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Sample records for totally performance-based utilizing

  1. The Evaluation of Teachers' Job Performance Based on Total Quality Management (TQM)

    Science.gov (United States)

    Shahmohammadi, Nayereh

    2017-01-01

    This study aimed to evaluate teachers' job performance based on total quality management (TQM) model. This was a descriptive survey study. The target population consisted of all primary school teachers in Karaj (N = 2917). Using Cochran formula and simple random sampling, 340 participants were selected as sample. A total quality management…

  2. Next-Generation Performance-Based Regulation: Emphasizing Utility Performance to Unleash Power Sector Innovation

    Energy Technology Data Exchange (ETDEWEB)

    Logan, Jeffrey S [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Zinaman, Owen R [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Littell, David [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Kadoch, Camille [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Baker, Phil [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Bharvirkar, Ranjit [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Dupuy, Max [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Hausauer, Brenda [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Linvill, Carl [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Migden-Ostrander, Janine [Regulatory Assistance Project (RAP), Montpelier, VT (United States); Rosenow, Jan [Regulatory Assistance Project; Xuan, Wang [Regulatory Assistance Project

    2017-09-12

    Performance-based regulation (PBR) enables regulators to reform hundred-year-old regulatory structures to unleash innovations within 21st century power systems. An old regulatory paradigm built to ensure safe and reliable electricity at reasonable prices from capital-intensive electricity monopolies is now adjusting to a new century of disruptive technological advances that change the way utilities make money and what value customers expect from their own electricity company. Advanced technologies are driving change in power sectors around the globe. Innovative technologies are transforming the way electricity is generated, delivered, and consumed. These emerging technology drivers include renewable generation, distributed energy resources such as distributed generation and energy storage, demand-side management measures such as demand-response, electric vehicles, and smart grid technologies and energy efficiency (EE). PBR enables regulators to recognize the value that electric utilities bring to customers by enabling these advanced technologies and integrating smart solutions into the utility grid and utility operations. These changes in the electric energy system and customer capacities means that there is an increasing interest in motivating regulated entities in other areas beyond traditional cost-of-service performance regulation. This report addresses best practices gleaned from more than two decades of PBR in practice, and analyzes how those best practices and lessons can be used to design innovative PBR programs. Readers looking for an introduction to PBR may want to focus on Chapters 1-5. Chapters 6 and 7 contain more detail for those interested in the intricate workings of PBR or particularly innovative PBR.

  3. Performance-based financing to increase utilization of maternal health services: Evidence from Burkina Faso

    Directory of Open Access Journals (Sweden)

    Maria Steenland

    2017-12-01

    Full Text Available Performance-based financing (PBF programs are increasingly implemented in low and middle-income countries to improve health service quality and utilization. In April 2011, a PBF pilot program was launched in Boulsa, Leo and Titao districts in Burkina Faso with the objective of increasing the provision and quality of maternal health services. We evaluate the impact of this program using facility-level administrative data from the national health management information system (HMIS. Primary outcomes were the number of antenatal care visits, the proportion of antenatal care visits that occurred during the first trimester of pregnancy, the number of institutional deliveries and the number of postnatal care visits. To assess program impact we use a difference-in-differences approach, comparing changes in health service provision post-introduction with changes in matched comparison areas. All models were estimated using ordinary least squares (OLS regression models with standard errors clustered at the facility level. On average, PBF facilities had 2.3 more antenatal care visits (95% CI [0.446–4.225], 2.1 more deliveries (95% CI [0.034–4.069] and 9.5 more postnatal care visits (95% CI [6.099, 12.903] each month after the introduction of PBF. Compared to the service provision levels prior to the interventions, this implies a relative increase of 27.7 percent for ANC, of 9.2 percent for deliveries, and of 118.7 percent for postnatal care. Given the positive results observed during the pre-pilot period and the limited resources available in the health sector, the PBF program in Burkina Faso may be a low-cost, high impact intervention to improve maternal and child health.

  4. Utility of the UCSD Performance-based Skills Assessment-Brief Japanese version: discriminative ability and relation to neurocognition

    Directory of Open Access Journals (Sweden)

    Chika Sumiyoshi

    2014-09-01

    Full Text Available The UCSD Performance-based Skills Assessment Brief (the UPSA-B has been widely used for evaluating functional capacity in patients with schizophrenia. The utility of the battery in a wide range of cultural contexts has been of concern among developers. The current study investigated the validity of the Japanese version of the UPSA-B as a measure of functional capacity and as a co-primary for neurocognion. Sixty-four Japanese patients with schizophrenia and 83 healthy adults entered the study. The Japanese version of the UPSA-B (UPSA-B Japanese version and the MATRICS Cognitive Consensus Battery Japanese version (MCCB Japanese version were administered. Normal controls performed significantly better than patients, with large effect sizes for the Total and the subscale scores of the UPSA-B. Receiver Operating Characteristic (ROC curve analysis revealed that the optimal cut-off point for the UPSA-B Total score was estimated at around 80. The UPSA-B Total score was significantly correlated with the MCCB Composite score and several domain scores, indicating the relationship between this co-primary measure and overall cognitive functioning in Japanese patients with schizophrenia. The results obtained here suggest that the UPSA-B Japanese version is an effective tool for evaluating disturbances of daily-living skills linked to cognitive functioning in schizophrenia, providing an identifiable cut-off point and relationships to neurocognition. Further research is warranted to evaluate the psychometrical properties and response to treatment of the Japanese version of the UPSA-B.

  5. Preoperative prediction of inpatient recovery of function after total hip arthroplasty using performance-based tests: a prospective cohort study.

    Science.gov (United States)

    Oosting, Ellen; Hoogeboom, Thomas J; Appelman-de Vries, Suzan A; Swets, Adam; Dronkers, Jaap J; van Meeteren, Nico L U

    2016-01-01

    The aim of this study was to evaluate the value of conventional factors, the Risk Assessment and Predictor Tool (RAPT) and performance-based functional tests as predictors of delayed recovery after total hip arthroplasty (THA). A prospective cohort study in a regional hospital in the Netherlands with 315 patients was attending for THA in 2012. The dependent variable recovery of function was assessed with the Modified Iowa Levels of Assistance scale. Delayed recovery was defined as taking more than 3 days to walk independently. Independent variables were age, sex, BMI, Charnley score, RAPT score and scores for four performance-based tests [2-minute walk test, timed up and go test (TUG), 10-meter walking test (10 mW) and hand grip strength]. Regression analysis with all variables identified older age (>70 years), Charnley score C, slow walking speed (10 mW >10.0 s) and poor functional mobility (TUG >10.5 s) as the best predictors of delayed recovery of function. This model (AUC 0.85, 95% CI 0.79-0.91) performed better than a model with conventional factors and RAPT scores, and significantly better (p = 0.04) than a model with only conventional factors (AUC 0.81, 95% CI 0.74-0.87). The combination of performance-based tests and conventional factors predicted inpatient functional recovery after THA. Two simple functional performance-based tests have a significant added value to a more conventional screening with age and comorbidities to predict recovery of functioning immediately after total hip surgery. Patients over 70 years old, with comorbidities, with a TUG score >10.5 s and a walking speed >1.0 m/s are at risk for delayed recovery of functioning. Those high risk patients need an accurate discharge plan and could benefit from targeted pre- and postoperative therapeutic exercise programs.

  6. State Performance-Based Regulation Using Multiyear Rate Plans for U.S. Electric Utilities

    Energy Technology Data Exchange (ETDEWEB)

    Lowry, Mark Newton [Pacific Economics Group Research LLC (United States); Makos, Matt [Pacific Economics Group Research LLC (United States); Deason, Jeff [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-07-31

    Electric utilities today must contain costs at a time when many need to modernize aging systems and all face major changes in technologies, customer preferences and competitive pressures.Most U.S. electric utility facilities are investor-owned, subject to rate and service regulation by state public utility commissions. Regulatory systems under which these utilities operate affect their performance and ability to meet these challenges. In this business environment, multiyear rate plans have some advantages over traditional rate regulation.The report focuses on key design issues and provides case studies of the multiyear rate plan approach, applicable to both vertically integrated and restructured states. Mark Newton Lowry and Matt Makos of Pacific Energy Group Research and Jeff Deason of Berkeley Lab authored the report; Lisa Schwartz, Berkeley Lab, was project manager and technical editor.The report is aimed primarily at state utility regulators and stakeholders in the state regulatory process. The multiyear rate approach also provides ideas on how to streamline oversight of public power utilities and rural electric cooperatives for their governing boards.Two key provisions of multiyear rate plans strengthen cost containment incentives and streamline regulation: 1. Reducing frequency of rate cases, typically to every four or five years 2. Using an attrition relief mechanism to escalate rates or revenue between rate cases to address cost pressures such as inflation and growth in number of customers, independently of the utility’s own cost Better utility performance can be achieved under well-designed multiyear rate plans while achieving lower regulatory costs. Benefits can be shared between utilities and their customers. But plans can be complex and involve significant changes in the regulatory system. Designing plans that stimulate utility performance without undue risk and share benefits fairly can be challenging.This report discusses the rationale for multiyear

  7. The efficacy of tourniquet assisted total knee arthroplasty on patient-reported and performance-based physical function

    DEFF Research Database (Denmark)

    Lohmann-Jensen, Rasmus; Holsgaard-Larsen, Anders; Emmeluth, Claus

    2014-01-01

    surgery. The non-tourniquet assisted TKA group will have surgery performed without application of a tourniquet. The primary aim is to compare tourniquet assisted to non-tourniquet assisted TKA on patient-reported physical function (KOOS-ADL). The secondary aim is to compare post-surgery pain, function...... in sports and recreation, quality of life, and performance-based physical function. The explorative outcomes include; use of pain medication, single-fiber muscle damage, and changes in mechanical muscle function. The primary endpoint will be at 3-months following surgical treatment, and the time...... randomized clinical trial comparing the efficacy of tourniquet assisted TKA on patient-reported physical function supported by a range of performance-based secondary outcome measures. As such it will provide high quality evidence that may help determine whether tourniquet should be used in future TKA...

  8. The Quality Adjusted Life Year: A Total-Utility Perspective.

    Science.gov (United States)

    Firth, Steven J

    2018-04-01

    Given that a properly formed utilitarian response to healthcare distribution issues should evaluate cost effectiveness against the total utility increase, it follows that any utilitarian cost-effectiveness metric should be sensitive to increases in both individual and social utility afforded by a given intervention. Quality adjusted life year (QALY) based decisionmaking in healthcare cannot track increases in social utility, and as a result, the QALY cannot be considered a strict utilitarian response to issues of healthcare distribution. This article considers arguments against, and a possible defence of, the QALY as a utilitarian concept; in response, the article offers a similar - but properly formed - utilitarian metric called the (IALY). This article also advances a tool called the 'glee factor' (GF) on which the IALY may lean in a similar way to which the QALY leans on the Rosser Index.

  9. Retail clinic utilization associated with lower total cost of care.

    Science.gov (United States)

    Sussman, Andrew; Dunham, Lisette; Snower, Kristen; Hu, Min; Matlin, Olga S; Shrank, William H; Choudhry, Niteesh K; Brennan, Troyen

    2013-04-01

    To better understand the impact of retail clinic use on a patient's annual total cost of care. A propensity score matched-pair, cohort design was used to analyze healthcare spending patterns among CVS Caremark employees in the year following a visit to a MinuteClinic, the retail clinics inside CVS pharmacies. De-identified medical and pharmacy claims for CVS Caremark employees and their dependents who received care at a retail clinic between June 1, 2009, and May 31, 2010, were matched to those of subjects who received care elsewhere. High-dimensional propensity score and greedy matching techniques were used to create a 1-to-1 matched cohort that was analyzed using generalized linear regression models. Individuals using a retail clinic had a lower total cost of care (-$262; 95% confidence interval, -$510 to -$31; P = .025) in the year following their clinic visit than individuals who received care in other settings. This savings was primarily due to lower medical expenses at physicians' offices ($77 savings, P = .008) and hospital inpatient care ($121 savings, P = .049). The 6022 retail clinic users also had 142 (12%) fewer emergency department visits (P = .01), though this was not related to significant cost savings. This study found that retail clinic use was associated with lower overall total cost of care compared with that at alternative sites. Savings may extend beyond the retail clinic visit itself to other types of medical utilization.

  10. Utility of adjunctive modalities in Coronary chronic total occlusion intervention

    Directory of Open Access Journals (Sweden)

    Hemal Bhatt

    2017-05-01

    Full Text Available Coronary chronic total occlusion (CTO intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i.e., using fractional flow reserve. In this review we present the current literature describing the utility and efficacy of these adjunctive modalities in CTO intervention.

  11. The Combined Utility of a Brief Functional Measure and Performance-Based Screening Test for Case Finding of Cognitive Impairment in Primary Healthcare.

    Science.gov (United States)

    Chan, Qun Lin; Shaik, Muhammad Amin; Xu, Jing; Xu, Xin; Chen, Christopher Li-Hsian; Dong, YanHong

    2016-04-01

    Use of a total risk score (TRS) based on vascular and sociodemographic risk factors has been recommended to identify patients at risk of cognitive impairment. Moreover, combining screening tests has been reported to improve positive predictive values (PPV) for case finding of cognitive impairment. We investigated the utility of the conjunctive combination of the informant-based AD8 and the performance-based National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol for the detection of cognitive impairment, defined by a clinical dementia rating (CDR) score ≥0.5, in patients at risk of cognitive impairment (TRS ≥3). Participants were recruited from 2 primary healthcare centers in Singapore and received the AD8, Montreal Cognitive Assessment, Mini-Mental State Examination, CDR, and a formal neuropsychological test battery. The scores for NINDS-CSN 5-minute protocol were extracted from the Montreal Cognitive Assessment items. Area under the receiver operating characteristics curve analyses were conducted to determine the discriminant indices of the screening instruments, the conjunctive combination (ie, screened positive on both tests), and the compensatory combination (ie, screened positive in either of or both tests). A total of 309 participants were recruited of whom 78.7% (n = 243) had CDR = 0 and 21.3% (n = 66) had CDR ≥0.5. The conjunctive combination of AD8 and NINDS-CSN 5-minute protocol achieved excellent PPV and acceptable sensitivity (PPV 91.7%, sensitivity 73.3%). The conjunctive combination of the AD8 and NINDS-CSN 5-minute protocol is brief and accurate, and hence, suitable for case finding of cognitive impairment (CDR ≥0.5) in patients screened positive on the TRS in primary healthcare centers. Copyright © 2016. Published by Elsevier Inc.

  12. Patient-reported outcome measures versus inertial performance-based outcome measures: A prospective study in patients undergoing primary total knee arthroplasty.

    Science.gov (United States)

    Bolink, S A A N; Grimm, B; Heyligers, I C

    2015-12-01

    Outcome assessment of total knee arthroplasty (TKA) by subjective patient reported outcome measures (PROMs) may not fully capture the functional (dis-)abilities of relevance. Objective performance-based outcome measures could provide distinct information. An ambulant inertial measurement unit (IMU) allows kinematic assessment of physical performance and could potentially be used for routine follow-up. To investigate the responsiveness of IMU measures in patients following TKA and compare outcomes with conventional PROMs. Patients with end stage knee OA (n=20, m/f=7/13; age=67.4 standard deviation 7.7 years) were measured preoperatively and one year postoperatively. IMU measures were derived during gait, sit-stand transfers and block step-up transfers. PROMs were assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS). Responsiveness was calculated by the effect size, correlations were calculated with Spearman's rho correlation coefficient. One year after TKA, patients performed significantly better at gait, sit-to-stand transfers and block step-up transfers. Measures of time and kinematic IMU measures demonstrated significant improvements postoperatively for each performance-based test. The largest improvement was found in block step-up transfers (effect size=0.56-1.20). WOMAC function score and KSS function score demonstrated moderate correlations (Spearman's rho=0.45-0.74) with some of the physical performance-based measures pre- and postoperatively. To characterize the changes in physical function after TKA, PROMs could be supplemented by performance-based measures, assessing function during different activities and allowing kinematic characterization with an ambulant IMU. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Performance-based ratemaking for electric utilities: Review of plans and analysis of economic and resource-planning issues. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Comnes, G.A.; Stoft, S.; Greene, N. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.; Hill, L.J. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.]|[Oak Ridge National Lab., TN (United States). Energy Div.

    1995-11-01

    Performance-Based Ratemaking (PBR) is a form of utility regulation that strengthens the financial incentives to lower rates, lower costs, or improve nonprice performance relative traditional regulation, which the authors call cost-of-service, rate-of-return (COS/ROR) regulation. Although the electric utility industry has considerable experience with incentive mechanisms that target specific areas of performance, implementation of mechanisms that cover a comprehensive set of utility costs or services is relatively rare. In recent years, interest in PBR has increased as a result of growing dissatisfaction with COS/ROR and as a result of economic and technological trends that are leading to more competition in certain segments of the electricity industry. In addition, incentive regulation has been used with some success in other public utility industries, most notably telecommunications in the US and telecommunications, energy, and water in the United Kingdom. In this report, the authors analyze comprehensive PBR mechanisms for electric utilities in four ways: (1) they describe different types of PBR mechanisms, (2) they review a sample of actual PBR plans, (3) they consider the interaction of PBR and utility-funded energy efficiency programs, and (4) they examine how PBR interacts with electric utility resource planning and industry restructuring. The report should be of interest to technical staff of utilities and regulatory commissions that are actively considering or designing PBR mechanisms. 16 figs., 17 tabs.

  14. Performance-based ratemaking for electric utilities: Review of plans and analysis of economic and resource-planning issues. Volume 2, Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Comnes, G.A.; Stoft, S.; Greene, N. [Lawrence Berkeley Lab., CA (United States); Hill, L.J. [Oak Ridge National Lab., TN (United States)

    1995-11-01

    This document contains summaries of the electric utilities performance-based rate plans for the following companies: Alabama Power Company; Central Maine Power Company; Consolidated Edison of New York; Mississippi Power Company; New York State Electric and Gas Corporation; Niagara Mohawk Power Corporation; PacifiCorp; Pacific Gas and Electric; Southern California Edison; San Diego Gas & Electric; and Tucson Electric Power. In addition, this document also contains information about LBNL`s Power Index and Incentive Properties of a Hybrid Cap and Long-Run Demand Elasticity.

  15. Assessments of Total Lightning Data Utility in Weather Forecasting

    Science.gov (United States)

    Buechler, Dennis E.; Goodman, Steve; LaCasse, Katherine; Blakeslee, Richard; Darden, Chris

    2005-01-01

    National Weather Service forecasters in Huntsville, Alabama have had access to total lightning data from the North Alabama Lightning Mapping Array (LMA) since 2003. Forecasters can monitor real-time total lightning observations on their AWIPS (Advanced Weather Interactive Processing System (AWIPS) workstations. The lightning data is used to supplement other observations such as radar and satellite data. The lightning data is updated every 2 min, providing more timely evidence of storm growth or decay than is available from 5 min radar scans. Total lightning observations have been used to positively impact warning decisions in a number of instances. A number of approaches are being pursued to assess the usefulness of total lightning measurements to the operational forecasting community in the warning decision process. These approaches, which include both qualitative and quantitative assessment methods, will be discussed. submitted to the American Meteorological Society (AMS) Conference on Meteorological Applications of Lightning Data to be held in San Diego, CA January 9-13,2005. This will be a presentation and an extended abstract will be published on a CD available from the AMS.

  16. Security Analysis of the Electronic Management System for a Total Site Utility System

    DEFF Research Database (Denmark)

    Manso Cortes, Oscar

    2016-01-01

    This paper presents the Security Analysis of the Electronic Management System (EMS) of a Total Site Utility System as proposed under the scope of the Efenis project. The Efenis project has been funded by the European Commission via the seventh framework programme (EC FP7) with the aim to improve ...

  17. Gender Disparities in Osteoarthritis-Related Health Care Utilization Before Total Knee Arthroplasty.

    Science.gov (United States)

    Bawa, Harpreet S; Weick, Jack W; Dirschl, Douglas R

    2016-10-01

    Women older than 50 years have higher prevalence of knee osteoarthritis (OA) and experience greater functional disability than men. No studies have examined large populations to identify knee OA-related health care utilization differences. The purpose of this investigation was to evaluate gender differences in the utilization of OA-related health care resources in the 12 months preceding total knee arthroplasty (TKA). Truven Health MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefit databases were reviewed from 2005 to 2012. Subjects were included if they underwent TKA, had associated diagnosis of lower leg OA, and were continuously in the database for 12 months preceding TKA. Patient-specific OA-related health care utilization was identified. Multivariate logistic regression analysis controlling for age, region, and Charlson Comorbidity Index was performed to isolate the influence of gender. A total of 244,059 patients with a mean age of 64.8 years consisting of 61.2% women were included. Multivariate logistic regression adjusted odds ratios showed that when compared to men, women were 30%, 20%, 31%, 18%, 19%, 29%, and 39%, more likely to receive a narcotic analgesic, nonnarcotic analgesics, corticosteroid injection, hyaluronic acid injection, knee magnetic resonance imaging, a physical therapy evaluation, and occupational therapy evaluation in the 12 months preceding TKA, respectively. Women have a significantly higher utilization of knee OA-related health care in the 12 months preceding TKA. Although the precise cause for this discrepancy in care cannot be determined from this study, it highlights a potential bias in management of advanced knee OA and directions for further investigation. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Total-body photography in skin cancer screening: the clinical utility of standardized imaging.

    Science.gov (United States)

    Rosenberg, Alexandra; Meyerle, Jon H

    2017-05-01

    Early detection of skin cancer is essential to reducing morbidity and mortality from both melanoma and nonmelanoma skin cancers. Total-body skin examinations (TBSEs) may improve early detection of malignant melanomas (MMs) but are controversial due to the poor quality of data available to establish a mortality benefit from skin cancer screening. Total-body photography (TBP) promises to provide a way forward by lowering the costs of dermatologic screening while simultaneously leveraging technology to increase patient access to dermatologic care. Standardized TBP also offers the ability for dermatologists to work synergistically with modern computer technology involving algorithms capable of analyzing high-quality images to flag concerning lesions that may require closer evaluation. On a population level, inexpensive TBP has the potential to increase access to skin cancer screening and it has several specific applications in a military population. The utility of standardized TBP is reviewed in the context of skin cancer screening and teledermatology.

  19. Utility of noninvasive transcutaneous measurement of postoperative hemoglobin in total joint arthroplasty patients.

    Science.gov (United States)

    Stoesz, Michael; Wood, Kristin; Clark, Wesley; Kwon, Young-Min; Freiberg, Andrew A

    2014-11-01

    This study prospectively evaluated the clinical utility of a noninvasive transcutaneous device for postoperative hemoglobin measurement in 100 total hip and knee arthroplasty patients. A protocol to measure hemoglobin noninvasively, prior to venipuncture, successfully avoided venipuncture in 73% of patients. In the remaining 27 patients, there were a total of 48 venipunctures performed during the postoperative hospitalization period due to reasons including transcutaneous hemoglobin measurement less than or equal to 9 g/dL (19), inability to obtain a transcutaneous hemoglobin measurement (8), clinical signs of anemia (3), and noncompliance with the study protocol (18). Such screening protocols may provide a convenient and cost-effective alternative to routine venipuncture for identifying patients at risk for blood transfusion after elective joint arthroplasty. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Total and high molecular weight adiponectin have similar utility for the identification of insulin resistance

    Directory of Open Access Journals (Sweden)

    Aguilar-Salinas Carlos A

    2010-06-01

    Full Text Available Abstract Background Insulin resistance (IR and related metabolic disturbances are characterized by low levels of adiponectin. High molecular weight adiponectin (HMWA is considered the active form of adiponectin and a better marker of IR than total adiponectin. The objective of this study is to compare the utility of total adiponectin, HMWA and the HMWA/total adiponectin index (SA index for the identification of IR and related metabolic conditions. Methods A cross-sectional analysis was performed in a group of ambulatory subjects, aged 20 to 70 years, in Mexico City. Areas under the receiver operator characteristic (ROC curve for total, HMWA and the SA index were plotted for the identification of metabolic disturbances. Sensitivity and specificity, positive and negative predictive values, and accuracy for the identification of IR were calculated. Results The study included 101 men and 168 women. The areas under the ROC curve for total and HMWA for the identification of IR (0.664 vs. 0.669, P = 0.74, obesity (0.592 vs. 0.610, P = 0.32, hypertriglyceridemia (0.661 vs. 0.671, P = 0.50 and hypoalphalipoproteinemia (0.624 vs. 0.633, P = 0.58 were similar. A total adiponectin level of 8.03 μg/ml was associated with a sensitivity of 57.6%, a specificity of 65.9%, a positive predictive value of 50.0%, a negative predictive value of 72.4%, and an accuracy of 62.7% for the diagnosis of IR. The corresponding figures for a HMWA value of 4.25 μg/dl were 59.6%, 67.1%, 51.8%, 73.7% and 64.2%. The area under the ROC curve of the SA index for the identification of IR was 0.622 [95% CI 0.554-0.691], obesity 0.613 [95% CI 0.536-0.689], hypertriglyceridemia 0.616 [95% CI 0.549-0.683], and hypoalphalipoproteinemia 0.606 [95% CI 0.535-0.677]. Conclusions Total adiponectin, HMWA and the SA index had similar utility for the identification of IR and metabolic disturbances.

  1. Social Media and Total Joint Arthroplasty: An Analysis of Patient Utilization on Instagram.

    Science.gov (United States)

    Ramkumar, Prem N; Navarro, Sergio M; Haeberle, Heather S; Chughtai, Morad; Flynn, Megan E; Mont, Michael A

    2017-09-01

    The purpose of this study was to analyze the nature of shared content of total joint arthroplasty patients on Instagram. Specifically, we evaluated social media posts for: (1) perspective and timing; (2) tone; (3) focus (activities of daily living [ADLs], rehabilitation, return-to-work); and (4) the comparison between hip and knee arthroplasties. A search of the public Instagram domain was performed over a 6-month period. Total hip and knee arthroplasties (THA and TKA) were selected for the analysis using the following terms: "#totalhipreplacement," "#totalkneereplacement," and associated terms. 1287 individual public posts of human subjects were shared during the period. A categorical scoring system was utilized for media format (photo or video), time (preoperative, perioperative, or postoperative) period, tone (positive or negative), return-to-work, ADLs, rehabilitation, surgical site, radiograph image, satisfaction, and dissatisfaction. Ninety-one percent of the posts were shared during the postoperative period. Ninety-three percent of posts had a positive tone. Thirty-four percent of posts focused on both ADLs and 33.8% on rehabilitation. TKA patients shared more about their surgical site (14.5% vs 3.3%, P Instagram, arthroplasty patients did so with a positive tone, starting a week after surgery. TKA posts focused more on rehabilitation and wound healing than THA patients, whereas THA patients shared more posts on ADLs. The analysis of social media posts provides insight into what matters to patients after total joint arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Does Orthopaedic Outpatient Care Reduce Emergency Department Utilization After Total Joint Arthroplasty?

    Science.gov (United States)

    Chaudhary, Muhammad Ali; Lange, Jeffrey K; Pak, Linda M; Blucher, Justin A; Barton, Lauren B; Sturgeon, Daniel J; Koehlmoos, Tracey; Haider, Adil H; Schoenfeld, Andrew J

    2018-05-22

    Emergency department (ED) visits after elective surgical procedures are a potential target for interventions to reduce healthcare costs. More than 1 million total joint arthroplasties (TJAs) are performed each year with postsurgical ED utilization estimated in the range of 10%. We asked whether (1) outpatient orthopaedic care was associated with reduced ED utilization and (2) whether there were identifiable factors associated with ED utilization within the first 30 and 90 days after TJA. An analysis of adult TRICARE beneficiaries who underwent TJA (2006-2014) was performed. TRICARE is the insurance program of the Department of Defense, covering > 9 million beneficiaries. ED use within 90 days of surgery was the primary outcome and postoperative outpatient orthopaedic care the primary explanatory variable. Patient demographics (age, sex, race, beneficiary category), clinical characteristics (length of hospital stay, prior comorbidities, complications), and environment of care were used as covariates. Logistic regression adjusted for all covariates was performed to determine factors associated with ED use. We found that orthopaedic outpatient care (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.68-0.77) was associated with lower odds of ED use within 90 days. We also found that index hospital length of stay (OR, 1.07; 95% CI, 1.04-1.10), medical comorbidities (OR, 1.16; 95% CI, 1.08-1.24), and complications (OR, 2.47; 95% CI, 2.24-2.72) were associated with higher odds of ED use. When considering that at 90 days, only 3928 patients sustained a complication, a substantial number of ED visits (11,486 of 15,414 [75%]) after TJA may be avoidable. Enhancing access to appropriate outpatient care with improved discharge planning may reduce ED use after TJA. Further research should be directed toward unpacking the situations, outside of complications, that drive patients to access the ED and devise interventions that could mitigate such behavior. Level III

  3. Utilization of Total Joint Arthroplasty in Physician-Owned Specialty Hospitals vs Acute Care Facilities.

    Science.gov (United States)

    Chen, Antonia F; Pflug, Emily; O'Brien, Daniel; Maltenfort, Mitchell G; Parvizi, Javad

    2017-07-01

    The recent emergence of physician-owned specialty hospitals has sparked controversy about overutilization. Thus, the purpose of this study was to compare utilization patterns of total joint arthroplasty (TJA) between physician-specialty hospitals (PSHs) and acute care hospitals (ACHs). A retrospective study was conducted from January 2010 to August 2014 comparing primary TJA patients between a PSH and an ACH; 103 PSH patients were matched to 103 ACH patients by age, gender, BMI, and ASA classification with similar case distribution between facilities. All surgeons in the study operated at both hospitals and were shareholders of the PSH. Information on nonoperative treatments, and timing to the initial appointment, consent, and surgery were analyzed using univariate analysis. Nonoperative treatments before surgery were similar between hospitals (P = 1.00). The time from the initial appointment to consent was longer for PSH (P = .0001). However, the time from consent to the date of surgery (P = .04) and the timing from symptoms to initial appointment (P = .006) was shorter for PSH. The time from initial appointment to the day of surgery was similar between groups (P = .20). Patients were more likely to be consented for surgery on their first clinic visit when undergoing surgery at ACH (87 of 103, 84.4%) compared to PSH (61 of 103; 59.2%; P total knee arthroplasty (P = .001) and total hip arthroplasty patients (P = .001) at PSH. Facility ownership in PSH resulted in similar conservative treatment before TJA. The time to surgical consent after the initial appointment was longer PSH, whereas the time from consent to the date of surgery was shorter at the PSH. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Total Syntheses of Polycyclic Polyprenylated Acylphloroglucinol Natural Products and Analogs Utilizing Alkylative Dearomatizations and Cationic Cyclizations

    Science.gov (United States)

    Boyce, Jonathan H.

    Polycyclic polyprenylated acylphloroglucinols (PPAPs) are structurally complex natural products with promising biological activities. These compounds have interesting anticancer and anti-HIV properties as well as other biological activities making them highly attractive synthetic targets. We report a stereodivergent, asymmetric total synthesis of (-)-clusianone in six steps from commercial materials. We have implemented a challenging cationic cyclization forging a bond between two sterically encumbered quaternary carbon atoms. Mechanistic studies point to the unique ability of formic acid to mediate the cyclization forming the clusianone framework. We also present a biosynthesis-inspired, diversity-oriented synthesis approach for rapid construction of PPAP analogs via palladium-catalyzed dearomative conjunctive allylic alkylation (DCAA). These efficient palladium-catalyzed protocols construct the [3.3.1]-bicyclic PPAP core in a single step from their stable aromatic precursors. The first syntheses of 13,14-didehydroxyisogarcinol and garcimultiflorone A stereoisomers are reported in six steps from a commercially available phloroglucinol. Lewis acid-controlled, diastereoselective cationic oxycyclizations enabled asymmetric syntheses of (-)-6-epi-13,14-didehydroxyisogarcinol and (+)-30-epi-13,14-didehydroxyisogarcinol. A similar strategy enabled production of the meso-derived isomers (+/-)-6,30- epi-13,14-didehydroxyisogarcinol and (+/-)-6,30-epi -garcmultiflorone A. A convenient strategy for gram scale synthesis of these stereoisomers was developed utilizing diastereomer separation at a later stage in the synthesis that minimized the number of necessary synthetic operations to access all possible stereoisomers. Finally, we report cationic rearrangements of dearomatized acylphloroglucinols leading to the formation of unprecedented PPAP scaffolds. A novel type A [3.3.1]-bicyclic PPAP was produced as a major product and the structure confirmed by X-ray crystallographic

  5. The Assessment of Biofuel Utilization Policy on the Total Output and CO2 Emissions in Thailand

    Directory of Open Access Journals (Sweden)

    Suthathip Suanmali

    2013-07-01

    Full Text Available The transport sector is the largest energy-consuming sector in Thailand. Its primary energy supply is heavily depended on imported oil. Since 2005, world crude oil price has been rising and had reached a record of 147 $/barrel. Therefore the policy on promotion of biofuel utilization was initiated in 2005 by the Ministry of Energy; however, the economy-wide impacts have been rarely assessed. This paper presents the energy Input-Output Analysis (IO of the economy-wide impacts on the promotion policy, in particular, the change in Greenhouse Gas (GHG emissions. In order to measure the total GHG emission from different economic sectors, the contribution of emissions has to be considered. In this paper, the focus is placed on CO2 emissions. To calculate the amount of CO2 emissions, the emission amount of various final consumptions in the economy evaluated by the IO must be applied. The direct CO2 emissions in final energy consumptions in Thailand are evaluated by using conversion factors from Guidelines to Defra's GHG conversion factors, Annexes updated in June 2007. The CO2 emissions in various economic sectors will be calculated and compared with the figures in 2015 when the policy is fully implemented.

  6. A Physical Heart Failure Simulation System Utilizing the Total Artificial Heart and Modified Donovan Mock Circulation.

    Science.gov (United States)

    Crosby, Jessica R; DeCook, Katrina J; Tran, Phat L; Betterton, Edward; Smith, Richard G; Larson, Douglas F; Khalpey, Zain I; Burkhoff, Daniel; Slepian, Marvin J

    2017-07-01

    With the growth and diversity of mechanical circulatory support (MCS) systems entering clinical use, a need exists for a robust mock circulation system capable of reliably emulating and reproducing physiologic as well as pathophysiologic states for use in MCS training and inter-device comparison. We report on the development of such a platform utilizing the SynCardia Total Artificial Heart and a modified Donovan Mock Circulation System, capable of being driven at normal and reduced output. With this platform, clinically relevant heart failure hemodynamics could be reliably reproduced as evidenced by elevated left atrial pressure (+112%), reduced aortic flow (-12.6%), blunted Starling-like behavior, and increased afterload sensitivity when compared with normal function. Similarly, pressure-volume relationships demonstrated enhanced sensitivity to afterload and decreased Starling-like behavior in the heart failure model. Lastly, the platform was configured to allow the easy addition of a left ventricular assist device (HeartMate II at 9600 RPM), which upon insertion resulted in improvement of hemodynamics. The present configuration has the potential to serve as a viable system for training and research, aimed at fostering safe and effective MCS device use. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  7. Patterns of pharmacotherapy and health care utilization and costs prior to total hip or total knee replacement in patients with osteoarthritis.

    Science.gov (United States)

    Berger, Ariel; Bozic, Kevin; Stacey, Brett; Edelsberg, John; Sadosky, Alesia; Oster, Gerry

    2011-08-01

    To examine patterns of pharmacotherapy and health care utilization and costs prior to total knee replacement (TKR) or total hip replacement (THR) in patients with osteoarthritis (OA). Using a large US health insurance claims database, we identified all patients with OA who were ages ≥40 years and had undergone TKR or THR between January 1, 2006 and December 31, 2007. Patients with care utilization and costs over the 2-year period preceding surgery. A total of 16,527 patients met all study entry criteria. Their mean ± SD age was 56.6 ± 6.1 years, and 56% of them were women. In the 2 years preceding surgery, 55% of patients received prescription nonsteroidal antiinflammatory drugs, 58% received opioids, and 50% received injections of corticosteroids. The numbers of patients receiving these drugs increased steadily during the presurgery period. The mean ± SD total health care costs in the 2 years preceding surgery were $19,466 ± 29,869, of which outpatient care, inpatient care, and pharmacotherapy represented 45%, 20%, and 20%, respectively. Costs increased from $2,094 in the eighth calendar quarter prior to surgery to $3,100 in the final quarter. Patients with OA who undergo THR or TKR have relatively high levels of use of pain-related pharmacotherapy and high total health care costs in the 2-year period preceding surgery. Levels of utilization and cost increase as the date of surgery approaches. Copyright © 2011 by the American College of Rheumatology.

  8. Diagnostic Utility of Total IgE in Foods, Inhalant, and Multiple Allergies in Saudi Arabia.

    Science.gov (United States)

    Al-Mughales, Jamil A

    2016-01-01

    Objective. To assess the diagnostic significance of total IgE in foods, inhalant, and multiple allergies. Methods. Retrospective review of the laboratory records of patients who presented with clinical suspicion of food or inhalant allergy between January 2013 and December 2014. Total IgE level was defined as positive for a value >195 kU/L; and diagnosis was confirmed by the detection of specific IgE (golden standard) for at least one food or inhalant allergen and at least two allergens in multiple allergies. Results. A total of 1893 (male ratio = 0.68, mean age = 39.0 ± 19.2 years) patients were included. Total IgE had comparable sensitivity (55.8% versus 59.6%) and specificity (83.9% versus 84.4%) in food versus inhalant allergy, respectively, but a superior PPV in inhalant allergy (79.1% versus 54.4%). ROC curve analysis showed a better diagnostic value in inhalant allergies (AUC = 0.817 (95% CI = 0.796-0.837) versus 0.770 (95% CI = 0.707-0.833)). In multiple allergies, total IgE had a relatively good sensitivity (78.6%), while negative IgE testing (allergies with 91.5% certitude. Conclusion. Total IgE assay is not efficient as a diagnostic test for foods, inhalant, or multiple allergies. The best strategy should refer to specific IgE testing guided by a comprehensive atopic history.

  9. A Retention Assessment Process: Utilizing Total Quality Management Principles and Focus Groups

    Science.gov (United States)

    Codjoe, Henry M.; Helms, Marilyn M.

    2005-01-01

    Retaining students is a critical topic in higher education. Methodologies abound to gather attrition data as well as key variables important to retention. Using the theories of total quality management and focus groups, this case study gathers and reports data from current college students. Key results, suggestions for replication, and areas for…

  10. Combining total energy and energy industrial center concepts to increase utilization efficiency of geothermal energy

    Science.gov (United States)

    Bayliss, B. P.

    1974-01-01

    Integrating energy production and energy consumption to produce a total energy system within an energy industrial center which would result in more power production from a given energy source and less pollution of the environment is discussed. Strong governmental support would be required for the crash drilling program necessary to implement these concepts. Cooperation among the federal agencies, power producers, and private industry would be essential in avoiding redundant and fruitless projects, and in exploiting most efficiently our geothermal resources.

  11. Total Synthesis of Ustiloxin D Utilizing an Ammonia-Ugi Reaction.

    Science.gov (United States)

    Brown, Aaron L; Churches, Quentin I; Hutton, Craig A

    2015-10-16

    Total synthesis of the highly functionalized cyclic peptide natural product, ustiloxin D, has been achieved in a convergent manner. Our strategy incorporates an asymmetric allylic alkylation to construct the tert-alkyl aryl ether linkage between the dopa and isoleucine residues. The elaborated β-hydroxydopa derivative is rapidly converted to a linear tripeptide through an ammonia-Ugi reaction. Subsequent cyclization and global deprotection affords ustiloxin D in six steps from a known β-hydroxydopa derivative.

  12. Performance-Based Funding Brief

    Science.gov (United States)

    Washington Higher Education Coordinating Board, 2011

    2011-01-01

    A number of states have made progress in implementing performance-based funding (PFB) and accountability. This policy brief summarizes main features of performance-based funding systems in three states: Tennessee, Ohio, and Indiana. The brief also identifies key issues that states considering performance-based funding must address, as well as…

  13. Duplex Ultrasonography Has Limited Utility in Detection of Postoperative DVT After Primary Total Joint Arthroplasty.

    Science.gov (United States)

    Vira, Shaleen; Ramme, Austin J; Alaia, Michael J; Steiger, David; Vigdorchik, Jonathan M; Jaffe, Frederick

    2016-07-01

    Duplex ultrasound is routinely used to evaluate suspected deep venous thrombosis after total joint arthroplasty. When there is a clinical suspicion for a pulmonary embolism, a chest angiogram (chest CTA) is concomitantly obtained. Two questions were addressed: First, for the population of patients who receive duplex ultrasound after total joint arthroplasty, what is the rate of positive results? Second, for these patients, how many of these also undergo chest CTA for clinical suspicion of pulmonary embolus and how many of these tests are positive? Furthermore, what is the correlation between duplex ultrasound results and chest CTA results? A retrospective chart review was conducted of total joint replacement patients in 2011 at a single institution. Inclusion criteria were adult patients who underwent a postoperative duplex ultrasonography for clinical suspicion of deep venous thrombosis (DVT). Demographic data, result of duplex scan, clinical indications for obtaining the duplex scan, and DVT prophylaxis used were recorded. Additionally, if a chest CTA was obtained for clinical suspicion for pulmonary embolus, results and clinical indication for obtaining the test were recorded. The rate of positive results for duplex ultrasonography and chest CTA was computed and correlated based on clinical indications. Two hundred ninety-five patients underwent duplex ultrasonography of which only 0.7% were positive for a DVT. One hundred three patients underwent a chest CTA for clinical suspicion of a pulmonary embolism (PE) of which 26 revealed a pulmonary embolus, none of which had a positive duplex ultrasound. Postoperative duplex scans have a low rate of positive results. A substantial number of patients with negative duplex results subsequently underwent chest CTA for clinical suspicion for which a pulmonary embolus was found, presumably resulting from a DVT despite negative duplex ultrasound result. A negative duplex ultrasonography should not rule out the presence of a

  14. Single/total-economy aspects of production and utilization of energy from renewable raw materials

    Energy Technology Data Exchange (ETDEWEB)

    Meinhold, K

    1982-01-01

    ''Biosprit (biologically produced gasohol) can compete with synthetically produced ethanol for use in commerce and industries but not fully so with petrol due to the present refinery selling prices. Nevertheless, a 10% admixture will increase the price of one litre of petrol only slightly. If the consumer is not meant to cover this price increase, it could be covered by a small proportion of those expenditures which will be saved through a changeover to biogasohol production and which have been payed for necessary export refunding so far. Even at present, there is a considerable benefit involved for the overall national economy if there was a changeover to biogasohol production. In terms of total economy, transitional or initial subsidization would be just as justified as it is with initial promotion by the government with the introduction of new technologies.

  15. Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    William D. Bugbee

    2013-01-01

    Full Text Available Customized patient instrumentation (CPI combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA. We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accuracy of implant placement. Twenty-five consecutive TKAs using CPI were analyzed. Preoperative CT scans of the lower extremities were segmented using a computer program. Limb alignment and mechanical axis were computed. Virtual implantation of computer-aided design models was done. Postoperative coronal and sagittal view radiographs were obtained. Using 3D image-matching software, relative positions of femoral and tibial implants were determined. Twenty-five TKAs implanted using traditional instrumentation were also analyzed. For CPI, difference in alignment from the preoperative plan was calculated. In the CPI group, the mean absolute difference between the planned and actual femoral placements was 0.67° in the coronal plane and 1.2° in the sagittal plane. For tibial alignment, the mean absolute difference was 0.9° in the coronal plane and 1.3° in the sagittal plane. For traditional instrumentation, difference from ideal placement for the femur was 1.5° in the coronal plane and 2.3° in the sagittal plane. For the tibia, the difference was 1.8° in the coronal plane. CPI achieved accurate implant positioning and was superior to traditional TKA instrumentation.

  16. Lab-on-a-chip based total-phosphorus analysis device utilizing a photocatalytic reaction

    Science.gov (United States)

    Jung, Dong Geon; Jung, Daewoong; Kong, Seong Ho

    2018-02-01

    A lab-on-a-chip (LOC) device for total phosphorus (TP) analysis was fabricated for water quality monitoring. Many commercially available TP analysis systems used to estimate water quality have good sensitivity and accuracy. However, these systems also have many disadvantages such as bulky size, complex pretreatment processes, and high cost, which limit their application. In particular, conventional TP analysis systems require an indispensable pretreatment step, in which the fluidic analyte is heated to 120 °C for 30 min to release the dissolved phosphate, because many phosphates are soluble in water at a standard temperature and pressure. In addition, this pretreatment process requires elevated pressures of up to 1.1 kg cm-2 in order to prevent the evaporation of the heated analyte. Because of these limiting conditions required by the pretreatment processes used in conventional systems, it is difficult to miniaturize TP analysis systems. In this study, we employed a photocatalytic reaction in the pretreatment process. The reaction was carried out by illuminating a photocatalytic titanium dioxide (TiO2) surface formed in a microfluidic channel with ultraviolet (UV) light. This pretreatment process does not require elevated temperatures and pressures. By applying this simplified, photocatalytic-reaction-based pretreatment process to a TP analysis system, greater degrees of freedom are conferred to the design and fabrication of LOC devices for TP monitoring. The fabricated LOC device presented in this paper was characterized by measuring the TP concentration of an unknown sample, and comparing the results with those measured by a conventional TP analysis system. The TP concentrations of the unknown sample measured by the proposed LOC device and the conventional TP analysis system were 0.018 mgP/25 mL and 0.019 mgP/25 mL, respectively. The experimental results revealed that the proposed LOC device had a performance comparable to the conventional bulky TP analysis

  17. Impact of Anterior vs Posterior Approach for Total Hip Arthroplasty on Post-Acute Care Service Utilization.

    Science.gov (United States)

    L'Hommedieu, Coles E; Gera, James J; Rupp, Gerald; Salin, Jeffery W; Cox, John S; Duwelius, Paul J

    2016-09-01

    Controversy exists as to which surgical approach is best for total hip arthroplasty (THA). Previous studies suggested that the tissue-sparing anterior approach should result in a more rapid recovery requiring fewer postacute services, ultimately decreasing overall episodic cost. The purpose of this cross-sectional study was to determine if any significant differences exist between the anterior vs posterior approaches on postacute care service utilization, readmissions, or episodic cost. Claims data from 26,773 Medicare fee-for-service beneficiaries receiving elective THAs (Medical Severity-Diagnosis Related Groups (MS-DRGs) 469/470) were analyzed. Claims data were collected from the 2-year period, January 2013 through December 2014. The posterior surgical approach was performed on 23,653 patients while 3120 patients received the anterior approach. Data analysis showed negligible effect sizes in postacute care service utilization, readmission rate, and cost between the surgical approaches for elective THA (MS-DRG 469 and 470). Average THA total episode cost was negligibly higher for procedures using the anterior approach compared to the posterior approach ($22,517 and $22,068, respectively). Statistically significant differences were observed in inpatient rehab and home health cost and service utilization. However, the effect sizes of these comparisons are negligible when accounting for the large sample size. All other comparisons showed minimal and statistically insignificant variation. The results indicate that surgical approach alone is not the primary driver of postacute care service utilization, quality outcomes, or cost. Other factors such as physician-led patient-focused care pathways, care coordination, rapid rehabilitation protocols, perioperative pain management protocols, and patient education are integral for effective patient care. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement.

    Science.gov (United States)

    Snow, Richard; Granata, Jaymes; Ruhil, Anirudh V S; Vogel, Karen; McShane, Michael; Wasielewski, Ray

    2014-10-01

    Health-care costs following acute hospital care have been identified as a major contributor to regional variation in Medicare spending. This study investigated the associations of preoperative physical therapy and post-acute care resource use and its effect on the total cost of care during primary hip or knee arthroplasty. Historical claims data were analyzed using the Centers for Medicare & Medicaid Services Limited Data Set files for Diagnosis Related Group 470. Analysis included descriptive statistics of patient demographic characteristics, comorbidities, procedures, and post-acute care utilization patterns, which included skilled nursing facility, home health agency, or inpatient rehabilitation facility, during the ninety-day period after a surgical hospitalization. To evaluate the associations, we used bivariate and multivariate techniques focused on post-acute care use and total episode-of-care costs. The Limited Data Set provided 4733 index hip or knee replacement cases for analysis within the thirty-nine-county Medicare hospital referral cluster. Post-acute care utilization was a significant variable in the total cost of care for the ninety-day episode. Overall, 77.0% of patients used post-acute care services after surgery. Post-acute care utilization decreased if preoperative physical therapy was used, with only 54.2% of the preoperative physical therapy cohort using post-acute care services. However, 79.7% of the non-preoperative physical therapy cohort used post-acute care services. After adjusting for demographic characteristics and comorbidities, the use of preoperative physical therapy was associated with a significant 29% reduction in post-acute care use, including an $871 reduction of episode payment driven largely by a reduction in payments for skilled nursing facility ($1093), home health agency ($527), and inpatient rehabilitation ($172). The use of preoperative physical therapy was associated with a 29% decrease in the use of any post-acute care

  19. Quality of Recovery, Postdischarge Hospital Utilization, and 2-Year Functional Outcomes After an Outpatient Total Knee Arthroplasty Program.

    Science.gov (United States)

    Gauthier-Kwan, Olivier Y; Dobransky, Johanna S; Dervin, Geoffrey F

    2018-02-05

    Outpatient total knee arthroplasty (TKA) has been made possible with advances in perioperative care and standardized clinical inpatient pathways. While many studies report on benefits of outpatient programs, none explore patient-reported outcome measures. As such, our goals were to compare the short-term quality of recovery; highlight postdischarge hospital resources utilization; and report on 2-year functional outcomes scores. This was a prospective comparative cohort study of 43 inpatients (43 TKAs) and 43 outpatients (43 TKAs) operated on by a single surgeon between September 28, 2010 and May 5, 2015. All patients were given a diary to complete at 1, 3, 7, 14, and 28 days postoperatively; we collected 90-day complications, readmissions, and emergency department visits; Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index scores were completed preoperatively and 2 years postoperatively. SPSS (IBM, version 22.0) was used for all statistical analyses. Quality of recovery (QoR-9) was similar in the outpatient TKA group compared with the inpatient group. No statistically significant differences were observed for Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Osteoarthritis Index subscores (P > .05). There was 1 readmission in both outpatient and inpatient groups. Six inpatients and 8 outpatients returned to the emergency department for any reason within 90 days, with no statistical significance observed between the 2 groups (P = .771). Outpatient TKA in selected patients produced similar short-term and 2-year patient-reported outcome measures and a comparable 90-day postdischarge hospital resource utilization when compared to an inpatient cohort, supporting further investigation into outpatient TKA. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. A Method of Determination of an Acquisition Program in Order to Maximize the Total Utility Using Linear Programming in Integer Numbers

    Directory of Open Access Journals (Sweden)

    Alin Cristian Ioan

    2010-03-01

    Full Text Available This paper solves in a different way the problem of maximization of the total utility using the linear programming in integer numbers. The author uses the diofantic equations (equations in integers numbers and after a decomposing in different cases, he obtains the maximal utility.

