Science.gov (United States)

    Hubertus, J; Piehlmeier, W; Heinrich, M

    2016-09-01

    The Critical Incident Reporting System (CIRS) is a tool for employees to report anonymously of near misses. Its efficiency and improvement of safety is proved by many studies. Our department introduced CIRS in 2009 and it is used frequently. As the number of reports decreased over time we asked for factors responsible for the reduced use. All employees had access to CIRS and have been trained in several courses of instruction. Accomplished results and consequences were published in biannual newsletters. In 2014 we initiated an anonymous employee attitude survey to ask for their experience and satisfaction with CIRS. 88 near misses were reported since 2009. 44 (50%) reports were classified as RS1, 34 (38.6%) as RS2, and 10 (11.4%) as RS3. No RS4 reports were notified. Most reports concerned problems with administration of medication (n=26; 29.5%) and problems with technical devices (n=18; 20.5%). 75 (83%) of our employees participated in the survey. 64 (86.5%) discerned that CIRS is anonymous. 31 (41.9%) reported already a near miss. Of note, two-third didn't realize an improvement following their report. On the other hand, only half of the pollees stated to read the newsletter. Even if efficiency and advantages of CIRS are proved and undeniable, sufficient and perpetual feedback of results and improvements developed by the CIRS team and regular trainings of the employees are mandatory for the success of CIRS. © Georg Thieme Verlag KG Stuttgart · New York.

  12. CONSORT-EHEALTH: Improving and Standardizing Evaluation Reports of Web-based and Mobile Health Interventions

    Science.gov (United States)

    2011-01-01

    Background Web-based and mobile health interventions (also called “Internet interventions” or "eHealth/mHealth interventions") are tools or treatments, typically behaviorally based, that are operationalized and transformed for delivery via the Internet or mobile platforms. These include electronic tools for patients, informal caregivers, healthy consumers, and health care providers. The Consolidated Standards of Reporting Trials (CONSORT) statement was developed to improve the suboptimal reporting of randomized controlled trials (RCTs). While the CONSORT statement can be applied to provide broad guidance on how eHealth and mHealth trials should be reported, RCTs of web-based interventions pose very specific issues and challenges, in particular related to reporting sufficient details of the intervention to allow replication and theory-building. Objective To develop a checklist, dubbed CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth), as an extension of the CONSORT statement that provides guidance for authors of eHealth and mHealth interventions. Methods A literature review was conducted, followed by a survey among eHealth experts and a workshop. Results A checklist instrument was constructed as an extension of the CONSORT statement. The instrument has been adopted by the Journal of Medical Internet Research (JMIR) and authors of eHealth RCTs are required to submit an electronic checklist explaining how they addressed each subitem. Conclusions CONSORT-EHEALTH has the potential to improve reporting and provides a basis for evaluating the validity and applicability of eHealth trials. Subitems describing how the intervention should be reported can also be used for non-RCT evaluation reports. As part of the development process, an evaluation component is essential; therefore, feedback from authors will be solicited, and a before-after study will evaluate whether reporting has been improved

  13. Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism

    OpenAIRE

    Ma, Truong; Kornbau, Craig

    2017-01-01

    Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...

  14. Risk of Bias in Reports of In Vivo Research: A Focus for Improvement.

    Directory of Open Access Journals (Sweden)

    Malcolm R Macleod

    2015-10-01

    Full Text Available The reliability of experimental findings depends on the rigour of experimental design. Here we show limited reporting of measures to reduce the risk of bias in a random sample of life sciences publications, significantly lower reporting of randomisation in work published in journals of high impact, and very limited reporting of measures to reduce the risk of bias in publications from leading United Kingdom institutions. Ascertainment of differences between institutions might serve both as a measure of research quality and as a tool for institutional efforts to improve research quality.

  15. Reporting Data with "Over-the-Counter" Data Analysis Supports Improves Educators' Data Analyses

    Science.gov (United States)

    Rankin, Jenny Grant

    2014-01-01

    The benefits of making data-informed decisions to improve learning rely on educators correctly interpreting given data. Many educators routinely misinterpret data, even at districts with proactive support for data use. The tool most educators use for data analyses, which is an information technology data system or its reports, typically reports…

  16. Incomplete reporting of enhanced recovery elements and its impact on achieving quality improvement

    DEFF Research Database (Denmark)

    Day, R W; Fielder, S; Calhoun, J

    2015-01-01

    per cent), length of stay (47, 94 per cent) and mortality (45, 90 per cent). CONCLUSION: The current standard of reporting is frequently incomplete. To transfer knowledge and facilitate implementation of pathways that demonstrate improvements in perioperative care and recovery, a consistent structured...

  17. Improving a newly developed patient-reported outcome for thyroid patients, using cognitive interviewing

    DEFF Research Database (Denmark)

    Watt, Torquil; Rasmussen, Ase Krogh; Groenvold, Mogens

    2008-01-01

    Objective To improve a newly developed patient-reported outcome measure for thyroid patients using cognitive interviewing. Methods Thirty-one interviews using immediate retrospective and expansive probing were conducted among patients with non-toxic goiter (n = 4), nodular toxic goiter (n = 5) Gr...

  18. The Graduation Cliff: Improving the Post-School Outcomes of Students with Disabilities. Summary Report

    Science.gov (United States)

    McFadden, Erica Skogebo; Daugherty, David B.; Lee, Sang Eun; Fisher, Kim W.; Hack, Anthony; Spyra, Ed

    2015-01-01

    There is a federal movement to improve student outcomes targeting some of these predictors in several recently launched initiatives, but where does Arizona stand? What are we currently doing to move the needle, and what do we still need to do? This report prepared for the Arizona Developmental Disabilities Planning Council has two objectives: (1)…

  19. Licensee Event Report System. Evaluation of first year results, and recommendations for improvements. Supplement No. 2

    International Nuclear Information System (INIS)

    1985-09-01

    This report describes an evaluation of an industry-wide sample of Licensee Event Reports (LERs) that was conducted to determine whether or not these LERs were prepared in accordance with the requirements set forth in 10 CFR 50.73. The study was performed at the Idaho National Engineering Laboratory (INEL), by EG and G, Inc. This evaluation (NUREG/CR-4178) indicated that although the overall quality of the LERs was good, many LERs failed to meet all of the requirements. This report presents the methodology that was used to evaluate the LERs, the conclusions reached concerning problem areas in the reports, and suggestions as to how the overall quality and completeness of reports can be improved

  20. Dementia post-radiotherapy: improvement with acetylcholinesterase inhibitor A case report

    Directory of Open Access Journals (Sweden)

    Antonio Eduardo Damin

    Full Text Available Abstract Cognitive decline associated with radiotherapy is a progressive complication that affects many patients submitted to this form of treatment. The lack of an effective treatment drives research for new treatment options to improve the quality of life of patients with this disorder. We report the case of a 64 year-old man who developed a severe dementia of the frontal subcortical type, which was associated with subcortical frontal lesions and appeared as a late complication of radiotherapy used to treat a pituitary tumor. After many pharmacological attempts to improve his cognitive and behavioral problems, the patient showed a significant improvement in the cognitive, functional and behavioral impairments after treatment with an acetylcholinesterase inhibitor. This report discusses hypotheses for the positive effect of this treatment.

  1. Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: three case reports.

    Science.gov (United States)

    Yeates, Erin M; Molfenter, Sonja M; Steele, Catriona M

    2008-01-01

    Dysphagia, or difficulty swallowing, often occurs secondary to conditions such as stroke, head injury or progressive disease, many of which increase in frequency with advancing age. Sarcopenia, the gradual loss of muscle bulk and strength, can place older individuals at greater risk for dysphagia. Data are reported for three older participants in a pilot trial of a tongue-pressure training therapy. During the experimental therapy protocol, participants performed isometric strength exercises for the tongue as well as tongue pressure accuracy tasks. Biofeedback was provided using the Iowa Oral Performance Instrument (IOPI), an instrument that measures tongue pressure. Treatment outcome measures show increased isometric tongue strength, improved tongue pressure generation accuracy, improved bolus control on videofluoroscopy, and improved functional dietary intake by mouth. These preliminary results indicate that, for these three adults with dysphagia, tongue-pressure training was beneficial for improving both instrumental and functional aspects of swallowing. The experimental treatment protocol holds promise as a rehabilitative tool for various dysphagia populations.

  2. Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times.

    Science.gov (United States)

    Andriole, Katherine P; Prevedello, Luciano M; Dufault, Allen; Pezeshk, Parham; Bransfield, Robert; Hanson, Richard; Doubilet, Peter M; Seltzer, Steven E; Khorasani, Ramin

    2010-03-01

    Radiology report signature time (ST) can be a substantial component of total report turnaround time. Poor turnaround time resulting from lengthy ST can adversely affect patient care. The combination of technology adoption with financial incentive was evaluated to determine if ST improvement can be augmented and sustained. This prospective study was performed at a 751-bed, urban, tertiary care adult teaching hospital. Test-site imaging volume approximated 48,000 examinations per month. The radiology department has 100 trainees and 124 attending radiologists serving multiple institutions. Over a study period of 4 years and 4 months, three interventions focused on radiologist signature performance were implemented: 1) a notification paging application that alerted radiologists when reports were ready for signature, 2) a picture archiving and communications systems (PACS)-integrated speech recognition report generation system, and 3) a departmental financial incentive to reward radiologists semiannually for ST performance. Signature time was compared before and after the interventions. Wilcoxon and linear regression statistical analyses were used to assess the significance of trends. Technology adoption (paging plus speech recognition) reduced median ST from >5 to 24 to 15 to 18 hours (P financial incentive further improved 80th-percentile ST to 4 to 8 hours (P Technology interventions coupled with financial incentive can result in synergistic and sustainable improvement in radiologist report-signing behavior. The addition of a financial incentive leads to better performance than that achievable through technology alone.

  3. Improvement in the incident reporting and investigation procedures using process excellence (DMAI2C) methodology

    International Nuclear Information System (INIS)

    Miles, Elizabeth N.

    2006-01-01

    In 1996, Health and Safety introduced an incident investigation process called Learning to Look ( C) to Johnson and Johnson. This process provides a systematic way of analyzing work-related injuries and illness, uncovers root cause that leads to system defects, and points to viable solutions. The process analyzed involves three steps: investigation and reporting of the incident, determination of root cause, and development and implementation of a corrective action plan. The process requires the investigators to provide an initial communication for work-related serious injuries and illness as well as lost workday cases to Corporate Headquarters within 72h of the incident with a full investigative report to follow within 10 days. A full investigation requires a written report, a cause-result logic diagram (CRLD), a corrective action plan (CAP) and a report of incident costs (SafeCost) all due to be filed electronically. It is incumbent on the principal investigator and his or her investigative teams to assemble the various parts of the investigation and to follow up with the relevant parties to ensure corrective actions are implemented, and a full report submitted to Corporate executives. Initial review of the system revealed that the process was not working as designed. A number of reports were late, not signed by the business leaders, and in some instances, all cause were not identified. Process excellence was the process used to study the issue. The team used six sigma DMAI 2 C methodologies to identify and implement system improvements. The project examined the breakdown of the critical aspects of the reporting and investigation process that lead to system errors. This report will discuss the study findings, recommended improvements, and methods used to monitor the new improved process

  4. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    International Nuclear Information System (INIS)

    Jaimes, Camilo; Murcia, Diana J.; Miguel, Karen; DeFuria, Cathryn; Sagar, Pallavi; Gee, Michael S.

    2018-01-01

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  5. Identification of quality improvement areas in pediatric MRI from analysis of patient safety reports

    Energy Technology Data Exchange (ETDEWEB)

    Jaimes, Camilo [Massachusetts General Hospital, Harvard Medical School, Division of Neuroradiology, Department of Radiology, Boston, MA (United States); Murcia, Diana J. [Massachusetts General Hospital, Harvard Medical School, Division of Abdominal Imaging, Department of Radiology, Boston, MA (United States); Miguel, Karen; DeFuria, Cathryn [Massachusetts General Hospital, Harvard Medical School, Quality and Safety Office, Department of Radiology, Boston, MA (United States); Sagar, Pallavi; Gee, Michael S. [Massachusetts General Hospital for Children, Harvard Medical School, Division of Pediatric Imaging, Department of Radiology, Boston, MA (United States)

    2018-01-15

    Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015. The safety report database was queried for events matching the same demographic and dates. Data on patient age, gender, location (inpatient, outpatient, emergency room [ER]), and the use of sedation/general anesthesia were recorded. Safety reports were grouped into categories based on the cause and their severity. Descriptive statistics were used to summarize continuous variables. Chi-square analyses were performed for univariate determination of statistical significance of variables associated with safety report rates. A multivariate logistic regression was used to control for possible confounding effects. A total of 16,749 pediatric MRI studies and 88 safety reports were analyzed, yielding a rate of 0.52%. There were significant differences in the rate of safety reports between patients younger than 6 years (0.89%) and those older (0.41%) (P<0.01), sedated (0.8%) and awake children (0.45%) (P<0.01), and inpatients (1.1%) and outpatients (0.4%) (P<0.01). The use of sedation/general anesthesia is an independent risk factor for a safety report (P=0.02). The most common causes for safety reports were service coordination (34%), drug reactions (19%), and diagnostic test and ordering errors (11%). The overall rate of safety reports in pediatric MRI is 0.52%. Interventions should focus on vulnerable populations, such as younger patients, those requiring sedation, and those in need of acute medical attention. (orig.)

  6. Support for reporting guidelines in surgical journals needs improvement: A systematic review.

    Science.gov (United States)

    Agha, Riaz A; Barai, Ishani; Rajmohan, Shivanchan; Lee, Seon; Anwar, Mohammed O; Fowler, Alexander J; Orgill, Dennis P; Altman, Douglas G

    2017-09-01

    Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047-8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the 73 (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  7. A Quantitative Assessment of the Reporting Quality of Herbal Medicine Research: The Road to Improvement.

    Science.gov (United States)

    Naumann, Ken

    2018-02-01

    To quantify different aspects of the quality of reporting of herbal medicine clinical trials, to determine how that quality is affecting the conclusions of meta-analyses, and to target areas for improvement in future herbal medicine research reporting. The Electronic databases PubMed, Academic Search Premier, ScienceDirect, and Alt HealthWatch were searched for meta-analyses of herbal medicines in refereed journals and Cochrane Reviews in the years 2000-2004 and 2010-2014. The search was limited to meta-analyses of randomized controlled trials involving humans and published in English. Judgments and descriptions within the meta-analyses were used to report on risks of bias in the included clinical trials and the meta-analyses themselves. Out of 3264 citations, 9 journal-published meta-analyses were selected from 2000 to 2004, 116 from 2010 to 2014, and 44 Cochrane Reviews from 2010 to 2014. Across both time frames and categories of publication, herbal medicines include a significant number of clinical trials that do not meet the recommended standards for clinical trial reporting. This quantitative assessment identified significant publication bias and other bias risks that may be due to inadequate trial design or incomplete reporting of outcomes. Suggested improvements to herbal medicine clinical trial reporting are discussed.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-02-01

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

  9. Making Residents Part of the Safety Culture: Improving Error Reporting and Reducing Harms.

    Science.gov (United States)

    Fox, Michael D; Bump, Gregory M; Butler, Gabriella A; Chen, Ling-Wan; Buchert, Andrew R

    2017-01-30

    Reporting medical errors is a focus of the patient safety movement. As frontline physicians, residents are optimally positioned to recognize errors and flaws in systems of care. Previous work highlights the difficulty of engaging residents in identification and/or reduction of medical errors and in integrating these trainees into their institutions' cultures of safety. The authors describe the implementation of a longitudinal, discipline-based, multifaceted curriculum to enhance the reporting of errors by pediatric residents at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center. The key elements of this curriculum included providing the necessary education to identify medical errors with an emphasis on systems-based causes, modeling of error reporting by faculty, and integrating error reporting and discussion into the residents' daily activities. The authors tracked monthly error reporting rates by residents and other health care professionals, in addition to serious harm event rates at the institution. The interventions resulted in significant increases in error reports filed by residents, from 3.6 to 37.8 per month over 4 years (P error reporting correlated with a decline in serious harm events, from 15.0 to 8.1 per month over 4 years (P = 0.01). Integrating patient safety into the everyday resident responsibilities encourages frequent reporting and discussion of medical errors and leads to improvements in patient care. Multiple simultaneous interventions are essential to making residents part of the safety culture of their training hospitals.

  10. Integrated approach towards the application of horizontal wells to improve waterflooding performance. Annual report

    Energy Technology Data Exchange (ETDEWEB)

    Kelkar, M.; Liner, C.; Kerr, D.

    1995-05-01

    This annual report describes the progress during the second year of the project on Integrated Approach Towards the Application of Horizontal Wells to Improve Waterflooding Performance. This project is funded under the Department of Energy`s Class I program which is targeted towards improving the reservoir performance of mature oil fields located in fluvial-dominated deltaic deposits. The project involves an integrated approach to characterize the reservoir followed by the drilling of horizontal injection wells to improve production performance. The type of data we have integrated include cross bore hole seismic surveys, geological interpretation based on logs and cores, and engineering information. This report covers the second phase of the project which includes a detailed reservoir description of the field by integrating all the available information, followed by flow simulation of the Self Unit under various operating conditions. Based on an examination of the various operating parameters, we observed that the best possible solution to improve the Self Unit performance is to recomplete and stimulate most of the wells followed by an increase in the water injection rate. Drilling of horizontal injection well, although helpful in improving the performance, was not found to be economically feasible. The proposed reservoir management plan will be implemented shortly.

  11. Improvement of gross motor and cognitive abilities by an exercise training program: three case reports

    Directory of Open Access Journals (Sweden)

    Alesi M

    2014-03-01

    Full Text Available Marianna Alesi,1 Giuseppe Battaglia,2 Michele Roccella,1 Davide Testa,1 Antonio Palma,2 Annamaria Pepi1 1Department of Psychology, 2Department of Law, Social and Sport Science, University of Palermo, Palermo, Italy Background: This work examined the efficacy of an integrated exercise training program (coach and family in three children with Down syndrome to improve their motor and cognitive abilities, in particular reaction time and working memory. Methods: The integrated exercise training program was used in three children with Down syndrome, comprising two boys (M1, with a chronological age of 10.3 years and a mental age of 4.7 years; M2, with a chronological age of 14.6 years and a mental age of less than 4 years and one girl (F1, chronological age 14.0 years and a mental age of less than 4 years. Results: Improvements in gross motor ability scores were seen after the training period. Greater improvements in task reaction time were noted for both evaluation parameters, ie, time and omissions. Conclusion: There is a close interrelationship between motor and cognitive domains in individuals with atypical development. There is a need to plan intervention programs based on the simultaneous involvement of child and parents and aimed at promoting an active lifestyle in individuals with Down syndrome. Keywords: disability, Down syndrome, gross motor abilities, cognitive abilities, physical activity

  12. Improving gross motor function and postural control with hippotherapy in children with Down syndrome: case reports.

    Science.gov (United States)

    Champagne, Danielle; Dugas, Claude

    2010-11-01

    The purpose of this case report is to describe the impact of an 11-week hippotherapy program on the gross motor functions of two children (respectively 28 and 37 months old) diagnosed with Down syndrome. Hippotherapy is a strategy that uses the horse's motion to stimulate and enhance muscle contraction and postural control. The children were assessed by the Gross Motor Function Measure (GMFM) and accelerometry. The results indicate that both children improved on many dimensions of the GMFM. Power spectral analysis of the acceleration signals showed improvement in postural control of either the head or trunk, because the children adopted two different adaptative strategies to perturbation induced by the moving horse.

  13. Fuel utilization improvements in a once-through PWR fuel cycle. Final report on Task 6

    International Nuclear Information System (INIS)

    Dabby, D.

    1979-06-01

    In studying the position of the United States Department of Energy, Non-proliferation Alternative Systems Assessment Program, this report determines the uranium saving associated with various improvement concepts applicable to a once-through fuel cycle of a standard four-loop Westinghouse Pressurized Water Reactor. Increased discharged fuel burnup from 33,000 to 45,000 MWD/MTM could achieve a 12% U 3 O 8 saving by 1990. Improved fuel management schemes combined with coastdown to 60% power, could result in U 3 O 8 savings of 6%

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

    International Nuclear Information System (INIS)

    Crouthamel, C.E.

    1978-10-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  16. Conflicting race/ethnicity reports: lessons for improvement in data quality.

    Science.gov (United States)

    Webster, Pamela S; Fulton, John P; Sampangi, Swathi

    2013-01-01

    To learn the frequency of conflicting race/ethnicity reports, to examine patterns of conflicting reports, and to identify possible avenues for data quality improvement. As part of the Data Improvement Project on Patient Ethnicity and Race (DIPPER), an analysis of conflicting race/ethnicity reports for cancer cases was conducted. Using matched hospital discharge data and central cancer registry data from 2009, the race/ethnicity of patients in the 2 datasets were compared. Those with conflicting reports ("mismatched") were examined more closely. From a sample of 2,356 patients, 187 had conflicting reports for their race (7.9%) and 357 had conflicting reports for their ethnicity (15% was thus developed). In the 2009 hospital discharge data, an unknown response occurred nearly twice as often for Hispanic ethnicity as for race. Almost 85% of the mismatched race cases were classified as non-white in the hospital discharge data and white in the central cancer registry data. The most common ethnicity mismatch was coded unknown by the hospital but non-Hispanic by the registry. Hospital cancer registrars occasionally lack easy access to race and, more often, ethnicity data. More attention should be given to discrepancies (including allowing staff to flag and verify existing data), and staff training should improve both perceived and real data accuracy. In the future, hospitals and registries would be better served by pairing race and ethnicity together in the electronic medical record. This would ensure quick, easy access for cancer registrars. Perhaps standard setters should add ethnicity to the gold standard criteria for registries.

  17. Improving Hospital Reporting of Patient Race and Ethnicity--Approaches to Data Auditing.

    Science.gov (United States)

    Zingmond, David S; Parikh, Punam; Louie, Rachel; Lichtensztajn, Daphne Y; Ponce, Ninez; Hasnain-Wynia, Romana; Gomez, Scarlett Lin

    2015-08-01

    To investigate new metrics to improve the reporting of patient race and ethnicity (R/E) by hospitals. California Patient Discharge Database (PDD) and birth registry, 2008-2009, Healthcare and Cost Utilization Project's State Inpatient Database, 2008-2011, cancer registry 2000-2008, and 2010 US Census Summary File 2. We examined agreement between hospital reported R/E versus self-report among mothers delivering babies and a cancer cohort in California. Metrics were created to measure root mean squared differences (RMSD) by hospital between reported R/E distribution and R/E estimates using R/E distribution within each patient's zip code of residence. RMSD comparisons were made to corresponding "gold standard" facility-level measures within the maternal cohort for California and six comparison states. Maternal birth hospitalization (linked to the state birth registry) and cancer cohort records linked to preceding and subsequent hospitalizations. Hospital discharges were linked to the corresponding Census zip code tabulation area using patient zip code. Overall agreement between the PDD and the gold standard for the maternal cohort was 86 percent for the combined R/E measure and 71 percent for race alone. The RMSD measure is modestly correlated with the summary level gold standard measure for R/E (r = 0.44). The RMSD metric revealed general improvement in data agreement and completeness across states. "Other" and "unknown" categories were inconsistently applied within inpatient databases. Comparison between reported R/E and R/E estimates using zip code level data may be a reasonable first approach to evaluate and track hospital R/E reporting. Further work should focus on using more granular geocoded data for estimates and tracking data to improve hospital collection of R/E data. © Health Research and Educational Trust.

  18. Feedback from incident reporting: information and action to improve patient safety.

    Science.gov (United States)

    Benn, J; Koutantji, M; Wallace, L; Spurgeon, P; Rejman, M; Healey, A; Vincent, C

    2009-02-01

    Effective feedback from incident reporting systems in healthcare is essential if organisations are to learn from failures in the delivery of care. Despite the wide-scale development and implementation of incident reporting in healthcare, studies in the UK suggest that information concerning system vulnerabilities could be better applied to improve operational safety within organisations. In this article, the findings and implications of research to identify forms of effective feedback from incident reporting are discussed, to promote best practices in this area. The research comprised a mixed methods review to investigate mechanisms of effective feedback for healthcare, drawing upon experience within established reporting programmes in high-risk industry and transport domains. Systematic searches of published literature were undertaken, and 23 case studies describing incident reporting programmes with feedback were identified for analysis from the international healthcare literature. Semistructured interviews were undertaken with 19 subject matter experts across a range of domains, including: civil aviation, maritime, energy, rail, offshore production and healthcare. In analysis, qualitative information from several sources was synthesised into practical requirements for developing effective feedback in healthcare. Both action and information feedback mechanisms were identified, serving safety awareness, improvement and motivational functions. The provision of actionable feedback that visibly improved systems was highlighted as important in promoting future reporting. Fifteen requirements for the design of effective feedback systems were identified, concerning: the role of leadership, the credibility and content of information, effective dissemination channels, the capacity for rapid action and the need for feedback at all levels of the organisation, among others. Above all, the safety-feedback cycle must be closed by ensuring that reporting, analysis and

  19. Breast calcifications. A standardized mammographic reporting and data system to improve positive predictive value

    International Nuclear Information System (INIS)

    Perugini, G.; Bonzanini, B.; Valentino, C.

    1999-01-01

    The purpose of this work is to investigate the usefulness of a standardized reporting and data system in improving the positive predictive value of mammography in breast calcifications. Using the Breast Imaging Reporting and Data System lexicon developed by the American College of Radiology, it is defined 5 descriptive categories of breast calcifications and classified diagnostic suspicion of malignancy on a 3-grade scale (low, intermediate and high). Two radiologists reviewed 117 mammographic studies selected from those of the patients submitted to surgical biopsy for mammographically detected calcifications from January 1993 to December 1997, and classified them according to the above criteria. The positive predictive value was calculated for all examinations and for the stratified groups. Defining a standardized system for assessing and describing breast calcifications helps improve the diagnostic accuracy of mammography in clinical practice [it

  20. Improvement of a portable high-energy radiographic inspection system: Final report

    International Nuclear Information System (INIS)

    Owen, R.D.

    1987-02-01

    This report describes the development of miniaturized linear accelerator (MINAC) technology, including descriptions of all major developments sponsored by EPRI subsequent to previously sponsored work. In addition, this report describes MINAC-related developments in both real-time x-ray imaging and radiographic image data processing systems which were sponsored by EPRI concurrently. The objectives of this program have been to achieve modifications identified as desirable improvements to the basic ''MINAC 3'' equipment; to expand the range and effectiveness of MINAC applications through design improvements, achievement of wider energy/output capabilities, and the development of suitable imaging and digital processing technologies; and to provide technical information on high-energy radiographic equipment useful to scientists, educators, institutions, NDE technicians and others who may benefit from detailed information on the special equipment. Program, equipment and technical descriptions are followed by conclusions and recommendations for future work

  1. A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: Part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder.

    Science.gov (United States)

    Schaffer, Ayal; Isometsä, Erkki T; Azorin, Jean-Michel; Cassidy, Frederick; Goldstein, Tina; Rihmer, Zoltán; Sinyor, Mark; Tondo, Leonardo; Moreno, Doris H; Turecki, Gustavo; Reis, Catherine; Kessing, Lars Vedel; Ha, Kyooseob; Weizman, Abraham; Beautrais, Annette; Chou, Yuan-Hwa; Diazgranados, Nancy; Levitt, Anthony J; Zarate, Carlos A; Yatham, Lakshmi

    2015-11-01

    Many factors influence the likelihood of suicide attempts or deaths in persons with bipolar disorder. One key aim of the International Society for Bipolar Disorders Task Force on Suicide was to summarize the available literature on the presence and magnitude of effect of these factors. A systematic review of studies published from 1 January 1980 to 30 May 2014 identified using keywords 'bipolar disorder' and 'suicide attempts or suicide'. This specific paper examined all reports on factors putatively associated with suicide attempts or suicide deaths in bipolar disorder samples. Factors were subcategorized into: (1) sociodemographics, (2) clinical characteristics of bipolar disorder, (3) comorbidities, and (4) other clinical variables. We identified 141 studies that examined how 20 specific factors influenced the likelihood of suicide attempts or deaths. While the level of evidence and degree of confluence varied across factors, there was at least one study that found an effect for each of the following factors: sex, age, race, marital status, religious affiliation, age of illness onset, duration of illness, bipolar disorder subtype, polarity of first episode, polarity of current/recent episode, predominant polarity, mood episode characteristics, psychosis, psychiatric comorbidity, personality characteristics, sexual dysfunction, first-degree family history of suicide or mood disorders, past suicide attempts, early life trauma, and psychosocial precipitants. There is a wealth of data on factors that influence the likelihood of suicide attempts and suicide deaths in people with bipolar disorder. Given the heterogeneity of study samples and designs, further research is needed to replicate and determine the magnitude of effect of most of these factors. This approach can ultimately lead to enhanced risk stratification for patients with bipolar disorder. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  2. A review of factors associated with greater likelihood of suicide attempts and suicide deaths in bipolar disorder: Part II of a report of the International Society for Bipolar Disorders Task Force on Suicide in Bipolar Disorder

    Science.gov (United States)

    Schaffer, Ayal; Isometsä, Erkki T; Azorin, Jean-Michel; Cassidy, Frederick; Goldstein, Tina; Rihmer, Zoltán; Sinyor, Mark; Tondo, Leonardo; Moreno, Doris H; Turecki, Gustavo; Reis, Catherine; Kessing, Lars Vedel; Ha, Kyooseob; Weizman, Abraham; Beautrais, Annette; Chou, Yuan-Hwa; Diazgranados, Nancy; Levitt, Anthony J; Zarate, Carlos A; Yatham, Lakshmi

    2018-01-01

    Objectives Many factors influence the likelihood of suicide attempts or deaths in persons with bipolar disorder. One key aim of the International Society for Bipolar Disorders Task Force on Suicide was to summarize the available literature on the presence and magnitude of effect of these factors. Methods A systematic review of studies published from 1 January 1980 to 30 May 2014 identified using keywords ‘bipolar disorder’ and ‘suicide attempts or suicide’. This specific paper examined all reports on factors putatively associated with suicide attempts or suicide deaths in bipolar disorder samples. Factors were subcategorized into: (1) sociodemographics, (2) clinical characteristics of bipolar disorder, (3) comorbidities, and (4) other clinical variables. Results We identified 141 studies that examined how 20 specific factors influenced the likelihood of suicide attempts or deaths. While the level of evidence and degree of confluence varied across factors, there was at least one study that found an effect for each of the following factors: sex, age, race, marital status, religious affiliation, age of illness onset, duration of illness, bipolar disorder subtype, polarity of first episode, polarity of current/recent episode, predominant polarity, mood episode characteristics, psychosis, psychiatric comorbidity, personality characteristics, sexual dysfunction, first-degree family history of suicide or mood disorders, past suicide attempts, early life trauma, and psychosocial precipitants. Conclusion There is a wealth of data on factors that influence the likelihood of suicide attempts and suicide deaths in people with bipolar disorder. Given the heterogeneity of study samples and designs, further research is needed to replicate and determine the magnitude of effect of most of these factors. This approach can ultimately lead to enhanced risk stratification for patients with bipolar disorder. PMID:26175498

  3. Measuring the Success of Changes to Existing Business Intelligence Solutions to Improve Business Intelligence Reporting

    OpenAIRE

    Dedić, Nedim; Stanier, Clare

    2016-01-01

    Evaluating the success of changes to an existing Business Intelligence (BI) environment means that there is a need to compare the level of user satisfaction with the original and amended versions of the application. The focus of this paper is on producing an evaluation tool, which can be used to measure the success of changes to existing BI solutions to support improved BI reporting. The paper identifies the users involved in the BI process and investigates what is meant by satisfaction in th...

  4. Socio-economic considerations of cleaning Greater Vancouver's air

    International Nuclear Information System (INIS)

    2005-08-01

    Socio-economic considerations of better air quality on the Greater Vancouver population and economy were discussed. The purpose of the study was to provide socio-economic information to staff and stakeholders of the Greater Vancouver Regional District (GVRD) who are participating in an Air Quality Management Plan (AQMP) development process and the Sustainable Region Initiative (SRI) process. The study incorporated the following methodologies: identification and review of Canadian, American, and European quantitative socio-economic, cost-benefit, cost effectiveness, competitiveness and health analyses of changes in air quality and measures to improve air quality; interviews with industry representatives in Greater Vancouver on competitiveness impacts of air quality changes and ways to improve air quality; and a qualitative analysis and discussion of secondary quantitative information that identifies and evaluates socio-economic impacts arising from changes in Greater Vancouver air quality. The study concluded that for the Greater Vancouver area, the qualitative analysis of an improvement in Greater Vancouver air quality shows positive socio-economic outcomes, as high positive economic efficiency impacts are expected along with good social quality of life impacts. 149 refs., 30 tabs., 6 appendices

  5. Predicting Manual Therapy Treatment Success in Patients With Chronic Ankle Instability: Improving Self-Reported Function.

    Science.gov (United States)

    Wikstrom, Erik A; McKeon, Patrick O

    2017-04-01

      Therapeutic modalities that stimulate sensory receptors around the foot-ankle complex improve chronic ankle instability (CAI)-associated impairments. However, not all patients have equal responses to these modalities. Identifying predictors of treatment success could improve clinician efficiency when treating patients with CAI.   To conduct a response analysis on existing data to identify predictors of improved self-reported function in patients with CAI.   Secondary analysis of a randomized controlled clinical trial.   Sports medicine research laboratories.   Fifty-nine patients with CAI, which was defined in accordance with the International Ankle Consortium recommendations.   Participants were randomized into 3 treatment groups (plantar massage [PM], ankle-joint mobilization [AJM], or calf stretching [CS]) that received six 5-minute treatments over 2 weeks.   Treatment success, defined as a patient exceeding the minimally clinically important difference of the Foot and Ankle Ability Measure-Sport (FAAM-S).   Patients with ≤5 recurrent sprains and ≤82.73% on the Foot and Ankle Ability Measure had a 98% probability of having a meaningful FAAM-S improvement after AJM. As well, ≥5 balance errors demonstrated 98% probability of meaningful FAAM-S improvements from AJM. Patients <22 years old and with ≤9.9 cm of dorsiflexion had a 99% probability of a meaningful FAAM-S improvement after PM. Also, those who made ≥2 single-limb-stance errors had a 98% probability of a meaningful FAAM-S improvement from PM. Patients with ≤53.1% on the FAAM-S had an 83% probability of a meaningful FAAM-S improvement after CS.   Each sensory-targeted ankle-rehabilitation strategy resulted in a unique combination of predictors of success for patients with CAI. Specific indicators of success with AJM were deficits in self-reported function, single-limb balance, and <5 previous sprains. Age, weight-bearing-dorsiflexion restrictions, and single-limb balance

  6. Summary report of the consultants' meeting on improvement of the standard cross sections for light elements

    International Nuclear Information System (INIS)

    Carlson, A.D.; Muir, D.W.; Pronyaev, V.G.

