Sample records for technical efficiency score

  1. Has competition increased hospital technical efficiency?

    PubMed

    Lee, Keon-Hyung; Park, Jungwon; Lim, Seunghoo; Park, Sang-Chul

    2015-01-01

    Hospital competition and managed care have affected the hospital industry in various ways including technical efficiency. Hospital efficiency has become an important topic, and it is important to properly measure hospital efficiency in order to evaluate the impact of policies on the hospital industry. The primary independent variable is hospital competition. By using the 2001-2004 inpatient discharge data from Florida, we calculate the degree of hospital competition in Florida for 4 years. Hospital efficiency scores are developed using the Data Envelopment Analysis and by using the selected input and output variables from the American Hospital Association's Annual Survey of Hospitals for those acute care general hospitals in Florida. By using the hospital efficiency score as a dependent variable, we analyze the effects of hospital competition on hospital efficiency from 2001 to 2004 and find that when a hospital was located in a less competitive market in 2003, its technical efficiency score was lower than those in a more competitive market.

  2. Technical Efficiency of Hospitals in Tehran, Iran.

    PubMed

    Kakeman, Edris; Rahimi Forushani, Abbas; Dargahi, Hossein

    2016-04-01

    Nowadays, restriction on access and optimum use of resources is the main challenge of development in all organizations. Therefore, the aim of this study was to determine the technical efficiency and its factors, influencing hospitals of Tehran. This research was a descriptive-analytical and retrospective study conducted in 2014-2015. Fifty two hospitals with public, private, and social security ownership type were selected for this study. The required data was collected by a researcher-made check list in 3 sections of background data, inputs and outputs. The data was analyzed by DEAP 1.0.2, and STATA-13 technique. Seventeen (31/48) of hospitals had the efficiency score of 1 as the highest technical efficiency. The highest average score of efficiency was related to social security hospitals as 84.32, and then the public and private hospitals with the average of 84.29 and 79.64 respectively. Tobit regression results showed that the size, type of practice, and ownership of hospitals were effective on the degree of their technical efficiency. However, there was no significant correlation between teaching / non-teaching hospitals with technical efficiency. Establishment of competition system among hospitals, constitution of medium size hospitals and allocation of budget to hospitals based on national accreditation system are recommended.

  3. Ownership and technical efficiency of hospitals: evidence from Ghana using data envelopment analysis.

    PubMed

    Jehu-Appiah, Caroline; Sekidde, Serufusa; Adjuik, Martin; Akazili, James; Almeida, Selassi D; Nyonator, Frank; Baltussen, Rob; Asbu, Eyob Zere; Kirigia, Joses Muthuri

    2014-04-08

    In order to measure and analyse the technical efficiency of district hospitals in Ghana, the specific objectives of this study were to (a) estimate the relative technical and scale efficiency of government, mission, private and quasi-government district hospitals in Ghana in 2005; (b) estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient; and (c) use Tobit regression analysis to estimate the impact of ownership on hospital efficiency. In the first stage, we used data envelopment analysis (DEA) to estimate the efficiency of 128 hospitals comprising of 73 government hospitals, 42 mission hospitals, 7 quasi-government hospitals and 6 private hospitals. In the second stage, the estimated DEA efficiency scores are regressed against hospital ownership variable using a Tobit model. This was a retrospective study. In our DEA analysis, using the variable returns to scale model, out of 128 district hospitals, 31 (24.0%) were 100% efficient, 25 (19.5%) were very close to being efficient with efficiency scores ranging from 70% to 99.9% and 71 (56.2%) had efficiency scores below 50%. The lowest-performing hospitals had efficiency scores ranging from 21% to 30%.Quasi-government hospitals had the highest mean efficiency score (83.9%) followed by public hospitals (70.4%), mission hospitals (68.6%) and private hospitals (55.8%). However, public hospitals also got the lowest mean technical efficiency scores (27.4%), implying they have some of the most inefficient hospitals.Regarding regional performance, Northern region hospitals had the highest mean efficiency score (83.0%) and Volta Region hospitals had the lowest mean score (43.0%).From our Tobit regression, we found out that while quasi-government ownership is positively associated with hospital technical efficiency, private ownership negatively affects hospital efficiency. It would be prudent for policy-makers to examine the