  1. Genistein, a phytoestrogen, improves total cholesterol, and Synergy, a prebiotic, improves calcium utilization, but there were no synergistic effects.

    Science.gov (United States)

    Legette, LeeCole L; Lee, Wang-Hee; Martin, Berdine R; Story, Jon A; Arabshahi, Ali; Barnes, Stephen; Weaver, Connie M

    2011-08-01

    Prebiotics and phytoestrogens have sparked great interest because evidence indicates that the consumption of these dietary constituents leads to lower cholesterol levels and inhibition of postmenopausal bone loss. The aim of this study was to determine the effect of both a prebiotic (Synergy) and a phytoestrogen (genistein) on bone and blood lipid levels in an animal model of postmenopausal women. A 4-week feeding study was conducted in 5-month-old ovariectomized (OVX) Sprague-Dawley rats to examine the effect of genistein, Synergy (a prebiotic), and genistein and Synergy combined on bone density and strength, calcium metabolism, and lipid biomarkers. There were six treatment groups: sham control, OVX control, OVX rats receiving daily estradiol injections, and OVX rats receiving an AIN-93M diet supplement with 200 ppm genistein, with 5% Synergy or with 200 ppm genistein and 5% Synergy combined. The rats receiving genistein had significantly lower total serum cholesterol concentrations than OVX rats in the control group (17%), OVX rats receiving daily estradiol injections (14%), and OVX rats fed the 5% Synergy diet (19%). Consumption of Synergy improved calcium absorption efficiency (41%) compared with nonconsumption (OVX control). Sham control rats had a significantly higher femoral bone density, as determined by underwater weighing, than did the rats in all of the OVX groups. Genistein consumption restored total and trabecular bone mineral density at the distal femur similar to the levels of sham rats. Genistein supplementation imparts modest heart health benefits and improves bone geometry at the distal femur, and prebiotic consumption (Synergy) results in improved calcium utilization strength in ovariectomized rats, but the combination produced no synergistic effects.

  2. Cost-utility analysis comparing radioactive iodine, anti-thyroid drugs and total thyroidectomy for primary treatment of Graves' disease.

    Science.gov (United States)

    Donovan, Peter J; McLeod, Donald S A; Little, Richard; Gordon, Louisa

    2016-12-01

    Little data is in existence about the most cost-effective primary treatment for Graves' disease. We performed a cost-utility analysis comparing radioactive iodine (RAI), anti-thyroid drugs (ATD) and total thyroidectomy (TT) as first-line therapy for Graves' disease in England and Australia. We used a Markov model to compare lifetime costs and benefits (quality-adjusted life-years (QALYs)). The model included efficacy, rates of relapse and major complications associated with each treatment, and alternative second-line therapies. Model parameters were obtained from published literature. One-way sensitivity analyses were conducted. Costs were presented in 2015£ or Australian Dollars (AUD). RAI was the least expensive therapy in both England (£5425; QALYs 34.73) and Australia (AUD5601; 30.97 QALYs). In base case results, in both countries, ATD was a cost-effective alternative to RAI (£16 866; 35.17 QALYs; incremental cost-effectiveness ratio (ICER) £26 279 per QALY gained England; AUD8924; 31.37 QALYs; ICER AUD9687 per QALY gained Australia), while RAI dominated TT (£7115; QALYs 33.93 England; AUD15 668; 30.25 QALYs Australia). In sensitivity analysis, base case results were stable to changes in most cost, transition probabilities and health-relative quality-of-life (HRQoL) weights; however, in England, the results were sensitive to changes in the HRQoL weights of hypothyroidism and euthyroidism on ATD. In this analysis, RAI is the least expensive choice for first-line treatment strategy for Graves' disease. In England and Australia, ATD is likely to be a cost-effective alternative, while TT is unlikely to be cost-effective. Further research into HRQoL in Graves' disease could improve the quality of future studies. © 2016 European Society of Endocrinology.

  3. Performance-based inspection and maintenance strategies

    International Nuclear Information System (INIS)

    Vesely, W.E.

    1995-01-01

    Performance-based inspection and maintenance strategies utilize measures of equipment performance to help guide inspection and maintenance activities. A relevant measure of performance for safety system components is component unavailability. The component unavailability can also be input into a plant risk model such as a Probabilistic Risk Assessment (PRA) to determine the associated plant risk performance. Based on the present and projected unavailability performance, or the present and projected risk performance, the effectiveness of current maintenance activities can be evaluated and this information can be used to plan future maintenance activities. A significant amount of information other than downtimes or failure times is collected or can be collected when an inspection or maintenance is conducted which can be used to estimate the component unavailability. This information generally involves observations on the condition or state of the component or component piecepart. The information can be detailed such as the amount of corrosion buildup or can be general such as the general state of the component described as ' high degradation', ' moderate degradation', or ' low degradation'. Much of the information collected in maintenance logs is qualitative and fuzzy. As part of an NRC Research program on performance-based engineering modeling, approaches have been developed to apply Fuzzy Set Theory to information collected on the state of the component to determine the implied component or component piecepart unavailability. Demonstrations of the applications of Fuzzy Set Theory are presented utilizing information from plant maintenance logs. The demonstrations show the power of Fuzzy Set Theory in translating engineering information to reliability and risk implications

  4. Fiscal 1976 Sunshine Project result report. Research on solar energy utilization systems (total system); 1976 nendo taiyo energy riyo system chosa kenkyu seika hokokusho. Total system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1977-03-01

    For every solar energy utilization field, its background, feasibility, impact in practical use, and R and D policy in Japan were studied. Heating and hot water supply by solar energy are already practical because of less technical problems and reasonable profitability, and cooling is also practical as far as a technical viewpoint. At present, the technical level of solar heat power generation is in the stage of basic technology, however, in the future, development of economically reasonable systems will be demanded as well as establishment of its technology. The most difficult problem for realizing practical solar cell power generation systems is cost reduction. It is also another problem that a big demand of Si for solar cells further exceeds the current yield of Si in a semiconductor industry. A small-scale hybrid solar cell power generation system applicable to the roof of general residences is already feasible. Although a solar furnace is still poor in application to industrial fields, it is expected as the leading part for a future solar heat chemical industry. (NEDO)

  5. Fiscal 1974 Sunshine Project result report. Research on solar energy utilization systems (total system); 1974 nendo taiyo energy riyo system chosa kenkyu seika hokokusho. Total system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1975-03-01

    The current most important solar energy utilization fields are solar energy power generation (solar heat and photovoltaic power generation), and solar heat cooling and heating. A solar heat power system collects or stores solar thermal energy as energy source of power systems, and converts it to electric power through heat exchange systems. To establish such system, not only R and D on a collector, absorption capsule, storage unit and heat transfer unit, but also complete study on an optimum system configuration and environmental impact are necessary. A photovoltaic power system converts solar energy to electric power directly by photoelectric conversion device such solar cell. Except specific local uses, drastic cost reduction and improvement of a conversion efficiency (at present 12-15%) and life (several years) are necessary for solar cells. Although a lot of solar heat cooling and heating systems is in practical use in Japan, for its further diffusion an important research task is development of heat collector excellent in efficiency, cost, life and maintainability. (NEDO)

  6. Association Between Provider Volume and Comorbidity on Hospital Utilization and Outcomes of Total Hip Arthroplasty Among National Health Insurance Enrollees

    Directory of Open Access Journals (Sweden)

    Chung-Shih Huang

    2011-06-01

    Conclusions: This study revealed that the volume of THAs performed by individual surgeons was a more important determinant of hospital utilization than hospital volume. Perioperative adverse events were associated with patients' age and comorbidity.

  7. The dramatic increase in total knee replacement utilization rates in the United States cannot be fully explained by growth in population size and the obesity epidemic.

    Science.gov (United States)

    Losina, Elena; Thornhill, Thomas S; Rome, Benjamin N; Wright, John; Katz, Jeffrey N

    2012-02-01

    Total knee replacement utilization in the United States more than doubled from 1999 to 2008. Although the reasons for this increase have not been examined rigorously, some have attributed the increase to population growth and the obesity epidemic. Our goal was to investigate whether the rapid increase in total knee replacement use over the past decade can be sufficiently attributed to changes in these two factors. We used data from the Nationwide Inpatient Sample to estimate changes in total knee replacement utilization rates from 1999 to 2008, stratified by age (eighteen to forty-four years, forty-five to sixty-four years, and sixty-five years or older). We obtained data on obesity prevalence and U.S. population growth from federal sources. We compared the rate of change in total knee replacement utilization with the rates of population growth and change in obesity prevalence from 1999 to 2008. In 2008, 615,050 total knee replacements were performed in the United States adult population, 134% more than in 1999. During the same time period, the overall population size increased by 11%. While the population of forty-five to sixty-four-year-olds grew by 29%, the number of total knee replacements in this age group more than tripled. The number of obese and non-obese individuals in the United States increased by 23% and 4%, respectively. Assuming unchanged indications for total knee replacement among obese and non-obese individuals with knee osteoarthritis over the last decade, these changes fail to account for the 134% growth in total knee replacement use. Population growth and obesity cannot fully explain the rapid expansion of total knee replacements in the last decade, suggesting that other factors must also be involved. The disproportionate increase in total knee replacements among younger patients may be a result of a growing number of knee injuries and expanding indications for the procedure.

  8. Pharmacokinetic-pharmacodynamic modeling of antipsychotic drugs in patients with schizophrenia Part I : The use of PANSS total score and clinical utility

    NARCIS (Netherlands)

    Reddy, Venkatesh Pilla; Kozielska, Magdalena; Suleiman, Ahmed Abbas; Johnson, Martin; Vermeulen, An; Liu, Jing; de Greef, Rik; Groothuis, Geny M. M.; Danhof, Meindert; Proost, Johannes H.

    Background: To develop a pharmacokinetic-pharmacodynamic (PK-PD) model using individual-level data of Positive and Negative Syndrome Scale (PANSS) total score to characterize the antipsychotic drug effect taking into account the placebo effect and dropout rate. In addition, a clinical utility (CU)

  9. Impact of Neuromuscular Electrical Stimulation (NMES) on 90-Day Episode Costs and Post-Acute Care Utilization in Total Knee Replacement Patients with Disuse Atrophy.

    Science.gov (United States)

    Pal, Sarmistha; Chughtai, Morad; Sultan, Assem A; Khlopas, Anton; Sodhi, Nipun; George, Nicole E; Etcheson, Jennifer I; Gwam, Chukwuweike U; Newman, Jared M; Samuel, Linsen T; Bhave, Anil; DaVanzo, Joan E; Mont, Michael A

    2017-12-22

    This study evaluated differences in: 1) total episode payments, 2) probability of hospital readmission, 3) probability of inpatient rehab facility (IRF) and utilization, and 4) probability of skilled nursing care facility (SNF) utilization in patients who had disuse atrophy and underwent a total knee arthroplasty (TKA) and either did, or did not, receive preoperative home-based neuromuscular electrical stimulation (NMES) therapy. We used the Medicare limited dataset for a 5% sample of beneficiaries from 2014 and 2015 to construct episodes-of-care for TKA (DRG-470) patients with disuse atrophy who underwent a TKA during the 30 days prior to hospital admission and 90 days post-discharge. Patients were stratified into those who either did or did not receive pre- and postoperative NMES therapy. An ordinary least square (OLS) model was used to estimate the impact of NMES on total episode. Linear probability models were used to estimate the impact of NMES on SNF or IRF utilization and readmission. A $3,274 reduction in episode payments for patients who used preoperative NMES versus those who did not (ptotal episode payments and SNF utilization for TKA patients with disuse atrophy who had NMES therapy was demonstrated.

  10. Utilizing the Total Design Method in medicine: maximizing response rates in long, non-incentivized, personal questionnaire postal surveys.

    Science.gov (United States)

    Kazzazi, Fawz; Haggie, Rebecca; Forouhi, Parto; Kazzazi, Nazar; Malata, Charles M

    2018-01-01

    Maximizing response rates in questionnaires can improve their validity and quality by reducing non-response bias. A comprehensive analysis is essential for producing reasonable conclusions in patient-reported outcome research particularly for topics of a sensitive nature. This often makes long (≥7 pages) questionnaires necessary but these have been shown to reduce response rates in mail surveys. Our work adapted the "Total Design Method," initially produced for commercial markets, to raise response rates in a long (total: 11 pages, 116 questions), non-incentivized, very personal postal survey sent to almost 350 women. A total of 346 women who had undergone mastectomy and immediate breast reconstruction from 2008-2014 (inclusive) at Addenbrooke's University Hospital were sent our study pack (Breast-Q satisfaction questionnaire and support documents) using our modified "Total Design Method." Participants were sent packs and reminders according to our designed schedule. Of the 346 participants, we received 258 responses, an overall response rate of 74.5% with a useable response rate of 72.3%. One hundred and six responses were received before the week 1 reminder (30.6%), 120 before week 3 (34.6%), 225 before the week 7 reminder (64.6%) and the remainder within 3 weeks of the final pack being sent. The median age of patients that the survey was sent to, and the median age of the respondents, was 54 years. In this study, we have demonstrated the successful implementation of a novel approach to postal surveys. Despite the length of the questionnaire (nine pages, 116 questions) and limitations of expenses to mail a survey to ~350 women, we were able to attain a response rate of 74.6%.

  11. Pearl millet utilization in ccommercial laying hen diets formulated on a total or digestible amino acid basis

    Directory of Open Access Journals (Sweden)

    RS Filardi

    2005-06-01

    Full Text Available An experiment was carried out to evaluate the effect of replacing corn with pearl millet in commercial layer diets, formulated according to the minimal requirements for total and digestible amino acids. Two hundred and forty Lohmann LSL laying hens with 25 weeks of age were distributed in a completely randomized experimental design according to a 2 x 5 factorial arrangement with 3 replicates of 8 birds. Feed was formulated on two amino acid basis (total or digestible according to Rostagno et al. (2000 and there were five pearl millet inclusion levels (0%, 25%, 50%, 75%, and 100%. Performance and egg quality were evaluated during five periods of 21 days.At the end of each period, feed intake, egg production, egg weight and feed conversion were evaluated. In the last three days of each period, the following egg quality parameters were evaluated: Haugh Unit, yolk pigmentation index, egg specific weight, shell percentage and shell thickness. Digestible amino acid requirements resulted in decreased feed intake (p<0.01 and increased production costs per mass of eggs (kg or per dozen eggs (p<0.01 compared to total amino acid requirements. There was a linear reduction in feed intake, egg production, egg weight and yolk pigmentation index with increasing inclusion levels of pearl millet. Therefore, increasing levels of replacement of corn by pearl millet affected bird performance negatively. Besides, production costs were higher with increasing pearl millet levels.

  12. Selecting a cutoff point for a developmental screening test based on overall diagnostic indices and total expected utilities of professional preferences.

    Science.gov (United States)

    Liao, Hua-Fang; Cheng, Ling-Yee; Hsieh, Wu-Shiun; Yang, Ming-Chin

    2010-03-01

    A cutoff point in a test with sounded validity and professional preferences can help to make an accurate clinical decision. This study aimed to determine a cutoff point between two strategies for a developmental screening checklist (referred to as Taipei II). Cutoff point A was set as one or more item failed and cutoff point B was set as two or more items failed or one or more marked item failed. This study was based on the total expected utilities of professional preferences and overall diagnostic indices. A self-administered questionnaire was developed to collect the estimated utility from professionals involved in early childhood interventions (n = 81) regarding four screening outcomes (probabilities of true positive, false positive, true negative, or false negative) and costs. The total expected utilities were calculated from the probabilities of four screening outcomes and utility values. The diagnostic odds ratio was higher for strategy B (695 and 209, respectively) than that of strategy A (184 and 150, respectively) when using the Taipei II on children under 3 years of age and age 3 and over. Strategy B also had a higher median total expected utilities score than strategy A (0.78 vs. 0.72 for children or = 3). If only one cutoff point can be chosen, the authors suggest that clinicians should choose cutoff point B when using the Taipei II for screening. However, two cutoff points of Taipei II, a combination of strategy A and B, can also be used clinically. 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

  13. The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

    Science.gov (United States)

    Göthlin, Jan H.

    2013-01-01

    Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty. Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP) and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis. Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip. Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections. PMID:24078921

  14. The Utility of Digital Linear Tomosynthesis Imaging of Total Hip Joint Arthroplasty with Suspicion of Loosening: A Prospective Study in 40 Patients

    Directory of Open Access Journals (Sweden)

    Jan H. Göthlin

    2013-01-01

    Full Text Available Aim. The clinical utility of digital linear tomosynthesis in musculoskeletal applications has been validated in only a few reports. Technical performance and utility in hip prosthesis imaging have been discussed in technical reports, but no clinical evaluation has been reported. The purpose of the current study was to assess the added clinical utility of digital linear tomosynthesis compared to radiography in loosening of total hip joint arthroplasty. Materials and Methods. In a prospective study, radiography and digital tomosynthesis were performed in 40 consecutive patients with total hip arthroplasty referred for suspect prosthesis loosening. Tomosynthesis images were compared to anterior-posterior (AP and cross-table lateral radiographs regarding demarcation and extent of demineralization and osteolysis. Further noted were skeletal fractures, cement fractures, fragmentation, and artifacts interfering with the diagnosis. Results. Tomosynthesis was superior to radiography with sharper delineation of demineralization and osteolysis in the AP projection. A limitation was the inability to generate lateral tomosynthesis images, with inferior assessment of the area anterior and posterior to the acetabular cup compared to cross-table radiographs. Artifacts interfering with diagnosis were found in one hip. Conclusion. Tomosynthesis improved evaluation of total hip arthroplasty in the AP projection but was limited by the lack of lateral projections.

  15. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Bone marrow transplantation for girls with aplastic anemia utilizing modified field of total lymphoid irradiation and cyclophosphamide

    International Nuclear Information System (INIS)

    Hanada, Ryoji; Kawakami, Tetsuo; Akuta, Naoko; Moriwaki, Kohichi; Kato, Shizue; Inaba, Toshiya; Hayashi, Yasuhide; Yamamoto, Keiko

    1990-01-01

    A preparative regimen for allogeneic bone marrow transplantation, consisting of total lymphoid irradiation (TLI) with 750 cGy and cyclophosphamide (CY), was used in five girls with aplastic anemia. All patients received bone marrow from HLA matched/mixed lymphocyte culture negative siblings. In our regimen the 'inverted Y' field to irradiate the pelvic nodes was modified, which did not include the whole pelvic cavity in an attempt to protect the ovaries from irradiation. Although some of the pelvic nodes was supported not to be irradiated in order to protect the ovaries, engraftment occurred in all five patients including four who had been transfused prior to transplantation. All five are alive from 47 days to 1378 days (median 285 days) after transplantation without tranplantation-associated complications. The calculated dose to the ovaries was sixteen percent of the entire dose of the regimen. Both of the two evaluable patients that had received tranplantation just before or during the puberty are developing normal sex maturity including menstruation. This study suggests that our preparative regimen is effective not only for engraftment of the donor marrow but also for protecting the ovaries from irradiation. (author)

  17. Introducing a novel method to estimate the total heat transfer coefficient inside irregular-shape cavities utilizing thermoelectric modules; Special application in solar engineering

    DEFF Research Database (Denmark)

    Asadi, Amin; Rahbar, Nader; Rezaniakolaei, Alireza

    The main objective of the present study is to introduce a novel method to measure the total heat transfer coefficient inside irregular-shape cavities, used in solar applications, utilizing thermoelectric modules. Applying mathematical and thermodynamics modeling, the governing equations related...... to the total heat transfer coefficient between thermoelectric and glass cover as a function of ambient temperature, glass temperature, and output voltage has been derived. Investigating the accuracy of the proposed equation, an experimental case study has been performed. The experimental setup consists...... of three parts; a heat sink, a thermoelectric module, and a glass cover. All the experiments have been performed on the typical winter day and under the real climatic conditions of Semnan (35° 33′ N, 53° 23′ E), Iran. The results showed that the proposed method has the ability to measure the total heat...

  18. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

    Directory of Open Access Journals (Sweden)

    Brennan Sharon L

    2012-04-01

    Full Text Available Abstract Background The utilization of total hip replacement (THR surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years. Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  19. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

    2012-04-30

    The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  20. Effect of selective and nonselective beta-blockers on resting energy production rate and total body substrate utilization in chronic heart failure.

    Science.gov (United States)

    Podbregar, Matej; Voga, Gorazd

    2002-12-01

    In chronic heart failure (CHF) beta-blockers reduce myocardial oxygen consumption and improve myocardial efficiency by shifting myocardial substrate utilization from increased free fatty acid oxidation to increased glucose oxidation. The effect of selective and nonselective beta-blockers on total body resting energy production rate (EPR) and substrate utilization is not known. Twenty-six noncachectic patients with moderately severe heart failure (New York Heart Association class II or III, left ventricular ejection fraction < 0.40) were treated with carvedilol (37.5 +/- 13.5 mg/12 h) or bisoprolol (5.4 +/- 3.0 mg/d) for 6 months. Indirect calorimetry was performed before and after 6 months of treatment. Resting EPR was decreased in carvedilol (5.021 +/- 0.803 to 4.552 +/- 0.615 kJ/min, P <.001) and bisoprolol group (5.230 +/- 0.828 to 4.978 +/- 0.640 kJ/min, P <.05; nonsignificant difference between groups). Lipid oxidation rate decreased in carvedilol and remained unchanged in bisoprolol group (2.4 +/- 1.4 to 1.5 +/- 0.9 mg m(2)/kg min versus 2.7 +/- 1.1 to 2.5 +/- 1.1 mg m(2)/kg min, P <.05). Glucose oxidation rate was increased only in carvedilol (2.6 +/- 1.4 to 4.4 +/- 1.6 mg m(2)/kg min, P <.05), but did not change in bisoprolol group. Both selective and nonselective beta-blockers reduce total body resting EPR in noncachectic CHF patients. Carvedilol compared to bisoprolol shifts total body substrate utilization from lipid to glucose oxidation.

  1. The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model.

    Science.gov (United States)

    Barlow, Brian T; McLawhorn, Alexander S; Westrich, Geoffrey H

    2017-05-03

    Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. Markov model analysis was conducted from the societal perspective with use of direct and indirect costs. Costs, expressed in 2013 U.S. dollars, were derived from the literature, the National Inpatient Sample, and the Centers for Medicare & Medicaid Services. Effectiveness was expressed in quality-adjusted life years (QALYs). The model was populated with health state utilities and state transition probabilities derived from previously published literature. The analysis was performed for a patient's lifetime, and costs and effectiveness were discounted at 3% annually. The principal outcome was the incremental cost-effectiveness ratio (ICER), with a willingness-to-pay threshold of $100,000/QALY. Sensitivity analyses were performed to explore relevant uncertainty. In the base case, DM total hip arthroplasty showed absolute dominance over conventional total hip arthroplasty, with lower accrued costs ($39,008 versus $40,031 U.S. dollars) and higher accrued utility (13.18 versus 13.13 QALYs) indicating cost-savings. DM total hip arthroplasty ceased being cost-saving when its implant costs exceeded those of conventional total hip arthroplasty by $1,023, and the cost-effectiveness threshold for DM implants was $5,287 greater than that for conventional implants. DM was not cost-effective when the annualized incremental probability of revision from any unforeseen failure mechanism or mechanisms exceeded 0.29%. The probability of intraprosthetic dislocation exerted the most influence on model results. This model

  2. Staff background paper on performance-based rate making

    International Nuclear Information System (INIS)

    Fraser, J.; Brownell, B.

    1998-10-01

    An alternative to the traditional cost of service (COS) regulation for electric utilities in British Columbia has been proposed. The alternative to pure COS regulation is performance-based rate making (PBR). PBR partially decouples a utility's rates from its costs and ties utility profits to performance relative to specific benchmarks. The motivation underlying PBR is that ideally, it provides incentives for utilities to cost-effectively achieve pre-defined goals. This report describes the design of PBR mechanisms, base rate PBR formulas, base rate PBR in other jurisdictions including New York, California, Maine and New Jersey. The report also describes gas procurement PBR in other jurisdictions, as well as British Columbia Utilities' Commission's own experience with PBR. In general, PBR has the potential to provide resource efficiency, allocative efficiency, support for introduction of new services, and reduced regulatory administrative costs. 15 refs., 4 tabs

  3. Performance Based Logistics - A Bridge Between Acquisition Reform and Logistics Supply Chain Management

    National Research Council Canada - National Science Library

    Hurst, Dana

    2006-01-01

    .... Performance based logistics links acquisition and supply chain management in the Total Life Cycle Systems Management and thus may provide the opportunity for true reform resulting in increased...

  4. Utilization and Short-Term Outcomes of Primary Total Hip and Knee Arthroplasty in the United States and Canada: An Analysis of New York and Ontario Administrative Data.

    Science.gov (United States)

    Cram, Peter; Landon, Bruce E; Matelski, John; Ling, Vicki; Stukel, Therese A; Paterson, J Michael; Gandhi, Rajiv; Hawker, Gillian A; Ravi, Bheeshma

    2018-04-01

    Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common and effective surgical procedures. This study sought to compare utilization and short-term outcomes of primary TKA and THA in adjacent regions of Canada and the United States. The study was designed as a retrospective cohort study of patients who underwent primary TKA or THA, comparing administrative data from New York and Ontario in 2012-2013. Demographic features of the TKA and THA patients, per capita utilization rates, and short-term outcomes were compared between the jurisdictions. A higher percentage of New York hospitals performed TKA compared to Ontario hospitals (75.7% versus 42.1%; P New York hospitals (mean 179 versus 327 in Ontario hospitals; P New York compared to Ontario, both for TKA (16.1 TKAs versus 21.4 TKAs per 10,000 population per year; P New York hospitals; P New York patients were discharged directly home (46.2% versus 90.9% of Ontario patients; P New York compared to Ontario (30-day rates, 4.6% versus 3.9% [P New York but has a smaller percentage of hospitals performing these procedures. Patients are more likely to be discharged home and less likely to be readmitted in Ontario. Our results suggest areas where each jurisdiction could improve. © 2017, American College of Rheumatology.

  5. The interplay of dietary nutrient level and varying calcium to phosphorus ratios on efficacy of a bacterial phytase: 2. Ileal and total tract nutrient utilization.

    Science.gov (United States)

    Olukosi, O A; Fru-Nji, F

    2014-12-01

    A 14-d broiler experiment was conducted to assess the effects of 2 dietary variables on efficacy of a bacterial 6-phytase from Citobacter braakii on nutrient and phytate P (PP) utilization. Diets were formulated with or without nutrient matrix values (matrix) for phytase as negative control (NC) or positive control (PC), respectively, and with 2 Ca:total P (tP) levels (2:1 or 2.5:1). The diets were supplemented with 0, 1,000, or 2,000 phytase units (FYT)/kg of diet, thus producing a 2 × 2 × 3 factorial arrangement. Excreta were collected on d 19 to 21 and ileal digesta on d 21. There was no 3-way interaction on digestibility of any nutrient. There was matrix × phytase (P phytase interaction (P phytase increased (P phytase supplementation in diets with 2:1 Ca:tP, whereas there was no effect of phytase supplementation on PP disappearance or Ca retention in diets with 2.5:1 Ca:tP. Total P and Ca retention were reduced (P phytase supplementation on P utilization is reduced when diets contain adequate P as exemplified in the PC diets and that the negative impact of wide Ca:tP is more pronounced in diets with phytase matrix allowance as exemplified in the NC diets. ©2014 Poultry Science Association Inc.

  6. Association between muscle atrophy/weakness and health care costs and utilization among patients receiving total knee replacement surgery: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Chen SY

    2013-08-01

    Full Text Available Shih-Yin Chen,1 Ning Wu,1 Yuan-Chi Lee,1 Yang Zhao21Health Economics and Epidemiology, Evidera, Lexington, Massachusetts, 2Health Economics and Outcomes Research, Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USAPurpose: The aim of the study reported here was to examine health care resource utilization, costs, and risk of rehospitalization for total knee replacement (TKR patients with and without muscle atrophy/weakness (MAW.Patients and methods: Individuals aged 50–64 years with commercial insurance or 65+ years with Medicare Supplemental Insurance (Medicare who had a hospitalization for TKR between January 1, 2006 and September 30, 2009 were identified from a large US claims database. First hospitalization for TKR was defined as the index stay. All patients were classified into three cohorts according to when MAW was diagnosed relative to TKR: pre-MAW, post-MAW, and no MAW. The association between MAW and health care costs over the 12-month post-index period and the probability of rehospitalization were assessed via multivariate regressions.Results: The study sample included 53,696 Medicare and 46,058 commercial insurance TKR patients. Controlling for cross-cohort differences, both the pre- and post-MAW cohorts had significantly higher total health care costs (Medicare US$4,201 and US$9,404 higher, commercial insurance US$2,737 and US$6,640 higher, respectively than the no MAW cohort (all P < 0.05. The post-MAW cohort in both populations was also more likely to have any all-cause or replacement-related rehospitalization compared with the no MAW cohort.Conclusion: Among US patients undergoing TKR, those with MAW had higher health care utilization and costs than patients without MAW.Keywords: rehospitalization, resource utilization, Medicare, health insurance, USA

  7. TAP 2: Performance-Based Training Manual

    International Nuclear Information System (INIS)

    1993-08-01

    Cornerstone of safe operation of DOE nuclear facilities is personnel performing day-to-day functions which accomplish the facility mission. Performance-based training is fundamental to the safe operation. This manual has been developed to support the Training Accreditation Program (TAP) and assist contractors in efforts to develop performance-based training programs. It provides contractors with narrative procedures on performance-based training that can be modified and incorporated for facility-specific application. It is divided into sections dealing with analysis, design, development, implementation, and evaluation

  8. Performance-based regulation. Panel Discussion

    International Nuclear Information System (INIS)

    Youngblood, Robert; Bier, Vicki M.; Bukowski, Richard W.; Prasad Kadambi, N.; Koonce, James F.

    2001-01-01

    Full text of publication follows: Performance-based regulation is a part of the NRC's Strategic Plan and is realizing steady progress in conceptual development for actual applications. For example, high-level, conceptual guidelines have been proposed that would apply to reactors, materials, and waste areas. Performance-based approaches are also being applied in other regulated industries such as FAA and OSHA. The discussion will include comments from speakers from different parts of the nuclear industry and other industries regarding benefits and weaknesses of performance-based regulation. (authors)

  9. Performance-based planning and programming guidebook.

    Science.gov (United States)

    2013-09-01

    "Performance-based planning and programming (PBPP) refers to the application of performance management principles within the planning and programming processes of transportation agencies to achieve desired performance outcomes for the multimodal tran...

  10. Guidewire and microcatheter utilization patterns during antegrade wire escalation in chronic total occlusion percutaneous coronary intervention: Insights from a contemporary multicenter registry.

    Science.gov (United States)

    Karatasakis, Aris; Tarar, Muhammad Nauman J; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Yeh, Robert W; Jaffer, Farouc A; Wyman, R Michael; Lombardi, William L; Grantham, J Aaron; Kandzari, David E; Lembo, Nicholas J; Moses, Jeffrey W; Kirtane, Ajay J; Parikh, Manish; Garcia, Santiago; Doing, Anthony; Pershad, Ashish; Shah, Alpesh; Patel, Mitul; Bahadorani, John; Shoultz, Charles A; Danek, Barbara A; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

    2017-03-01

    We sought to describe contemporary guidewire and microcatheter utilization for antegrade wire escalation (AWE) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Equipment utilization for AWE has been variable and evolving over time. We examined device utilization during 694 AWE attempts in 679 patients performed at 15 experienced US centers between May 2012 and April 2015. Mean age was 65.6 ± 9.7 years, and 85% of the patients were men. Successful wiring occurred in 436 AWE attempts (63%). Final technical and procedural success was 91% and 89%, respectively. The mean number of guidewire types used for AWE was 2.2 ± 1.4. The most frequently used guidewire types were the Pilot 200 (Abbott Vascular, 56% of AWE procedures), Fielder XT (Asahi Intecc, 45%), and the Confianza Pro 12 (Asahi Intecc, 28%). The same guidewires were the ones that most commonly crossed the occlusion: Pilot 200 (36% of successful AWE crossings), Fielder XT (20%), and Confianza Pro 12 (11%). A microcatheter or over-the-wire balloon was used for 81% of AWE attempts; the Corsair microcatheter (Asahi Intecc) was the most commonly used (44%). No significant association was found between guidewire type and incidence of major adverse cardiac events (MACE). Our contemporary, multicenter CTO PCI registry demonstrates that the most commonly used wires for AWE are polymer-jacketed guidewires. "Stiff" and polymer-jacketed guidewires appear to provide high crossing rates without an increase in MACE or perforation, and may thus be considered for upfront use. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Performance-Based Evaluation and School Librarians

    Science.gov (United States)

    Church, Audrey P.

    2015-01-01

    Evaluation of instructional personnel is standard procedure in our Pre-K-12 public schools, and its purpose is to document educator effectiveness. With Race to the Top and No Child Left Behind waivers, states are required to implement performance-based evaluations that demonstrate student academic progress. This three-year study describes the…

  12. Overview of Performance Based Practical Design

    Science.gov (United States)

    2018-03-01

    DOI: https://doi.org/10.13023/KTC.RR.2018.03 State transportation agencies (STAs) have increasingly turned to practical design and performance based practical design(PBPD) to inform project development and implementation and to reduce project cos...

  13. Mixed movements/performance-based drawing

    DEFF Research Database (Denmark)

    Brabrand, Helle

    2011-01-01

    Mixed Movements is a research project engaged in performance-based architectural drawing. As one in a series working with architectonic implementation in relation to body and movements, the actual project relates body-movement and dynamic drawing and presents the material as interactive ‘space-time-tables’....

  14. Performance-Based Rewards and Work Stress

    Science.gov (United States)

    Ganster, Daniel C.; Kiersch, Christa E.; Marsh, Rachel E.; Bowen, Angela

    2011-01-01

    Even though reward systems play a central role in the management of organizations, their impact on stress and the well-being of workers is not well understood. We review the literature linking performance-based reward systems to various indicators of employee stress and well-being. Well-controlled experiments in field settings suggest that certain…

  15. Performance-based Pareto optimal design

    NARCIS (Netherlands)

    Sariyildiz, I.S.; Bittermann, M.S.; Ciftcioglu, O.

    2008-01-01

    A novel approach for performance-based design is presented, where Pareto optimality is pursued. Design requirements may contain linguistic information, which is difficult to bring into computation or make consistent their impartial estimations from case to case. Fuzzy logic and soft computing are

  16. The utility of the Philips SRI-100 real time portal imaging device in a case of postoperative irradiation for prevention of heterotopic bone formation following total hip replacement

    International Nuclear Information System (INIS)

    Kiffer, J.D.; Quong, G.; Lawlor, M.; Schumer, W.; Aitken, L.; Wallace, A.

    1994-01-01

    The new Radiation Oncology Department at the Heidelberg Repatriation Hospital in Melbourne, Australia commenced operation in June 1992. As part of quality control the Philips SL-15 linear accelerator was fitted with the Philips SRI-100 Real Time Portal Imaging Device (RTPID), the first such apparatus in Australia. One of its major advantages over older systems is its ability to provide a permanent hard copy of the image of the field treated. The computer image can be immediately manipulated and enhanced on the screen (with respect to such qualities as brightness and contrast) prior to the printing of the hard copy. This is a significant improvement over the more cumbersome older port films that required developing time, without any pre-assessment of the image quality. The utility of the Philips SRI-100 RTPID is demonstrated in the case of a patient irradiated soon after total hip replacement, as prophylaxis against heterotopic bone formation (HBF). The rapidity and quality of image production is a major advantage in these patients where post operative pain may result in positional change between film exposure and image production. Extremely accurate shielding block position is essential to shield the prosthesis(and allow bone ingrowth for fixation) whilst avoiding inadvertent shielding of the areas at risk for HBF. A review of the literature on this topic is provided. 14 refs., 4 figs

  17. Translation of First North American 50 and 70 cc Total Artificial Heart Virtual and Clinical Implantations: Utility of 3D Computed Tomography to Test Fit Devices.

    Science.gov (United States)

    Ferng, Alice S; Oliva, Isabel; Jokerst, Clinton; Avery, Ryan; Connell, Alana M; Tran, Phat L; Smith, Richard G; Khalpey, Zain

    2017-08-01

    Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  18. Increased health care utilization by survivors of childhood lymphoblastic leukemia is confined to those treated with cranial or total body irradiation: a case cohort study

    International Nuclear Information System (INIS)

    Holmqvist, Anna Sällfors; Moëll, Christian; Hjorth, Lars; Lindgren, Anna; Garwicz, Stanislaw; Wiebe, Thomas; Øra, Ingrid

    2014-01-01

    Previous studies have indicated that survivors of childhood acute lymphoblastic leukemia (ALL) have an increased morbidity measured in terms of health care utilization. However, earlier studies have several potentially important limitations. To overcome some of these, we investigated hospital contact rates, and predictors thereof, among 5-year survivors of ALL in a population-based setting, and compared them to a control cohort regarding outcome measures from a comprehensive nation-wide health register. All individuals diagnosed with ALL before the age of 18 in Southern Sweden during 1970–1999 and alive January 2007 (n = 213; male = 107) were identified through the Swedish Cancer Register. Each subject was matched to fifty controls, identified in the Swedish Population Register. All study subjects were linked to the National Hospital Register and detailed information was obtained on all hospital contacts (hospital admissions and outpatients visits) starting five years after cancer diagnosis, and the corresponding date for the controls, until 2009. The median follow-up among the 5-year survivors of ALL was 16 years (range 5–33), accruing a total of 3,527 person-years. Of the 213 5-year survivors, 105 (49.3%) had at least one hospital contact compared to 3,634 (34.1%) of the controls (p < 0.001). Survivors had more hospital contacts (3 [1–6] vs. 2 [1–4] contacts, p < 0.001) and more total days in hospital (6 [2–18] vs. 3 [1–7] days, p < 0.001) than the controls during the study period. Logistic regression analysis showed that survivors treated with cranial irradiation and/or total body irradiation (45% and 7%, respectively) had an increased risk of at least one hospital contact (OR 2.3, 95%CI; 1.5–3.6 and OR 11.0, 95%CI; 3.2–50.7, respectively), while there was no significant difference between the non-irradiated survivors and controls. We show that irradiated survivors of childhood ALL have an increased morbidity measured in terms of hospital

  19. Predictive Utility of the Total Glasgow Coma Scale Versus the Motor Component of the Glasgow Coma Scale for Identification of Patients With Serious Traumatic Injuries.

    Science.gov (United States)

    Chou, Roger; Totten, Annette M; Carney, Nancy; Dandy, Spencer; Fu, Rongwei; Grusing, Sara; Pappas, Miranda; Wasson, Ngoc; Newgard, Craig D

    2017-08-01

    The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care. Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Health and Psychosocial Instruments, and the Cochrane databases were searched through June 2016 for English-language cohort studies. We included studies that compared the area under the receiver operating characteristic curve (AUROC) of the tGCS versus the mGCS or Simplified Motor Scale assessed in the field or shortly after arrival in the emergency department for predicting the outcomes described above. Meta-analyses were performed with a random-effects model, and subgroup and sensitivity analyses were conducted. We included 18 head-to-head studies of predictive utility (n=1,703,388). For inhospital mortality, the tGCS was associated with slightly greater discrimination than the mGCS (pooled mean difference in [AUROC] 0.015; 95% confidence interval [CI] 0.009 to 0.022; I 2 =85%; 12 studies) or the Simplified Motor Scale (pooled mean difference in AUROC 0.030; 95% CI 0.024 to 0.036; I 2 =0%; 5 studies). The tGCS was also associated with greater discrimination than the mGCS or Simplified Motor Scale for nonmortality outcomes (differences in AUROC from 0.03 to 0.05). Findings were robust in subgroup and sensitivity analyses. The tGCS is associated with slightly greater discrimination than the mGCS or Simplified Motor Scale for identifying severe trauma. The small differences in discrimination are likely to be

  20. Real-time web-based assessment of total population risk of future emergency department utilization: statewide prospective active case finding study.

    Science.gov (United States)

    Hu, Zhongkai; Jin, Bo; Shin, Andrew Y; Zhu, Chunqing; Zhao, Yifan; Hao, Shiying; Zheng, Le; Fu, Changlin; Wen, Qiaojun; Ji, Jun; Li, Zhen; Wang, Yong; Zheng, Xiaolin; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng B

    2015-01-13

    An easily accessible real-time Web-based utility to assess patient risks of future emergency department (ED) visits can help the health care provider guide the allocation of resources to better manage higher-risk patient populations and thereby reduce unnecessary use of EDs. Our main objective was to develop a Health Information Exchange-based, next 6-month ED risk surveillance system in the state of Maine. Data on electronic medical record (EMR) encounters integrated by HealthInfoNet (HIN), Maine's Health Information Exchange, were used to develop the Web-based surveillance system for a population ED future 6-month risk prediction. To model, a retrospective cohort of 829,641 patients with comprehensive clinical histories from January 1 to December 31, 2012 was used for training and then tested with a prospective cohort of 875,979 patients from July 1, 2012, to June 30, 2013. The multivariate statistical analysis identified 101 variables predictive of future defined 6-month risk of ED visit: 4 age groups, history of 8 different encounter types, history of 17 primary and 8 secondary diagnoses, 8 specific chronic diseases, 28 laboratory test results, history of 3 radiographic tests, and history of 25 outpatient prescription medications. The c-statistics for the retrospective and prospective cohorts were 0.739 and 0.732 respectively. Integration of our method into the HIN secure statewide data system in real time prospectively validated its performance. Cluster analysis in both the retrospective and prospective analyses revealed discrete subpopulations of high-risk patients, grouped around multiple "anchoring" demographics and chronic conditions. With the Web-based population risk-monitoring enterprise dashboards, the effectiveness of the active case finding algorithm has been validated by clinicians and caregivers in Maine. The active case finding model and associated real-time Web-based app were designed to track the evolving nature of total population risk, in a

  1. The Performance-based Funding Scheme of Universities

    Directory of Open Access Journals (Sweden)

    Juha KETTUNEN

    2016-05-01

    Full Text Available The purpose of this study is to analyse the effectiveness of the performance-based funding scheme of the Finnish universities that was adopted at the beginning of 2013. The political decision-makers expect that the funding scheme will create incentives for the universities to improve performance, but these funding schemes have largely failed in many other countries, primarily because public funding is only a small share of the total funding of universities. This study is interesting because Finnish universities have no tuition fees, unlike in many other countries, and the state allocates funding based on the objectives achieved. The empirical evidence of the graduation rates indicates that graduation rates increased when a new scheme was adopted, especially among male students, who have more room for improvement than female students. The new performance-based funding scheme allocates the funding according to the output-based indicators and limits the scope of strategic planning and the autonomy of the university. The performance-based funding scheme is transformed to the strategy map of the balanced scorecard. The new funding scheme steers universities in many respects but leaves the research and teaching skills to the discretion of the universities. The new scheme has also diminished the importance of the performance agreements between the university and the Ministry. The scheme increases the incentives for universities to improve the processes and structures in order to attain as much public funding as possible. It is optimal for the central administration of the university to allocate resources to faculties and other organisational units following the criteria of the performance-based funding scheme. The new funding scheme has made the universities compete with each other, because the total funding to the universities is allocated to each university according to the funding scheme. There is a tendency that the funding schemes are occasionally

  2. ‘Overall Regional Planning, Whole Advancement, and Terminal Offer’is the Fundamental Outset for Prohibition of Burning Straw in Field and Total Utilization of Straws in China

    Directory of Open Access Journals (Sweden)

    CHANG Zhi-zhou

    2015-08-01

    Full Text Available Straw burning is a serious problem, which draws high attention from the whole society. In this study, the issues of management, policy and techniques regarding to the straw burning and its integrated utilization were analyzed. Based on the analysis results, a novel strategy, i.e., overall regional planning, village basis, combination of collection and returning, policy guidance and market operation, was raised to inhibit straw burning and enhance the efficiency of straw utilization. In technology, the methods of regional control, balance of harvest and return, effective collection, improving application, creative mechanism were emphasized. In addition, the effect of total utilization replying on the method of overall regional planning and whole advancement was presented on the village-scale. The application results in Chemen Township, Sihong County, Jiangsu Province showed that the goal of total utilization of straws and prohibition of burning in the regional scale could be achieved according to the novel strategy.

  3. Analytical perspectives on performance-based management

    DEFF Research Database (Denmark)

    Wadmann, Sarah; Johansen, Sarah; Lind, Ane

    2013-01-01

    Performance-based management (PBM) has become a dominant form of governance in health care and there is a need for careful assessment of its function and effects. This article contains a cross-disciplinary literature synthesis of current studies of PBM. Literature was retrieved by database search...... perspectives allows appreciation of otherwise implicit assumptions and potential implications of PBM. Reflections on such differences are important to ensure vigilant appropriation of shifting management tools in health quality governance.......Performance-based management (PBM) has become a dominant form of governance in health care and there is a need for careful assessment of its function and effects. This article contains a cross-disciplinary literature synthesis of current studies of PBM. Literature was retrieved by database searches....... In the functionalist perspective, PBM is perceived as a management tool aimed at improving health care services by means of market-based mechanisms. In the interpretive perspective, the adoption of PBM is understood as consequence of institutional and individual agents striving for public legitimacy. In the post...

  4. Approach to performance based regulation development

    International Nuclear Information System (INIS)

    Spogen, L.R.; Cleland, L.L.

    1977-06-01

    An approach to the development of performance based regulations (PBR's) is described. Initially, a framework is constructed that consists of a function hierarchy and associated measures. The function at the top of the hierarchy is described in terms of societal objectives. Decomposition of this function into subordinate functions and their subsequent decompositions yield the function hierarchy. ''Bottom'' functions describe the roles of system components. When measures are identified for the performance of each function and means of aggregating performances to higher levels are established, the framework may be employed for developing PBR's. Consideration of system flexibility and performance uncertainty guide in determining the hierarchical level at which regulations are formulated. Ease of testing compliance is also a factor. To show the viability of the approach, the framework developed by Lawrence Livermore Laboratory for the Nuclear Regulatory Commission for evaluation of material control systems at fixed facilities is presented

  5. Mixed Movements/performance-based drawing

    DEFF Research Database (Denmark)

    Brabrand, Helle

    2010-01-01

    Mixed Movements is a research project engaged in performance-based architectural drawing. The project experiments with drawing-series as montages of materials and forces, making the drawing appear in its changing character. The moving components are conditioned by different circumstances...... that question each other, working as well with space-time motives as with expressions and techniques. A series poses questions both to the kind of forces it raises as well as to the kind of sensual affects it produces – to how the body resonates with the rhythms and tensions that appear in the drawing....... A drawing-series is then both a machine, a diagram, and an appearance, what we call a resonance-model, creating links between tectonic and drawing constructions, kinaesthetic competences and actual body-movements....

  6. TAP 2, Performance-Based Training Manual

    Energy Technology Data Exchange (ETDEWEB)

    1991-07-01

    Training programs at DOE nuclear facilities should provide well- trained, qualified personnel to safely and efficiently operate the facilities in accordance with DOE requirements. A need has been identified for guidance regarding analysis, design, development, implementation, and evaluation of consistent and reliable performance-based training programs. Accreditation of training programs at Category A reactors and high-hazard and selected moderate-hazard nonreactor facilities will assure consistent, appropriate, and cost-effective training of personnel responsible for the operation, maintenance, and technical support of these facilities. Training programs that are designed and based on systematically job requirements, instead of subjective estimation of trainee needs, yield training activities that are consistent and develop or improve knowledge, skills, and abilities that can be directly related to the work setting. Because the training is job-related, the content of these programs more efficiently and effectively meets the needs of the employee. Besides a better trained work force, a greater level of operational reactor safety can be realized. This manual is intended to provide an overview of the accreditation process and a brief description of the elements necessary to construct and maintain training programs that are based on the requirements of the job. Two comparison manuals provide additional information to assist contractors in their efforts to accredit training programs.

  7. TAP 2, Performance-Based Training Manual

    International Nuclear Information System (INIS)

    1991-07-01

    Training programs at DOE nuclear facilities should provide well- trained, qualified personnel to safely and efficiently operate the facilities in accordance with DOE requirements. A need has been identified for guidance regarding analysis, design, development, implementation, and evaluation of consistent and reliable performance-based training programs. Accreditation of training programs at Category A reactors and high-hazard and selected moderate-hazard nonreactor facilities will assure consistent, appropriate, and cost-effective training of personnel responsible for the operation, maintenance, and technical support of these facilities. Training programs that are designed and based on systematically job requirements, instead of subjective estimation of trainee needs, yield training activities that are consistent and develop or improve knowledge, skills, and abilities that can be directly related to the work setting. Because the training is job-related, the content of these programs more efficiently and effectively meets the needs of the employee. Besides a better trained work force, a greater level of operational reactor safety can be realized. This manual is intended to provide an overview of the accreditation process and a brief description of the elements necessary to construct and maintain training programs that are based on the requirements of the job. Two comparison manuals provide additional information to assist contractors in their efforts to accredit training programs

  8. Students academic performance based on behavior

    Science.gov (United States)

    Maulida, Juwita Dien; Kariyam

    2017-12-01

    Utilization of data in an information system that can be used for decision making that utilizes existing data warehouse to help dig useful information to make decisions correctly and accurately. Experience API (xAPI) is one of the enabling technologies for collecting data, so xAPI can be used as a data warehouse that can be used for various needs. One software application whose data is collected in xAPI is LMS. LMS is a software used in an electronic learning process that can handle all aspects of learning, by using LMS can also be known how the learning process and the aspects that can affect learning achievement. One of the aspects that can affect the learning achievement is the background of each student, which is not necessarily the student with a good background is an outstanding student or vice versa. Therefore, an action is needed to anticipate this problem. Prediction of student academic performance using Naive Bayes algorithm obtained accuracy of 67.7983% and error 32.2917%.

  9. Performance-based containment leakage testing

    International Nuclear Information System (INIS)

    Cybulskis, P.

    1995-01-01

    The U.S. Nuclear Regulatory Commission (NRC) is reviewing regulatory requirements in an effort to revise those that are marginal to safety but impose significant burdens on licensees. Identification of requirements marginal to safety and development and evaluation of alternatives utilize the NRC safety goals and insights from probabilistic risk assessments (PRAs). Since earlier studies found design-basis containment leakage to be a minor contributor to reactor accident risk, containment leakage testing has been selected as a candidate for change in regulations. This paper summarizes the technical analyses supporting the NRC proposal to amend Appendix J of 10 CFR Part 50 as its first effort to decrease unnecessary regulatory burdens on licensees

  10. Policy and Validity Prospects for Performance-Based Assessment.

    Science.gov (United States)

    Baker, Eva L.; And Others

    1994-01-01

    This article describes performance-based assessment as expounded by its proponents, comments on these conceptions, reviews evidence regarding the technical quality of performance-based assessment, and considers its validity under various policy options. (JDD)

  11. Cost savings from performance-based maintenance contracting

    NARCIS (Netherlands)

    Straub, A.