    2001-06-01

    This report summarizes the results of the Consultants' Meeting on Improvement of the Standard Cross Sections for Light Elements. The approaches and computer programs used for evaluation of neutron standard cross sections and their uncertainties were presented by the participants. Special attention was paid to the reasons for strong uncertainty reduction observed in the model fits. The meeting participants discussed the plan of the INDC recommended Co-ordinated Research Project (CRP) on 'Improvement of the Standard Cross Sections for Light Elements'. This CRP will address the problem of uncertainty reduction along with other methodological improvements needed in order to produce a new, and internationally accepted, evaluation of neutron standard cross sections for light elements. (author)

  7. A Nephrology Fellows' Communication Skills Course: An Educational Quality Improvement Report.

    Science.gov (United States)

    Cohen, Robert A; Jackson, Vicki A; Norwich, Diana; Schell, Jane O; Schaefer, Kristen; Ship, Amy N; Sullivan, Amy M

    2016-08-01

    Nephrology fellows need expertise navigating challenging conversations with patients throughout the course of advanced kidney disease. However, evidence shows that nephrologists receive inadequate training in this area. This study assessed the effectiveness of an educational quality improvement intervention designed to enhance fellows' communication with patients who have advanced kidney disease. Quality improvement project. Full-day annual workshops (2013-2014) using didactics, discussion, and practice with simulated patients. Content focused on delivering bad news, acknowledging emotion, discussing care goals in dialysis decision making when prognosis is uncertain, and addressing dialysis therapy withdrawal and end of life. Participants were first-year nephrology fellows from 2 Harvard-affiliated training programs (N=26). Study assessed the effectiveness of an intervention designed to enhance fellows' communication skills. Primary outcomes were changes in self-reported patient communication skills, attitudes, and behaviors related to discussing disease progression, prognostic uncertainty, dialysis therapy withdrawal, treatments not indicated, and end of life; responding to emotion; eliciting patient goals and values; and incorporating patient goals into recommendations. Surveys measured prior training, pre- and postcourse perceived changes in skills and values, and reported longer term (3-month) changes in communication behaviors, using both closed- and open-ended items. Response rates were 100% (pre- and postsurveys) and 68% (follow-up). Participants reported improvement in all domains, with an overall mean increase of 1.1 (summed average scores: precourse, 2.8; postcourse, 3.9 [1-5 scale; 5 = "extremely well prepared"]; Pskills taught, such as "Ask-Tell-Ask" and using open-ended questions. Self-reported data may overestimate actual changes; small sample size and the programs' affiliation with a single medical school may limit generalizability. A day

  8. Improving knowledge management through the support of image examination and data annotation using DICOM structured reporting.

    Science.gov (United States)

    Torres, José Salavert; Damian Segrelles Quilis, J; Espert, Ignacio Blanquer; García, Vicente Hernandez

    2012-12-01

    An important effort has been invested on improving the image diagnosis process in different medical areas using information technologies. The field of medical imaging involves two main data types: medical imaging and reports. Developments based on the DICOM standard have demonstrated to be a convenient and widespread solution among the medical community. The main objective of this work is to design a Web application prototype that will be able to improve diagnosis and follow-on of breast cancer patients. It is based on TRENCADIS middleware, which provides a knowledge-oriented storage model composed by federated repositories of DICOM image studies and DICOM-SR medical reports. The full structure and contents of the diagnosis reports are used as metadata for indexing images. The TRENCADIS infrastructure takes full advantage of Grid technologies by deploying multi-resource grid services that enable multiple views (reports schemes) of the knowledge database. The paper presents a real deployment of such Web application prototype in the Dr. Peset Hospital providing radiologists with a tool to create, store and search diagnostic reports based on breast cancer explorations (mammography, magnetic resonance, ultrasound, pre-surgery biopsy and post-surgery biopsy), improving support for diagnostics decisions. A technical details for use cases (outlining enhanced multi-resource grid services communication and processing steps) and interactions between actors and the deployed prototype are described. As a result, information is more structured, the logic is clearer, network messages have been reduced and, in general, the system is more resistant to failures. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Study of amended reports to evaluate and improve surgical pathology processes.

    Science.gov (United States)

    Meier, Frederick A; Varney, Ruan C; Zarbo, Richard J

    2011-09-01

    : Amended surgical pathology reports record defects in the process of transforming tissue specimens into diagnostic information. : Systematic study of amended reports tests 2 hypotheses: (a) that tracking amendment frequencies and the distribution of amendment types reveals relevant aspects of quality in surgical pathology's daily transformation of specimens into diagnoses and (b) that such tracking measures the effect, or lack of effect, of efforts to improve surgical pathology processes. : We applied a binary definition of altered reports as either amendments or addenda and a taxonomy of defects that caused amendments as misidentifications, specimen defects, misinterpretations, and report defects. During the introduction of a LEAN process improvement approach-the Henry Ford Productions System-we followed trends in amendment rates and defect fractions to (a) evaluate specific interventions, (b) sort case-by-case root causes of misidentifications, specimen defects, and misinterpretations, and (c) audit the ongoing accuracy of the classification of changed reports. LEAN is the management and production system of the Toyota Motor Corporation that promotes continuous improvement; it considers wasted resources expended for purposes other than creating value for end customers and targets such expenditures for elimination. : Introduction of real-time editing of amendments saw annual amendment rates increase from 4.8/1000 to 10.1/1000 and then decrease in an incremental manner to 5.6/1000 as Henry Ford Productions System-specific interventions were introduced. Before introduction of HFPS interventions, about a fifth of the amendments were due to misidentifications, a 10th were due to specimen defects, a quarter due to misinterpretation, and almost half were due to report defects. During the period of the initial application of HFPS, the fraction of amendments due to misidentifications decreased as those due to report defects increased, in a statistically linked manner. As

  10. Report: EPA Is Taking Steps to Improve State Drinking Water Program Reviews and Public Water Systems Compliance Data

    Science.gov (United States)

    Report #17-P-0326, July 18, 2017. The EPA is taking action to improve oversight tools used to determine whether public water systems are monitoring and reporting drinking water quality in accordance with the Safe Drinking Water Act.

  11. Greater trochanteric pain syndrome diagnosis and treatment.

    Science.gov (United States)

    Mallow, Michael; Nazarian, Levon N

    2014-05-01

    Lateral hip pain, or greater trochanteric pain syndrome, is a commonly seen condition; in this article, the relevant anatomy, epidemiology, and evaluation strategies of greater trochanteric pain syndrome are reviewed. Specific attention is focused on imaging of this syndrome and treatment techniques, including ultrasound-guided interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Improving human reliability through better nuclear power plant system design. Progress report

    International Nuclear Information System (INIS)

    Golay, M.W.

    1995-01-01

    The project on open-quotes Development of a Theory of the Dependence of Human Reliability upon System Designs as a Means of Improving Nuclear Power Plant Performanceclose quotes has been undertaken in order to address the important problem of human error in advanced nuclear power plant designs. Most of the creativity in formulating such concepts has focused upon improving the mechanical reliability of safety related plant systems. However, the lack of a mature theory has retarded similar progress in reducing the likely frequencies of human errors. The main design mechanism used to address this class of concerns has been to reduce or eliminate the human role in plant operations and accident response. The plan of work being pursued in this project is to perform a set of experiments involving human subject who are required to operate, diagnose and respond to changes in computer-simulated systems, relevant to those encountered in nuclear power plants. In the tests the systems are made to differ in complexity in a systematic manner. The computer program used to present the problems to be solved also records the response of the operator as it unfolds. Ultimately this computer is also to be used in compiling the results of the project. The work of this project is focused upon nuclear power plant applications. However, the persuasiveness of human errors in using all sorts of electromechanical machines gives it a much greater potential importance. Because of this we are attempting to pursue our work in a fashion permitting broad generalizations

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

    International Nuclear Information System (INIS)

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

    1988-07-01

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

  14. Mandatory Reporting? Issues to consider when developing legislation and policy to improve discovery of child abuse

    Directory of Open Access Journals (Sweden)

    Emma Davies

    2014-10-01

    Full Text Available Article by Dr Emma Davies (School of Law, Liverpool John Moores University, Associate Professor Ben Mathews (School of Law, Queensland University of Technology and Professor John Read (Institute of Psychology, Health and Society, University of Liverpool. In the United Kingdom, recent investigations into child sexual abuse occurring within schools, the Catholic Church and the British Broadcasting Corporation, have intensified debate on ways to improve the discovery of child sexual abuse, and child maltreatment generally. One approach adopted in other jurisdictions to better identify cases of severe child maltreatment is the introduction of some form of legislative mandatory reporting to require designated persons to report known and suspected cases. The debate in England has raised the prospect of whether adopting a strategy of some kind of mandatory reporting law is advisable. The purpose of this article is to add to this debate by identifying fundamental principles, issues and complexities underpinning policy and even legislative developments in the interests of children and society. The article will first highlight the data on the hidden nature of child maltreatment and the background to the debate. Secondly, it will identify some significant gaps in knowledge that need to be filled. Thirdly, the article will summarise the barriers to reporting abuse and neglect. Fourthly, we will identify a range of options for, and clarify the dilemmas in developing, legislative mandatory reporting, addressing two key issues: who should be mandated to report, and what types of child maltreatment should they be required to report? Finally, we draw attention to some inherently different goals and competing interests, both between and within the various institutions involved in the safeguarding of children and the criminal prosecution of some offenders. Based on this analysis we offer some concluding observations that we hope contribute to informed and careful

  15. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    International Nuclear Information System (INIS)

    Cohen, Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-01-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O ampersand M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O ampersand M Improvement Program. O ampersand M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O ampersand M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O ampersand M costs was achieved. Based on the lessons learned, an optimum solar- field O ampersand M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O ampersand M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts

  16. Final Report on the Operation and Maintenance Improvement Program for Concentrating Solar Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Cohen Gilbert E.; Kearney, David W.; Kolb, Gregory J.

    1999-06-01

    This report describes the results of a six-year, $6.3 million project to reduce operation and maintenance (O&M) costs at power plants employing concentrating solar power (CSP) technology. Sandia National Laboratories teamed with KJC Operating Company to implement the O&M Improvement Program. O&M technologies developed during the course of the program were demonstrated at the 150-MW Kramer Junction solar power park located in Boron, California. Improvements were made in the following areas: (a) efficiency of solar energy collection, (b) O&M information management, (c) reliability of solar field flow loop hardware, (d) plant operating strategy, and (e) cost reduction associated with environmental issues. A 37% reduction in annual O&M costs was achieved. Based on the lessons learned, an optimum solar- field O&M plan for future CSP plants is presented. Parabolic trough solar technology is employed at Kramer Junction. However, many of the O&M improvements described in the report are also applicable to CSP plants based on solar power tower or dish/engine concepts.

  17. Reported care giver strategies for improving drinking water for young children.

    Science.gov (United States)

    McLennan, John D; Farrelly, Ashley

    2010-11-01

    Care givers may engage in a variety of strategies to try and improve drinking water for children. However, the pattern of these efforts is not well known, particularly for young children in high-risk situations. The objective of this study was to determine care giver-reported strategies for young children with (1) undernutrition and (2) living in an unplanned poor peri-urban community in the Dominican Republic. Practices reported by care givers of young children from a community and clinic group were extracted from interviews conducted between 2004 and 2008 (n = 563). These results were compared to two previous similar samples interviewed in 1997 (n = 341). Bottled water is currently the most prevalent reported strategy for improving drinking water for young children. Its use increased from 6% to 69% in the community samples over the last decade and from 13% to 79% in the clinic samples. Boiling water continues to be a common strategy, particularly for the youngest children, though its overall use has decreased over time. Household-level chlorination is infrequently used and has dropped over time. Care givers are increasingly turning to bottled water in an attempt to provide safe drinking water for their children. While this may represent a positive trend for protecting children from water-transmitted diseases, it may represent an inefficient approach to safe drinking water provision that may place a financial burden on low-income families.

  18. Ectopic decidua of the greater omentum: a case report

    Directory of Open Access Journals (Sweden)

    Biserka Pigac

    2016-04-01

    Full Text Available Ectopic decidua is defined as extrauterine deposits of decidual stromal cells. It occurs in 85-100% of pregnancies. Focal sites can be present in various locations, yet a peritoneal location is rare. A 24- year- old woman underwent a cesarean section in 39th week of her first pregnancy, during which adhesions of the omentum to the fundus, entire left side of the uterus, and a part of the right front abdominal wall were found. An operative specimen was taken for a pathohistological analysis under the assumption of being fibrous adhesive tissue. The analysis revealed ectopic decidual tissue composed of large, polygonal cells with eosinophilic cytoplasm, and large nuclei with conspicuous nucleoli infiltrated with mature fatty cells and lymphocytes. Strong staining for vimentin was observed in the decidual cell cytoplasm and for a progesterone- receptor in the cell nuclei, medium staining was detected for S-100, and negative staining for CK 5/ 6, HMB-45, desmin, smooth muscle actin, estrogen and androgen- receptors. We present this case in order to educate clinicians and pathologists about the phenomenon of ectopic deciduosis. Although it can exist as asymptomatic condition, we point out the importance of considering this condition since it can result in serious pathology, like intraperitoneal hemorrhage and labour obstruction, if remains unrecognized. Another pitfall is possible confusion of this entity with other conditions. A resemblance to adhesions of the omentum and malignant neoplastic lesions, like squamous cell and metastatic carcinoma, metastatic melanoma, malignant decidual mesothelioma, metastatic mucin -producing adenocarcinoma, can be deceiving. These obstacles may present a pitfall to clinicians and pathologists, with a negative impact on patient treatment and outcome.

  19. Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members.

    Science.gov (United States)

    Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C

    2011-03-01

    The objectives of the Breakthrough Series Collaborative are to close the gap between what we know and what we do, and to contribute to continuous quality improvement (CQI) of healthcare through collaborative learning. The improvement efforts are guided by a systematic approach, combining professional and improvement knowledge. To explore what the improvement teams have learnt from participating in the collaborative and from dealing with promoting and inhibiting factors encountered. Qualitative interviews with 19 team members were conducted in four focus groups, using the Critical Incident Technique. A critical incident is one that makes significant contributions, either positively or negatively, to an activity. The elements of a culture of improvement are revealed by the critical incidents, and reflect the eight domains of knowledge, as a product of collaborative learning. The improvement knowledge and skills of individuals are important elements, but not enough to achieve sustainable changes. 90% of the material reflects the need for a system of CQI to solve the problems that organisations experience in trying to make lasting improvements. A pattern of three success factors for CQI emerges: (1) continuous and reliable information, including measurement, about best and current practice; (2) engagement of everybody in all phases of the improvement work: the patient and family, the leadership, the professional environment and the staff; and (3) an infrastructure based on improvement knowledge, with multidisciplinary teams, available coaching, learning systems and sustainability systems.

  20. Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

    Science.gov (United States)

    Ivanovic, Jelena; Anstee, Caitlin; Ramsay, Tim; Gilbert, Sebastien; Maziak, Donna E; Shamji, Farid M; Sundaresan, R Sudhir; Villeneuve, P James; Seely, Andrew J E

    2015-10-01

    Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon's clinical performance. Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. Copyright © 2015 The Society of Thoracic

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

    Science.gov (United States)

    2013-05-20

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

  2. Powerplant productivity improvement study: policy analysis and incentive assessment. Final report

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-05-01

    Policy options that the Illinois Commerce Commission might adopt in order to promote improved power plant productivity for existing units in Illinois are identified and analyzed. These policy options would generally involve either removing existing disincentives and/or adding direct incentives through the regulatory process. The following activities are reported: in-depth review of existing theoretical and empirical literature in the areas of power plant reliability, regulatory utility efficiency and performance incentives, and impacts of various regulatory mechanisms such as the Fuel Adjustment Clauses on productivity; contacts with other state public utility commissions known to be investigating or implementing productivity improvement incentive mechanisms; documentation and analysis of incentive mechanisms adopted or under consideration in other states; analysis of current regulatory practice in Illinois as it relates to power plant productivity incentives and disincentives; identification of candidate incentive mechanisms for consideration by the Illinois Commerce Commission; and analysis and evaluation of these candidates. 72 references, 8 figures.

  3. Improvement of post-hypoxic action myoclonus with levetiracetam add-on therapy: A case report

    Directory of Open Access Journals (Sweden)

    Božić Ksenija

    2014-01-01

    Full Text Available Introduction. Chronic post-anoxic myoclonus, also known as Lance-Adams syndrome, may develop following hypoxic brain injury, and is resistant to pharmacological therapy. Case report. The patient we presented developed post-anoxic action myoclonus with severe, completely incapacitating myoclonic jerks. Myoclonus did not respond to the treatment with commonly used agents, i.e. valproate and clonazepam alone or in combination. Improvement of the action myoclonus was observed only after adding levetiracetam. Conclusion. Although Lance-Adams syndrome may not be fully curable at this point, levetiracetam appears to be a promising agent that can significantly improve functional level and overall quality of life of patients with this disorder.

  4. Improved vacuum sealing drainage in the treatment of gas gangrene: a case report.

    Science.gov (United States)

    Liu, Zhaofa; Zhao, Dewei; Wang, Benjie

    2015-01-01

    In this case, improved vacuum sealing drainage was used for gas gangrene treatment, which is different from traditional therapies of gas gangrene and this is the first report of using improved vacuum sealing drainage to treat gas gangrene. The patient was a 12-year-old Asian Male who was presented to the Emergency Department with a one-day history of left femoral progressing swelling, paining and fevering. Four days ago, rusty iron bars were plugged into the muscle of the left femoral when he played. Then he was taken to the local clinic and injected with tetanus antitoxin. A diagnosis of gas gangrene was made and modified vacuum sealing drainage device was used after thorough debridement. After two weeks' treatment, left femoral was kept and gas gangrene was cured successfully.

  5. Report on a programme of testing and improving the geosphere models used within SYVAC

    International Nuclear Information System (INIS)

    Broyd, T.W.; Deaves, D.M.; Gibson, A.E.; Rutledge, K.W.

    1985-03-01

    A number of geosphere models for use with the SYVAC (System Variability Analysis Code) computer program have been developed, and are described in various previous reports. The SYVAC computer program provides an assessment of the dose effect to man resulting from buried wastes, using a series of submodels to represent transport processes in the vault, geosphere and biosphere. The work reported herein describes a programme of testing and improvements carried out on these models. It is concluded that the individual solution methods work well within stated parametric limits, and that further development studies should await a commitment to use SYVAC for the radiological assessment of specific named sites. The exception to this general rule may be the consideration of overall time scales and time stepping methods used within SYVAC. (author)

  6. A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.

    Science.gov (United States)

    Gilbert, Abigail L; Lee, Jungwha; Ehrlich-Jones, Linda; Semanik, Pamela A; Song, Jing; Pellegrini, Christine A; Pinto Pt, Daniel; Dunlop, Dorothy D; Chang, Rowland W

    2018-04-01

    Arthritis is a leading cause of chronic pain and functional limitations. Exercise is beneficial for improving strength and function and decreasing pain. We evaluated the effect of a motivational interviewing-based lifestyle physical activity intervention on self-reported physical function in adults with knee osteoarthritis (KOA) or rheumatoid arthritis (RA). Participants were randomized to intervention or control. Control participants received a brief physician recommendation to increase physical activity to meet national guidelines. Intervention participants received the same brief baseline physician recommendation in addition to motivational interviewing sessions at baseline, 3, 6, and 12 months. These sessions focused on facilitating individualized lifestyle physical activity goal setting. The primary outcome was change in self-reported physical function. Secondary outcomes were self-reported pain and accelerometer-measured physical activity. Self-reported KOA outcomes were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for KOA (WOMAC scores range from 0 to 68 for function and 0 to 20 for pain) and the Health Assessment Questionnaire (HAQ) for RA. Outcomes were measured at baseline, 3, 6, 12, and 24 months. Multiple regression accounting for repeated measures was used to evaluate the overall intervention effect on outcomes controlling for baseline values. Participants included 155 adults with KOA (76 intervention and 79 control) and 185 adults with RA (93 intervention and 92 control). Among KOA participants, WOMAC physical function improvement was greater in the intervention group compared to the control group [difference = 2.21 (95% CI: 0.01, 4.41)]. WOMAC pain improvement was greater in the intervention group compared to the control group [difference = 0.70 (95% CI: -0.004, 1.41)]. There were no significant changes in physical activity. Among RA participants, no significant intervention effects were found. Participants

  7. Call to action: Better care, better health, and greater value in college health.

    Science.gov (United States)

    Ciotoli, Carlo; Smith, Allison J; Keeling, Richard P

    2018-03-05

    It is time for action by leaders across higher education to strengthen quality improvement (QI) in college health, in pursuit of better care, better health, and increased value - goals closely linked to students' learning and success. The size and importance of the college student population; the connections between wellbeing, and therefore QI, and student success; the need for improved standards and greater accountability; and the positive contributions of QI to employee satisfaction and professionalism all warrant a widespread commitment to building greater capacity and capability for QI in college health. This report aims to inspire, motivate, and challenge college health professionals and their colleagues, campus leaders, and national entities to take both immediate and sustainable steps to bring QI to the forefront of college health practice - and, by doing so, to elevate care, health, and value of college health as a key pathway to advancing student success.

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

    Directory of Open Access Journals (Sweden)

    Wei Chen

    2016-01-01

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

  9. Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement.

    Science.gov (United States)

    2014-10-01

    Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public (such as live birth) nor on the harms, including maternal risks during pregnancy and fetal anomalies. This is complicated by the multiple participants in infertility trials which may include a woman (mother), a man (father), and a third individual if successful, their offspring (child), who is also the desired outcome of treatment. The primary outcome of interest and many adverse events occur after cessation of infertility treatment and during pregnancy and the puerperium, which creates a unique burden of follow-up for clinical trial investigators and participants. In 2013, because of the inconsistencies in trial reporting and the unique aspects of infertility trials not adequately addressed by existing Consolidated Standards of Reporting Trials (CONSORT) statements, we convened a consensus conference in Harbin, China, with the aim of planning modifications to the CONSORT checklist to improve the quality of reporting of clinical trials testing infertility treatment. The consensus group recommended that the preferred primary outcome of all infertility trials is live birth (defined as any delivery of a live infant after ≥20 weeks' gestation) or cumulative live birth, defined as the live birth per women over a defined time period (or number of treatment cycles). In addition, harms to all participants should be systematically collected and reported, including during the intervention, any resulting pregnancy, and the neonatal period. Routine information should be collected and reported on both male and female participants in the trial. We propose to track the change in quality that these guidelines may produce in published trials testing infertility treatments. Our ultimate goal is to increase the transparency of benefits and risks of infertility treatments to provide better medical care to affected individuals and couples

  10. The Space Situational Assessment Report to Improve Public Awareness in China

    Science.gov (United States)

    Li, Hongbo; Zhang, Qi; Xie, Zebing; Wei, Xiangwang; Wang, Tao

    For improvement of public awareness of the impact of space activities in China, a Space Situational Assessment Report 2013 will be issued in March 2014. More than ten Chinese main medium are invited for a special press conference. The Space Situational Assessment Report aims to introduce international space activities to Chinese public, and provide a common, comprehensive knowledge base to support the development of national policies and international security cooperation of outer space. The full report organizes international space activities until 2013 according to three parts those are Foundations, Strategies and Environment, including nine chapters, such as Space laws and policies; Space facility and equipment; Institutions and Human Resource; Military space, Civil space and Commercial space; Natural space environment; Space situational awareness, etc. A kind of Space Situational Assessment Index System is presented as a globally-focused analytic framework that defines, measures, and ranks national space activity. To use for a variety of public themes, different assessment indexes are constituted by scores of individual qualitative and quantitative metrics based on the Index System. Three research organizaitons of space sciences and technologies collaborated on the Space Situational Assessment Report. It is a scholarly and ungovernmental work.

  11. Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

    Directory of Open Access Journals (Sweden)

    Rebecca Rhead

    Full Text Available As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence.Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560 provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates.94.3% (528/560 and 92.7% (519/560 of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well.Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that

  12. Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

    Science.gov (United States)

    Rhead, Rebecca; Masimirembwa, Collen; Cooke, Graham; Takaruza, Albert; Nyamukapa, Constance; Mutsimhi, Cosmas; Gregson, Simon

    2016-01-01

    As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence. Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560) provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates. 94.3% (528/560) and 92.7% (519/560) of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well. Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that ART adherence

  13. Correlation between pain response and improvements in patient-reported outcomes and health-related quality of life in duloxetine-treated patients with diabetic peripheral neuropathic pain

    Directory of Open Access Journals (Sweden)

    Ogawa K

    2015-08-01

    Full Text Available Kei Ogawa,1 Shinji Fujikoshi,2 William Montgomery,3 Levent Alev1 1Medical Science, 2Statistical Science, Eli Lilly Japan K.K., Kobe, Japan; 3Global Patient Outcomes and Real World Evidence, Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia Objective: We assessed whether quality of life (QoL improvement in duloxetine-treated patients with diabetic peripheral neuropathic pain (DPNP correlates with the extent of pain relief.Methods: Pooled data from three multicountry, double-blind, 12-week, placebo-controlled trials of duloxetine-treated (duloxetine 60 mg once daily; total number =335 patients with DPNP were analyzed. Based on improvement in 24-hour average pain scores, patients were stratified into four groups. Improvement in QoL, which was measured as the change from baseline in two patient-reported health outcome measures (Short Form [SF]-36 and five-dimension version of the EuroQol Questionnaire [EQ-5D], was evaluated and compared among the four groups. Pearson’s correlation coefficient was calculated to assess the correlation between improvement in pain scores and improvement in QoL.Results: The group with more pain improvement generally showed greater mean change from baseline in all of the SF-36 scale scores and on the EQ-5D index. Pearson’s correlation coefficients ranged from 0.114 to 0.401 for the SF-36 scale scores (P<0.05, and it was 0.271 for the EQ-5D (P<0.001.Conclusion: Improvement in pain scores was positively correlated with improvement in QoL and patient-reported outcomes in duloxetine-treated patients. Keywords: diabetic peripheral neuropathic pain, duloxetine, efficacy, function, quality of life

  14. Aggregate analysis of regulatory authority assessors' comments to improve the quality of periodic safety update reports.

    Science.gov (United States)

    Jullian, Sandra; Jaskiewicz, Lukasz; Pfannkuche, Hans-Jürgen; Parker, Jeremy; Lalande-Luesink, Isabelle; Lewis, David J; Close, Philippe

    2015-09-01

    Marketing authorization holders (MAHs) are expected to provide high-quality periodic safety update reports (PSURs) on their pharmaceutical products to health authorities (HAs). We present a novel instrument aiming at improving quality of PSURs based on standardized analysis of PSUR assessment reports (ARs) received from the European Union HAs across products and therapeutic areas. All HA comments were classified into one of three categories: "Request for regulatory actions," "Request for medical and scientific information," or "Data deficiencies." The comments were graded according to their impact on patients' safety, the drug's benefit-risk profile, and the MAH's pharmacovigilance system. A total of 476 comments were identified through the analysis of 63 PSUR HA ARs received in 2013 and 2014; 47 (10%) were classified as "Requests for regulatory actions," 309 (65%) as "Requests for medical and scientific information," and 118 (25%) comments were related to "Data deficiencies." The most frequent comments were requests for labeling changes (35 HA comments in 19 ARs). The aggregate analysis revealed commonly raised issues and prompted changes of the MAH's procedures related to the preparation of PSURs. The authors believe that this novel instrument based on the evaluation of PSUR HA ARs serves as a valuable mechanism to enhance the quality of PSURs and decisions about optimization of the use of the products and, therefore, contributes to improve further the MAH's pharmacovigilance system and patient safety. Copyright © 2015 John Wiley & Sons, Ltd.

  15. Anterior capsulotomy improves persistent developmental stuttering with a psychiatric disorder: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Zhang SZ

    2014-04-01

    Full Text Available Shizhen Zhang,* Peng Li,* Zhujun Zhang, Wei WangDepartment of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China *These authors contributed equally to this workAbstract: Stuttering is characterized by disrupted fluency of verbal expression, and occurs mostly in children. Persistent developmental stuttering (PDS may occur in adults. Reports of the surgical management of PDS are limited. Here we present the case of a 28-year-old man who had had PDS since the age of 7 years, was diagnosed with depression and anxiety disorder at the age of 24 years, and had physical concomitants. He underwent a bilateral anterior capsulotomy 4 years after the diagnosis. Over one year of follow-up, his physical concomitants resolved, and significant improvements in his psychiatric disorders and PDS were observed. To the best of our knowledge, this is the first report of simultaneous improvement in a patient's PDS and psychiatric disorder after a bilateral anterior capsulotomy.Keywords: persistent developmental stuttering, psychiatric disorders, anterior capsulotomy

  16. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1991-1995 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.; Flagg, Thomas A.; Mahnken, Conrad V.W.

    1996-08-01

    In this report, the National Marine Fisheries Service (NMFS), in collaboration with the Bonneville Power Administration (BPA), the Washington State Department of Fish and Wildlife (WDFW), and the US Fish and Wildlife Service (USFWS), presents research findings and guidelines for development and evaluation of innovative culture techniques to increase postrelease survival of hatchery fish. The Natural Rearing Enhancement System (NATURES) described in this report is a collection of experimental approaches designed to produce hatchery-reared chinook salmon (Oncorhynchus tshawytscha) that exhibit wild-like behavior, physiology, and morphology. The NATURES culture research for salmonids included multiple tests to develop techniques such as: raceways equipped with cover, structure, and natural substrates to promote development of proper body camouflage coloration; feed-delivery systems that condition fish to orient to the bottom rather than the surface of the rearing vessel; predator conditioning of fish to train them to avoid predators; and supplementing diets with natural live foods to improve foraging ability. The underlying assumptions are that NATURES will: (1) promote the development of natural cryptic coloration and antipredator behavior; (2) increase postrelease foraging efficiency; (3) improve fish health and condition by alleviating chronic, artificial rearing habitat-induced stress; and (4) reduce potential genetic selection pressures induced by the conventional salmon culture environment. A goal in using NATURES is to provide quality fish for rebuilding depleted natural runs.

  17. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1996-1998 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.

    2001-09-13

    This report covers the 1996-1998 Natural Rearing Enhancement System (NATURES) research for increasing hatchery salmon postrelease survival and producing fish with more wild-like behavior, physiology, and morphology prior to release. Experiments were conducted evaluating automatic subsurface feeders; natural diets; exercise systems; seminatural raceway habitat enriched with cover, structure, and substrate; and predator avoidance conditioning for hatchery salmonids. Automatic subsurface feed delivery systems did not affect chinook salmon depth distribution or vulnerability to avian predators. Live-food diets only marginally improved the ability of chinook salmon to capture prey in stream enclosures. A prototype exercise system that can be retrofitted to raceways was developed, however, initial testing indicated that severe amounts of exercise may increase in culture mortality. Rearing chinook salmon in seminatural raceway habitat with gravel substrate, woody debris structure, and overhead cover improved coloration and postrelease survival without impacting in-culture health or survival. Steelhead fry reared in enriched environments with structure, cover, and point source feeders dominated and outcompeted conventionally reared fish. Exposing chinook salmon to caged predators increased their postrelease survival. Chinook salmon showed an antipredator response to chemical stimuli from injured conspecifics and exhibited acquired predator recognition following exposure to paired predator-prey stimuli. The report also includes the 1997 Natural Rearing System Workshop proceedings.

  18. Using a web-based image quality assurance reporting system to improve image quality.

    Science.gov (United States)

    Czuczman, Gregory J; Pomerantz, Stuart R; Alkasab, Tarik K; Huang, Ambrose J

    2013-08-01

    The purpose of this study is to show the impact of a web-based image quality assurance reporting system on the rates of three common image quality errors at our institution. A web-based image quality assurance reporting system was developed and used beginning in April 2009. Image quality endpoints were assessed immediately before deployment (period 1), approximately 18 months after deployment of a prototype reporting system (period 2), and approximately 12 months after deployment of a subsequent upgraded department-wide reporting system (period 3). A total of 3067 axillary shoulder radiographs were reviewed for correct orientation, 355 shoulder CT scans were reviewed for correct reformatting of coronal and sagittal images, and 346 sacral MRI scans were reviewed for correct acquisition plane of axial images. Error rates for each review period were calculated and compared using the Fisher exact test. Error rates of axillary shoulder radiograph orientation were 35.9%, 7.2%, and 10.0%, respectively, for the three review periods. The decrease in error rate between periods 1 and 2 was statistically significant (p < 0.0001). Error rates of shoulder CT reformats were 9.8%, 2.7%, and 5.8%, respectively, for the three review periods. The decrease in error rate between periods 1 and 2 was statistically significant (p = 0.03). Error rates for sacral MRI axial sequences were 96.5%, 32.5%, and 3.4%, respectively, for the three review periods. The decrease in error rates between periods 1 and 2 and between periods 2 and 3 was statistically significant (p < 0.0001). A web-based system for reporting image quality errors may be effective for improving image quality.

  19. Improvement in self-reported confidence in nurses' professional skills in the emergency department.

    Science.gov (United States)

    Rautava, Veli-Pekka; Palomäki, Erika; Innamaa, Tapio; Perttu, Mika; Lehto, Päivi; Palomäki, Ari

    2013-03-05

    The aim of this study was to assess nurses' self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software.During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses' skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Nurses' self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (pskills of nurses. This improvement was especially

  20. Improvement in self-reported confidence in nurses’ professional skills in the emergency department

    Science.gov (United States)

    2013-01-01

    Background The aim of this study was to assess nurses’ self-reported confidence in their professional skills before and after an extensive Emergency Department (ED) reform in Kanta-Häme Central Hospital. Methods Emergency nurses participated in transitional training commencing two years before the establishment of the new organization in 2007. Training was followed by weekly practical educational sessions in the new ED. During this process nurses improved their transition skills, defined house rules for the new clinic and improved their knowledge of new technology and instruments. The main processes involving critically ill ED patients were described and modelled with an electronic flow chart software. During the transitional training nurses compiled lists of practical skills and measures needed in the ED. These were updated after feedback from physicians in primary and secondary care and head physicians in Kanta-Häme Central Hospital. The final 189-item list comprised 15 different categories, each containing from 4 to 35 items. Based on the work described above, a questionnaire was developed to reflect ED nurses’ skills in clinical measures but also to estimate the need for professional education and practical training. Nurses working in the ED were asked to fill the questionnaire in January 2007 (response rate 97%) and in January 2011 (response rate 98%). Results Nurses’ self-reported confidence in their professional skills improved significally in eight classes out of fifteen. These classes were cannulations, urinary catheterizations, patient monitoring, cardiac patients, equipment, triage and nurse practising, psychiatric patients as well as infection risk. Best results were noted in urinary catheterizations, patient monitoring and infection risk. When studying the group of nurses participating in both surveys in 2007 and 2011, improvements were observed in all fifteen categories. All but two of these changes were significant (pskills of nurses. This

  1. Quality Improvement in Pediatric Endoscopy: A Clinical Report From the NASPGHAN Endoscopy Committee.

    Science.gov (United States)

    Kramer, Robert E; Walsh, Catharine M; Lerner, Diana G; Fishman, Douglas S

    2017-07-01

    The current era of healthcare reform emphasizes the provision of effective, safe, equitable, high-quality, and cost-effective care. Within the realm of gastrointestinal endoscopy in adults, renewed efforts are in place to accurately define and measure quality indicators across the spectrum of endoscopic care. In pediatrics, however, this movement has been less-defined and lacks much of the evidence-base that supports these initiatives in adult care. A need, therefore, exists to help define quality metrics tailored to pediatric practice and provide a toolbox for the development of robust quality improvement (QI) programs within pediatric endoscopy units. Use of uniform standards of quality reporting across centers will ensure that data can be compared and compiled on an international level to help guide QI initiatives and inform patients and their caregivers of the true risks and benefits of endoscopy. This report is intended to provide pediatric gastroenterologists with a framework for the development and implementation of endoscopy QI programs within their own centers, based on available evidence and expert opinion from the members of the NASPGHAN Endoscopy Committee. This clinical report will require expansion as further research pertaining to endoscopic quality in pediatrics is published.

  2. Combining bimodal presentation schemes and buzz groups improves clinical reasoning and learning at morning report.

    Science.gov (United States)

    Balslev, Thomas; Rasmussen, Astrid Bruun; Skajaa, Torjus; Nielsen, Jens Peter; Muijtjens, Arno; De Grave, Willem; Van Merriënboer, Jeroen

    2014-12-11

    Abstract Morning reports offer opportunities for intensive work-based learning. In this controlled study, we measured learning processes and outcomes with the report of paediatric emergency room patients. Twelve specialists and 12 residents were randomised into four groups and discussed the same two paediatric cases. The groups differed in their presentation modality (verbal only vs. verbal + text) and the use of buzz groups (with vs. without). The verbal interactions were analysed for clinical reasoning processes. Perceptions of learning and judgment of learning were reported in a questionnaire. Diagnostic accuracy was assessed by a 20-item multiple-choice test. Combined bimodal presentation and buzz groups increased the odds ratio of clinical reasoning to occur in the discussion of cases by a factor of 1.90 (p = 0.013), indicating superior reasoning for buzz groups working with bimodal materials. For specialists, a positive effect of bimodal presentation was found on perceptions of learning (p presentation on diagnostic accuracy was noted in the specialists (p presentation and buzz group discussion of emergency cases improves clinicians' clinical reasoning and learning.

  3. Training attention improves decision making in individuals with elevated self-reported depressive symptoms.

    Science.gov (United States)

    Cooper, Jessica A; Gorlick, Marissa A; Denny, Taylor; Worthy, Darrell A; Beevers, Christopher G; Maddox, W Todd

    2014-06-01

    Depression is often characterized by attentional biases toward negative items and away from positive items, which likely affects reward and punishment processing. Recent work has reported that training attention away from negative stimuli reduced this bias and reduced depressive symptoms. However, the effect of attention training on subsequent learning has yet to be explored. In the present study, participants were required to learn to maximize reward during decision making. Undergraduates with elevated self-reported depressive symptoms received attention training toward positive stimuli prior to performing the decision-making task (n = 20; active training). The active-training group was compared to two other groups: undergraduates with elevated self-reported depressive symptoms who received placebo training (n = 22; placebo training) and a control group with low levels of depressive symptoms (n = 33; nondepressive control). The placebo-training depressive group performed worse and switched between options more than did the nondepressive controls on the reward maximization task. However, depressives that received active training performed as well as the nondepressive controls. Computational modeling indicated that the placebo-trained group learned more from negative than from positive prediction errors, leading to more frequent switching. The nondepressive control and active-training depressive groups showed similar learning from positive and negative prediction errors, leading to less-frequent switching and better performance. Our results indicate that individuals with elevated depressive symptoms are impaired at reward maximization, but that the deficit can be improved with attention training toward positive stimuli.

  4. SU-F-T-163: Improve Proton Therapy Efficiency: Report of a Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Y [Procure Proton Therapy Center, Oklahoma City, OK (United States); Flanz, J [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Mah, D [Procure Treatment Center, Somerset, NJ (United States); Pankuch, M; Kreydick, B [Northwestern Medicine Proton Center, Warrenville, IL (United States); Beltran, C [Mayo Clinic, Rochester, MN (United States); Robison, B; Schreuder, A [Provision Healthcare Partners, Knoxville, TN (United States)

    2016-06-15

    Purpose: The technology of proton therapy, especially the pencil beam scanning technique, is evolving very quickly. However, the efficiency of proton therapy seems to lag behind conventional photon therapy. The purpose of the abstract is to report on the findings of a workshop on improvement of QA, planning and treatment efficiency in proton therapy. Methods: A panel of physicists, clinicians, and vendor representatives from over 18 institutions in the United States and internationally were convened in Knoxville, Tennessee in November, 2015. The panel discussed several topics on how to improve proton therapy efficiency, including 1) lean principle and failure mode and effects analysis, 2) commissioning and machine QA, 3) treatment planning, optimization and evaluation, 4) patient positioning and IGRT, 5) vendor liaison and machine availability, and 6) staffing, education and training. Results: The relative time needed for machine QA, treatment planning & check in proton therapy was found to range from 1 to 2.5 times of that in photon therapy. Current status in proton QA, planning and treatment was assessed. Key areas for efficiency improvement, such as elimination of unnecessary QA items or steps and development of efficient software or hardware tools, were identified. A white paper to summarize our findings is being written. Conclusion: It is critical to improve efficiency by developing reliable proton beam lines, efficient software tools on treatment planning, optimization and evaluation, and dedicated proton QA device. Conscious efforts and collaborations from both industry leaders and proton therapy centers are needed to achieve this goal and further advance the technology of proton therapy.

  5. Image-Rich Radiology Reports: A Value-Based Model to Improve Clinical Workflow.

    Science.gov (United States)

    Patel, Bhavik N; Lopez, Jose M; Jiang, Brian G; Roth, Christopher J; Nelson, Rendon C

    2017-01-01

    To determine the value of image-rich radiology reports (IRRR) by evaluating the interest and preferences of referring physicians, potential impact on clinical workflow, and the willingness of radiologists to create them. Referring physicians and radiologists were interviewed in this prospective, HIPAA-compliant study. Subject willingness to participate in the study was determined by an e-mail. A single investigator conducted all interviews using a standard questionnaire. All subjects reviewed a video mockup demonstration of IRRR and three methods for viewing embedded images, as follows: (1) clickable hyperlinks to access a scrollable stack of images, (2) scrollable and enlargeable small-image thumbnails, and (3) scrollable but not enlargeable medium-sized images. Questionnaire responses, free comments, and general impressions were captured and analyzed. Seventy-two physicians (36 clinicians, 36 radiologists) were interviewed. Thirty-one clinicians (86%) expressed interest in using IRRR. Seventy-seven percent of subjects believed IRRR would improve communication. Ten clinicians (28%) preferred method 1, 18 (50%) preferred method 2, and 8 (22%) preferred method 3 for embedding images. Thirty clinicians (83%) stated that IRRR would improve efficiency. Twenty-two radiologists (61%) preferred selecting a tool button with a mouse and right-clicking images to embed them, 13 (36%) preferred pressing a function key, and 11 (31%) preferred dictating series and image numbers. The average time radiologists were willing to expend for embedding images was 66.7 seconds. Referring physicians and radiologist both believe IRRR would add value by improving communication with the potential to improve the workflow efficiency of referring physicians. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Improved clinical documentation leads to superior reportable outcomes: An accurate representation of patient's clinical status.

    Science.gov (United States)

    Elkbuli, Adel; Godelman, Steven; Miller, Ashley; Boneva, Dessy; Bernal, Eileen; Hai, Shaikh; McKenney, Mark

    2018-05-01

    Clinical documentation can be an underappreciated. Trauma Centers (TCs) are now routinely evaluated for quality performance. TCs with poor documentation may not accurately reflect actual injury burden or comorbidities and can impact accuracy of mortality measures. Markers exist to adjust crude death rates for injury severity: observed over expected deaths (O/E) adjust for injury; Case Mix Index (CMI) reflects disease burden, and Severity of Illness (SOI) measures organ dysfunction. We aim to evaluate the impact of implementing a Clinical Documentation Improvement Program (CDIP) on reported outcomes. Review of 2-years of prospectively collected data for trauma patients, during the implementation of CDIP. A two-group prospective observational study design was used to evaluate the pre-implementation and the post-implementation phase of improved clinical documentation. T-test and Chi-Squared were used with significance defined as p deaths out of 1419 (3.45%), while post-implementation period, had 38 deaths out of 1454 (2.61%), (non-significant). There was however, a significant difference between O/E ratios. In the pre-phase, the O/E was 1.36 and 0.70 in the post-phase (p < 0.001). The two groups also differed on CMI with a pre-group mean of 2.48 and a post-group of 2.87 (p < 0.001), indicating higher injury burden in the post-group. SOI started at 2.12 and significantly increased to 2.91, signifying more organ system dysfunction (p < 0.018). Improved clinical documentation results in improved accuracy of measures of mortality, injury severity, and comorbidities and a more accurate reflection in O/E mortality ratios, CMI, and SOI. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  7. A report on developing a checklist to assess company plans focused on improving safety awareness, safe behaviour and safety culture: final report

    NARCIS (Netherlands)

    Steijger, N.; Starren, H.; Keus, M.; Gort, J.; Vervoort, M.

    2003-01-01

    This report describes the process of developing a checklist to asses company plans focused on improving safety awareness, safe behaviour and safety culture. These plans are part of a programme initiated by the Ministry of Social Affairs and Employment aiming at improving the safety performance of

  8. Greater trochanteric fracture with occult intertrochanteric extension.

    Science.gov (United States)

    Reiter, Michael; O'Brien, Seth D; Bui-Mansfield, Liem T; Alderete, Joseph

    2013-10-01

    Proximal femoral fractures are frequently encountered in the emergency department (ED). Prompt diagnosis is paramount as delay will exacerbate the already poor outcomes associated with these injuries. In cases where radiography is negative but clinical suspicion remains high, magnetic resonance imaging (MRI) is the study of choice as it has the capability to depict fractures which are occult on other imaging modalities. Awareness of a particular subset of proximal femoral fractures, namely greater trochanteric fractures, is vital for both radiologists and clinicians since it has been well documented that they invariably have an intertrochanteric component which may require surgical management. The detection of intertrochanteric or cervical extension of greater trochanteric fractures has been described utilizing MRI but is underestimated with both computed tomography (CT) and bone scan. Therefore, if MRI is unavailable or contraindicated, the diagnosis of an isolated greater trochanteric fracture should be met with caution. The importance of avoiding this potential pitfall is demonstrated in the following case of an elderly woman with hip pain and CT demonstrating an isolated greater trochanteric fracture who subsequently returned to the ED with a displaced intertrochanteric fracture.

  9. Greater Somalia, the never-ending dream?

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2015-01-01

    This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost...

  10. Improving Robustness Assessment Methodologies for Structures Impacted by Missiles (IRIS-2012) - Final Report

    International Nuclear Information System (INIS)

    Orbovic, Neb; Blahoainu, Andrei; Sagals, Genadis; Tarallo, Francois; Rambach, Jean-Mathieu; Huerta, Alejandro; White, Andrew; Nevander, Olli; ); Riera, Jorge Daniel; Krauthammer, Ted; Krutzik, Norbert; Arros, Jorma; Rouqand, Alain; Stangenberg, Friedhelm; Schwer, Leonard E.

    2014-01-01

    This report documents the results and conclusions of the second phase of the Integrity and Ageing of Components and Structures Working Group (WGIAGE) activity 'Improving Robustness assessment of structures Impacted by missiles', called IRIS-2012. The objective of the activity was to conduct a post-test benchmark study to improve models and evaluation techniques used in IRIS-2010. The benchmark was open to the new participants and some of IRIS-2010 participants did not take part of IRIS-2012. For this reason the team numbers in two benchmarks are different and to make direct comparisons it is necessary to have both lists. For IRIS-2010 benchmark a series of repeated test was performed: two bending rupture tests and three punching rupture tests. For IRIS-2012 and based on recommendation from IRIS-2010, tri-axial tests and Brazilian tensile test were additionally performed in order to calibrate constitutive models. The benchmark was officially launched in February 2012 with the participation of twenty six teams from twenty different institutions (Safety Authorities, TSOs, Utilities, Vendors, Research Institutes and Consulting Companies), from ten different countries from Europe, North America and Asia (plus 1 international organisation). A three day workshop was convened in October 2012 in Ottawa, Ontario, Canada where each participating team presented and discussed their results and performed simulations. Based on IRIS-2010 results and recommendations, OECD/NEA members recognized that there was a need to continue the work on understanding and improving simulation of structural impact. The goal of the new IRIS-2012 benchmark was to: 1) Update and improve existing FE models, for teams that participated in IRIS-2010, or to create new models for new participants. In order to improve FE models it was requested to: Simulate uni-axial unconfined concrete test and tri-axial concrete tests, using the results provided by IRSN, as well as the Brazilian test (concrete tensile

  11. Medication Errors in Pediatric Anesthesia: A Report From the Wake Up Safe Quality Improvement Initiative.

    Science.gov (United States)

    Lobaugh, Lauren M Y; Martin, Lizabeth D; Schleelein, Laura E; Tyler, Donald C; Litman, Ronald S

    2017-09-01

    Wake Up Safe is a quality improvement initiative of the Society for Pediatric Anesthesia that contains a deidentified registry of serious adverse events occurring in pediatric anesthesia. The aim of this study was to describe and characterize reported medication errors to find common patterns amenable to preventative strategies. In September 2016, we analyzed approximately 6 years' worth of medication error events reported to Wake Up Safe. Medication errors were classified by: (1) medication category; (2) error type by phase of administration: prescribing, preparation, or administration; (3) bolus or infusion error; (4) provider type and level of training; (5) harm as defined by the National Coordinating Council for Medication Error Reporting and Prevention; and (6) perceived preventability. From 2010 to the time of our data analysis in September 2016, 32 institutions had joined and submitted data on 2087 adverse events during 2,316,635 anesthetics. These reports contained details of 276 medication errors, which comprised the third highest category of events behind cardiac and respiratory related events. Medication errors most commonly involved opioids and sedative/hypnotics. When categorized by phase of handling, 30 events occurred during preparation, 67 during prescribing, and 179 during administration. The most common error type was accidental administration of the wrong dose (N = 84), followed by syringe swap (accidental administration of the wrong syringe, N = 49). Fifty-seven (21%) reported medication errors involved medications prepared as infusions as opposed to 1 time bolus administrations. Medication errors were committed by all types of anesthesia providers, most commonly by attendings. Over 80% of reported medication errors reached the patient and more than half of these events caused patient harm. Fifteen events (5%) required a life sustaining intervention. Nearly all cases (97%) were judged to be either likely or certainly preventable. Our findings

  12. Improving the reporting of clinical trials of infertility treatments (IMPRINT): modifying the CONSORT statement†‡.

    Science.gov (United States)

    Legro, Richard S; Wu, Xiaoke; Barnhart, Kurt T; Farquhar, Cynthia; Fauser, Bart C J M; Mol, Ben

    2014-10-10

    Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public (such as live birth) nor on the harms, including maternal risks during pregnancy and fetal anomalies. This is complicated by the multiple participants in infertility trials which may include a woman (mother), a man (father), and result in a third individual if successful, their offspring (child), who is also the desired outcome of treatment. The primary outcome of interest and many adverse events occur after cessation of infertility treatment and during pregnancy and the puerperium, which create a unique burden of follow-up for clinical trial investigators and participants. In 2013, because of the inconsistencies in trial reporting and the unique aspects of infertility trials not adequately addressed by existing Consolidated Standards of Reporting Trials (CONSORT) statements, we convened a consensus conference in Harbin, China, with the aim of planning modifications to the CONSORT checklist to improve the quality of reporting of clinical trials testing infertility treatment. The consensus group recommended that the preferred primary outcome of all infertility trials is live birth (defined as any delivery of a live infant ≥20 weeks gestations) or cumulative live birth, defined as the live birth per women over a defined time period (or number of treatment cycles). In addition, harms to all participants should be systematically collected and reported, including during the intervention, any resulting pregnancy, and during the neonatal period. Routine information should be collected and reported on both male and female participants in the trial. We propose to track the change in quality that these guidelines may produce in published trials testing infertility treatments. Our ultimate goal is to increase the transparency of benefits and risks of infertility treatments to provide better medical care to affected individuals and

  13. High Flow Nasal Cannula Therapy for Improving Obstructive Sleep Apnea: A Case Report

    Directory of Open Access Journals (Sweden)

    Se Joong Kim

    2015-06-01

    Full Text Available Although continuous positive airway pressure is the treatment of choice for obstructive sleep apnea, its compliance is low. Therefore, alternative therapeutic strategies are often required. High flow nasal cannula therapy uses an air compressor to deliver a constant flow of oxygen via the nasal cannula at a maximum of 60 L/m. It can produce positive end expiratory pressure and increase end expiratory pharyngeal pressure, which can help to alleviate upper airway obstruction. This is a case report of high flow nasal cannula therapy for a 71 year-old man. He had an obstructive sleep apnea and severe desaturation but failed to use continuous positive airway pressure. He underwent titration with high flow nasal cannula under polysomnography. Using high flow nasal cannula at an airflow of 45 L/m, his apnea-hypopnea, respiratory arousal and oxygen desaturation were improved. Importantly, he is very compliant with high flow nasal cannula therapy.

  14. Preliminary report of an intervention to improve mammography skills of radiologists

    International Nuclear Information System (INIS)

    D'Orsi, C.J.; Karellas, A.; Costanza, M.E.; Gaw, V.P.

    1989-01-01

    This paper presents a preliminary report of an intervention to improve mammography skills of radiologists. Although implementation of the screening guidelines has not occurred as readily as had been anticipated, use of mammograms is increasing. As the demand for this relatively new technology increases, both the availability of the test and the quality of the test done are valid concerns. Until recently, few radiology training programs provided trainees with opportunities to develop these skills. As a result, few radiologists who have been in practice more than five years have had formal training in the interpretation of mammograms. Thus providing practicing radiologists with the opportunities to develop skills in mammographic interpretation will serve to increase both availability and quality of mammographic exams

  15. Development of NMRI spectroscopy for improved petroleum recovery, Annex 6. Annual report, 1991

    Energy Technology Data Exchange (ETDEWEB)

    Barrufet, M.A.; Flumerfelt, R.W.; Jennings, J.W.; Walsh, M.P.; Watson, A.T.

    1991-12-31

    The overall objectives are to develop and apply Nuclear Magnetic Resonance Imaging (NMRI) and CT X-Ray Scanning methods for determining rock, fluid, and petrophysical properties and for fundamental studies of multiphase flow behavior in porous media. Specific objectives are to: (1) develop NMRI procedures for measuring porosity, permeability, pore size distribution, capillary pressure, and wetting characteristics, (2) apply imaging methods for improved methods of determining two- and three-phase relative permeability functions, (3) apply NMRI for development of a better understanding of dispersed phase displacement processes, and (4) apply imaging methods to develop a better understanding of saturation distribution and fingering during miscible displacements. The objectives have been organized into four subtasks. Annual progress reports for each subtask are provided.

  16. A C.L.E.A.R. Approach to Report Writing: A Framework for Improving the Efficacy of Psychoeducational Reports

    Science.gov (United States)

    Mastoras, Sarah M.; Climie, Emma A.; McCrimmon, Adam W.; Schwean, Vicki L.

    2011-01-01

    Psychoeducational reports are the primary means for a school psychologist to communicate the results of an assessment. Although reports should be written in the most efficient and reader-friendly manner, this is not always the case. Additionally, problems in report writing have remained relatively consistent for several decades, despite…

  17. Specific Physician Orders Improve Pain Detection and Pain Reports in Nursing Home Residents: Preliminary Data.

    Science.gov (United States)

    Monroe, Todd B; Misra, Sumathi; Habermann, Ralf C; Dietrich, Mary S; Bruehl, Stephen P; Cowan, Ronald L; Newhouse, Paul A; Simmons, Sandra F

    2015-10-01

    Despite evidence that many nursing home residents' pain is poorly managed, reasons for this poor management remain unanswered. The aim of this study was to determine if specific order sets related to pain assessment would improve pain management in nursing home (NH) residents. Outcomes included observed nurse pain assessment queries and resident reports of pain. The pretest/post-test study was performed in a 240-bed for-profit nursing home in the mid-southern region of the United States and participants were 43 nursing home residents capable of self-consent. Medical chart abstraction was performed during a 2-week (14-day) period before the implementation of specific order sets for pain assessment (intervention) and a 2-week (14-day) period after the intervention. Trained research assistants observed medication administration passes and performed participant interviews after each medication pass. One month after intervention implementation, 1 additional day of observations was conducted to determine data reliability. Nurses were observed to ask residents about pain more frequently, and nurses continued to ask about pain at higher rates 1 month after the intervention was discontinued. The proportion of residents who reported pain also significantly increased in response to increased nurse queries (e.g., "Do you have any pain right now?"), which underscores the importance of nurses directly asking residents about pain. Notably 70% of this long-stay NH population only told the nurses about their pain symptoms when asked directly. Findings uncover that using specific pain order sets seems to improve the detection of pain, which should be a routine part of nursing assessment. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  18. Final Report SBIR Phase I, Improvement of Properties of Tubular Internal-Tin Nb3Sn

    International Nuclear Information System (INIS)

    Gregory, Eric

    2009-01-01

    Final report of SBIR to develop an economical process that can produce the best material for high field magnets to be used in the next generation of accelerators. The overall problem is to develop an economical process that can produce material with good properties for high field magnets to be used in the future for High Energy Physics (HEP) applications. The Internal-tin (IT) process, called by some the Restacked Rod process (RRP), for making Nb 3 Sn has been very successful in achieving high J c properties in the high field region. As a result it has been used effectively in several high field magnets. Originally, when this material was processed to give the highest J c it behaved unstably in the low field region and consequently did not perform as well in magnets designed for intermediate field applications. In this field range, the Powder-in-Tube (PIT) material, that has a lower d eff and a high RRR, behaved more reliably. The IT material has been improved to give better stability in the low field range and consequently the process offers a considerable challenge to the PIT process for application in both types of magnets. The PIT material has two principal drawbacks - lower J c and high cost. Work has been carried out to address these two problems and Supergenics I LLC has reported, on a low cost tubular process that is under development. It has fewer problems than the (IT) process in making low d eff materials and is of lower cost than both the IT and PIT processes. At the present stage, the J c 's that have been achieved are similar to those of the PIT material but are below those of the IT material. The purpose of the work proposed here is to improve the properties of the material made by this tubular process that has been described previously.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1982-03-01

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

  20. Benchmark Report on Key Outage Attributes: An Analysis of Outage Improvement Opportunities and Priorities

    Energy Technology Data Exchange (ETDEWEB)

    Germain, Shawn St. [Idaho National Laboratory (INL), Idaho Falls, ID (United States); Farris, Ronald [Idaho National Laboratory (INL), Idaho Falls, ID (United States)

    2014-09-01

    Advanced Outage Control Center (AOCC), is a multi-year pilot project targeted at Nuclear Power Plant (NPP) outage improvement. The purpose of this pilot project is to improve management of NPP outages through the development of an AOCC that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. This report documents the results of a benchmarking effort to evaluate the transferability of technologies demonstrated at Idaho National Laboratory and the primary pilot project partner, Palo Verde Nuclear Generating Station. The initial assumption for this pilot project was that NPPs generally do not take advantage of advanced technology to support outage management activities. Several researchers involved in this pilot project have commercial NPP experience and believed that very little technology has been applied towards outage communication and collaboration. To verify that the technology options researched and demonstrated through this pilot project would in fact have broad application for the US commercial nuclear fleet, and to look for additional outage management best practices, LWRS program researchers visited several additional nuclear facilities.

  1. Improvement of visual field defects after focal resection for occipital lobe epilepsy: case report.

    Science.gov (United States)

    Yamamoto, Takahiro; Hamasaki, Tadashi; Nakamura, Hideo; Yamada, Kazumichi

    2018-03-01

    Improvement of visual field defects after surgical treatment for occipital lobe epilepsy is rare. Here, the authors report on a 24-year-old man with a 15-year history of refractory epilepsy that developed after he had undergone an occipital craniotomy to remove a cerebellar astrocytoma at the age of 4. His seizures started with an elementary visual aura, followed by secondary generalized tonic-clonic convulsion. Perimetry revealed left-sided incomplete hemianopia, and MRI showed an old contusion in the right occipital lobe. After evaluation with ictal video-electroencephalography, electrocorticography, and mapping of the visual cortex with subdural electrodes, the patient underwent resection of the scarred tissue, including the epileptic focus at the occipital lobe. After surgery, he became seizure free and his visual field defect improved gradually. In addition, postoperative 123 I-iomazenil (IMZ) SPECT showed partly normalized IMZ uptake in the visual cortex. This case is a practical example suggesting that neurological deficits attributable to the functional deficit zone can be remedied by successful focal resection.

  2. Feasibility study on improving SO/sub 2/ abatement economics through improvements in byproduct utilization. Final report. 2 Volumes

    Energy Technology Data Exchange (ETDEWEB)

    1984-01-17

    This study was undertaken to assess the technical feasibility of improving SO/sub 2/ abatement economics through improvements in byproduct utilization, and to recommend the most appropriate strategy for fostering the development and commericalization of such technology. Existing byproduct technology was reviewed and the potential for new technology assessed. This was done by a literature review and a survey of individuals and organizations actively engaged in this area. The assessment is confined to technical aspects only. This phase of the study concludes that there is a wide range of abatement byproduct technology, at various stages of development, which if appropriately exploited, offers the potential of improving byproduct utility and value, and hence the economics of Canadian SO/sub 2/ abatement. The second phase of this study addresses the problem of the most effective strategy for ensuring the development and commercialization of appropriate byproduct technology. This is based on discussions with individuals and organizations involved in the field, and assessment of the motivation and potential effectiveness of alternative approaches within the context of a diverse Canadian industry, the technology status in Canada and the national need. Includes 51-page bibliography. 400 refs., 14 tabs.

  3. Room for improvement

    DEFF Research Database (Denmark)

    Sandal, Louise F; Thorlund, Jonas B; Moore, Andrew J

    2018-01-01

    -reported outcomes and qualitative findings supported the primary finding, while improvements in muscle strength and aerobic capacity did not differ between exercise groups. CONCLUSION: Results suggest that the physical environment contributes to treatment response. Matching patients' preferences to treatment rooms...... significance (p=0.07). Waitlist group reported no improvement (-0.05 95% CI -0.5 to 0.4). In interviews, participants from the standard environment expressed greater social cohesion and feeling at home. Qualitative themes identified; reflection, sense of fellowship and transition. Secondary patient...... may improve patient-reported outcomes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02043613....

  4. Embedded Sensors and Controls to Improve Component Performance and Reliability -- Bench-scale Testbed Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Melin, Alexander M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kisner, Roger A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Drira, Anis [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Reed, Frederick K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-09-01

    Embedded instrumentation and control systems that can operate in extreme environments are challenging due to restrictions on sensors and materials. As a part of the Department of Energy's Nuclear Energy Enabling Technology cross-cutting technology development programs Advanced Sensors and Instrumentation topic, this report details the design of a bench-scale embedded instrumentation and control testbed. The design goal of the bench-scale testbed is to build a re-configurable system that can rapidly deploy and test advanced control algorithms in a hardware in the loop setup. The bench-scale testbed will be designed as a fluid pump analog that uses active magnetic bearings to support the shaft. The testbed represents an application that would improve the efficiency and performance of high temperature (700 C) pumps for liquid salt reactors that operate in an extreme environment and provide many engineering challenges that can be overcome with embedded instrumentation and control. This report will give details of the mechanical design, electromagnetic design, geometry optimization, power electronics design, and initial control system design.

  5. Can use of an administrative database improve accuracy of hospital-reported readmission rates?

    Science.gov (United States)

    Edgerton, James R; Herbert, Morley A; Hamman, Baron L; Ring, W Steves

    2018-05-01

    Readmission rates after cardiac surgery are being used as a quality indicator; they are also being collected by Medicare and are tied to reimbursement. Accurate knowledge of readmission rates may be difficult to achieve because patients may be readmitted to different hospitals. In our area, 81 hospitals share administrative claims data; 28 of these hospitals (from 5 different hospital systems) do cardiac surgery and share Society of Thoracic Surgeons (STS) clinical data. We used these 2 sources to compare the readmissions data for accuracy. A total of 45,539 STS records from January 2008 to December 2016 were matched with the hospital billing data records. Using the index visit as the start date, the billing records were queried for any subsequent in-patient visits for that patient. The billing records included date of readmission and hospital of readmission data and were compared with the data captured in the STS record. We found 1153 (2.5%) patients who had STS records that were marked "No" or "missing," but there were billing records that showed a readmission. The reported STS readmission rate of 4796 (10.5%) underreported the readmission rate by 2.5 actual percentage points. The true rate should have been 13.0%. Actual readmission rate was 23.8% higher than reported by the clinical database. Approximately 36% of readmissions were to a hospital that was a part of a different hospital system. It is important to know accurate readmission rates for quality improvement processes and institutional financial planning. Matching patient records to an administrative database showed that the clinical database may fail to capture many readmissions. Combining data with an administrative database can enhance accuracy of reporting. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  6. Utilization of wind energy in greater Hanover

    International Nuclear Information System (INIS)

    Sahling, U.

    1993-01-01

    Since the beginning of the Eighties, the association of communities of Greater Hanover has dealt intensively with energy and ecopolitical questions in the scope of regional planning. Renewable energy sources play a dominant role in this context. This brochure is the third contribution to the subject ''Energy policy and environmental protection''. Experts as well as possibly interested parties are addressed especially. For all 8 contributions contained, separate entries have been recorded in this database. (BWI) [de

  7. Small cities face greater impact from automation

    OpenAIRE

    Frank, Morgan R.; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad

    2017-01-01

    The city has proven to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: How will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across U.S. urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content su...

  8. The Greater Sekhukhune-CAPABILITY outreach project.

    Science.gov (United States)

    Gregersen, Nerine; Lampret, Julie; Lane, Tony; Christianson, Arnold

    2013-07-01

    The Greater Sekhukhune-CAPABILITY Outreach Project was undertaken in a rural district in Limpopo, South Africa, as part of the European Union-funded CAPABILITY programme to investigate approaches for capacity building for the translation of genetic knowledge into care and prevention of congenital disorders. Based on previous experience of a clinical genetic outreach programme in Limpopo, it aimed to initiate a district clinical genetic service in Greater Sekhukhune to gain knowledge and experience to assist in the implementation and development of medical genetic services in South Africa. Implementing the service in Greater Sekhukhune was impeded by a developing staff shortage in the province and pressure on the health service from the existing HIV/AIDS and TB epidemics. This situation underscores the need for health needs assessment for developing services for the care and prevention of congenital disorders in middle- and low-income countries. However, these impediments stimulated the pioneering of innovate ways to offer medical genetic services in these circumstances, including tele-teaching of nurses and doctors, using cellular phones to enhance clinical care and adapting and assessing the clinical utility of a laboratory test, QF-PCR, for use in the local circumstances.

  9. Operational technology for greater confinement disposal

    International Nuclear Information System (INIS)

    Dickman, P.T.; Vollmer, A.T.; Hunter, P.H.

    1984-12-01

    Procedures and methods for the design and operation of a greater confinement disposal facility using large-diameter boreholes are discussed. It is assumed that the facility would be located at an operating low-level waste disposal site and that only a small portion of the wastes received at the site would require greater confinement disposal. The document is organized into sections addressing: facility planning process; facility construction; waste loading and handling; radiological safety planning; operations procedures; and engineering cost studies. While primarily written for low-level waste management site operators and managers, a detailed economic assessment section is included that should assist planners in performing cost analyses. Economic assessments for both commercial and US government greater confinement disposal facilities are included. The estimated disposal costs range from $27 to $104 per cubic foot for a commercial facility and from $17 to $60 per cubic foot for a government facility. These costs are based on average site preparation, construction, and waste loading costs for both contact- and remote-handled wastes. 14 figures, 22 tables

  10. Orthodontic clockwise rotation of maxillomandibular complex for improving facial profile in late teenagers with Class III malocclusion: A preliminary report

    OpenAIRE

    Eric JW Liou; Yu-Chi Wang

    2018-01-01

    Objective: Orthodontic camouflage treatments improve occlusion but might worsen facial profile in patients with Class III malocclusion. It has been reported that surgical clockwise rotation of maxillomandibular complex (MMc) improves facial profile by reducing chin prominence and chin throat length in patients with Class III malocclusion. The purpose of this report was to illustrate two orthodontic techniques for clockwise rotation of the MMc in late teenagers with Class III malocclusion and ...

  11. Impact of a reengineered electronic error-reporting system on medication event reporting and care process improvements at an urban medical center.

    Science.gov (United States)

    McKaig, Donald; Collins, Christine; Elsaid, Khaled A

    2014-09-01

    A study was conducted to evaluate the impact of a reengineered approach to electronic error reporting at a 719-bed multidisciplinary urban medical center. The main outcome of interest was the monthly reported medication errors during the preimplementation (20 months) and postimplementation (26 months) phases. An interrupted time series analysis was used to describe baseline errors, immediate change following implementation of the current electronic error-reporting system (e-ERS), and trend of error reporting during postimplementation. Errors were categorized according to severity using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Medication Error Index classifications. Reported errors were further analyzed by reporter and error site. During preimplementation, the monthly reported errors mean was 40.0 (95% confidence interval [CI]: 36.3-43.7). Immediately following e-ERS implementation, monthly reported errors significantly increased by 19.4 errors (95% CI: 8.4-30.5). The change in slope of reported errors trend was estimated at 0.76 (95% CI: 0.07-1.22). Near misses and no-patient-harm errors accounted for 90% of all errors, while errors that caused increased patient monitoring or temporary harm accounted for 9% and 1%, respectively. Nurses were the most frequent reporters, while physicians were more likely to report high-severity errors. Medical care units accounted for approximately half of all reported errors. Following the intervention, there was a significant increase in reporting of prevented errors and errors that reached the patient with no resultant harm. This improvement in reporting was sustained for 26 months and has contributed to designing and implementing quality improvement initiatives to enhance the safety of the medication use process.

  12. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2002-2003.

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Sheryl

    2004-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near the present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville Confederated

  13. Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project, Annual Report 2001-2002.