    2009-01-01

    New procurement approaches combined with performance-based building approaches should reduce costs, but empirical qualitative and quantitative studies are lacking. Performance-based maintenance contracts give maintenance suppliers incentives to improve their way of working. Innovative,

  12. Tibialis Anterior Tendon: A Reliable Anatomical Landmark Indicating the Ankle Centre. Potential Utility in Extra-Medullary Alignment During Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Avadhoot P. Kantak

    2017-07-01

    Full Text Available Background Extramedullary alignment is a well established surgical technique during total knee replacement. There are different methods to achieve accuracy but variability is quite extensive. To attain uniformity in the surgical technique we have been using the tibialis tendon to align our resection guide. This may prove to be a useful aid for surgeons during knee replacement surgery. Objectives The purpose of our study was to establish if tibialis anterior tendon represents the centre of ankle joint and if it could be used as an anatomical reference for alignment during knee replacement. Methods We designed a retrospective radiological cohort study. We studied sixty MRI scans of normal ankles. The centre of ankle joint was marked as a bisection point of the intermalleolar line at the level of superior surface of the talus. A line was drawn connecting the centre of Achilles tendon to the ankle centre and this was extended anteriorly. This line was found to have a constant relation to the ankle centre and it would simulate the positioning of the standard alignment device used. Results The tibialis anterior tendon lies less than 3mm medial to the ankle centre in the frontal plane. Conclusions We conclude that the tibialis anterior tendon can be used during knee replacement surgery as an accurate alignment guide.

  13. Productivity, total and utilized nitrogen and water use efficiency of soybean grown in reclaimed sandy soil as affected by water regime

    International Nuclear Information System (INIS)

    Abdallah, A.A.G.; Thabet, E.M.A.

    2002-01-01

    Field experiment was performed at the experimental farm, Inshas, atomic energy authority, Egypt, in tafla and sand mixture soil (1:7). The experiment was laid out using sprinkler irrigation system with a line source which allows a gradual variation of irrigation from high to low irrigation, whereas the calculated amount of irrigation water levels were 1565, 1050 and 766.5 (m 3 / feddan). Two soybean varieties (crawford and giza 35) were planted. The obtained results indicated that: a) irrigation with high (1562 m 3 /fed.) and medium (1050 m 3 /fed.) water levels increased total seed wield of the two soybean varieties. b) the highest value of water use efficiency was observed when both soybean varieties irrigated with water level of 1050 m 3 /fed. c) seed protein content in crawford variety was higher in giza 35 variety at the irrigation level of 1562 m 3 /fed. d) seeds of both two soybean varieties showed increase of its atom excess percentage at high and medium water levels, and reflecting increase of nitrogen use efficiency. e) significant increment in seed yield kg/plot. Has been indicated by irrigation with water level of 1050 m 3 /fed. As compared to higher and lower water levels

  14. Bone marrow transplantation for girls with aplastic anemia utilizing modified field of total lymphoid irradiation and cyclophosphamide; With emphasis on the field of pelvic cavity

    Energy Technology Data Exchange (ETDEWEB)

    Hanada, Ryoji; Kawakami, Tetsuo; Akuta, Naoko; Moriwaki, Kohichi; Kato, Shizue; Inaba, Toshiya; Hayashi, Yasuhide; Yamamoto, Keiko (Saitama Children' s Medical Center, Saitama (Japan))

    1990-12-01

    A preparative regimen for allogeneic bone marrow transplantation, consisting of total lymphoid irradiation (TLI) with 750 cGy and cyclophosphamide (CY), was used in five girls with aplastic anemia. All patients received bone marrow from HLA matched/mixed lymphocyte culture negative siblings. In our regimen the 'inverted Y' field to irradiate the pelvic nodes was modified, which did not include the whole pelvic cavity in an attempt to protect the ovaries from irradiation. Although some of the pelvic nodes was supported not to be irradiated in order to protect the ovaries, engraftment occurred in all five patients including four who had been transfused prior to transplantation. All five are alive from 47 days to 1378 days (median 285 days) after transplantation without tranplantation-associated complications. The calculated dose to the ovaries was sixteen percent of the entire dose of the regimen. Both of the two evaluable patients that had received tranplantation just before or during the puberty are developing normal sex maturity including menstruation. This study suggests that our preparative regimen is effective not only for engraftment of the donor marrow but also for protecting the ovaries from irradiation. (author).

  15. Clinical Utility of Additional Measurement of Total Lung Capacity in Diagnosing Obstructive Lung Disease in Subjects With Restrictive Pattern of Spirometry.

    Science.gov (United States)

    Lee, Hyun; Chang, Boksoon; Kim, Kyunga; Song, Won Jun; Chon, Hae Ri; Kang, Hyung Koo; Kim, Jung Soo; Jeong, Byeong-Ho; Oh, Yeon-Mok; Koh, Won-Jung; Park, Hye Yun

    2016-04-01

    Total lung capacity (TLC), forced expiratory flow between 25 and 75% (FEF25-75%), peak expiratory flow (PEF), or post-bronchodilator volume response is recommended to detect obstructive abnormalities in the lung. The present study was performed to evaluate the usefulness of these pulmonary function test (PFT) parameters to diagnose obstructive lung disease in subjects with a restrictive pattern of spirometry. A retrospective study was conducted in 64 subjects with a restrictive pattern of spirometry (normal FEV1/FVC and low FVC) out of 3,030 patients who underwent all pre- and post-bronchodilator spirometry and lung volume measurement between April 2008 and December 2010. After subjects were clinically classified into those with obstructive lung disease, restrictive lung disease, and mixed lung disease, the agreements between the clinical diagnosis and PFT classification according to TLC, FEF(25-75%), PEF, and post-bronchodilator response criteria were compared. Of 64 subjects, 18 (28.1%) were classified with obstructive lung disease, 39 (60.9%) had restrictive lung disease, 1 (1.6%) had mixed lung disease, and 6 (9.4%) had no clinical lung disease. Among the 58 subjects with clinical lung disease, 22 (37.9%), 37 (63.8%), 33 (56.9%), and 3 (5.2%) were classified as having obstructive pattern based on TLC, FEF25-75%, PEF, and post-bronchodilator response criteria, respectively. The kappa coefficients for the agreement between the clinical classification and PFT classification using TLC, FEF25-75%, PEF, and post-bronchodilator response criteria in 58 subjects were 0.59, 0.18, 0.17, and spirometry, when obstructive lung disease is clinically suspected. Copyright © 2016 by Daedalus Enterprises.

  16. O the Determination of the Complex Refractive Index of Powdered Materials in the 9 TO 11 Micrometer Spectral Region Utilizing AN Attenuated Total Reflectance Technique.

    Science.gov (United States)

    Gillespie, James Bryce

    1982-03-01

    A specific method of determining the complex refractive index of powdered materials using attenuated total reflectance (ATR) spectroscopy was investigated. A very precise laser/goniometric ATR system was assembled and applied to powdered samples of carbon blacks, graphite, kaolin clay, quartz, calcite, and sodalime glass beads. The reflectivity data fell into two categories: (1) data representative of a medium having a unique effective refractive index and (2) data representative of a scattering medium having no unique refractive index. Data of the first kind were obtained from all the carbon black, graphite, and kaolin clay samples. The Fahrenfort-Visser solution of the Fresnel equations was applied to the goniometric reflectivity data for these samples to obtain the complex refractive index of these effective media. The complex refractive index obtained in this manner is not that of the bulk material but is instead a value which may be related to the bulk material value through some refractive index mixing rule. A systematic experiment using carbon black of particle size 0.0106 mm diameter was conducted to determine the applicability of several mixture rules for the volume packing fraction range of .2 to .6 which is most often encountered. The Bruggemann effective medium theory produced credible results while the Lorentz-Lorenz rule and the empirical Biot-Arago rule were invalid in this volume packing region. The Bruggemann rule was applied to lampblack, Mogul-L carbon black, graphite, and kaolin clay to obtain the complex refractive indices of these materials from the ATR spectroscopy data. Goniometric reflectivity data representative of an inhomogeneous scattering medium were obtained from all the powdered quartz, powdered calcite, and sodalime glass beads samples. These samples all contained particles with diameters nearly as large as the wavelength. These data demonstrate that the ATR technique, coupled with an effective medium analysis, may be used to obtain

  17. Utilization of downscaled microwave satellite data and GRACE Total Water Storage anomalies for improving streamflow prediction in the Lower Mekong Basin

    Science.gov (United States)

    Lakshmi, V.; Gupta, M.; Bolten, J. D.

    2016-12-01

    The Mekong river is the world's eighth largest in discharge with draining an area of 795,000 km² from the Eastern watershed of the Tibetan Plateau to the Mekong Delta including, Myanmar, Laos PDR, Thailand, Cambodia, Vietnam and three provinces of China. The populations in these countries are highly dependent on the Mekong River and they are vulnerable to the availability and quality of the water resources within the Mekong River Basin. Soil moisture is one of the most important hydrological cycle variables and is available from passive microwave satellite sensors (such as AMSR-E, SMOS and SMAP), but their spatial resolution is frequently too coarse for effective use by land managers and decision makers. The merging of satellite observations with numerical models has led to improved land surface predictions. Although performance of the models have been continuously improving, the laboratory methods for determining key hydraulic parameters are time consuming and expensive. The present study assesses a method to determine the effective soil hydraulic parameters using a downscaled microwave remote sensing soil moisture product based on the NASA Advanced Microwave Scanning Radiometer (AMSR-E). The soil moisture downscaling algorithm is based on a regression relationship between 1-km MODIS land surface temperature and 1-km Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) to produce an enhanced spatial resolution ASMR-E-based soil moisture product. Since the optimized parameters are based on the near surface soil moisture information, further constraints are applied during the numerical simulation through the assimilation of GRACE Total Water Storage (TWS) within the land surface model. This work improves the hydrological fluxes and the state variables are optimized and the optimal parameter values are then transferred for retrieving hydrological fluxes. To evaluate the performance of the system in helping improve

  18. Effect of lime treatment of olive meal on in vitro utilization of total mixed ration containing olive meal as partial maize replacer

    Directory of Open Access Journals (Sweden)

    Ajmal Ashraf

    Full Text Available Aim: Present study pertains to lime treatment of olive meal to improve its digestibility. The objective of the present study was to assess the in vitro dry matter degradability of total mixed ration containing lime treated olive meal at varied levels of maize replacement to know the optimum level of lime and treated olive meal as maize replacement in small ruminant diets. Materials and methods: Study was carried out in two phases. In phase I, A complete diet was formulated and treated with lime at variable concentrations (0-8% at 25% of maize replacement and subjected to in vitro studies as per Tilley and Terry. On the basis of the results of this phase, a concentration of lime for olive treatment was selected and tested at variable levels of maize replacement (0-50% by treated olive cake in phase II. Data was analyzed as per the procedures suggested by Snedecor and Cochran. Results: The in vitro dry matter digestibility (IVDMD of composite diet increased from 43.95% at 0% lime treatment to 48.68% on treating with 8% lime with significant (P<0.05 increase at 6% treatment level. Lime treatment beyond 6% had no further significant effect on improving the digestibility. Graded levels of maize replacement by olive meal treated with 6% lime (lime percentage selected from phase I showed that the in vitro digestibility of mixed ration was not compromised up to 40% replacement level of maize by treated olive meal. Improved digestibility with lime treatment may be due to weakening of internal Hydrogen bonding, thereby disrupting the fiber structure in olive meal. Further lime may be saponifying the high level of fat present in olive meal, which may otherwise negatively impact the digestibility values. Conclusion: It can be concluded that the treatment with up to 6% of lime can effectively increase the digestibility of olive meal. Treated olive meal can replace up to 40% of maize from daily ration without affecting the digestibility of composite ration

  19. 48 CFR 52.232-32 - Performance-Based Payments.

    Science.gov (United States)

    2010-10-01

    ... Contracting Officer, such excess shall be credited as a reduction in the unliquidated performance-based... adjustments. (e) Reduction or suspension of performance-based payments. The Contracting Officer may reduce or... sound and generally accepted accounting principles and practices: (i) Parts, materials, inventories, and...

  20. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  1. Expected utility without utility

    OpenAIRE

    Castagnoli, E.; Licalzi, M.

    1996-01-01

    This paper advances an interpretation of Von Neumann–Morgenstern’s expected utility model for preferences over lotteries which does not require the notion of a cardinal utility over prizes and can be phrased entirely in the language of probability. According to it, the expected utility of a lottery can be read as the probability that this lottery outperforms another given independent lottery. The implications of this interpretation for some topics and models in decision theory are considered....

  2. 48 CFR 970.1100-1 - Performance-based contracting.

    Science.gov (United States)

    2010-10-01

    ... Federal Procurement Policy's Seven Steps to Performance-Based Acquisition located at Web site http://www...) performance standards and objectives and quality assurance surveillance plans; provide performance incentives... planning processes. Measurable performance criteria, objective measures, and where appropriate, performance...

  3. Performance-based seismic design of steel frames utilizing colliding bodies algorithm.

    Science.gov (United States)

    Veladi, H

    2014-01-01

    A pushover analysis method based on semirigid connection concept is developed and the colliding bodies optimization algorithm is employed to find optimum seismic design of frame structures. Two numerical examples from the literature are studied. The results of the new algorithm are compared to the conventional design methods to show the power or weakness of the algorithm.

  4. Performance Based Logistics... What’s Stopping Us

    Science.gov (United States)

    2016-03-01

    performance-based life cycle product support, where outcomes are acquired through performance-based arrangements that deliver Warfighter requirements and...correlates to the acquisition life cycle framework: spend the time and effort to identify and lock in the PBL requirements; conduct an analysis to...studies and reports on PBLs over the past 15 or more years. Much like fashion styles, the af- finity for PBLs has ebbed and flowed during this time

  5. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  6. Guidelines for performance-based supplier audits (NCIG-16)

    International Nuclear Information System (INIS)

    Lauderdale, J.R.; Mattu, R.K.; Roman, W.S.

    1990-06-01

    This document provides guidelines for planning and conducting performance-based audits of suppliers of items used in nuclear power plants. A common purpose of audits is to provide a basis for confidence in the supplier's controls to ensure that products received will perform their intended functions satisfactorily. Performance-based audits offer means of raising the level of confidence. This confidence comes from evaluation of important features of the product and the processes and activities that produce it. This document does not add requirements to those in existing codes, standards, or regulations. The guidance herein is intended to complement the information in existing industry standards and practices. Performance-based audits are one element of an effective procurement program. A companion EPRI/NCIG document, EPRI NP-6629, Guidelines for the Procurement and Receipt of Items for Nuclear Power Plants (NCIG-15), provides guidance for other elements of an effective procurement program

  7. Product and process effectiveness using performance-based auditing techniques

    International Nuclear Information System (INIS)

    Horseman, M.L.

    1995-01-01

    Focus is the backbone of genius. Focus is the lifeblood of adequate products and effective processes. Focus is the theme of Performance-Based Audits (PBA). The Civilian Radioactive Waste Management (CRWM) Program is using the PBA tool extensively to focus on the evaluation of product adequacy and process effectiveness. The term Performance-Based Audit has been around for several years. however, the approach presented here for the systematic end-product selection, planning, and measurement of adequacy and effectiveness is new and innovative

  8. Performance-Based Regulation In A High Distributed Energy Resources Future

    Energy Technology Data Exchange (ETDEWEB)

    Newton Lowry, Mark [Pacific Economics Group Research LLC, Madison, WI (United States); Woolf, Tim [Synapse Energy Economics, Cambridge, MA (United States); Schwartz, Lisa C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2018-03-07

    Performance-based regulation (PBR) of utilities has emerged as an important ratemaking option in the last 25 years. It has been implemented in numerous jurisdictions across the United States and is common in many other advanced industrialized countries. PBR’s appeal lies chiefly in its ability to strengthen utility performance incentives relative to traditional cost-of-service regulation (COSR). Some forms of PBR can streamline regulation and provide utilities with greater operating flexibility. Ideally, the benefits of better performance are shared by the utility and its customers. The shortcomings of traditional COSR in providing electric utilities with incentives that are aligned with certain regulatory goals are becoming increasingly clear. In particular, COSR can provide strong incentives to increase electricity sales and utility rate base. Further, some parties express concern that traditional COSR does not provide utilities with appropriate financial incentives to address evolving industry challenges such as changing customer demands for electricity services, increased levels of distributed energy resources (DERs), and growing pressure to mitigate carbon dioxide emissions. In addition, attention to potential new regulatory models to support the “utility of the future” has renewed interest in PBR. This report describes key elements of PBR and explains some of the advantages and disadvantages of various PBR options. We present pertinent issues from the perspectives of utilities and customers. In practice, these different perspectives are not diametrically opposed. Nonetheless, this framework is useful for illustrating how various aspects of PBR may be viewed by those key groups. Regulators have a unique perspective, in that they must balance consumer, utility, and other interests with the goal of achieving a result that is in the overall public interest.

  9. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  10. Introducing a performance-based objective clinical examination into ...

    African Journals Online (AJOL)

    Purpose: To describe how a formative Objective Structured Clinical Examination was applied to fourth year pharmacy students at a university in Northern Cyprus. Methods: A blueprint-guided performance-based objective clinical examination was implemented. Group-prepared case scenarios based on course objectives ...

  11. A Model of Statistics Performance Based on Achievement Goal Theory.

    Science.gov (United States)

    Bandalos, Deborah L.; Finney, Sara J.; Geske, Jenenne A.

    2003-01-01

    Tests a model of statistics performance based on achievement goal theory. Both learning and performance goals affected achievement indirectly through study strategies, self-efficacy, and test anxiety. Implications of these findings for teaching and learning statistics are discussed. (Contains 47 references, 3 tables, 3 figures, and 1 appendix.)…

  12. Performance Based Building and its application to Healthy Buildings

    NARCIS (Netherlands)

    Loomans, M.G.L.C.; Bluyssen, P.M.

    2005-01-01

    The European funded Project PeBBu, Performance Based Building, is a Thematic network under the Competitive and Sustainable Growth program, which started September 1st, 2001 andwill run for 4 years. In one of the domains of PeBBu, the domain Indoor Environment, a stateof-the-art on the Performance

  13. Performance-Based Accountability in Qatar: A State in Progress

    Science.gov (United States)

    Jaafar, Sonia Ben

    2011-01-01

    It has become a normative practice to include Performance-Based Accountability (PBA) policies in educational reforms to foster school changes that enhance student learning and success. There is considerable variation in PBA models that have an important impact on how they operate in schools. It is, therefore, important to characterize PBA models…

  14. Performance-based contracting in public procurement of developing countries

    NARCIS (Netherlands)

    Ambaw, Baynesagn Asfaw

    2017-01-01

    This research is focused on the application of Performance-based Contracting (PBC) in public procurement system of developing countries. We define five research objectives (ROs) that focus on this common issue. The first objective (RO1) mainly deals with the theory behind and the theoretical

  15. Performance-based maintenance procurement by Dutch housing associations

    NARCIS (Netherlands)

    Straub, A.

    2004-01-01

    OTB Research institute has established a long-term research program to performance-based maintenance procurement in the technical management of housing stock. Stakeholders: housing associations, contractors and the Dutch Building Research Foundation are directly involved in this research program.

  16. Performance-Based Measurement: Action for Organizations and HPT Accountability

    Science.gov (United States)

    Larbi-Apau, Josephine A.; Moseley, James L.

    2010-01-01

    Basic measurements and applications of six selected general but critical operational performance-based indicators--effectiveness, efficiency, productivity, profitability, return on investment, and benefit-cost ratio--are presented. With each measurement, goals and potential impact are explored. Errors, risks, limitations to measurements, and a…

  17. Performance-based shape optimization of continuum structures

    International Nuclear Information System (INIS)

    Liang Qingquan

    2010-01-01

    This paper presents a performance-based optimization (PBO) method for optimal shape design of continuum structures with stiffness constraints. Performance-based design concepts are incorporated in the shape optimization theory to achieve optimal designs. In the PBO method, the traditional shape optimization problem of minimizing the weight of a continuum structure with displacement or mean compliance constraints is transformed to the problem of maximizing the performance of the structure. The optimal shape of a continuum structure is obtained by gradually eliminating inefficient finite elements from the structure until its performance is maximized. Performance indices are employed to monitor the performance of optimized shapes in an optimization process. Performance-based optimality criteria are incorporated in the PBO method to identify the optimum from the optimization process. The PBO method is used to produce optimal shapes of plane stress continuum structures and plates in bending. Benchmark numerical results are provided to demonstrate the effectiveness of the PBO method for generating the maximum stiffness shape design of continuum structures. It is shown that the PBO method developed overcomes the limitations of traditional shape optimization methods in optimal design of continuum structures. Performance-based optimality criteria presented can be incorporated in any shape and topology optimization methods to obtain optimal designs of continuum structures.

  18. Performance-based procurement for low disturbance brdige construction projects

    NARCIS (Netherlands)

    Sebastian, R.; Claeson-Jonsson, C.; Di Giulio, R.

    2013-01-01

    Purpose – This paper aims to introduce a method of performance-based procurement, based on the most economically advantageous tender (MEAT), for low-disturbance bridge construction projects in urban environment. Design/methodology/approach – The first part of this paper reviews the key performance

  19. Performance Based Criteria for Ship Collision and Grounding

    DEFF Research Database (Denmark)

    Pedersen, Preben Terndrup

    2009-01-01

    The paper outlines a probabilistic procedure whereby the maritime industry can develop performance based rules to reduce the risk associated with human, environmental and economic costs of collision and grounding events and identify the most economic risk control options associated with prevention...

  20. Estimation of the total efficiency of metabolizable energy utilization for maintenance and growth by cattle in tropical conditions Estimação da eficiência total de utilização da energia metabolizável para manutenção e crescimento por bovinos em condições tropicais

    Directory of Open Access Journals (Sweden)

    Douglas Sampaio Henrique

    2005-06-01

    Full Text Available Data of 320 animals were obtained from eight comparative slaughter studies performed under tropical conditions and used to estimate the total efficiency of utilization of the metabolizable energy intake (MEI, which varied from 77 to 419 kcal kg-0.75d-1. The provided data also contained direct measures of the recovered energy (RE, which allowed calculating the heat production (HE by difference. The RE was regressed on MEI and deviations from linearity were evaluated by using the F-test. The respective estimates of the fasting heat production and the intercept and the slope that composes the relationship between RE and MEI were 73 kcal kg-0.75d-1, 42 kcal kg-0.75d-1 and 0.37. Hence, the total efficiency was estimated by dividing the net energy for maintenance and growth by the metabolizable energy intake. The estimated total efficiency of the ME utilization and analogous estimates based on the beef cattle NRC model were employed in an additional study to evaluate their predictive powers in terms of the mean square deviations for both temperate and tropical conditions. The two approaches presented similar predictive powers but the proposed one had a 22% lower mean squared deviation even with its more simplified structure.Foram utilizadas 320 informações obtidas a partir de 8 estudos de abate comparativo conduzidos em condições tropicais para se estimar a eficiência total de utilização da energia metabolizável consumida, a qual variou de 77 a 419kcal kg-0.75d-1. Os dados também continham informações sobre a energia retida (RE, o que permitiu o cálculo da produção de calor por diferença. As estimativas da produção de calor em jejum e dos coeficientes linear e angular da regressão entre RE e MEI foram respectivamente, 73 kcal kg-0.75d-1, 42 kcal kg-0.75d-1 e 0,37. Em seguida, a eficiência total foi estimada dividindo-se a energia líquida para mantença e produção pelo consumo de energia metabolizável. A eficiência total de

  1. Proposed Performance-Based Metrics for the Future Funding of Graduate Medical Education: Starting the Conversation.

    Science.gov (United States)

    Caverzagie, Kelly J; Lane, Susan W; Sharma, Niraj; Donnelly, John; Jaeger, Jeffrey R; Laird-Fick, Heather; Moriarty, John P; Moyer, Darilyn V; Wallach, Sara L; Wardrop, Richard M; Steinmann, Alwin F

    2017-12-12

    Graduate medical education (GME) in the United States is financed by contributions from both federal and state entities that total over $15 billion annually. Within institutions, these funds are distributed with limited transparency to achieve ill-defined outcomes. To address this, the Institute of Medicine convened a committee on the governance and financing of GME to recommend finance reform that would promote a physician training system that meets society's current and future needs. The resulting report provided several recommendations regarding the oversight and mechanisms of GME funding, including implementation of performance-based GME payments, but did not provide specific details about the content and development of metrics for these payments. To initiate a national conversation about performance-based GME funding, the authors asked: What should GME be held accountable for in exchange for public funding? In answer to this question, the authors propose 17 potential performance-based metrics for GME funding that could inform future funding decisions. Eight of the metrics are described as exemplars to add context and to help readers obtain a deeper understanding of the inherent complexities of performance-based GME funding. The authors also describe considerations and precautions for metric implementation.

  2. Quality verification at Arkansas Nuclear One using performance-based concepts

    International Nuclear Information System (INIS)

    Cooper, R.M.

    1990-01-01

    Performance-based auditing is beginning to make an impact within the nuclear industry. Its use provides performance assessments of the operating plant. In the past, this company along with most other nuclear utilities, performed compliance-based audits. These audits focused on paper reviews of past activities that were completed in weeks or months. This type of audit did not provide a comprehensive assessment of the effectiveness of an activity's performance, nor was it able to identify any performance problems that may have occurred. To respond to this discrepancy, a comprehensive overhaul of quality assurance (QA) assessment programs was developed. The first major change was to develop a technical specification (tech spec) audit program, with the objective of auditing each tech spec line item every 5 yr. To achieve performance-based results within the tech spec audit program, a tech spec surveillance program was implemented whose goal is to observe 75% of the tech-spec required tests every 5 yr. The next major change was to develop a QA surveillance program that would provide surveillance coverage for the remainder of the plant not covered by the tech spec surveillance program. One other improvement was to merge the QA/quality control (QC) functions into one nuclear quality group. The final part of the quality verification effort is trending of the quality performance-based data (including US Nuclear Regulatory Commission (NRC) violations)

  3. [Performance based regulation: a strategy to increase breastfeeding rates].

    Science.gov (United States)

    Cobo-Armijo, Fernanda; Charvel, Sofía; Hernández-Ávila, Mauricio

    2017-01-01

    The decreasing breastfeeding rate in México is of public health concern. In this paper we discus an innovative regulatory approach -Performance Based Regulation- and its application to improve breastfeeding rates. This approach, forces industry to take responsibility for the lack of breastfeeding and its consequences. Failure to comply with this targets results in financial penalties. Applying performance based regulation as a strategy to improve breastfeeding is feasible because: the breastmilk substitutes market is an oligopoly, hence it is easy to identify the contribution of each market participant; the regulation's target population is clearly defined; it has a clear regulatory standard which can be easily evaluated, and sanctions to infringement can be defined under objective parameters. modify public policy, celebrate concertation agreements with the industry, create persuasive sanctions, strengthen enforcement activities and coordinate every action with the International Code of Marketing of Breast-milk Substitutes.

  4. Experience with performance based training of nuclear criticality safety engineers

    International Nuclear Information System (INIS)

    Taylor, R.G.

    1993-01-01

    For non-reactor nuclear facilities, the U.S. Department of Energy (DOE) does not require that nuclear criticality safety engineers demonstrate qualification for their job. It is likely, however, that more formalism will be required in the future. Current DOE requirements for those positions which do have to demonstrate qualification indicate that qualification should be achieved by using a systematic approach such as performance based training (PBT). Assuming that PBT would be an acceptable mechanism for nuclear criticality safety engineer training in a more formal environment, a site-specific analysis of the nuclear criticality safety engineer job was performed. Based on this analysis, classes are being developed and delivered to a target audience of newer nuclear criticality safety engineers. Because current interest is in developing training for selected aspects of the nuclear criticality safety engineer job, the analysis is incompletely developed in some areas

  5. Performance based regulation: a strategy to increase breastfeeding rates

    Directory of Open Access Journals (Sweden)

    Fernanda Cobo-Armijo

    2017-05-01

    Full Text Available The decreasing breastfeeding rate in México is of public health concern. In this paper we discus an innovative regulatory ap­proach -Performance Based Regulation- and its application to improve breastfeeding rates. This approach, forces industry to take responsibility for the lack of breastfeeding and its consequences. Failure to comply with this targets results in financial penalties. Applying performance based regulation as a strategy to improve breastfeeding is feasible because: the breastmilk substitutes market is an oligopoly, hence it is easy to identify the contribution of each market participant; the regulation’s target population is clearly defined; it has a clear regulatory standard which can be easily evaluated, and sanctions to infringement can be defined under objective parameters. Recommendations: modify public policy, celebrate concertation agreements with the industry, create persuasive sanctions, strengthen enforcement activities and coordinate every action with the International Code of Marketing of Breast-milk Substitutes.

  6. Performance-Based (Risk-Informed) Regulation: A Regulatory Perspective

    International Nuclear Information System (INIS)

    Kadambi, N. Prasad

    2005-01-01

    Performance-based regulation (PBR) has been mandated at the national level in the United States and at the agency level, where appropriate, at the U.S. Nuclear Regulatory Commission (USNRC). Guidance has been developed that implements the USNRC's definitions of PBR and other such conceptual regulatory improvements. This paper describes why PBR is important, what constitutes PBR in the context of direction provided at the USNRC, and how PBR can be implemented using a five-step process. The process steps articulate questions to be posed by the analyst regarding various aspects of a regulatory issue so that a suitably performance-based resolution can be developed. A regulatory alternative thus developed can be included among other options to be considered as part of the regulatory decision-making process

  7. Performance Based Plastic Design of Concentrically Braced Frame attuned with Indian Standard code and its Seismic Performance Evaluation

    Directory of Open Access Journals (Sweden)

    Sejal Purvang Dalal

    2015-12-01

    Full Text Available In the Performance Based Plastic design method, the failure is predetermined; making it famous throughout the world. But due to lack of proper guidelines and simple stepwise methodology, it is not quite popular in India. In this paper, stepwise design procedure of Performance Based Plastic Design of Concentrically Braced frame attuned with the Indian Standard code has been presented. The comparative seismic performance evaluation of a six storey concentrically braced frame designed using the displacement based Performance Based Plastic Design (PBPD method and currently used force based Limit State Design (LSD method has also been carried out by nonlinear static pushover analysis and time history analysis under three different ground motions. Results show that Performance Based Plastic Design method is superior to the current design in terms of displacement and acceleration response. Also total collapse of the frame is prevented in the PBPD frame.

  8. Investigation of Concrete Electrical Resistivity As a Performance Based Test

    OpenAIRE

    Malakooti, Amir

    2017-01-01

    The purpose of this research project was to identify the extent that concrete resistivity measurements (bulk and/or surface) can be used as a performance based lab test to improve the quality of concrete in Utah bridge decks. By allowing UDOT to specify a required resistivity, concrete bridge deck quality will increase and future maintenance costs will decrease. This research consisted of two phases: the field phase and the lab phase. In the field phase, concrete samples were gathered from...

  9. Pareto utility

    NARCIS (Netherlands)

    Ikefuji, M.; Laeven, R.J.A.; Magnus, J.R.; Muris, C.H.M.

    2013-01-01

    In searching for an appropriate utility function in the expected utility framework, we formulate four properties that we want the utility function to satisfy. We conduct a search for such a function, and we identify Pareto utility as a function satisfying all four desired properties. Pareto utility

  10. Double Marginalization in Performance-Based Advertising: Implications and Solutions

    OpenAIRE

    Chrysanthos Dellarocas

    2012-01-01

    An important current trend in advertising is the replacement of traditional pay-per-exposure (pay-per-impression) pricing models with performance-based mechanisms in which advertisers pay only for measurable actions by consumers. Such pay-per-action (PPA) mechanisms are becoming the predominant method of selling advertising on the Internet. Well-known examples include pay-per-click, pay-per-call, and pay-per-sale. This work highlights an important, and hitherto unrecognized, side effect of PP...

  11. Performance-Based Technology Selection Filter description report

    International Nuclear Information System (INIS)

    O'Brien, M.C.; Morrison, J.L.; Morneau, R.A.; Rudin, M.J.; Richardson, J.G.

    1992-05-01

    A formal methodology has been developed for identifying technology gaps and assessing innovative or postulated technologies for inclusion in proposed Buried Waste Integrated Demonstration (BWID) remediation systems. Called the Performance-Based Technology Selection Filter, the methodology provides a formalized selection process where technologies and systems are rated and assessments made based on performance measures, and regulatory and technical requirements. The results are auditable, and can be validated with field data. This analysis methodology will be applied to the remedial action of transuranic contaminated waste pits and trenches buried at the Idaho National Engineering Laboratory (INEL)

  12. Performance-Based Technology Selection Filter description report

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, M.C.; Morrison, J.L.; Morneau, R.A.; Rudin, M.J.; Richardson, J.G.

    1992-05-01

    A formal methodology has been developed for identifying technology gaps and assessing innovative or postulated technologies for inclusion in proposed Buried Waste Integrated Demonstration (BWID) remediation systems. Called the Performance-Based Technology Selection Filter, the methodology provides a formalized selection process where technologies and systems are rated and assessments made based on performance measures, and regulatory and technical requirements. The results are auditable, and can be validated with field data. This analysis methodology will be applied to the remedial action of transuranic contaminated waste pits and trenches buried at the Idaho National Engineering Laboratory (INEL).

  13. An ecologically valid performance-based social functioning assessment battery for schizophrenia.

    Science.gov (United States)

    Shi, Chuan; He, Yi; Cheung, Eric F C; Yu, Xin; Chan, Raymond C K

    2013-12-30

    Psychiatrists pay more attention to the social functioning outcome of schizophrenia nowadays. How to evaluate the real world function among schizophrenia is a challenging task due to culture difference, there is no such kind of instrument in terms of the Chinese setting. This study aimed to report the validation of an ecologically valid performance-based everyday functioning assessment for schizophrenia, namely the Beijing Performance-based Functional Ecological Test (BJ-PERFECT). Fifty community-dwelling adults with schizophrenia and 37 healthy controls were recruited. Fifteen of the healthy controls were re-tested one week later. All participants were administered the University of California, San Diego, Performance-based Skill Assessment-Brief version (UPSA-B) and the MATRICS Consensus Cognitive Battery (MCCB). The finalized assessment included three subdomains: transportation, financial management and work ability. The test-retest and inter-rater reliabilities were good. The total score significantly correlated with the UPSA-B. The performance of individuals with schizophrenia was significantly more impaired than healthy controls, especially in the domain of work ability. Among individuals with schizophrenia, functional outcome was influenced by premorbid functioning, negative symptoms and neurocognition such as processing speed, visual learning and attention/vigilance. © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Performance-based supplier audits - a quality and technical partnership

    International Nuclear Information System (INIS)

    Martin, E.L.

    1993-01-01

    The nuclear utility industry will realize the necessity and advantages of integrating engineering and quality assurance efforts into a unified, balanced approach to overview the activities of their suppliers (manufacturers)

  15. Concepts and techniques for conducting performance-based audits

    International Nuclear Information System (INIS)

    Espy, I.J.

    1990-01-01

    Quality assurance (QA) audits have historically varied in purpose and approach and have earned labels that attempt to name each type of audit. Some more common labels for QA audits include compliance, program, product, and performance-based. While documentation and methodologies are important and hence controlled, an organizations product has ultimate impact on the user. Product quality then must be of more concern to the user than documentation and methodologies of the provider. Performance-based auditing (PBA) provides for assessing product quality by evaluating the suppliers activities that produce and affect product quality. PBA is defined as auditing that evaluates the ability of an activity to regularly produce and release only acceptable product, where product refers to the output of the activity. The output may be hardware, software, or a service, and acceptability includes suitability to the users needs. To satisfy this definition, PBA should focus on the activities that produce and affect product and should evaluate the systematics of each activity in terms of its ability to produce acceptable product. The activity evaluation model provides a framework for evaluating the systematicness of any activity. Elements of the activity evaluation model are described

  16. Effect- and Performance-Based Auditory Feedback on Interpersonal Coordination

    Directory of Open Access Journals (Sweden)

    Tong-Hun Hwang

    2018-03-01

    Full Text Available When two individuals interact in a collaborative task, such as carrying a sofa or a table, usually spatiotemporal coordination of individual motor behavior will emerge. In many cases, interpersonal coordination can arise independently of verbal communication, based on the observation of the partners' movements and/or the object's movements. In this study, we investigate how social coupling between two individuals can emerge in a collaborative task under different modes of perceptual information. A visual reference condition was compared with three different conditions with new types of additional auditory feedback provided in real time: effect-based auditory feedback, performance-based auditory feedback, and combined effect/performance-based auditory feedback. We have developed a new paradigm in which the actions of both participants continuously result in a seamlessly merged effect on an object simulated by a tablet computer application. Here, participants should temporally synchronize their movements with a 90° phase difference and precisely adjust the finger dynamics in order to keep the object (a ball accurately rotating on a given circular trajectory on the tablet. Results demonstrate that interpersonal coordination in a joint task can be altered by different kinds of additional auditory information in various ways.

  17. Performance based design of reinforced concrete beams under impact

    Directory of Open Access Journals (Sweden)

    S. Tachibana

    2010-06-01

    Full Text Available The purpose of this research is to collect fundamental data and to establish a performance-based design method for reinforced concrete beams under perpendicular impact load.

    Series of low speed impact experiments using reinforced concrete beams were performed varying span length, cross section and main reinforcement.

    The experimental results are evaluated focusing on the impact load characteristics and the impact behaviours of reinforced concrete beams. Various characteristic values and their relationships are investigated such as the collision energy, the impact force duration, the energy absorbed by the beams and the beam response values. Also the bending performance of the reinforced concrete beams against perpendicular impact is evaluated.

    An equation is proposed to estimate the maximum displacement of the beam based on the collision energy and the static ultimate bending strength. The validity of the proposed equation is confirmed by comparison with experimental results obtained by other researchers as well as numerical results obtained by FEM simulations. The proposed equation allows for a performance based design of the structure accounting for the actual deformation due to the expected impact action.

  18. Experience with performance based training of nuclear criticality safety engineers

    International Nuclear Information System (INIS)

    Taylor, R.G.

    1993-01-01

    Historically, new entrants to the practice of nuclear criticality safety have learned their job primarily by on-the-job training (OJT) often by association with an experienced nuclear criticality safety engineer who probably also learned their job by OJT. Typically, the new entrant learned what he/she needed to know to solve a particular problem and accumulated experience as more problems were solved. It is likely that more formalism will be required in the future. Current US Department of Energy requirements for those positions which have to demonstrate qualification indicate that it should be achieved by using a systematic approach such as performance based training (PBT). Assuming that PBT would be an acceptable mechanism for nuclear criticality safety engineer training in a more formal environment, a site-specific analysis of the nuclear criticality safety engineer job was performed. Based on this analysis, classes are being developed and delivered to a target audience of newer nuclear criticality safety engineers. Because current interest is in developing training for selected aspects of the nuclear criticality safety engineer job, the analysis i's incompletely developed in some areas. Details of this analysis are provided in this report

  19. Exploratory analysis of normative performance on the UCSD Performance-Based Skills Assessment-Brief.

    Science.gov (United States)

    Vella, Lea; Patterson, Thomas L; Harvey, Philip D; McClure, Margaret McNamara; Mausbach, Brent T; Taylor, Michael J; Twamley, Elizabeth W

    2017-10-01

    The UCSD Performance-Based Skills Assessment (UPSA) is a performance-based measure of functional capacity. The brief, two-domain (finance and communication ability) version of the assessment (UPSA-B) is now widely used in both clinical research and treatment trials. To date, research has not examined possible demographic-UPSA-B relationships within a non-psychiatric population. We aimed to produce and describe preliminary normative scores for the UPSA-B over a full range of ages and educational attainment. The finance and communication subscales of the UPSA were administered to 190 healthy participants in the context of three separate studies. These data were combined to examine the effects of age, sex, and educational attainment on the UPSA-B domain and total scores. Fractional polynomial regression was used to compute demographically-corrected T-scores for the UPSA-B total score, and percentile rank conversion was used for the two subscales. Age and education both had significant non-linear effects on the UPSA-B total score. The finance subscale was significantly related to both gender and years of education, whereas the communication subscale was not significantly related to any of the demographic characteristics. Demographically corrected T-scores and percentile ranks for UPSA-B scores are now available for use in clinical research. Published by Elsevier B.V.

  20. How to construct a service quality index in performance based ratemaking

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, B.R.

    1996-04-01

    Nothing will derail the movement to competition quicker than a falloff in service quality. During the uncertain transition to a more competitive electricity market, utility regulators should carry out their duty to ensure adequate service quality by adopting innovative performance tracking methods. Despite all the talk - and there is plenty of that - the restructuring of the electric utility industry is not yet upon us. But many state regulatory bodies - having already experienced restructuring in the telecommunications industry, in which many employed new regulatory models known under the rubric of performance-based regulation - are beginning to experiment with some form of PBR in the increasingly competitive electricity industry. PBR is usually undertaken on the assumption that, in a more competitive industry, a lighter regulatory hand coupled with the discipline of market competition will produce better results for both utility customers and shareholders. PBR, as an alternative to traditional base rate regulation, typically retains strict control over basic service rates for core customers, either by freezing prices or establishing a formula that restricts the utility`s ability to raise prices for these customer groups. The utilty is usually given significant pricing and marketing flexibility over more competitive services and the ability to retain earnings from these services. A hallmark of these alternative schemes is their multi-year nature: the utility is offered the opportunity to earn higher profits over, say, a two-to-five year period, in return for stricter regulatory controls on prices charged to core customers. The purpose of this article, based in large part on the telecommunications experience, is to describe why it is necessary to address customer service issues that are inherent in PBR and to provide the basic tools to create a customer service and reliability index that can be included in any alternative rate plan for a utilty.

  1. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  2. Fire-safety engineering and performance-based codes

    DEFF Research Database (Denmark)

    Sørensen, Lars Schiøtt

    project administrators, etc. The book deals with the following topics: • Historical presentation on the subject of fire • Legislation and building project administration • European fire standardization • Passive and active fire protection • Performance-based Codes • Fire-safety Engineering • Fundamental......Fire-safety Engineering is written as a textbook for Engineering students at universities and other institutions of higher education that teach in the area of fire. The book can also be used as a work of reference for consulting engineers, Building product manufacturers, contractors, building...... thermodynamics • Heat exchange during the fire process • Skin burns • Burning rate, energy release rate and design fires • Proposal to Risk-based design fires • Proposal to a Fire scale • Material ignition and flame spread • Fire dynamics in buildings • Combustion products and toxic gases • Smoke inhalation...

  3. Do Performance-Based Codes Support Universal Design in Architecture?

    DEFF Research Database (Denmark)

    Grangaard, Sidse; Frandsen, Anne Kathrine

    2016-01-01

    – Universal Design (UD). The empirical material consists of input from six workshops to which all 700 Danish Architectural firms were invited, as well as eight group interviews. The analysis shows that the current prescriptive requirements are criticized for being too homogenous and possibilities...... for differentiation and zoning are required. Therefore, a majority of professionals are interested in a performance-based model because they think that such a model will support ‘accessibility zoning’, achieving flexibility because of different levels of accessibility in a building due to its performance. The common...... of educational objectives is suggested as a tool for such a boost. The research project has been financed by the Danish Transport and Construction Agency....

  4. Investigating Psychometric Isomorphism for Traditional and Performance-Based Assessment

    Science.gov (United States)

    Fay, Derek M.; Levy, Roy; Mehta, Vandhana

    2018-01-01

    A common practice in educational assessment is to construct multiple forms of an assessment that consists of tasks with similar psychometric properties. This study utilizes a Bayesian multilevel item response model and descriptive graphical representations to evaluate the psychometric similarity of variations of the same task. These approaches for…

  5. Planning for risk-informed/performance-based fire protection at nuclear power plants. Final report

    International Nuclear Information System (INIS)

    Najafi, B.; Parkinson, W.J.; Lee, J.A.

    1997-12-01

    This document presents a framework for discussing issues and building consensus towards use of fire modeling and risk technology in nuclear power plant fire protection program implementation. The plan describes a three-phase approach: development of core technologies, implementation of methods, and finally, case studies and pilot applications to verify viability of such methods. The core technologies are defined as fire modeling, fire and system tests, use of operational data, and system and risk techniques. The implementation phase addresses the programmatic issues involved in implementing a risk-informed/performance-based approach in an integrated approach with risk/performance measures. The programmatic elements include: (1) a relationship with fire codes and standards development as defined by the ongoing effort of NFPA for development of performance-based standards; (2) the ability for NRC to undertake inspection and enforcement; and (3) the benefit to utilities in terms of cost versus safety. The case studies are intended to demonstrate applicability of single issue resolution while pilot applications are intended to check the applicability of the integrated program as a whole

  6. Research on performance-based seismic design criteria

    Institute of Scientific and Technical Information of China (English)

    谢礼立; 马玉宏

    2002-01-01

    The seismic design criterion adopted in the existing seismic design codes is reviewed. It is pointed out that the presently used seismic design criterion is not satisfied with the requirements of nowadays social and economic development. A new performance-based seismic design criterion that is composed of three components is presented in this paper. It can not only effectively control the economic losses and casualty, but also ensure the building(s function in proper operation during earthquakes. The three components are: classification of seismic design for buildings, determination of seismic design intensity and/or seismic design ground motion for controlling seismic economic losses and casualties, and determination of the importance factors in terms of service periods of buildings. For controlling the seismic human losses, the idea of socially acceptable casualty level is presented and the (Optimal Economic Decision Model( and (Optimal Safe Decision Model( are established. Finally, a new method is recommended for calculating the importance factors of structures by adjusting structures service period on the base of more important structure with longer service period than the conventional ones. Therefore, the more important structure with longer service periods will be designed for higher seismic loads, in case the exceedance probability of seismic hazard in different service period is same.

  7. Performance-based financing: the same is different.

    Science.gov (United States)

    Renmans, Dimitri; Holvoet, Nathalie; Criel, Bart; Meessen, Bruno

    2017-07-01

    Although it is increasingly acknowledged within the Performance-Based Financing (PBF) research community that PBF is more than just payments based on outputs verified for quality, this narrow definition of PBF is still very present in many studies and evaluations. This leads to missed opportunities, misunderstandings and an unhelpful debate. Therefore, we reinforce the claim that PBF should be viewed as a reform package focused on targeted services with many different aspects that go beyond the health worker level. Failing to acknowledge the importance of the different elements of PBF negatively influences the task of practitioners, researchers and policymakers alike. After making the case for this wider definition, we propose three research pathways (describing, understanding and framing PBF) and give a short and tentative starting point for future research, leaving the floor open for more in-depth discussions. From these three vantage points it appears that when it comes to PBF 'the same is different'. Notwithstanding the increased complexity due to the use of the wider definition, progress on these three different research pathways will strongly improve our knowledge, lead to better adapted PBF programs and create a more nuanced debate on PBF. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  9. Performance-based quality assurance: the regulatory viewpoint

    International Nuclear Information System (INIS)

    Sajaroff, Pedro M.

    2000-01-01

    This paper complements and upgrades a previous one recently presented, the aim is a further contribution to a wide dissemination of this new methodology and way of thinking. Modern quality management techniques emphasizes errors prevention instead of finding and correcting them, in line with the new generation of ISO-9000 documents. Performance-based QA is coherent with this 'right-first-time' attitude, resting on the managerial role (establishing and applying policies and instructions allowing to integrate quality objectives to everyday work) and on the responsibility of every single involved person (the attainment of such objectives). The contents of the final draft of the revised IAEA NUSS Code on QA -namely 'Quality Assurance for Safety in Nuclear Power Plants and other Nuclear Facilities', is based on that approach, so it is not perspective. The text only contains ten basic requirements, where the objective is improving nuclear safety through an improvement in the methods applied for attaining quality during design, construction, commissioning, operation and decommissioning of nuclear installations. These requirements are assigned to: 'Management' (QA programme; training and qualification; non-conformance control and corrective actions; document control and records); 'Performance' (work; design; procurement; inspection and testing for acceptance) and 'Assessment' (management self-assessment; independent assessment). The management is responsible for planning, organization, direction, control and support; the line groups are responsible for attaining quality; and the assessment group is responsible for analyzing the management's and the line groups' effectiveness. From the regulatory point of view in the performance context, operating organizations will have to demonstrate the effective fulfillment of QA requirements to the satisfaction of regulatory authorities. This is not a novel mechanism, it is usual within the regulatory performance approach. The Code is

  10. Performance-based building codes: a call for injury prevention indicators that bridge health and building sectors.

    Science.gov (United States)

    Edwards, N

    2008-10-01

    The international introduction of performance-based building codes calls for a re-examination of indicators used to monitor their implementation. Indicators used in the building sector have a business orientation, target the life cycle of buildings, and guide asset management. In contrast, indicators used in the health sector focus on injury prevention, have a behavioural orientation, lack specificity with respect to features of the built environment, and do not take into account patterns of building use or building longevity. Suggestions for metrics that bridge the building and health sectors are discussed. The need for integrated surveillance systems in health and building sectors is outlined. It is time to reconsider commonly used epidemiological indicators in the field of injury prevention and determine their utility to address the accountability requirements of performance-based codes.

  11. 48 CFR 52.232-28 - Invitation To Propose Performance-Based Payments.

    Science.gov (United States)

    2010-10-01

    ... establishing performance bases and performance-based finance payment amounts). (2) A listing of— (i) The...). As prescribed in FAR 32.1005(b)(2), add the following paragraph (f) to the basic provision: (f) The...

  12. Asymmetric aminolytic kinetic resolution of racemic epoxides using recyclable chiral polymeric Co(III)-salen complexes: a protocol for total utilization of racemic epoxide in the synthesis of (R)-Naftopidil and (S)-Propranolol.

    Science.gov (United States)

    Kumar, Manish; Kureshy, Rukhsana I; Shah, Arpan K; Das, Anjan; Khan, Noor-ul H; Abdi, Sayed H R; Bajaj, Hari C

    2013-09-20

    Chiral polymeric Co(III) salen complexes with chiral ((R)/(S)-BINOL, diethyl tartrate) and achiral (piperazine and trigol) linkers with varying stereogenic centers were synthesized for the first time and used as catalysts for aminolytic kinetic resolution (AKR) of a variety of terminal epoxides and glycidyl ethers to get enantio-pure epoxides (ee, 99%) and N-protected β-amino alcohols (ee, 99%) with quantitative yield in 16 h at RT under optimized reaction conditions. This protocol was also used for the synthesis of two enantiomerically pure drug molecules (R)-Naftopidil (α1-blocker) and (S)-Propranolol (β-blocker) as a key step via AKR of single racemic naphthylglycidyl ether with Boc-protected isoproylamine with 100% epoxide utilization at 1 g level. The catalyst 1 was successfully recycled for a number of times.