    Energy Technology Data Exchange (ETDEWEB)

    Sears, Sheryl

    2003-01-01

    The construction of Chief Joseph and Grand Coulee Dams completely and irrevocably blocked anadromous fish migrations to the Upper Columbia River. Historically this area hosted vast numbers of salmon returning to their natal waters to reproduce and die. For the native peoples of the region, salmon and steelhead were a principle food source, providing physical nourishment and spiritual sustenance, and contributing to the religious practices and the cultural basis of tribal communities. The decaying remains of spawned-out salmon carcasses contributed untold amounts of nutrients into the aquatic, aerial, and terrestrial ecosystems of tributary habitats in the upper basin. Near the present site of Kettle Falls, Washington, the second largest Indian fishery in the state existed for thousands of years. Returning salmon were caught in nets and baskets or speared on their migration to the headwater of the Columbia River in British Columbia. Catch estimates at Kettle Falls range from 600,000 in 1940 to two (2) million around the turn of the century (UCUT, Report No.2). The loss of anadromous fish limited the opportunities for fisheries management and enhancement exclusively to those actions addressed to resident fish. The Lake Roosevelt Rainbow Trout Habitat/Passage Improvement Project is a mitigation project intended to enhance resident fish populations and to partially mitigate for anadromous fish losses caused by hydropower system impacts. This substitution of resident fish for anadromous fish losses is considered in-place and out-of-kind mitigation. Upstream migration and passage barriers limit the amount of spawning and rearing habitat that might otherwise be utilized by rainbow trout. The results of even limited stream surveys and habitat inventories indicated that a potential for increased natural production exists. However, the lack of any comprehensive enhancement measures prompted the Upper Columbia United Tribes Fisheries Center (UCUT), Colville Confederated

  14. To report or not to report: a psychosocial investigation aimed at improving early detection of Avian Influenza outbreaks

    NARCIS (Netherlands)

    A.R.W. Elbers; M.J. Gorgievski-Duijvesteijn (Marjan); K. Zarafshani (Kiumars); G. Koch (Guus)

    2010-01-01

    textabstractSummary: The aim of this study was to identify difficulties and barriers to reporting clinically suspect situations, possibly caused by avian influenza (AI), and to explore possible incentives to reporting such situations, with the ultimate aim of facilitating early detection of AI

  15. A call for action: Improve reporting of research studies to increase the scientific basis for regulatory decision-making

    DEFF Research Database (Denmark)

    Ågerstrand, Marlene; Christiansen, Sofie; Hanberg, Annika

    2018-01-01

    This is a call for action to scientific journals to introduce reporting requirements for toxicity and ecotoxicity studies. Such reporting requirements will support the use of peer-reviewed research studies in regulatory decision-making. Moreover, this could improve the reliability...... and reproducibility of published studies in general and make better use of the resources spent in research....

  16. A call for action: Improve reporting of research studies to increase the scientific basis for regulatory decision-making

    DEFF Research Database (Denmark)

    Ågerstrand, Marlene; Christiansen, Sofie; Hanberg, Annika

    2018-01-01

    This is a call for action to scientific journals to introduce reporting requirements for toxicity and ecotoxicity studies. Such reporting requirements will support the use of peer-reviewed research studies in regulatory decision-making. Moreover, this could improve the reliability and reproducibi...

  17. Federally Sponsored Research at Educational Institutions: A Need for Improved Accountability. Report by the U.S. General Accounting Office.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    This report discusses federally sponsored research at educational institutions and suggests ways to improve accountability for these funds. The following suggestions are made for minimizing problems presented in this report: (1) development of more definitive cost principles for both the institutions and the Federal auditors to follow; (2) more…

  18. College Affordability for Low-Income Adults: Improving Returns on Investment for Families and Society. Report #C412

    Science.gov (United States)

    Gault, Barbara; Reichlin, Lindsey; Román, Stephanie

    2014-01-01

    This report examines how efforts to understand and improve college affordability can be informed by the experiences and circumstances of low-income adults, students of color, and students with dependent children. The report discusses how the time and financial demands associated with financial independence, parenthood, and work affect a student's…

  19. Active music therapy improves cognition and behaviour in chronic vascular encephalopathy: a case report.

    Science.gov (United States)

    Giovagnoli, Anna Rita; Oliveri, Serena; Schifano, Letizia; Raglio, Alfredo

    2014-02-01

    This study describes the effects of active music therapy (AMT) on cognition and behaviour in chronic vascular encephalopathy. A single case study investigated different cognitive and psycho-behavioural changes after AMT. An adult patient with memory, attention, and verbal fluency deficits associated with Vascular Cognitive Impairment-No Dementia (VCI-ND) was treated. A four-months AMT course was based on creative and interactive music playing. Sixteen sessions were conducted simultaneously to the pharmacological therapy. Cognitive performances, mood, interpersonal interactions, and perceived abilities were assessed using standardized neuropsychological and psycho-behavioural measurements. At baseline, the patient reported a tendency to feel tense, nervous, and angry and difficulties in memory and visuospatial performances, frequently accompanied by attention drops. The social network was a habitual component of the patient's life, but not a source of sharing of personal experiences, safety or comfort. Neuropsychological tests showed deficits in object and figure naming, verbal fluency, short and long-term verbal memory, short-term spatial memory, selective attention, and visuomotor coordination. After AMT, the cognitive profile significantly improved in attention, visuomotor coordination, and verbal and spatial memory. Such positive changes were confirmed at the three-months follow-up. An increase of the interpersonal interactions and consistent reduction of anxiety were also observed. In selected patients with VCI-ND, a well-structured AMT intervention added to standard therapy may contribute in determining a stable improvement of cognitive and psycho-behavioural aspects. Controlled studies are needed to confirm these promising results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Comprehensive approach to improving maternal health and achieving MDG 5: report from the mountains of Lesotho.

    Directory of Open Access Journals (Sweden)

    Hind Satti

    Full Text Available BACKGROUND: Although it is now widely recognized that reductions in maternal mortality and improvements in women's health cannot be achieved through simple, vertical strategies, few programs have provided successful models for how to integrate services into a comprehensive program for maternal health. We report our experience in rural Lesotho, where Partners In Health (PIH in partnership with the Ministry of Health and Social Welfare implemented a program that provides comprehensive care of pregnant women from the community to the clinic level. METHODS: Between May and July 2009, PIH trained 100 women, many of whom were former traditional birth attendants, to serve as clinic-affiliated maternal health workers. They received performance-based incentives for accompanying pregnant women during antenatal care (ANC visits and facility-based delivery. A nurse-midwife provided ANC and delivery care and supervised the maternal health workers. To overcome geographic barriers to delivering at the clinic, women who lived far from the clinic stayed at a maternal lying-in house prior to their expected delivery dates. We analyzed data routinely collected from delivery and ANC registers to compare service utilization before and after implementation of the program. RESULTS: After the establishment of the program, the average number first ANC visits increased from 20 to 31 per month. The clinic recorded 178 deliveries in the first year of the program and 216 in the second year, compared to 46 in the year preceding the program. During the first two years of the program, 49 women with complications were successfully transported to the district hospital, and no maternal deaths occurred among the women served by the program. CONCLUSIONS: Our results demonstrate that it is possible to achieve dramatic improvements in the utilization of maternal health services and facility-based delivery by strengthening human resource capacity, implementing active follow-up in the

  1. Improvements in tongue strength and pressure-generation precision following a tongue-pressure training protocol in older individuals with dysphagia: Three case reports

    Directory of Open Access Journals (Sweden)

    Erin M Yeates

    2008-12-01

    Full Text Available Erin M Yeates1, Sonja M Molfenter1, Catriona M Steele1,2,3,41Toronto Rehabilitation Institute, Toronto, Canada; 2Department of Speech-Language Pathology, University of Toronto, Toronto, Canada; 3Canadian Institutes of Health Research New Investigator in Aging; 4Bloorview Kids Rehab, Toronto, CanadaAbstract: Dysphagia, or difficulty swallowing, often occurs secondary to conditions such as stroke, head injury or progressive disease, many of which increase in frequency with advancing age. Sarcopenia, the gradual loss of muscle bulk and strength, can place older individuals at greater risk for dysphagia. Data are reported for three older participants in a pilot trial of a tongue-pressure training therapy. During the experimental therapy protocol, participants performed isometric strength exercises for the tongue as well as tongue pressure accuracy tasks. Biofeedback was provided using the Iowa Oral Performance Instrument (IOPI, an instrument that measures tongue pressure. Treatment outcome measures show increased isometric tongue strength, improved tongue pressure generation accuracy, improved bolus control on videofluoroscopy, and improved functional dietary intake by mouth. These preliminary results indicate that, for these three adults with dysphagia, tongue-pressure training was beneficial for improving both instrumental and functional aspects of swallowing. The experimental treatment protocol holds promise as a rehabilitative tool for various dysphagia populations.Keywords: speech-language pathology, dysphagia, rehabilitation, aging, strength, accuracy

  2. Greater happiness for a greater number: Is that possible in Austria?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2011-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the happiness of the great number could not be measured

  3. Greater happiness for a greater number: Is that possible? If so how? (Arabic)

    NARCIS (Netherlands)

    R. Veenhoven (Ruut); E. Samuel (Emad)

    2012-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time, the happiness of the great number could not be

  4. Greater happiness for a greater number: Is that possible in Germany?

    NARCIS (Netherlands)

    R. Veenhoven (Ruut)

    2009-01-01

    textabstractWhat is the final goal of public policy? Jeremy Bentham (1789) would say: greater happiness for a greater number. He thought of happiness as subjective enjoyment of life; in his words as “the sum of pleasures and pains”. In his time the Happiness of the great number could not be measured

  5. The a3 problem solving report: a 10-step scientific method to execute performance improvements in an academic research vivarium.

    Science.gov (United States)

    Bassuk, James A; Washington, Ida M

    2013-01-01

    The purpose of this study was to illustrate the application of A3 Problem Solving Reports of the Toyota Production System to our research vivarium through the methodology of Continuous Performance Improvement, a lean approach to healthcare management at Seattle Children's (Hospital, Research Institute, Foundation). The Report format is described within the perspective of a 10-step scientific method designed to realize measurable improvements of Issues identified by the Report's Author, Sponsor and Coach. The 10-step method (Issue, Background, Current Condition, Goal, Root Cause, Target Condition, Countermeasures, Implementation Plan, Test, and Follow-up) was shown to align with Shewhart's Plan-Do-Check-Act process improvement cycle in a manner that allowed for quantitative analysis of the Countermeasure's outcomes and of Testing results. During fiscal year 2012, 9 A3 Problem Solving Reports were completed in the vivarium under the teaching and coaching system implemented by the Research Institute. Two of the 9 reports are described herein. Report #1 addressed the issue of the vivarium's veterinarian not being able to provide input into sick animal cases during the work day, while report #7 tackled the lack of a standard in keeping track of weekend/holiday animal health inspections. In each Report, a measurable Goal that established the basis for improvement recognition was present. A Five Whys analysis identified the Root Cause for Report #1 as historical work patterns that existed before the veterinarian was hired on and that modern electronic communication tools had not been implemented. The same analysis identified the Root Cause for Report #7 as the vivarium had never standardized the process for weekend/holiday checks. Successful outcomes for both Reports were obtained and validated by robust audit plans. The collective data indicate that vivarium staff acquired a disciplined way of reporting on, as well as solving, problems in a manner consistent with high

  6. The a3 problem solving report: a 10-step scientific method to execute performance improvements in an academic research vivarium.

    Directory of Open Access Journals (Sweden)

    James A Bassuk

    Full Text Available The purpose of this study was to illustrate the application of A3 Problem Solving Reports of the Toyota Production System to our research vivarium through the methodology of Continuous Performance Improvement, a lean approach to healthcare management at Seattle Children's (Hospital, Research Institute, Foundation. The Report format is described within the perspective of a 10-step scientific method designed to realize measurable improvements of Issues identified by the Report's Author, Sponsor and Coach. The 10-step method (Issue, Background, Current Condition, Goal, Root Cause, Target Condition, Countermeasures, Implementation Plan, Test, and Follow-up was shown to align with Shewhart's Plan-Do-Check-Act process improvement cycle in a manner that allowed for quantitative analysis of the Countermeasure's outcomes and of Testing results. During fiscal year 2012, 9 A3 Problem Solving Reports were completed in the vivarium under the teaching and coaching system implemented by the Research Institute. Two of the 9 reports are described herein. Report #1 addressed the issue of the vivarium's veterinarian not being able to provide input into sick animal cases during the work day, while report #7 tackled the lack of a standard in keeping track of weekend/holiday animal health inspections. In each Report, a measurable Goal that established the basis for improvement recognition was present. A Five Whys analysis identified the Root Cause for Report #1 as historical work patterns that existed before the veterinarian was hired on and that modern electronic communication tools had not been implemented. The same analysis identified the Root Cause for Report #7 as the vivarium had never standardized the process for weekend/holiday checks. Successful outcomes for both Reports were obtained and validated by robust audit plans. The collective data indicate that vivarium staff acquired a disciplined way of reporting on, as well as solving, problems in a manner

  7. Improved solid oxide fuel cell stacks: Power density, durability and modularity. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Lund Frandsen, H.; Kiebach, W.R.; Hoeegh, J. (Technical Univ. of Denmark. Risoe National Lab. for Sustainable Energy, Roskilde (Denmark)) (and others)

    2010-10-15

    This report presents the work performed within the project PSO2009-1-10207 during the period from 01-04-2009 - 31-06-2010. The report is divided into three parts covering the three work packages: Stack components; Stacks and durability; and Large SOFC systems: modularity and scalability. The project contains 38 milestones and all milestones in the project have been either fully or partly fulfilled. Two major achievements within this project concern the robustness towards dynamic operations and implementation of cells with more active cathodes: Within this project tools to evaluate and test SOFC stacks with respect to robustness during dynamic operations has been developed. From stack tests performed under dynamic conditions it was observed that the effect on degradation and failure seemed to be very little. The thermo-mechanical models developed in this project in combination with the dynamic stack model was used in combination to understand why. The results clearly showed that the hardest stress field applied to the cells arises from the steady state operating point rather than from the dynamic conditions. This is a very promising result concerning the fact that especially small CHP units in a commercial system will experience dynamic conditions from load cycling and thermal cycling. A new type of cell with a more active cathode has been formulated and introduced into the TOFC stacks in this project. The aim was to improve the effect of the stack by 25 %. However, compared to a standard stack with the ''old'' cells, the stack effect was increased by 44% - from a cross flow stack with standard 2G cells to a cross flow stack with 2.5G cells. The new type of cells also show an excellent stability towards moisture in the cathode feed, and a stack with 2.5G cells has been tested for 12.000 hrs with a degradation rate of 30 mOMEGAcm2/1000 hr. (Author)

  8. Improving the security of electricity supply - report by a rapporteur ad int

    International Nuclear Information System (INIS)

    Forsten, J.; Lehtonen, M.

    2002-07-01

    The storms 'Pyry' and 'Janika', which swept over Finland in October-November 2001, caused serious damages to the operability of electric systems and led to long-term and extensive interruptions in electricity supply especially in Pirkanmaa, Central Home, Poijat-Hame and in the Uusimaa region. Although the security of electricity supply in Finland has in general been on a high level, the needs of customers concerning the quality of electrical power are constantly growing, and the operational reliability of the distribution networks will thereby have to be developed. The Rapporteur ad int. appointed by the Ministry of Trade and Industry on 21 November 2001 considers that such a scheme complementing the price reduction under the Electricity Market Act should be set up that would require a fixed compensation from the distribution network operators in the case of non deliverance of electricity. The fixed compensation should be paid automatically for e.g. interruptions lasting over 12 hours. The sum would depend on the length of the interruption and on the customer's annual rate of the network service fee. The Rapporteur also gives a number of other recommendations for improving the situation. Each distribution network operator is to choose the means of improvement on a technical-economical basis. The required level in the design, construction, operation and maintenance of an electrical network should guarantee that the interruptions in electricity supply would not exceed six hours even in exceptional circumstances. Ensuring electrical safety is of prime importance in disturbance situations. Shortening the interruption times and improving the quality of electricity call for sustained investment planning and activities. The distribution network operators should draw up a ten-year action plan. including measures aiming to reduce interruptions and the related timetables. To be able to keep the interruption times short in extensive cases of disturbance, the distribution

  9. Report: EPA Should Improve Controls for Managing Contractor-Held Property

    Science.gov (United States)

    Report #12-P-0388, April 3, 2012. EPA does not have effective oversight of CHP, did not accurately report CHP in its FY 2010 financial statements, and did not fully implement corrective actions from an OIG 2006 audit report.

  10. Search for greater stability in nuclear regulation

    International Nuclear Information System (INIS)

    Asselstine, J.K.

    1985-01-01

    The need for greater stability in nuclear regulation is discussed. Two possible approaches for dealing with the problems of new and rapidly changing regulatory requirements are discussed. The first approach relies on the more traditional licensing reform initiatives that have been considered off and on for the past decade. The second approach considers a new regulator philosophy aimed at the root causes of the proliferation of new safety requirements that have been imposed in recent years. For the past few years, the concepts of deregulation and regulatory reform have been in fashion in Washington, and the commercial nuclear power program has not remained unaffected. Many look to these concepts to provide greater stability in the regulatory program. The NRC, the nuclear industry and the administration have all been avidly pursuing regulatory reform initiatives, which take the form of both legislative and administrative proposals. Many of these proposals look to the future, and, if adopted, would have little impact on currently operating nuclear power plants or plants now under construction

  11. Women at greater risk of HIV infection.

    Science.gov (United States)

    Mahathir, M

    1997-04-01

    Although many people believe that mainly men get infected with HIV/AIDS, women are actually getting infected at a faster rate than men, especially in developing countries, and suffer more from the adverse impact of AIDS. As of mid-1996, the Joint UN Program on AIDS estimated that more than 10 million of the 25 million adults infected with HIV since the beginning of the epidemic are women. The proportion of HIV-positive women is growing, with almost half of the 7500 new infections daily occurring among women. 90% of HIV-positive women live in a developing country. In Asia-Pacific, 1.4 million women have been infected with HIV out of an estimated total 3.08 million adults from the late 1970s until late 1994. Biologically, women are more vulnerable than men to infection because of the greater mucus area exposed to HIV during penile penetration. Women under age 17 years are at even greater risk because they have an underdeveloped cervix and low vaginal mucus production. Concurrent sexually transmitted diseases increase the risk of HIV transmission. Women's risk is also related to their exposure to gender inequalities in society. The social and economic pressures of poverty exacerbate women's risk. Prevention programs are discussed.

  12. Torsion of the greater omentum: A rare preoperative diagnosis

    International Nuclear Information System (INIS)

    Tandon, Ankit Anil; Lim, Kian Soon

    2010-01-01

    Torsion of the greater omentum is a rare acute abdominal condition that is seldom diagnosed preoperatively. We report the characteristic computed tomography (CT) scan findings and the clinical implications of this unusual diagnosis in a 41-year-old man, who also had longstanding right inguinal hernia. Awareness of omental torsion as a differential diagnosis in the acute abdomen setting is necessary for correct patient management

  13. Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report

    Directory of Open Access Journals (Sweden)

    Mann Christian

    2011-09-01

    Full Text Available Abstract Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100% oxygen with a flow of 2.0 L/minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O, with pressure support of 4 cmH2O, trigger at 1.4 mL/second, and a maximum inspiratory time of 0.7 seconds. Over the course of seven weeks, the patient's maximum daytime fraction of inspired oxygen via nasal cannula decreased from 1.0 to 0.75, his respiratory rate from 64 breaths/minute to 50 breaths/minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented, noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy.

  14. Embedded Sensors and Controls to Improve Component Performance and Reliability: Conceptual Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Kisner, Roger A [ORNL; Melin, Alexander M [ORNL; Burress, Timothy A [ORNL; Fugate, David L [ORNL; Holcomb, David Eugene [ORNL; Wilgen, John B [ORNL; Miller, John M [ORNL; Wilson, Dane F [ORNL; Silva, Pamela C [ORNL; Whitlow, Lynsie J [ORNL; Peretz, Fred J [ORNL

    2012-10-01

    The overall project objective is to demonstrate improved reliability and increased performance made possible by deeply embedding instrumentation and controls (I&C) in nuclear power plant components. The project is employing a highly instrumented canned rotor, magnetic bearing, fluoride salt pump as its I&C technology demonstration vehicle. The project s focus is not primarily on pump design, but instead is on methods to deeply embed I&C within a pump system. However, because the I&C is intimately part of the basic millisecond-by-millisecond functioning of the pump, the I&C design cannot proceed in isolation from the other aspects of the pump. The pump will not function if the characteristics of the I&C are not embedded within the design because the I&C enables performance of the basic function rather than merely monitoring quasi-stable performance. Traditionally, I&C has been incorporated in nuclear power plant (NPP) components after their design is nearly complete; adequate performance was obtained through over-design. This report describes the progress and status of the project and provides a conceptual design overview for the embedded I&C pump.

  15. Combined diversity and improved energy detection in cooperative spectrum sensing with faded reporting channels

    Directory of Open Access Journals (Sweden)

    Srinivas Nallagonda

    2016-04-01

    Full Text Available In this paper we evaluate the performance of cooperative spectrum sensing (CSS where each cognitive radio (CR employs an improved energy detector (IED with multiple antennas and uses selection combining (SC for detecting the primary user (PU in noisy and faded sensing (S channels. We derive an expression for the probability of false alarm and expressions for probability of missed detection in non-faded (AWGN and Rayleigh faded sensing environments in terms of cumulative distribution function (CDF. Each CR transmits its decision about PU via noisy and faded reporting (R channel to fusion center (FC. In this paper we assume that S-channels are noisy and Rayleigh faded while several cases of fading are considered for R-channels such as: (i Hoyt (or Nakagami-q, (ii Rayleigh, (iii Rician (or Nakagami-n, and (iv Weibull. A Binary Symmetric channel (BSC with a fixed error probability (r in the R-channel is also considered. The impact of fading in R-channel, S-channel and several network parameters such as IED parameter, normalized detection threshold, number of CRs, and number of antennas on missed detection and total error probability is assessed. The effects of Hoyt, Rician, and Weibull fading parameters on overall performance of IED-CSS are also highlighted.

  16. Improvements of the cash-flow statement control function in financial reporting

    Directory of Open Access Journals (Sweden)

    Metka Duhovnik

    2008-06-01

    Full Text Available On the basis of deductive considerations applying professional judgement, the article focuses on the additional value of accounting information that can be given to the users of fi nancial statements by a properly prepared statement of cash fl ows. It is based on the fi nding that the professional literature is inconsistent in distinguishing liquidity and profi tability information, and consequently also in distinguishing between the ratios calculated on that basis. It therefore stimulates an improvement in the quality of accounting information with a direct statement of cash fl ows, based on tracing instead of calculating the actual cash fl ow. On the basis of fi nancial statements, including a direct statement of cash fl ows, the ratio analysis of fi nancial statements should be approached from both aspects of profi tability and cash return. The cash fl ow ratios would serve as a control mechanism over the assumptions used when preparing the balance sheet and income statement within the chosen financial reporting framework.

  17. Uses of tuberculosis mortality surveillance to identify programme errors and improve database reporting.

    Science.gov (United States)

    Selig, L; Guedes, R; Kritski, A; Spector, N; Lapa E Silva, J R; Braga, J U; Trajman, A

    2009-08-01

    In 2006, 848 persons died from tuberculosis (TB) in Rio de Janeiro, Brazil, corresponding to a mortality rate of 5.4 per 100 000 population. No specific TB death surveillance actions are currently in place in Brazil. Two public general hospitals with large open emergency rooms in Rio de Janeiro City. To evaluate the contribution of TB death surveillance in detecting gaps in TB control. We conducted a survey of TB deaths from September 2005 to August 2006. Records of TB-related deaths and deaths due to undefined causes were investigated. Complementary data were gathered from the mortality and TB notification databases. Seventy-three TB-related deaths were investigated. Transmission hazards were identified among firefighters, health care workers and in-patients. Management errors included failure to isolate suspected cases, to confirm TB, to correct drug doses in underweight patients and to trace contacts. Following the survey, 36 cases that had not previously been notified were included in the national TB notification database and the outcome of 29 notified cases was corrected. TB mortality surveillance can contribute to TB monitoring and evaluation by detecting correctable and specific programme- and hospital-based care errors, and by improving the accuracy of TB database reporting. Specific local and programmatic interventions can be proposed as a result.

  18. A CHANGE DETECTION AND RESOURCE-AWARE DATA SENSING APPROACHES FOR IMPROVING THE REPORTING PROTOCOL MECHANISM FOR MOBILE USER

    Directory of Open Access Journals (Sweden)

    annisaa sri indrawanti

    2015-08-01

    Full Text Available Update mechanism is an important process that relays information to the end-user by sending the data from the client to the server. There are several kinds of update mechanism that are used, one of them is reporting protocol. Reporting protocol sends the data from the client to the server continuously in a certain time interval. Reporting protocol occasionally sends the same information repeatedly to the end-user and sometimes the data aren’t needed by the end-user. This is an issue, because it can cause a large amount of bandwidth usage. In this research, we have developed an improvement of the reporting protocol mechanism for mobile user using change detection and resource-aware data sensing to minimize the bandwidth and resource usage. The improvement of reporting protocol that is implemented reduces frequency of data transfer with the prediction of the changes in user activity and position. The prediction is used as a trigger when the data is about to be sent. The results have shown that the adaptive reporting protocol could improve the performance of the overall reporting protocol. This is shown by the improvement of the bandwidth efficiency up to 36-97%, memory efficiency at 1.5-6% and battery efficiency at 7-13%.

  19. Towards Greater Harmonisation of Decommissioning Cost Estimates

    International Nuclear Information System (INIS)

    O'Sullivan, Patrick; ); Laraia, Michele; ); LaGuardia, Thomas S.

    2010-01-01

    The NEA Decommissioning Cost Estimation Group (DCEG), in collaboration with the IAEA Waste Technology Section and the EC Directorate-General for Energy and Transport, has recently studied cost estimation practices in 12 countries - Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Slovakia, Spain, Sweden, the United Kingdom and the United States. Its findings are to be published in an OECD/NEA report entitled Cost Estimation for Decommissioning: An International Overview of Cost Elements, Estimation Practices and Reporting Requirements. This booklet highlights the findings contained in the full report. (authors)

  20. The outcome of endoscopy for recalcitrant greater trochanteric pain syndrome.

    Science.gov (United States)

    Drummond, James; Fary, Camdon; Tran, Phong

    2016-11-01

    Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here. We retrospectively reviewed 49 patients (57 operations) who had undergone endoscopic longitudinal vertical iliotibial band release and trochanteric bursectomy. Inclusion criteria included diagnosed GTPS with a minimum of six months of non-operative treatment. Exclusion criteria included concomitant intra- or extra-articular hip pathology and previous hip surgery including total hip arthroplasty. Outcomes were assessed using the Visual Analogue Scale, Oxford hip Score and International Hip Outcome Tool (iHOT-33). The series included 42 females and 7 males with a mean age of 65.0 years (26.7-88.6). Mean follow-up time was 20.7 months (5.3-41.2). Eight patients had full thickness gluteal tendon tears, of which 7 were repaired. Adjuvant PRP was injected intraoperatively in 38 of 57 operations (67.2 %). At follow-up, overall mean Visual Analogue Scale values had decreased from 7.8 to 2.8 (p < 0.001), Oxford hip Scores had increased from 20.4 to 37.3 (p < 0.001) and iHOT-33 scores had increased from 23.8 to 70.2 (p < 0.001). Of the 57 operations performed, patients reported feeling very satisfied with the surgical outcome in 28 operations (49.1 %), satisfied in 17 operations (29.8 %) and less than satisfied in 12 operations (21.1 %). While the majority of patients with GTPS will improve with non-operative management, endoscopic iliotibial band release, trochanteric bursectomy and gluteal tendon repair is a safe and effective treatment for severe

  1. Small cities face greater impact from automation.

    Science.gov (United States)

    Frank, Morgan R; Sun, Lijun; Cebrian, Manuel; Youn, Hyejin; Rahwan, Iyad

    2018-02-01

    The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. © 2018 The Authors.

  2. Small cities face greater impact from automation

    Science.gov (United States)

    Sun, Lijun; Cebrian, Manuel; Rahwan, Iyad

    2018-01-01

    The city has proved to be the most successful form of human agglomeration and provides wide employment opportunities for its dwellers. As advances in robotics and artificial intelligence revive concerns about the impact of automation on jobs, a question looms: how will automation affect employment in cities? Here, we provide a comparative picture of the impact of automation across US urban areas. Small cities will undertake greater adjustments, such as worker displacement and job content substitutions. We demonstrate that large cities exhibit increased occupational and skill specialization due to increased abundance of managerial and technical professions. These occupations are not easily automatable, and, thus, reduce the potential impact of automation in large cities. Our results pass several robustness checks including potential errors in the estimation of occupational automation and subsampling of occupations. Our study provides the first empirical law connecting two societal forces: urban agglomeration and automation's impact on employment. PMID:29436514

  3. The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

    Science.gov (United States)

    Brody, Stuart; Krüger, Tillmann H C

    2006-03-01

    Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

  4. Facilitating Improvements in Laboratory Report Writing Skills with Less Grading: A Laboratory Report Peer-Review Process

    Directory of Open Access Journals (Sweden)

    Jennifer R. Brigati

    2015-02-01

    Full Text Available Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading. T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading. While the grading process described here does not lead to statistically significant gains (or reductions in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings.

  5. Facilitating improvements in laboratory report writing skills with less grading: a laboratory report peer-review process.

    Science.gov (United States)

    Brigati, Jennifer R; Swann, Jerilyn M

    2015-05-01

    Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading). T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading). While the grading process described here does not lead to statistically significant gains (or reductions) in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings.

  6. Facilitating Improvements in Laboratory Report Writing Skills with Less Grading: A Laboratory Report Peer-Review Process†

    Science.gov (United States)

    Brigati, Jennifer R.; Swann, Jerilyn M.

    2015-01-01

    Incorporating peer-review steps in the laboratory report writing process provides benefits to students, but it also can create additional work for laboratory instructors. The laboratory report writing process described here allows the instructor to grade only one lab report for every two to four students, while giving the students the benefits of peer review and prompt feedback on their laboratory reports. Here we present the application of this process to a sophomore level genetics course and a freshman level cellular biology course, including information regarding class time spent on student preparation activities, instructor preparation, prerequisite student knowledge, suggested learning outcomes, procedure, materials, student instructions, faculty instructions, assessment tools, and sample data. T-tests comparing individual and group grading of the introductory cell biology lab reports yielded average scores that were not significantly different from each other (p = 0.13, n = 23 for individual grading, n = 6 for group grading). T-tests also demonstrated that average laboratory report grades of students using the peer-review process were not significantly different from those of students working alone (p = 0.98, n = 9 for individual grading, n = 6 for pair grading). While the grading process described here does not lead to statistically significant gains (or reductions) in student learning, it allows student learning to be maintained while decreasing instructor workload. This reduction in workload could allow the instructor time to pursue other high-impact practices that have been shown to increase student learning. Finally, we suggest possible modifications to the procedure for application in a variety of settings. PMID:25949758

  7. The Wind Forecast Improvement Project (WFIP): A Public/Private Partnership for Improving Short Term Wind Energy Forecasts and Quantifying the Benefits of Utility Operations. The Southern Study Area, Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Freedman, Jeffrey M. [AWS Truepower, LLC, Albany, NY (United States); Manobianco, John [MESO, Inc., Troy, NY (United States); Schroeder, John [Texas Tech Univ., Lubbock, TX (United States). National Wind Inst.; Ancell, Brian [Texas Tech Univ., Lubbock, TX (United States). Atmospheric Science Group; Brewster, Keith [Univ. of Oklahoma, Norman, OK (United States). Center for Analysis and Prediction of Storms; Basu, Sukanta [North Carolina State Univ., Raleigh, NC (United States). Dept. of Marine, Earth, and Atmospheric Sciences; Banunarayanan, Venkat [ICF International (United States); Hodge, Bri-Mathias [National Renewable Energy Lab. (NREL), Golden, CO (United States); Flores, Isabel [Electricity Reliability Council of Texas (United States)

    2014-04-30

    This Final Report presents a comprehensive description, findings, and conclusions for the Wind Forecast Improvement Project (WFIP) -- Southern Study Area (SSA) work led by AWS Truepower (AWST). This multi-year effort, sponsored by the Department of Energy (DOE) and National Oceanographic and Atmospheric Administration (NOAA), focused on improving short-term (15-minute - 6 hour) wind power production forecasts through the deployment of an enhanced observation network of surface and remote sensing instrumentation and the use of a state-of-the-art forecast modeling system. Key findings from the SSA modeling and forecast effort include: 1. The AWST WFIP modeling system produced an overall 10 - 20% improvement in wind power production forecasts over the existing Baseline system, especially during the first three forecast hours; 2. Improvements in ramp forecast skill, particularly for larger up and down ramps; 3. The AWST WFIP data denial experiments showed mixed results in the forecasts incorporating the experimental network instrumentation; however, ramp forecasts showed significant benefit from the additional observations, indicating that the enhanced observations were key to the model systems’ ability to capture phenomena responsible for producing large short-term excursions in power production; 4. The OU CAPS ARPS simulations showed that the additional WFIP instrument data had a small impact on their 3-km forecasts that lasted for the first 5-6 hours, and increasing the vertical model resolution in the boundary layer had a greater impact, also in the first 5 hours; and 5. The TTU simulations were inconclusive as to which assimilation scheme (3DVAR versus EnKF) provided better forecasts, and the additional observations resulted in some improvement to the forecasts in the first 1 - 3 hours.

  8. An improvement of the Earthworm Based Earthquake Alarm Reporting system in Taiwan

    Science.gov (United States)

    Chen, D. Y.; Hsiao, N. C.; Yih-Min, W.

    2017-12-01

    The Central Weather Bureau of Taiwan (CWB) has operated the Earthworm Based Earthquake Alarm Reporting (eBEAR) system for the purpose of earthquake early warning (EEW). The system has been used to report EEW messages to the general public since 2016 through text message from the mobile phones and the television programs. The system for inland earthquakes is able to provide accurate and fast warnings. The average epicenter error is about 5 km and the processing time is about 15 seconds. The epicenter error is defined as the distance between the epicenter estimated by the EEW system and the epicenter estimated by man. The processing time is defined as the time difference between the time earthquakes occurred and the time the system issued warning. The CWB seismic network consist about 200 seismic stations. In some area of Taiwan the distance between each seismic station is about 10 km. It means that when an earthquake occurred the seismic P wave is able to propagate through 6 stations, which is the minimum number of required stations in the EEW system, within 20 km. If the latency of data transmitting is about 1 sec, the P-wave velocity is about 6 km per sec and we take 3-sec length time window to estimate earthquake magnitude, then the processing should be around 8 sec. In fact, however, the average processing time is larger than this figure. Because some outliers of P-wave onset picks may exist in the beginning of the earthquake occurrence, the Geiger's method we used in the EEW system for earthquake location is not stable. It usually takes more time to wait for enough number of good picks. In this study we used grid search method to improve the estimations of earthquake location. The MAXEL algorithm (Sheen et al., 2015, 2016) was tested in the EEW system by simulating historical earthquakes occurred in Taiwan. The results show the processing time can be reduced and the location accuracy is acceptable for EEW purpose.