  13. What is a new drug worth? An innovative model for performance-based pricing.

    Science.gov (United States)

    Dranitsaris, G; Dorward, K; Owens, R C; Schipper, H

    2015-05-01

    This article focuses on a novel method to derive prices for new pharmaceuticals by making price a function of drug performance. We briefly review current models for determining price for a new product and discuss alternatives that have historically been favoured by various funding bodies. The progressive approach to drug pricing, proposed herein, may better address the views and concerns of multiple stakeholders in a developed healthcare system by acknowledging and incorporating input from disparate parties via comprehensive and successive negotiation stages. In proposing a valid construct for performance-based pricing, the following model seeks to achieve several crucial objectives: earlier and wider access to new treatments; improved transparency in drug pricing; multi-stakeholder involvement through phased pricing negotiations; recognition of innovative product performance and latent changes in value; an earlier and more predictable return for developers without sacrificing total return on investment (ROI); more involved and informed risk sharing by the end-user. © 2014 John Wiley & Sons Ltd.

  14. Analyzing the Operation of Performance-Based Accountability Systems for Public Services. Technical Report

    Science.gov (United States)

    Camm, Frank; Stecher, Brian M.

    2010-01-01

    Empirical evidence of the effects of performance-based public management is scarce. This report describes a framework used to organize available empirical information on one form of performance-based management, a performance-based accountability system (PBAS). Such a system identifies individuals or organizations that must change their behavior…

  15. Research needs for risk-informed, performance-based regulation

    International Nuclear Information System (INIS)

    Cloninger, T.H.

    1997-01-01

    This presentation was made by an executive in the utility which operates the South Texas Project reactors, and summarizes their perspective on probabilistic safety analysis, risk-based operation, and risk-based regulation. They view it as a tool to help them better apply their resources to maintain the level of safety necessary to protect the public health and safety. South Texas served as one of the pilot plants for the application of risk-based regulation to the maintenance rule. The author feels that the process presents opportunities as well as challenges. Among the opportunities is the involvement of more people in the process, and the sense of investment they take in the decisions, in addition to the insight they can offer. In the area of challenges there is the need for better understanding of how to apply what already is known on problems, rather than essentially reinventing the wheel to address problems. Research is needed to better understand when some events are not truly of a significant safety concern. The demarcation between deterministic decisions and the appropriate application of risk-based decisions must be better defined, for the sake of the operator as well as the public observing plant operation

  16. Performance-based potential for residential energy efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Performance-based potential for residential energy efficiency

    2013-01-15

    Energy performance contracts (EPCs) have proven an effective mechanism for increasing energy efficiency in nearly all sectors of the economy since their introduction nearly 30 years ago. In the modern form, activities undertaken as part of an EPC are scoped and implemented by experts with specialized technical knowledge, financed by commercial lenders, and enable a facility owner to limit risk and investment of time and resources while receiving the rewards of improved energy performance. This report provides a review of the experiences of the US with EPCs and discusses the possibilities for the residential sector to utilize EPCs. Notably absent from the EPC market is the residential segment. Historically, research has shown that the residential sector varies in several key ways from markets segments where EPCs have proven successful, including: high degree of heterogeneity of energy use characteristics among and within households, comparatively small quantity of energy consumed per residence, limited access to information about energy consumption and savings potential, and market inefficiencies that constrain the value of efficiency measures. However, the combination of recent technological advances in automated metering infrastructure, flexible financing options, and the expansion of competitive wholesale electricity markets to include energy efficiency as a biddable supply-side resource present an opportunity for EPC-like efforts to successfully engage the residential sector, albeit following a different model than has been used in EPCs traditionally.(Author)

  17. Estimating Utility

    DEFF Research Database (Denmark)

    Arndt, Channing; Simler, Kenneth R.

    2010-01-01

    A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes a......, with the current approach tending to systematically overestimate (underestimate) poverty in urban (rural) zones.......A fundamental premise of absolute poverty lines is that they represent the same level of utility through time and space. Disturbingly, a series of recent studies in middle- and low-income economies show that even carefully derived poverty lines rarely satisfy this premise. This article proposes...... an information-theoretic approach to estimating cost-of-basic-needs (CBN) poverty lines that are utility consistent. Applications to date illustrate that utility-consistent poverty measurements derived from the proposed approach and those derived from current CBN best practices often differ substantially...

  18. FY 1986 report on research and development of super heat pump energy accumulation system. R and D of total systems (Surveys on heat sources and heat-utilization systems); 1986 nendo super heat pump energy shuseki system kenkyu kaihatsu seika hokokusho. Total system no kenkyu (netsugen netsu riyokei no chosa)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1987-03-01

    The heat source systems and heat utilization systems are surveyed and studied for the super heat pump energy accumulation systems, in order to clarify effective application and application types of these systems in the domestic and industrial energy areas. These works include surveys on literature, both domestic and foreign, surveys on actual situations of the related facilities and plants and on-the-spot hearing, and numerical simulation to establish the basic data for some items. The FY 1986 program includes the literature surveys on heat source and heat utilization systems and on-the-spot hearing for the domestic energy areas, reviews of heat demand variation patterns, and studies on methodology for applying the data to the areas not investigated so far. For the industrial areas to which super heat pumps are potentially applicable, the chemical, refining, food manufacturing and plastic manufacturing/processing industries are selected, to study problems related to system structures and conditions of the heat pump systems in these areas. (NEDO)

  19. Preserving Envelope Efficiency in Performance Based Code Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Brian A. [Thornton Energy Consulting (United States); Sullivan, Greg P. [Efficiency Solutions (United States); Rosenberg, Michael I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Baechler, Michael C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-06-20

    The City of Seattle 2012 Energy Code (Seattle 2014), one of the most progressive in the country, is under revision for its 2015 edition. Additionally, city personnel participate in the development of the next generation of the Washington State Energy Code and the International Energy Code. Seattle has pledged carbon neutrality by 2050 including buildings, transportation and other sectors. The United States Department of Energy (DOE), through Pacific Northwest National Laboratory (PNNL) provided technical assistance to Seattle in order to understand the implications of one potential direction for its code development, limiting trade-offs of long-lived building envelope components less stringent than the prescriptive code envelope requirements by using better-than-code but shorter-lived lighting and heating, ventilation, and air-conditioning (HVAC) components through the total building performance modeled energy compliance path. Weaker building envelopes can permanently limit building energy performance even as lighting and HVAC components are upgraded over time, because retrofitting the envelope is less likely and more expensive. Weaker building envelopes may also increase the required size, cost and complexity of HVAC systems and may adversely affect occupant comfort. This report presents the results of this technical assistance. The use of modeled energy code compliance to trade-off envelope components with shorter-lived building components is not unique to Seattle and the lessons and possible solutions described in this report have implications for other jurisdictions and energy codes.

  20. Effects of adding food by-products mainly including noodle waste to total mixed ration silage on fermentation quality, feed intake, digestibility, nitrogen utilization and ruminal fermentation in wethers.

    Science.gov (United States)

    Ishida, Kyohei; Yani, Srita; Kitagawa, Masayuki; Oishi, Kazato; Hirooka, Hiroyuki; Kumagai, Hajime

    2012-11-01

    Four wethers were used in a 4 × 4 Latin square design experiment to evaluate the applicability of two types of total mixed ration (TMR) silage with food by-products. Four food by-products (i.e., potato waste, soy sauce cake, soybean curd residue and noodle waste) were obtained and mixed with commercial concentrate (CC) as TMR silage. The two types of TMR silage, T1 and T2, each contained CC, in addition to all by-products for T1 (TRE1), and soy sauce cake and noodle waste for T2 (TRE2) on a dry matter (DM) basis. The silage was well-fermented with low pH values and high lactic acid concentration. As the experimental treatments, T1, T2 and CC (CTL) were fed with a basal diet. The result showed that the digestibility of DM and organic matter (OM) were higher for T1 than for CC (P < 0.05), while crude protein digestibility was not significantly different among T1, T2 and CC. The retained nitrogen was not affected by inclusion of food by-products. Ruminal pH in TRE1 and TRE2 immediately decreased compared to that in CTL. The study suggested that the two types of TMR silage, including food by-products, might be used as a substitute for commercial concentrate. © 2012 The Authors. Animal Science Journal © 2012 Japanese Society of Animal Science.

  1. Performance-based functional impairment and readmission and death: a prospective study.

    Science.gov (United States)

    Aubert, Carole E; Folly, Antoine; Mancinetti, Marco; Hayoz, Daniel; Donzé, Jacques D

    2017-06-08

    Readmission and death are frequent after a hospitalisation and difficult to predict. While many predictors have been identified, few studies have focused on functional status. We assessed whether performance-based functional impairment at discharge is associated with readmission and death after an acute medical hospitalisation. We prospectively included patients aged ≥50 years admitted to the Department of General Internal Medicine of a large community hospital. Functional status was assessed shortly before discharge using the Timed Up and Go test performed twice in a standard way by trained physiotherapists and was defined as a test duration ≥15 s. Sensitivity analyses using a cut-off at >10 and >20 s were performed. The primary and secondary outcome measures were unplanned readmission and death, respectively, within 6 months after discharge. Within 6 months after discharge, 107/338 (31.7%) patients had an unplanned readmission and 31/338 (9.2%) died. Functional impairment was associated with higher risk of death (OR 2.44, 95% CI 1.15 to 5.18), but not with unplanned readmission (OR 1.34, 95% CI 0.84 to 2.15). No significant association was found between functional impairment and the total number of unplanned readmissions (adjusted OR 1.59, 95% CI 0.95 to 2.67). Functional impairment at discharge of an acute medical hospitalisation was associated with higher risk of death, but not of unplanned readmission within 6 months after discharge. Simple performance-based assessment may represent a better prognostic measure for mortality than for readmission. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Electric utilities in Illinois

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    Although the conference dealt specifically with concerns of the electric utilities in Illinois, the issues were dealt with in the national context as well. A separate abstract was prepared for each of the 5 sections of this proceeding. A total of 25 papers were presented. Section titles are: Forecasting, Planning and Siting, Reliability, Rates and Financing, and Future Developments.

  3. Future regulatory research needs on risk-informed and performance-based regulation

    International Nuclear Information System (INIS)

    Kim, Wong Sik; Kim, Hho Jung

    2004-01-01

    The USNRC has pursued the incorporation of risk-informed and performance-based regulation (RIPBR) into nuclear safety regulatory system, as an alternative to improve existing nuclear safety regulation of nuclear power plants, which is deterministic and prescriptive. It focuses on the use of risk insight from probabilistic safety assessment (PSA). Recently, it becomes necessary to find a way to improve regulatory efficiency and effectiveness in order to cover the increasing regulatory needs in Korea. Also, the utility has optimized design and operation of the plant using PSA insight and equipment performance information. According to the increase of the necessity for regulatory improvement using risk and performance information, KINS (Korea Institute of Nuclear Safety) is developing, as a part of a mid and long-term project of Nuclear R and D program, how to adopt the RIPBR in Korean nuclear regulatory system. As the interim results, three basic directions and several principles that are necessary to implement RIPBR model were already identified from the previous study. This paper suggests a direction to future regulatory research on RIPBR based on the previous studies including the review of international trend of RIPBR and the evaluation of risk-informed regulatory environment

  4. Improved nuclear power plant operations through performance-based safety regulation

    International Nuclear Information System (INIS)

    Golay, M.W.

    1998-01-01

    The US Nuclear Regulatory Commission (NRC) has recently instituted use of Risk-Informed, Performance-Based Regulation (RIPBR) for protecting public safety in the use of nuclear power. This was done most importantly during June 1997 in issuance of revised Regulatory Guides and Standard Review Plan (SRP) guidance to licensees and the NRC staff. The propose of RIPBR is to replace the previously-used system of prescriptive regulation, which focuses upon what licensees must do, to a system which focuses upon what they must achieve. RIPBR is goals-oriented and the previous system is means-oriented. This regulatory change is potentially revolutionary, and offers many opportunities for improving the efficiency of improving both nuclear power operations and safety. However, it must be nurtured carefully if is to be successful. The work reported in this paper is concerned with showing how RIPBR can be implemented successfully, with benefits in both areas being attained. It is also concerned with how several of the practical barriers to establishing a workable new regulatory system can be overcome. This work, sponsored by the US Dept. of Energy, is being performed in collaboration with Northeast Utilities Services Crop. and the Idaho National Engineering Laboratory. In our work we have examined a practical safety-related example at the Millstone 3 nuclear power station for implementation of RIPBR. In this examination we have formulated a set of modifications to the plant's technical specifications, and are in the process of investigating their bases and refining the modifications. (author)

  5. Performance-Based Measures Associate With Frailty in Patients With End-Stage Liver Disease.

    Science.gov (United States)

    Lai, Jennifer C; Volk, Michael L; Strasburg, Debra; Alexander, Neil

    2016-12-01

    Physical frailty, as measured by the Fried Frailty Index, is increasingly recognized as a critical determinant of outcomes in patients with cirrhosis. However, its utility is limited by the inclusion of self-reported components. We aimed to identify performance-based measures associated with frailty in patients with cirrhosis. Patients with cirrhosis, aged 50 years or older, underwent: 6-minute walk test (cardiopulmonary endurance), chair stands in 30 seconds (muscle endurance), isometric knee extension (lower extremity strength), unipedal stance time (static balance), and maximal step length (dynamic balance/coordination). Linear regression associated each physical performance test with frailty. Principal components exploratory factor analysis evaluated the interrelatedness of frailty and the 5 physical performance tests. Of 40 patients with cirrhosis, with a median age of 64 years and Model for End-stage Liver Disease (MELD) MELD of 12.10 (25%) were frail by Fried Frailty Index ≥3. Frail patients with cirrhosis had poorer performance in 6-minute walk test distance (231 vs 338 m), 30-second chair stands (7 vs 10), isometric knee extension (86 vs 122 Newton meters), and maximal step length (22 vs 27 in. (P ≤ 0.02 for each). Each physical performance test was significantly associated with frailty (P test to a single factor-frailty. Frailty in cirrhosis is a multidimensional construct that is distinct from liver dysfunction and incorporates endurance, strength, and balance. Our data provide specific targets for prehabilitation interventions aimed at reducing frailty in patients with cirrhosis in preparation for liver transplantation.

  6. Multiattribute Utility Theory without Expected Utility Foundations

    NARCIS (Netherlands)

    Stiggelbout, A.M.; Wakker, P.P.

    1995-01-01

    Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

  7. Multiattribute utility theory without expected utility foundations

    NARCIS (Netherlands)

    Wakker, P.P.; Miyamoto, J.

    1996-01-01

    Methods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities, and simplifying decompositions of multiattribute utilities.

  8. Neuropsychological predictors of performance-based measures of functional capacity and social skills in individuals with severe mental illness.

    Science.gov (United States)

    Mahmood, Zanjbeel; Burton, Cynthia Z; Vella, Lea; Twamley, Elizabeth W

    2018-04-13

    Neuropsychological abilities may underlie successful performance of everyday functioning and social skills. We aimed to determine the strongest neuropsychological predictors of performance-based functional capacity and social skills performance across the spectrum of severe mental illness (SMI). Unemployed outpatients with SMI (schizophrenia, bipolar disorder, or major depression; n = 151) were administered neuropsychological (expanded MATRICS Consensus Cognitive Battery), functional capacity (UCSD Performance-Based Skills Assessment-Brief; UPSA-B), and social skills (Social Skills Performance Assessment; SSPA) assessments. Bivariate correlations between neuropsychological performance and UPSA-B and SSPA total scores showed that most neuropsychological tests were significantly associated with each performance-based measure. Forward entry stepwise regression analyses were conducted entering education, diagnosis, symptom severity, and neuropsychological performance as predictors of functional capacity and social skills. Diagnosis, working memory, sustained attention, and category and letter fluency emerged as significant predictors of functional capacity, in a model that explained 43% of the variance. Negative symptoms, sustained attention, and letter fluency were significant predictors of social skill performance, in a model explaining 35% of the variance. Functional capacity is positively associated with neuropsychological functioning, but diagnosis remains strongly influential, with mood disorder participants outperforming those with psychosis. Social skill performance appears to be positively associated with sustained attention and verbal fluency regardless of diagnosis; however, negative symptom severity strongly predicts social skills performance. Improving neuropsychological functioning may improve psychosocial functioning in people with SMI. Published by Elsevier Ltd.

  9. Performance-Based Service Quality Model: An Empirical Study on Japanese Universities

    Science.gov (United States)

    Sultan, Parves; Wong, Ho

    2010-01-01

    Purpose: This paper aims to develop and empirically test the performance-based higher education service quality model. Design/methodology/approach: The study develops 67-item instrument for measuring performance-based service quality with a particular focus on the higher education sector. Scale reliability is confirmed using the Cronbach's alpha.…

  10. 48 CFR 32.1007 - Administration and payment of performance-based payments.

    Science.gov (United States)

    2010-10-01

    ... contractor's experience, performance record, reliability, financial strength, and the adequacy of controls... of performance-based payments. 32.1007 Section 32.1007 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Performance-Based Payments 32.1007...

  11. The Effects of Performance-Based Assessment Criteria on Student Performance and Self-Assessment Skills

    Science.gov (United States)

    Fastre, Greet Mia Jos; van der Klink, Marcel R.; van Merrienboer, Jeroen J. G.

    2010-01-01

    This study investigated the effect of performance-based versus competence-based assessment criteria on task performance and self-assessment skills among 39 novice secondary vocational education students in the domain of nursing and care. In a performance-based assessment group students are provided with a preset list of performance-based…

  12. Performance-Based Scholarships: Replication at Six Sites Using Randomized Controlled Trials

    Science.gov (United States)

    Mayer, Alexander

    2014-01-01

    Performance-based scholarships were developed to help tackle some of the financial obstacles facing students in the postsecondary education system. In general, these scholarships aim to help reduce the financial burdens of low-income college students, and are structured to help incentivize good academic progress. Performance-based scholarships…

  13. Designing Scholarships to Improve College Success: Final Report on the Performance-Based Scholarship Demonstration

    Science.gov (United States)

    Mayer, Alexander K.; Patel, Reshma; Rudd, Timothy; Ratledge, Alyssa

    2015-01-01

    Performance-based scholarships have two main goals: (1) to give students more money for college; and (2) to provide incentives for academic progress. MDRC launched the Performance-Based Scholarship (PBS) Demonstration in 2008 to evaluate the effectiveness of these scholarships in a diverse set of states, institutions, and low-income student…

  14. Introduction of performance-based financing in burundi was associated with improvements in care and quality.

    Science.gov (United States)

    Bonfrer, Igna; Soeters, Robert; Van de Poel, Ellen; Basenya, Olivier; Longin, Gashubije; van de Looij, Frank; van Doorslaer, Eddy

    2014-12-01

    Several governments in low- and middle-income countries have adopted performance-based financing to increase health care use and improve the quality of health services. We evaluated the effects of performance-based financing in the central African nation of Burundi by exploiting the staggered rollout of this financing across provinces during 2006-10. We found that performance-based financing increased the share of women delivering their babies in an institution by 22 percentage points, which reflects a relative increase of 36 percent, and the share of women using modern family planning services by 5 percentage points, a relative change of 55 percent. The overall quality score for health care facilities increased by 45 percent during the study period, but performance-based financing was found to have no effect on the quality of care as reported by patients. We did not find strong evidence of differential effects of performance-based financing across socioeconomic groups. The performance-based financing effects on the probability of using care when ill were found to be even smaller for the poor. Our findings suggest that a supply-side intervention such as performance-based financing without accompanying access incentives for poor people is unlikely to improve equity. More research into the cost-effectiveness of performance-based financing and how best to target vulnerable populations is warranted. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Performance-based seismic assessment of vulnerability of dam using time history analysis

    Directory of Open Access Journals (Sweden)

    Elmrabet Oumnia

    2018-01-01

    Full Text Available The current performance-based seismic assessment procedure can be computationally intensive as it requires many time history analyses (THA each requiring time intensive post-processing of results. Time history analysis is a part of structural analysis and is the calculation of the response of a structure to any earthquake. It is one of the main processes of structural design in regions where earthquakes are prevalent. The objective of this study is to evaluate the seismic performance of embankment dam located on the Oued RHISS in the Province of AL HOCEIMA using the THA method. To monitor structural behavior, the seismic vulnerability of structure is evaluated under real earthquake records with considering the soil-structure-fluide interaction. In this study, a simple assistant program is developed for implementing earthquake analyses of structure with ANSYS, ground acceleration–time history data are used for seismic analysis and dynamic numerical simulations were conducted to study and identify the total response of the soil-structure system.

  16. Performance Based Envelopes: A Theory of Spatialized Skins and the Emergence of the Integrated Design Professional

    Directory of Open Access Journals (Sweden)

    Franca Trubiano

    2013-10-01

    Full Text Available Realigning the design of building envelopes within the measures of air, light and heat has rendered possible an inventive form of practice whose benefits are far in excess of the metrics of data and analysis. For many of its most advanced practitioners, the contemporary design of facades engages the true potential of “performance” when it deepens, broadens and complicates the theoretical dimension of this most liminal of surfaces. Of particular interest to this paper is a discussion of new theoretical paradigms associated with the design and operation of high performance envelopes of which four characteristics of this emergent sub-discipline are herein examined. To begin with, the way in which building envelopes are no longer separators, dividers and barriers between a building’s interior and exterior conditions, but rather, “spatially” defined environments that fully engage the totality of a building’s engineering systems, is discussed. Cantilevered Louvers, Double Skin Facades and Hybrid Conditioned Atria are representative of this new paradigm as is the use of Responsive Technologies to optimize their behaviors. Lastly, the paper examines the rise of the new integrated design building envelope professional called upon to deliver ever-better performing skins, whether in the guise of energy modeler, climate engineer or façade construction specialist. Hence, this paper develops a theoretical structure within which to describe, analyze and interpret the values made possible by this new and expanding field of performance based envelopes.

  17. Review of performance-based incentives in community-based family planning programmes

    Science.gov (United States)

    Bellows, Nicole M; Askew, Ian; Bellows, Benjamin

    2015-01-01

    Background One strategy for improving family planning (FP) uptake at the community level is the use of performance-based incentives (PBIs), which offer community distributors financial incentives to recruit more users of FP. This article examines the use of PBIs in community-based FP programmes via a literature search of the peer-reviewed and grey literature conducted in April 2013. Results A total of 28 community-based FP programmes in 21 countries were identified as having used PBIs. The most common approach was a sales commission model where distributors received commission for FP products sold, while a referral payment model for long-term methods was also used extensively. Six evaluations were identified that specifically examined the impact of the PBI in community-based FP programmes. Overall, the results of the evaluations are mixed and more research is needed; however, the findings suggest that easy-to-understand PBIs can be successful in increasing the use of FP at the community level. Conclusion For future use of PBIs in community-based FP programmes it is important to consider the ethics of incentivising FP and ensuring that PBIs are non-coercive and choice-enhancing. PMID:25037703

  18. Utilities objectives

    International Nuclear Information System (INIS)

    Cousin, Y.; Fabian, H.U.

    1996-01-01

    The policy of French and german utilities is to make use of nuclear energy as a long term, competitive and environmentally friendly power supply. The world electricity generation is due to double within the next 30 years. In the next 20 to 30 years the necessity of nuclear energy will be broadly recognized. More than for most industries, to deal properly with nuclear energy requires the combination of a consistent political will, of a proper institutional framework, of strong and legitimate control authorities, of a sophisticated industry and of operators with skilled management and human resources. One of the major risk facing nuclear energy is the loss of competitiveness. This can be achieved only through the combination of an optimized design, a consistent standardization, a proper industrial partnership and a stable long term strategy. Although the existing plants in Western Europe are already very safe, the policy is clearly to enhance the safety of the next generation of nuclear plants which are designing today. The French and German utilities have chosen an evolutionary approach based on experience and proven technologies, with an enhanced defense in depth and an objective of easier operation and maintenance. The cost objective is to maintain and improve what has been achieved in the best existing power plants in both countries. This calls for rational choices and optimized design to meet the safety objectives, a strong standardization policy, short construction times, high availability and enough flexibility to enable optimization of the fuel cycle throughout the lifetime of the plants. The conceptual design phase has proven that the French and German teams from industry and from the utilities are able to pursue both the safety and the cost objectives, basing their decision on a rational approach which could be accepted by the safety authorities. (J.S.)

  19. Thorium utilization

    Energy Technology Data Exchange (ETDEWEB)

    Trauger, D B [Oak Ridge National Lab., TN (USA)

    1978-01-01

    Some of the factors that provide incentive for the utilization of thorium in specific reactor types are explored and the constraints that stand in the way are pointed out. The properties of thorium and derived fuels are discussed, and test and reactor operating experience is reviewed. In addition, symbiotic systems of breeder and converter reactor are suggested as being particularly attractive systems for energy production. Throughout the discussion, the High-Temperature Gas-Cooled Reactor and Molten Salt Reactor are treated in some detail because they have been developed primarily for use with thorium fuel cycles.

  20. Japanese utilities' plutonium utilization program

    International Nuclear Information System (INIS)

    Matsuo, Yuichiro.

    1996-01-01

    Japan's 10 utility companies are working and will continue to work towards establishing a fully closed nuclear fuel cycle. The key goals of which are: (1) reprocessing spent fuel; (2) recycling recovered uranium and plutonium; and (3) commercializing fast breeder technology by around the year 2030. This course of action by the Japanese electric power industry is in full accordance with Japan's national policy outlined in the government's report ''The Long-Term Program for Research, Development, and Nuclear Energy,'' which was published in June 1994. The Japanese civilian nuclear program is a long-term program that looks into the 21st century and beyond. It is quite true that sustaining the recycling option for energy security and the global environment demands a large investment. For it to be accepted by the public, safety must be the highest priority and will be pursued at a great cost if necessary. In its history, Japan has learned that as technology advances, costs will come down. The Japanese utility industry will continue investment in technology without compromising safety until the recycling option becomes more competitive with other options. This effort will be equally applied to the development of the commercial FBRs. The Japanese utility industry is confident that Japan's stable policy and strong objective to develop competitive and peaceful technology will contribute to the global economy and the environment without increasing the threat of plutonium proliferation

  1. Multiattribute Utility Theory without Expected Utility Foundations

    NARCIS (Netherlands)

    J. Miyamoto (John); P.P. Wakker (Peter)

    1996-01-01

    textabstractMethods for determining the form of utilities are needed for the implementation of utility theory in specific decisions. An important step forward was achieved when utility theorists characterized useful parametric families of utilities and simplifying decompositions of multiattribute

  2. A direction to adopting risk-informed and performance-based regulation (RIPBR) in Korea

    International Nuclear Information System (INIS)

    Kim, W.S.; Sung, K.Y.; Lee, C.J.; Choi, Y.H.; Choi, Y.S.; Kim, H.J.

    2004-01-01

    The USNRC has pursued the incorporation of new regulatory approach of risk-informed and performance-based regulation (RIPBR) into nuclear safety regulation, as an alternative to improve existing nuclear safety regulation of nuclear power plants, which is deterministic and prescriptive. It focuses on the use of risk insight from probabilistic safety assessment (PSA). Recently, it becomes necessary to find a way to improve regulatory efficiency and effectiveness in order to cover the increasing regulatory needs in Korea. Also, the utility has optimized design and operation of the plant using PSA insight and equipment performance information. According to the increase of the necessity for regulatory improvement using risk and performance information, KINS (Korea Institute of Nuclear Safety) is developing, as a part of mid- and long-term project of Nuclear development program, how to adopt the RIPBR in Korean nuclear regulation. This paper presents the interim result of the study that comprises the assessment of feasibility to adopt the RIPBR, and basic directions and principles for implementing RIPBR model. It is concluded that adopting RIPBR is essential for risk management of the plant, public acceptance to nuclear safety, improvement of existing regulation, minimization of unnecessary regulatory burden, and effective use of regulatory resources, etc. Three basic directions and several principles that are necessary to implement RIPBR model are identified from the study. The application of the directions and principles to the assessment of RIPBR model to be established in the near future is expected to result in making the adoption of new regulatory system more objective and consistent. (authors)

  3. Reliability- and performance-based robust design optimization of MEMS structures considering technological uncertainties

    Science.gov (United States)

    Martowicz, Adam; Uhl, Tadeusz

    2012-10-01

    The paper discusses the applicability of a reliability- and performance-based multi-criteria robust design optimization technique for micro-electromechanical systems, considering their technological uncertainties. Nowadays, micro-devices are commonly applied systems, especially in the automotive industry, taking advantage of utilizing both the mechanical structure and electronic control circuit on one board. Their frequent use motivates the elaboration of virtual prototyping tools that can be applied in design optimization with the introduction of technological uncertainties and reliability. The authors present a procedure for the optimization of micro-devices, which is based on the theory of reliability-based robust design optimization. This takes into consideration the performance of a micro-device and its reliability assessed by means of uncertainty analysis. The procedure assumes that, for each checked design configuration, the assessment of uncertainty propagation is performed with the meta-modeling technique. The described procedure is illustrated with an example of the optimization carried out for a finite element model of a micro-mirror. The multi-physics approach allowed the introduction of several physical phenomena to correctly model the electrostatic actuation and the squeezing effect present between electrodes. The optimization was preceded by sensitivity analysis to establish the design and uncertain domains. The genetic algorithms fulfilled the defined optimization task effectively. The best discovered individuals are characterized by a minimized value of the multi-criteria objective function, simultaneously satisfying the constraint on material strength. The restriction of the maximum equivalent stresses was introduced with the conditionally formulated objective function with a penalty component. The yielded results were successfully verified with a global uniform search through the input design domain.

  4. Research on the comparison of performance-based concept and force-based concept

    Science.gov (United States)

    Wu, Zeyu; Wang, Dongwei

    2011-03-01

    There are two ideologies about structure design: force-based concept and performance-based concept. Generally, if the structure operates during elastic stage, the two philosophies usually attain the same results. But beyond that stage, the shortage of force-based method is exposed, and the merit of performance-based is displayed. Pros and cons of each strategy are listed herein, and then which structure is best suitable to each method analyzed. At last, a real structure is evaluated by adaptive pushover method to verify that performance-based method is better than force-based method.

  5. Institutional total energy case studies

    Energy Technology Data Exchange (ETDEWEB)

    Wulfinghoff, D.

    1979-07-01

    Profiles of three total energy systems in institutional settings are provided in this report. The plants are those of Franciscan Hospital, a 384-bed facility in Rock Island, Illinois; Franklin Foundation Hospital, a 100-bed hospital in Franklin, Louisiana; and the North American Air Defense Command Cheyenne Mountain Complex, a military installation near Colorado Springs, Colorado. The case studies include descriptions of plant components and configurations, operation and maintenance procedures, reliability, relationships to public utilities, staffing, economic efficiency, and factors contributing to success.

  6. Utility training

    International Nuclear Information System (INIS)

    Villaros, P.E.; Luxo, Armando; Bruant, Jacques

    1977-01-01

    The study of operational training systems for electro-nuclear utilities may be conducted through two different approaches. A first analytical approach consists of determining, for each position of a given organization chart, the necessary qualifications required and the corresponding complementary training to be provided. This approach applies preferentially to existing classical systems which are converted to nuclear operation with objectives of minimum structural changes and conservation of maximum efficiency. A second synthetical approach consists of determining the specific characteristics of nuclear plant operation, then, of deducting the training contingencies and the optimized organization chart of the plant, while taking into account, at each step, the parameters linked to local conditions. This last approach is studied in some detail in the present paper, taking advantage of its better suitability to the problems raised at the first stage of an electro-nuclear program development. In this respect, the possibility offered by this apprach to coordinate the training system of a given nuclear power station personnel with the overall problem of developing a skilled industrial labor force in the country, may lead to reconsideration of some usual priorities in the economy of operation of the nuclear power plant

  7. Investigating the relationship between outsourcing and performance based on Balanced Score Card (Case study Ilam Post Office

    Directory of Open Access Journals (Sweden)

    Karam Khalili

    2014-01-01

    Full Text Available Today, outsourcing can play a crucial role in satisfying customers and meeting their requirements; therefore post office has devoted some of its services and supports for improving the performance, reducing the expenses, and modifying the organizational structure. The main purpose of this study is to investigate the relationship between outsourcing and the performance based on Balanced Score Card (Ilam Post Office in 2013. This study was a descriptive-survey and it utilized a questionnaire for collecting data. SPSS software was used to analyze the data. Useable data were gathered from 18 managers and assistants. T-student and correlation method was used for data analysis. The results showed that there are a strong and positive relationship between outsourcing post office activities and performance management in three aspects of financial, customers and internal processes; however there was a positive and weak relationship between the aspect of learning and outsourcing.

  8. Evaluating performance-based test and specifications for sulfate resistance in concrete

    Science.gov (United States)

    2000-12-01

    This research project involved an experimental evaluation of the sulfate resistance of various concretes and mortars for the purpose of establishing performance-based specifications for the durability of concrete against sulfate attack. The research ...

  9. The Challenge of Moving from Performance Based Logistics to an Operational Logistics Framework

    National Research Council Canada - National Science Library

    Bryant, Russell E

    2005-01-01

    ... and qualified forces for the combatant commanders of the 21st century. One focal area is within the logistics area of overall warfighter support, commonly referred to as performance based logistics (PBL...

  10. Adding a Performance-Based Component to Surface Warfare Officer Bonuses: Will it Affect Retention?

    National Research Council Canada - National Science Library

    Carman, Aron S; Mudd, Ryan M

    2008-01-01

    ... Authorization and the current officer inventory beginning at 9 years of commissioned service. The objective of this study was to analyze the 13-year retention effect of adding a performance-based component to the SWO Critical Skills Bonus (CSB...

  11. ANALYSIS OF FREE ROUTE AIRSPACE AND PERFORMANCE BASED NAVIGATION IMPLEMENTATION IN THE EUROPEAN AIR NAVIGATION SYSTEM

    Directory of Open Access Journals (Sweden)

    Svetlana Pavlova

    2014-12-01

    Full Text Available European Air Traffic Management system requires continuous improvements as air traffic is increasingday by day. For this purpose it was developed by international organizations Free Route Airspace and PerformanceBased Navigation concepts that allow to offer a required level of safety, capacity, environmental performance alongwith cost-effectiveness. The aim of the article is to provide detailed analysis of Free Route Airspace and PerformanceBased Navigation implementation status within European region including Ukrainian air navigation system.

  12. The effect of performance-based pay systems on job satisfaction and stress

    OpenAIRE

    Hornbach, Jessica Janina

    2013-01-01

    Previous investigations regarding the health- and wellbeing-related outcomes of performance-based pay systems have been scarce and ambiguous so far. Considering the huge economic and organizational impact of stress-related health problems, it is important to further investigate this relation, including the impact of different variables that can help to explain the variation in the relationship between performance-based pay and job strain. The main purpose of this study is to challenge the res...

  13. PERFORMANCE BASED PAY AS A DETERMINANT OF JOB SATISFACTION: A STUDY IN MALAYSIA GIATMARA CENTERS

    OpenAIRE

    Azman ISMAIL; Nurhana M RAFIUDDIN; Mohd Hamran MOHAMAD; Norashikin Sahol HAMID; Aniza WAMIN; Nurzawani ZAKARIA

    2011-01-01

    Compensation management literature highlights that performance based pay has two major characteristics: participation in pay systems and adequacy of pay. The ability of management to properly implement such pay systems may lead to increased job satisfaction in organizations. Though, the nature of this relationship is interesting, little is known about the influence of performance based pay on job satisfaction in compensation management literature. Therefore, this study was conducted to examin...

  14. Study on institutionalization of risk-informed performance-based regulation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, M. G.; Hong, S. Y.; Seo, M. R. [Korea Electric Power Research Institute, Taejon (Korea, Republic of)

    2003-02-15

    In this study, for the institutionalization of risk informed and performance based regulation in Korea, the latest technical movements of overseas countries are examined and reviewed. And the issues that was found when license change petition using risk information was submitted in Korean regulatory body are reviewed. Based on these review, the applicable areas to domestic situation will be found and proposed. This study can contribute to setting up the proper direction for the institutionalization of risk informed and performance based regulation.

  15. Performance-Based Outcomes After Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ Between Sports.

    Science.gov (United States)

    Mai, Harry T; Chun, Danielle S; Schneider, Andrew D; Erickson, Brandon J; Freshman, Ryan D; Kester, Benjamin; Verma, Nikhil N; Hsu, Wellington K

    2017-08-01

    Excellent outcomes have been reported for anterior cruciate ligament (ACL) reconstruction (ACLR) in professional athletes in a number of different sports. However, no study has directly compared these outcomes between sports. To determine if differences in performance-based outcomes exist after ACLR between professional athletes of each sport. Cohort study; Level of evidence, 3. National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) athletes undergoing primary ACLR for an acute rupture were identified through an established protocol of injury reports and public archives. Sport-specific performance statistics were collected before and after surgery for each athlete. Return to play (RTP) was defined as a successful return to the active roster for at least 1 regular-season game after ACLR. Of 344 professional athletes who met the inclusion criteria, a total of 298 (86.6%) returned to play. NHL players had a significantly higher rate of RTP (95.8% vs 83.4%, respectively; P = .04) and a shorter recovery time (258 ± 110 days vs 367 ± 268 days, respectively; P NBA and NFL players showed decreased performance at season 1 after ACLR ( P ≤ .001). NFL players continued to have lower performance at seasons 2 and 3 ( P = .002), while NBA players recovered to baseline performance. The data indicate that NFL athletes fare the worst after ACLR with the lowest survival rate, shortest postoperative career length, and sustained decreases in performance. NHL athletes fare the best with the highest rates of RTP, highest survival rates, longest postoperative career lengths, and no significant changes in performance. The unique physical demand that each sport requires is likely one of the explanations for these differences in outcomes.

  16. Modelling of proton exchange membrane fuel cell performance based on semi-empirical equations

    Energy Technology Data Exchange (ETDEWEB)

    Al-Baghdadi, Maher A.R. Sadiq [Babylon Univ., Dept. of Mechanical Engineering, Babylon (Iraq)

    2005-08-01

    Using semi-empirical equations for modeling a proton exchange membrane fuel cell is proposed for providing a tool for the design and analysis of fuel cell total systems. The focus of this study is to derive an empirical model including process variations to estimate the performance of fuel cell without extensive calculations. The model take into account not only the current density but also the process variations, such as the gas pressure, temperature, humidity, and utilization to cover operating processes, which are important factors in determining the real performance of fuel cell. The modelling results are compared well with known experimental results. The comparison shows good agreements between the modeling results and the experimental data. The model can be used to investigate the influence of process variables for design optimization of fuel cells, stacks, and complete fuel cell power system. (Author)

  17. X - FACTOR EVALUATION UNDER RPI-X REGULATION FOR INDIAN ELECTRICITY DISTRIBUTION UTILITIES

    Directory of Open Access Journals (Sweden)

    PAVAN KHETRAPAL

    2017-07-01

    Full Text Available With regulators’ growing interest in improving operational efficiency and quality supply, the time is nearing when performance based regulation will become norm for regulating the distribution tariff in Indian electricity distribution sector. In this context, the State Electricity Regulatory Commissions proposed replacing rate-of-return regulation with most commonly used performance based regulatory regime, i.e., Price Cap regulation also known as RPI-X (Retail Price Index - Productivity Offset regulatory framework. However, the potential problem associated with applying price cap regulation scheme in practice is the determination of productivity offset or X factor used in price caps setting. This paper proposed an approach to calculate the X-factor for 58 government-owned and privately-owned electricity distribution utilities in India during a five year period from 2007/08 to 2011/12. A Stochastic Frontier model through an input distance function is first applied to compute the Malmquist Total Factor Productivity (TFP and the estimated TFP is then used to calculate the utility-specific X-factor. With rely on calculated X-factor, the distribution utilities would be able to cap either on prices or revenues thus accounting the inflation in the tariff determination. This will be more realistic approach as compared to cost plus approach.

  18. Health care utilization

    DEFF Research Database (Denmark)

    Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren

    An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...

  19. Utility customer issues

    International Nuclear Information System (INIS)

    Downey, W.H.

    1997-01-01

    Customer issues affected by the restructuring of the $250 billion US electric power industry were discussed. In the past the industry's vertically integrated utilities conducted their business in protected geographic markets. With deregulation and greater competition, that industry structure will change. This presentation highlighted the strategies that Unicom is using to react to the restructuring of the electric power industry. The underlying principle is for the utility to reinvent itself to change its market orientation and focus on customer services, such as reliability, responsiveness, custom tailored solutions, and guaranteed savings over time. Attempting to become total energy providers and delivering integrated solutions to meet the needs of large industrial and commercial consumers, intensive market research, improved service and installation, and sophisticated customer retention initiatives will also have to be high on the agenda

  20. Correlations between Energy and Displacement Demands for Performance-Based Seismic Engineering

    Science.gov (United States)

    Mollaioli, Fabrizio; Bruno, Silvia; Decanini, Luis; Saragoni, Rodolfo

    2011-01-01

    The development of a scientific framework for performance-based seismic engineering requires, among other steps, the evaluation of ground motion intensity measures at a site and the characterization of their relationship with suitable engineering demand parameters (EDPs) which describe the performance of a structure. In order to be able to predict the damage resulting from earthquake ground motions in a structural system, it is first necessary to properly identify ground motion parameters that are well correlated with structural response and, in turn, with damage. Since structural damage during an earthquake ground motion may be due to excessive deformation or to cumulative cyclic damage, reliable methods for estimating displacement demands on structures are needed. Even though the seismic performance is directly related to the global and local deformations of the structure, energy-based methodologies appear more helpful in concept, as they permit a rational assessment of the energy absorption and dissipation mechanisms that can be effectively accomplished to balance the energy imparted to the structure. Moreover, energy-based parameters are directly related to cycles of response of the structure and, therefore, they can implicitly capture the effect of ground motion duration, which is ignored by conventional spectral parameters. Therefore, the identification of reliable relationships between energy and displacement demands represents a fundamental issue in both the development of more reliable seismic code provisions and the evaluation of seismic vulnerability aimed at the upgrading of existing hazardous facilities. As these two aspects could become consistently integrated within a performance-based seismic design methodology, understanding how input and dissipated energy are correlated with displacement demands emerges as a decisive prerequisite. The aim of the present study is the establishment of functional relationships between input and dissipated energy

  1. An Examination of the Performance Based Building Code on the Design of a Commercial Building

    Directory of Open Access Journals (Sweden)

    John Greenwood

    2012-11-01

    Full Text Available The Building Code of Australia (BCA is the principal code under which building approvals in Australia are assessed. The BCA adopted performance-based solutions for building approvals in 1996. Performance-based codes are based upon a set of explicit objectives, stated in terms of a hierarchy of requirements beginning with key general objectives. With this in mind, the research presented in this paper aims to analyse the impact of the introduction of the performance-based code within Western Australia to gauge the effect and usefulness of alternative design solutions in commercial construction using a case study project. The research revealed that there are several advantages to the use of alternative designs and that all parties, in general, are in favour of the performance-based building code of Australia. It is suggested that change in the assessment process to streamline the alternative design path is needed for the greater use of the performance-based alternative. With appropriate quality control measures, minor variations to the deemed-to-satisfy provisions could easily be managed by the current and future building surveying profession.

  2. Performance-based classrooms: A case study of two elementary teachers of mathematics and science

    Science.gov (United States)

    Jones, Kenneth W.

    This case study depicts how two elementary teachers develop classrooms devoted to performance-based instruction in mathematics and science. The purpose is to develop empirical evidence of classroom practices that leads to a conceptual framework about the nature of performance-based instruction. Performance-based assessment and instruction are defined from the literature to entail involving students in tasks that are complex and engaging, requiring them to apply knowledge and skills in authentic contexts. In elementary mathematics and science, such an approach emphasizes problem solving, exploration, inquiry, and reasoning. The body of the work examines teacher beliefs, curricular orientations, instructional strategies, assessment approaches, management and organizational skills, and interpersonal relationships. The focus throughout is on those aspects that foster student performance in elementary mathematics and science. The resulting framework describes five characteristics that contribute to performance-based classrooms: a caring classroom community, a connectionist learning theory, a thinking and doing curriculum, diverse opportunities for learning, and ongoing assessment, feedback, and adjustment. The conclusion analyzes factors external to the classroom that support or constrain the development of performance-based classrooms and discusses the implications for educational policy and further research.

  3. Performance-based regulation: enterprise responsibility for reducing death, injury, and disease caused by consumer products.

    Science.gov (United States)

    Sugarman, Stephen D

    2009-12-01

    This article offers a bold new idea for confronting the staggering level of death, injury, and disease caused by five consumer products: cigarettes, alcohol, guns, junk food, and motor vehicles. Business leaders try to frame these negative outcomes as "collateral damage" that is someone else's problem. That framing not only is morally objectionable but also overlooks the possibility that, with proper prodding, industry could substantially lessen these public health disasters. I seek to reframe the public perception of who is responsible and propose to deploy a promising approach called "performance-based regulation" to combat the problem. Performance-based regulation would impose on manufacturers a legal obligation to reduce the negative social costs of their products. Rather than involving them in litigation or forcing them to operate differently (as "command-and-control" regimes do), performance-based regulation allows the firms to determine how best to decrease bad public health consequences. Like other public health strategies, performance-based regulation focuses on those who are far more likely than individual consumers to achieve real gains. Analogous to a tax on causing harm that exceeds a threshold level, performance-based regulation seeks to harness private initiative in pursuit of the public good.

  4. Health worker preferences for performance-based payment schemes in a rural health district in Burkina Faso

    Directory of Open Access Journals (Sweden)

    Maurice Yé

    2016-01-01

    Full Text Available Background: One promising way to improve the motivation of healthcare providers and the quality of healthcare services is performance-based incentives (PBIs also referred as performance-based financing. Our study aims to explore healthcare providers’ preferences for an incentive scheme based on local resources, which aimed at improving the quality of maternal and child health care in the Nouna Health District. Design: A qualitative and quantitative survey was carried out in 2010 involving 94 healthcare providers within 34 health facilities. In addition, in-depth interviews involving a total of 33 key informants were conducted at health facility levels. Results: Overall, 85% of health workers were in favour of an incentive scheme based on the health district's own financial resources (95% CI: [71.91; 88.08]. Most health workers (95 and 96% expressed a preference for financial incentives (95% CI: [66.64; 85.36] and team-based incentives (95% CI: [67.78; 86.22], respectively. The suggested performance indicators were those linked to antenatal care services, prevention of mother-to-child human immunodeficiency virus transmission, neonatal care, and immunization. Conclusions: The early involvement of health workers and other stakeholders in designing an incentive scheme proved to be valuable. It ensured their effective participation in the process and overall acceptance of the scheme at the end. This study is an important contribution towards the designing of effective PBI schemes.

  5. A study on the relevance and influence of the existing regulation and risk informed/performance based regulation

    Energy Technology Data Exchange (ETDEWEB)

    Cheong, B. J.; Kang, J. M.; Kim, H. S.; Koh, S. H.; Kang, D. H.; Park, C. H. [Cheju Univ., Jeju (Korea, Republic of)

    2003-02-15

    The goal of this study is to estimate the relevance and Influence of the Existing Regulation and the RI-PBR to the institutionalization of the regulatory system. This study reviews the current regulatory system and the status of the RI-PBR implementation of the US NRC and Korea based upon SECY Papers, Risk Informed Regulation Implementation Plan (RIRIP) of the US NRC and other domestic studies. In order to investigate the perceptions, knowledge level, ground for the regulatory change, a survey was performed to Korean nuclear utilities, researchers and regulators on the perception on the RIR. The questionnaire was composed of 50 questions regarding personal details on work experience, level of education and specific field of work ; level of knowledge on the risk informed performance based regulation (RI-PBR); the perception of the current regulation, the effectiveness, level of procedure, flexibility, dependency on the regulator and personal view, and the perception of the RI-PBR such as flexibility of regulation, introduction time and the effect of RI-PBR, safety improvement, public perception, parts of the existing regulatory system that should be changed, etc. 515 answered from all sectors of the nuclear field; utilities, engineering companies, research institutes, and regulatory bodies.

  6. Performance-based management and quality of work: an empirical assessment.

    Science.gov (United States)

    Falzon, Pierre; Nascimento, Adelaide; Gaudart, Corinne; Piney, Cécile; Dujarier, Marie-Anne; Germe, Jean-François

    2012-01-01

    In France, in the private sector as in the public sector, performance-based management tends to become a norm. Performance-based management is supposed to improve service quality, productivity and efficiency, transparency of allotted means and achieved results, and to better focus the activity of employees and of the whole organization. This text reports a study conducted for the French Ministry of Budget by a team of researchers in ergonomics, sociology and management science, in order to assess the impact of performance-based management on employees, on teams and on work organization. About 100 interviews were conducted with employees of all categories and 6 working groups were set up in order to discuss and validate or amend our first analyses. Results concern several aspects: workload and work intensification, indicators and performance management and the transformation of jobs induced by performance management.

  7. Introduction into scientific work methods-a necessity when performance-based codes are introduced

    DEFF Research Database (Denmark)

    Dederichs, Anne; Sørensen, Lars Schiøtt

    The introduction of performance-based codes in Denmark in 2004 requires new competences from people working with different aspects of fire safety in the industry and the public sector. This abstract presents an attempt in reducing problems with handling and analysing the mathematical methods...... and CFD models when applying performance-based codes. This is done within the educational program "Master of Fire Safety Engineering" at the department of Civil Engineering at the Technical University of Denmark. It was found that the students had general problems with academic methods. Therefore, a new...

  8. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  9. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  10. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  11. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  12. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  13. Protocol for the process evaluation of interventions combining performance-based financing with health equity in Burkina Faso.

    Science.gov (United States)

    Ridde, Valéry; Turcotte-Tremblay, Anne-Marie; Souares, Aurélia; Lohmann, Julia; Zombré, David; Koulidiati, Jean Louis; Yaogo, Maurice; Hien, Hervé; Hunt, Matthew; Zongo, Sylvie; De Allegri, Manuela

    2014-10-12

    The low quality of healthcare and the presence of user fees in Burkina Faso contribute to low utilization of healthcare and elevated levels of mortality. To improve access to high-quality healthcare and equity, national authorities are testing different intervention arms that combine performance-based financing with community-based health insurance and pro-poor targeting. There is a need to evaluate the implementation of these unique approaches. We developed a research protocol to analyze the conditions that led to the emergence of these intervention arms, the fidelity between the activities initially planned and those conducted, the implementation and adaptation processes, the sustainability of the interventions, the possibilities for scaling them up, and their ethical implications. The study adopts a longitudinal multiple case study design with several embedded levels of analyses. To represent the diversity of contexts where the intervention arms are carried out, we will select three districts. Within districts, we will select both primary healthcare centers (n =18) representing different intervention arms and the district or regional hospital (n =3). We will select contrasted cases in relation to their initial performance (good, fair, poor). Over a period of 18 months, we will use quantitative and qualitative data collection and analytical tools to study these cases including in-depth interviews, participatory observation, research diaries, and questionnaires. We will give more weight to qualitative methods compared to quantitative methods. Performance-based financing is expanding rapidly across low- and middle-income countries. The results of this study will enable researchers and decision makers to gain a better understanding of the factors that can influence the implementation and the sustainability of complex interventions aiming to increase healthcare quality as well as equity.