  9. Terminator Operon Reporter: combining a transcription termination switch with reporter technology for improved gene synthesis and synthetic biology applications.

    Science.gov (United States)

    Zampini, Massimiliano; Mur, Luis A J; Rees Stevens, Pauline; Pachebat, Justin A; Newbold, C James; Hayes, Finbarr; Kingston-Smith, Alison

    2016-05-25

    Synthetic biology is characterized by the development of novel and powerful DNA fabrication methods and by the application of engineering principles to biology. The current study describes Terminator Operon Reporter (TOR), a new gene assembly technology based on the conditional activation of a reporter gene in response to sequence errors occurring at the assembly stage of the synthetic element. These errors are monitored by a transcription terminator that is placed between the synthetic gene and reporter gene. Switching of this terminator between active and inactive states dictates the transcription status of the downstream reporter gene to provide a rapid and facile readout of the accuracy of synthetic assembly. Designed specifically and uniquely for the synthesis of protein coding genes in bacteria, TOR allows the rapid and cost-effective fabrication of synthetic constructs by employing oligonucleotides at the most basic purification level (desalted) and without the need for costly and time-consuming post-synthesis correction methods. Thus, TOR streamlines gene assembly approaches, which are central to the future development of synthetic biology.

  10. To report or not to report: a psychosocial investigation aimed at improving early detection of avian influenza outbreaks

    NARCIS (Netherlands)

    Elbers, A.R.W.; Gorgievski, M.J.; Zarafshani, K.; Koch, G.

    2010-01-01

    The aim of this study was to identify limitations - and solutions for those limitations – with respect to reporting clinically suspect situations on poultry farms, possibly caused by Avian Influenza (AI) with the ultimate aim to facilitate early detection of AI-outbreaks. Focus group sessions were

  11. Improving clinical cognitive testing: report of the AAN Behavioral Neurology Section Workgroup.

    Science.gov (United States)

    Daffner, Kirk R; Gale, Seth A; Barrett, A M; Boeve, Bradley F; Chatterjee, Anjan; Coslett, H Branch; D'Esposito, Mark; Finney, Glen R; Gitelman, Darren R; Hart, John J; Lerner, Alan J; Meador, Kimford J; Pietras, Alison C; Voeller, Kytja S; Kaufer, Daniel I

    2015-09-08

    To evaluate the evidence basis of single-domain cognitive tests frequently used by behavioral neurologists in an effort to improve the quality of clinical cognitive assessment. Behavioral Neurology Section members of the American Academy of Neurology were surveyed about how they conduct clinical cognitive testing, with a particular focus on the Neurobehavioral Status Exam (NBSE). In contrast to general screening cognitive tests, an NBSE consists of tests of individual cognitive domains (e.g., memory or language) that provide a more comprehensive diagnostic assessment. Workgroups for each of 5 cognitive domains (attention, executive function, memory, language, and spatial cognition) conducted evidence-based reviews of frequently used tests. Reviews focused on suitability for office-based clinical practice, including test administration time, accessibility of normative data, disease populations studied, and availability in the public domain. Demographic and clinical practice data were obtained from 200 respondents who reported using a wide range of cognitive tests. Based on survey data and ancillary information, between 5 and 15 tests in each cognitive domain were reviewed. Within each domain, several tests are highlighted as being well-suited for an NBSE. We identified frequently used single-domain cognitive tests that are suitable for an NBSE to help make informed choices about clinical cognitive assessment. Some frequently used tests have limited normative data or have not been well-studied in common neurologic disorders. Utilizing standardized cognitive tests, particularly those with normative data based on the individual's age and educational level, can enhance the rigor and utility of clinical cognitive assessment. © 2015 American Academy of Neurology.

  12. Performance improvement of silicon nitride ball bearings by ion implantation. CRADA final report

    International Nuclear Information System (INIS)

    Williams, J.M.; Miner, J.

    1998-01-01

    The present report summarizes technical results of CRADA No. ORNL 92-128 with the Pratt and Whitney Division of United Technologies Corporation. The stated purpose of the program was to assess the 3effect of ion implantation on the rolling contact performance of engineering silicon nitride bearings, to determine by post-test analyses of the bearings the reasons for improved or reduced performance and the mechanisms of failure, if applicable, and to relate the overall results to basic property changes including but not limited to swelling, hardness, modulus, micromechanical properties, and surface morphology. Forty-two control samples were tested to an intended runout period of 60 h. It was possible to supply only six balls for ion implantation, but an extended test period goal of 150 h was used. The balls were implanted with C-ions at 150 keV to a fluence of 1.1 x 10 17 /cm 2 . The collection of samples had pre-existing defects called C-cracks in the surfaces. As a result, seven of the control samples had severe spalls before reaching the goal of 60 h for an unacceptable failure rate of 0.003/sample-h. None of the ion-implanted samples experienced engineering failure in 150 h of testing. Analytical techniques have been used to characterize ion implantation results, to characterize wear tracks, and to characterize microstructure and impurity content. In possible relation to C-cracks. It is encouraging that ion implantation can mitigate the C-crack failure mode. However, the practical implications are compromised by the fact that bearings with C-cracks would, in no case, be acceptable in engineering practice, as this type of defect was not anticipated when the program was designed. The most important reason for the use of ceramic bearings is energy efficiency

  13. Improved techniques for fluid diversion in oil recovery. First annual report

    Energy Technology Data Exchange (ETDEWEB)

    Seright, R.S.

    1993-12-01

    This three-year project has two general objectives. The first objective is to compare the effectiveness of gels in fluid diversion with those of other types of processes. Several different types of fluid-diversion processes are being compared, including those using gels, foams, emulsions, and particulates. The ultimate goals of these comparisons are to (1) establish which of these processes are most effective in a given application, and (2) determine whether aspects of one process can be combined with those of other processes to improve performance. Analyses and experiments are being performed to verify which materials are the most effective in entering and blocking high-permeability zones. Another objective of the project is to identify the mechanisms by which materials (particularly gels) selectively reduce permeability to water more than to oil. This report describes work performed during the first year of the project. Following the introduction, Chapters 2 through 5 present several surveys concerning field applications of gel treatments. Based on the results of the surveys, guidelines are proposed in Chapter 5 for the selection of candidates for gel treatments (both injection wells and production wells). Chapters 6, 7, 8, and 11 discuss theoretical work that was performed during the project. Chapter 6 examines whether Hall plots indicated selectivity during gelant placement. Chapter 7 discusses several important theoretical aspects of gel treatments in production wells with water-coning problems. Chapter 8 considers exploitation of density differences during gelant placement. Chapter 11 presents a preliminary consideration of the use of precipitates as blocking agents. Chapters 9 and 10 detail the experimental work for the project. Chapter 9 describes an experimental investigation of gelant placement in fractured systems. Chapter 10 describes experiments that probe the mechanisms for disproportionate permeability reduction by gels.

  14. Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

    Science.gov (United States)

    Fogarty, Colleen T; Winters, Paul; Farah, Subrina

    2016-05-01

    Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered. We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices." One hundred thirty-nine resident physicians and faculty supervisors in five residency training programs at the University of Rochester Medical Center participated in the workshops. Participants were asked to complete an 11-item survey of behaviors related to their use of the electronic health record prior to training and after attending training. We used paired t-tests to assess changes in self-reported behavior from pre-intervention to post-intervention. We trained 139 clinicians in the workshops; 110 participants completed the baseline assessment and 39 completed both the baseline and post-intervention assessment. Data from post-curriculum respondents found a statistically significant increase in "I told the patient when turning my attention from the patient to the computer," from 60% of the time prior to the training to 70% of the time after. Data from our program evaluation demonstrated improvement in one communication behavior. Sample size limited the detection of other changes; further research should investigate effective training techniques for patient-centered communication while using the electronic health record. © The Author(s) 2016.

  15. Improving linear accelerator service response with a real- time electronic event reporting system.

    Science.gov (United States)

    Hoisak, Jeremy D P; Pawlicki, Todd; Kim, Gwe-Ya; Fletcher, Richard; Moore, Kevin L

    2014-09-08

    To track linear accelerator performance issues, an online event recording system was developed in-house for use by therapists and physicists to log the details of technical problems arising on our institution's four linear accelerators. In use since October 2010, the system was designed so that all clinical physicists would receive email notification when an event was logged. Starting in October 2012, we initiated a pilot project in collaboration with our linear accelerator vendor to explore a new model of service and support, in which event notifications were also sent electronically directly to dedicated engineers at the vendor's technical help desk, who then initiated a response to technical issues. Previously, technical issues were reported by telephone to the vendor's call center, which then disseminated information and coordinated a response with the Technical Support help desk and local service engineers. The purpose of this work was to investigate the improvements to clinical operations resulting from this new service model. The new and old service models were quantitatively compared by reviewing event logs and the oncology information system database in the nine months prior to and after initiation of the project. Here, we focus on events that resulted in an inoperative linear accelerator ("down" machine). Machine downtime, vendor response time, treatment cancellations, and event resolution were evaluated and compared over two equivalent time periods. In 389 clinical days, there were 119 machine-down events: 59 events before and 60 after introduction of the new model. In the new model, median time to service response decreased from 45 to 8 min, service engineer dispatch time decreased 44%, downtime per event decreased from 45 to 20 min, and treatment cancellations decreased 68%. The decreased vendor response time and reduced number of on-site visits by a service engineer resulted in decreased downtime and decreased patient treatment cancellations.

  16. Costs associated with data collection and reporting for diabetes quality improvement in primary care practices: a report from SNOCAP-USA.

    Science.gov (United States)

    West, David R; Radcliff, Tiffany A; Brown, Tiffany; Cote, Murray J; Smith, Peter C; Dickinson, W Perry

    2012-01-01

    Information about the costs and experiences of collecting and reporting quality measure data are vital for practices deciding whether to adopt new quality improvement initiatives or monitor existing initiatives. Six primary care practices from Colorado's Improving Performance in Practice program participated. We conducted structured key informant interviews with Improving Performance in Practice coaches and practice managers, clinicians, and staff and directly observed practices. Practices had 3 to 7 clinicians and 75 to 300 patients with diabetes, half had electronic health records, and half were members of an independent practice association. The estimated per-practice cost of implementation for the data collection and reporting for the diabetes quality improvement program was approximately $15,552 per practice (about $6.23 per diabetic patient per month). The first-year maintenance cost for this effort was approximately $9,553 per practice ($3.83 per diabetic patient per month). The cost of implementing and maintaining a diabetes quality improvement effort that incorporates formal data collection, data management, and reporting is significant and quantifiable. Policymakers must become aware of the financial and cultural impact on primary care practices when considering value-based purchasing initiatives.

  17. Have CONSORT guidelines improved the quality of reporting of randomised controlled trials published in public health dentistry journals?

    Science.gov (United States)

    Savithra, Prakash; Nagesh, Lakshminarayan Shetty

    2013-01-01

    To assess a) whether the quality of reporting of randomised controlled trials (RCTs) has improved since the formulation of the Consolidated Standards of Reporting Trials (CONSORT) statement and b) whether there is any difference in reporting of RCTs between the selected public health dentistry journals. A hand search of the journals of public health dentistry was performed and four journals were identified for the study. They were Community Dentistry and Oral Epidemiology (CDOE), Community Dental Health (CDH), Journal of Public Health Dentistry (JPHD) and Oral Health and Preventive Dentistry (OHPD). A total of 114 RCTs published between 1990 and 2009 were selected. CONSORT guidelines were applied to each selected article in order to assess and determine any improvement since the publication of CONSORT guidelines. The chi-square test was employed to determine any statistical significant difference in quality of reporting of RCTs before and after the publication of the CONSORT guidelines. A comparison was also done to determine any statistically significant difference in quality of reporting of RCTs between the selected journals. Title, abstract, discussion and conclusion sections of the selected articles showed adherence to the CONSORT guidelines, whereas the compliance was poor with respect to the methodology section. The quality of reporting of RCTs is generally poor in public health dentistry journals. Overall, the quality of reporting has not substantially improved since the publication of CONSORT guidelines.

  18. Improvement of the structure of reports of Ukrainian higher educational institutions in terms of deregulation and state authority decentralization

    Directory of Open Access Journals (Sweden)

    V.S. Ambarchian

    2015-09-01

    Full Text Available Improvement of the structure and content of financial and budgetary reports of domestic higher educational institutions, enhance of financial statements completeness in order to enable citizens to control a university activity. During the research both general scientific and specific scientific economic methods were implemented. The general methods include induction, deduction, analogy and comparison. Among specific methods of economic research grouping, table method, graphical method, method of informational and logical analysis were used. The paper characterizes legal documents which regulate the process of university financial statements preparation and presentation in different countries. Financial reports of Ukrainian, American and British universities are compared. The author determines the major directions of improvement of the structure and content of domestic university reports with the purpose of their completeness enhancing. As a result of the research performed the proper recommendations of improvement of domestic universities reporting are suggested. The author conforms the reporting information with the Managerial report which discloses the information about the reporting period achievements and the efficiency of budget resources expenditure.

  19. Picture archiving and communication systems lead to sustained improvements in reporting times and productivity: results of a 5-year audit

    Energy Technology Data Exchange (ETDEWEB)

    Mackinnon, A.D.; Billington, R.A.; Adam, E.J.; Dundas, D.D. [Department of Radiology, St Georges Hospital NHS Trust, London (United Kingdom); Patel, U. [Department of Radiology, St Georges Hospital NHS Trust, London (United Kingdom)], E-mail: Uday.Patel@stgeorges.nhs.uk

    2008-07-15

    Aim: To evaluate the impact of picture archiving and communications systems (PACS) on reporting times and productivity in a large teaching hospital. Materials and methods: Reporting time, defined as the time taken from patient registration to report availability, and productivity, defined as the number of reports issued per whole time equivalent (WTE) radiologist per month, were studied for 2 years pre- and 3 years post-PACS installation. Mean reporting time was calculated for plain radiographs and specialist radiology techniques [computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine]. Productivity, total department workload, and unreported film rates were also assessed. Pre- and post-PACS findings were compared. Results: Between 2002-2006 the number of radiological patient episodes increased by 30% from 11,531/month to 15,057/month. This was accompanied by a smaller increase in WTE reporting radiologists, from 32 to 37 (15%). Mean reporting times have improved substantially post-PACS, plain radiograph reporting time decreased by 26% (from 6.8 to 5 days; p = 0.002) and specialty modalities by 24% (4.1 to 3.1 days; p < 0.001). Radiologist productivity has increased by 18% (337 films to 407 films/WTE radiologist/month). Unreported films have decreased from 5 to 4% for plain radiographs and are steady for specialty modalities (< 1%). In most areas improvements have been sustained over a 3-year period. Conclusion: Since the introduction of PACS, reporting times have decreased by 25% and the productivity improved by 18%. Sustained improvements are felt to reflect the efficiencies and cultural change that accompanied the introduction of PACS and digital dictation.

  20. Protecting and improving health through the radiological sciences. A report to the Surgeon General

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1966-04-01

    , the Committee in this report makes a number of recommendations to the Surgeon General and urges that he take appropriate steps for their early implementation. For convenience, these recommendations are summarized as follows: 1. The Public Health Service should take immediate steps to strengthen its programs in the radiological sciences by unifying their administrative direction. Such action is needed to assure an orderly development of the broad spectrum of radiological activities for which the Service is responsible and to give continuous attention to the balance of benefit and risk in all matters pertaining to the human application of ionizing radiation. 2. The Service should undertake the following training and research and development programs to upgrade the quality of the radiological services which have become such a critical part of medical and dental care and to improve radiation protection practices in the health professions: (a) a series of training programs: (i) to strengthen radiological instruction of medical students; (ii) to increase the number of academic radiologists in American medical schools; and (iii) to increase the number of practicing radiologists in the United States. (b) a series of training programs to provide increasing numbers of radiochemists, radiological engineers, radiobiologists, radiological physicists and radiological health specialists. (c) a series of training programs to provide increasing numbers of technologists in the several disciplines of the radiological sciences. (d) a series of applied research and development programs to increase the effectiveness and safety with which radiological procedures are employed in the health professions.

  1. Protecting and improving health through the radiological sciences. A report to the Surgeon General

    International Nuclear Information System (INIS)

    1966-04-01

    , the Committee in this report makes a number of recommendations to the Surgeon General and urges that he take appropriate steps for their early implementation. For convenience, these recommendations are summarized as follows: 1. The Public Health Service should take immediate steps to strengthen its programs in the radiological sciences by unifying their administrative direction. Such action is needed to assure an orderly development of the broad spectrum of radiological activities for which the Service is responsible and to give continuous attention to the balance of benefit and risk in all matters pertaining to the human application of ionizing radiation. 2. The Service should undertake the following training and research and development programs to upgrade the quality of the radiological services which have become such a critical part of medical and dental care and to improve radiation protection practices in the health professions: (a) a series of training programs: (i) to strengthen radiological instruction of medical students; (ii) to increase the number of academic radiologists in American medical schools; and (iii) to increase the number of practicing radiologists in the United States. (b) a series of training programs to provide increasing numbers of radiochemists, radiological engineers, radiobiologists, radiological physicists and radiological health specialists. (c) a series of training programs to provide increasing numbers of technologists in the several disciplines of the radiological sciences. (d) a series of applied research and development programs to increase the effectiveness and safety with which radiological procedures are employed in the health professions

  2. Natural Propagation and Habitat Improvement, Volume 2, Idaho, 1985 Annual and Final Reports.

    Energy Technology Data Exchange (ETDEWEB)

    Hair, Don

    1986-09-01

    The individual reports in this volume have been separately abstracted for inclusion in the data base. The reports describe fish habitat enhancement projects on the Lochsa River, Eldorado and Camas Creeks, and the Clearwater River. (ACR)

  3. Plastic Foam Withstands Greater Temperatures And Pressures

    Science.gov (United States)

    Cranston, John A.; Macarthur, Doug

    1993-01-01

    Improved plastic foam suitable for use in foam-core laminated composite parts and in tooling for making fiber/matrix-composite parts. Stronger at high temperatures, more thermally and dimensionally stable, machinable, resistant to chemical degradation, and less expensive. Compatible with variety of matrix resins. Made of polyisocyanurate blown with carbon dioxide and has density of 12 to 15 pounds per cubic feet. Does not contibute to depletion of ozone from atmosphere. Improved foam used in cores of composite panels in such diverse products as aircraft, automobiles, railroad cars, boats, and sporting equipment like surfboards, skis, and skateboards. Also used in thermally stable flotation devices in submersible vehicles. Machined into mandrels upon which filaments wound to make shells.

  4. Moderate Baseline Vagal Tone Predicts Greater Prosociality in Children

    Science.gov (United States)

    Miller, Jonas G.; Kahle, Sarah; Hastings, Paul D.

    2016-01-01

    Vagal tone is widely believed to be an important physiological aspect of emotion regulation and associated positive behaviors. However, there is inconsistent evidence for relations between children’s baseline vagal tone and their helpful or prosocial responses to others (Hastings & Miller, 2014). Recent work in adults suggests a quadratic association (inverted U-shape curve) between baseline vagal tone and prosociality (Kogan et al., 2014). The present research examined whether this nonlinear association was evident in children. We found consistent evidence for a quadratic relation between vagal tone and prosociality across 3 samples of children using 6 different measures. Compared to low and high vagal tone, moderate vagal tone in early childhood concurrently predicted greater self-reported prosociality (Study 1), observed empathic concern in response to the distress of others and greater generosity toward less fortunate peers (Study 2), and longitudinally predicted greater self-, mother-, and teacher-reported prosociality 5.5 years later in middle childhood (Study 3). Taken together, our findings suggest that moderate vagal tone at rest represents a physiological preparedness or tendency to engage in different forms of prosociality across different contexts. Early moderate vagal tone may reflect an optimal balance of regulation and arousal that helps prepare children to sympathize, comfort, and share with others. PMID:27819463

  5. Urban acid deposition in Greater Manchester

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D.S.; Longhurst, J.W.S.; Gee, D.R.; Hare, S.E. (Manchester Polytechnic, Manchester (UK). Acid Rain Information Centre)

    1989-08-01

    Data are presented from a monitoring network of 18 bulk precipitation collectors and one wet-only collector in the urban area of Greater Manchester, in the north west of England. Weekly samples were analysed for all the major ions in precipitation along with gaseous nitrogen dioxide concentrations from diffusion tubes. Statistical analysis of the data shows significant spatial variation of non marine sulphate, nitrate, ammonium, acidity and calcium concentrations, and nitrogen dioxide concentrations. Calcium is thought to be responsible for the buffering of acidity and is of local origin. Wet deposition is the likely removal process for calcium in the atmosphere and probably by below cloud scavenging. Nitrate and ammonium concentrations and depositions show close spatial, temporal and statistical association. Examination of high simultaneous episodes of nitrate and ammonium deposition shows that these depositions cannot be explained in terms of trajectories and it is suggested that UK emissions of ammonia may be important. Statistical analysis of the relationships between nitrate and ammonium depositions, concentrations and precipitation amount suggest that ammonia from mesoscale sources reacts reversibly with nitric acid aerosol and is removed by below cloud scavenging. High episodes of the deposition of non marine sulphate are difficult to explain by trajectory analysis alone, perhaps suggesting local sources. In a comparison between wet deposition and bulk deposition, it was shown that only 15.2% of the non marine sulphur was dry deposited to the bulk precipitation collector. 63 refs., 86 figs., 31 tabs.

  6. Extension and improvement of the FENDL library for fusion applications. Summary report of an IAEA consultants' meeting

    International Nuclear Information System (INIS)

    Herman, M.

    1999-11-01

    The discussions and conclusions of the meeting on 'Extension and Improvement of the FENDL Library' are summarized in this report. It is shown that the FENDL-2.0 activation sublibrary was validated successfully. However, a number of deficiencies was identified. Possible improvements are proposed which should lead to the release of the FENDL-2.1 version of the library early in 2001. A separate abstract and indexing was provided for five contributions of participants to the meeting

  7. Flue gas conditioning for improved particle collection in electrostatic precipitators. First topical report, Results of laboratory screening of additives

    Energy Technology Data Exchange (ETDEWEB)

    Durham, M.D.

    1993-04-16

    Several tasks have been completed in a program to evaluate additives to improve fine particle collection in electrostatic precipitators. Screening tests and laboratory evaluations of additives are summarized in this report. Over 20 additives were evaluated; four were found to improve flyash precipitation rates. The Insitec particle analyzer was also evaluated; test results show that the analyzer will provide accurate sizing and counting information for particles in the size range of {le} 10 {mu}m dia.

  8. Critical Evaluation as an Aid to Improved Report Writing: A Case Study

    Science.gov (United States)

    Walker, Mirabelle; Williams, Judith

    2014-01-01

    Report writing is an important employability skill for Engineers and Technologists, and this case study describes how a Technology degree module took a novel approach to developing students' report writing skills. Students learned how to use a criterion-referenced critical evaluation framework for reports and other technological documents. They…

  9. Challenges of implementation and implementation research: Learning from an intervention study designed to improve tumor registry reporting

    Directory of Open Access Journals (Sweden)

    Ann Scheck McAlearney

    2016-08-01

    Full Text Available Objectives: Implementation of interventions designed to improve the quality of medical care often proceeds differently from what is planned. Improving existing conceptual models to better understand the sources of these differences can help future projects avoid these pitfalls and achieve desired effectiveness. To inform an adaptation of an existing theoretical model, we examined unanticipated changes that occurred in an intervention designed to improve reporting of adjuvant therapies for breast cancer patients at a large, urban academic medical center. Methods: Guided by the complex innovation implementation conceptual framework, our study team observed and evaluated the implementation of an intervention designed to improve reporting to a tumor registry. Findings were assessed against the conceptual framework to identify boundary conditions and modifications that could improve implementation effectiveness. Results: The intervention successfully increased identification of the managing medical oncologist and treatment reporting. During implementation, however, unexpected external challenges including hospital acquisitions of community practices and practices’ responses to government incentives to purchase electronic medical record systems led to unanticipated changes and associated threats to implementation. We present a revised conceptual model that incorporates the sources of these unanticipated challenges. Conclusion: This report of our experience highlights the importance of monitoring implementation over time and accounting for changes that affect both implementation and measurement of intervention impact. In this article, we use our study to examine the challenges of implementation research in health care, and our experience can help future implementation efforts.

  10. Reducing the carbon footprint of the operating theatre: a multicentre quality improvement report.

    Science.gov (United States)

    Southorn, T; Norrish, A R; Gardner, K; Baxandall, R

    2013-06-01

    Currently, there are very few provisions for recycling in theatres. We measured the weight of clinical waste for several orthopaedic operations. This waste was then examined and sorted into domestic waste and clinical waste. With staff education it is possible to reduce the amount of clinical waste generated by the operating theatre by roughly 50%. A greater awareness of disposal options leads to a reduction in waste disposed of by incineration.

  11. Project CHECO Southeast Asia Report. VNAF Improvement and Modernization Program, July 1971 - December 1973

    Science.gov (United States)

    1975-01-01

    Thus it’s not too difficult to understand that Vietnamese who follow Confucius, Mencius and Mo Tzu or who subscribe to Taoism , Buddhism or other...Bombing System, improving the Air Liaison Officer (ALO)/FAC system, improving the airlift control system, improving the food distribution system, and...to have to sustain many, many places that are surrounded and cannot get food and supplies other than by airlift, then they don’t have the capability

  12. Patient expectations predict greater pain relief with joint arthroplasty.

    Science.gov (United States)

    Gandhi, Rajiv; Davey, John Roderick; Mahomed, Nizar

    2009-08-01

    We examined the relationship between patient expectations of total joint arthroplasty and functional outcomes. We surveyed 1799 patients undergoing primary hip or knee arthroplasty for demographic data and Western Ontario McMaster University Osteoarthritis Index scores at baseline, 3 months, and 1 year of follow-up. Patient expectations were determined with 3 survey questions. The patients with the greatest expectations of surgery were younger, male, and had a lower body mass index. Linear regression modeling showed that a greater expectation of pain relief with surgery independently predicted greater reported pain relief at 1 year of follow-up, adjusted for all relevant covariates (P relief after joint arthroplasty is an important predictor of outcomes at 1 year.

  13. DOD Major Automated Information Systems: Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility

    Science.gov (United States)

    2016-03-01

    Leadership Responsibility Report to Congressional Committees March 2016 GAO-16-336 United States Government Accountability Office United...INFORMATION SYSTEMS Improvements Can Be Made in Reporting Critical Changes and Clarifying Leadership Responsibility Why GAO Did This Study The National...milestone decisions for MAIS programs. AT&L can delegate decision authority for MAIS programs to a component head who may further delegate the authority

  14. Active implementation strategy of CONSORT adherence by a dental specialty journal improved randomized clinical trial reporting.

    Science.gov (United States)

    Pandis, Nikolaos; Shamseer, Larissa; Kokich, Vincent G; Fleming, Padhraig S; Moher, David

    2014-09-01

    To describe a novel CONsolidated Standards of Reporting Trials (CONSORT) adherence strategy implemented by the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO) and to report its impact on the completeness of reporting of published trials. The AJO-DO CONSORT adherence strategy, initiated in June 2011, involves active assessment of randomized clinical trial (RCT) reporting during the editorial process. The completeness of reporting CONSORT items was compared between trials submitted and published during the implementation period (July 2011 to September 2013) and trials published between August 2007 and July 2009. Of the 42 RCTs submitted (July 2011 to September 2013), 23 were considered for publication and assessed for completeness of reporting, seven of which were eventually published. For all published RCTs between 2007 and 2009 (n = 20), completeness of reporting by CONSORT item ranged from 0% to 100% (Median = 40%, interquartile range = 60%). All published trials in 2011-2013, reported 33 of 37 CONSORT (sub) items. Four CONSORT 2010 checklist items remained problematic even after implementation of the adherence strategy: changes to methods (3b), changes to outcomes (6b) after the trial commenced, interim analysis (7b), and trial stopping (14b), which are typically only reported when applicable. Trials published following implementation of the AJO-DO CONSORT adherence strategy completely reported more CONSORT items than those published or submitted previously. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Pectus patient information website has improved access to care and patient reported outcomes.

    Science.gov (United States)

    Tikka, Theofano; Webb, Joanne; Agostini, Paula; Kerr, Amy; Mannion, Glenn; Steyn, Richard S; Bishay, Ehab; Kalkat, Maninder S; Rajesh, Pala B; Naidu, Babu

    2016-04-26

    Pectus is the most common congenital disorder. Awareness amongst primary care physicians and the general public is poor. NHS commissioning bodies plan to withdraw funding for this surgery because they deem a lack of sufficient evidence of benefit. The purpose of this study is to assess the effects of introducing a patient information website on referral and activity patterns and on patients reported outcomes. We produced an innovative information website, www.pectus.co.uk , accessible to the general public, providing information about pectus deformities; management options and advice about surgery. Referral patterns and number of cases where studied before and after the introduction of the website in 2010. Patients' satisfaction post-op was assessed using the Brompton's single step questionnaire (SSQ). The website had considerable traffic with 2179 hits in 2012, 4983 in 2013 and 7416 in 2014. This has led to 1421 contacts and 372 email enquiries. These emails have resulted in an increased number of patients who have been assessed and go on to have surgery. We asked 59 pectus excavatum patients who were operated from 2008 to 2014 to complete the SSQ. We received 32 replies. Eighty-four percent (16/19) of patients who visited the website and then underwent surgery, found the website useful. All patients scored satisfactorily in SSQ. Even though those who visited the website tended to be more satisfied with the surgical outcomes this did not reach statistical significance. This group of patients said that would have the operation again given the option compared to 76.9 % of the group who did not visit the website before surgery (p=0.031). Despite the fact that patients who visited the website experienced more post-operative complications were equally or more satisfied with post-operative outcomes. The overall SSQ obtainable score was not different for the two subgroups, being more widespread in the group that did not visit the website. The introduction of a pectus

  16. Improvement in patient–reported outcomes after group poetry therapy of women with breast cancer

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Gozashti

    2017-07-01

    Full Text Available Background: One of the best ways of achieving the patients’ views and expectations about the effects of a therapeutic or palliative intervention on their quality of life is using PatientReported Outcome Measures (PROMs. Poetry therapy as a psychotherapy intervention has been used for palliation of stressful conditions of several chronic diseases and disabilities. In the present study, we aimed to evaluate the effectiveness of group poetry therapy on the quality of life measures in women with breast cancer.Methods: A total of 30 women with breast cancer, undergoing chemotherapy at a referral center in the north of Iran, participated in the current quasi-experimental before-after study conducted in 2016. The study protocol included eight weekly sessions of group poetry therapy using poems from the great Persian poets. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30 was completed by the patients before beginning group poetry therapy and, twice more, one week and two months after the last session. Items of the questionnaire were manually scored and then analyzed using appropriate statistical tests in IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.Results: A total of 28 patients participated in all the group poetry therapy sessions and completed the questionnaire. The mean and standard deviation of age were 45±66. The changes in the score of quality of life from 51.8 to 65.5 and 69 were observed to be significant in the one-week and two-month follow ups (both with P=0.002. Also, changes in symptom score from 34.5 to 23.7 (P=0.01 and functional score from 65.6 to 77.2 (P=0.01 in the two-month follow up were found to be statistically significant.Conclusion: Based on the findings of the study, it can be concluded that group poetry therapy, as a psychotherapy approach, can be used to improve quality of life in breast cancer patients.

  17. Toyota A3 report: a tool for process improvement in healthcare.

    Science.gov (United States)

    Lee, Te-Shu; Kuo, Mu-Hsing

    2009-01-01

    It is proposed that the A3 problem solving process be used by hospital staff to improve its healthcare workflow. A hypothetical case study is given to demonstrate the applicability and benefits of the methodology. The research results show that A3 is a useful tool for healthcare organizations seeking to continuously improve their healthcare service quality.

  18. Appeal for legislation on greater safety.

    Science.gov (United States)

    Baillie, Jonathan

    2011-10-01

    An Essex-headquartered company which claims to manufacture the world's leading "brand" of glass vision panel, is calling for legislation to regulate the quality and design of such products. With no statutory governance currently in place, it is concerned that a rash of badly-designed, poorer quality variants, that it says have emerged in recent years, pose a significant self-harm and ligature risk to mentally unwell patients in hospitals, and a potential danger to staff when components like internal fittings and the glass itself, especially should the latter be too thin and thus easy to break, are used as "weapons". HEJ editor Jonathan Baillie reports.

  19. Garnet peridotite found in the Greater Antilles

    Science.gov (United States)

    Abbott, Richard N., Jr.; Draper, Grenville; Keshav, Shantanu

    Although Alpine peridotites are relatively common in collisional orogenic zones, garnet-bearing peridotites are rare and only associated with high pressure/ultra-high pressure or temperature (HP/UHP or T) terranes [Brueckner and Medaris, 2000; Medaris, 1999]. Until recently all reported occurrences of Alpine-type garnet peridotites and HP/UHP terranes were in Eurasia and Africa, with one occurrence in the Seward Peninsula, Alaska [Till, 1981;Lieberman and Till, 1987]. Now a new Alpine-type garnet peridotite locality has been discovered in the Caribbean island of Hispaniola. This discovery is the second of its kind in the Americas.

  20. Protocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials.

    Science.gov (United States)

    Welch, Vivian; Jull, J; Petkovic, J; Armstrong, R; Boyer, Y; Cuervo, L G; Edwards, Sjl; Lydiatt, A; Gough, D; Grimshaw, J; Kristjansson, E; Mbuagbaw, L; McGowan, J; Moher, D; Pantoja, T; Petticrew, M; Pottie, K; Rader, T; Shea, B; Taljaard, M; Waters, E; Weijer, C; Wells, G A; White, H; Whitehead, M; Tugwell, P

    2015-10-21

    Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies.