  14. Self-reported physical fitness of older persons : A substitute for performance-based measures of physical fitness?

    NARCIS (Netherlands)

    vanHeuvelen, MJG; Kempen, GIJM; Ormel, J; de Greef, M.H.G.

    1997-01-01

    To evaluate the validity of self-report measures of physical fitness as substitutes for performance-based tests, self-reports and performance-based tests of physical fitness were compared. Subjects were a community-based sample of older adults (N = 624) aged 57 and over. The performance-based tests

  15. The Relationship between Video Game Use and a Performance-Based Measure of Persistence

    Science.gov (United States)

    Ventura, Matthew; Shute, Valerie; Zhao, Weinan

    2013-01-01

    An online performance-based measure of persistence was developed using anagrams and riddles. Persistence was measured by recording the time spent on unsolved anagrams and riddles. Time spent on unsolved problems was correlated to a self-report measure of persistence. Additionally, frequent video game players spent longer times on unsolved problems…

  16. Evaluation of a performance-based standards approach to heavy vehicle design to reduce pavement wear

    CSIR Research Space (South Africa)

    Nordengen, Paul A

    2013-11-01

    Full Text Available As a result of successful initiatives in Australia, New Zealand and Canada, the introduction of a performance-based standards (PBS) approach in the heavy vehicle sector in South Africa was identified by the Council for Scientific and Industrial...

  17. A Humanistic Approach to Performance-Based Teacher Education. PBTE Series No. 10.

    Science.gov (United States)

    Nash, Paul

    Questions are reaised in making performance-based teacher education (PBTE) a more humanistic enterprise. A definition of the term "humanistic" could include such qualities as freedom, uniqueness, creativity, productivity, wholeness, responsibility, and social humanization. As to freedom, a humanistic approach to PBTE would encourage people to act…

  18. The Influence of Performance-Based Accountability on the Distribution of Teacher Salary Increases

    Science.gov (United States)

    Bifulco, Robert

    2010-01-01

    This study examines how aspects of a district's institutional and policy environment influence the distribution of teacher salary increases. The primary hypothesis tested is that statewide performance-based accountability policies influence the extent to which districts backload teacher salary increases. I use data on teacher salaries from the…

  19. Performance based durability design of a bored tunnel with concrete lining

    NARCIS (Netherlands)

    Vries, H. de; Siemes, A.J.M.

    2002-01-01

    Design for durability is gradually changing from a deem-to-satisfy approach to a performance based approach. The conventional building codes give in principle only construction rules. If these rules are fulfilled, it is assumed that the structure will have an adequate durability. But specifications

  20. A three-level framework for performance-based railway timetabling

    DEFF Research Database (Denmark)

    Goverde, Rob M P; Bešinović, Nikola; Binder, Anne

    2016-01-01

    . This paper presents a performance-based railway timetabling framework integrating timetable construction and evaluation on three levels: microscopic, macroscopic, and a corridor fine-tuning level, where each performance indicator is optimized or evaluated at the appropriate level. A modular implementation...

  1. Reliability in the performance-based concept of fib Model Code 2010

    NARCIS (Netherlands)

    Bigaj-van Vliet, A.; Vrouwenvelder, T.

    2013-01-01

    The design philosophy of the new fib Model Code for Concrete Structures 2010 represents the state of the art with regard to performance-based approach to the design and assessment of concrete structures. Given the random nature of quantities determining structural behaviour, the assessment of

  2. Performance-based alternative assessments as a means of eliminating gender achievement differences on science tests

    Science.gov (United States)

    Brown, Norman Merrill

    1998-09-01

    Historically, researchers have reported an achievement difference between females and males on standardized science tests. These differences have been reported to be based upon science knowledge, abstract reasoning skills, mathematical abilities, and cultural and social phenomena. This research was designed to determine how mastery of specific science content from public school curricula might be evaluated with performance-based assessment models, without producing gender achievement differences. The assessment instruments used were Harcourt Brace Educational Measurement's GOALSsp°ler: A Performance-Based Measure of Achievement and the performance-based portion of the Stanford Achievement Testspcopyright, Ninth Edition. The identified independent variables were test, gender, ethnicity, and grade level. A 2 x 2 x 6 x 12 (test x gender x ethnicity x grade) factorial experimental design was used to organize the data. A stratified random sample (N = 2400) was selected from a national pool of norming data: N = 1200 from the GOALSsp°ler group and N = 1200 from the SAT9spcopyright group. The ANOVA analysis yielded mixed results. The factors of test, gender, ethnicity by grade, gender by grade, and gender by grade by ethnicity failed to produce significant results (alpha = 0.05). The factors yielding significant results were ethnicity, grade, and ethnicity by grade. Therefore, no significant differences were found between female and male achievement on these performance-based assessments.

  3. Are Performance-Based Accountability Systems Effective? Evidence from Five Sectors. Research Brief

    Science.gov (United States)

    Leuschner, Kristin J.

    2010-01-01

    During the past two decades, performance-based accountability systems (PBASs), which link financial or other incentives to measured performance as a means of improving services, have gained popularity among policymakers. Although PBASs can vary widely across sectors, they share three main components: goals (i.e., one or more long-term outcomes to…

  4. Feasibility Study of a Performance-Based Teacher Education Curriculum in Language Arts.

    Science.gov (United States)

    Rudman, Masha Kabakow

    This report of a feasibility study, conducted under the provisions of a model elementary teacher education grant from the U.S. Office of Education, is in five parts. Chapter one contains an overview of and rationale for a performance-based teacher education program, a brief history of the study, the attitude and ability goals expected from…

  5. Putting the Focus on Student Engagement: The Benefits of Performance-Based Assessment

    Science.gov (United States)

    Barlowe, Avram; Cook, Ann

    2016-01-01

    For more than two decades, the New York Performance Standards Consortium, a coalition of 38 public high schools, has steered clear of high-stakes testing, which superficially assess student learning. Instead, the consortium's approach relies on performance-based assessments--essays, research papers, science experiments, and high-level mathematical…

  6. Articulated, Performance-Based Instruction Objectives Guide for Automotive Mechanics. Final Document. Revised.

    Science.gov (United States)

    Henderson, William Edward, Jr.

    Developed during a project designed to provide continuous, performance-based vocational training at the secondary and postsecondary levels, this instructional guide is intended to help teachers implement a laterally and vertically articulated secondary level automotive mechanics program. Introductory materials include descriptions of Automotive…

  7. Targeting the poorest in a performance-based financing programme in northern Cameroon

    NARCIS (Netherlands)

    I.J.E. Flink (Ilse); Ziebe, R. (Roland); Vagaï, D. (Djebba); Van De Looij, F. (Frank); Van 'T Riet, H. (Hilda); A.J. Houweling (Tanja)

    2016-01-01

    textabstractPerformance-Based Financing (PBF) is a promising approach to improve health system performance in developing countries, but there are concerns that it may inadequately address inequalities in access to care. Incentives for reaching the poor may prove beneficial, but evidence remains

  8. Using performance-based contracts to foster innovation in outsourced service delivery

    NARCIS (Netherlands)

    Sumo, Regien; van der Valk, Wendy; Duijsters, Geert; van Weele, Arjan

    2016-01-01

    While many scholars claim that Performance-based Contracts (PBCs) foster supplier-led innovation, empirical research into their actual use and effects remains limited. We therefore explore two cases of IT outsourcing through such contracts to see whether, and if so how, PBCs foster innovation. Our

  9. The Influence of Performance-Based Management on Teaching and Research Performance of Finnish Senior Academics

    Science.gov (United States)

    Kivistö, Jussi; Pekkola, Elias; Lyytinen, Anu

    2017-01-01

    Despite the widespread use of performance-based management in higher education, empirical research on its actual impact has remained scarce, particularly in Europe. With agency theory as a framework, our study utilised survey data collected from Finnish universities in order to explore the influence of performance management on perceived teaching…

  10. Explicit MPC design and performance-based tuning of an Adaptive Cruise Control Stop-&-Go

    NARCIS (Netherlands)

    Naus, G.J.L.; Ploeg, J.; Molengraft, M.J.G. van de; Steinbuch, M.

    2008-01-01

    This paper presents the synthesis, the implementation and the performance-based tuning of an Adaptive Cruise Control (ACC) Stop-&-Go (S&G) design. A Model Predictive Control (MPC) framework is adopted to design the controller. Performance of the controller is evaluated, distinguishing between

  11. The effects of performance-based assessment criteria on student performance and self-assessment skills

    NARCIS (Netherlands)

    Fastré, Greet; Van der Klink, Marcel; Van Merriënboer, Jeroen

    2010-01-01

    Fastré, G. M. J., Van der Klink, M. R., & Van Merriënboer, J. J. G. (2010). The effects of performance-based assessment criteria on student performance and self-assessment skills. Advances in Health Science Education, 15(4), 517-532.

  12. The Performance-Based Research Fund, Gender and a Cultural Cringe

    Science.gov (United States)

    Curtis, Bruce

    2016-01-01

    This article explores ways the Performance-based Research Fund (PBRF) produces gendered results and expresses a cultural cringe. It is argued that the research evaluation is fixated with being "world-class" at the expense of academic practice that focuses on New Zealand. In this context, disadvantage faced by female academics under the…

  13. The Massachusetts Community College Performance-Based Funding Formula: A New Model for New England?

    Science.gov (United States)

    Salomon-Fernandez, Yves

    2014-01-01

    The Massachusetts community college system is entering a second year with funding for each of its 15 schools determined using a new performance-based formula. Under the new model, 50% of each college's allocation is based on performance on metrics related to enrollment and student success, with added incentives for "at-risk" students…

  14. An Analysis of Performance-Based Funding Policies and Recommendations for the Florida College System

    Science.gov (United States)

    Balog, Scott E.

    2016-01-01

    Nearly 30 states have adopted or are transitioning to performance-based funding programs for community colleges that allocate funding based on institutional performance according to defined metrics. While embraced by state lawmakers and promoted by outside advocacy groups as a method to improve student outcomes, enhance accountability and ensure…

  15. Grading the Metrics: Performance-Based Funding in the Florida State University System

    Science.gov (United States)

    Cornelius, Luke M.; Cavanaugh, Terence W.

    2016-01-01

    A policy analysis of Florida's 10-factor Performance-Based Funding system for state universities. The focus of the article is on the system of performance metrics developed by the state Board of Governors and their impact on institutions and their missions. The paper also discusses problems and issues with the metrics, their ongoing evolution, and…

  16. Minnesota's Nursing Facility Performance-Based Incentive Payment Program: An Innovative Model for Promoting Care Quality

    Science.gov (United States)

    Cooke, Valerie; Arling, Greg; Lewis, Teresa; Abrahamson, Kathleen A.; Mueller, Christine; Edstrom, Lisa

    2010-01-01

    Purpose: Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration…

  17. The Influence of Teacher Motivation in the Context of Performance-Based Compensation

    Science.gov (United States)

    Glass, Jason E.

    2011-01-01

    The purpose of this study was to examine teacher motivation in the context of performance-based compensation systems. The researcher specifically sought to address four research questions: 1. To what extent are teachers motivated for behavioristic/economic reasons and extrinsic rewards? 2. To what extent are teachers motivated for altruistic/PSM…

  18. Perceptions of success in performance-based procurement: Differences between clients and contractors

    NARCIS (Netherlands)

    van Duren, J.M.A.; Doree, Andries G.; Voordijk, Johannes T.

    2015-01-01

    Purpose – The purpose of this study is to analyse, from the perspective of agency theory, differences between client and contractor in their perceptions of changes in uncertainty and in inclination to opportunistic behaviour while using a performance-based procurement procedure. In agency theory,

  19. A comparison between prescriptive- and performance-based approaches in fire safety design of structures

    DEFF Research Database (Denmark)

    Budny, Iwona; Giuliani, Luisa

    2010-01-01

    methodology of the performance-based fire design approach is considered, with the avail of computer-aided simulations of the main frame of the car-park. Nonlinear analyses, with respect to thermally induced effects and emphasis laid to the collapse modality, are carried out on a frame of the considered...

  20. Performance-Based Compensation: Linking Performance to Teacher Salaries. Ask the Team

    Science.gov (United States)

    Behrstock-Sherratt, Ellen; Potemski, Amy

    2013-01-01

    To achieve the goal of attracting and retaining talented professionals in education, performance-based compensation systems (PBCS) must offer salaries that are both fair and sufficiently competitive at each point across an educator's career continuum. Although many states, especially with the support of the Teacher Incentive Fund (TIF) grants,…

  1. Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services. Monograph

    Science.gov (United States)

    Stecher, Brian M.; Camm, Frank; Damberg, Cheryl L.; Hamilton, Laura S.; Mullen, Kathleen J.; Nelson, Christopher; Sorensen, Paul; Wachs, Martin; Yoh, Allison; Zellman, Gail L.

    2010-01-01

    Performance-based accountability systems (PBASs), which link incentives to measured performance as a means of improving services to the public, have gained popularity. While PBASs can vary widely across sectors, they share three main components: goals, incentives, and measures. Research suggests that PBASs influence provider behaviors, but little…

  2. Persistence to Graduation for Students with Disabilities: Implications for Performance-Based Outcomes

    Science.gov (United States)

    Knight, William; Wessel, Roger D.; Markle, Larry

    2018-01-01

    The study sought to determine whether students with disabilities are disadvantaged because of state and institutional performance-based policies providing incentives for 4-year graduation. In a longitudinal study of 32,187 students at a Midwestern Research University, the retention and graduation rates, and mean years to graduation, of students…

  3. Model Solutions for Performance-Based Seismic Analysis of an Anchored Sheet Pile Quay Wall

    NARCIS (Netherlands)

    Habets, C.J.W.; Peters, D.J.; de Gijt, J.G.; Metrikine, A.; Jonkman, S.N.

    2016-01-01

    Conventional seismic designs of quay walls in ports are mostly based on pseudo-static analysis. A more advanced alternative is the Performance-Based Design (PBD) method, which evaluates permanent deformations and amounts of (repairable) damage under seismic loading. The aim of this study is to

  4. Evaluation of the Terminal Area Precision Scheduling and Spacing System for Performance-Based Navigation Arrivals

    Science.gov (United States)

    Jung, Jaewoo; Swenson, Harry; Thipphavong, Jane; Martin, Lynne Hazel; Chen, Liang; Nguyen, Jimmy

    2013-01-01

    The growth of global demand for air transportation has put increasing strain on the nation's air traffic management system. To relieve this strain, the International Civil Aviation Organization has urged all nations to adopt Performance-Based Navigation (PBN), which can help to reduce air traffic congestion, decrease aviation fuel consumption, and protect the environment. NASA has developed a Terminal Area Precision Scheduling and Spacing (TAPSS) system that can support increased use of PBN during periods of high traffic, while supporting fuel-efficient, continuous descent approaches. In the original development of this system, arrival aircraft are assigned fuel-efficient Area Navigation (RNAV) Standard Terminal Arrival Routes before their initial descent from cruise, with routing defined to a specific runway. The system also determines precise schedules for these aircraft that facilitate continuous descent through the assigned routes. To meet these schedules, controllers are given a set of advisory tools to precisely control aircraft. The TAPSS system has been evaluated in a series of human-in-the-loop (HITL) air traffic simulations during 2010 and 2011. Results indicated increased airport arrival throughput up to 10 over current operations, and maintained fuel-efficient aircraft decent profiles from the initial descent to landing with reduced controller workload. This paper focuses on results from a joint NASA and FAA HITL simulation conducted in 2012. Due to the FAA rollout of the advance terminal area PBN procedures at mid-sized airports first, the TAPSS system was modified to manage arrival aircraft as they entered Terminal Radar Approach Control (TRACON). Dallas-Love Field airport (DAL) was selected by the FAA as a representative mid-sized airport within a constrained TRACON airspace due to the close proximity of a major airport, in this case Dallas-Ft Worth International Airport, one of the busiest in the world. To address this constraint, RNAV routes and

  5. Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment.

    Science.gov (United States)

    Chen, Hui-Mei; Lin, Hsiu-Fen; Huang, Mei-Feng; Chang, Chun-Wei; Yeh, Yi-Chun; Lo, Yi-Ching; Yen, Cheng-Fang; Chen, Cheng-Sheng

    2016-01-01

    Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants' reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL), for vascular cognitive impairment (VCI) by examining its psychometric properties and diagnostic accuracy. Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD), 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE), Lawton-IADL and Barthel Index (BI), were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined. Cronbach's alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = -0.587, p cognitive domain of Lawton IADL (r = -0.663) than with physical domain of Lawton IADL (r = -0.541). The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812-0.965) to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%. The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD.

  6. Validation of Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL, a Performance- Based Measurement of Instrumental Activities of Daily Living for Patients with Vascular Cognitive Impairment.

    Directory of Open Access Journals (Sweden)

    Hui-Mei Chen

    Full Text Available Patients with cerebrovascular diseases often presented both cognitive and physical impairment. Disability in everyday functioning involving cognitive impairment among patients may be hard to completely rely on informants' reports, as their reports may be confounded with physical impairment. The aim of this study was to validate a performance-based measure of functional assessment, the Taiwan Performance-Based Instrumental Activities of Daily Living (TPIADL, for vascular cognitive impairment (VCI by examining its psychometric properties and diagnostic accuracy.Ninety-seven patients with cerebrovascular diseases, including 30 with vascular dementia (VaD, 28 with mild cognitive impairment and 39 with no cognitive impairment, and 49 healthy control adults were recruited during study period. The TPIADL, as well as the Mini Mental State Examination (MMSE, Lawton-IADL and Barthel Index (BI, were performed. The internal consistency, convergent and criteria validity of the TPIADL were examined.Cronbach's alpha of the TPIADL test was 0.84. The TPIADL scores were significantly correlated with the Lawton IADL (r = -0.587, p <0.01. Notably, the TPIADL had a higher correlation coefficient with the cognitive domain of Lawton IADL (r = -0.663 than with physical domain of Lawton IADL (r = -0.541. The area under the relative operating characteristic curve was 0.888 (95% CI = 0.812-0.965 to differentiate VaD from other groups. The optimal cut-off point of the TPIADL for detecting VaD was 6/7, which gives a sensitivity of 73.3% and a specificity of 84.5%.The TPIADL is a brief and sensitive tool for the detection of IADL impairment in patients with VaD.

  7. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  8. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  9. Performance-based training: from job and task analysis to training materials

    International Nuclear Information System (INIS)

    Davis, L.T.; Spinney, R.W.

    1983-01-01

    Historically, the smoke filled room approach has been used to revise training programs: instructors would sit down and design a program based on existing training materials and any federal requirements that applied. This failure to reflect a systematic definition of required job functions, responsibilities and performance standards in training programs has resulted in generic program deficiencies: they do not provide complete training of required skills and knowledge. Recognition of this need for change, coupled with a decrease in experienced industry personnel inputs and long training pipelines, has heightened the need for efficient performance-based training programs which are derived from and referenced to job performance criteria. This paper presents the process for developing performance-based training materials based on job and task analysis products

  10. ADMINISTRATOR’S ROLE IN PERFORMANCE BASED REWARD AS A DETERMINANT OF EMPLOYEE OUTCOMES

    Directory of Open Access Journals (Sweden)

    Azman ISMAIL

    2015-06-01

    Full Text Available According to the recent literature pertaining on workplace compensation program, administrators often play two important roles in planning and implementing performance based reward: communication and performance appraisal. Recent studies in this field highlights that the ability of administrators to appropriately communicate pay information and appraise employee performance may have a significant impact on employee outcomes, especially job satisfaction and organizational commitment. Therefore, this study was conducted to assess the relationship between administrator’s role in performance based reward and employee outcomes using self-administered questionnaires collected from employees at a district council in Malaysia. The outcomes of the SmartPLS path model analysis showed that pay communication does not act as an important determinant of job satisfaction, but performance appraisal does act as an important determinant of job satisfaction. Conversely, both pay communication and performance appraisal act as important determinants of organizational commitment. Hence, discussion, implications and conclusion are elaborated.

  11. Effect of Manager’s Role in Performance Based Pay on Employee Outcomes

    Directory of Open Access Journals (Sweden)

    Azman, I

    2014-12-01

    Full Text Available According to the recent literature pertaining on Islamic based organizational compensation, performance based pay consists of two essential features: communication and performance appraisal. Recent studies in this field highlights that the ability of managers to appropriately communicate pay information and appraise employee performance may have a significant impact on employee outcomes, especially job satisfaction and organizational commitment. Therefore, this study was undertaken to assess the relationship between manager’s role in performance based pay and employee outcomes using self-administered questionnaires collected from employees at a district council in Peninsular Malaysia. The outcomes of the SmartPLS path model analysis showed that pay communication does not act as an important determinant of job satisfaction, but performance appraisal does act as an important determinant of job satisfaction. Conversely, pay communication and performance appraisal act as important determinants of organizational commitment. In addition, this study provides discussion, implications and conclusion

  12. PERFORMANCE BASED PAY AS A DETERMINANT OF JOB SATISFACTION: A STUDY IN MALAYSIA GIATMARA CENTERS

    Directory of Open Access Journals (Sweden)

    Azman ISMAIL

    2011-01-01

    Full Text Available Compensation management literature highlights that performance based payhas two major characteristics: participation in pay systems and adequacy ofpay. The ability of management to properly implement such pay systems maylead to increased job satisfaction in organizations. Though, the nature of thisrelationship is interesting, little is known about the influence of performancebased pay on job satisfaction in compensation management literature.Therefore, this study was conducted to examine the relationship between payfor performance and job satisfaction in Malaysian GIATMARA centers. Theresults of exploratory factor analysis confirmed that measurement scalesused in this study satisfactorily met the standards of validity and reliabilityanalyses. An outcome of stepwise regression analysis shows thatdeterminant of job satisfaction is performance based pay. Further, this resultconfirms that pay for performance is an important antecedent for jobsatisfaction in the studied organizations.

  13. PERFORMANCE-BASED CONTRACTING IN CONSTRUCTION PHASE AND MAINTENANCE PHASE OF PAVEMENT

    Science.gov (United States)

    Yoshida, Takeshi

    Performance-based contracting for pavement in Japan started as performance warranties in construction phase, in 1999. Recently, road agencies have recognized the applicability of this type of contracting in outsourcing of maintenance activities. The objectives of this study are to clarify the issues of performance specifying in construction phase and maintenance phase of pavement, and to propose measures to be taken. This paper, with the recognition that the life of each pavement depends on performance standards for various attributes, reviews domestic and foreign examples of performance-based contracting. A performance standard based on the average of current practices can enhance product quality and service life with a warranty contract. Repair thresholds and response time for each deficiency should be considered as performance standards in maintenance phase.

  14. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  15. Performance-Based Risk-Sharing Arrangements: U.S. Payer Experience.

    Science.gov (United States)

    Goble, Joseph A; Ung, Brian; van Boemmel-Wegmann, Sascha; Navarro, Robert P; Parece, Andrew

    2017-10-01

    As a result of global concern about rising drug costs, many U.S. payers and European agencies such as the National Health Service have partnered with pharmaceutical companies in performance-based risk-sharing arrangements (PBRSAs) by which manufacturers share financial risk with health care purchasing entities and authorities. However, PBRSAs present many administrative and legal challenges that have minimized successful contract experiences in the United States. To (a) identify drug and disease characteristics and contract components that contribute to successful PBRSA experiences and the primary barriers to PBRSA execution and (b) explore solutions to facilitate contract negotiation and execution. A 37-item, web-based survey instrument (Qualtrics), approximately 20 minutes in duration, was open during July and August 2016. The survey was emailed to 90 pharmacy and medical directors of various health care organizations. Statistical analysis included the Kruskal-Wallis test and chi-square tests to examine differences among payer responses. Survey responses were anonymized and data were aggregated. Twenty-seven individuals completed the survey (30% completion rate). The majority of respondents worked for regional health plans (52%, n = 14), covering at least 1 million lives (63%, n = 17), with at least 7 years of managed care experience (81%, n = 22). A total of 51 PBRSAs were active among respondents at the time of the survey. Easily obtainable and evaluable drug data and medical data were the most important drug and disease attributes for successful PBRSAs, respectively. Pharmacy claims and patient demographic data were assessed as "very easy and inexpensive" to collect. Type and amount of manufacturer payment for drug outcome performance failure, endpoint measurement, and necessary clinical data for drug performance measurement were all critical factors for successful PBRSAs. Standardized contract templates and transparent contract financial risk evaluation and

  16. Comparative Analysis of Reward and Employee Performance Based on Gender at Central Bank of Bank Sulut

    OpenAIRE

    Pandowo, Merinda; Lapian, S.L.H.V Joyce; Oroh, Ryan Vitaly

    2014-01-01

    Employee are the big asset of organization. Employee Performance are have big effect of organization performance. The best way to attract employee performance is rewarding employee. Reward can be tangible such money, bonuses or called extrinsic reward and intangible reward such promotion, holiday or called intrinsic reward. The purpose of this research are to analyzed significant differences in employee performance based on reward between male and female. To achieve the objectives researcher ...

  17. Performance-based contracts for road projects comparative analysis of different types

    CERN Document Server

    Gajurel, Ashish

    2014-01-01

    This book focuses on the aspects of contracting contracts, basically related to road construction and management contracts. The book presents an analytical study of Performance-Based Road Management and Maintenance (PMMR), Funktionsbauvertrag (FBV) (Function-Based Construction Contract) and Public Private Partnerships (PPP). A separate chapter is also included about the comparative study of these contract types. The book provides useful material for university libraries, construction companies and government departments of construction.

  18. Performance-based analysis of current South African semi-trailer designs

    CSIR Research Space (South Africa)

    Thorogood, R

    2009-07-01

    Full Text Available , performance based standards, dynamic stability, tractor semi- trailers, directional response, static rollover threshold Introduction South African heavy vehicles are currently designed according to prescriptive standards designed and enforced... productivity. These include Central Tyre Inflation (CTI), on-board weighing, new materials such as Domex and vehicle satellite tracking, all leading towards increased payloads and reduced costs. There have also been improvements in technology...

  19. Performance-based standards (PBS) vehicles for transport in the agricultural sector

    CSIR Research Space (South Africa)

    Nordengen, Paul A

    2008-07-01

    Full Text Available manufacturers start designing vehicles on an ad hoc basis. It should be borne in mind that PBS vehicle designs include certain safety features, and must be loaded in the correct manner. The RTMS approach offers the most suitable way of ensuring.... The objectives of the Performance-Based Standards (PBS) philosophy are to utilise technology to reduce road damage, improve safety, increase payloads and reduce costs. To overcome the limitations of prescriptive legislation, is has been proposed that PBS...

  20. Work-family conflict, emotional exhaustion and performance-based self-esteem: reciprocal relationships.

    Science.gov (United States)

    Richter, Anne; Schraml, Karin; Leineweber, Constanze

    2015-01-01

    The three constructs of work-family conflict, emotional exhaustion and performance-based self-esteem are all related to tremendous negative consequences for the individual, the organization as well as for society. Even though there are studies that connect two of those constructs, the prospective relations between all three of them have not been studied yet. We explored the prospective relations between the three constructs in a large Swedish data set representative of the Swedish workforce. Gender differences in the relations were investigated. Longitudinal data with a 2-year time lag were gathered from 3,387 working men and women who responded to the 2006 and 2008 waves of the Swedish Longitudinal Occupational Survey of Health. Four different cross-lagged models were analysed. In the best fitting model, higher levels of work-family conflict at time 1 were associated with an increased level of performance-based self-esteem at time 2, but not with emotional exhaustion, after controlling for having children, gender, education and age. Also, relationships between emotional exhaustion at time 1 and work-family conflict and performance-based self-esteem at time 2 could be established. Furthermore, relationships between performance-based self-esteem time 1 and work-family conflict and emotional exhaustion time 2 were found. Multiple-group analysis did not show any differences in the relations of the tested constructs over time for either men or women. We conclude that the three constructs are interrelated and best understood through a reciprocal model. No differences were found between men and women.

  1. Performance-based empathy mediates the influence of working memory on social competence in schizophrenia.

    Science.gov (United States)

    Smith, Matthew J; Horan, William P; Cobia, Derin J; Karpouzian, Tatiana M; Fox, Jaclyn M; Reilly, James L; Breiter, Hans C

    2014-07-01

    Empathic deficits have been linked to poor functioning in schizophrenia, but this work is mostly limited to self-report data. This study examined whether performance-based empathy measures account for incremental variance in social competence and social attainment above and beyond self-reported empathy, neurocognition, and clinical symptoms. Given the importance of working memory in theoretical models of empathy and in the prediction of functioning in schizophrenia, we also examined whether empathy mediates the relationship between working memory and functioning. Sixty outpatients and 45 healthy controls were compared on performance-based measures of 3 key components of empathic responding, including facial affect perception, emotional empathy (affective responsiveness), and cognitive empathy (emotional perspective-taking). Participants also completed measures of self-reported empathy, neurocognition, clinical symptoms, and social competence and attainment. Patients demonstrated lower accuracy than controls across the 3 performance-based empathy measures. Among patients, these measures showed minimal relations to self-reported empathy but significantly correlated with working memory and other neurocognitive functions as well as symptom levels. Furthermore, cognitive empathy explained significant incremental variance in social competence (∆R (2) = .07, P working memory and social competence. Performance-based measures of empathy were sensitive to functionally relevant disturbances in schizophrenia. Working memory deficits appear to have an important effect on these disruptions in empathy. Empathy is emerging as a promising new area for social cognitive research and for novel recovery-oriented treatment development. © The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  2. Model Solutions for Performance-Based Seismic Analysis of an Anchored Sheet Pile Quay Wall

    OpenAIRE

    C. J. W. Habets; D. J. Peters; J. G. de Gijt; A. V. Metrikine; S. N. Jonkman

    2016-01-01

    Conventional seismic designs of quay walls in ports are mostly based on pseudo-static analysis. A more advanced alternative is the Performance-Based Design (PBD) method, which evaluates permanent deformations and amounts of (repairable) damage under seismic loading. The aim of this study is to investigate the suitability of this method for anchored sheet pile quay walls that were not purposely designed for seismic loads. A research methodology is developed in which pseudo-static, permanent-di...

  3. Reproducibility of the Internal Load and Performance-Based Responses to Simulated Amateur Boxing.

    Science.gov (United States)

    Thomson, Edward D; Lamb, Kevin L

    2017-12-01

    Thomson, ED and Lamb, KL. Reproducibility of the internal load and performance-based responses to simulated amateur boxing. J Strength Cond Res 31(12): 3396-3402, 2017-The aim of this study was to examine the reproducibility of the internal load and performance-based responses to repeated bouts of a three-round amateur boxing simulation protocol (boxing conditioning and fitness test [BOXFIT]). Twenty-eight amateur boxers completed 2 familiarization trials before performing 2 complete trials of the BOXFIT, separated by 4-7 days. To characterize the internal load, mean (HRmean) and peak (HRpeak) heart rate, breath-by-breath oxygen uptake (V[Combining Dot Above]O2), aerobic energy expenditure, excess carbon dioxide production (CO2excess), and ratings of perceived exertion were recorded throughout each round, and blood lactate determined post-BOXFIT. Additionally, an indication of the performance-based demands of the BOXFIT was provided by a measure of acceleration of the punches thrown in each round. Analyses revealed there were no significant differences (p > 0.05) between repeated trials in any round for all dependent measures. The typical error (coefficient variation %) for all but 1 marker of internal load (CO2excess) was 1.2-16.5% and reflected a consistency that was sufficient for the detection of moderate changes in variables owing to an intervention. The reproducibility of the punch accelerations was high (coefficient of variance % range = 2.1-2.7%). In general, these findings suggest that the internal load and performance-based efforts recorded during the BOXFIT are reproducible and, thereby, offer practitioners a method by which meaningful changes impacting on performance could be identified.

  4. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  5. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  6. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  7. Performance-based Reward Administration Enhancing Employees’ Feelings of Interactional Justice

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2017-04-01

    Full Text Available The transformation in international business landscape has changed organizational management especially reward administration. This is done in order to maintain the organization’s competitiveness in global market place. In the field of reward administration, an emerging trend can be observed whereby most organizations are moving toward the application of psychological elements in administering organizational reward system. The ultimate objective of this study is to investigate the association between performance-based reward administration and interactional justice. The proposed model was empirically tested using a sample of 113 employees from fire and rescue agency in Peninsular Malaysia. This study found an evidence that performance-based reward administration (i.e., communication, participation and performance appraisal is positively and significantly associated with interactional justice. This findings proves that the ability of administrators to appropriately implement communication openness, inspire participative decision-making and organize fairness performance appraisal in administering performance-based reward have significantly evoked the feeling of interactional justice when employees perceived that they are being fairly treated in the reward system.

  8. Performance-based contracting for maintaining transportation assets with emphasis on bridges

    Directory of Open Access Journals (Sweden)

    Alsharqawi Mohammed

    2017-01-01

    Full Text Available With a large number of aging transportation infrastructure assets in North America and the growing problem of deterioration across the globe, managing these assets have been the subject of ongoing research. There is an overwhelming amount of maintenance and rehabilitation works to be done and selecting a suitable maintenance, repair or replacement (MRR strategy is one of the most challenging tasks for decision makers. Limited budget and resources are even making the decision making process more challenging. Maintaining infrastructure to the highest possible condition while investing the minimal amount of money has promoted innovative contracting approaches. Transportation agencies have increased private sector involvement through long term performance-based maintenance contracts or what is called Performance-Based Contracting. PBC is a type of contract that pays a contractor based on the results achieved, not on the methods for performing the maintenance work. By looking into the literature, it is observed that agencies are expanding the amount of contracting they do in order to maintain and achieve a better standard of infrastructure facilities. Therefore, the objective of this paper is to study and review performance-based contracting for transportation infrastructure with emphasis on bridge assets.

  9. Current status and trends in performance-based risk-sharing arrangements between healthcare payers and medical product manufacturers.

    Science.gov (United States)

    Carlson, Josh J; Gries, Katharine S; Yeung, Kai; Sullivan, Sean D; Garrison, Louis P

    2014-06-01

    Our objective was to identify and characterize publicly available cases and related trends for performance-based risk-sharing arrangements (PBRSAs). We performed a review of PBRSAs over the past 20 years (1993-2013) using available databases and reports from colleagues and healthcare experts. These were categorized according to a previously published taxonomy of scheme types and assessed in terms of the underlying product and market attributes for each scheme. Macro-level trends were identified related to the timing of scheme adoption, countries involved, types of arrangements, and product and market factors. Our search yielded 148 arrangements. From this set, 65 arrangements included a coverage with an evidence development component, 20 included a conditional treatment continuation component, 54 included a performance-linked reimbursement component, and 42 included a financial utilization component. Each type of scheme addresses fundamental uncertainties that exist when products enter the market. The pace of adoption appears to be slowing, but new countries continue to implement PBRSAs. Over this 20-year period, there has been a consistent movement toward arrangements that minimize administrative burden. In conclusion, the pace of PBRSA adoption appears to be slowing but still has traction in many health systems. These remain a viable coverage and reimbursement mechanism for a wide range of medical products. The long-term viability and growth of these arrangements will rest in the ability of the parties to develop mutually beneficial arrangements that entail minimal administrative burden in their development and implementation.

  10. Time Functions as Utilities

    Science.gov (United States)

    Minguzzi, E.

    2010-09-01

    Every time function on spacetime gives a (continuous) total preordering of the spacetime events which respects the notion of causal precedence. The problem of the existence of a (semi-)time function on spacetime and the problem of recovering the causal structure starting from the set of time functions are studied. It is pointed out that these problems have an analog in the field of microeconomics known as utility theory. In a chronological spacetime the semi-time functions correspond to the utilities for the chronological relation, while in a K-causal (stably causal) spacetime the time functions correspond to the utilities for the K + relation (Seifert’s relation). By exploiting this analogy, we are able to import some mathematical results, most notably Peleg’s and Levin’s theorems, to the spacetime framework. As a consequence, we prove that a K-causal (i.e. stably causal) spacetime admits a time function and that the time or temporal functions can be used to recover the K + (or Seifert) relation which indeed turns out to be the intersection of the time or temporal orderings. This result tells us in which circumstances it is possible to recover the chronological or causal relation starting from the set of time or temporal functions allowed by the spacetime. Moreover, it is proved that a chronological spacetime in which the closure of the causal relation is transitive (for instance a reflective spacetime) admits a semi-time function. Along the way a new proof avoiding smoothing techniques is given that the existence of a time function implies stable causality, and a new short proof of the equivalence between K-causality and stable causality is given which takes advantage of Levin’s theorem and smoothing techniques.

  11. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  12. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  13. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  14. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  15. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  16. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  17. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  18. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  19. Performance-based contracting in home-care work in The Netherlands: professionalism under pressure?

    Science.gov (United States)

    Oomkens, Rosanne; Hoogenboom, Marcel; Knijn, Trudie

    2016-07-01

    Our aim was to improve the understanding of the relationships between performance-based contracting, management supportiveness and professionalism in home care. Using path analysis, this article explores the relationships between home-care workers' perceptions of management support, implementation of performance-based contracting (i.e. use of strict time registration rules and cost-efficiency measures) and autonomy and intrinsic job satisfaction. We hypothesised that: use of strict time registration rules and cost-efficiency measures relates to lower levels of autonomy and intrinsic job satisfaction (H1); there is an indirect relationship between use of strict time registration rules and use of cost-efficiency measures and intrinsic job satisfaction via autonomy (H2); higher levels of management support relate to the use of looser time registration rules and less use of cost-efficiency measures (H3); and higher levels of management support relate to higher levels of autonomy and intrinsic job satisfaction (H4). We used data from a cross-sectional survey conducted in 2010 of a sample of Dutch home-care workers (N = 156, response rate = 34%). Overall, our study suggests that the consequences of performance-based contracting for professionalism are ambiguous. More specifically, using strict time registration rules is related to lower levels of autonomy, whereas using cost-efficiency measures does not seem to affect autonomy (H1). Performance-based contracting has no consequences for the level of fulfilment home-care workers find in their job, as neither of the two contracting dimensions measured was directly or indirectly related to intrinsic job satisfaction (H1, H2). The role of managers must be taken into account when studying performance-based contracting, because perceived higher management support is related to managers' less frequent use of both strict time registration rules and of cost-efficiency measures (H3). The insight we gained into the importance of

  20. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  1. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  2. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  3. Costs of performance based maintenance for local roads: Case study Albania

    Science.gov (United States)

    Jokanović, Igor; Grujić, Bojana; Zeljić, Dragana; Grujić, Žarko; Svilar, Mila

    2017-12-01

    The provision and maintenance of road infrastructure is a major global business, consequently it is essential that road maintenance services are provided in the most cost effective manner. Without regular maintenance, roads can rapidly fall into disrepair, preventing realization of the longer term impacts of road improvements on development, such as increased agricultural production and growth in school enrollment, which is of particular importance for a network of local (access) roads. Inadequate local roads maintenance in Albania is proposed to be solved by implementing performance based maintenance approach for which the costing exercise is presented within the paper.

  4. Evaluation of a Performance-Based Expert Elicitation: WHO Global Attribution of Foodborne Diseases

    DEFF Research Database (Denmark)

    Aspinall, W. P.; Cooke, R. M.; Havelaar, A. H.

    2016-01-01

    . This paper presents new findings from a large-scale international SEJ study intended to estimate the global burden of foodborne disease on behalf of WHO. The study involved 72 experts distributed over 134 expert panels, with panels comprising thirteen experts on average. Elicitations were conducted in five...... languages. Performance-based weighted solutions for target questions of interest were formed for each panel. These weights were based on individual expert's statistical accuracy and informativeness, determined using between ten and fifteen calibration variables from the experts' field with known values...

  5. Performance-Based Technology Selection Filter description report. INEL Buried Waste Integrated Demonstration System Analysis project

    Energy Technology Data Exchange (ETDEWEB)

    O`Brien, M.C.; Morrison, J.L.; Morneau, R.A.; Rudin, M.J.; Richardson, J.G.

    1992-05-01

    A formal methodology has been developed for identifying technology gaps and assessing innovative or postulated technologies for inclusion in proposed Buried Waste Integrated Demonstration (BWID) remediation systems. Called the Performance-Based Technology Selection Filter, the methodology provides a formalized selection process where technologies and systems are rated and assessments made based on performance measures, and regulatory and technical requirements. The results are auditable, and can be validated with field data. This analysis methodology will be applied to the remedial action of transuranic contaminated waste pits and trenches buried at the Idaho National Engineering Laboratory (INEL).

  6. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis

    DEFF Research Database (Denmark)

    Dobson, F; Hinman, R S; Hall, M

    2012-01-01

    OBJECTIVES: To systematically review the measurement properties of performance-based measures to assess physical function in people with hip and/or knee osteoarthritis (OA). METHODS: Electronic searches were performed in MEDLINE, CINAHL, Embase, and PsycINFO up to the end of June 2012. Two...... investigating measurement properties of performance measures, including responsiveness and interpretability in people with hip and/or knee OA, is needed. Consensus on which combination of measures will best assess physical function in people with hip/and or knee OA is urgently required....

  7. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  8. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  9. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  10. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  11. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  12. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  13. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  14. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  15. From 'Compliance-based' to 'Performance-based' Quality - A trend in and evolution of U. S. quality standards

    International Nuclear Information System (INIS)

    Brown, Douglas A.; Taylor, H. Stephen; Johnson, Robert B.; Erler, Bryan A.; Daley, Thomas J.

    1995-01-01

    efficient utilization of nuclear energy are outlined. These controls are reflected in a draft addenda to NQA-1. While recognizing that there are specific regulatory requirements that NQA-1 must continue to reflect, the draft addenda shifts its focus to the achievement of results, i. e., 'performance-based' quality. It emphasizes the roles of the individual worker and line management in the achievement of quality. The draft addenda to NQA-1 also encourages the application of requirements in a manner relative to the importance of the item or activity. This is consistent with a trend in the industry to go to a 'graded' approach to quality based on the safety significance of structures, systems, and components. At present, equal priority and levels of requirements are often applied to items, activities, and issues irrespective of their safety significance. A 'graded' approach to quality, with multiple levels of breadth and/or depth of requirements, provides potential material cost and labor savings. It also allows for categorization of issues so that they can be resolved in a time-frame commensurate with their safety significance

  16. Performance-based interpretation bias in clinically anxious youths: relationships with attention, anxiety, and negative cognition.

    Science.gov (United States)

    Rozenman, Michelle; Amir, Nader; Weersing, V Robin

    2014-09-01

    This preliminary investigation sought to examine basic interpretive biases, as assessed via performance-based means, in the context of anxious symptomatology, attention, and negative cognition in children and adolescents. At a single assessment, 26 youths diagnosed with primary separation anxiety, social phobia, or generalized anxiety disorder completed performance-based assessments of interpretation and attention. Youths and parents also completed diagnostic interviews and youths completed a measure of negative self-statements. Components of interpretation (threat-valence judgments and speed of responding) were examined, and interpretation was explored as a correlate of youth anxiety, attention bias, and negative self-statements. Results found percentage of negative interpretations endorsed as the strongest predictor of anxiety symptoms; this index was also correlated with attention bias. Slower rejection of benign interpretations was also associated with youth-reported negative self-statements.This initial investigation provides support for a relationship between interpretation bias and anxiety and preliminary evidence for a relationship between attention and interpretation biases. Continued research dismantling the stages of basic cognition within the chain of information processing may provide a better understanding of the mechanisms underlying anxiety disorders in youths and lead to continued development and refinement of cognitive interventions. Copyright © 2014. Published by Elsevier Ltd.

  17. Quality performance-based training enhances safe and effective transport operations

    International Nuclear Information System (INIS)

    McCall, D.L.

    1993-01-01

    If the hazardous materials transportation industry is to reduce human error, reduce accidents, and improve its public image, there must be assurance that transportation personnel are properly trained and qualified to perform their jobs in a safe and efficient manner. This training must make them intimately aware of the hazards and risks associated with transport activities, ensure understanding of responsibilities and liabilities unique to their job, and ensure that they can competently perform functional duties vital to safety. To ensure that trained and qualified personnel are on the job, it is essential that the training be performance-based and require trainees to demonstrate functional proficiency. Performance-based training has proven to be a highly effective means of ensuring personnel are qualified to conduct their assignments safely and efficiently. This training is designed around the basic premise that training must be provided that supplies the information necessary for each worker to perform their assigned duties at a predetermined and acceptable level of expertise and skill. (J.P.N.)

  18. The development of performance-based practical assessment model at civil engineering workshop in state polytechnic

    Science.gov (United States)

    Kristinayanti, W. S.; Mas Pertiwi, I. G. A. I.; Evin Yudhi, S.; Lokantara, W. D.

    2018-01-01

    Assessment is an important element in education that shall oversees students’ competence not only in terms of cognitive aspect, but alsothe students’ psychomotorin a comprehensive way. Civil Engineering Department at Bali State Polytechnic,as a vocational education institution, emphasizes on not only the theoretical foundation of the study, but also the application throughpracticum in workshop-based learning. We are aware of a need for performance-based assessment for these students, which would be essential for the student’s all-round performance in their studies.We try to develop a performance-based practicum assessment model that is needed to assess student’s ability in workshop-based learning. This research was conducted in three stages, 1) learning needs analysis, 2) instruments development, and 3) testing of instruments. The study uses rubrics set-up to test students’ competence in the workshop and test the validity. We obtained 34-point valid statement out of 35, and resulted in value of Cronbach’s alpha equal to 0.977. In expert test we obtained a value of CVI = 0.75 which means that the drafted assessment is empirically valid within thetrial group.

  19. Development of a Performance-Based Measure of Executive Functions in Patients with Schizophrenia.

    Directory of Open Access Journals (Sweden)

    En-Chi Chiu

    Full Text Available A performance-based measure for assessing executive functions (EF is useful to understand patients' real life performance of EF. This study aimed to develop a performance-based measure of executive functions (PEF based on the Lezak model and to examine psychometric properties (i.e., unidimensionality and reliability of the PEF using Rasch analysis in patients with schizophrenia. We developed the PEF in three phases: (1 designing the preliminary version of PEF; (2 consultation with experts, cognitive interviews with patients, and pilot tests on patients to revise the preliminary PEF; (3 establishment of the final version of the PEF and examination of unidimensionality and Rasch reliability. Two hundred patients were assessed using the revised PEF. After deleting items which did not satisfy the Rasch model's expectations, the final version of the PEF contained 1 practice item and 13 test items for assessing the four domains of EF (i.e., volition, planning, purposive action, and effective performance. For unidimensional and multidimensional Rasch analyses, the 4 domains showed good reliability (i.e., 0.77-0.85 and 0.87-0.90, respectively. Our results showed that the PEF had satisfactory unidimensionality and Rasch reliability. Therefore, clinicians and researchers could use the PEF to assess the four domains of EF in patients with schizophrenia.

  20. Comparison of self-reported and performance-based measures of functional ability in elderly patients in an emergency department

    DEFF Research Database (Denmark)

    Nielsen, Louise M.; Kirkegaard, Hans; Østergaard, Lisa Gregersen

    2016-01-01

    Background Assessment of functional ability in elderly patients is often based on self-reported rather than performance-based measures. This study aims to compare self-reported and performance-based measures of functional ability in a population of elderly patients at an emergency department (ED)...

  1. Are performance-based measures predictive of work participation in patients with musculoskeletal disorders? A systematic review

    NARCIS (Netherlands)

    Kuijer, P. P. F. M.; Gouttebarge, V.; Brouwer, S.; Reneman, M. F.; Frings-Dresen, M. H. W.

    Assessments of whether patients with musculoskeletal disorders (MSDs) can participate in work mainly consist of case history, physical examinations, and self-reports. Performance-based measures might add value in these assessments. This study answers the question: how well do performance-based

  2. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis

    DEFF Research Database (Denmark)

    Dobson, F; Hinman, R S; Roos, Ewa M.

    2013-01-01

    To recommend a consensus-derived set of performance-based tests of physical function for use in people diagnosed with hip or knee osteoarthritis (OA) or following joint replacement.......To recommend a consensus-derived set of performance-based tests of physical function for use in people diagnosed with hip or knee osteoarthritis (OA) or following joint replacement....

  3. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  4. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  5. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  6. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  7. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  8. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  9. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  10. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  11. Total quality in spent fuel pool reracking

    International Nuclear Information System (INIS)

    Cranston, J.S.; Bradbury, R.B.; Cacciapouti, R.J.

    1993-01-01

    The nuclear utility environment is one of strict cost control under prescriptive regulations and increasing public scrutiny. This paper presents the results of A Total Quality approach, by a dedicated team, that addresses the need for increased on-site spent fuel storage in this environment. Innovations to spent fuel pool reracking, driven by utilities' specific technical needs and shrinking budgets, have resulted in both product improvements and lower prices. A Total Quality approach to the entire turnkey project is taken, thereby creating synergism and process efficiency in each of the major phases of the project: design and analysis, licensing, fabrication, installation and disposal. Specific technical advances and the proven quality of the team members minimizes risk to the utility and its shareholders and provides a complete, cost effective service. Proper evaluation of spent fuel storage methods and vendors requires a full understanding of currently available customer driven initiatives that reduce cost while improving quality. In all phases of a spent fuel reracking project, from new rack design and analysis through old rack disposal, the integration of diverse experts, at all levels and throughout all phases of a reracking project, better serves utility needs. This Total Quality environment in conjunction with many technical improvements results in a higher quality product at a lower cost

  12. Are health workers motivated by income? Job motivation of Cambodian primary health workers implementing performance-based financing.

    Science.gov (United States)

    Khim, Keovathanak

    2016-01-01

    Financial incentives are widely used in performance-based financing (PBF) schemes, but their contribution to health workers' incomes and job motivation is poorly understood. Cambodia undertook health sector reform from the middle of 2009 and PBF was employed as a part of the reform process. This study examines job motivation for primary health workers (PHWs) under PBF reform in Cambodia and assesses the relationship between job motivation and income. A cross-sectional self-administered survey was conducted on 266 PHWs, from 54 health centers in the 15 districts involved in the reform. The health workers were asked to report all sources of income from public sector jobs and provide answers to 20 items related to job motivation. Factor analysis was conducted to identify the latent variables of job motivation. Factors associated with motivation were identified through multivariable regression. PHWs reported multiple sources of income and an average total income of US$190 per month. Financial incentives under the PBF scheme account for 42% of the average total income. PHWs had an index motivation score of 4.9 (on a scale from one to six), suggesting they had generally high job motivation that was related to a sense of community service, respect, and job benefits. Regression analysis indicated that income and the perception of a fair distribution of incentives were both statistically significant in association with higher job motivation scores. Financial incentives used in the reform formed a significant part of health workers' income and influenced their job motivation. Improving job motivation requires fixing payment mechanisms and increasing the size of incentives. PBF is more likely to succeed when income, training needs, and the desire for a sense of community service are addressed and institutionalized within the health system.

  13. Entrez Programming Utilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Entrez Programming Utilities (E-utilities) are a set of eight server-side programs that provide a stable interface into the Entrez query and database system at...

  14. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  15. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  16. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  17. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  18. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  19. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  20. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  1. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  2. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  3. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  4. Total Lightning as an Indicator of Mesocyclone Behavior

    Science.gov (United States)

    Stough, Sarah M.; Carey, Lawrence D.; Schultz, Christopher J.

    2014-01-01

    Apparent relationship between total lightning (in-cloud and cloud to ground) and severe weather suggests its operational utility. Goal of fusion of total lightning with proven tools (i.e., radar lightning algorithms. Preliminary work here investigates circulation from Weather Suveilance Radar- 1988 Doppler (WSR-88D) coupled with total lightning data from Lightning Mapping Arrays.

  5. Scaling earthquake ground motions for performance-based assessment of buildings

    Science.gov (United States)

    Huang, Y.-N.; Whittaker, A.S.; Luco, N.; Hamburger, R.O.

    2011-01-01

    The impact of alternate ground-motion scaling procedures on the distribution of displacement responses in simplified structural systems is investigated. Recommendations are provided for selecting and scaling ground motions for performance-based assessment of buildings. Four scaling methods are studied, namely, (1)geometric-mean scaling of pairs of ground motions, (2)spectrum matching of ground motions, (3)first-mode-period scaling to a target spectral acceleration, and (4)scaling of ground motions per the distribution of spectral demands. Data were developed by nonlinear response-history analysis of a large family of nonlinear single degree-of-freedom (SDOF) oscillators that could represent fixed-base and base-isolated structures. The advantages and disadvantages of each scaling method are discussed. The relationship between spectral shape and a ground-motion randomness parameter, is presented. A scaling procedure that explicitly considers spectral shape is proposed. ?? 2011 American Society of Civil Engineers.

  6. ANALISA RISIKO TAHAP PERAWATAN JALAN DALAM PENERAPAN PERFORMANCE BASED CONTRACT PADA PROYEK JALAN DI JAWA TIMUR

    Directory of Open Access Journals (Sweden)

    Eko Prihartanto

    2016-06-01

    Full Text Available Road as the main infrastructure in cross overland to connect starting area to the destination area. The level of damage that occurred after the implementation reduce the road’s service quality. Performance Based Contract (PBC has stages such as Design, Build, Operation, and Maintenance. PBC is expected to minimize the budget for road construction due to damage that routinely occurs every year. PBC has the maintenance stage to meet the performance who have risk reducing road maintenance after road completion and operation. Risk variables in this study use variables in the maintenance stage from the PBC application in Eastern Java road project. It uses Probability Impact Analysis method to analyze road maintenance risk in PBC application. The results are highest score of risk variable in the maintenance stage as the descriptive analysis references to compare the threat and opportunity in PBC application. Then, it is used to create strategy in order to fulfil dominant risk in the maintenance stage.

  7. Advanced nuclear power plant regulation using risk-informed and performance-based methods

    International Nuclear Information System (INIS)

    Modarres, Mohammad

    2009-01-01

    This paper proposes and discusses implications of a largely probabilistic regulatory framework using best-estimate, goal-driven, risk-informed, and performance-based methods. This framework relies on continuous probabilistic assessment of performance of a set of time-dependent, safety-critical systems, structures, components, and procedures that assure attainment of a broad set of overarching technology-neutral protective, mitigative, and preventive goals under all phases of plant operations. In this framework acceptable levels of performance are set through formal apportionment so that they are commensurate with the overarching goals. Regulatory acceptance would be the based on the confidence level with which the plant conforms to these goals and performance objectives. The proposed framework uses the traditional defense-in-depth design and operation regulatory philosophy when uncertainty in conforming to specific goals and objectives is high. Finally, the paper discusses the steps needed to develop a corresponding technology-neutral regulatory approach from the proposed framework

  8. Managing wind turbine reliability and maintenance via performance-based contract

    DEFF Research Database (Denmark)

    Jin, Tongdan; Ding, Yi; Guo, Huairui

    2012-01-01

    between system cost, reliability and spare parts stocking. This analytical insight into the system performance allows the turbine manufacturer to optimize design, production, and after-sales services. The study aims to create a theoretical basis to facilitate the transition of the maintenance paradigm......Performance-based contracting (PBC) is reshaping the acquisition, operation, and maintenance of capital equipment. Under the PBC scheme, we propose a holistic approach for lowering the cost of wind turbine ownership while meeting the availability requirement. Our effects are focused on integrated...... firms who design and market wind turbines, and also provide maintenance and repair service. PBC differs from conventional service contracts in that the wind farmers compensate the service provider for the system performance, not the spare parts and repair labor. We explore the analytical relationship...

  9. Analysis of concept and application or Risk-Informed Performed-Based Regulation (RI-PBR)

    International Nuclear Information System (INIS)

    Kim, W. S.; Sung, K. Y.; Lee, C. J.; Kim, H. J.

    2002-01-01

    For improving regulation of nuclear power plants, the USNRC is adopting the Risk-Informed Performance-Based Regulation (RI-PBR) as an alternative, in parallel with implementing current deterministic regulation. This paper introduces a research plan for 'Institutionalization of RI-PBR' that is being conducted by KINS as a national project for evaluating feasibility for application of the alternative to Korean regulation system. Analysis of regulation characteristics, case study and experience on RI-PBR were presented as interim research results. In addition, the future plan of development of RI-PBR concept as understandable to the public and evaluation of level of techniques needed for implementation of RI-PBR was introduced

  10. Development of a performance-based industrial energy efficiency indicator for corn refining plants.

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, G. A.; Decision and Information Sciences; USEPA

    2006-07-31

    Organizations that implement strategic energy management programs have the potential to achieve sustained energy savings if the programs are carried out properly. A key opportunity for achieving energy savings that plant managers can take is to determine an appropriate level of energy performance by comparing their plant's performance with that of similar plants in the same industry. Manufacturing facilities can set energy efficiency targets by using performance-based indicators. The U.S. Environmental Protection Agency (EPA), through its ENERGY STAR{reg_sign} program, has been developing plant energy performance indicators (EPIs) to encourage a variety of U.S. industries to use energy more efficiently. This report describes work with the corn refining industry to provide a plant-level indicator of energy efficiency for facilities that produce a variety of products--including corn starch, corn oil, animal feed, corn sweeteners, and ethanol--for the paper, food, beverage, and other industries in the United States. Consideration is given to the role that performance-based indicators play in motivating change; the steps needed to develop indicators, including interacting with an industry to secure adequate data for an indicator; and the actual application and use of an indicator when complete. How indicators are employed in the EPA's efforts to encourage industries to voluntarily improve their use of energy is discussed as well. The report describes the data and statistical methods used to construct the EPI for corn refining plants. Individual equations are presented, as are the instructions for using them in an associated Excel spreadsheet.

  11. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

  12. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  13. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  14. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Monopolist requires totally liberalization

    International Nuclear Information System (INIS)

    Janoska, J.

    2003-01-01

    Slovenske elektrarne (SE), a.s, Bratislava in present time operates some sources, which would be off at normal conditions. It was caused by high electricity price on European markets. It is possible to sell 1 MWh for 12 thousands Slovak crowns abroad in last months. It is also advantageous to initialise thermal sources for power plant, where variable expenses are higher - from 1200 to 1300 Slovak crowns per MWh. SE are mainly trying to sell most of electricity on domestic market because returnability of dominant nuclear power plants was projected for this market. Utilizing capacities profit via domestic market covers fixed costs of power plants. Besides, power plant can demand regulated price 1272 Slovak crowns per 1 MWh. SE sources have capacity of 6800 MW, but maximal daily load uses for example in December approximately 4000 MW. Overflows are more higher in the summer - load dropped to 2200 MW in the beginning of September in last year. It is noted in issue that price increase in Europe is noticed. Price of primary power electricity will remain at liquid markets at 28 Euro (1176 Slovak crowns) in the following year prices fluctuate from 38 to 40 Euro (to 1700 Slovak crowns) per 1 MW at load peaks. Price increase is caused by lack of sources - it does not keep up to satisfy demand increase. Sources are gradually laid up and no new sources are built. Production capacities will decrease also in SE - by laying up of two 440 MW blocks of Bohunice NPP V-1. Price increase trend will continue according to SE businessmen till it is advantageous to build new source. Present price trend can be accelerated by decision about completing of Mochovce NPP 3-4

  16. Assessing control of postural stability in community-living older adults using performance-based limits of stability

    DEFF Research Database (Denmark)

    Jbabdi, Myriam; Boissy, Patrice; Hamel, Mathieu

    2008-01-01

    BACKGROUND: Balance disability measurements routinely used to identify fall risks in frail populations have limited value in the early detection of postural stability deficits in community-living older adults. The objectives of the study were to 1) measure performance-based limits of stability (LOS......-session performance variability during multiple trials using the performance-based LOS paradigm. METHODS: Twenty-four healthy community-living older adults (10 men, 14 women) aged between 62 to 85 (mean age +/- sd, 71.5 +/- 6 yrs) participated in the study. Subjects' performance-based LOS were established by asking...

  17. Da abordagem do TQM (Total Quality Management Ao GQM (Global Quality Management: a inserção e utilização da metodologia do projeto axiomático no desenvolvimento de modelos de gestão sistêmica da qualidade From the TQM (Total Quality Management approach to GQM (Global Quality Management: the insertion and utilization of the axiomatic design methodology in the development of a quality systemic management model

    Directory of Open Access Journals (Sweden)

    Felipe Araújo Calarge

    2001-08-01

    Full Text Available A palavra qualidade tem sido nos últimos anos sinônimo de sucesso ou fracasso em muitas empresas, sendo que esta situação resulta de como estas empresas compreendem os conceitos de qualidade. O desenvolvimento destes conceitos tem feito com que a qualidade deixe de ser simplesmente um meio de controle de produtos e processos, a fim de se desenvolver uma abordagem sistêmica de gestão da qualidade para toda a organização. O objetivo deste artigo é apresentar uma proposta de um modelo de gestão sistêmica da qualidade orientado pelas necessidades e atributos do cliente de uma empresa. No desenvolvimento deste trabalho é utilizado a abordagem do Projeto Axiomático, estabelecida em função de axiomas, corolários e teoremas, com o objetivo de implementar "boas práticas de projeto" na construção do modelo de gestão sistêmica da qualidade.In the past The the word quality has been in the past years synonymous of success or loss failure in many firms, and this situation is a results in of how these firms understanding the quality concepts. The development of these are responsible for a kind of quality that has simply last its original means concerning quality concepts has made that the quality abandons the simple way of products and processes control, in order to develop a systemic approach of quality management in the whole organization. The objective of this paper is to present a proposal of a quality systemic management model oriented by taking into account the firm's customer wants and attributes characteristics . In For the development of this work it is utilized the Axiomatic Design approach is used, which is established in function of axioms, corollaries and theorems, with the objective of to improve "good practices of design" in the construction of the quality systemic management model.

  18. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  19. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  20. Risk Management and Simulation Based Live Fire Test and Evaluation in the Performance Based Defense Business Environment

    National Research Council Canada - National Science Library

    Brown, R

    1999-01-01

    The objective of this analysis is to reduce the policy and management process costs of Congressionally mandated Live Fire Test and Evaluation procedures in the new Performance Based Defense Acquisition environment...

  1. Relationship between psychological factors and performance-based and self-reported disability in chronic low back pain

    NARCIS (Netherlands)

    Schiphorst Preuper, H.R.; Reneman, M.F.; Boonstra, Antje; Dijkstra, P.U.; Versteegen, G.J.; Geertzen, J.H.; Brouwer, S.

    2008-01-01

    Cross sectional study, performed in an outpatient university based pain rehabilitation setting. To analyze the relationship between psychological factors (psychosocial distress, depression, self efficacy, self-esteem, fear of movement, pain cognitions and coping reactions) and performance-based and

  2. Toward a Culture of Consequences: Performance-Based Accountability Systems for Public Services.

    Science.gov (United States)

    Stecher, Brian M; Camm, Frank; Damberg, Cheryl L; Hamilton, Laura S; Mullen, Kathleen J; Nelson, Christopher; Sorensen, Paul; Wachs, Martin; Yoh, Allison; Zellman, Gail L; Leuschner, Kristin J; Camm, Frank; Stecher, Brian M

    2012-01-01

    Performance-based accountability systems (PBASs), which link incentives to measured performance as a means of improving services to the public, have gained popularity. While PBASs can vary widely across sectors, they share three main components: goals, incentives, and measures. Research suggests that PBASs influence provider behaviors, but little is known about PBAS effectiveness at achieving performance goals or about government and agency experiences. This study examines nine PBASs that are drawn from five sectors: child care, education, health care, public health emergency preparedness, and transportation. In the right circumstances, a PBAS can be an effective strategy for improving service delivery. Optimum circumstances include having a widely shared goal, unambiguous observable measures, meaningful incentives for those with control over the relevant inputs and processes, few competing interests, and adequate resources to design, implement, and operate the PBAS. However, these conditions are rarely fully realized, so it is difficult to design and implement PBASs that are uniformly effective. PBASs represent a promising policy option for improving the quality of service-delivery activities in many contexts. The evidence supports continued experimentation with and adoption of this approach in appropriate circumstances. Even so, PBAS design and its prospects for success depend on the context in which it will operate. Also, ongoing system evaluation and monitoring are integral components of a PBAS; they inform refinements that improve system functioning over time. Empirical evidence of the effects of performance-based public management is scarce. This article also describes a framework used to evaluate a PBAS. Such a system identifies individuals or organizations that must change their behavior for the performance of an activity to improve, chooses an implicit or explicit incentive structure to motivate these organizations or individuals to change, and then

  3. An Analysis of Organizational Performance Based on Hospital Specialization Level and Strategy Type.

    Science.gov (United States)

    Kim, Han-Sung; Kim, Young-Hoon; Woo, Jung-Sik; Hyun, Sook-Jung

    2015-01-01

    Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized. This study uses the information theory index (ITI) and the Herfindahl-Hirschman index (HHI) to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care. The results show that a focused strategy (high HHI) improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI) improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds). In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care.

  4. IMPROVING THE TRANSMISSION PERFORMANCE BASED ON MINIMIZING ENERGY IN MOBILE ADHOC NETWORKS

    Directory of Open Access Journals (Sweden)

    Gundala Swathi

    2015-06-01

    Full Text Available Networking is collectively no of mobile nodes allocate users to correctly detect a distant environment. These wireless mobile networks want strong but simple, scalable, energy efficient and also self organize routing algorithms. In Mobile technology small quantity of power electronics and less power radio frequency have permit the expansion of small, comparatively economical and less power nodes, are associated in a wireless mobile networkIn this study we proposed method are: energy effectiveness, energetic occurrence zone and multiple hop TRANSMIT, taking into concern between the energy of transmit nodes and distance from the transmit node to the trusted neighbor node, link weight energy utilization and distance are measured as most important constraint for decide on greatest possible path from Zone Head (ZH to the neighbor node. In this we use the different constraints and lessen the quantity of distribution messages during the Transmit node choice point to decrease the energy utilization of the complete network.

  5. Performance Based Evaluation of Concrete Strength under Various Curing Conditions to Investigate Climate Change Effects

    Directory of Open Access Journals (Sweden)

    Tae-Kyun Kim

    2015-07-01

    Full Text Available Recently, the manifestation of global warming-induced climate change has been observed through super typhoons, heavy snowfalls, torrential rains, and extended heat waves. These climate changes have been occurring all over the world and natural disasters have caused severe damage and deterioration of concrete structures and infrastructure. In an effort to deal with these problems due to extreme and abnormal climate changes, studies have been conducted to develop construction technologies and design guidelines. Nevertheless, study results applicable to construction sites continue to be ineffective and insufficient. Therefore, this study proposes ways to cope with climate change by considering the effect of concrete curing condition variations on concrete material performance. More specifically, the 3-, 7- and 28-day compressive and split tensile strength properties of concrete mix cured under various climatic factors including temperature, relative humidity, wind speed, and sunlight exposure time were evaluated to determine whether the concrete meets the current design requirements. Thereafter, a performance based evaluation (PBE was performed using satisfaction probabilities based on the test values to understand the problems associated with the current mix proportion design practice and to identify countermeasures to deal with climate change-induced curing conditions.

  6. Evaluation of the Terminal Sequencing and Spacing System for Performance Based Navigation Arrivals

    Science.gov (United States)

    Thipphavong, Jane; Jung, Jaewoo; Swenson, Harry N.; Martin, Lynne; Lin, Melody; Nguyen, Jimmy

    2013-01-01

    NASA has developed the Terminal Sequencing and Spacing (TSS) system, a suite of advanced arrival management technologies combining timebased scheduling and controller precision spacing tools. TSS is a ground-based controller automation tool that facilitates sequencing and merging arrivals that have both current standard ATC routes and terminal Performance-Based Navigation (PBN) routes, especially during highly congested demand periods. In collaboration with the FAA and MITRE's Center for Advanced Aviation System Development (CAASD), TSS system performance was evaluated in human-in-the-loop (HITL) simulations with currently active controllers as participants. Traffic scenarios had mixed Area Navigation (RNAV) and Required Navigation Performance (RNP) equipage, where the more advanced RNP-equipped aircraft had preferential treatment with a shorter approach option. Simulation results indicate the TSS system achieved benefits by enabling PBN, while maintaining high throughput rates-10% above baseline demand levels. Flight path predictability improved, where path deviation was reduced by 2 NM on average and variance in the downwind leg length was 75% less. Arrivals flew more fuel-efficient descents for longer, spending an average of 39 seconds less in step-down level altitude segments. Self-reported controller workload was reduced, with statistically significant differences at the p less than 0.01 level. The RNP-equipped arrivals were also able to more frequently capitalize on the benefits of being "Best-Equipped, Best- Served" (BEBS), where less vectoring was needed and nearly all RNP approaches were conducted without interruption.

  7. Performance-based methodology for assessing seismic vulnerability and capacity of buildings

    Science.gov (United States)

    Shibin, Lin; Lili, Xie; Maosheng, Gong; Ming, Li

    2010-06-01

    This paper presents a performance-based methodology for the assessment of seismic vulnerability and capacity of buildings. The vulnerability assessment methodology is based on the HAZUS methodology and the improved capacitydemand-diagram method. The spectral displacement ( S d ) of performance points on a capacity curve is used to estimate the damage level of a building. The relationship between S d and peak ground acceleration (PGA) is established, and then a new vulnerability function is expressed in terms of PGA. Furthermore, the expected value of the seismic capacity index (SCev) is provided to estimate the seismic capacity of buildings based on the probability distribution of damage levels and the corresponding seismic capacity index. The results indicate that the proposed vulnerability methodology is able to assess seismic damage of a large number of building stock directly and quickly following an earthquake. The SCev provides an effective index to measure the seismic capacity of buildings and illustrate the relationship between the seismic capacity of buildings and seismic action. The estimated result is compared with damage surveys of the cities of Dujiangyan and Jiangyou in the M8.0 Wenchuan earthquake, revealing that the methodology is acceptable for seismic risk assessment and decision making. The primary reasons for discrepancies between the estimated results and the damage surveys are discussed.

  8. Performance-based, cost- and time-effective PCB analytical methodology

    International Nuclear Information System (INIS)

    Alvarado, J. S.

    1998-01-01

    Laboratory applications for the analysis of PCBs (polychlorinated biphenyls) in environmental matrices such as soil/sediment/sludge and oil/waste oil were evaluated for potential reduction in waste, source reduction, and alternative techniques for final determination. As a consequence, new procedures were studied for solvent substitution, miniaturization of extraction and cleanups, minimization of reagent consumption, reduction of cost per analysis, and reduction of time. These new procedures provide adequate data that meet all the performance requirements for the determination of PCBs. Use of the new procedures reduced costs for all sample preparation techniques. Time and cost were also reduced by combining the new sample preparation procedures with the power of fast gas chromatography. Separation of Aroclor 1254 was achieved in less than 6 min by using DB-1 and SPB-608 columns. With the greatly shortened run times, reproducibility can be tested quickly and consequently with low cost. With performance-based methodology, the applications presented here can be applied now, without waiting for regulatory approval

  9. Performance-based parameter tuning method of model-driven PID control systems.

    Science.gov (United States)

    Zhao, Y M; Xie, W F; Tu, X W

    2012-05-01

    In this paper, performance-based parameter tuning method of model-driven Two-Degree-of-Freedom PID (MD TDOF PID) control system has been proposed to enhance the control performances of a process. Known for its ability of stabilizing the unstable processes, fast tracking to the change of set points and rejecting disturbance, the MD TDOF PID has gained research interest recently. The tuning methods for the reported MD TDOF PID are based on internal model control (IMC) method instead of optimizing the performance indices. In this paper, an Integral of Time Absolute Error (ITAE) zero-position-error optimal tuning and noise effect minimizing method is proposed for tuning two parameters in MD TDOF PID control system to achieve the desired regulating and disturbance rejection performance. The comparison with Two-Degree-of-Freedom control scheme by modified smith predictor (TDOF CS MSP) and the designed MD TDOF PID tuned by the IMC tuning method demonstrates the effectiveness of the proposed tuning method. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

  10. Beyond integrated safeguards: Performance-based assessments for future nuclear controls

    International Nuclear Information System (INIS)

    Pilat, Joseph F.; Budlong Sylvester, Kory W.

    2001-01-01

    Full text: In the future, if the nuclear nonproliferation and arms control agendas are to advance, they will likely become increasingly seen as parallel undertakings with the objective of comprehensive cradle-to-grave controls over nuclear materials and possibly even warheads removed from defense programs along with materials in civilian use. This 'back to the future' prospect was envisioned in the Acheson-Lillienthal Report and the Baruch Plan, and more modestly in the Atoms-for-Peace Proposal. Unlike the grand plans of the early nuclear years, today's and tomorrow's undertakings will more likely consist of a series of incremental steps with the goal of expanding nuclear controls. These steps will be undertaken at a time of fundamental change in the IAEA safeguards system, and they will be influenced by those changes in profound ways. This prospective influence needs to be taken into account as the IAEA develops and implements integrated safeguards, including its efforts to establish new safeguards criteria, undertake technological and administrative improvements in safeguards, implement credible capabilities for the detection of undeclared nuclear facilities and activities and, perhaps, provide for a more intensive involvement in applying safeguards in new roles such as the verification of a Fissile Material Cutoff Treaty. Performance-based criteria offer one promising way to address the effectiveness of integrated safeguards and to provide a common means of assessing the other key areas of a comprehensive approach to nuclear controls as these develop independently and to the extent that they are coordinated in the future. (author)

  11. Do Performance-based Health Measures Reflect Differences in Frailty Among Immigrants Age 50+ in Europe?

    Science.gov (United States)

    Brothers, Thomas D; Theou, Olga; Rockwood, Kenneth

    2014-09-01

    Life course influences, including country of residence and country of birth, are associated with frailty index scores. We investigated these associations using performance-based health measures. Among 33,745 participants age 50+ (mean age 64.8 ± 10.1; 55% women) in the Survey of Health, Ageing, and Retirement in Europe, grip strength, delayed word recall, and semantic verbal fluency were assessed. Participants were grouped by country of residence (Northern/Western Europe or Southern/Eastern Europe), and by country of birth (native-born, immigrants born in low- and middle-income countries [LMICs], or immigrants born in high-income countries [HICs]). Participants in Southern/Eastern Europe had lower mean test scores than those in Northern/Western Europe, and their scores did not differ by country of birth group. In Northern/Western Europe, compared with native-born participants, LMIC-born immigrants demonstrated lower mean grip strength (32.8 ± 7.6 kg vs. 35.7 ± 7.7 kg), delayed recall (2.9 ± 1.9 vs. 3.6 ± 1.9), and verbal fluency scores (16.0 ± 6.9 vs. 20.3 ± 7.0). HIC-born immigrants had mean scores higher than LMIC-born immigrants, but lower than native-born participants (all pnational income levels of both country of residence and country of birth. This was similar to previously observed differences in frailty index scores.

  12. Strength Performance Based on Flexibility from Laterite Soil Using Tire Powder and Micro Silica

    Directory of Open Access Journals (Sweden)

    Behrouz Gordan

    2015-01-01

    Full Text Available In terms of environmental issues and human health, one of the advisable techniques to improve soil behavior is the use of scrap tires for soil structures. According to the literature, Tire-Derived Aggregates (TDA are one of the valuable materials in different field of Geotechnical that can be used. TDA properties correspond to some important factors such as high level of flexible, lightweight, high permeability and economic material comparing with sand. Strength performance based on increasing flexibility from laterite soil is the main goal of this study. For this purpose, tropical laterite soil was mixed using TDA and micro silica (MS. As a research method, unconfined tests were carried for thirteen samples based on different percentage of the additives. As a result, the significant reduction for elasticity modulus and strength was observed when soil mixed just using TDA. In addition, the rate of strain at the peak of the curve was dramatically increased. The best performance was found using 6% additives when the ratio was 3% MS and 3% TDA. In fact, the effect of MS was more to increase strength. To recommend, the seepage controlling will investigate at next.

  13. The oral case presentation: toward a performance-based rhetorical model for teaching and learning

    Directory of Open Access Journals (Sweden)

    Mei Yuit Chan

    2015-07-01

    Full Text Available The oral case presentation is an important communicative activity in the teaching and assessment of students. Despite its importance, not much attention has been paid to providing support for teachers to teach this difficult task to medical students who are novices to this form of communication. As a formalized piece of talk that takes a regularized form and used for a specific communicative goal, the case presentation is regarded as a rhetorical activity and awareness of its rhetorical and linguistic characteristics should be given due consideration in teaching. This paper reviews practitioners’ and the limited research literature that relates to expectations of medical educators about what makes a good case presentation, and explains the rhetorical aspect of the activity. It is found there is currently a lack of a comprehensive model of the case presentation that projects the rhetorical and linguistic skills needed to produce and deliver a good presentation. Attempts to describe the structure of the case presentation have used predominantly opinion-based methodologies. In this paper, I argue for a performance-based model that would not only allow a description of the rhetorical structure of the oral case presentation, but also enable a systematic examination of the tacit genre knowledge that differentiates the expert from the novice. Such a model will be a useful resource for medical educators to provide more structured feedback and teaching support to medical students in learning this important genre.

  14. Conspecific and not performance-based attraction on immigrants drives colony growth in a waterbird.

    Science.gov (United States)

    Tenan, Simone; Fasola, Mauro; Volponi, Stefano; Tavecchia, Giacomo

    2017-09-01

    Local recruitment and immigration play an important part in the dynamics and growth of animal populations. However, their estimation and incorporation into open population models is, in most cases, problematic. We studied factors affecting the growth of a recently established colony of Eurasian spoonbill (Platalea leucorodia) and assessed the contribution of local recruits, i.e. birds born in the colony, and immigrants, i.e. birds of unknown origin, to colony growth. We applied an integrated population model that accounts for uncertainty in breeding state assignment and merges population surveys, local fecundity and individual longitudinal data of breeding and non-breeding birds, to estimate demographic rates and the relative role of recruitment and immigration in driving the local dynamics. We also used this analytical framework to assess the degree of support for the 'performance-based' and 'conspecific attraction' hypotheses as possible mechanisms of colony growth. Among the demographic rates, only immigration was positively and significantly correlated with population growth rate. In addition, the number of immigrants settling in the colony was positively correlated with colony size in the previous and current year, but was not correlated with fecundity of the previous year. Our results suggest that the variation in immigration affected colony dynamics and that conspecific attraction likely triggered the relevant role of immigration in the growth of a recently formed waterbird colony, supporting the need of including immigration in population analysis. © 2017 The Authors. Journal of Animal Ecology © 2017 British Ecological Society.

  15. Profiting from negawatts: Reducing absolute consumption and emissions through a performance-based energy economy

    International Nuclear Information System (INIS)

    Steinberger, Julia K.; Niel, Johan van; Bourg, Dominique

    2009-01-01

    Current energy and GHG emissions policies either focus directly on emissions or promote renewable production and the implementation of specific efficiency measures. Meanwhile, the fundamental structure of the energy market based on profits through energy throughput remains largely unchallenged. This policy oversight prevents the transition to an energy economy in which profits are based on energy services delivered at the lowest energy cost: a performance-based energy economy (PBEE). The PBEE applies the combined concepts of the performance economy and energy services to the energy sector. Energy Service Companies (ESCOs) are discussed as an example of PBEE practices. The implications for energy suppliers and consumers as well as the conditions for PBEE diffusion and consequences for technological change are also explored. The expected environmental, social and economic benefits are described. However, absolute consumption and emissions reductions may prove elusive due to the rebound effect. In order to forestall rebound-led increases, complementary policy measures likely to lead to absolute reductions are required

  16. FIRE SAFETY IN NUCLEAR POWER PLANTS: A RISK-INFORMED AND PERFORMANCE-BASED APPROACH

    Energy Technology Data Exchange (ETDEWEB)

    AZARM,M.A.; TRAVIS,R.J.

    1999-11-14

    The consideration of risk in regulatory decision-making has long been a part of NRC's policy and practice. Initially, these considerations were qualitative and were based on risk insights. The early regulations relied on good practices, past insights, and accepted standards. As a result, most NRC regulations were prescriptive and were applied uniformly to all areas within the regulatory scope. Risk technology is changing regulations by prioritizing the areas within regulatory scope based on risk, thereby focusing on the risk-important areas. Performance technology, on the other hand, is changing the regulations by allowing requirements to be adjusted based on the specific performance expected and manifested, rather than a prior prescriptive requirement. Consistent with the objectives of risk-informed and performance-based regulatory requirements, BNL evaluated the feasibility of applying risk- and performance-technologies to modifying NRC's current regulations on fire protection for nuclear power plants. This feasibility study entailed several case studies (trial applications). This paper describes the results of two of them. Besides the case studies, the paper discusses an overall evaluation of methodologies for fire-risk analysis to support the risk-informed regulation. It identifies some current shortcomings and proposes some near-term solutions.

  17. performance-based approach to design and evaluation of nuclear security systems for Brazilian nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Tavares, Renato L. A.; Filho, Josélio S. M., E-mail: renato.tavares@cnen.gov.br, E-mail: joselio@cnen.gov.br [Comissão Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil). Diretoria de Radioproteção e Segurança Nuclear. Divisão de Normas e Segurança Física; Fontes, Gladson S.; Fiel, J.C.B., E-mail: gsfontes@hotmail.com, E-mail: fiel@ime.eb.br [Instituto Militar de Engenharia (SE-7/IME), Rio de Janeiro, RJ (Brazil). Seção de Engenharia Nuclear

    2017-07-01

    This study presents an application of a performance-based approach to definition of requirements, design and evaluation of physical protection systems for nuclear facilities. Such approach considers a probabilistic analysis of the threat, equipment, systems and response forces used to prevent, dissuade and detain malicious acts against the integrity of facilities and the nuclear materials inside them. Nowadays, in the context of Brazilian nuclear facilities licensing, a mostly prescriptive approach is adopted, which despite having advantages such as simplified inspections and homogeneous regulatory requisites amid different fuel cycle facility types, does not consider evolution, dynamism and capacities of external or internal threats to facilities and to Brazilian Nuclear Program itself, neither provides metrics to evaluate system performance facing such threats. In order to preserve actual plans and systems confidentiality, a facility hypothetical model is created, including a research reactor and a waste storage facility. It is expected that the methodology and results obtained in this study serve in the future as a basis to Brazilian nuclear operators, in elaboration process of their Physical Protection Plans, which must comply with future regulation CNEN-NN 2.01, a revision of CNEN-NE 2.01, once that regulation will include performance requisites. (author)

  18. Profiting from negawatts. Reducing absolute consumption and emissions through a performance-based energy economy

    Energy Technology Data Exchange (ETDEWEB)

    Steinberger, Julia K. [IPTEH, Quartier Sorge-Bat. Amphipole, University of Lausanne, CH-1015-Lausanne (Switzerland); Institute of Social Ecology, Klagenfurt University, Schottenfeldg. 29, A-1070 Vienna (Austria); van Niel, Johan [IPTEH, Quartier Sorge-Bat. Amphipole, University of Lausanne, CH-1015-Lausanne (Switzerland); CREIDD, University of Technology of Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France); Bourg, Dominique [IPTEH, Quartier Sorge-Bat. Amphipole, University of Lausanne, CH-1015-Lausanne (Switzerland)

    2009-01-15

    Current energy and GHG emissions policies either focus directly on emissions or promote renewable production and the implementation of specific efficiency measures. Meanwhile, the fundamental structure of the energy market based on profits through energy throughput remains largely unchallenged. This policy oversight prevents the transition to an energy economy in which profits are based on energy services delivered at the lowest energy cost: a performance-based energy economy (PBEE). The PBEE applies the combined concepts of the performance economy and energy services to the energy sector. Energy Service Companies (ESCOs) are discussed as an example of PBEE practices. The implications for energy suppliers and consumers as well as the conditions for PBEE diffusion and consequences for technological change are also explored. The expected environmental, social and economic benefits are described. However, absolute consumption and emissions reductions may prove elusive due to the rebound effect. In order to forestall rebound-led increases, complementary policy measures likely to lead to absolute reductions are required. (author)

  19. Profiting from negawatts: Reducing absolute consumption and emissions through a performance-based energy economy

    Energy Technology Data Exchange (ETDEWEB)

    Steinberger, Julia K. [IPTEH, Quartier Sorge-Bat. Amphipole, University of Lausanne, CH-1015-Lausanne (Switzerland); Institute of Social Ecology, Klagenfurt University, Schottenfeldg. 29, A-1070 Vienna (Austria)], E-mail: julia.steinberger@uni-klu.ac.at; Niel, Johan van [IPTEH, Quartier Sorge-Bat. Amphipole, University of Lausanne, CH-1015-Lausanne (Switzerland); CREIDD, University of Technology of Troyes, 12 rue Marie Curie, BP 2060, 10010 Troyes Cedex (France); Bourg, Dominique [IPTEH, Quartier Sorge-Bat. Amphipole, University of Lausanne, CH-1015-Lausanne (Switzerland)

    2009-01-15

    Current energy and GHG emissions policies either focus directly on emissions or promote renewable production and the implementation of specific efficiency measures. Meanwhile, the fundamental structure of the energy market based on profits through energy throughput remains largely unchallenged. This policy oversight prevents the transition to an energy economy in which profits are based on energy services delivered at the lowest energy cost: a performance-based energy economy (PBEE). The PBEE applies the combined concepts of the performance economy and energy services to the energy sector. Energy Service Companies (ESCOs) are discussed as an example of PBEE practices. The implications for energy suppliers and consumers as well as the conditions for PBEE diffusion and consequences for technological change are also explored. The expected environmental, social and economic benefits are described. However, absolute consumption and emissions reductions may prove elusive due to the rebound effect. In order to forestall rebound-led increases, complementary policy measures likely to lead to absolute reductions are required.

  20. A fuzzy MCDM approach for evaluating school performance based on linguistic information

    Science.gov (United States)

    Musani, Suhaina; Jemain, Abdul Aziz

    2013-11-01

    Decision making is the process of finding the best option among the feasible alternatives. This process should consider a variety of criteria, but this study only focus on academic achievement. The data used is the percentage of candidates who obtained Malaysian Certificate of Education (SPM) in Melaka based on school academic achievement for each subject. 57 secondary schools in Melaka as listed by the Ministry of Education involved in this study. Therefore the school ranking can be done using MCDM (Multi Criteria Decision Making) methods. The objective of this study is to develop a rational method for evaluating school performance based on linguistic information. Since the information or level of academic achievement provided in linguistic manner, there is a possible chance of getting incomplete or uncertain problems. So in order to overcome the situation, the information could be provided as fuzzy numbers. Since fuzzy set represents the uncertainty in human perceptions. In this research, VIKOR (Multi Criteria Optimization and Compromise Solution) has been used as a MCDM tool for the school ranking process in fuzzy environment. Results showed that fuzzy set theory can solve the limitations of using MCDM when there is uncertainty problems exist in the data.

  1. Combining auctions and performance-based payments in a forest enrichment field trial in Western Kenya.

    Science.gov (United States)

    Khalumba, Mercelyne; Wünscher, Tobias; Wunder, Sven; Büdenbender, Mirjam; Holm-Müller, Karin

    2014-06-01

    Cost-effectiveness is an important aspect in the assessment of payments for environmental services (PES) initiatives. In participatory field trials with communities in Western Kenya, we combined procurement auctions for forest enrichment contracts with performance-based payments and compared the outcomes with a baseline scenario currently used by the Kenyan Forest Service. Procurement auctions were the most cost-effective. The competitive nature of the auction reduced contracting expenses (provision costs), and the result-oriented payments provided additional incentives to care for the planted seedlings, resulting in their improved survival rates (service quantity). These gains clearly exceeded increases in transaction costs associated with conducting an auction. The number of income-poor auction participants and winners was disproportionately high and local institutional buy-in was remarkably strong. Our participatory approach may, however, require adaptations when conducted at a larger scale. Although the number of contracts we monitored was limited and prohibited the use of statistical tests, our study is one of the first to reveal the benefits of using auctions for PES in developing countries. © 2014 Society for Conservation Biology.

  2. Performance Based Failure Criteria of the Base Isolation System for Nuclear Power Plants

    International Nuclear Information System (INIS)

    Kim, Jung Han; Kim, Min Kyu; Choi, In Kil

    2013-01-01

    The realistic approach to evaluate the failure state of the base isolation system is necessary. From this point of view, several concerns are reviewed and discussed in this study. This is the preliminary study for the performance based risk assessment of a base isolated nuclear power plant. The items to evaluate the capacity and response of an individual base isolator and a base isolation system were briefly outlined. However, the methodology to evaluate the realistic fragility of a base isolation system still needs to be specified. For the quantification of the seismic risk for a nuclear power plant structure, the failure probabilities of the structural component for the various seismic intensity levels need to be calculated. The failure probability is evaluated as the probability when the seismic response of a structure exceeds the failure criteria. Accordingly, the failure mode of the structural system caused by an earthquake vibration should be defined first. The type of a base isolator appropriate for a nuclear power plant structure is regarded as an elastometric rubber bearing with a lead core. The failure limit of the lead-rubber bearing (LRB) is not easy to be predicted because of its high nonlinearity and a complex loading condition by an earthquake excitation. Furthermore, the failure mode of the LRB system installed below the nuclear island cannot be simply determined because the basemat can be sufficiently supported if the number of damaged isolator is not much

  3. performance-based approach to design and evaluation of nuclear security systems for Brazilian nuclear facilities

    International Nuclear Information System (INIS)

    Tavares, Renato L. A.; Filho, Josélio S. M.; Fontes, Gladson S.; Fiel, J.C.B.

    2017-01-01

    This study presents an application of a performance-based approach to definition of requirements, design and evaluation of physical protection systems for nuclear facilities. Such approach considers a probabilistic analysis of the threat, equipment, systems and response forces used to prevent, dissuade and detain malicious acts against the integrity of facilities and the nuclear materials inside them. Nowadays, in the context of Brazilian nuclear facilities licensing, a mostly prescriptive approach is adopted, which despite having advantages such as simplified inspections and homogeneous regulatory requisites amid different fuel cycle facility types, does not consider evolution, dynamism and capacities of external or internal threats to facilities and to Brazilian Nuclear Program itself, neither provides metrics to evaluate system performance facing such threats. In order to preserve actual plans and systems confidentiality, a facility hypothetical model is created, including a research reactor and a waste storage facility. It is expected that the methodology and results obtained in this study serve in the future as a basis to Brazilian nuclear operators, in elaboration process of their Physical Protection Plans, which must comply with future regulation CNEN-NN 2.01, a revision of CNEN-NE 2.01, once that regulation will include performance requisites. (author)

  4. An index approach to performance-based payments for water quality.

    Science.gov (United States)

    Maille, Peter; Collins, Alan R

    2012-05-30

    In this paper we describe elements of a field research project that presented farmers with economic incentives to control nitrate runoff. The approach used is novel in that payments are based on ambient water quality and water quantity produced by a watershed rather than proxies for water quality conservation. Also, payments are made based on water quality relative to a control watershed, and therefore, account for stochastic fluctuations in background nitrate levels. Finally, the program pays farmers as a group to elicit team behavior. We present our approach to modeling that allowed us to estimate prices for water and resulting payment levels. We then compare these preliminary estimates to the actual values recorded over 33 months of fieldwork. We find that our actual payments were 29% less than our preliminary estimates, due in part to the failure of our ecological model to estimate discharge accurately. Despite this shortfall, the program attracted the participation of 53% of the farmers in the watershed, and resulted in substantial nitrate abatement activity. Given this favorable response, we propose that research efforts focus on implementing field trials of group-level performance-based payments. Ideally these programs would be low risk and control for naturally occurring contamination. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. The oral case presentation: toward a performance-based rhetorical model for teaching and learning

    Science.gov (United States)

    Chan, Mei Yuit

    2015-01-01

    The oral case presentation is an important communicative activity in the teaching and assessment of students. Despite its importance, not much attention has been paid to providing support for teachers to teach this difficult task to medical students who are novices to this form of communication. As a formalized piece of talk that takes a regularized form and used for a specific communicative goal, the case presentation is regarded as a rhetorical activity and awareness of its rhetorical and linguistic characteristics should be given due consideration in teaching. This paper reviews practitioners’ and the limited research literature that relates to expectations of medical educators about what makes a good case presentation, and explains the rhetorical aspect of the activity. It is found there is currently a lack of a comprehensive model of the case presentation that projects the rhetorical and linguistic skills needed to produce and deliver a good presentation. Attempts to describe the structure of the case presentation have used predominantly opinion-based methodologies. In this paper, I argue for a performance-based model that would not only allow a description of the rhetorical structure of the oral case presentation, but also enable a systematic examination of the tacit genre knowledge that differentiates the expert from the novice. Such a model will be a useful resource for medical educators to provide more structured feedback and teaching support to medical students in learning this important genre. PMID:26194482

  6. FIRE SAFETY IN NUCLEAR POWER PLANTS: A RISK-INFORMED AND PERFORMANCE-BASED APPROACH

    International Nuclear Information System (INIS)

    AZARM, M.A.; TRAVIS, R.J.

    1999-01-01

    The consideration of risk in regulatory decision-making has long been a part of NRC's policy and practice. Initially, these considerations were qualitative and were based on risk insights. The early regulations relied on good practices, past insights, and accepted standards. As a result, most NRC regulations were prescriptive and were applied uniformly to all areas within the regulatory scope. Risk technology is changing regulations by prioritizing the areas within regulatory scope based on risk, thereby focusing on the risk-important areas. Performance technology, on the other hand, is changing the regulations by allowing requirements to be adjusted based on the specific performance expected and manifested, rather than a prior prescriptive requirement. Consistent with the objectives of risk-informed and performance-based regulatory requirements, BNL evaluated the feasibility of applying risk- and performance-technologies to modifying NRC's current regulations on fire protection for nuclear power plants. This feasibility study entailed several case studies (trial applications). This paper describes the results of two of them. Besides the case studies, the paper discusses an overall evaluation of methodologies for fire-risk analysis to support the risk-informed regulation. It identifies some current shortcomings and proposes some near-term solutions

  7. US utility partnerships

    International Nuclear Information System (INIS)

    Worthington, B.

    1995-01-01

    Activities of the United States Energy Association were reviewed, as well as the manner in which its members are benefitting from the Association's programs. The principal cooperative program set up is the Utility Partnership Program, which was described. Through this program the Association is matching US companies, both electric utilities and gas utilities, with counterparts in Eastern Europe or the former Soviet Union. So far, about 25 partnerships were signed, e.g. in the Czech Republic, in Kazakhstan, in Poland, and in Slovakia. It was estimated that the return to the United States from the investments made by the American government in these Utility Partnership Programs has been well over 100-fold

  8. Assessing control of postural stability in community-living older adults using performance-based limits of stability

    Directory of Open Access Journals (Sweden)

    Boissy Patrick

    2008-03-01

    Full Text Available Abstract Background Balance disability measurements routinely used to identify fall risks in frail populations have limited value in the early detection of postural stability deficits in community-living older adults. The objectives of the study were to 1 measure performance-based limits of stability (LOS in community-living older adults and compare them to theoretical LOS computed from data proposed by the Balance Master® system, 2 explore the feasibility of a new measurement approach based on the assessment of postural stability during weight-shifting tasks at performance-based LOS, 3 quantify intra-session performance variability during multiple trials using the performance-based LOS paradigm. Methods Twenty-four healthy community-living older adults (10 men, 14 women aged between 62 to 85 (mean age ± sd, 71.5 ± 6 yrs participated in the study. Subjects' performance-based LOS were established by asking them to transfer their body weight as far as possible in three directions (forward, right and left without changing their base of support. LOS were computed as the maximal excursion of the COP in each direction among three trials. Participants then performed two experimental tasks that consisted in controlling, with the assistance of visual feedback, their centre of pressure (COP within two predefined targets set at 100% of their performance-based LOS. For each tasks 8 trials were performed. Ground reaction forces and torques during performance-based LOS evaluation and experimental tasks were recorded with a force plate. Sway area and medio-lateral mean COP displacement speed variables were extracted from force plate recordings. Results Significant differences between theoretical LOS computed from maximum leaning angles derived from anthropometric characteristics and performance-based LOS were observed. Results showed that a motor learning effect was present as the participants optimized their weight-shifting strategy through the first three

  9. Incapacidad laboral total

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1997-04-01

    Full Text Available Se realizó un estudio longitudinal, descriptivo y retrospectivo con el objetivo de conocer el comportamiento de la incapacidad permanente para el trabajo en el municipio "San Cristóbal" durante el decenio 1982-1991, y se aplicó el método de encuesta por el que se recogieron datos que fueron extraídos del modelo oficial de peritaje médico laboral y de la entrevista con el peritado. Los resultados fueron plasmados en tablas de contingencias donde se relacionan las variables por cada año estudiado, y se aplicó la prueba estadística de chi cuadrado. El número de individuos dictaminados con incapacidad laboral total fue de 693; predominó en reportes el año 1988 con 114 casos y muy discretamente el sexo femenino sobre el masculino, el grupo etáreo de 45 a 54 años con 360 casos y la artrosis como entidad valorada por ortopedia, con análisis estadísticos significativos. No resultó estadísticamente significativo, el predominio de la hipertensión arterial sistémica entre las entidades valoradas por la especialidad de medicina interna como causas de incapacidad laboral. Fue muy significativa la variación del número de dictaminados por la comisión en cada uno de los años estudiados y que el porcentaje de ellos que se encontraban realizando trabajos que demandan esfuerzo físico de moderado a intenso al momento de aplicar la encuesta, ascendió al 64,9.A longitudinal, descriptive and retrospective study was conducted in order to know the behavior of permanent labor disability at the municipality of San Cristóbal during 1982-1991. A survey was done to collect data taken from the official model of medical inspections and from the interview with the disabled worker. The results were shown in contingency tables where the variables are related by every year studied. The chi square statistical test was applied. The number of individuals with labor disability was 693. As for reports, the year 1988 predominated with 114. There was a discreet

  10. Proposed modifications of Environmental Protection Agency Method 1601 for detection of coliphages in drinking water, with same-day fluorescence-based detection and evaluation by the performance-based measurement system and alternative test protocol validation approaches.

    Science.gov (United States)

    Salter, Robert S; Durbin, Gregory W; Conklin, Ernestine; Rosen, Jeff; Clancy, Jennifer

    2010-12-01

    Coliphages are microbial indicators specified in the Ground Water Rule that can be used to monitor for potential fecal contamination of drinking water. The Total Coliform Rule specifies coliform and Escherichia coli indicators for municipal water quality testing; thus, coliphage indicator use is less common and advances in detection methodology are less frequent. Coliphages are viral structures and, compared to bacterial indicators, are more resistant to disinfection and diffuse further distances from pollution sources. Therefore, coliphage presence may serve as a better predictor of groundwater quality. This study describes Fast Phage, a 16- to 24-h presence/absence modification of U.S. Environmental Protection Agency (EPA) Method 1601 for detection of coliphages in 100 ml water. The objective of the study is to demonstrate that the somatic and male-specific coliphage modifications provide results equivalent to those of Method 1601. Five laboratories compared the modifications, featuring same-day fluorescence-based prediction, to Method 1601 by using the performance-based measurement system (PBMS) criterion. This requires a minimum 50% positive response in 10 replicates of 100-ml water samples at coliphage contamination levels of 1.3 to 1.5 PFU/100 ml. The laboratories showed that Fast Phage meets PBMS criteria with 83.5 to 92.1% correlation of the same-day rapid fluorescence-based prediction with the next-day result. Somatic coliphage PBMS data are compared to manufacturer development data that followed the EPA alternative test protocol (ATP) validation approach. Statistical analysis of the data sets indicates that PBMS utilizes fewer samples than does the ATP approach but with similar conclusions. Results support testing the coliphage modifications by using an EPA-approved national PBMS approach with collaboratively shared samples.

  11. Are performance-based measures predictive of work participation in patients with musculoskeletal disorders? A systematic review.

    Science.gov (United States)

    Kuijer, P P F M; Gouttebarge, V; Brouwer, S; Reneman, M F; Frings-Dresen, M H W

    2012-02-01

    Assessments of whether patients with musculoskeletal disorders (MSDs) can participate in work mainly consist of case history, physical examinations, and self-reports. Performance-based measures might add value in these assessments. This study answers the question: how well do performance-based measures predict work participation in patients with MSDs? A systematic literature search was performed to obtain longitudinal studies that used reliable performance-based measures to predict work participation in patients with MSDs. The following five sources of information were used to retrieve relevant studies: PubMed, Embase, AMA Guide to the Evaluation of Functional Ability, references of the included papers, and the expertise and personal file of the authors. A quality assessment specific for prognostic studies and an evidence synthesis were performed. Of the 1,230 retrieved studies, eighteen fulfilled the inclusion criteria. The studies included 4,113 patients, and the median follow-up period was 12 months. Twelve studies took possible confounders into account. Five studies were of good quality and thirteen of moderate quality. Two good-quality and all thirteen moderate-quality studies (83%) reported that performance-based measures were predictive of work participation. Two good-quality studies (11%) reported both an association and no association between performance-based measures and work participation. One good-quality study (6%) found no effect. A performance-based lifting test was used in fourteen studies and appeared to be predictive of work participation in thirteen studies. Strong evidence exists that a number of performance-based measures are predictive of work participation in patients with MSDs, especially lifting tests. Overall, the explained variance was modest.

  12. X-rays utilization

    International Nuclear Information System (INIS)

    Rebigan, F.