  1. Symptomatic improvement reported after receiving Reiki at a cancer infusion center.

    Science.gov (United States)

    Marcus, Dawn A; Blazek-O'Neill, Betsy; Kopar, Jennifer L

    2013-03-01

    To evaluate patient-perceived benefits from receiving Reiki at a cancer infusion center. During a 6-month period, adults at a university hospital receiving Reiki through volunteer services were invited to complete a survey asking about perceived changes after Reiki. Changes in pain, mood, distress, sleep, and appetite were rated on a 5-point scale from no benefit to great benefit. Surveys were distributed after completing treatment and were returned in postage-paid envelops. A total of 145 surveys were completed (34.5% response rate), with 47 participants seen in the cancer infusion center and 98 in other areas of the hospital. Reiki was rated as a positive experience by 94% at the cancer center and 93% of others, with 92% at the cancer center and 86% of others interested in receiving additional Reiki sessions. Symptomatic improvement was similar for people at the cancer center and others, respectively, with much to great improvement for 89% and 86% for relaxation, 75% and 75% for anxiety/worry, 81% and 78% for improved mood, 43% and 35% for improved sleep, 45% and 49% for reduced pain, 38% and 43% for reduced isolation/loneliness, 75% and 63% for improved attitude, and 30% and 30% for improved appetite. Response was unaffected by previous exposure to Reiki, massage, or other touch therapy. Reiki results in a broad range of symptomatic benefits, including improvements in common cancer-related symptoms.

  2. Improving detection of first-episode psychosis by mental health-care services using a self-report questionnaire

    NARCIS (Netherlands)

    Boonstra, Nynke; Wunderink, Lex; Sytema, Sjoerd; Wiersma, Durk

    2009-01-01

    Objective: To examine the utility of the Community Assessment of Psychic Experiences (CAPE)-42, a self-report questionnaire, to improve detection of first-episode psychosis in new referrals to mental health services. Method: At first contact with mental health-care services patients were asked to

  3. Improving Students' Report Writing Quality in an EAP Context: Group versus Individual

    Science.gov (United States)

    Ali, Holi Ibrahim Holi

    2012-01-01

    This paper looks into report writing quality on both individual and group bases in an EAP context. A total of 100 EFL students at post foundation level in a University College in Oman, and 15 EFL teachers were selected randomly. Questionnaires were administered to investigate their perceptions and experiences with report writing quality on…

  4. On Improving the Definition of Reporting and its Place in the Enterprise Development Strategy

    Directory of Open Access Journals (Sweden)

    Chernikova Irina B.

    2017-09-01

    Full Text Available The interpretations of the concept of «reporting» have been considered according to different sources and an own vision of this category has been suggested based on an analysis of the tendency of relations in the economic sphere. Also an own interpretation of accounting as a process has been suggested. The need to correctly define reporting in terms of the overall enterprise strategy and formation of the correct stakeholders’ perception of reporting as an information array has been substantiated. The authors have clarified the place of the non-financial reporting in the overall development strategy of enterprise and demonstrated the appropriateness of providing interested users with full information about the activities of enterprise. The main possibilities for introducing an open reporting mechanism have been indicated.

  5. Final Report Collaborative Project: Improving the Representation of Coastal and Estuarine Processes in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frank [Univ. of Connecticut, Storrs, CT (United States); Dennis, John [Univ. of Connecticut, Storrs, CT (United States); MacCready, Parker [Univ. of Connecticut, Storrs, CT (United States); Whitney, Michael M. [Univ. of Connecticut, Storrs, CT (United States)

    2016-09-30

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation.

  6. Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention.

    Science.gov (United States)

    Lawton, Rebecca; O'Hara, Jane Kathryn; Sheard, Laura; Armitage, Gerry; Cocks, Kim; Buckley, Hannah; Corbacho, Belen; Reynolds, Caroline; Marsh, Claire; Moore, Sally; Watt, Ian; Wright, John

    2017-08-01

    To evaluate the efficacy of the Patient Reporting and Action for a Safe Environment intervention. A multicentre cluster randomised controlled trial. Clusters were 33 hospital wards within five hospitals in the UK. All patients able to give informed consent were eligible to take part. Wards were allocated to the intervention or control condition. The ward-level intervention comprised two tools: (1) a questionnaire that asked patients about factors contributing to safety (patient measure of safety (PMOS)) and (2) a proforma for patients to report both safety concerns and positive experiences (patient incident reporting tool). Feedback was considered in multidisciplinary action planning meetings. Primary outcomes were routinely collected ward-level harm-free care (HFC) scores and patient-level feedback on safety (PMOS). Intervention uptake and retention of wards was 100% and patient participation was high (86%). We found no significant effect of the intervention on any outcomes at 6 or 12 months. However, for new harms (ie, those for which the wards were directly accountable) intervention wards did show greater, though non-significant, improvement compared with control wards. Analyses also indicated that improvements were largest for wards that showed the greatest compliance with the intervention. Adherence to the intervention, particularly the implementation of action plans, was poor. Patient safety outcomes may represent too blunt a measure. Patients are willing to provide feedback about the safety of their care. However, we were unable to demonstrate any overall effect of this intervention on either measure of patient safety and therefore cannot recommend this intervention for wider uptake. Findings indicate promise for increasing HFC where wards implement ≥75% of the intervention components. ISRCTN07689702; pre-results. 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/.

  7. Closing the quality gap: revisiting the state of the science (vol. 5: public reporting as a quality improvement strategy).

    Science.gov (United States)

    Totten, Annette M; Wagner, Jesse; Tiwari, Arpita; O'Haire, Christen; Griffin, Jessica; Walker, Miranda

    2012-07-01

    The goal of this review was to evaluate the effectiveness of public reporting of health care quality information as a quality improvement strategy. We sought to determine if public reporting results in improvements in health care delivery and patient outcomes. We also considered whether public reporting affects the behavior of patients or of health care providers. Finally we assessed whether the characteristics of the public reports and the context affect the impact of public reports. Articles available between 1980 and 2011 were identified through searches of the following bibliographical databases: MEDLINE®, Embase, EconLit, PsychINFO, Business Source Premier, CINAHL, PAIS, Cochrane Database of Systematic Reviews, EPOC Register of Studies, DARE, NHS EED, HEED, NYAM Grey Literature Report database, and other sources (experts, reference lists, and gray literature). We screened citations based on inclusion and exclusion criteria developed based on our definition of public reporting. We initially did not exclude any studies based on study design. Of the 11,809 citations identified through title and abstract triage, we screened and reviewed 1,632 articles. A total of 97 quantitative and 101 qualitative studies were included, abstracted, entered into tables, and evaluated. The heterogeneity of outcomes as well as methods prohibited formal quantitative synthesis. Systematic reviews were used to identify studies, but their conclusions were not incorporated into this review. For most of the outcomes, the strength of the evidence available to assess the impact of public reporting was moderate. This was due in part to the methodological challenges researchers face in designing and conducting research on the impact of population-level interventions. Public reporting is associated with improvement in health care performance measures such as those included in Nursing Home Compare. Almost all identified studies found no evidence or only weak evidence that public reporting

  8. Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy.

    Science.gov (United States)

    Powell, Daniel K; Lin, Eaton; Silberzweig, James E; Kagetsu, Nolan J

    2014-03-01

    To retrospectively compare resident adherence to checklist-style structured reporting for maxillofacial computed tomography (CT) from the emergency department (when required vs. suggested between two programs). To compare radiology resident reporting accuracy before and after introduction of the structured report and assess its ability to decrease the rate of undetected pathology. We introduced a reporting checklist for maxillofacial CT into our dictation software without specific training, requiring it at one program and suggesting it at another. We quantified usage among residents and compared reporting accuracy, before and after counting and categorizing faculty addenda. There was no significant change in resident accuracy in the first few months, with residents acting as their own controls (directly comparing performance with and without the checklist). Adherence to the checklist at program A (where it originated and was required) was 85% of reports compared to 9% of reports at program B (where it was suggested). When using program B as a secondary control, there was no significant difference in resident accuracy with or without using the checklist (comparing different residents using the checklist to those not using the checklist). Our results suggest that there is no automatic value of checklists for improving radiology resident reporting accuracy. They also suggest the importance of focused training, checklist flexibility, and a period of adjustment to a new reporting style. Mandatory checklists were readily adopted by residents but not when simply suggested. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  9. Reports of unintended consequences of financial incentives to improve management of hypertension.

    Directory of Open Access Journals (Sweden)

    Sylvia J Hysong

    Full Text Available Given the increase in financial-incentive programs nationwide, many physicians and physician groups are concerned about potential unintended consequences of providing financial incentives to improve quality of care. However, few studies examine whether actual unintended consequences result from providing financial incentives to physicians. We sought to document the extent to which the unintended consequences discussed in the literature were observable in a randomized clinical trial (RCT of financial incentives.We conducted a qualitative observational study nested within a larger RCT of financial incentives to improve hypertension care. We conducted 30-minute telephone interviews with primary care personnel at facilities participating in the RCT housed at12 geographically dispersed Veterans Affairs Medical Centers nationwide. Participants answered questions about unintended effects, clinic team dynamics, organizational impact on care delivery, study participation. We employed a blend of inductive and deductive qualitative techniques for analysis.Sixty-five participants were recruited from RCT enrollees and personnel not enrolled in the larger RCT, plus one primary care leader per site.Emergent themes included possible patient harm, emphasis on documentation over improving care, reduced professional morale, and positive spillover. All discussions of unintended consequences involving patient harm were only concerns, not actual events. Several unintended consequences concerned ancillary initiatives for quality improvement (e.g., practice guidelines and performance measurement systems rather than financial incentives.Many unintended consequences of financial incentives noted were either only concerns or attributable to ancillary quality-improvement initiatives. Actual unintended consequences included improved documentation of care without necessarily improving actual care, and positive unintended consequences.Clinicaltrials.gov Identifier: NCT

  10. Greater Caregiving Risk, Better Infant Memory Performance?

    Science.gov (United States)

    Rifkin-Graboi, Anne; Quan, Jeffry; Richmond, Jenny; Goh, Shaun Kok Yew; Sim, Lit Wee; Chong, Yap Seng; Francois-Bureau, Jean; Chen, Helen; Qiu, Anqi

    2018-04-16

    Poor early life care often relates to cognitive difficulties. However, newer work suggests that in early-life, adversity may associate with enhanced or accelerated neurodevelopment. We examine associations between postnatal caregiving risks (i.e., higher self-reported postnatal-anxiety and lower observed maternal sensitivity) and infant relational memory (i.e. via deferred imitation and relational binding). Using subsamples of 67-181 infants (aged 433-477 post-conceptual days, or roughly five to seven months since birth) taking part in the GUSTO study, we found such postnatal caregiving risk significantly predictive of "better" performance on a relational binding task following a brief delay, after Bonferroni adjustments. Subsequent analyses suggest that the association between memory and these risks may specifically be apparent amongst infants spending at least 50% of their waking hours in the presence of their mothers. Our findings echo neuroimaging research concerning similar risk exposure and larger infant hippocampal volume, and likewise underscore the importance of considering developmental context in understanding early life experience. With this in mind, these findings caution against the use of cognitive outcomes as indices of experienced risk. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

  11. Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

    Science.gov (United States)

    Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

    Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

  12. Report: Improvements Needed by EPA to Reduce Risk in Employee Hiring Process

    Science.gov (United States)

    Report #15-P-0253, August 3, 2015. Without verification of prior employment or references, the potential exists that the EPA will not hire the best possible staff, or will hire an employee based on false statements.

  13. Designing a Safety Reporting Smartphone Application to Improve Patient Safety After Total Hip Arthroplasty.

    Science.gov (United States)

    Krumsvik, Ole Andreas; Babic, Ankica

    2017-01-01

    This paper presents a safety reporting smartphone application which is expected to reduce the occurrence of postoperative adverse events after total hip arthroplasty (THA). A user-centered design approach was utilized to facilitate optimal user experience. Two main implemented functionalities capture patient pain levels and well-being, the two dimensions of patient status that are intuitive and commonly checked. For these and other functionalities, mobile technology could enable timely safety reporting and collection of patient data out of a hospital setting. The HCI expert, and healthcare professionals from the Haukeland University Hospital in Bergen have assessed the design with respect to the interaction flow, information content, and self-reporting functionalities. They have found it to be practical, intuitive, sufficient and simple for users. Patient self-reporting could help recognizing safety issues and adverse events.

  14. Report: Plans to Migrate Data to the New EPA Acquisition System Need Improvement

    Science.gov (United States)

    Report #10-P-0071, February 24, 2010. EPA’s plans for migrating data from ICMS to EAS lack sufficient incorporation of data integrity and quality checks to ensure the complete and accurate transfer of procurement data.

  15. Reporting to Improve Reproducibility and Facilitate Validity Assessment for Healthcare Database Studies V1.0

    NARCIS (Netherlands)

    Wang, Shirley V.; Schneeweiss, Sebastian; Berger, Marc L.; Brown, Jeffrey; de Vries, Frank; Douglas, Ian; Gagne, Joshua J.; Gini, Rosa; Klungel, Olaf; Mullins, C. Daniel; Nguyen, Michael D.; Rassen, Jeremy A.; Smeeth, Liam; Sturkenboom, Miriam C J M

    2017-01-01

    Purpose: Defining a study population and creating an analytic dataset from longitudinal healthcare databases involves many decisions. Our objective was to catalogue scientific decisions underpinning study execution that should be reported to facilitate replication and enable assessment of validity

  16. Reporting to Improve Reproducibility and Facilitate Validity Assessment for Healthcare Database Studies V1.0

    NARCIS (Netherlands)

    Wang, Shirley V.; Schneeweiss, Sebastian; Berger, Marc L.; Brown, Jeffrey; de Vries, Frank|info:eu-repo/dai/nl/303546670; Douglas, Ian; Gagne, Joshua J.; Gini, Rosa; Klungel, Olaf|info:eu-repo/dai/nl/181447649; Mullins, C. Daniel; Nguyen, Michael D.; Rassen, Jeremy A.; Smeeth, Liam; Sturkenboom, Miriam C J M

    2017-01-01

    Purpose Defining a study population and creating an analytic dataset from longitudinal healthcare databases involves many decisions. Our objective was to catalogue scientific decisions underpinning study execution that should be reported to facilitate replication and enable assessment of validity of

  17. CONTRACT MANAGEMENT: No DOD Proposal to Improve Contract Service Costs Reporting

    National Research Council Canada - National Science Library

    2001-01-01

    ... were being improperly justified and classified and accounting systems used to track expenditures were inadequate. In view of these concerns, the Congress requires us to provide an annual assessment of DOD actions to address reporting problems.

  18. Report: Improvements Needed in EPA’s Network Traffic Management Practices

    Science.gov (United States)

    Report #11-P-0159, March 14, 2011. OEI does not have consistent, repeatable intrusion detection system monitoring practices in place, which inhibits EPA’s ability to monitor unusual network activity and thus protect Agency systems and associated data.

  19. Report: Improvements Needed in CSB’s Identity and Access Management and Incident Response Security Functions

    Science.gov (United States)

    Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.

  20. Report: EPA’s National Security Information Program Could Be Improved

    Science.gov (United States)

    Report #12-P-0543, June 18, 2012. Under its classified NSI program, EPA has assigned responsibilities and provided guidance, training, and oversight. EPA program offices provide secure equipment and space, following NSI program specifications.

  1. Improved mutagen-testing systems in mice. Progress report, 1 June 1975--31 May 1976

    International Nuclear Information System (INIS)

    Roderick, T.H.

    1976-01-01

    Progress is reported on the following research projects: detection of inversions; inversions produced by chemical mutagens and x radiation; phenotypic effects of inversions; linkage of inversions; cytology of inversions; Robertsonian metacentric translocations; and somatic crossing-over in mammals

  2. Report: Ongoing Management Improvements and Further Evaluation Vital to EPA Stewardship and Voluntary Programs

    Science.gov (United States)

    Report #2005-P-00007, February 17, 2005. We asked stakeholders to define stewardship, list motivators and obstacles to participating in stewardship programs, and outline key roles for EPA to play to foster participating in environmental stewardship.

  3. Report: Controls and Oversight Needed to Improve Administration of EPA’s Customer Service Lines

    Science.gov (United States)

    Report #13-P-0432, September 26, 2013. The EPA has a variety of resources—including telephone hotlines, Web clearinghouses, and other online reference information—which the OIG has categorized as customer service lines (CSLs).

  4. Report: Wells Band Council Needs to Improve Its Accounting System to Comply With Federal Regulations

    Science.gov (United States)

    Report #14-2-0316, July 14, 2014. The Wells Band Council’s accounting system did not comply with federal regulations, which resulted in $390,000 of questioned costs and proposed high-risk designation for the grantee.

  5. Report: EPA Needs to Improve Oversight of Its Information Technology Projects

    Science.gov (United States)

    Report #2005-P-00023, September 14, 2005. EPA’s Office of Environmental Information (OEI) did not sufficiently oversee information technology projects to ensure they met planned budgets and schedules.

  6. Report: EPA Needs to Improve Recording Information Technology Investments and Issue a Policy Covering All Investments

    Science.gov (United States)

    Report #15-P-0292, September 22, 2015. The EPA management of its $334 million in IT investments is noncompliant with its current policy. Thus, the EPA is at risk of not managing taxpayer dollars properly.

  7. Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to support Healthcare Quality Improvement.

    Science.gov (United States)

    Grundmeier, Robert W; Masino, Aaron J; Casper, T Charles; Dean, Jonathan M; Bell, Jamie; Enriquez, Rene; Deakyne, Sara; Chamberlain, James M; Alpern, Elizabeth R

    2016-11-09

    Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports. A sample of 1,000 radiology reports was used to construct three candidate classification models. A test set of 500 reports was used to validate the model performance. Blinded manual review of radiology reports by two independent physicians provided the reference standard. Each radiology report was segmented and word stem and bigram features were constructed. Common English "stop words" and rare features were excluded. We used 10-fold cross-validation to select optimal configuration parameters for each model. Accuracy, recall, precision and the F1 score were calculated. The final model was compared to the use of diagnosis codes for the identification of patients with long bone fractures. There were 329 unique word stems and 344 bigrams in the training documents. A support vector machine classifier with Gaussian kernel performed best on the test set with accuracy=0.958, recall=0.969, precision=0.940, and F1 score=0.954. Optimal parameters for this model were cost=4 and gamma=0.005. The three classification models that we tested all performed better than diagnosis codes in terms of accuracy, precision, and F1 score (diagnosis code accuracy=0.932, recall=0.960, precision=0.896, and F1 score=0.927). NLP methods using a corpus of 1,000 training documents accurately identified acute long bone fractures from radiology reports. Strategic use of straightforward NLP methods, implemented with freely available

  8. Improving the creation and reporting of structured findings during digital pathology review

    Directory of Open Access Journals (Sweden)

    Ida Cervin

    2016-01-01

    Full Text Available Background: Today, pathology reporting consists of many separate tasks, carried out by multiple people. Common tasks include dictation during case review, transcription, verification of the transcription, report distribution, and report the key findings to follow-up registries. Introduction of digital workstations makes it possible to remove some of these tasks and simplify others. This study describes the work presented at the Nordic Symposium on Digital Pathology 2015, in Linköping, Sweden. Methods: We explored the possibility to have a digital tool that simplifies image review by assisting note-taking, and with minimal extra effort, populates a structured report. Thus, our prototype sees reporting as an activity interleaved with image review rather than a separate final step. We created an interface to collect, sort, and display findings for the most common reporting needs, such as tumor size, grading, and scoring. Results: The interface was designed to reduce the need to retain partial findings in the head or on paper, while at the same time be structured enough to support automatic extraction of key findings for follow-up registry reporting. The final prototype was evaluated with two pathologists, diagnosing complicated partial mastectomy cases. The pathologists experienced that the prototype aided them during the review and that it created a better overall workflow. Conclusions: These results show that it is feasible to simplify the reporting tasks in a way that is not distracting, while at the same time being able to automatically extract the key findings. This simplification is possible due to the realization that the structured format needed for automatic extraction of data can be used to offload the pathologists′ working memory during the diagnostic review.

  9. [Vertical social mobility in Spain and ways to improve it. SESPAS report 2014].

    Science.gov (United States)

    García-Altés, Anna; Ortún, Vicente

    2014-06-01

    In this article, we analyze the extent to which an individual's socioeconomic status is inherited and how equality of opportunity could be increased to improve social mobility. Poverty and deprivation can stop being dynastic-like if the social elevator works. In Spain, income inequality, measured by the Gini coefficient, rose from 0.31 in 2006 to 0.35 in 2012 (moving away from Scandinavia and Central Europe and more closely resembling income inequality in the UK or the United States), while the degree of intergenerational mobility is half-way between that in Italy and the United States. To change this situation and make the social elevator work, primary education should be improved and the health system should be steered toward primary healthcare. This will not be feasible without an improvement in politics and the institutional framework that determine these factors. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia.

    Science.gov (United States)

    Reid, Kathryn J; Baron, Kelly Glazer; Lu, Brandon; Naylor, Erik; Wolfe, Lisa; Zee, Phyllis C

    2010-10-01

    To assess the efficacy of moderate aerobic physical activity with sleep hygiene education to improve sleep, mood and quality of life in older adults with chronic insomnia. Seventeen sedentary adults aged >or=55 years with insomnia (mean age 61.6 [SD±4.3] years; 16 female) participated in a randomized controlled trial comparing 16 weeks of aerobic physical activity plus sleep hygiene to non-physical activity plus sleep hygiene. Eligibility included primary insomnia for at least 3 months, habitual sleep duration 5. Outcomes included sleep quality, mood and quality of life questionnaires (PSQI, Epworth Sleepiness Scale [ESS], Short-form 36 [SF-36], Center for Epidemiological Studies Depression Scale [CES-D]). The physical activity group improved in sleep quality on the global PSQI (pimprovements in vitality (p=.017) compared to baseline scores. Aerobic physical activity with sleep hygiene education is an effective treatment approach to improve sleep quality, mood and quality of life in older adults with chronic insomnia.

  11. Effects of a proposed quality improvement process in the proportion of the reported ultrasound findings unsupported by stored images.

    Science.gov (United States)

    Schenone, Mauro; Ziebarth, Sarah; Duncan, Jose; Stokes, Lea; Hernandez, Angela

    2018-02-05

    To investigate the proportion of documented ultrasound findings that were unsupported by stored ultrasound images in the obstetric ultrasound unit, before and after the implementation of a quality improvement process consisting of a checklist and feedback. A quality improvement process was created involving utilization of a checklist and feedback from physician to sonographer. The feedback was based on findings of the physician's review of the report and images using a check list. To assess the impact of this process, two groups were compared. Group 1 consisted of 58 ultrasound reports created prior to initiation of the process. Group 2 included 65 ultrasound reports created after process implementation. Each chart was reviewed by a physician and a sonographer. Findings considered unsupported by stored images by both reviewers were used for analysis, and the proportion of unsupported findings was compared between the two groups. Results are expressed as mean ± standard error. A p value of improvement process implementation. Thus, we present a simple yet effective quality improvement process to reduce unsupported ultrasound findings.

  12. Mayors and Public Education: The Case for Greater Involvement

    Science.gov (United States)

    Usdan, Michael D.

    2006-01-01

    Over the last generation, a new politics of education has evolved throughout the United States. Since the 1983 watershed report "A Nation at Risk" (National Commission on Excellence in Education, 1983), the country's most influential business and political leaders--and, more recently, mayors--have spearheaded efforts to improve student achievement…

  13. Self-assessment on the competencies and reported improvement priorities for pediatrics residents.

    Science.gov (United States)

    Li, Su-Ting T; Tancredi, Daniel J; Burke, Ann E; Guillot, Ann; Guralnick, Susan; Trimm, R Franklin; Mahan, John D

    2012-12-01

    Self-assessment and self-directed learning are essential to becoming an effective physician. To identify factors associated with resident self-assessment on the competencies, and to determine whether residents chose areas of self-assessed relative weakness as areas for improvement in their Individualized Learning Plan (ILP). We performed a cross-sectional analysis of the American Academy of Pediatrics' PediaLink ILP database. Pediatrics residents self-assessed their competency in the 6 Accreditation Council for Graduate Medical Education competencies using a color-coded slider scale with end anchors "novice" and "proficient" (0-100), and then chose at least 1 competency to improve. Multivariate regression explored the relationship between overall confidence in core competencies, sex, level of training, and degree (MD or DO) status. Correlation examined whether residents chose to improve competencies in which they rated themselves as lower. A total of 4167 residents completed an ILP in academic year 2009-2010, with residents' ratings improving from advanced beginner (48 on a 0-100 scale) in postgraduate year-1 residents (PGY-1s) to competent (75) in PGY-3s. Residents rated themselves as most competent in professionalism (mean, 75.3) and least competent in medical knowledge (mean, 55.8) and systems-based practice (mean, 55.2). In the adjusted regression model, residents' competency ratings increased by level of training and whether they were men. In PGY-3s, there was no difference between men and women. Residents selected areas for improvement that correlated to competencies where they had rated themselves lower (P knowledge and systems-based practice, even as PGY-3s. Residents tended to choose subcompetencies, which they rated as lower to focus on improving.

  14. Use of Processed Nerve Allografts to Repair Nerve Injuries Greater Than 25 mm in the Hand.

    Science.gov (United States)

    Rinker, Brian; Zoldos, Jozef; Weber, Renata V; Ko, Jason; Thayer, Wesley; Greenberg, Jeffrey; Leversedge, Fraser J; Safa, Bauback; Buncke, Gregory

    2017-06-01

    Processed nerve allografts (PNAs) have been demonstrated to have improved clinical results compared with hollow conduits for reconstruction of digital nerve gaps less than 25 mm; however, the use of PNAs for longer gaps warrants further clinical investigation. Long nerve gaps have been traditionally hard to study because of low incidence. The advent of the RANGER registry, a large, institutional review board-approved, active database for PNA (Avance Nerve Graft; AxoGen, Inc, Alachua, FL) has allowed evaluation of lower incidence subsets. The RANGER database was queried for digital nerve repairs of 25 mm or greater. Demographics, injury, treatment, and functional outcomes were recorded on standardized forms. Patients younger than 18 and those lacking quantitative follow-up data were excluded. Recovery was graded according to the Medical Research Council Classification for sensory function, with meaningful recovery defined as S3 or greater level. Fifty digital nerve injuries in 28 subjects were included. There were 22 male and 6 female subjects, and the mean age was 45. Three patients gave a previous history of diabetes, and there were 6 active smokers. The most commonly reported mechanisms of injury were saw injuries (n = 13), crushing injuries (n = 9), resection of neuroma (n = 9), amputation/avulsions (n = 8), sharp lacerations (n = 7), and blast/gunshots (n = 4). The average gap length was 35 ± 8 mm (range, 25-50 mm). Recovery to the S3 or greater level was reported in 86% of repairs. Static 2-point discrimination (s2PD) and Semmes-Weinstein monofilament (SWF) were the most common completed assessments. Mean s2PD in 24 repairs reporting 2PD data was 9 ± 4 mm. For the 38 repairs with SWF data, protective sensation was reported in 33 repairs, deep pressure in 2, and no recovery in 3. These data compared favorably with historical data for nerve autograft repairs, with reported levels of meaningful recovery of 60% to 88%. There were no reported adverse effects

  15. 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.

  16. Urgent need to improve the quality of case report in traditional Chinese medicine: Assessment on reporting quality of 3,417 cases.

    Science.gov (United States)

    Fu, Shu-Fei; Kun, Wai; Zeng, Xiao-Xi; Zhang, Li; Cheng, Chung-Wah; Song, Lisa; Zhong, Linda Li-Dan; Lin, Jia; Wang, Yong-Yan; Shang, Hong-Cai; Bian, Zhao-Xia

    2016-06-01

    improving the contents and format of case reports in TCM.

  17. Improvements to the COBRA-TF (EPRI) computer code for steam generator analysis. Final report

    International Nuclear Information System (INIS)

    Stewart, C.W.; Barnhart, J.S.; Koontz, A.S.

    1980-09-01

    The COBRA-TF (EPRI) code has been improved and extended for pressurized water reactor steam generator analysis. New features and models have been added in the areas of subcooled boiling and heat transfer, turbulence, numerics, and global steam generator modeling. The code's new capabilities are qualified against selected experimental data and demonstrated for typical global and microscale steam generator analysis

  18. Improving the Study Skills of Discrepant Achieving Seventh Grade Students. Research and Development Report 30.

    Science.gov (United States)

    Baker, Roger G.; Pappas, James P.

    Three approaches to the problem of helping underachieving seventh grade boys improve their study habits are compared: (1) behavior modification; (2) group counseling; and (3) didactic instruction. A pre-post criteria format sought to measure change in terms of: (1) academic achievement as measured by grade point average; and (2) study habits and…

  19. Improved control rod drive handling equipment for BWRs [boiling-water reactors]: Final report

    International Nuclear Information System (INIS)

    Turner, A.P.L.; Gorman, J.A.

    1987-08-01

    Improved equipment for removing and replacing control rod drives (CRDs) in BWR plants has been designed, built and tested. Control rod drives must be removed from the reactor periodically for servicing. Removal and replacement of CRDs using equipment originally supplied with the plant has long been recognized as one of the more difficult and highest radiation exposure maintenance operations that must be performed at BWR plants. The improved equipment was used for the first time at Quad Cities, Unit 2, during a Fall 1986 outage. The trial of the equipment was highly successful, and it was shown that the new equipment significantly improves CRD handling operations. The new equipment significantly simplifies the sequence of operations required to lower a CRD from its housing, upend it to a horizontal orientation, and transport it out of the reactor containment. All operations of the new equipment are performed from the undervessel equipment handling platform, thus, eliminating the requirement for a person to work on the lower level of the undervessel gallery which is often highly contaminated. Typically, one less person is required to operate the equipment than were used with the older equipment. The new equipment incorporates a number of redundant and fail safe features that improve operations and reduce the chances for accidents

  20. Investigating Information Needs to Improve Cooperation Between Developers and Bug Reporters

    NARCIS (Netherlands)

    Breu, S.; Premraj, R.; Sillito, J.; Zimmermann, T.

    2010-01-01

    For many software projects, bug tracking systems play a central role in supporting collaboration between the developers and the users of the software. To better understand this collaboration and how tool support can be improved, we have quantitatively and qualitatively analysed the questions asked

  1. Research Base for Improved Classroom Learning: Brain or Behavior? Evidence Speaks Reports, Vol 1, #9

    Science.gov (United States)

    Bruer, John T.

    2015-01-01

    Implicit in recent Evidence Speaks postings is the need to develop evidence-based interventions for improving student achievement. Comparative analysis of the education research literature versus the educational neuroscience literature suggests that education research, grounded in the behavioral and cognitive sciences, is currently the better…

  2. Brief Report: Longitudinal Improvements in the Quality of Joint Attention in Preschool Children with Autism

    Science.gov (United States)

    Lawton, Kathy; Kasari, Connie

    2012-01-01

    Children with autism exhibit deficits in their quantity and quality of joint attention. Early autism intervention studies rarely document improvement in joint attention quality. The purpose of this study was to determine whether there was a change in joint attention quality for preschoolers with autism who were randomized to a joint attention…

  3. Improving Learning Analytics--Combining Observational and Self-Report Data on Student Learning

    Science.gov (United States)

    Ellis, Robert A.; Han, Feifei; Pardo, Abelardo

    2017-01-01

    The field of education technology is embracing a use of learning analytics to improve student experiences of learning. Along with exponential growth in this area is an increasing concern of the interpretability of the analytics from the student experience and what they can tell us about learning. This study offers a way to address some of the…

  4. Final Report: Systematic Development of a Subgrid Scaling Framework to Improve Land Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Dickinson, Robert Earl [Univ. of Texas, Austin, TX (United States)

    2016-07-11

    We carried out research to development improvements of the land component of climate models and to understand the role of land in climate variability and change. A highlight was the development of a 3D canopy radiation model. More than a dozen publications resulted.

  5. Report on best practice for improved μ-IM injection moulding simulation

    DEFF Research Database (Denmark)

    Tosello, Guido; Costa, Franco; Hansen, Hans Nørgaard

    2010-01-01

    Data analysis and simulations on micro-moulding experiments have been conducted. Micro moulding simulations have been executed taking into account actual processing conditions implementation in the software. Numerous aspects of the simulation set-up have been considered in order to improve the si...

  6. Improving bethesda reporting in thyroid cytology: A team effort goes a long way and still miles to go…

    Directory of Open Access Journals (Sweden)

    Subramanian Kannan

    2017-01-01

    Full Text Available Context: Fine-needle aspiration cytology is the first step in evaluation of thyroid nodules. Although the Bethesda classification for reporting thyroid cytology has been purported that this uniformity in reporting cytology thereby facilitating clinical decision-making, there are also studies indicating that the reporting percentage and the rates of malignancy in each category vary considerably from center to center making the clinical decision more difficult. Aim and Materials and Methods: We looked at our retrospective cytology and histopathology data of thyroid nodules operated between 2012 and 2014 and then prospectively collected data during 2015–2016. In the prospective arm, for every thyroid nodule that was sampled, there was a discussion between the endocrinologist and the cytopathologist on the risk of thyroid cancer (based on the patient's history, examination findings, sonographic pattern, and the cytological appearance. Results: We noted that there was considerable improvement in reporting standards with the rates of nondiagnostic cytology dropping from 11% to 5%, an increased reporting of Bethesda Category 2 and 6 which are the definitive strata of benign and malignant nodules (38% to 41% in Category 2 and 7% to 11% in Category 6 with a high specificity (100%. There was a decline in numbers of Category 4 and 5 (13% to 9% in Category 4 and 12% to 3% in Category 5. The reporting prevalence of Category 3 increased from 19% to 27%. Conclusions: We conclude that a team approach between the clinician who performs the ultrasound and the reporting cytopathologist improves Bethesda reporting, its predictive value, and thus potentially avoiding unnecessary thyroidectomies in benign thyroid nodules and hemithyroidectomies in thyroid cancers.

  7. Transformational change: nurses substituting for ophthalmologists for intravitreal injections – a quality-improvement report

    Directory of Open Access Journals (Sweden)

    Michelotti MM

    2014-04-01

    Full Text Available Monica M Michelotti,1 Salwa Abugreen,2 Simon P Kelly,1 Jiten Morarji,1 Debra Myerscough,2 Tina Boddie,2 Ann Haughton,1 Natalie Nixon,2 Brenda Mason,1 Evangelos Sioras11Ophthalmology Department, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK; 2Ophthalmology Department, East Lancashire NHS Trust, Blackburn, UKBackground: The dramatic increase in need for anti-vascular endothelial growth factor (anti-VEGF intravitreal therapy in the treatment of retinal disease and the absence of an equivalent increase in ophthalmologists to undertake such intravitreal injections created a patient-safety risk. Timing of intravitreal therapy (IVT is critical to prevent vision loss and local clinics lacked capacity to treat patients appropriately. We aimed to improve capacity for IVT by nurse injections.Materials and methods: A multidisciplinary prospective service-improvement process was undertaken at two adjacent general hospitals in the northwest of England. IVT injections by nurses were a principal component of solution development. After we had obtained appropriate institutional approval, experienced ophthalmic nurses were trained, supervised, and assessed to undertake IVT. Ophthalmologists directly supervised the first 200 injections, and a retina specialist was always on site.Results: Nurses undertook 3,355 intravitreal injections between June 2012 and November 2013, with minor adverse events (0.3% subconjunctival hemorrhage and corneal abrasion. There were no patient complaints at either hospital.Conclusion: Experienced ophthalmic nurses quickly learned how to perform such injections safely. IVT by nurses was well accepted by patients and staff. Hospital A trained three nurses sequentially for improved flexibility in scheduling. Novel use of appropriately trained nonmedical staff can improve efficiency and access in an overburdened service with time-sensitive disease. Retinal assessment was undertaken by ophthalmologists only. Improved access to IVT

  8. Mental contrasting of a dieting wish improves self-reported health behaviour

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Oettingen, Gabriele; Mayer, Doris

    2012-01-01

    , they were directed to mentally contrast or indulge in thoughts and images about the named dieting wish. A control condition was given no directions. Two weeks after the experiment, dieters retrospectively rated their behaviour change: in the mental contrasting condition they reported having eaten relatively...... fewer calories overall, fewer high-calorie food and more low-calorie food compared to those in the indulging and control conditions, and they also reported having been more physically active. This transfer effect from one health domain to another suggests a more generalised effect of mental contrasting......Mentally contrasting a desired future with present reality standing in its way promotes commitment to feasible goals, whereas mentally indulging in a desired future does not. Dieting students (N¼134) reported their most important dieting wish that they deemed attainable within a 2-week period. Then...

  9. Recommendations for improving the quality of reporting clinical electrochemotherapy studies based on qualitative systematic review

    DEFF Research Database (Denmark)

    Campana, LG; Clover, AJ; Valpione, S

    2016-01-01

    Electrochemotherapy is becoming a well-established treatment for malignancies of skin and non-skin origin and its use is widening across Europe. The technique was developed and optimized from solid experimental and clinical evidence. A consensus document is now warranted to formalize reporting re...... studies and to provide the recommendations for reporting clinical trials on electrochemotherapy....... results, which should strengthen evidence-based practice recommendations. This consensus should be derived from high quality clinical data collection, clinical expertise and summarizing patient feedback. The first step, which is addressed in this paper, aims to critically analyze the quality of published...

  10. Does work-site physical activity improve self-reported psychosocial workplace factors and job satisfaction?

    DEFF Research Database (Denmark)

    Roessler, K K; Rugulies, R; Bilberg, R

    2013-01-01

    PURPOSE: To investigate whether a work-site strength-training program has a positive effect on self-reported psychosocial workplace factors and job satisfaction. METHODS: We conducted a randomized controlled trial among laboratory technicians implementing neck and shoulder exercises for pain relief......, with 199 participants in the training group and 228 in the control group. Influence at work, sense of community, time pressure, and job satisfaction were measured with the Copenhagen Psychosocial Questionnaire at baseline and post-intervention after 20 weeks. RESULTS: There was no statistically significant...... of a work-site strength-training program on self-reported psychosocial workplace factors and job satisfaction....

  11. A Smartphone-Based Application Improves the Accuracy, Completeness, and Timeliness of Cattle Disease Reporting and Surveillance in Ethiopia

    Directory of Open Access Journals (Sweden)

    Tariku Jibat Beyene

    2018-01-01

    Full Text Available Accurate disease reporting, ideally in near real time, is a prerequisite to detecting disease outbreaks and implementing appropriate measures for their control. This study compared the performance of the traditional paper-based approach to animal disease reporting in Ethiopia to one using an application running on smartphones. In the traditional approach, the total number of cases for each disease or syndrome was aggregated by animal species and reported to each administrative level at monthly intervals; while in the case of the smartphone application demographic information, a detailed list of presenting signs, in addition to the putative disease diagnosis were immediately available to all administrative levels via a Cloud-based server. While the smartphone-based approach resulted in much more timely reporting, there were delays due to limited connectivity; these ranged on average from 2 days (in well-connected areas up to 13 days (in more rural locations. We outline the challenges that would likely be associated with any widespread rollout of a smartphone-based approach such as the one described in this study but demonstrate that in the long run the approach offers significant benefits in terms of timeliness of disease reporting, improved data integrity and greatly improved animal disease surveillance.

  12. Radiation monitoring: Quarterly report for the Greater Manchester Fire and Civil Defence Authority and the Manchester Area Pollution Advisory Council. Manchester Area Gamma Radiation Air Monitoring System (MANAGRAMS): report covering period of 3 months 01/07/1996 to 30/09/1996

    International Nuclear Information System (INIS)

    1996-01-01

    Gamma radiation monitoring data from ten outstations in the Manchester area for the period 01/07/1996 to 30/09/1996 are presented. For each station there is a summary table, a background radiation graph showing 6 hour mean levels and a wind rose graph showing the direction of the wind as a percentage of the total. A line graph comparison between stations is provided for the background 6 hour mean levels and a bar chart comparison of total dose during the reporting period. Graphs of barometric pressure and temperature taken from extra sensors at the Trafford station are also presented. (UK)

  13. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report

    Directory of Open Access Journals (Sweden)

    Parker Stephen W

    2005-02-01

    Full Text Available Abstract Background Vestibular rehabilitation (VR is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC, have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width, lower extremity sagittal plane mechanical energy expenditures (MEE, and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity, were measured. Results Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Conclusion Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster

  14. Lake Roosevelt Rainbow Trout : Habitat/Passage Improvement Project Annual Report 2000.

    Energy Technology Data Exchange (ETDEWEB)

    Sear, Sheri

    2001-02-01

    Lake Franklin D. Roosevelt was created with the completion of the Grand Coulee Dam in 1942. The lake stretches 151 miles up-stream to the International border between the United States and Canada at the 49th parallel. Increased recreational use, subsistence and sport fishing has resulted in intense interest and possible exploitation of the resources within the lake. Previous studies of the lake and its fishery have been limited. Early studies indicate that natural reproduction within the lake and tributaries are not sufficient to support a rainbow trout (Onchoryhnchus mykiss) fishery (Scholz et. al., 1988). These studies indicate that the rainbow trout population may be limited by lack of suitable habitat for spawning and rearing (Scholz et. al., 1988). The initial phase of this project (Phase I, baseline data collection- 1990-91) was directed at the assessment of limiting factors such as quality and quantity of available spawning gravel, identification of passage barriers, and assessment of other limiting factors. Population estimates were conducted using the Seber/LeCren removal/depletion method. After the initial assessment of stream parameters, several streams were selected for habitat/passage improvement projects (Phase II, implementation-1992-96). At the completion of project habitat improvements, the final phase (Phase III, monitoring) began. This phase will assess changes and gauge the success achieved through the improvements. The objective of the project is to correct passage barriers and improve habitat conditions of selected tributaries to Lake Roosevelt for adfluvial rainbow trout that utilize tributary streams for spawning and rearing. Streams with restorable habitats were selected for improvements. Completion of improvement efforts should increase the adfluvial rainbow trout contribution to the resident fishery in Lake Roosevelt. Three co-operating agencies, the Confederated Tribes of the Colville Reservation (CCT), the Spokane Tribe of Indians (STI

  15. Lake Roosevelt Rainbow Trout : Habitat/Passage Improvement Project Annual Report 1999.

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Charles D.

    2000-02-01

    Lake Franklin D. Roosevelt was created with the completion of the Grand Coulee Dam in 1942. The lake stretches 151 miles up-stream to the International border between the United States and Canada at the 49th parallel. Increased recreational use, subsistence and sport fishing has resulted in intense interest and possible exploitation of the resources within the lake. Previous studies of the lake and its fishery have been limited. Early studies indicate that natural reproduction within the lake and tributaries are not sufficient to support a rainbow trout (Onchoryhnchus mykiss) fishery (Scholz et. al., 1988). These studies indicate that the rainbow trout population may be limited by lack of suitable habitat for spawning and rearing (Scholz et. al., 1988). The initial phase of this project (Phase I, baseline data collection- 1990-91) was directed at the assessment of limiting factors such as quality and quantity of available spawning gravel, identification of passage barriers, and assessment of other limiting factors. Population estimates were conducted using the Seber/LeCren removal/depletion method. After the initial assessment of stream parameters, several streams were selected for habitat/passage improvement projects (Phase II, implementation-1992-96). At the completion of project habitat improvements, the final phase (Phase III, monitoring) began. This phase will assess changes and gauge the success achieved through the improvements. The objective of the project is to correct passage barriers and improve habitat conditions of selected tributaries to Lake Roosevelt for adfluvial rainbow trout that utilize tributary streams for spawning and rearing. Streams with restorable habitats were selected for improvements. Completion of improvement efforts should increase the adfluvial rainbow trout contribution to the resident fishery in Lake Roosevelt. Three co-operating agencies, the Confederated Tribes of the Colville Reservation (CCT), the Spokane Tribe of Indians (STI

  16. Cycle-Based Budgeting and Continuous Improvement at Jefferson County Public Schools: Year 1 Report

    Science.gov (United States)

    Yan, Bo

    2016-01-01

    This report documents the first-year of implementing Cycle-based Budgeting at Jefferson County Public Schools (Louisville, KY). To address the limitations of incremental budgeting and zero-based budgeting, a Cycle-based Budgeting model was developed and implemented in JCPS. Specifically, each new program needs to submit an on-line budget request…

  17. Assessing Resilience: How Plans, Strategies, and After Action Reports Can Improve Our Understanding of Organizational Preparedness

    Science.gov (United States)

    2016-09-01

    BOMBING AFTER ACTION REPORT ...................................................................................................55 C. MAY 2014 SAN...Continuity of Operations DHS Department of Homeland Security DPS Texas Department of Public Safety EMS Emergency Medical Services ESL English as a Second...2013 Boston Marathon bombings , and the 2014 wildfires in San Diego County. This chapter also provides overall findings regarding the adaptive

  18. Project CHERISH (Children in Home Environments: Regulation To Improve Safety and Health). Final Report.

    Science.gov (United States)

    Grubb, Paul Dallas

    In 1990, Project CHERISH (Children in Home Environments: Regulation to Increase Safety and Health) enabled the Texas Department of Human Services to implement and evaluate several innovative strategies to strengthen regulation of family day care homes. This report contains descriptions of those strategies, an evaluation of their efficacy, and…

  19. Report: EPA Needs to Improve Its Information Technology Audit Follow-Up Processes

    Science.gov (United States)

    Report #16-P-0100, March 10, 2016. The EPA’s audit follow-up oversight for offices reviewed did not ensure that agreed-to corrective actions were managed effectively in the agency’s Management Audit Tracking System (MATS).

  20. Report: EPA Needs to Improve Internal Controls to Increase Cost Recovery

    Science.gov (United States)

    Report #09-P-0144, April 27, 2009. Within a sample of removal actions we reviewed, EPA collected from responsible parties approximately 11 percent ($31.4 of $294.5 million) of the Federal Government’s costs for conducting the removal actions.

  1. The Medicare Cost Report and the limits of hospital accountability: improving financial accounting data.

    Science.gov (United States)

    Kane, N M; Magnus, S A

    2001-02-01

    Health policy makers, legislators, providers, payers, and a broad range of other players in the health care market routinely seek information on hospital financial performance. Yet the data at their disposal are limited, especially since hospitals' audited financial statements--the "gold standard" in hospital financial reporting--are not publicly available in many states. As a result, the Medicare Cost Report (MCR), filed annually by most U.S. hospitals in order to receive payment for treating Medicare patients, has become the primary public source of hospital financial information. However, financial accounting elements in the MCR are unreliable, poorly defined, and lacking in critical detail. Comparative analyses of MCRs and matched, audited financial statements reveal long-standing problems with the MCR's data, including major differences in reported profits; variations in the reporting of both revenues and expenses; an absence of relevant details, such as charity care, bad debt, operating versus nonoperating income, and affiliate transactions; an inconsistent classification of changes in net assets; and a failure to provide cash flow statements. Because of these problems, MCR financial data give only a limited and often inaccurate picture of the financial position of hospitals. Audited financial statements provide a more complete perspective, enabling analysts to address important questions left unanswered by the MCR data. Regulatory action is needed to create a national database of financial information based upon audited statements.

  2. Healthier Schools: A Review of State Policies for Improving Indoor Air Quality. Research Report.

    Science.gov (United States)

    Bernstein, Tobie

    Existing indoor air quality (IAQ) policies for schools reflect the variety of institutional, political, social, and economic contexts that exist within individual states. The purpose of this report is to provide a better understanding of the types of policy strategies used by states in addressing general indoor air quality problems. The policies…

  3. Lip muscle training improves obstructive sleep apnea and objective sleep: a case report

    Directory of Open Access Journals (Sweden)

    Hiroshi Suzuki

    Full Text Available The present study assessed the potential of lip muscle training for improving sleep. A patient with heavy snoring, daytime sleepiness and dry mouth underwent lip muscle training. Lip closure force LCFmax increased by 67.3% and LCFmin by 152% post-training. AHI decreased from 12.2 to 3.9 events/h by reducing hypopneic episodes. TST, sleep stage N3 and REM sleep increased, and WASO, sleep stage N1, and AI decreased. The patient switched from mouth to nose breathing during sleep and stopped snoring. Improved LCF, by moving the tongue into the anterior-superior oral cavity, may increase upper airway space and reduce the hypopnea index.

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

    International Nuclear Information System (INIS)

    1998-03-01

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

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

    International Nuclear Information System (INIS)

    Hopkins, G.C.

    1980-11-01

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

  6. Improved superconductor for transmission line applications, phase I. Final report, January 1, 1975--June 30, 1975

    International Nuclear Information System (INIS)

    Braginski, A.I.; Mauser, S.F.; Roland, G.W.; Burghardt, R.R.; Daniel, M.R.; Janocko, M.A.

    1975-01-01

    The analysis of an existing superconducting power transmission cable design indicated that economic benefits in the area of refrigeration can be derived from the substitution of Nb 3 Ge superconductor for the presently planned Nb 3 Sn. However, the cost of Nb 3 Ge must be comparable to that of Nb 3 Sn, which is achievable when preparing Nb 3 Ge by the chemical vapor deposition. Alternatively, technical benefits can be obtained. The most essential and prerequisite requirement is that the Nb 3 Ge critical current density be improved significantly over the present state-of-the art. Other properties of Nb 3 Ge are generally suitable for the transmission line application and/or require only moderate improvements. (auth)

  7. Provincial development of a patient-reported outcome initiative to guide patient care, quality improvement, and research.

    Science.gov (United States)

    Olson, Robert A; Howard, Fuchsia; Lapointe, Vincent; Schellenberg, Devin; Nichol, Alan; Bowering, Gale; Curtis, Susan; Walter, Allison; Brown, Steven; Thompson, Corinne; Bergin, Jackie; Lomas, Sheri; French, John; Halperin, Ross; Tyldesley, Scott; Beckham, Wayne

    2018-01-01

    The BC Cancer Agency Radiotherapy (RT) program started the Prospective Outcomes and Support Initiative (POSI) at all six centres to utilize patient-reported outcomes for immediate clinical care, quality improvement, and research. Patient-reported outcomes were collected at time of computed tomography simulation via tablet and 2 to 4 weeks post-RT via either tablet or over the phone by a registered nurse. From 2013 to 2016, patients were approached on 20,150 attempts by POSI for patients treated with RT for bone metastases (52%), brain metastases (11%), lung cancer (17%), gynecological cancer (16%), head and neck cancer (2%), and other pilots (2%). The accrual rate for all encounters was 85% (n = 17,101), with the accrual rate varying between the lowest and the highest accruing centre from 78% to 89% ( P < .001) and varying by tumour site ( P < .001). Using the POSI database, we have performed research and quality improvement initiatives that have changed practice.

  8. Energy Research Advisory Board, Civilian Nuclear Power Panel: Subpanel 1 report, Light water reactor utilization and improvement: Volume 2

    International Nuclear Information System (INIS)

    1986-10-01

    The Secretary of Energy requested that the Office of Nuclear Energy prepare a strategic national plan that outlines the Department's role in the future development of civilian nuclear power and that the Energy Research Advisory Board establish an ad hoc panel to review and comment on this plan. The Energy Research Advisory Board formed a panel for this review and three subpanels were formed. One subpanel was formed to address the institutional issues surrounding nuclear power, one on research and development for advanced nuclear power plants and a third subpanel on light water reactor utilization and improvement. The subpanel on light water reactors held two meetings at which representatives of the DOE, the NRC, EPRI, industry and academic groups made presentations. This is the report of the subpanel on light water reactor utilization and improvement. This report presents the subpanel's assessment of initiatives which the Department of Energy should undertake in the national interest, to develop and support light water reactor technologies

  9. Marked improvement of vulvovaginitis of unknown origin in a pediatric patient--case report.

    Science.gov (United States)

    Check, J H; Cohen, R

    2014-01-01

    To present a novel therapy for pediatric vulvovaginitis. An eight-year-old girl with persistent severe vulvovaginitis of unknown origin also complained of unexplained weight gain and sudden academic difficulties. She was treated with dextroamphetamine sulfate. She not only showed very quick and excellent relief from her vulvovaginitis but she also lost weight and improved her mentality. Sympathomimetic amine therapy may benefit pediatric vulvovaginitis when an infectious cause cannot be ascertained.

  10. Improving CERN's Presence on Wikipedia - Project Report, Summer Student Lecture Program 2017

    CERN Document Server

    Storehaug, Ida

    2017-01-01

    Dissemination of information on high energy physics and related technologies is at the core of CERN’s mission, making research done at CERN available, both to the public and other researchers. Wikipedia, being the most used social media site for researchers and a popular source of science information for the public, is an obvious platform for CERN to be present on. Between 19 June and 25 August 2017, as part of the CERN Summer Student Program, a project to improve CERN’s presence on Wikipedia was carried out in the department of Scientific Information Service at CERN. In the following the use of references in the collection of CERN-related Wikipedia articles is discussed, and the topics of plagiarism and licenses are raised. Furthermore, methods to benefit from the CERN community and archives are described, followed by a summary of how to get a Wikipedia article accepted by the Wikipedia community. Lists of Wikipedia articles created or improved and of Wikipedia articles in need of improvement are given.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-02-28

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

  12. Identification of at-risk students and strategies to improve academic success in first year health programs. A Practice Report

    Directory of Open Access Journals (Sweden)

    Andrew Gerard Pearson

    2013-04-01

    Full Text Available The transition to university is a difficult process for many students, having a negative impact on their academic performance, ultimately resulting in failure or withdrawal from one or more courses in their first semester. This practice report describes a profile analysis and readiness assessment designed to identify students at high academic risk. Students so identified were offered additional workshops to address assumed knowledge and academic skills. Attendance at the workshops correlated with improved academic outcomes.

  13. Novel Contact Materials for Improved Performance CdTe Solar Cells Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Rockett, Angus [Colorado School of Mines, Golden, CO (United States); Marsillac, Sylvain [Old Dominion Univ., Norfolk, VA (United States); Collins, Robert [Univesity of Toledo

    2018-04-15

    This program has explored a number of novel materials for contacts to CdTe solar cells in order to reduce the back contact Schottky barrier to zero and produce an ohmic contact. The project tested a wide range of potential contact materials including TiN, ZrN, CuInSe2:N, a-Si:H and alloys with C, and FeS2. Improved contacts were achieved with FeS2. As part of understanding the operation of the devices and controlling the deposition processes, a number of other important results were obtained. In the process of this project and following its conclusion it led to research that resulted in seven journal articles, nine conference publications, 13 talks presented at conferences, and training of eight graduate students. The seven journal articles were published in 2015, 2016, and 2017 and have been cited, as of March 2018, 52 times (one cited 19 times and two cited 11 times). We demonstrated high levels of doping of CIS with N but electrical activity of the resulting N was not high and the results were difficult to reproduce. Furthermore, even with high doping the contacts were not good. Annealing did not improve the contacts. A-Si:H was found to produce acceptable but unstable contacts, degrading even over a day or two, apparently due to H incorporation into the CdTe. Alloying with C did not improve the contacts or stability. The transition metal nitrides produced Schottky type contacts for all materials tested. While these contacts were found to be unsatisfactory, we investigated FeS2 and found this material to be effective and comparable to the best contacts currently available. The contacts were found to be chemically stable under heat treatment and preferable to Cu doped contacts. Thus, we demonstrated an improved contact material in the course of this project. In addition, we developed new ways of controlling the deposition of CdTe and other materials, demonstrated the nature of defects in CdTe, and studied the distribution of conductivity and carrier type in Cd

  14. Land cover mapping of Greater Mesoamerica using MODIS data

    Science.gov (United States)

    Giri, Chandra; Jenkins, Clinton N.

    2005-01-01

    A new land cover database of Greater Mesoamerica has been prepared using moderate resolution imaging spectroradiometer (MODIS, 500 m resolution) satellite data. Daily surface reflectance MODIS data and a suite of ancillary data were used in preparing the database by employing a decision tree classification approach. The new land cover data are an improvement over traditional advanced very high resolution radiometer (AVHRR) based land cover data in terms of both spatial and thematic details. The dominant land cover type in Greater Mesoamerica is forest (39%), followed by shrubland (30%) and cropland (22%). Country analysis shows forest as the dominant land cover type in Belize (62%), Cost Rica (52%), Guatemala (53%), Honduras (56%), Nicaragua (53%), and Panama (48%), cropland as the dominant land cover type in El Salvador (60.5%), and shrubland as the dominant land cover type in Mexico (37%). A three-step approach was used to assess the quality of the classified land cover data: (i) qualitative assessment provided good insight in identifying and correcting gross errors; (ii) correlation analysis of MODIS- and Landsat-derived land cover data revealed strong positive association for forest (r2 = 0.88), shrubland (r2 = 0.75), and cropland (r2 = 0.97) but weak positive association for grassland (r2 = 0.26); and (iii) an error matrix generated using unseen training data provided an overall accuracy of 77.3% with a Kappa coefficient of 0.73608. Overall, MODIS 500 m data and the methodology used were found to be quite useful for broad-scale land cover mapping of Greater Mesoamerica.

  15. Leveraging health information exchange to improve population health reporting processes: lessons in using a collaborative-participatory design process.

    Science.gov (United States)

    Revere, Debra; Dixon, Brian E; Hills, Rebecca; Williams, Jennifer L; Grannis, Shaun J

    2014-01-01

    Surveillance, or the systematic monitoring of disease within a population, is a cornerstone function of public health. Despite significant investment in information technologies (IT) to improve the public's health, health care providers continue to rely on manual, spontaneous reporting processes that can result in incomplete and delayed surveillance activities. Participatory design principles advocate including real users and stakeholders when designing an information system to ensure high ecological validity of the product, incorporate relevance and context into the design, reduce misconceptions designers can make due to insufficient domain expertise, and ultimately reduce barriers to adoption of the system. This paper focuses on the collaborative and informal participatory design process used to develop enhanced, IT-enabled reporting processes that leverage available electronic health records in a health information exchange to prepopulate notifiable-conditions report forms used by public health authorities. Over nine months, public health stakeholders, technical staff, and informatics researchers were engaged in a multiphase participatory design process that included public health stakeholder focus groups, investigator-engineering team meetings, public health survey and census regarding high-priority data elements, and codesign of exploratory prototypes and final form mock-ups. A number of state-mandated report fields that are not highly used or desirable for disease investigation were eliminated, which allowed engineers to repurpose form space for desired and high-priority data elements and improve the usability of the forms. Our participatory design process ensured that IT development was driven by end user expertise and needs, resulting in significant improvements to the layout and functionality of the reporting forms. In addition to informing report form development, engaging with public health end users and stakeholders through the participatory design

  16. Improving disclosure and consent: "is it safe?": new ethics for reporting personal exposures to environmental chemicals.

    Science.gov (United States)

    Brody, Julia Green; Morello-Frosch, Rachel; Brown, Phil; Rudel, Ruthann A; Altman, Rebecca Gasior; Frye, Margaret; Osimo, Cheryl A; Pérez, Carla; Seryak, Liesel M

    2007-09-01

    The recent flood of research concerning pollutants in personal environmental and biological samples-blood, urine, breastmilk, household dust and air, umbilical cord blood, and other media-raises questions about whether and how to report results to individual study participants. Clinical medicine provides an expert-driven framework, whereas community-based participatory research emphasizes participants' right to know and the potential to inform action even when health effects are uncertain. Activist efforts offer other models. We consider ethical issues involved in the decision to report individual results in exposure studies and what information should be included. Our discussion is informed by our experience with 120 women in a study of 89 pollutants in homes and by interviews with other researchers and institutional review board staff.

  17. Cognitive Behavioral Treatment to Improve Adherence to Hemodialysis Fluid Restrictions: A Case Report

    Directory of Open Access Journals (Sweden)

    Heather M. Anson

    2009-01-01

    Full Text Available This case report describes outpatient psychological treatment targeting adherence to fluid restrictions in a hemodialysis patient. The consequences of nonadherence to fluid restrictions in hemodialysis patients range from minor discomfort to increased hospitalizations and mortality rates. In addition, when patients chronically fail to adhere, they may no longer be candidates for kidney transplant. The interventions focused on polydipsia, characterized by excessive fluid intake. The methods involved 11-sessions of individual psychotherapy incorporating strategies including increasing awareness, decreasing motivation, increasing effort, engaging in competing events, conducting thought stopping, breaking repetitive routines, eliciting social support, and receiving reinforcement. Results demonstrated that the patient successfully restricted his fluid intake at or below recommended levels 83% of days after fading of treatment began. This case report demonstrates the success of cognitive behavioral treatment strategies with a nonpsychiatric hemodialysis patient.

  18. Improving the regulation of safety at DOE nuclear facilities. Final report: Appendices

    International Nuclear Information System (INIS)

    1995-12-01

    The report strongly recommends that, with the end of the Cold War, safety and health at DOE facilities should be regulated by outside agencies rather than by any regulatory scheme, DOE must maintain a strong internal safety management system; essentially all aspects of safety at DOE's nuclear facilities should be externally regulated; and existing agencies rather than a new one should be responsible for external regulation

  19. Cognitive Behavioral Treatment to Improve Adherence to Hemodialysis Fluid Restrictions: A Case Report

    OpenAIRE

    Anson, Heather M.; Byrd, Michelle R.; Koch, Ellen I.

    2009-01-01

    This case report describes outpatient psychological treatment targeting adherence to fluid restrictions in a hemodialysis patient. The consequences of nonadherence to fluid restrictions in hemodialysis patients range from minor discomfort to increased hospitalizations and mortality rates. In addition, when patients chronically fail to adhere, they may no longer be candidates for kidney transplant. The interventions focused on polydipsia, characterized by excessive fluid intake. The methods in...

  20. Improving the regulation of safety at DOE nuclear facilities. Final report: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-01

    The report strongly recommends that, with the end of the Cold War, safety and health at DOE facilities should be regulated by outside agencies rather than by any regulatory scheme, DOE must maintain a strong internal safety management system; essentially all aspects of safety at DOE`s nuclear facilities should be externally regulated; and existing agencies rather than a new one should be responsible for external regulation.

  1. Improving the regulation of safety at DOE nuclear facilities. Final report

    International Nuclear Information System (INIS)

    1995-12-01

    The report strongly recommends that, with the end of the Cold War, safety and health at DOE facilities should be regulated by outside agencies rather than by DOE itself. The three major recommendations are: under any regulatory scheme, DOE must maintain a strong internal safety management system; essentially all aspects of safety at DOE's nuclear facilities should be externally regulated; and existing agencies rather than a new one should be responsible for external regulation

  2. Triangulated Proxy Reporting: a technique for improving how communication partners come to know people with severe cognitive impairment.

    Science.gov (United States)

    Lyons, Gordon; De Bortoli, Tania; Arthur-Kelly, Michael

    2017-09-01

    This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings. Implications for Rehabilitation Triangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners. TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support. TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals.

  3. Develop improved metal hydride technology for the storage of hydrogen. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    Sapru, K.

    1998-12-04

    The overall objective was to develop commercially viable metal hydrides capable of reversibly storing at least 3 wt.% hydrogen for use with PEM fuel cells and hydrogen fueled internal combustion engine (HICE) applications. Such alloys are expected to result in system capacities of greater than 2 wt.%, making metal hydride storage systems (MHSS`s) a practical means of supplying hydrogen for many consumer applications. ECD`s (Energy Conversion Devices, Inc.) past work on sputtered thin films of transition metal-based alloys led to the commercialization of it`s nickel/metal hydride batteries, and similar work on thin film Mg-based alloys demonstrated potential to achieve very high gravimetric and volumetric energy densities approaching 2,500 Wh/Kg and 2,500 Wh/M{sup 3} respectively. Under this 2-year cost shared project with the DOE, the authors have successfully demonstrated the feasibility of scaling up the Mg-based hydrides from thin film to bulk production without substantial loss of storage capacity. ECD made progress in alloy development by means of compositional and process modification. Processes used include Mechanical Alloying, Melt spinning and novel Gas Phase Condensation. It was showed that the same composition when prepared by melt-spinning resulted in a more homogeneous material having a higher PCT plateau pressure as compared to mechanical alloying. It was also shown that mechanically alloyed Mg-Al-Zn results in much higher plateau pressures, which is an important step towards reducing the desorption temperature. While significant progress has been made during the past two years in alloy development and understanding the relationship between composition, structure, morphology, and processing parameters, additional R and D needs to be performed to achieve the goals of this work.

  4. Natural Propagation and Habitat Improvement, Volume 1, Oregon, 1985 Annual and Final Reports.

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Ken

    1986-10-01

    The Hot Springs Fork of the Collawash River is a major sub-drainage in the Clackamas River drainage. Emphasis species for natural production are spring chinook, coho salmon, and winter steelhead. Increased natural production appears limited by a lack of quality rearing habitat. Habitat complexity over approximately 70% of accessible area to anadromous fish has been reduced over the last 40 years by numerous factors. Natural passage barriers limit anadromous fish access to over 7 miles of high quality habitat. In the first year of a multi-year effort to improve fish habitat in the Hot Springs Fork drainage, passage enhancement on two tributaries and channel rehabilitation on one of those tributaries was completed. Three waterfalls on Nohorn Creek were evaluated and passage improved on the uppermost waterfall to provide steelhead full access to 2.4 miles of good quality habitat. The work was completed in October 1985 and involved blasting three jump pools and two holding pools into the waterfall. On Pansy Creek, four potential passage barriers were evaluated and passage improvement work conducted on two logjams and one waterfall. Minor modifications were made to a waterfall to increase flow into a side channel which allows passage around the waterfall. Channel rehabilitation efforts on Pansy Creek (RM 0.0 to 0.3) to increase low flow pool rearing habitat and spawning habitat including blasting five pools into areas of bedrock substrate and using a track-mounted backhoe to construct instream structures. On site materials were used to construct three log sills, three boulder berms, a boulder flow deflector, and five log and boulder structures. Also, an alcove was excavated to provide overwinter rearing habitat. Pre-project monitoring consisting of physical and biological data collection was completed in the project area.

  5. How to improve the validity of sexual behaviour reporting: systematic review of questionnaire delivery modes in developing countries.

    Science.gov (United States)

    Langhaug, Lisa F; Sherr, Lorraine; Cowan, Frances M

    2010-03-01

    To systematically review comparative research from developing countries on the effects of questionnaire delivery mode. We searched Medline, EMbase and PsychINFO and ISSTDR conference proceedings. Randomized control trials and quasi-experimental studies were included if they compared two or more questionnaire delivery modes, were conducted in a developing country, reported on sexual behaviours and occurred after 1980. A total of 28 articles reporting on 26 studies met the inclusion criteria. Heterogeneity of reported trial outcomes between studies made it inappropriate to combine trial outcomes. Eighteen studies compared audio computer-assisted survey instruments (ACASI) or its derivatives [personal digital assistant (PDA) or computer-assisted personal interview (CAPI)] against another self-administered questionnaires, face-to-face interviews or random response technique. Despite wide variation in geography and populations sampled, there was strong evidence that computer-assisted interviews lowered item-response rates and raised rates of reporting sensitive behaviours. ACASI also improved data entry quality. A wide range of sexual behaviours were reported including vaginal, oral, anal and/or forced sex, age of sexual debut, condom use at first and/or last sex. Validation of self-reports using biomarkers was rare. These data reaffirm that questionnaire delivery modes do affect self-reported sexual behaviours and that use of ACASI can significantly reduce reporting bias. Its acceptability and feasibility in developing country settings should encourage researchers to consider its use when conducting sexual health research. Triangulation of self-reported data using biomarkers is recommended. Standardizing sexual behaviour measures would allow for meta-analysis.

  6. Greater-confinement disposal of low-level radioactive wastes

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Gilbert, T.L.; Luner, C.; Merry-Libby, P.A.; Meshkov, N.K.; Yu, C.

    1985-01-01

    Low-level radioactive wastes include a broad spectrum of wastes that have different radionuclide concentrations, half-lives, and physical and chemical properties. Standard shallow-land burial practice can provide adequate protection of public health and safety for most low-level wastes, but a small volume fraction (about 1%) containing most of the activity inventory (approx.90%) requires specific measures known as ''greater-confinement disposal'' (GCD). Different site characteristics and different waste characteristics - such as high radionuclide concentrations, long radionuclide half-lives, high radionuclide mobility, and physical or chemical characteristics that present exceptional hazards - lead to different GCD facility design requirements. Facility design alternatives considered for GCD include the augered shaft, deep trench, engineered structure, hydrofracture, improved waste form, and high-integrity container. Selection of an appropriate design must also consider the interplay between basic risk limits for protection of public health and safety, performance characteristics and objectives, costs, waste-acceptance criteria, waste characteristics, and site characteristics. This paper presents an overview of the factors that must be considered in planning the application of methods proposed for providing greater confinement of low-level wastes. 27 refs

  7. Final Report: Utilizing Alternative Fuel Ignition Properties to Improve SI and CI Engine Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Wooldridge, Margaret; Boehman, Andre; Lavoie, George; Fatouraie, Mohammad

    2017-11-30

    Experimental and modeling studies were completed to explore leveraging physical and chemical fuel properties for improved thermal efficiency of internal combustion engines. Fundamental studies of the ignition chemistry of ethanol and iso-octane blends and constant volume spray chamber studies of gasoline and diesel sprays supported the core research effort which used several reciprocating engine platforms. Single cylinder spark ignition (SI) engine studies were carried out to characterize the impact of ethanol/gasoline, syngas (H2 and CO)/gasoline and other oxygenate/gasoline blends on engine performance. The results of the single-cylinder engine experiments and other data from the literature were used to train a GT Power model and to develop a knock criteria based on reaction chemistry. The models were used to interpret the experimental results and project future performance. Studies were also carried out using a state of the art, direct injection (DI) turbocharged multi- cylinder engine with piezo-actuated fuel injectors to demonstrate the promising spray and spark timing strategies from single-cylinder engine studies on the multi-cylinder engine. Key outcomes and conclusions of the studies were: 1. Efficiency benefits of ethanol and gasoline fuel blends were consistent and substantial (e.g. 5-8% absolute improvement in gross indicated thermal efficiency (GITE)). 2. The best ethanol/gasoline blend (based on maximum thermal efficiency) was determined by the engine hardware and limits based on component protection (e.g. peak in-cylinder pressure or maximum turbocharger inlet temperature) – and not by knock limits. Blends with <50% ethanol delivered significant thermal efficiency gains with conventional SI hardware while maintain good safety integrity to the engine hardware. 3. Other compositions of fuel blends including syngas (H2 and CO) and other dilution strategies provided significant efficiency gains as well (e.g. 5% absolute improvement in ITE). 4. When the

  8. Report on the feasibility study for improving electric motor service centers in Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, J.S.; Jallouk, P.A.; Staunton, R.H.