    1979-03-01

    The modality of X-ray utilization in different activities and economy is given. One presents firstly quantities and units used in radiation dosimetry and other fields. One gives the generation of X-rays, their properties as well as the elements of radiation protection. The utilization characteristics of these radiations in different fields are finally given. (author)

  13. Fighting childhood obesity through performance-based regulation of the food industry.

    Science.gov (United States)

    Sugarman, Stephen D; Sandman, Nirit

    2007-04-01

    That childhood obesity is an alarming public health problem is clear and widely appreciated. What is altogether unclear is what our society should do about it. Some people think the solution lies in using tort law to sue McDonald's, Coca-Cola, and other corporations. We reject that notion. Others believe that government should order specific changes in the behavior of food companies and school officials--and yet, there is little reason for confidence that these "command and control" strategies will make a difference. Instead, we propose "performance-based regulation" of the food industry. This is analogous to the approach our country is now taking with respect to elementary and secondary education (most prominently in the No Child Left Behind legislation). Schools are not told how to achieve better educational results, but better outcomes are demanded of them. This strategy has also been used in the environmental context to reduce harmful power plant emissions, and it has been briefly proposed as a way of regulating cigarette companies. In this Article, we propose that large firms selling food and drink that is high in sugar or fat will be assigned the responsibility of reducing obesity rates in a specific pool of children. A firm's share of the overall responsibility will be based on its share of the "bad' food market, and the children assigned to it will be organized by geographically proximate schools where obesity rates are currently above the plan's nationwide target rate of 8 percent (the actual childhood obesity rate today is approximately 16 percent). Firms that fail to achieve their goals will be subject to serious financial penalties.

  14. Impact of implementing performance-based financing on childhood malnutrition in Rwanda.

    Science.gov (United States)

    Binagwaho, Agnes; Condo, Jeanine; Wagner, Claire; Ngabo, Fidele; Karema, Corine; Kanters, Steve; Forrest, Jamie I; Bizimana, Jean de Dieu

    2014-11-04

    Malnutrition remains a serious concern in Rwanda, particularly among children under-5 years. Performance-based financing (PBF), an innovative health systems financing strategy, has been implemented at the national level since 2008. This study aimed to assess the impact of PBF and other factors associated with the prevalence of three classifications of malnutrition (stunting, wasting and underweight) in children under-5 years in Rwanda. The study is a cross-sectional study comprising of 713 children under five years old from 557 households, whose anthropometric measurements (height, weight and age) had been obtained as part of the 2008 Rwanda General Health and HIV household survey. Z-scores for height-for-age, weight-for-age, weight-for-height, and body mass index-for-age were analyzed according to the World Health Organization 2006 Child Growth Standards. Random intercept logistic regression models were used to regress each anthropometric measure (WAZ, HAZ and WHZ) against child, maternal and household characteristics. Child participants ranged in age from 0 to 60 months, 20.2% of children were under 12 months and 5.1% were HIV positive. The prevalence of wasting was 8.8%; of stunting was 58.4%; and of underweight status was 20.7%. Maternal emotional and social wellbeing was protective of wasting in children under-5 years of age. Living in districts implementing PBF was protective of wasting (Adjusted Odds Ratio: 0.43; 95% confidence interval: 0.19-0.97). Living in a district with PBF was not found to be associated with either stunting or underweight status among children under-5. PBF may have a protective association with particular forms of malnutrition among children under-5 years in Rwanda. These findings warrant further investigation in relation to the impact of implementing innovative financing schemes on health outcomes.

  15. Performance-based financing for improving HIV/AIDS service delivery: a systematic review.

    Science.gov (United States)

    Suthar, Amitabh B; Nagata, Jason M; Nsanzimana, Sabin; Bärnighausen, Till; Negussie, Eyerusalem K; Doherty, Meg C

    2017-01-04

    Although domestic HIV/AIDS financing is increasing, international HIV/AIDS financing has plateaued. Providing incentives for the health system (i.e. performance-based financing [PBF]) may help countries achieve more with available resources. We systematically reviewed effects of PBF on HIV/AIDS service delivery to inform WHO guidelines. PubMed, WHO Index Medicus, conference databases, and clinical trial registries were searched in April 2015 for randomised trials, comparative contemporaneous studies, or time-series studies. Studies evaluating PBF in people with HIV were included when they reported service quality, access, or cost. Meta-analyses were not possible due to limited data. This study is registered with PROSPERO, number CRD42015023207. Four studies, published from 2009 to 2015 and including 173,262 people, met the eligibility criteria. All studies were from Sub-Saharan Africa. PBF did not improve individual testing coverage (relative risk [RR], 1.00, 95% confidence interval [CI] 0.89 to 1.13), improved couples testing coverage (RR 1.11, 95% CI 1.02 to 1.20), and improved pregnant women testing coverage (RR 1.29, 95% CI 1.28-1.30). PBF improved coverage of antiretrovirals in pregnant women (RR 1.55, 95% CI 1.50 to 1.59), infants (RR 1.92, 95% CI 1.84 to 2.01), and adults (RR 1.74, 1.64 to 1.85). PBF reduced attrition (RR 0.84, 95% CI 0.74 to 0.96) and treatment failure (odds ratio 0.55, 95% CI 0.32 to 0.97). Potential harms were not reported. Although the limited data suggests PBF positively affected HIV service access and quality, critical health system and governance knowledge gaps remain. More research is needed to inform national policymaking.

  16. Setting performance-based financing in the health sector agenda: a case study in Cameroon.

    Science.gov (United States)

    Sieleunou, Isidore; Turcotte-Tremblay, Anne-Marie; Fotso, Jean-Claude Taptué; Tamga, Denise Magne; Yumo, Habakkuk Azinyui; Kouokam, Estelle; Ridde, Valery

    2017-08-01

    More than 30 countries in sub-Saharan Africa have introduced performance-based financing (PBF) in their healthcare systems. Yet, there has been little research on the process by which PBF was put on the national policy agenda in Africa. This study examines the policy process behind the introduction of PBF program in Cameroon. The research is an explanatory case study using the Kingdon multiple streams framework. We conducted a document review and 25 interviews with various types of actors involved in the policy process. We conducted thematic analysis using a hybrid deductive-inductive approach for data analysis. By 2004, several reports and events had provided evidence on the state of the poor health outcomes and health financing in the country, thereby raising awareness of the situation. As a result, decision-makers identified the lack of a suitable health financing policy as an important issue that needed to be addressed. The change in the political discourse toward more accountability made room to test new mechanisms. A group of policy entrepreneurs from the World Bank, through numerous forms of influence (financial, ideational, network and knowledge-based) and building on several ongoing reforms, collaborated with senior government officials to place the PBF program on the agenda. The policy changes occurred as the result of two open policy windows (i.e. national and international), and in both instances, policy entrepreneurs were able to couple the policy streams to effect change. The policy agenda of PBF in Cameroon underlined the importance of a perceived crisis in the policy reform process and the advantage of building a team to carry forward the policy process. It also highlighted the role of other sources of information alongside scientific evidence (eg.: workshop and study tour), as well as the role of previous policies and experiences, in shaping or influencing respectively the way issues are framed and reformers' actions and choices.

  17. Performance-based maintenance of gas turbines for reliable control of degraded power systems

    Science.gov (United States)

    Mo, Huadong; Sansavini, Giovanni; Xie, Min

    2018-03-01

    Maintenance actions are necessary for ensuring proper operations of control systems under component degradation. However, current condition-based maintenance (CBM) models based on component health indices are not suitable for degraded control systems. Indeed, failures of control systems are only determined by the controller outputs, and the feedback mechanism compensates the control performance loss caused by the component deterioration. Thus, control systems may still operate normally even if the component health indices exceed failure thresholds. This work investigates the CBM model of control systems and employs the reduced control performance as a direct degradation measure for deciding maintenance activities. The reduced control performance depends on the underlying component degradation modelled as a Wiener process and the feedback mechanism. To this aim, the controller features are quantified by developing a dynamic and stochastic control block diagram-based simulation model, consisting of the degraded components and the control mechanism. At each inspection, the system receives a maintenance action if the control performance deterioration exceeds its preventive-maintenance or failure thresholds. Inspired by realistic cases, the component degradation model considers random start time and unit-to-unit variability. The cost analysis of maintenance model is conducted via Monte Carlo simulation. Optimal maintenance strategies are investigated to minimize the expected maintenance costs, which is a direct consequence of the control performance. The proposed framework is able to design preventive maintenance actions on a gas power plant, to ensuring required load frequency control performance against a sudden load increase. The optimization results identify the trade-off between system downtime and maintenance costs as a function of preventive maintenance thresholds and inspection frequency. Finally, the control performance-based maintenance model can reduce

  18. Impact of performance-based financing on primary health care services in Haiti.

    Science.gov (United States)

    Zeng, Wu; Cros, Marion; Wright, Katherine D; Shepard, Donald S

    2013-09-01

    To strengthen Haiti's primary health care (PHC) system, the country first piloted performance-based financing (PBF) in 1999 and subsequently expanded the approach to most internationally funded non-government organizations. PBF complements support (training and technical assistance). This study evaluates (a) the separate impact of PBF and international support on PHC's service delivery; (b) the combined impact of PBF and technical assistance on PHC's service delivery; and (c) the costs of PBF implementation in Haiti. To minimize the risk of facilities neglecting potential non-incentivized services, the incentivized indicators were randomly chosen at the end of each year. We obtained quantities of key services from four departments for 217 health centres (15 with PBF and 202 without) from 2008 through 2010, computed quarterly growth rates and analysed the results using a difference-in-differences approach by comparing the growth of incentivized and non-incentivized services between PBF and non-PBF facilities. To interpret the statistical analyses, we also interviewed staff in four facilities. Whereas international support added 39% to base costs of PHC, incentive payments added only 6%. Support alone increased the quantities of PHC services over 3 years by 35% (2.7%/quarter). However, support plus incentives increased these amounts by 87% over 3 years (5.7%/quarter) compared with facilities with neither input. Incentives alone was associated with a net 39% increase over this period, and more than doubled the growth of services (P < 0.05). Interview findings found no adverse impacts and, in fact, indicated beneficial impacts on quality. Incentives proved to be a relatively inexpensive, well accepted and very effective complement to support, suggesting that a small amount of money, strategically used, can substantially improve PHC. Haiti's experience, after more than a decade of use, indicates that incentives are an effective tool to strengthen PHC.

  19. Optimum Performance-Based Seismic Design Using a Hybrid Optimization Algorithm

    Directory of Open Access Journals (Sweden)

    S. Talatahari

    2014-01-01

    Full Text Available A hybrid optimization method is presented to optimum seismic design of steel frames considering four performance levels. These performance levels are considered to determine the optimum design of structures to reduce the structural cost. A pushover analysis of steel building frameworks subject to equivalent-static earthquake loading is utilized. The algorithm is based on the concepts of the charged system search in which each agent is affected by local and global best positions stored in the charged memory considering the governing laws of electrical physics. Comparison of the results of the hybrid algorithm with those of other metaheuristic algorithms shows the efficiency of the hybrid algorithm.

  20. Automated ISS Flight Utilities

    Science.gov (United States)

    Offermann, Jan Tuzlic

    2016-01-01

    EVADES output. As mentioned above, GEnEVADOSE makes extensive use of ROOT version 6, the data analysis framework developed at the European Organization for Nuclear Research (CERN), and the code is written to the C++11 standard (as are the other projects). My second project is the Automated Mission Reference Exposure Utility (AMREU).Unlike GEnEVADOSE, AMREU is a combination of three frameworks written in both Python and C++, also making use of ROOT (and PyROOT). Run as a combination of daily and weekly cron jobs, these macros query the SRAG database system to determine the active ISS missions, and query minute-by-minute radiation dose information from ISS-TEPC (Tissue Equivalent Proportional Counter), one of the radiation detectors onboard the ISS. Using this information, AMREU creates a corrected data set of daily radiation doses, addressing situations where TEPC may be offline or locked up by correcting doses for days with less than 95% live time (the total amount time the instrument acquires data) by averaging the past 7 days. As not all errors may be automatically detectable, AMREU also allows for manual corrections, checking an updated plaintext file each time it runs. With the corrected data, AMREU generates cumulative dose plots for each mission, and uses a Python script to generate a flight note file (.docx format) containing these plots, as well as information sections to be filled in and modified by the space weather environment officers with information specific to the week. AMREU is set up to run without requiring any user input, and it automatically archives old flight notes and information files for missions that are no longer active. My other projects involve cleaning up a large data set from the Charged Particle Directional Spectrometer (CPDS), joining together many different data sets in order to clean up information in SRAG SQL databases, and developing other automated utilities for displaying information on active solar regions, that may be used by the

  1. An Analysis of Organizational Performance Based on Hospital Specialization Level and Strategy Type.

    Directory of Open Access Journals (Sweden)

    Han-Sung Kim

    Full Text Available Hospitals are studying the focused factory concept and attempting to increase their power in a competitive industry by becoming more specialized.This study uses the information theory index (ITI and the Herfindahl-Hirschman index (HHI to analyze the extent of specialization by Korean hospitals that receive national health insurance reimbursements. Hierarchical regression analysis is used to assess the impact of hospital specialization on the following four aspects of operational performance: productivity, profitability, efficiency and quality of care.The results show that a focused strategy (high HHI improves the income and adjusted number of patients per specialist through the efficient utilization of human resources. However, a diversified strategy (high ITI improves the hospital utilization ratio, income per bed and adjusted number of patients per bed (controlling for material resources such as beds. In addition, as the concentration index increases, case-mix mortality rates and referral rates decrease, indicating that specialization has a positive relationship with quality of care.

  2. Laboratory cost and utilization containment.

    Science.gov (United States)

    Steiner, J W; Root, J M; White, D C

    1991-01-01

    The authors analyzed laboratory costs and utilization in 3,771 cases of Medicare inpatients admitted to a New England academic medical center ("the Hospital") from October 1, 1989 to September 30, 1990. The data were derived from the Hospital's Decision Resource System comprehensive data base. The authors established a historical reference point for laboratory costs as a percentage of total inpatient costs using 1981-82 Medicare claims data and cost report information. Inpatient laboratory costs were estimated at 9.5% of total inpatient costs for pre-Diagnostic Related Groups (DRGs) Medicare discharges. Using this reference point and adjusting for the Hospital's 1990 case mix, the "expected" laboratory cost was 9.3% of total cost. In fact, the cost averaged 11.5% (i.e., 24% above the expected cost level), and costs represented an even greater percentage of DRG reimbursement at 12.9%. If we regard the reimbursement as a total cost target (to eliminate losses from Medicare), then that 12.9% is 39% above the "expected" laboratory proportion of 9.3%. The Hospital lost an average of $1,091 on each DRG inpatient. The laboratory contributed 29% to this loss per case. Compared to other large hospitals, the Hospital was slightly (3%) above the mean direct cost per on-site test and significantly (58%) above the mean number of inpatient tests per inpatient day compared to large teaching hospitals. The findings suggest that careful laboratory cost analyses will become increasingly important as the proportion of patients reimbursed in a fixed manner grows. The future may hold a prospective zero-based laboratory budgeting process based on predictable patterns of DRG admissions or other fixed-reimbursement admission and laboratory utilization patterns.

  3. Utility portfolio diversification

    International Nuclear Information System (INIS)

    Griffes, P.H.

    1990-01-01

    This paper discusses portfolio analysis as a method to evaluate utility supply decisions. Specifically a utility is assumed to increase the value of its portfolio of assets whenever it invests in a new supply technology. This increase in value occurs because the new asset either enhances the return or diversifies the risks of the firm's portfolio of assets. This evaluation method is applied to two supply innovations in the electric utility industry: jointly-owned generating plants and supply contracts with independent power producers (IPPs)

  4. Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach

    Directory of Open Access Journals (Sweden)

    Elisabeth Paul

    2018-01-01

    Full Text Available Background Performance-based financing (PBF is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC followed suit through a health system strengthening (HSS project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach – especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness – and explores the mechanisms at stake so as to better understand how the “PBF package” functions and produces effects. Methods An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors’ capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Results Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank’s mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users’ platforms, as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers’ motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and

  5. Performance-based plastic design of earthquake resistant reinforced concrete moment frames

    Science.gov (United States)

    Liao, Wen-Cheng

    Performance-Based Plastic Design (PBPD) method has been recently developed to achieve enhanced performance of earthquake resistant structures. The design concept uses pre-selected target drift and yield mechanism as performance criteria. The design base shear for selected hazard level is determined by equating the work needed to push the structure monotonically up to the target drift to the corresponding energy demand of an equivalent SDOF oscillator. This study presents development of the PBPD approach as applied to reinforced concrete special moment frame (RC SMF) structures. RC structures present special challenge because of their complex and degrading ("pinched") hysteretic behavior. In order to account for the degrading hysteretic behavior the 1-EMA 440 C2 factor approach was used in the process of determining the design base shear. Four baseline RC SMF (4, 8, 12 and 20-story) as used in the FEMA P695 were selected for this study. Those frames were redesigned by the PBPD approach. The baseline frames and the PBPD frames were subjected to extensive inelastic pushover and time-history analyses. The PBPD frames showed much improved response meeting all desired performance objectives, including the intended yield mechanisms and the target drifts. On the contrary, the baseline frames experienced large story drifts due to flexural yielding of the columns. The work-energy equation to determine design base shear can also be used to estimate seismic demands, called the energy spectrum method. In this approach the skeleton force-displacement (capacity) curve of the structure is converted into energy-displacement plot (Ec) which is superimposed over the corresponding energy demand plot ( Ed) for the specified hazard level to determine the expected peak displacement demands. In summary, this study shows that the PBPD approach can be successfully applied to RC moment frame structures as well, and that the responses of the example moment frames were much improved over those

  6. MSIS Drug Utilization Datamart

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page provides background needed to take advantage of the capabilities of the MSIS Drug Utilization Datamart. This mart allows the user to develop high-level...

  7. Utility franchises reconsidered

    Energy Technology Data Exchange (ETDEWEB)

    Weidner, B.

    1981-11-01

    It is easier to obtain a public utility franchise than one for a fast food store because companies like Burger King value the profit share and control available with a franchise arrangement. The investor-owned utilities (IOUs) in Chicago and elsewhere gets little financial or regulatory benefit, although they do have an alternative because the franchise can be taken over by the city with a one-year notice. As IOUs evolved, the annual franchise fee has been incorporated into the rate in a move that taxes ratepayers and maximizes profits. Cities that found franchising unsatisfactory are looking for ways to terminate the franchise and finance a takeover, but limited-term and indeterminate franchises may offer a better mechanism when public needs and utility aims diverge. A directory lists franchised utilities by state and comments on their legal status. (DCK)

  8. Chemical Search Web Utility

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Chemical Search Web Utility is an intuitive web application that allows the public to easily find the chemical that they are interested in using, and which...

  9. Performance-based evaluation of graphic displays for nuclear-power-plant control rooms

    International Nuclear Information System (INIS)

    Petersen, R.J.; Banks, W.W.; Gertman, D.I.

    1982-01-01

    This paper reports several methodologies for evaluating the perceptual and perceptual/decision making aspects of displays used in the control rooms of nuclear power plants. This NRC funded study focuses upon the Safety Parameter Display System (SPDS) and relates the utility of the display to objective performance and preference measures obtained in experimental conditions. The first condition is a traditional laboratory setting where classical experimental methodologies can be employed. The second condition is an interactive control room simulation where the operator's performance is assessed while he/she operates the simulator. The third condition is a rating scale designed to assess operator preferences and opinions regarding a variety of display formats. The goal of this study is the development of a cost-efficient display evaluation methodology which correlates highly with the operator's ability to control a plant

  10. Performance Based Clustering for Benchmarking of Container Ports: an Application of Dea and Cluster Analysis Technique

    Directory of Open Access Journals (Sweden)

    Jie Wu

    2010-12-01

    Full Text Available The operational performance of container ports has received more and more attentions in both academic and practitioner circles, the performance evaluation and process improvement of container ports have also been the focus of several studies. In this paper, Data Envelopment Analysis (DEA, an effective tool for relative efficiency assessment, is utilized for measuring the performances and benchmarking of the 77 world container ports in 2007. The used approaches in the current study consider four inputs (Capacity of Cargo Handling Machines, Number of Berths, Terminal Area and Storage Capacity and a single output (Container Throughput. The results for the efficiency scores are analyzed, and a unique ordering of the ports based on average cross efficiency is provided, also cluster analysis technique is used to select the more appropriate targets for poorly performing ports to use as benchmarks.

  11. Performance-based specifications and control of concrete durability state-of-the-art report RILEM TC 230-PSC

    CERN Document Server

    Luco, Luis

    2016-01-01

    This work gives an overview of significant research from recent years concerning performance-based design and quality control for concrete durability and its implementation. In engineering practice, performance approaches are often still used in combination with prescriptive requirements. This is largely because, for most durability test methods, sufficient practical experience still has to be gained before engineers and owners are prepared to fully rely on them.   This book, compiled by RILEM TC 230-PSC, is intended to assist efforts to successfully build the foundation for the full implementation of performance-based approaches through the exchange of relevant knowledge and experience between researchers and practitioners worldwide.  .

  12. Utility requirements for HTGRs

    International Nuclear Information System (INIS)

    Nicholls, D.R.

    1997-01-01

    Eskom, the state utility of South Africa, is currently evaluating the technical and economic feasibility of the helium cooled Pebble Bed Modular Reactor with a closed cycle gas turbine power conversion system for future power generating additions to its electric system. This paper provides an overview of the Eskom system including the needs of the utility for future generation capacity and the key performance requirements necessary for incorporation of this gas cooled reactor plant. (author)

  13. Utility, games, and narratives

    OpenAIRE

    Fioretti, Guido

    2009-01-01

    This paper provides a general overview of theories and tools to model individual and collective decision-making. In particular, stress is laid on the interaction of several decision-makers. A substantial part of this paper is devoted to utility maximization and its application to collective decision-making, Game Theory. However, the pitfalls of utility maximization are thoroughly discussed, and the radically alternative approach of viewing decision-making as constructing narratives is pre...

  14. Utility requirements for fusion

    International Nuclear Information System (INIS)

    Vondrasek, R.J.

    1982-02-01

    This report describes work done and results obtained during performance of Task 1 of a study of Utility Requirements and Criteria for Fusion Options. The work consisted of developing a list of utility requirements for fusion optics containing definition of the requirements and showing their relative importance to the utility industry. The project team members developed a preliminary list which was refined by discussions and literature searches. The refined list was recast as a questionnaire which was sent to a substantial portion of the utility industry in this country. Forty-three questionnaire recipients responded including thirty-two utilities. A workshop was held to develop a revised requirements list using the survey responses as a major input. The list prepared by the workshop was further refined by a panel consisting of vice presidents of the three project team firms. The results of the study indicate that in addition to considering the cost of energy for a power plant, utilities consider twenty-three other requirements. Four of the requirements were judged to be vital to plant acceptability: Plant Capital Cost, Financial Liability, Plant Safety and Licensability

  15. Microorganism Utilization for Synthetic Milk

    Science.gov (United States)

    Morford, Megan A.; Khodadad, Christina L.; Caro, Janicce I.; Spencer, LaShelle E.; Richards, Jeffery T.; Strayer, Richard F.; Birmele, Michele N.; Wheeler, Raymond M.

    2014-01-01

    A desired architecture for long duration spaceflight, like aboard the International Space Station or for future missions to Mars, is to provide a supply of fresh food crops for the astronauts. However, some crops can create a high proportion of inedible plant waste. The main goal of the Synthetic Biology project, Cow in a Column, was to produce the components of milk (sugar, lipid, protein) from inedible plant waste by utilizing microorganisms (fungi, yeast, bacteria). Of particular interest was utilizing the valuable polysaccharide, cellulose, found in plant waste, to naturally fuel-through microorganism cellular metabolism- the creation of sugar (glucose), lipid (milk fat), and protein (casein) in order to produce a synthetic edible food product. Environmental conditions such as pH, temperature, carbon source, aeration, and choice microorganisms were optimized in the laboratory and the desired end-products, sugars and lipids, were analyzed. Trichoderma reesei, a known cellulolytic fungus, was utilized to drive the production of glucose, with the intent that the produced glucose would serve as the carbon source for milk fat production and be a substitute for the milk sugar lactose. Lipid production would be carried out by Rhodosporidium toruloides, yeast known to accumulate those lipids that are typically found in milk fat. Results showed that glucose and total lipid content were below what was expected during this phase of experimentation. In addition, individual analysis of six fatty acids revealed that the percentage of each fatty acid was lower than naturally produced bovine milk. Overall, this research indicates that microorganisms could be utilized to breakdown inedible solid waste to produce useable products. For future work, the production of the casein protein for milk would require the development of a genetically modified organism, which was beyond the scope of the original project. Additional trials would be needed to further refine the required

  16. The Multiple Object Test as a Performance Based Tool to Assess Cognitive Driven Activity of Daily Living Function in Parkinson's Disease.

    Science.gov (United States)

    Glonnegger, Hannah; Beyle, Aline; Cerff, Bernhard; Gräber, Susanne; Csoti, Ilona; Berg, Daniela; Liepelt-Scarfone, Inga

    2016-07-06

    There is need for multidimensional quantitative assessment of cognitive driven activities of daily living (ADL) functions in Parkinson's disease (PD). To determine whether there is an ADL profile related to cognitive impairment in PD assessed by the Multiple Object Test (MOT). We assumed MOT performance to be lower in PD patients versus controls and in PD patients with more severe cognitive impairment. 50 PD patients with no cognitive impairment (PD-NC), 54 patients with PD-mild cognitive impairment (PD-MCI), 29 with Parkinson's disease dementia (PDD), and 40 healthy controls (HC) were investigated. Besides comprehensive cognitive testing, the MOT, a performance based test consisting of five routine tasks (e.g., preparing a cup of coffee), was applied. Quantitative (total errors and time) and qualitative (error type) MOT parameters were analyzed. Total time and number of MOT errors was increased in PD patients compared to controls (p < 0.001). These parameters also differentiated PDD patients from other cognitive groups (p < 0.05). No control subject had ≥ 4 errors in the MOT, but 30% of PD patients, especially PDD, scored above this cut-off. Omission (p < 0.001) and mislocation (p < 0.03) errors were more prominent in PDD than other cognitive groups. Perplexity errors did not differ between PD-MCI and PDD but between PD-NC and PDD (p = 0.01). MOT parameters discriminating between cognitive groups correlated mainly with lower test performance in psychomotor speed and executive function. Performance based testing is promising to identify quantitative and qualitative ADL aspects differentiating between different cognitive groups which might be helpful for an early detection of PDD.

  17. Performance-based pay is fair, particularly when I perform better : Differential fairness perceptions of allocators and recipients

    NARCIS (Netherlands)

    Van Yperen, N.W.; Van den Bos, K.P.; de Graaff, D.

    2005-01-01

    We examined in two experiments the impact of the roles that people enact (allocator or recipient) and performance attributions (talent or effort) on fairness perceptions of pay systems (performance-based pay or job-based pay). To test the relative effects of the roles that people enact, in the

  18. The Use of Performance Based Funding in a Sport Organization: A Case Study of the United States Olympic Committee

    Science.gov (United States)

    2009-08-01

    description and analysis of a single instance, phenomenon, or social unit (Merriam, 1998). Management by Objective (MBO). A control system designed to...theoretical principles of performance based funding instead of testing a hypothesis, my epistemology will be constructivist. Constructionism Maynard...operate. This constitutes a vital epistemological position that constructionism takes in relation to the interaction between the investigator and

  19. Student Listening Gains in the Basic Communication Course: A Comparison of Self-Report and Performance-Based Competence Measures

    Science.gov (United States)

    Johnson, Danette Ifert; Long, Kathleen M.

    2007-01-01

    Direct listening instruction is a frequent component of basic communication courses. Research has found changes in self-perceived listening competence during a basic communication course and only a minimal relationship between self-perceived and performance-based measures of listening and other communication behaviors. Results of the present study…

  20. Improving the road wear performance of heavy vehicles in South Africa using a performance-based standards approach

    CSIR Research Space (South Africa)

    Nordengen, Paul A

    2010-05-01

    Full Text Available of the world to achieve regional harmonisation and effective road use have had limited success. Another approach is to consider performance-based standards (PBS); in this case standards specify the performance required from the operation of a vehicle on a...

  1. Teacher Reactions to the Performance-Based Bonus Program: How the Expectancy Theory Works in the South Korean School Culture

    Science.gov (United States)

    Ha, Bong-Woon; Sung, Youl-Kwan

    2011-01-01

    This study was conducted in order to examine how and to what extent the implementation of the performance-based bonus program in South Korean schools has motivated teachers to improve their behavior, as well as to identify any other positive or negative effects of the program. Interviews with teachers indicated that a large percentage of teachers…

  2. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review

    NARCIS (Netherlands)

    Dobson, F.; Hinman, R.S.; Leverstein-van Hall, M.A.; Terwee, C.B.; Roos, E.M.; Bennell, K.L.

    2012-01-01

    Objectives: To systematically review the measurement properties of performance-based measures to assess physical function in people with hip and/or knee osteoarthritis (OA). Methods: Electronic searches were performed in MEDLINE, CINAHL, Embase, and PsycINFO up to the end of June 2012. Two reviewers

  3. SiGe epitaxial memory for neuromorphic computing with reproducible high performance based on engineered dislocations

    Science.gov (United States)

    Choi, Shinhyun; Tan, Scott H.; Li, Zefan; Kim, Yunjo; Choi, Chanyeol; Chen, Pai-Yu; Yeon, Hanwool; Yu, Shimeng; Kim, Jeehwan

    2018-01-01

    Although several types of architecture combining memory cells and transistors have been used to demonstrate artificial synaptic arrays, they usually present limited scalability and high power consumption. Transistor-free analog switching devices may overcome these limitations, yet the typical switching process they rely on—formation of filaments in an amorphous medium—is not easily controlled and hence hampers the spatial and temporal reproducibility of the performance. Here, we demonstrate analog resistive switching devices that possess desired characteristics for neuromorphic computing networks with minimal performance variations using a single-crystalline SiGe layer epitaxially grown on Si as a switching medium. Such epitaxial random access memories utilize threading dislocations in SiGe to confine metal filaments in a defined, one-dimensional channel. This confinement results in drastically enhanced switching uniformity and long retention/high endurance with a high analog on/off ratio. Simulations using the MNIST handwritten recognition data set prove that epitaxial random access memories can operate with an online learning accuracy of 95.1%.

  4. Improving LAN Performance Based on IEEE802.1Q VLAN Switching Techniques

    Directory of Open Access Journals (Sweden)

    Dhurgham Abdulridha Jawad AL-Khaffaf

    2017-11-01

    Full Text Available VLAN is a set of users in different isolated logical LANs or broadcasting domains, they are communicated as a same LAN i.e. same broadcasting domain. Ethernet protocol is very popular over networks because it has a simple of implementation and ease of configuration. However, the support of Quality of Service (QoS has become an essential merit of Ethernet network. In this context, the problems of large network and data transport delay have been regained significant importance. Alleviating the end to end delay by using the VLAN technology to enhance the network performance. In this paper, we analyze and evaluate the performance of LAN and VLAN networks in different scenarios. Measuring key performance indicators such as traffic sent, traffic received, average delay and throughput. The simulation was carried out by employing OPNET 17.5 Student Version. Two different scenarios are presented to observe the performance of LAN and VLAN networks. The simulation results illustrated that there is more existing traffic without VLAN technology. Hence, VLANs prohibit the access to the network resources of other departments. Also, VLAN has half average queuing delay compared with no VLAN scenario. Therefore, VLANs can improve bandwidth utilization, power, speed and security.

  5. Invited Article: Threats to physician autonomy in a performance-based reimbursement system.

    Science.gov (United States)

    Larriviere, Daniel G; Bernat, James L

    2008-06-10

    Physician autonomy is currently threatened by the external application of pay for performance standards and required conformity to practice guidelines. This phenomenon is being driven by concerns over the economic viability of increasing per capita health care expenditures without a concomitant rise in favorable health outcomes and by the unjustified marked variations among physicians' practice patterns. Proponents contend that altering the reimbursement system to encourage physicians to make choices based upon the best available evidence would be one way to ensure better outcomes per health care dollar spent. Although physician autonomy is most easily justified when decisions are made by appealing to the best available evidence, incentivizing decision-making risks sacrificing physician autonomy to political and social forces if the limitations of evidence-based medicine are not respected. Any reimbursement system designed to encourage physicians to utilize the best available evidence by providing financial incentives must recognize physicians who try to play to the numbers as well as physicians who refuse to follow the best available evidence if doing so would conflict with good medicine or patient preferences. By designing, promulgating, and updating evidence-based clinical practice guidelines, medical specialty societies can limit threats to physician autonomy while improving medical practice.

  6. Measurement of utility.

    Science.gov (United States)

    Thavorncharoensap, Montarat

    2014-05-01

    The Quality Adjusted Life Year (QALY) is the most widely recommended health outcome measure for use in economic evaluations. The QALY gives a value to the effect of a given health intervention in terms of both quantity and quality. QALYs are calculated by multiplying the duration of time spent in a given health state, in years, by the quality of life weighted, known as utility. Utility can range from 0 (the worst health state-the equivalent of death) to 1 (the best health state-full health). This paper provides an overview of the various methods that can be used to measure utility and outlines the recommended protocol for measuring utility, as described in the Guidelines for Health Technology Assessment in Thailand (second edition). The recommendations are as follows: Wherever possible, primary data collection using EQ-5D-3L in patients using Thai value sets generated from the general public should be used. Where the EQ-5D-3L is considered inappropriate, other methods such as Standard gamble (SG), Time-trade-off (TTO), Visual analogue scale (VAS), Health Utilities Index (HUI), SF-6D, or Quality of well being (QWB) can be used. However, justification and full details on the chosen instrument should always be provided.

  7. Fiscal 1997 survey report. Subtask 3 (hydrogen utilization worldwide clean energy system technology) (WE-NET) (conceptual design of the total system/city-level energy estimation and assessment); 1997 nendo seika hokokusho. Suiso riyo kokusai clean energy system gijutsu (WE-NET) subtask zentai system gainen sekkei (toshi kibo deno yosoku hyoka)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    The paper described the fiscal 1997 result of the study of scenarios for introducing hydrogen to the urban area. In the case of studying it in London, it was found that hythane (mixture of hydrogen into town gas) was effective, but in the case of doing in Tokyo, it was found that the scenario was undesirable because of the increasing infracost. Accordingly, another scenario was studied. It was assessed from the aspects of environmental advantages, infracosts, and potential advantageous values in urban areas associated with hydrogen utilization (hydrogen premium). It is most effective to use hydrogen as a fuel of transportation means from the aspect of environmental merits as the decrease in external cost. In Tokyo, the dependence upon electric power is large, and therefore it is attractive to introduce highly efficient fuel cells which enable the dispersed cogeneration using hydrogen. The value of hydrogen is determined by the avoidance of environmentally influential substances and the surplus generated output by fuel cells (substitution for the existing natural gas). When the high external cost can be assumed, the value of hydrogen becomes large. The paper also considered the arrangement of infrastructures in Tokyo. 187 refs., 14 figs., 18 tabs.

  8. Implantation of total body irradiation in radiotherapy

    International Nuclear Information System (INIS)

    Habitzreuter, Angela Beatriz

    2010-01-01

    Before implementing a treatment technique, the characteristics of the beam under irradiation conditions must be well acknowledged and studied. Each one of the parameters used to calculate the dose has to be measured and validated before its utilization in clinical practice. This is particularly necessary when dealing with special techniques. In this work, all necessary parameters and measurements are described for the total body irradiation implementation in facilities designed for conventional treatments that make use of unconventional geometries to generate desired enlarged field sizes. Furthermore, this work presents commissioning data of this modality at Hospital das Clinicas of Sao Paulo using comparison of three detectors types for measurements of entrance dose during total body irradiation treatment. (author)

  9. Undergraduate students' perception and Utilization of electronic ...

    African Journals Online (AJOL)

    An evaluation of undergraduate students' perception and utilization of electronic information resources and services was carried out. The population of the study consisted of all registered library users in the 2014/2015 academic session. The total population of the study was 4, 211 registered users. Accidental sampling ...

  10. Electric utility report '80

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    A collection of brief atricles describes the trends and developments in Canada's electric utilities for the 1980's. Generating stations planned or under construction are listed. The trends in technology discused at a recent Canadian Electrical Association meeting are summarized in such areas as turbine stability control, power line vibration control, system reliability, substations and transformer specifications. Developments in nuclear generation are discussed and compared on the world scale where Japan, for example, has the world's largest nuclear program. Progress on fusion is discussed. In Canada the electric utilities are receiving the support of the comprehensive nuclear R and D program of Atomic Energy of Canada Ltd. New innovations in utility technology such as street lighting contactors, superconductive fault limiters and demand profile analyzers are discussed. (T.I.)

  11. Utility planning for decommissioning

    International Nuclear Information System (INIS)

    Williams, D.H.

    1982-01-01

    Though the biggest impact on a utility of nuclear power plant decommissioning may occur many years from now, procrastination of efforts to be prepared for that time is unwarranted. Foresight put into action through planning can significantly affect that impact. Financial planning can assure the recovery of decommissioning costs in a manner equitable to customers. Decision-making planning can minimize adverse affects of current decisions on later decommissioning impacts and prepare a utility to be equipped to make later decommissioning decisions. Technological knowledge base planning can support all other planning aspects for decommissioning and prepare a utility for decommissioning decisions. Informed project planning can ward off potentially significant pitfalls during decommissioning and optimize the effectiveness of the actual decommissioning efforts

  12. Markets: green utilities

    International Nuclear Information System (INIS)

    Wood, Elisa

    2006-01-01

    Publicly owned utilities have consistently led the United States in the rate of customer participation in green power programmes. The US has about 2000 community and state-owned utilities, which serve 43 million customers and account for about 16.6% of kilowatt-hour sales to consumers. In all, public power is responsible for about 10% of the nation's installed electric capacity. Investor owned utilities account for 39%, with the remainder of the nation's power mostly from independent power generators. Although IOUs have almost four times as much electric capacity as public power, they edge out public power by only a small margin when it comes to renewable capacity. IOUs are responsible for 24,577.5 MW of renewable capacity, compared to the 21,338 MW installed by public power. The reasons discussed by the author range from small town advantage to clean and cheap power. (Author)

  13. Eficiência de utilização da energia metabolizável para ganho de peso e exigências de energia metabolizável e nutrientes digestíveis totais de bovinos F1 Simental x Nelore Efficiency of metabolizable energy utilization for weight gain and requirements of metabolizable energy and total digestible nutrients in F1 Simental x Nellore bulls

    Directory of Open Access Journals (Sweden)

    Marcelo de Andrade Ferreira

    1999-04-01

    Full Text Available O objetivo deste trabalho foi estimar a eficiência de utilização da energia metabolizável (EM, para ganho de peso, e as exigências de energia metabolizável e nutrientes digestíveis totais de bovinos F1 Simental x Nelore, não-castrados, alimentados com rações contendo diferentes níveis de concentrado. Foram utilizados 29 animais com, em média, idade de 17 meses e peso vivo inicial de 354 kg. Cinco animais foram abatidos ao início do experimento, como referência, e o restante foi alimentado à vontade e distribuído nos tratamentos, de forma inteiramente casualizada, de acordo com o nível de concentrado na ração: 25; 37,5; 50; 62,5; e 75%. Os animais foram abatidos quando atingiram o peso de 500 kg. As concentrações de energia líquida das rações foram calculadas e as eficiências de utilização da energia metabolizável para ganho de peso foram estimadas, por análise de regressão, entre as energias líquidas para ganho, em relação à energia metabolizável (EM das rações. As exigências de EM para ganho de um quilograma de peso de corpo vazio aumentaram, à medida que se elevou o peso corporal dos animais e diminuíram, para mesmo peso vivo, à medida que se elevaram os níveis de concentrado nas rações. Estimaram-se as eficiências de utilização da energia metabolizável para ganho de peso em: 0,27; 0,26; 0,36; 0,39; e 0,42. O nível de concentrado melhorou a eficiência de utilização da EM para ganho de peso.The objective of this work was to estimate the efficiency of metabolizable energy utilization (ME for weight gain, and the requirements of metabolizable energy and total digestible nutrients in F1 Simental x Nellore bulls fed diets containing different concentrate levels. Twenty-nine animals averaging 17 of age and initial live weight of 354 kg were used. Five animals were slaughtered in the beginning of the experiment, as a reference, and the remainders were full fed and allotted to a completely randomized

  14. Octopus: LLL's computing utility

    International Nuclear Information System (INIS)

    Anon.

    1978-01-01

    The Laboratory's Octopus network constitutes one of the greatest concentrations of computing power in the world. This power derives from the network's organization as well as from the size and capability of its computers, storage media, input/output devices, and communication channels. Being in a network enables these facilities to work together to form a unified computing utility that is accessible on demand directly from the users' offices. This computing utility has made a major contribution to the pace of research and development at the Laboratory; an adequate rate of progress in research could not be achieved without it. 4 figures

  15. Utility FGD survey, January--December 1988

    Energy Technology Data Exchange (ETDEWEB)

    Hance, S.L.; McKibben, R.S.; Jones, F.M. (IT Corp., Cincinnati, OH (United States))

    1991-09-01

    The Utility FGD Survey report, which is generated by a computerized data base management system, represents a survey of operational and planned domestic utility flue gas desulfurization (FGD) systems. It summarizes information contributed by the utility industry, system and equipment suppliers, systems designers, research organizations, and regulatory agencies. The data cover system design, fuel characteristics, operating history, and actual system performance. Also included is a unit-by-unit discussion of problems and solutions associated with the boilers, scrubbers, and FGD systems. The development status (operational, under construction, or in the planning stages), system supplier, process, waste disposal practice, and regulatory class are tabulated alphabetically by utility company. Simplified process flow diagrams of FGD systems, definitions, and a glossary of terms are attached to the report. Current data for domestic FGD systems show systems in operation, systems under construction, and systems planned. The current total FGD-controlled capacity in the United States is 67,091 MW.

  16. Utility FGD survey, January--December 1988

    Energy Technology Data Exchange (ETDEWEB)

    Hance, S.L.; McKibben, R.S.; Jones, F.M. (IT Corp., Cincinnati, OH (United States))

    1991-09-01

    The Utility FGD Survey report, which is generated by a computerized data base management system, represents a survey of operational and planned domestic utility flue gas desulfurization (FGD) systems. It summarizes information contributed by the utility industry, system and equipment suppliers, system designers, research organizations, and regulatory agencies. The data cover system design, fuel characteristics, operating history, and actual system performance. Also included is a unit-by-unit discussion of problems and solutions associated with the boilers, scrubbers, and FGD systems. The development status (operational, under construction, or in the planning stages), system supplier, process, waste disposal practice, and regulatory class are tabulated alphabetically by utility company. Simplified process flow diagrams of FGD systems, definitions, and a glossary of terms are attached to the report. Current data for domestic FGD systems show systems in operation, systems under construction, and systems planned. The current total FGD-controlled capacity in the United States is 67,091 MW.

  17. Trends in Utility Green Pricing Programs (2004)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Brown, E.

    2005-10-01

    In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, nearly 600 utilities in regulated electricity markets--or almost 20% of all utilities nationally--provide their customers a "green power" option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals about 125. Through these programs, more than 40 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2004 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities as benchmarks by which to gauge the success of their green power programs.

  18. Comparison of Serum Concentrations of Total Cholesterol and Total ...

    African Journals Online (AJOL)

    Tuberculosis (TB) is one of the most dangerous tropical diseases that complicates HIV infection in Nigeria to date. Over two million Nigerians are known to be infected with TB and many more are at risk of the infection. Serum concentrations of total cholesterol and total lipid of 117 female TB patients attending chest clinic at ...

  19. Changes in total and differential white cell counts, total lymphocyte ...

    African Journals Online (AJOL)

    Background: Published reports on the possible changes in the various immune cell populations, especially the total lymphocyte and CD4 cell counts, during the menstrual cycle in Nigerian female subjects are relatively scarce. Aim: To determine possible changes in the total and differential white blood cell [WBC] counts, ...

  20. Male Adolescent Contraceptive Utilization.

    Science.gov (United States)

    Finkel, Madelon Lubin; Finkel, David J.

    1978-01-01

    The contraceptive utilization of a sample of sexually active, urban, high school males (Black, Hispanic, and White) was examined by anonymous questionnaire. Contraceptive use was haphazard, but White males tended to be more effective contraceptors than the other two groups. Reasons for nonuse were also studied. (Author/SJL)

  1. "Utilizing" signal detection theory.

    Science.gov (United States)

    Lynn, Spencer K; Barrett, Lisa Feldman

    2014-09-01

    What do inferring what a person is thinking or feeling, judging a defendant's guilt, and navigating a dimly lit room have in common? They involve perceptual uncertainty (e.g., a scowling face might indicate anger or concentration, for which different responses are appropriate) and behavioral risk (e.g., a cost to making the wrong response). Signal detection theory describes these types of decisions. In this tutorial, we show how incorporating the economic concept of utility allows signal detection theory to serve as a model of optimal decision making, going beyond its common use as an analytic method. This utility approach to signal detection theory clarifies otherwise enigmatic influences of perceptual uncertainty on measures of decision-making performance (accuracy and optimality) and on behavior (an inverse relationship between bias magnitude and sensitivity optimizes utility). A "utilized" signal detection theory offers the possibility of expanding the phenomena that can be understood within a decision-making framework. © The Author(s) 2014.

  2. RICE BRAIN UTILIZATION IN COMMERCIAL LAYING HENS DIETS FORMULATED ON TOTAL AND DIGESTIBLE AMINO ACID BASIS UTILIZAÇÃO DO FARELO DE ARROZ EM RAÇÕES PARA POEDEIRAS COMERCIAIS FORMULADAS COM BASE EM AMINOÁCIDOS TOTAIS E DIGESTÍVEIS

    Directory of Open Access Journals (Sweden)

    Vinicius Assuena

    2007-09-01

    Full Text Available

    The objective of this study was evaluate the per-formance, egg quality and production costs of commercial laying hens fed with rice meal and formulated on total and digestible amino acids basis. During 5 periods of 28 days 192 Lohmann LSL hens 25 weeks of age were distributed in a completely random experiment in a factorial scheme with 8 treatments and 3 replications of 8 birds each. The factorial scheme consisted in two amino acid recommen-dation (total and digestible and four inclusion levels of rice meal (0, 5, 10 and 15%. The performance and egg quality were evaluated during five cycles of 28 days. Un-der the conditions of this experiment, the use of digest-ible amino acid values determined low performance and higher production cost in comparison with the total amino acid values. The diets formulated with different rice meal levels did not affected performance and egg quality pa-rameters evaluated, however, the use of rice meal in lay-ing hens diets should be determined depending on avail-ability and cost, while was observed over 6% of inclusion the egg production costs was increased.

    KEY-WORDS: Alternative feed, amino acid recommendation, egg quality, performance.

    O experimento teve por objetivo avaliar o desem-penho, a qualidade e o custo de produção dos ovos de poe-deiras comerciais, alimentadas com rações contendo fare-lo de arroz e formuladas com base em aminoácidos totais e digestíveis. Empregaram-se 192 poedeiras da linhagem Lohmann LSL com 26 semanas de idade, distribuídas em um delineamento inteiramente ao acaso em esquema fato-rial 2 x 4 (duas recomendações de aminoácidos x 4 níveis de inclusão do farelo de arroz,  sendo utilizadas três repe-tições de oito aves por tratamento. Os tratamentos consis-tiram da combinação de duas recomendações de aminoá-cidos (totais ou digestíveis e quatro níveis de inclusão do farelo de arroz (0 %, 5 %, 10 % e 15 %. Durante cinco ciclos de 28 dias, avaliaram

  3. Coordinating a Service Supply Chain under Arms Offset Program’s Intervention by Performance-Based Contracting

    Directory of Open Access Journals (Sweden)

    Yi-Kuei Lin

    2016-01-01

    Full Text Available This paper investigates a support service supply chain for coordinating with a local third-party logistics provider by arms offset program’s intervention and develops a performance-based contracting framework for the coordinating problem, which remains scarce in the literatures. The performance-based contracting framework evaluates payments and profits for the support service by a game-theoretical approach with principal-agent model. We prove that the proposed framework is an effective tool in acquiring the balance between maximum profit and minimum payment for both parties in the coordinating problem without moral hazard issue. A numerical study consolidates the formulated schemes as contracting preference for both parties’ decision with a higher profit margin at a lower customer’s payment.

  4. Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain

    DEFF Research Database (Denmark)

    Wæhrens, Eva Ejlersen; Amris, Kirstine; Fisher, Anne G

    2010-01-01

    . The investigated psychometric properties of the AMPS included discrimination between a sample of healthy women and those with chronic widespread pain, as well as stability when no intervention was provided and sensitivity to change following intervention. Data were obtained based on a repeated measures design......-report and performance-based assessment of ADL offer distinct but complementary information about ability. The present study, therefore, investigated the applicability of a performance-based measure of ADL ability, the Assessment of Motor and Process Skills (AMPS), among 50 women with chronic widespread pain...... performing AMPS evaluations twice pre- and twice post-rehabilitation. Results indicated that the ADL motor ability measures of the participants were significantly lower than those of healthy women of same age, the ADL motor and ADL process ability measures remained stable when no intervention was provided...

  5. Technical methods for a risk-informed, performance-based fire protection program at nuclear power plants

    International Nuclear Information System (INIS)

    Dey, M.K.

    1998-01-01

    This paper presents a technical review and examination of technical methods that are available for developing a risk-informed, performance-based fire protection program at a nuclear plant. The technical methods include ''engineering tools'' for examining the fire dynamics of fire protection problems, reliability techniques for establishing an optimal fire protection surveillance program, fire computer codes for analyzing important fire protection safety parameters, and risk-informed approaches that can range from drawing qualitative insights from risk information to quantifying the risk impact of alternative fire protection approaches. Based on this technical review and examination, it is concluded that methods for modeling fires, and reliability and fire PRA analyses are currently available to support the initial implementation of simple risk-informed, performance-based approaches in fire protection programs. (author)

  6. Technical methods for a risk-informed, performance-based fire protection program at nuclear power plants

    International Nuclear Information System (INIS)

    Dey, M.K.

    2000-01-01

    This paper presents a technical review and examination of technical methods that are available for developing a risk-informed, performance-based fire protection program at a nuclear plant. The technical methods include 'engineering tools' for examining the fire dynamics of fire protection problems, reliability techniques for establishing an optimal fire protection surveillance program, fire computer codes for analyzing important fire protection safety parameters, and risk-informed approaches that can range from drawing qualitative insights from risk information to quantifying the risk impact of alternative fire protection approaches. Based on this technical review and examination, it is concluded that methods for modeling fires, and reliability and fire probabilistic risk analyses (PRA) are currently available to support the initial implementation of simple risk-informed, performance-based approaches in fire protection programs. (orig.) [de

  7. Performance-Based Outcomes Following Lisfranc Injury Among Professional American Football and Rugby Athletes.

    Science.gov (United States)

    Singh, Sameer K; George, Andrew; Kadakia, Anish R; Hsu, Wellington K

    2018-04-27

    Professional National Football League (NFL) and rugby athletes have high rates of Lisfranc injuries. Although favorable return-to-play rates have been previously reported, a thorough assessment of postinjury performance is lacking. Professional NFL and rugby athletes who sustained a Lisfranc injury were identified using a well-established protocol confirmed by multiple sources of the public record. Return-to-play rate and time to return were determined for each athlete. League participation and game performance were collected 1 season prior to injury and up to 3 seasons after injury. Statistical analysis was performed, with P≤.05 being significant. A total of 47 athletes (NFL=35, rugby=12) with Lisfranc injuries were identified, having 23 ligamentous injuries and 24 fractures. Thirty-five (75%) were treated operatively. Among NFL players, 29 (83%) returned to play, taking 10.0±2.9 months to do so. Overall, NFL players started fewer games 2 and 3 seasons following surgery (P=.002 and .035, respectively) and showed a significant decline in performance 1 season after return compared with preinjury levels (21%; P=.05). Offensive players had a significantly greater decline in statistical performance compared with defensive counterparts (P=.02). Although professional NFL athletes return to play at a high rate (83%) following Lisfranc injury, their league participation and performance is significantly decreased on return. Ligamentous and bony injuries have similar prognoses; however, offensive players show greater declines in performance compared with defensive players. To best guide therapy, players, coaches, and team physicians should be aware of the impact of Lisfranc injuries on career performance and longevity. [Orthopedics. 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.