    1999-12-10

    On March 3 and 4, 1998, a visit was made to Oak Ridge National Laboratory (ORNL) by two officials from Ghana: Mr. I.K. Mintah, Acting Executive Director, Technical Wing, Ministry of Mines and Energy (MOME) and Dr. A.K. Ofosu-Ahenkorah, Coordinator, Energy Efficiency and Conservation Program, MOME. As a result of this visit, Dr. John S. Hsu of ORNL was invited by MOME to visit the Republic of Ghana in order to study the feasibility of improving electric motor service centers in Ghana.

  9. Improved Advanced Actuated Hybrid Mirrors Final Report CRADA No. TC02130.0

    Energy Technology Data Exchange (ETDEWEB)

    Barbee, T. W. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Ealey, M. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-08-25

    This was a collaborative effort to develop and demonstrate an improved Advanced Actuated Hybrid Mirrors (AAHM) for commercial or Government purposes. The AAHM consists of a nanolaminate film replicating a precision optical surface bonded to a Silicon Carbide (SiC) substrate with active figure control capability. The goal of this project was to further the development of specific AAHM technologies. The intent of the CRADA was to combine the expertise of LLNL and NG Xinetics in the manufacture and test of a very high quality AAHM, incorporating lessons learned from earlier joint efforts.

  10. Taino and African maternal heritage in the Greater Antilles.

    Science.gov (United States)

    Bukhari, Areej; Luis, Javier Rodriguez; Alfonso-Sanchez, Miguel A; Garcia-Bertrand, Ralph; Herrera, Rene J

    2017-12-30

    Notwithstanding the general interest and the geopolitical importance of the island countries in the Greater Antilles, little is known about the specific ancestral Native American and African populations that settled them. In an effort to alleviate this lacuna of information on the genetic constituents of the Greater Antilles, we comprehensively compared the mtDNA compositions of Cuba, Dominican Republic, Haiti, Jamaica and Puerto Rico. To accomplish this, the mtDNA HVRI and HVRII regions, as well as coding diagnostic sites, were assessed in the Haitian general population and compared to data from reference populations. The Taino maternal DNA is prominent in the ex-Spanish colonies (61.3%-22.0%) while it is basically non-existent in the ex-French and ex-English colonies of Haiti (0.0%) and Jamaica (0.5%), respectively. The most abundant Native American mtDNA haplogroups in the Greater Antilles are A2, B2 and C1. The African mtDNA component is almost fixed in Haiti (98.2%) and Jamaica (98.5%), and the frequencies of specific African haplogroups vary considerably among the five island nations. The strong persistence of Taino mtDNA in the ex-Spanish colonies (and especially in Puerto Rico), and its absence in the French and English excolonies is likely the result of different social norms regarding mixed marriages with Taino women during the early years after the first contact with Europeans. In addition, this article reports on the results of an integrative approach based on mtDNA analysis and demographic data that tests the hypothesis of a southward shift in raiding zones along the African west coast during the period encompassing the Transatlantic Slave Trade. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Greater Confinement Disposal Program at the Savannah River Plant

    International Nuclear Information System (INIS)

    Towler, O.A.; Cook, J.R.; Peterson, D.L.

    1983-01-01

    Plans for improved LLW disposal at the Savannah River Plant include Greater Confinement Disposal (GCD) for the higher activity fractions of this waste. GCD practices will include waste segregation, packaging, emplacement below the root zone, and stabilizing the emplacement with cement. Statistical review of SRP burial records showed that about 95% of the radioactivity is associated with only 5% of the waste volume. Trigger values determined in this study were compared with actual burials in 1982 to determine what GCD facilities would be needed for a demonstration to begin in Fall 1983. Facilities selected include 8-feet-diameter x 30-feet-deep boreholes to contain reactor scrap, tritiated waste, and selected wastes from offsite

  12. Report: investigation concerning environmental improvement expenditures (1974 survey commissioned by Environmental Agency)

    Energy Technology Data Exchange (ETDEWEB)

    1975-08-01

    Environmental improvement expenditures were calculated from a pilot model for environmental conservation. An average cost for pollution elimination was postulated, and expenditures for lowering a pollution factor by one unit were calculated for construction, amortization, and operation. The pilot model consists of two sectors: economic activities sector (macromodel of Japanese economy, including factors based on industrial production, energy expenditures, and fuel consumption) and pollution factor sector, consisting of 5 pollution factors (sulfur oxides; nitrogen oxides; biological oxygen demand; general wastes; industrial wastes), their causes, treatment, amounts of emission, and target standards. External factors such as population changes and automobile usage are also included. Industries were divided into 20 groups for purposes of setting up a matrix for environmental improvement expenditures. Based on 1972 data, operational costs for desulfurization were calculated to be $410/S ton (direct desulfurization), and $760/S ton (indirect desulfurization), with the weighted averaged value being $609/S ton. Average construction costs for direct and indirect processes were calculated to be $5100/S Kg/hour. Average amortization costs were calculated to be $118/S ton.

  13. Using Primary Care Parenting Interventions to Improve Outcomes in Children with Developmental Disabilities: A Case Report

    Directory of Open Access Journals (Sweden)

    Cassandra L. Tellegen

    2012-01-01

    Full Text Available Parenting is central to the health and well-being of children. Children with developmental disabilities have been shown to be at increased risk of developing emotional and behavioral problems. Parent training programs are effective interventions for improving child behavior and family functioning. This paper describes the outcomes of a brief 4-session parenting intervention (Primary Care Stepping Stones Triple P targeting compliance and cooperative play skills in an 8-year-old girl with Asperger’s disorder and ADHD combined type. The intervention was associated with decreases in child behavior problems, increases in parenting confidence, and decreases in dysfunctional parenting styles. This paper demonstrates that low-intensity parenting interventions can lead to significant improvements in child behavior and family functioning. Such brief interventions are cost effective, can be widely disseminated, and have been designed to be delivered within primary health care settings. Pediatricians can play a key role in identifying parents in need of assistance and in helping them access evidence-based parenting interventions.

  14. Final Report Collaborative Project. Improving the Representation of Coastal and Estuarine Processes in Earth System Models

    Energy Technology Data Exchange (ETDEWEB)

    Bryan, Frank [National Center for Atmospheric Research, Boulder, CO (United States); Dennis, John [National Center for Atmospheric Research, Boulder, CO (United States); MacCready, Parker [Univ. of Washington, Seattle, WA (United States); Whitney, Michael [Univ. of Connecticut

    2015-11-20

    This project aimed to improve long term global climate simulations by resolving and enhancing the representation of the processes involved in the cycling of freshwater through estuaries and coastal regions. This was a collaborative multi-institution project consisting of physical oceanographers, climate model developers, and computational scientists. It specifically targeted the DOE objectives of advancing simulation and predictive capability of climate models through improvements in resolution and physical process representation. The main computational objectives were: 1. To develop computationally efficient, but physically based, parameterizations of estuary and continental shelf mixing processes for use in an Earth System Model (CESM). 2. To develop a two-way nested regional modeling framework in order to dynamically downscale the climate response of particular coastal ocean regions and to upscale the impact of the regional coastal processes to the global climate in an Earth System Model (CESM). 3. To develop computational infrastructure to enhance the efficiency of data transfer between specific sources and destinations, i.e., a point-to-point communication capability, (used in objective 1) within POP, the ocean component of CESM.

  15. Improving Clinical Outcomes in Patients With Methicillin-Sensitive Staphylococcus aureus Bacteremia and Reported Penicillin Allergy.

    Science.gov (United States)

    Blumenthal, Kimberly G; Parker, Robert A; Shenoy, Erica S; Walensky, Rochelle P

    2015-09-01

    Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia is a morbid infection. First-line MSSA therapies (nafcillin, oxacillin, cefazolin) are generally avoided in the 10% of patients reporting penicillin (PCN) allergy, but most of these patients are not truly allergic. We used a decision tree with sensitivity analyses to determine the optimal evaluation and treatment for patients with MSSA bacteremia and reported PCN allergy. Our model simulates 3 strategies: (1) no allergy evaluation, give vancomycin (Vanc); (2) allergy history-guided treatment: if history excludes anaphylactic features, give cefazolin (Hx-Cefaz); and (3) complete allergy evaluation with history-appropriate PCN skin testing: if skin test negative, give cefazolin (ST-Cefaz). Model outcomes included 12-week MSSA cure, recurrence, and death; allergic reactions including major, minor, and potentially iatrogenic; and adverse drug reactions. Vanc results in the fewest patients achieving MSSA cure and the highest rate of recurrence (67.3%/14.8% vs 83.4%/9.3% for Hx-Cefaz and 84.5%/8.9% for ST-Cefaz) as well as the greatest frequency of allergic reactions (3.0% vs 2.4% for Hx-Cefaz and 1.7% for ST-Cefaz) and highest rates of adverse drug reactions (5.2% vs 4.6% for Hx-Cefaz and 4.7% for ST-Cefaz). Even in a "best case for Vanc" scenario, Vanc yields the poorest outcomes. ST-Cefaz is preferred to Hx-Cefaz although sensitive to input variations. Patients with MSSA bacteremia and a reported PCN allergy should have the allergy addressed for optimal treatment. Full allergy evaluation with skin testing seems to be preferred, although more data are needed. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Improving cancer treatment with cyclotron produced radionuclides. Progress report, February 1987--September 1989

    Energy Technology Data Exchange (ETDEWEB)

    Larson, S.M.

    1989-12-31

    This report is divided into six sections, each section dealing with a separate aspect of the program. The six sections are entitled (1) In Vivo Measurement of Amino Acid Transport and Protein Synthesis, (2) Angiogenesis in Human Gliomas: Correlations with Blood Flow and Transport of C-11 AIB, (3) Use of F-18 Fluoropyrimidines for Design and Evaluation of Regional and Systemic Chemotherapeutic Strategies in Human Adenocarcinomas of the Gastrointestinal Tract, (4) Enzymatic Synthesis of Metabolites Labeled with N-13 or C-11, (5) Synthesis of Amino Acids Labeled with C-11, and (6) Instrumentation: Cyclotron and Imaging Systems.

  17. Improving balance, mobility, and dual-task performance in an adolescent with cerebral palsy: A case report.

    Science.gov (United States)

    Fisher-Pipher, Sarah; Kenyon, Lisa K; Westman, Marci

    2017-07-01

    Improving functional mobility is often a desired outcome for adolescents with cerebral palsy (CP). Traditional neurorehabilitation approaches are frequently directed at impairments; however, improvements may not be carried over into functional mobility. The purpose of this case report was to describe the examination, intervention, and outcomes of a task-oriented physical therapy intervention program to improve dynamic balance, functional mobility, and dual-task performance in an adolescent with CP. The participant was a 15-year-old girl with spastic triplegic CP (Gross Motor Classification System Level II). Examination procedures included the Canadian Occupational Performance Measure, 6-minute walk test, Muscle Power Sprint Test, 10 x 5-meter sprint test, Timed Up and Down Stairs Test, Gross Motor Function Measure, Gillette Functional Assessment Questionnaire, and functional lower extremity strength tests. Intervention focused on task-oriented dynamic balance and mobility tasks that incorporated coordination and speed demands as well as task-specific lower extremity and trunk strengthening activities. Dual task demands were integrated into all intervention activities. Post-intervention testing revealed improvements in cardiovascular endurance, anaerobic power, agility, stair climbing, gross motor skills, and mobility. The participant appeared to benefit from a task-oriented program to improve dynamic balance, functional mobility, and dual-task performance.

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

    International Nuclear Information System (INIS)

    Kelvin G. Lynn; Kelly A. Jones

    2007-01-01

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

  19. Final Report. Fumex-III. Improvement of Models Used for Fuel Behaviour Simulation

    International Nuclear Information System (INIS)

    Kulacsy, Katalin

    2013-01-01

    The FUMEX-III coordinated research programme organised by the IAEA was the first FUMEX exercise in which AEKI (Hungarian Academy of Sciences KFKI Atomic Energy Research Institute) took part with the partial support of Paks NPP. The aim of the participation was to test the code FUROM developed at AEKI against not only measurements but also other fuel behaviour simulation codes, to share and discuss modelling experience and issues, and to establish acquaintance with fuel modellers in other countries. Among the numerous cases proposed for the programme, AEKI chose to simulate normal operation up to high burn-up and ramp tests, with special interest in VVER rods and PWR rods with annular pellets. The US PWR 16x16, the SPC RE GINNA, the Kola3-MIR, the IFA-519.9 cases and the AREVA idealised rod were thus selected. The present Final Report gives a short description of the FUROM models relevant to the selected cases, presents the results for the 5 cases and summarises the conclusions of the FUMEX-III programme. The input parameters used for the simulations can be found in the Appendix at the end of the Report. Observations concerning the IFPE datasets are collected for each dataset in their respective Sections for possible use in the IFPE database. (author)

  20. Preliminary report of a gas conditioner to improve operational reliability of cryotherapy in developing countries

    Directory of Open Access Journals (Sweden)

    Broekhuizen Fredrik

    2006-02-01

    Full Text Available Abstract Background Cryotherapy is a safe, affordable, and effective method of treatment for cervical intraepithelial neoplasia. In some low-resource settings, environmental conditions or qualities of the refrigerant gas can lead to blockage of cryotherapy equipment, terminating treatment. A prototype of a gas conditioner to prevent operational failure was designed, built, and field tested. Methods The prototype conditioner device consists of an expansion chamber that filters and dries the refrigerant gas. Users in Peru and Kenya reported on their experience with the prototype conditioner. In Ghana, simulated cryotherapy procedures were used to test the effects of the prototype conditioner, as well as the commonly used "cough technique." Results Anecdotal reports from field use of the device were favorable. During simulated cryotherapy, the prevalence of blockage during freezing were 0% (0/25 with the device alone, 23.3% (7/30 with the cough technique alone, 5.9% (1/17 with both, and 55.2% (16/29 with neither (Pearson's Chi square = 26.6, df = 3, p Conclusion This prototype design of a cryotherapy gas conditioner is a potential solution for low-resource settings that are experiencing cryotherapy device malfunction.

  1. Peer Feedback, Learning, and Improvement: Answering the Call of the Institute of Medicine Report on Diagnostic Error.

    Science.gov (United States)

    Larson, David B; Donnelly, Lane F; Podberesky, Daniel J; Merrow, Arnold C; Sharpe, Richard E; Kruskal, Jonathan B

    2017-04-01

    In September 2015, the Institute of Medicine (IOM) published a report titled "Improving Diagnosis in Health Care," in which it was recommended that "health care organizations should adopt policies and practices that promote a nonpunitive culture that values open discussion and feedback on diagnostic performance." It may seem counterintuitive that a report addressing a highly technical skill such as medical diagnosis would be focused on organizational culture. The wisdom becomes clearer, however, when examined in the light of recent advances in the understanding of human error and individual and organizational performance. The current dominant model for radiologist performance improvement is scoring-based peer review, which reflects a traditional quality assurance approach, derived from manufacturing in the mid-1900s. Far from achieving the goals of the IOM, which are celebrating success, recognizing mistakes as an opportunity to learn, and fostering openness and trust, we have found that scoring-based peer review tends to drive radiologists inward, against each other, and against practice leaders. Modern approaches to quality improvement focus on using and enhancing interpersonal professional relationships to achieve and maintain high levels of individual and organizational performance. In this article, the authors review the recommendations set forth by the recent IOM report, discuss the science and theory that underlie several of those recommendations, and assess how well they fit with the current dominant approach to radiology peer review. The authors also offer an alternative approach to peer review: peer feedback, learning, and improvement (or more succinctly, "peer learning"), which they believe is better aligned with the principles promoted by the IOM. © RSNA, 2016.

  2. Improved design for large wind turbine blades of fibre composites (Phase 3) - Summary report

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, B.F. (Risoe DTU, Materials Research Div., Roskilde (Denmark)); Branner, K. (Risoe DTU, Wind Energy Div., Roskilde (Denmark)); Lund, E. (Aalborg Univ., Dept. of Mechanical Engineering, Aalborg (Denmark)); Wedel-Heinen, J. (Vestas Wind System, Randers (Denmark)); Garm, J.H. (LM Glasfiber, Kolding (Denmark))

    2009-06-15

    An overview is given of the activities of the project 'Improved design for large wind turbine blades (Phase 3)', partially supported by the Danish Energy Agency under the Ministry of Climate and Energy through the EFP-grant no. 33031-0078. The project was focussed at the development of new design methods for wind turbine blades, so that uncertainties associated with damage and defects can be reduced. The following topics with respect to failure modes were covered: Buckling-driven delamination of load-carrying laminates, cracking along interfaces in material joints, implementation of cohesive laws in finite element programmes and hierarchical finite element models. Methods and major research results of the project are summarised. Some future goals for future research activities are briefly discussed. (author)

  3. 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.

  4. Application of modern diagnostic methods to environmental improvement. Annual progress report, October 1994--September 1995

    International Nuclear Information System (INIS)

    Shepard, W.S.

    1995-12-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL), an interdisciplinary research department in the College of Engineering at Mississippi State University (MSU), is under contract with the US Department of Energy (DOE) to develop and apply advanced diagnostic instrumentation and analysis techniques to aid in solving DOE's nuclear waste problem. The program is a comprehensive effort which includes five focus areas: advanced diagnostic systems; development/application; torch operation and test facilities; process development; on-site field measurement and analysis; technology transfer/commercialization. As part of this program, diagnostic methods will be developed and evaluated for characterization, monitoring and process control. Also, the measured parameters, will be employed to improve, optimize and control the operation of the plasma torch and the overall plasma treatment process. Moreover, on-site field measurements at various DOE facilities are carried out to aid in the rapid demonstration and implementation of modern fieldable diagnostic methods. Such efforts also provide a basis for technology transfer

  5. Improved gas installations and services. Phase 1: Analysis project. Part report

    International Nuclear Information System (INIS)

    Nielsen, K.J.

    1996-05-01

    As Danish gas companies receive a large number of complaints related to the installation and operation of gas installations it was suggested that a course for personnel should be established in order to raise the standard of services and installation requirements. The first phase of the described project was to evaluate the quality of the gas installers' services so as to determine which aspects of installation and services should be emphasized during such a course. Interviews were carried out and questionnaires (illustrated within the document) sent out to installaters etc. Recommendations include that the level of information given to customers should be raised, also in relation to maintenance, and that installation should be improved. Analyses of the degree of customers' satisfaction, of the nature of the quality of services etc. expected, subjects for further training in this area and details of the training system are dealt with

  6. Improved design for large wind turbine blades of fibre composites (Phase 4) - Summary report

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, B.F.; Toftegaard, H.; Goutanos, S. (Risoe DTU, Materials Research Div., Roskilde (Denmark)); Branner, K.; Berring, P. (Risoe DTU, Wind Energy Div., Roskilde (Denmark)); Lund, E. (Aalborg Univ., Dept. of Mechanical Engineering, Aalborg (Denmark)); Wedel-Heinen, J. (Vestas Wind System, Randers (Denmark)); Garm, J.H. (LM Wind Power, Kolding (Denmark))

    2010-06-15

    Results are summarised for the project 'Improved design for large wind turbine blades (Phase 4)', partially supported by the Danish Energy Agency under the Ministry of Climate and Energy through the EUDP journal no.: 33033-0267. The aim of the project was to develop new and better design methods for wind turbine blades, so that uncertainties associated with damage and defects can be reduced. The topics that are studied include buckling-driven delamination of flat load-carrying laminates, cracking along interfaces in material joints (fracture mechanical characterisation and modelling), cyclic crack growth with large scale bridging and the use of cohesive laws in finite element programmes for simulating wind turbine blade failure. An overview is given of the methods and the major research results of the project. The implementation of the knowledge in the industry is discussed. Finally, some ideas for future research activities are considered. (author)

  7. Improving reservoir conformance using gelled polymer systems. Quarterly report, September 25--December 24, 1993

    Energy Technology Data Exchange (ETDEWEB)

    Green, D.W.; Willhite, G.P.; Buller, C.; McCool, S.; Vossoughi, S.; Michnick, M.

    1994-01-19

    The general objectives are to (1) to identify and develop gelled polymer systems which have potential to improve reservoir conformance of fluid displacement processes, (2) to determine the performance of these systems in bulk and in porous media, and (3) to develop methods to predict the capability of these systems to recover oil from petroleum reservoirs. This work focuses on three types of gel systems -- an aqueous polysaccharide (KUSP1) system that gels as a function of pH, the chromium(III)-polyacrylamide system and the aluminum citrate-polyacrylamide system. Laboratory research is directed at the fundamental understanding of the physics and chemistry of the gelation process in bulk form and in porous media. This knowledge will be used to develop conceptual and mathematical models of the gelation process. Mathematical models will then be extended to predict the performance of gelled polymer treatments in oil reservoirs. Results to date are summarized.

  8. Application of modern diagnostic methods to environmental improvement. Annual progress report, October 1994--September 1995

    Energy Technology Data Exchange (ETDEWEB)

    Shepard, W.S.

    1995-12-01

    The Diagnostic Instrumentation and Analysis Laboratory (DIAL), an interdisciplinary research department in the College of Engineering at Mississippi State University (MSU), is under contract with the US Department of Energy (DOE) to develop and apply advanced diagnostic instrumentation and analysis techniques to aid in solving DOE`s nuclear waste problem. The program is a comprehensive effort which includes five focus areas: advanced diagnostic systems; development/application; torch operation and test facilities; process development; on-site field measurement and analysis; technology transfer/commercialization. As part of this program, diagnostic methods will be developed and evaluated for characterization, monitoring and process control. Also, the measured parameters, will be employed to improve, optimize and control the operation of the plasma torch and the overall plasma treatment process. Moreover, on-site field measurements at various DOE facilities are carried out to aid in the rapid demonstration and implementation of modern fieldable diagnostic methods. Such efforts also provide a basis for technology transfer.

  9. HI-STAR. Health Improvements Through Space Technologies and Resources: Final Report

    Science.gov (United States)

    Finarelli, Margaret G.

    2002-01-01

    The purpose of this document is to describe a global strategy to integrate the use of space technology in the fight against malaria. Given the well-documented relationship between the vector and its environment, and the ability of existing space technologies to monitor environmental factors, malaria is a strong candidate for the application of space technology. The concept of a malaria early warning system has been proposed in the past' and pilot studies have been conducted. The HI-STAR project (Health Improvement through Space Technologies and Resources) seeks to build on this concept and enhance the space elements of the suggested framework. As such, the mission statement for this International Space University design project has been defined as follows: "Our mission is to develop and promote a global strategy to help combat malaria using space technology". A general overview of malaria, aspects of how space technology can be useful, and an outline of the HI-STAR strategy is presented.

  10. 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.

  11. Educating early childhood care and education providers to improve knowledge and attitudes about reporting child maltreatment: A randomized controlled trial.

    Science.gov (United States)

    Mathews, Ben; Yang, Chengwu; Lehman, Erik B; Mincemoyer, Claudia; Verdiglione, Nicole; Levi, Benjamin H

    2017-01-01

    Early childhood care and education providers (CCPs) work with over 7 million young children. These children are vulnerable to physical, sexual and emotional abuse, and neglect. However, CCPs make less than 1% of all reports of suspected child abuse and neglect that are made to child protective services. CCPs are therefore an untapped resource in the public health response to child maltreatment. However, their knowledge and attitudes about duties to report child maltreatment are poorly understood. Moreover, no rigorous research has tested whether their knowledge and attitudes about reporting child maltreatment can be improved. These gaps in knowledge are important because knowledge of the duty and positive attitudes towards it produce more effective reporting, and little evidence exists about how to enhance cognitive and affective attributes. Using the CONSORT approach, we report a single-blind test-retest randomized controlled trial evaluating iLook Out for Child Abuse, a customized online educational intervention for CCPs to increase knowledge and attitudes towards the reporting duty. 762 participants were randomized with results analyzed for 741 participants (372 in the intervention group; 369 in the control). Knowledge of the reporting duty increased in the intervention group from 13.54 to 16.19 out of 21 (2.65 increase, 95% CI: (2.37, 2.93); large effect size 0.95, p < 0.001); the control group remained stable, moving from 13.54 to 13.59 (0.05 increase, 95% CI: (-0.12, 0.22); negligible effect size 0.03, p = 0.684). Attitudes were enhanced on all 13 items for the intervention group, remaining stable in the control, with significant differences between groups on all items (p < 0.05). Gains were largely sustained at four month follow-up. Findings support education for CCPs and other professions. Future research should also explore effects of education on reporting behavior. US National Institutes of Health NCT02225301.

  12. Improved electrical efficiency and bottom ash quality on waste combustion plants. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Peter A.; Nesterov, I.; Boejer, M.; Hyks, J.; Astrup, T.; Kloeft, H.; Dam-Johansen, K.; Lundtorp, K.; Hedegaard Madsen, O.; Frandsen, F. (Technical Univ. of Denmark, Kgs. Lyngby (Denmark)); Mogensen, Erhardt (Babcock and Wilcox Voelund A/S, Glostrup (Denmark))

    2010-07-01

    Investigations making it possible to evaluate and further develop concepts to improve electrical efficiency in a waste combustion plant were performed. Furthermore, one objective of the study was to investigate the possibilities of improving waste bottom ash leaching properties by use of a rotary kiln treatment. The project work included construction of a bench-scale rotary kiln, performing ash rotary kiln treatment experiments, conducting gas suction probe measurements on a waste incineration plant and making some concept evaluations. The influence of the rotary kiln thermal treatment on the leaching of Ca, Al, Si, Mg, Ba, Sr, Cl, Cu, Pb, Zn, Cr, Mo, sulfate, DOC and carbonate was determined. As a result of these tests, the rotary kiln thermal treatment of bottom ashes can be recommended for reducing the leaching of Cu, Pb, Cl, Zn and DOC; however, an increased leaching of Cr and Mo should be expected. The combustion conditions above the grate of a waste incineration plant were investigated and the release and concentration of volatile ash species in the flue gas such as Cl, Na, K, Ca, Pb, Zn and S were measured. The conducted measurements show that flue gas from grate sections 3 and 4 can produce a sufficiently hot flue gas that contains only low concentrations of corrosive species, and therefore can be used to increase superheater temperatures. Implementation of the so-called flue gas split concept together with other steam circle modifications on a waste combustion plant, and using a reasonable increase in final steam temperature from 400 to 500 deg. C, have the potential to increase electrical efficiency from 24 to 30% (with respect to lower fuel heating value) in a waste combustion plant. (Author)

  13. Reducing Information's Speed Improves Verbal Cognition and Behavior in Autism: A 2-Cases Report.

    Science.gov (United States)

    Tardif, Carole; Latzko, Laura; Arciszewski, Thomas; Gepner, Bruno

    2017-06-01

    According to the temporal theory of autism spectrum disorders (ASDs), audiovisual changes in environment, particularly those linked to facial and verbal language, are often too fast to be faced, perceived, and/or interpreted online by many children with ASD, which could help explain their facial, verbal, and/or socioemotional interaction impairments. Our goal here was to test for the first time the impact of slowed-down audiovisual information on verbal cognition and behavior in 2 boys with ASD and verbal delay. Using 15 experimental sessions during 4 months, both boys were presented with various stimuli (eg, pictures, words, sentences, cartoons) and were then asked questions or given instructions regarding stimuli. The audiovisual stimuli and instructions/questions were presented on a computer's screen and were always displayed twice: at real-time speed (RTS) and at slowed-down speed (SDS) using the software Logiral. We scored the boys' verbal cognition performance (ie, ability to understand questions/instructions and answer them verbally/nonverbally) and their behavioral reactions (ie, attention, verbal/nonverbal communication, social reciprocity), and analyzed the effects of speed and order of the stimuli presentation on these factors. According to the results, both participants exhibited significant improvements in verbal cognition performance with SDS presentation compared with RTS presentation, and they scored better with RTS presentation when having SDS presentation before rather than after RTS presentation. Behavioral reactions were also improved in SDS conditions compared with RTS conditions. This initial evidence of a positive impact of slowed-down audiovisual information on verbal cognition should be tested in a large cohort of children with ASD and associated speech/language impairments. Copyright © 2017 by the American Academy of Pediatrics.

  14. [Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

    Science.gov (United States)

    Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

    2017-01-01

    PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

  15. Strontium isotopic geochemistry of intrusive rocks, Puerto Rico, Greater Antilles

    International Nuclear Information System (INIS)

    Jones, L.M.; Kesler, S.E.

    1980-01-01

    The strontium isotope geochemistry is given for three Puerto Rican intrusive rocks: the granodioritic Morovis and San Lorenzo plutons and the Rio Blanco stock of quartz dioritic composition. The average calculated initial 87 Sr/ 86 Sr ratios are 0.70370, 0.70355 and 0.70408, respectively. In addition, the San Lorenzo data establish a whole-rock isochron of 71 +- 2 m.y., which agrees with the previously reported K-Ar age of 73 m.y. Similarity of most of the intrusive rocks in the Greater Antilles with respect to their strontium isotopic geochemistry regardless of their major element composition indicates that intrusive magmas with a wide range of composition can be derived from a single source material. The most likely source material, in view of the available isotopic data, is the mantle wedge overlying the subduction zone. (orig.)

  16. Comparing statistical tests for detecting soil contamination greater than background

    International Nuclear Information System (INIS)

    Hardin, J.W.; Gilbert, R.O.

    1993-12-01

    The Washington State Department of Ecology (WSDE) recently issued a report that provides guidance on statistical issues regarding investigation and cleanup of soil and groundwater contamination under the Model Toxics Control Act Cleanup Regulation. Included in the report are procedures for determining a background-based cleanup standard and for conducting a 3-step statistical test procedure to decide if a site is contaminated greater than the background standard. The guidance specifies that the State test should only be used if the background and site data are lognormally distributed. The guidance in WSDE allows for using alternative tests on a site-specific basis if prior approval is obtained from WSDE. This report presents the results of a Monte Carlo computer simulation study conducted to evaluate the performance of the State test and several alternative tests for various contamination scenarios (background and site data distributions). The primary test performance criteria are (1) the probability the test will indicate that a contaminated site is indeed contaminated, and (2) the probability that the test will indicate an uncontaminated site is contaminated. The simulation study was conducted assuming the background concentrations were from lognormal or Weibull distributions. The site data were drawn from distributions selected to represent various contamination scenarios. The statistical tests studied are the State test, t test, Satterthwaite's t test, five distribution-free tests, and several tandem tests (wherein two or more tests are conducted using the same data set)

  17. Improving human reliability through better nuclear power plant system design. Final report

    International Nuclear Information System (INIS)

    Golay, Michael W.

    1998-01-01

    Increasing task complexity is claimed to be responsible for causing human operating errors, while a significant number of system failures are due to operating errors. An experimental study reported here was conducted to isolate varying task complexity as an important factor affecting human performance quality. Earlier work concerning problems of nuclear power plants has shown that human capability declined when dealing with increasing system complexity. The goal of this study was to investigate further the relationship between human operator performance quality and the complexity of tasks served to human operators. This was done by using a simple, interactive, dynamic and generalizable computer model to simulate the behavior of a human-operated dynamic fluid system. Twenty-two human subjects participated

  18. Development of a Natural Rearing System to Improve Supplemental Fish Quality, 1999-2003 Progress Report.

    Energy Technology Data Exchange (ETDEWEB)

    Maynard, Desmond J.

    2003-02-25

    The National Marine Fisheries Service (NMFS) has been conducting Natural Rearing Enhancement System (NATURES) research since the early 1990s. NATURES studies have looked at a variety of mechanisms to enhance production of wild-like salmonids from hatcheries. The goal of NATURES research is to develop fish culture techniques that enable hatcheries to produce salmon with more wild-like characteristics and increased postrelease survival. The development of such techniques is called for in the Columbia Basin Fish and Wildlife Program. This document is the draft report for the Supplemental Fish Quality Contract DE-AI79-91BP20651 Over the history of the project, the effects of seminatural raceway habitats, automated underwater feeders, exercise current velocities, live food diets, and predator avoidance training have been investigated. The findings of these studies are reported in an earlier contract report (Maynard et al. 1996a). The current report focuses on research that has been conducted between 1999 and 2002. This includes studies on the effect of exercise on salmon and steelhead trout, effects of predator avoid training, integration of NATUES protocols into production hatcheries, and the study of social behavior of steelhead grown in enriched and conventional environments. Traditionally, salmon (Oncorhynchus spp.) are reared in barren concrete raceways that lack natural substrate, in-stream structure, or overhead cover. The fish are fed in an unnatural manner with artificial feeds mechanically or hand broadcast across the water surface. This traditional approach has increased the egg-to-smolt survival of hatchery-reared fish by an order of magnitude over that experienced by wild-reared salmon. However, once hatchery-reared fish are released into the wild their smolt-to-adult survival is usually much lower than wild-reared salmon. The reduced postrelease survival of hatchery-reared fish may stem from differences in their behavior and morphology compared to wild

  19. Improved mutagen-testing systems in mice. Progress report, 1 June 1976--31 August 1977

    International Nuclear Information System (INIS)

    Roderick, T.H.

    1977-01-01

    Results are reported from studies on the production of chromosomal inversion by chemical treatment or irradiation of sperm in mice and to detect inversions by observing high frequencies of first meiotic anaphase bridges of their sons or by using chromosomal banding techniques to detect inverted segments cytologically. For each new inversion, which is either of considerable length or which has particularly useful experimental properties, we will determine its linkage group, mark it genetically, if possible, or place it with a genetically marked homologous chromosome, and study its cytological, physiological, and anatomical effects. The inversions are being used to construct recessive lethal testing systems for estimating mutational loads in populations exposed to radiation or either proved or potential chemical mutagens, to mark and maintain induced lethals for analysis of their potential dominant effects on fitness, and to study other basic problems in mammalian genetics

  20. IMPER: Characterization of the wind field over a large wind turbine rotor - final report; Improved performance

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt Paulsen, U.; Wagner, R.

    2012-01-15

    A modern wind turbine rotor with a contemporary rotor size would easily with the tips penetrate the air between 116 m and 30 m and herby experience effects of different wind. With current rules on power performance measurements such as IEC 61400-121 the reference wind speed is measured at hub height, an oversimplification of the wind energy power over the rotor disk area is carried out. The project comprised a number of innovative and coordinated measurements on a full scale turbine with remote sensing technology and simulations on a 500 kW wind turbine for the effects of wind field characterization. The objective with the present report is to give a short overview of the different experiments carried out and results obtained within the final phase of this project. (Author)