  8. Performance-based vs socially supportive culture: A cross-national study of descriptive norms and entrepreneurship

    OpenAIRE

    Ute Stephan; Lorraine M Uhlaner

    2010-01-01

    This paper is a cross-national study testing a framework relating cultural descriptive norms to entrepreneurship in a sample of 40 nations. Based on data from the Global Leadership and Organizational Behavior Effectiveness project, we identify two higher-order dimensions of culture – socially supportive culture (SSC) and performance-based culture (PBC) – and relate them to entrepreneurship rates and associated supply-side and demand-side variables available from the Global Entrepreneurship Mo...

  9. Performance-based service acquisition (PBSA) of TRIDENT strategic weapons systems (SWS) technical engineering support (TES) services

    OpenAIRE

    Arcidiacono, William J.

    2003-01-01

    CIVINS (Civilian Institutions) Thesis document Approved for public release ; distribution is unlimited The objective of this thesis is to determine whether the Strategic Systems Programs (SSP) should apply the concepts of Performance-Based Service Acquisition (PBSA) to Strategic Weapons Systems (SWS) Technical Engineering Support (TES) Services. This thesis provides a Department of Defense (DoD), Department of the Navy (DON), and SSP SWS program acquisition and PBSA history background, ...

  10. Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis.

    Science.gov (United States)

    Schmidt, Catherine T; Ward, Rachel E; Suri, Pradeep; Kiely, Dan K; Ni, Pengsheng; Anderson, Dennis E; Bean, Jonathan F

    2017-07-01

    To identify differences in health factors, neuromuscular attributes, and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis; and to determine which neuromuscular attributes are associated with performance-based measures of mobility. Cross-sectional; secondary data analysis of a cohort study. Outpatient rehabilitation center. Community-dwelling adults aged ≥65 years with self-reported mobility limitations and symptomatic lumbar spinal stenosis (N=54). Not applicable. Short Physical Performance Battery score, habitual gait speed, and chair stand test. Symptomatic lumbar spinal stenosis was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults, 54 (13%) met criteria for symptomatic lumbar spinal stenosis. Compared with participants without symptomatic lumbar spinal stenosis, those with symptomatic lumbar spinal stenosis had more comorbidities, higher body mass index, greater pain, and less balance confidence. Participants with symptomatic lumbar spinal stenosis had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared with participants without symptomatic lumbar spinal stenosis. Five neuromuscular attributes were associated with performance-based mobility among participants with symptomatic lumbar spinal stenosis: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry. Community-dwelling older adults with self-reported mobility limitations and symptomatic lumbar spinal stenosis exhibit poorer health characteristics, greater neuromuscular impairment, and worse mobility when compared with those without symptomatic lumbar spinal stenosis. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry

  11. Total hip arthroplasty in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Alma Becic; Johnsen, Søren Paaske; Overgaard, Søren

    2005-01-01

    The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs.......The annual number of total hip arthroplasties (THA) has increased in Denmark over the past 15 years. There is, however, limited detailed data available on the incidence of THAs....

  12. Congruences of totally geodesic surfaces

    International Nuclear Information System (INIS)

    Plebanski, J.F.; Rozga, K.

    1989-01-01

    A general theory of congruences of totally geodesic surfaces is presented. In particular their classification, based on the properties of induced affine connections, is provided. In the four-dimensional case canonical forms of the metric tensor admitting congruences of two-dimensional totally geodesic surfaces of rank one are given. Finally, congruences of two-dimensional extremal surfaces are studied. (author)

  13. Performance-Based Acquisition: A tool to reduce costs and improve performance at US Army environmental remediation sites

    International Nuclear Information System (INIS)

    Kosko, Nancy; Gilman, Janet; White, Debbie

    2007-01-01

    The US Army, like most US federal and state environmental organizations, is faced with limited resources to conduct environmental work, an increasing workload, and challenges in achieving closeout of its environmental cleanup programs. In 2001, in an effort to incorporate proven private sector tools into federal cleanup programs, the Department of Defense (DoD) Business Initiative Council (BIC), initiated the use of Performance-Based Acquisition (PBA) for environmental cleanup. Since fiscal year 2000, the US Army Environmental Command (USAEC) has successfully awarded more than 55 performance-based contracts for environmental remediation. These contracts range in size from $500,000 to $52.4 million, and include closing properties (Base Realignment and Closure (BRAC)) and some of the US Army's most complex active installations. The contracts address a range of activities including investigation through monitoring and site completion, as well as various technical challenges including dense non-aqueous phase liquids (DNAPL) in ground water, karst systems, munitions and explosives of concern, and biological agents. The contracts are most often firm-fixed price, and 50 percent of the contracts required contractors to purchase environmental insurance in the form of remediation stop loss insurance (also known as cleanup cost cap insurance). The USAEC has conducted continuous process improvement since inception of the initiative. This paper presents results of two studies that were conducted in 2005-2006 to determine what lessons learned can be applied to future activities and to measure performance of contractors currently executing work under the performance based contracts. (authors)

  14. Urea utilization in growing lambs. 7

    International Nuclear Information System (INIS)

    Ulbrich, M.

    1989-01-01

    The utilization quota of NPN and pure feed protein for body protein synthesis was calculated on the basis of N balance experiments with 15 N-labelled urea with the help of model concepts of a 3-pool model and its mathematical usage. In lambs weighing 13 kg the efficiency of amino acid and nucleic acid synthesis in the non-amino acid N pool was 64%. This results in a total utilization quota for NPN and pure protein in the ration of 40% and 60%, resp. Lambs weighing 27 kg showed an efficiency in amino acid and nucleic acid synthesis in the non-AA N pool of 77% and in the AA N pool of 60%. The total utilization quota of NPN was 47% and that of pure protein 56%. The pure protein in the ration was thus about twice as well utilized for total protein synthesis and for protein syntesis for crude protein retention as the NPN compounds in the ration. (author)

  15. Financial analysis and forecasting of the results of small businesses performance based on regression model

    Directory of Open Access Journals (Sweden)

    Svetlana O. Musienko

    2017-03-01

    Full Text Available Objective to develop the economicmathematical model of the dependence of revenue on other balance sheet items taking into account the sectoral affiliation of the companies. Methods using comparative analysis the article studies the existing approaches to the construction of the company management models. Applying the regression analysis and the least squares method which is widely used for financial management of enterprises in Russia and abroad the author builds a model of the dependence of revenue on other balance sheet items taking into account the sectoral affiliation of the companies which can be used in the financial analysis and prediction of small enterprisesrsquo performance. Results the article states the need to identify factors affecting the financial management efficiency. The author analyzed scientific research and revealed the lack of comprehensive studies on the methodology for assessing the small enterprisesrsquo management while the methods used for large companies are not always suitable for the task. The systematized approaches of various authors to the formation of regression models describe the influence of certain factors on the company activity. It is revealed that the resulting indicators in the studies were revenue profit or the company relative profitability. The main drawback of most models is the mathematical not economic approach to the definition of the dependent and independent variables. Basing on the analysis it was determined that the most correct is the model of dependence between revenues and total assets of the company using the decimal logarithm. The model was built using data on the activities of the 507 small businesses operating in three spheres of economic activity. Using the presented model it was proved that there is direct dependence between the sales proceeds and the main items of the asset balance as well as differences in the degree of this effect depending on the economic activity of small

  16. Biomass ash utilization

    Energy Technology Data Exchange (ETDEWEB)

    Bristol, D.R.; Noel, D.J.; O`Brien, B. [HYDRA-CO Operations, Inc., Syracuse, NY (United States); Parker, B. [US Energy Corp., Fort Fairfield, ME (United States)

    1993-12-31

    This paper demonstrates that with careful analysis of ash from multiple biomass and waste wood fired power plants that most of the ash can serve a useful purpose. Some applications require higher levels of consistency than others. Examples of ash spreading for agricultural purposes as a lime supplement for soil enhancement in Maine and North Carolina, as well as a roadbase material in Maine are discussed. Use of ash as a horticultural additive is explored, as well as in composting as a filtering media and as cover material for landfills. The ash utilization is evaluated in a framework of environmental responsibility, regulations, handling and cost. Depending on the chemical and physical properties of the biomass derived fly ash and bottom ash, it can be used in one or more applications. Developing a program that utilizes ash produced in biomass facilities is environmentally and socially sound and can be financially attractive.

  17. Utilization of research reactors

    International Nuclear Information System (INIS)

    1962-01-01

    About 200 research reactors are now in operation in different parts of the world, and at least 70 such facilities, which are in advanced stages of planning and construction, should be critical within the next two or three years. In the process of this development a multitude of problems are being encountered in formulating and carrying out programs for the proper utilization of these facilities, especially in countries which have just begun or are starting their atomic energy work. An opportunity for scientific personnel from different Member States to discuss research reactor problems was given at an international symposium on the Programing and Utilization of Research Reactors organized by the Agency almost immediately after the General Conference session. Two hundred scientists from 35 countries, as well as from the European Nuclear Energy Agency and EURATOM, attended the meeting which was held in Vienna from 16 to 21 October 1961

  18. Industrial coal utilization

    Energy Technology Data Exchange (ETDEWEB)

    None

    1979-01-01

    The effects of the National Energy Act on the use of coal in US industrial and utility power plants are considered. Innovative methods of using coal in an environmentally acceptable way are discussed: furnace types, fluidized-bed combustion, coal-oil-mixtures, coal firing in kilns and combustion of synthetic gas and liquid fuels. Fuel use in various industries is discussed with trends brought about by uncertain availability and price of natural gas and fuel oils: steel, chemical, cement, pulp and paper, glass and bricks. The symposium on Industrial Coal Utilization was sponsored by the US DOE, Pittsburgh Energy Technology Center, April 3 to 4, 1979. Twenty-one papers have been entered individually into the EDB. (LTN)

  19. Role of the utility

    International Nuclear Information System (INIS)

    Bellin, A.

    1986-03-01

    It is common to say that a nuclear programme needs basic infrastructures such as an appropriate educational system, governmental organizations for regulation, decision and inspection, engineering organizations for design and implementation, industrial infrastructures for manufacturing, erection and commissioning, operation organizations for running and maintaining power plants. This schematic organization is not sufficient to succeed in a nuclear programme: one has to consider very carefully the attribution of responsibilities. It appears, that, among all the different systems which exist in the world for the organization of a nuclear project, it is always the utility which bears the overall responsibility for the implementation of the project. It defines objectives such as production capacity, schedule, price; it takes part in the definition of a national policy for energy supply, for the choice of a type of reactor, for the implementation of a national nuclear industry; it selects sites and conducts feasibility studies including a preliminary project; it participates in the definition of organization charts and selects contractors; it calls for and obtains authorizations from regulatory bodies; it manages the project, coordinates contractors and permanently ensures that goals are attained as regards safety, quality, schedule, costs. The French utility has directly taken charge of all these basic responsibilities and this is commonly considered as a major reason of the success of the French nuclear programme. Depending on its capacities, the utility may delegate some of these responsibilities - mainly concerning engineering and project management - to experienced firms. Nevertheless, one has to remember that the utility bears the final responsibility and that it is probably the organization most fully aware of the fact that the final goal is not the construction of a nuclear power station but the production of nuclear electricity in the best and safest conditions

  20. Reactor utilization, Annex A

    International Nuclear Information System (INIS)

    Martinc, R.; Stanic, A.

    1984-01-01

    Reactor was operated until August 1984 due to prohibition issued by the Ministry since the reactor does not have the emergency cooling system nor special filters in the ventilation system yet. This means that the operation plan was fulfilled by 69%. This annex includes detailed tables containing data about utilization of reactor experimental channels, irradiated samples, as well as interruptions of operation. Detailed data about reactor power during this period are shown as well

  1. Electric utilities in 2007

    Energy Technology Data Exchange (ETDEWEB)

    Hyman, L.S. [Smith Barney Inc., New York, NY (United States)

    1998-10-01

    A century ago--in the year J.J. Thomson discovered the electron--electricity, gas and traction companies battled for markets, and corrupt city councils demanded their fair share of the take. One tycoon became so disgusted with the confusion and dishonesty that he decided to bribe the legislature to set up an honest, state-run regulatory agency that would bring order to chaos. But he was found out. The scandal set back the cause of regulation until 1907, the year in which the electric washing machine and the vacuum cleaner were invented. By then, electricity sales had septupled from 1897 levels, and three states had established utility regulation. In the coming decade, 1997 to 2007, the utility business could undergo similar dramatic change, but it will move toward less regulation and more competition during a period of slow growth. Management will have to work harder to achieve success, however, because much of the profits will have to come not from a growing market but from the pockets of competitors. By 2007, electricity will constitute a component of a larger energy and utility services industry that sells electricity, natural gas and possibly water, propane and telecommunications. Customized service will meet the needs of consumers of all sizes. The dominant firm in the industry, the virtual utility, may look more like a financial organization or a mass marketer than the traditional converter of raw material to energy. Emphasis on market-based pricing should lead to more efficient use of resources. If the process works right, the consumer wins.

  2. Utilization of biogas

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, J L; Ross, C C; Smith, M S; Harper, S R [Georgia Tech Research Corp., Atlanta, GA (USA)

    1989-01-01

    A comprehensive study of the systems and equipment required to convert biogas into useful thermal and/or electrical energy was conducted, and the results published in the Handbook on Biogas Utilization (Walsh et al., Georgia Institute of Technology, Atlanta, GA, 1988). The physical, chemical and combustion characteristics of biogas, and the impact of these characteristics on both new and modified combustion equipment, were considered. The study also included consideration of auxiliary equipment for biogas collection, clean-up, compression and storage. (author).

  3. UTILITY OF SIMPLIFIED LABANOTATION

    Directory of Open Access Journals (Sweden)

    Maria del Pilar Naranjo

    2016-02-01

    Full Text Available After using simplified Labanotation as a didactic tool for some years, the author can conclude that it accomplishes at least three main functions: efficiency of rehearsing time, social recognition and broadening of the choreographic consciousness of the dancer. The doubts of the dancing community about the issue of ‘to write or not to write’ are highly determined by the contexts and their own choreographic evolution, but the utility of Labanotation, as a tool for knowledge, is undeniable.

  4. Clean energy utilization technology

    International Nuclear Information System (INIS)

    Honma, Takuya

    1992-01-01

    The technical development of clean energy including the utilization of solar energy was begun in 1973 at the time of the oil crisis, and about 20 years elapsed. Also in Japan, the electric power buying system by electric power companies for solar light electric power and wind electric power has been started in 1992, namely their value as a merchandise was recognized. As for these two technologies, the works of making the international standards and JIS were begun. The range of clean energy or natural energy is wide, and its kinds are many. The utilization of solar heat and the electric power generation utilizing waves, tide and geotherm already reached the stage of practical use. Generally in order to practically use new energy, the problem of price must be solved, but the price is largely dependent on the degree of spread. Also the reliability, durability and safety must be ensured, and the easiness of use, effectiveness and trouble-saving maintenance and operation are required. For the purpose, it is important to packaging those skillfully in a system. The cases of intelligent natural energy systems are shown. Solar light and wind electric power generation systems and the technology of transporting clean energy are described. (K.I.)

  5. A systematic literature review of health state utility values in head and neck cancer.

    Science.gov (United States)

    Meregaglia, Michela; Cairns, John

    2017-09-02

    Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies. We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations. Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered

  6. Totality eclipses of the Sun

    CERN Document Server

    Littmann, Mark; Willcox, Ken

    2008-01-01

    A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. - ;A total eclipse of the Sun is the most awesome sight in the heavens. Totality: Eclipses of the Sun takes you to eclipses of the past, present, and future, and lets you see - and feel - why people travel to the ends of the Earth to observe them. Totality: Eclipses of the Sun is the best guide and reference book on solar eclipses ever written. It explains: how to observe them; how to photograph and videotape them; why they occur; their history and mythology; and future eclipses - when and where to see them. Totality also tells the remarkable story of how eclipses shocked scientists, revealed the workings of the Sun, and made Einstein famous. And the book shares the experiences and advice of many veteran eclipse observers. Totality: Eclipses of the Sun is profusely ill...

  7. Trends in Utility Green Pricing Programs (2005)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brown, Elizabeth [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2006-10-01

    In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 600 utilities—or about 20% of all utilities nationally—provide their customers a “green power” option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals more than 130. Through these programs, more than 50 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2005 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

  8. Total Product Life Cycle (TPLC)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Total Product Life Cycle (TPLC) database integrates premarket and postmarket data about medical devices. It includes information pulled from CDRH databases...

  9. Nutritional management after total laryngectomy

    African Journals Online (AJOL)

    28 September 2010 with a known diagnosis of cancer of the larynx. The patient, who underwent a total laryngectomy on 13 October, had a tracheostomy inserted .... status, leading to improved quality of life and better response to treatment.4.

  10. Market research for electric utilities

    International Nuclear Information System (INIS)

    Shippee, G.

    1999-01-01

    Marketing research is increasing in importance as utilities become more marketing oriented. Marketing research managers need to maintain autonomy from the marketing director or ad agency and make sure their work is relevant to the utility's operation. This article will outline a model marketing research program for an electric utility. While a utility may not conduct each and every type of research described, the programs presented offer a smorgasbord of activities which successful electric utility marketers often use or have access to

  11. Transmandibular approach to total maxillectomy

    OpenAIRE

    Tiwari, R. M.

    2001-01-01

    Total Maxillectomy through transfacial approach has been practiced in the treatment of Cancer for more than a decade. Its role in T3 - T4 tumors extending posteriorly through gthe bony wall is questionable, since an oncological radical procedure is often not possible. Recurrences in the infratemporal fossa are common. Despite the addition of radiotherapy five year survivals have not significantly improved. Transmandibular approach to Total Maxillectomy overcomes this shortcoming by including ...

  12. Leadership and Total Quality Management

    Science.gov (United States)

    1992-04-15

    leadership and management skills yields increased productivity. This paper will focus on the skills required of senior level leaders (leaders at the...publication until it has been cleared by the appropriate mii..-, service or government agency. Leadership and Total Quality Management An Individual Study...llty Codes fAvti1 and/or DltISpecial Abstract AUTHOR: Harry D. Gatanas, LTC, USA TITLE: Leadership and Total Quality Management FORMAT- Individual

  13. Access and utilization of water and sanitation facilities and their ...

    African Journals Online (AJOL)

    Elias Nyanza;ola

    This study was conducted to determine the access, utilization and determinants ... Results: A total of 175 households participated in the study. ..... et al., 2013; Mukoonyo et al., 2007) it is among the first studies to contribute to the evidence base.

  14. Veblen effect, marginal utility of money, and money illusion

    OpenAIRE

    Malakhov, Sergey

    2013-01-01

    The paper discovers microeconomic mechanism of Veblen effect as well as of Giffen case as results of the negative marginal utility of money. The marginal utility of consumption also becomes negative. The total consumption-leisure utility is increased due to the increase in leisure time. This overall effect results in the phenomenon of money illusion on the macroeconomic level. This general effect has deep historical and institutional grounds and, in order to minimize its disequilibrium econom...

  15. Electricity utilities: Nuclear sector

    International Nuclear Information System (INIS)

    Brosche, D.

    1992-01-01

    The safe and economic operation of nuclear power plants requires an appropriate infrastructure on the part of the operator as well as a high level of technical quality of the plants and of qualification of the personnel. Added to this are a variety of services rendered by specialist firms. The Bayernwerk utility, with plants of its own, has played a major role in the development of nuclear power in the Federal Republic of Germany. The importance of nuclear power to this firm is reflected in the pattern of its electricity sources and in the composition of its power plants. (orig.) [de

  16. Reactor utilization, Part 1

    International Nuclear Information System (INIS)

    Martinc, R.; Stanic, A.

    1981-01-01

    The reactor operating plan for 1981 was subject to the needs of testing operation with the 80% enriched fuel and was fulfilled on the whole. This annex includes data about reactor operation, review of shorter interruptions due to demands of the experiments, data about safety shutdowns caused by power cuts. Period of operation at low power levels was used mostly for activation analyses, and the operation at higher power levels were used for testing and regular isotope production. Detailed data about samples activation are included as well as utilization of the reactor as neutron source and the operating plan for 1982 [sr

  17. Energy utilization in Canada

    International Nuclear Information System (INIS)

    Klassen, J.

    1976-04-01

    The situation of the energy supply of Canada is characterized by its geographic location and by the dispersal of the energy consumers over a wide area. At present, the energy supply leaving the successful CANDU nuclear energy programme out of account, is based mainly on crude oil, natural gas, and electricity as well as on coal imported from the USA. The targets of Canadian enery policies and energy research are stated as follows: a) Reducing and optimizing energy consumption, b) introducing district heating, and c) utilizing the extensive local coal deposits. (GG) [de

  18. Managing the nuclear utility

    International Nuclear Information System (INIS)

    Williams, J.W. Jr.

    1985-01-01

    The Florida Power and Light Company (FP and L) is the fifth largest investor-owned utility in the country. The success of nuclear power generation at the St. Lucie Units 1 and 2 and Turkey Point Units 3 and 4 has resulted from a continuing management commitment to the nuclear program. The management of the power plants rely strongly on teamwork for most large projects and activities whether they entail plant operation, construction, or maintenance. Various examples of how teamwork has been used to realize the successful completion of projects or solutions to problems are given

  19. Tribal Utility Feasibility Study

    Energy Technology Data Exchange (ETDEWEB)

    Engel, R. A.; Zoellick, J. J.

    2007-06-30

    The Schatz Energy Research Center (SERC) assisted the Yurok Tribe in investigating the feasibility of creating a permanent energy services program for the Tribe. The original purpose of the DOE grant that funded this project was to determine the feasibility of creating a full-blown Yurok Tribal electric utility to buy and sell electric power and own and maintain all electric power infrastructure on the Reservation. The original project consultant found this opportunity to be infeasible for the Tribe. When SERC took over as project consultant, we took a different approach. We explored opportunities for the Tribe to develop its own renewable energy resources for use on the Reservation and/or off-Reservation sales as a means of generating revenue for the Tribe. We also looked at ways the Tribe can provide energy services to its members and how to fund such efforts. We identified opportunities for the development of renewable energy resources and energy services on the Yurok Reservation that fall into five basic categories: • Demand-side management – This refers to efforts to reduce energy use through energy efficiency and conservation measures. • Off-grid, facility and household scale renewable energy systems – These systems can provide electricity to individual homes and Tribal facilities in areas of the Reservation that do not currently have access to the electric utility grid. • Village scale, micro-grid renewable energy systems - These are larger scale systems that can provide electricity to interconnected groups of homes and Tribal facilities in areas of the Reservation that do not have access to the conventional electric grid. This will require the development of miniature electric grids to serve these interconnected facilities. • Medium to large scale renewable energy development for sale to the grid – In areas where viable renewable energy resources exist and there is access to the conventional electric utility grid, these resources can be

  20. Social group utility maximization

    CERN Document Server

    Gong, Xiaowen; Yang, Lei; Zhang, Junshan

    2014-01-01

    This SpringerBrief explains how to leverage mobile users' social relationships to improve the interactions of mobile devices in mobile networks. It develops a social group utility maximization (SGUM) framework that captures diverse social ties of mobile users and diverse physical coupling of mobile devices. Key topics include random access control, power control, spectrum access, and location privacy.This brief also investigates SGUM-based power control game and random access control game, for which it establishes the socially-aware Nash equilibrium (SNE). It then examines the critical SGUM-b

  1. The Shape of Utility Functions and Organizational Behavior

    NARCIS (Netherlands)

    J.M.E. Pennings; A. Smidts (Ale)

    2002-01-01

    textabstractBased on measurements with 332 owner-managers, the global shape of the utility function (i.e., S-shaped versus concave or convex over the total range of outcomes) appears to discriminate organizational behavior. Whereas the degree of risk aversion, based on the local shape of the utility

  2. Material Science in Cervical Total Disc Replacement

    Science.gov (United States)

    Pham, Martin H.; Mehta, Vivek A.; Tuchman, Alexander; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  3. Material Science in Cervical Total Disc Replacement

    Directory of Open Access Journals (Sweden)

    Martin H. Pham

    2015-01-01

    Full Text Available Current cervical total disc replacement (TDR designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti, and cobalt-chrome (CoCr. These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

  4. Material Science in Cervical Total Disc Replacement.

    Science.gov (United States)

    Pham, Martin H; Mehta, Vivek A; Tuchman, Alexander; Hsieh, Patrick C

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation.

  5. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  6. Total body water and total body potassium in anorexia nervosa

    International Nuclear Information System (INIS)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-01-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation

  7. Total 2004 annual report; TOTAL 2004 rapport annuel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  8. An algorithm for calculating exam quality as a basis for performance-based allocation of funds at medical schools.

    Science.gov (United States)

    Kirschstein, Timo; Wolters, Alexander; Lenz, Jan-Hendrik; Fröhlich, Susanne; Hakenberg, Oliver; Kundt, Günther; Darmüntzel, Martin; Hecker, Michael; Altiner, Attila; Müller-Hilke, Brigitte

    2016-01-01

    The amendment of the Medical Licensing Act (ÄAppO) in Germany in 2002 led to the introduction of graded assessments in the clinical part of medical studies. This, in turn, lent new weight to the importance of written tests, even though the minimum requirements for exam quality are sometimes difficult to reach. Introducing exam quality as a criterion for the award of performance-based allocation of funds is expected to steer the attention of faculty members towards more quality and perpetuate higher standards. However, at present there is a lack of suitable algorithms for calculating exam quality. In the spring of 2014, the students' dean commissioned the "core group" for curricular improvement at the University Medical Center in Rostock to revise the criteria for the allocation of performance-based funds for teaching. In a first approach, we developed an algorithm that was based on the results of the most common type of exam in medical education, multiple choice tests. It included item difficulty and discrimination, reliability as well as the distribution of grades achieved. This algorithm quantitatively describes exam quality of multiple choice exams. However, it can also be applied to exams involving short assay questions and the OSCE. It thus allows for the quantitation of exam quality in the various subjects and - in analogy to impact factors and third party grants - a ranking among faculty. Our algorithm can be applied to all test formats in which item difficulty, the discriminatory power of the individual items, reliability of the exam and the distribution of grades are measured. Even though the content validity of an exam is not considered here, we believe that our algorithm is suitable as a general basis for performance-based allocation of funds.

  9. An algorithm for calculating exam quality as a basis for performance-based allocation of funds at medical schools

    Directory of Open Access Journals (Sweden)

    Kirschstein, Timo

    2016-05-01

    Full Text Available Objective: The amendment of the Medical Licensing Act (ÄAppO in Germany in 2002 led to the introduction of graded assessments in the clinical part of medical studies. This, in turn, lent new weight to the importance of written tests, even though the minimum requirements for exam quality are sometimes difficult to reach. Introducing exam quality as a criterion for the award of performance-based allocation of funds is expected to steer the attention of faculty members towards more quality and perpetuate higher standards. However, at present there is a lack of suitable algorithms for calculating exam quality.Methods: In the spring of 2014, the students‘ dean commissioned the „core group“ for curricular improvement at the University Medical Center in Rostock to revise the criteria for the allocation of performance-based funds for teaching. In a first approach, we developed an algorithm that was based on the results of the most common type of exam in medical education, multiple choice tests. It included item difficulty and discrimination, reliability as well as the distribution of grades achieved. Results: This algorithm quantitatively describes exam quality of multiple choice exams. However, it can also be applied to exams involving short assay questions and the OSCE. It thus allows for the quantitation of exam quality in the various subjects and – in analogy to impact factors and third party grants – a ranking among faculty. Conclusion: Our algorithm can be applied to all test formats in which item difficulty, the discriminatory power of the individual items, reliability of the exam and the distribution of grades are measured. Even though the content validity of an exam is not considered here, we believe that our algorithm is suitable as a general basis for performance-based allocation of funds.

  10. Geothermal Resource Utilization

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, Paul J.

    1998-01-03

    Man has utilized the natural heat of the earth for centuries. Worldwide direct use of geothermal currently amounts to about 7,000 MWt, as compared to 1,500 MWe, now being used for the generation of electricity. Since the early 1970s, dwindling domestic reservoirs of oil and gas, continued price escalation of oil on the world market and environmental concerns associated with coal and nuclear energy have created a growing interest in the use of geothermal energy in the United States. The Department of Energy goals for hydrothermal resources utilization in the United States, expressed in barrels of oil equivalent, is 50 to 90 million bbl/yr by 1985 and 350 to 900 million bbl/yr by the year 2000. This relatively clean and highly versatile resource is now being used in a multitude of diverse applications (e.g., space heating and cooling, vegetable dehydration, agriculture, aquaculture, light manufacturing), and other applications requiring a reliable and economic source of heat.

  11. Utilization of coalbed methane

    Energy Technology Data Exchange (ETDEWEB)

    Gustavson, J.B. [Gustavson Associates Inc., Boulder, CO (United States)

    1996-02-01

    Substantial progress has been made in capturing coalbed methane (CBM gas), which constitutes a valuable source of clean burning energy. It is of importance to study the various potential uses of coalbed methane and to understand the various technologies required, as well as their economics and any institutional constraints. In industrialised countries, the uses of coalbed methane are almost solely dependent on microeconomics; coalbed methane must compete for a market against natural gas and other energy sources - and frequently, coalbed methane is not competitive against other energy sources. In developing countries, on the other hand, particularly where other sources of energy are in short supply, coalbed methane economics yield positive results. Here, constraints to development of CBM utilization are mainly lack of technology and investment capital. Sociological aspects such as attitude and cultural habits, may also have a strong negative influence. This paper outlines the economics of coalbed methane utilization, particularly its competition with natural gas, and touches upon the many different uses to which coalbed methane may be applied. 24 refs., 4 figs.

  12. Utilization of geothermal energy in the USSR

    International Nuclear Information System (INIS)

    Kononov, V.I.; Dvorov, I.M.

    1990-01-01

    This paper reports that at present geothermal energy is utilized in the USSR mostly for district heating, and for industrial and agricultural purposes. The populations of 7 towns have district heating that is supplied by thermal waters. The population supplied totals about 125,000 people. The total area of greenhouses is 850,000 m 2 . Electric energy generated at geothermal power stations still remains negligible with the installed capacity of the single Pauzhetka station (Kamchatka) being 11 MW. another station at Mutnovka is currently under construction and is expected to be producing 50 MW by 1992 and 200 MW by 1998. The proven geothermal resources in the USSR provide hope for a significant increase in the utilization of the earth's deep heat in the near future

  13. Calidad total en el ICESI

    OpenAIRE

    González Zamora, José Hipólito

    2010-01-01

    En primer lugar deseo dar la bienvenida esta reunión al ingeniero Francisco Gensini, director ejecutivo de INCOLDA, quien ha sido fuente constante de inspiración para el trabajo relacionado con Control Total de Calidad (C.T.C.) que se ha venido desarrollando en el ICESI. El ingeniero Gensini ha logrado aglutinar alrededor de INCOLDA al grupo de seis empresas de la región, líderes en el estudio y aplicación de los principios del Control Total de Calidad , es decir Rica Rondo S.A., Banco de Oc...

  14. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  15. Total phenolics and total flavonoids in selected Indian medicinal plants.

    Science.gov (United States)

    Sulaiman, C T; Balachandran, Indira

    2012-05-01

    Plant phenolics and flavonoids have a powerful biological activity, which outlines the necessity of their determination. The phenolics and flavonoids content of 20 medicinal plants were determined in the present investigation. The phenolic content was determined by using Folin-Ciocalteu assay. The total flavonoids were measured spectrophotometrically by using the aluminium chloride colorimetric assay. The results showed that the family Mimosaceae is the richest source of phenolics, (Acacia nilotica: 80.63 mg gallic acid equivalents, Acacia catechu 78.12 mg gallic acid equivalents, Albizia lebbeck 66.23 mg gallic acid equivalents). The highest total flavonoid content was revealed in Senna tora which belongs to the family Caesalpiniaceae. The present study also shows the ratio of flavonoids to the phenolics in each sample for their specificity.

  16. Data acquisition system and performance based on Apple II for using in experimental physics - Applications to spectrophotometer

    International Nuclear Information System (INIS)

    Costa, L.F.; Castro, J.C.

    1987-01-01

    A microcomputer based system oriented to experimental physics is described. The system was developed to achieve versatility, low cost, reliability and easy utilization. An application to this system to a dispersive spectrophotometer is also included. (author) [pt

  17. Utilities in UNIX

    International Nuclear Information System (INIS)

    Perez, L.

    2002-01-01

    This manual goes to the users with some or much experience in the unix operating system. In such manner that they can get more efficiency using the unix of the most vendors. Include the majority of UNIX commands, shell built-in functions to create scripts, and a brief explication of the variables in several environments. In addition, other products are included, more and more integrated in the most of the unix operating systems. For example: the scanning and processing language awk, the print server LPRng, GNU Utilities, batch subsystem, etc. The manual was initially based in an specific unix. But it and been written for use of the most unix that exist: Tru64 unix, aix, iris, hpux. solaris y linux. In this way, many examples in the chapter had been included. The purpose of this manual is to provide an UNIX reference for advanced users in any of the unix operating systems family. (Author)

  18. Hydrogen and energy utilities

    Energy Technology Data Exchange (ETDEWEB)

    Hustadt, Daniel [Vattenfall Europe Innovation GmbH (Germany)

    2010-07-01

    Renewable electricity generation plays one major role with the biggest share being wind energy. At the end of the year 2009 a wind power plant capacity of around 26 GW was installed in Germany. Several outlooks come to the conclusion that this capacity can be doubled in ten years (compare Figure 1). Additionally the German government has set a target of 26 GW installed off-shore capacity in North and Baltic Sea until 2030. At Vattenfall only a minor percentage of the electricity production comes from wind power today. This share will be increased up to 12% until 2030 following Vattenfall's strategy 'Making Electricity Clean'. This rapid development of wind power offers several opportunities but also means some challenges to Utilities. (orig.)

  19. Utility prudency issues

    International Nuclear Information System (INIS)

    Charnoff, G.

    1986-01-01

    The conventional legal standard of prudence found in the common law of public utility regulation precludes a judgment about past decisions based on present knowledge of whether the decisions proved in time to have been right or wrong. The proper inquiry is not whether every management decision proved to be correct. Rather, the proper inquiry as stated by the New York Public Service Commission in Re Consolidated Edison Co. of New York, Inc. is ...whether the company's conduct was reasonable at the time, under all of the circumstances, considering that the company had to solve its problems prospectively.... The exercise of prudence does not guarantee performance on schedule or within budget, or the making of correct decisions, when judged after the fact. But it does require or involve the exercise of reasoned decision making within a framework of reasonably available alternatives

  20. Performance based fault diagnosis

    DEFF Research Database (Denmark)

    Niemann, Hans Henrik

    2002-01-01

    Different aspects of fault detection and fault isolation in closed-loop systems are considered. It is shown that using the standard setup known from feedback control, it is possible to formulate fault diagnosis problems based on a performance index in this general standard setup. It is also shown...

  1. Linking payment to health outcomes: a taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers.

    Science.gov (United States)

    Carlson, Josh J; Sullivan, Sean D; Garrison, Louis P; Neumann, Peter J; Veenstra, David L

    2010-08-01

    To identify, categorize and examine performance-based health outcomes reimbursement schemes for medical technology. We performed a review of performance-based health outcomes reimbursement schemes over the past 10 years (7/98-010/09) using publicly available databases, web and grey literature searches, and input from healthcare reimbursement experts. We developed a taxonomy of scheme types by inductively organizing the schemes identified according to the timing, execution, and health outcomes measured in the schemes. Our search yielded 34 coverage with evidence development schemes, 10 conditional treatment continuation schemes, and 14 performance-linked reimbursement schemes. The majority of schemes are in Europe and Australia, with an increasing number in Canada and the U.S. These schemes have the potential to alter the reimbursement and pricing landscape for medical technology, but significant challenges, including high transaction costs and insufficient information systems, may limit their long-term impact. Future studies regarding experiences and outcomes of implemented schemes are necessary. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  2. Effects of Performance-Based Financial Incentives on Work Performance: A Study of Technical-Level Employees in the Private Sector in Sri Lanka

    Science.gov (United States)

    Wickramasinghe, Vathsala; Dabere, Sampath

    2012-01-01

    The objective of the study is to investigate the effect of performance-based financial incentives on work performance. The study hypothesized that the design features of performance-based financial incentive schemes themselves may influence individuals' work performance. For the study, survey methodology was used and 93 technical-level employees…

  3. Total Synthesis of Adunctin B.

    Science.gov (United States)

    Dethe, Dattatraya H; Dherange, Balu D

    2018-03-16

    Total synthesis of (±)-adunctin B, a natural product isolated from Piper aduncum (Piperaceae), has been achieved using two different strategies, in seven and three steps. The efficient approach features highly atom economical and diastereoselective Friedel-Crafts acylation, alkylation reaction and palladium catalyzed Wacker type oxidative cyclization.

  4. Edge colouring by total labellings

    DEFF Research Database (Denmark)

    Brandt, Stephan; Rautenbach, D.; Stiebitz, M.

    2010-01-01

    We introduce the concept of an edge-colouring total k-labelling. This is a labelling of the vertices and the edges of a graph G with labels 1, 2, ..., k such that the weights of the edges define a proper edge colouring of G. Here the weight of an edge is the sum of its label and the labels of its...

  5. What is Total Quality Management?

    Science.gov (United States)

    Bryan, William A.

    1996-01-01

    Provides a general overview of Total Quality Management (TQM) and explains why there is pressure for change in higher education institutions. Defines TQM and the various themes, tools, and beliefs that make it different from other management approaches. Presents 14 principles and how they might be applied to student affairs. (RJM)

  6. A totally diverting loop colostomy.

    Science.gov (United States)

    Merrett, N. D.; Gartell, P. C.

    1993-01-01

    A technique is described where the distal limb of a loop colostomy is tied with nylon or polydioxanone. This ensures total faecal diversion and dispenses with the supporting rod, enabling early application of stoma appliances. The technique does not interfere with the traditional transverse closure of a loop colostomy. PMID:8379632

  7. A generalization of total graphs

    Indian Academy of Sciences (India)

    M Afkhami

    2018-04-12

    Apr 12, 2018 ... product of any lower triangular matrix with the transpose of any element of U belongs to U. The ... total graph of R, which is denoted by T( (R)), is a simple graph with all elements of R as vertices, and ...... [9] Badawi A, On dot-product graph of a commutative ring, Communications in Algebra 43 (2015). 43–50.

  8. Total synthesis of nepetoidin B

    Science.gov (United States)

    The total synthesis of nepetoidin B (the 2-(3,4-dihydroxyphenyl)ethenyl ester of 3-(3,4-dihydroxy¬phenyl)-2-propenoic acid) has been achieved in two steps from commercially available 1,5-bis(3,4-dimethoxyphenyl)-1,4-pentadien-3-one. Tetramethylated nepetoidin B was prepared directly by Baeyer-Villig...

  9. The "Total Immersion" Meeting Environment.

    Science.gov (United States)

    Finkel, Coleman

    1980-01-01

    The designing of intelligently planned meeting facilities can aid management communication and learning. The author examines the psychology of meeting attendance; architectural considerations (lighting, windows, color, etc.); design elements and learning modes (furniture, walls, audiovisuals, materials); and the idea of "total immersion meeting…

  10. First total synthesis of Boehmenan

    Indian Academy of Sciences (India)

    The first total synthesis of dilignan Boehmenan has been achieved. A biomimetic oxidative coupling of the ferulic acid methyl ester in the presence of silver oxide is the crucial step in the synthesis sequence, generating the dihydrobenzofuran skeleton. Hydroxyl group was protected with DHP and reducted with LiAlH4 to ...

  11. Determination of total uranium by mass spectrometry utilizing the isotopic dilution technique

    International Nuclear Information System (INIS)

    Cretella, R.F.; Noutary, C.J.; Servant, R.E.

    1981-01-01

    The isotopic dilution associated to mass spectrometry is a high-sensitivity technique that allows to work with microquantities of the sample, making it possible to analize the content in highly radioactive solutions with excellent accuracy and minimum risk. The proposed technique is described and its results are discussed through the analysis of: 1) A synthetic sample that simulates dissolved spent fuel elements; 2) Uranium dioxide of nuclear purity and 3) Uranium concentrate. 233 U(ORNL) was employed as a tracer and a Nuclide 12-90-SU mass spectrometer of simple magnetic focus as measurement instrument. The accuracy reached in the analyses is better than 0.5% with a reliability of 95%. The analysis of the errors shows that their main contributing source are the errors in the measurement of the isotopic ratios. (M.E.L.) [es

  12. MODIFIED TECHNIQUE OF TOTAL LARYNGECTOMY

    Directory of Open Access Journals (Sweden)

    Predrag Spirić

    2010-12-01

    Full Text Available Surgical technique of total laryngectomy is well presented in many surgical textbooks. Essentially, it has remained the same since Gluck an Soerensen in 1922 described all its details. Generally, it stresses the U shape skin incision with releasing laryngeal structures and removing larynx from up to down. Further, pharyngeal reconstruction is performed with different kinds of sutures in two or more layers and is finished with skin suture and suction drainage. One of worst complications following this surgery is pharyngocutaneous fistula (PF. Modifications proposed in this this article suggests vertical skin incision with larynx removal from below upwards. In pharyngeal reconstruction we used the running locked suture in submucosal plan with „tobacco sac“ at the end on the tongue base instead of traditional T shaped suture. Suction drains were not used.The aim of study was to present the modified surgical technique of total laryingectomy and its impact on hospital stay duration and pharyngocutanous fistula formation. In this randomized study we analyzed 49 patients operated with modified surgical technique compared to 49 patient operated with traditional surgical technique of total laryngectomy. The modified technique of total laryngectomy was presented. Using modified technique we managed to decrease the PF percentage from previous 20,41% to acceptable 8,16% (p=0,0334. Also, the average hospital stay was shortened from 14,96 to 10,63 days (t =-2.9850; p=0.0358.The modified technique of total laryngectomy is safe, short and efficient surgical intervention which decreases the number of pharyngocutaneos fistulas and shortens the hospital stay.

  13. Energy utilities and the Internet

    International Nuclear Information System (INIS)

    2000-01-01

    The chances for energy utilities in the Netherlands to present themselves on the Internet are briefly outlined. It appears that other businesses are ahead of the Dutch utilities in offering electronic services with respect to energy

  14. Total Site Heat Integration Considering Pressure Drops

    Directory of Open Access Journals (Sweden)

    Kew Hong Chew

    2015-02-01

    Full Text Available Pressure drop is an important consideration in Total Site Heat Integration (TSHI. This is due to the typically large distances between the different plants and the flow across plant elevations and equipment, including heat exchangers. Failure to consider pressure drop during utility targeting and heat exchanger network (HEN synthesis may, at best, lead to optimistic energy targets, and at worst, an inoperable system if the pumps or compressors cannot overcome the actual pressure drop. Most studies have addressed the pressure drop factor in terms of pumping cost, forbidden matches or allowable pressure drop constraints in the optimisation of HEN. This study looks at the implication of pressure drop in the context of a Total Site. The graphical Pinch-based TSHI methodology is extended to consider the pressure drop factor during the minimum energy requirement (MER targeting stage. The improved methodology provides a more realistic estimation of the MER targets and valuable insights for the implementation of the TSHI design. In the case study, when pressure drop in the steam distribution networks is considered, the heating and cooling duties increase by 14.5% and 4.5%.

  15. Analysis on the cost performance and its impact to Japanese electric utilities and vision of the power portfolio

    International Nuclear Information System (INIS)

    Yamaguchi, Yuji; Matsuo, Yuji; Murakami, Tomoko

    2013-01-01

    Most of the nuclear power plants in Japan have been shut down since the Fukushima accident in March 2011, without being permitted to restart after periodical inspections. Accordingly, thermal power generation significantly increased in FY 2011. In this paper the authors made a quantitative analysis on the unit costs of power generation and on the financial performance based on the financial reports of electric utilities. The average unit cost in FY 2011 rose to 11.6 JPY/kWh, 3 JPY/kWh higher than that in FY 2010, and will rise further to 12.6 JPY/kWh in FY 2012. The total retained profit of 8 utilities decreased by some 1 trillion JPY from FY 2010 to FY 2011 and will decrease further to 1 trillion JPY by the end of FY 2012, which is the lowest level in history. Clear decisions on energy policies and future power portfolio, as well as the restructuring of the electricity system in line with the rapid change in the power portfolio will be highly required for policy planners in Japan. (author)

  16. Celss nutrition system utilizing snails

    Science.gov (United States)

    Midorikawa, Y.; Fujii, T.; Ohira, A.; Nitta, K.

    At the 40th IAF Congress in Malaga, a nutrition system for a lunar base CELSS was presented. A lunar base with a total of eight crew members was envisaged. In this paper, four species of plants—rice, soybean, lettuce and strawberry—were introduced to the system. These plants were sufficient to satisfy fundamental nutritional needs of the crew members. The supply of nutrition from plants and the human nutritional requirements could almost be balanced. Our study revealed that the necessary plant cultivation area per crew member would be nearly 40 m 3 in the lunar base. The sources of nutrition considered in the study were energy, sugar, fat, amino acids, inorganic salt and vitamins; however, calcium, vitamin B 2, vitamin A and sodium were found to be lacking. Therefore, a subsystem to supply these elements is of considerable value. In this paper, we report on a study for breeding snails and utilizing meat as food. Nutrients supplied from snails are shown to compensate for the abovementioned lacking elements. We evaluate the snail breeder and the associated food supply system as a subsystem of closed ecological life support system.

  17. Electric utilities and clean air

    International Nuclear Information System (INIS)

    Evans, J.E.

    1991-01-01

    This paper reports that electricity has become essential to American life. Approximately 70 percent of the nation's electricity is produced by burning fossil fuels, with coal, the most abundant, domestically-available, extracted natural resource, providing over 55 percent of the total electricity consumed. Emissions resulting from the burning of fossil fuels are regulated by both the federal and state governments. In 1970, Congress passed the comprehensive Clean Air Act which established a national program to protect the nation's air quality. In 1977, additional strict regulations were passed, which mandated even more stringent emission controls for factories, power plants and auto emissions. Prior to passage of the Clean Air Act of 1990, utilities were required to adhere to three major types of clean air regulations: National Ambient Air Quality Standards (NAAQS), New Source Performance Standards (NSPS), and Prevention of Significant Deterioration (PSD) review. NAAQS established limits for the maximum concentration levels of specific air pollutants in the ambient atmosphere. For example, for an area to be in compliance with the NAAQS for sulfur dioxide (SO 2 ), its annual average SO 2 concentration must not exceed 0.03 ppm of SO 2 and a peak 24 hour level of 0.14 ppm of SO 2 must not be exceeded more than once per year

  18. YEAR 2 BIOMASS UTILIZATION

    Energy Technology Data Exchange (ETDEWEB)

    Christopher J. Zygarlicke

    2004-11-01

    This Energy & Environmental Research Center (EERC) Year 2 Biomass Utilization Final Technical Report summarizes multiple projects in biopower or bioenergy, transportation biofuels, and bioproducts. A prototype of a novel advanced power system, termed the high-temperature air furnace (HITAF), was tested for performance while converting biomass and coal blends to energy. Three biomass fuels--wood residue or hog fuel, corn stover, and switchgrass--and Wyoming subbituminous coal were acquired for combustion tests in the 3-million-Btu/hr system. Blend levels were 20% biomass--80% coal on a heat basis. Hog fuel was prepared for the upcoming combustion test by air-drying and processing through a hammer mill and screen. A K-Tron biomass feeder capable of operating in both gravimetric and volumetric modes was selected as the HITAF feed system. Two oxide dispersion-strengthened (ODS) alloys that would be used in the HITAF high-temperature heat exchanger were tested for slag corrosion rates. An alumina layer formed on one particular alloy, which was more corrosion-resistant than a chromia layer that formed on the other alloy. Research activities were completed in the development of an atmospheric pressure, fluidized-bed pyrolysis-type system called the controlled spontaneous reactor (CSR), which is used to process and condition biomass. Tree trimmings were physically and chemically altered by the CSR process, resulting in a fuel that was very suitable for feeding into a coal combustion or gasification system with little or no feed system modifications required. Experimental procedures were successful for producing hydrogen from biomass using the bacteria Thermotoga, a deep-ocean thermal vent organism. Analytical procedures for hydrogen were evaluated, a gas chromatography (GC) method was derived for measuring hydrogen yields, and adaptation culturing and protocols for mutagenesis were initiated to better develop strains that can use biomass cellulose. Fly ash derived from

  19. Mesh Excision: Is Total Mesh Excision Necessary?

    Science.gov (United States)

    Wolff, Gillian F; Winters, J Christian; Krlin, Ryan M

    2016-04-01

    Nearly 29% of women will undergo a secondary, repeat operation for pelvic organ prolapse (POP) symptom recurrence following a primary repair, as reported by Abbott et al. (Am J Obstet Gynecol 210:163.e1-163.e1, 2014). In efforts to decrease the rates of failure, graft materials have been utilized to augment transvaginal repairs. Following the success of using polypropylene mesh (PPM) for stress urinary incontinence (SUI), the use of PPM in the transvaginal repair of POP increased. However, in recent years, significant concerns have been raised about the safety of PPM mesh. Complications, some specific to mesh, such as exposures, erosion, dyspareunia, and pelvic pain, have been reported with increased frequency. In the current literature, there is not substantive evidence to suggest that PPM has intrinsic properties that warrant total mesh removal in the absence of complications. There are a number of complications that can occur after transvaginal mesh placement that do warrant surgical intervention after failure of conservative therapy. In aggregate, there are no high-quality controlled studies that clearly demonstrate that total mesh removal is consistently more likely to achieve pain reduction. In the cases of obstruction and erosion, it seems clear that definitive removal of the offending mesh is associated with resolution of symptoms in the majority of cases and reasonable practice. There are a number of complications that can occur with removal of mesh, and patients should be informed of this as they formulate a choice of treatment. We will review these considerations as we examine the clinical question of whether total versus partial removal of mesh is necessary for the resolution of complications following transvaginal mesh placement.

  20. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...