  4. Ownership and technical efficiency of hospitals: evidence from Ghana using data envelopment analysis

    PubMed Central

    2014-01-01

    Background In order to measure and analyse the technical efficiency of district hospitals in Ghana, the specific objectives of this study were to (a) estimate the relative technical and scale efficiency of government, mission, private and quasi-government district hospitals in Ghana in 2005; (b) estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient; and (c) use Tobit regression analysis to estimate the impact of ownership on hospital efficiency. Methods In the first stage, we used data envelopment analysis (DEA) to estimate the efficiency of 128 hospitals comprising of 73 government hospitals, 42 mission hospitals, 7 quasi-government hospitals and 6 private hospitals. In the second stage, the estimated DEA efficiency scores are regressed against hospital ownership variable using a Tobit model. This was a retrospective study. Results In our DEA analysis, using the variable returns to scale model, out of 128 district hospitals, 31 (24.0%) were 100% efficient, 25 (19.5%) were very close to being efficient with efficiency scores ranging from 70% to 99.9% and 71 (56.2%) had efficiency scores below 50%. The lowest-performing hospitals had efficiency scores ranging from 21% to 30%. Quasi-government hospitals had the highest mean efficiency score (83.9%) followed by public hospitals (70.4%), mission hospitals (68.6%) and private hospitals (55.8%). However, public hospitals also got the lowest mean technical efficiency scores (27.4%), implying they have some of the most inefficient hospitals. Regarding regional performance, Northern region hospitals had the highest mean efficiency score (83.0%) and Volta Region hospitals had the lowest mean score (43.0%). From our Tobit regression, we found out that while quasi-government ownership is positively associated with hospital technical efficiency, private ownership negatively affects hospital efficiency. Conclusions It would be

  5. Measuring and Benchmarking Technical Efficiency of Public Hospitals in Tianjin, China

    PubMed Central

    Li, Hao; Dong, Siping

    2015-01-01

    China has long been stuck in applying traditional data envelopment analysis (DEA) models to measure technical efficiency of public hospitals without bias correction of efficiency scores. In this article, we have introduced the Bootstrap-DEA approach from the international literature to analyze the technical efficiency of public hospitals in Tianjin (China) and tried to improve the application of this method for benchmarking and inter-organizational learning. It is found that the bias corrected efficiency scores of Bootstrap-DEA differ significantly from those of the traditional Banker, Charnes, and Cooper (BCC) model, which means that Chinese researchers need to update their DEA models for more scientific calculation of hospital efficiency scores. Our research has helped shorten the gap between China and the international world in relative efficiency measurement and improvement of hospitals. It is suggested that Bootstrap-DEA be widely applied into afterward research to measure relative efficiency and productivity of Chinese hospitals so as to better serve for efficiency improvement and related decision making. PMID:26396090

  6. Commercial Building Energy Asset Score Program Overview and Technical Protocol (Version 1.1)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang, Na; Goel, Supriya; Makhmalbaf, Atefe

    The U.S. Department of Energy (DOE) is developing a voluntary national scoring system for commercial buildings to help building owners and managers assess a building’s energy-related systems independent of operations. The goal of the score is to facilitate cost-effective investment in energy efficiency improvements of commercial buildings. The system, known as the Commercial Building Energy Asset Score, will allow building owners and managers to compare their building infrastructure against peers and track building upgrades over time. The system will also help other building stakeholders (e.g., building investors, tenants, financiers, and appraisers) understand the relative efficiency of different buildings in amore » way that is independent from operations and occupancy. This report outlines the technical protocol used to generate the energy asset score, explains the scoring methodology, and provides additional details regarding the energy asset scoring tool. The alternative methods that were considered prior to developing the current approach are described in the Program Overview and Technical Protocol Version 1.0.« less

  7. Technical and scale efficiency in public and private Irish nursing homes - a bootstrap DEA approach.

    PubMed

    Ni Luasa, Shiovan; Dineen, Declan; Zieba, Marta

    2016-10-27

    This article provides methodological and empirical insights into the estimation of technical efficiency in the nursing home sector. Focusing on long-stay care and using primary data, we examine technical and scale efficiency in 39 public and 73 private Irish nursing homes by applying an input-oriented data envelopment analysis (DEA). We employ robust bootstrap methods to validate our nonparametric DEA scores and to integrate the effects of potential determinants in estimating the efficiencies. Both the homogenous and two-stage double bootstrap procedures are used to obtain confidence intervals for the bias-corrected DEA scores. Importantly, the application of the double bootstrap approach affords true DEA technical efficiency scores after adjusting for the effects of ownership, size, case-mix, and other determinants such as location, and quality. Based on our DEA results for variable returns to scale technology, the average technical efficiency score is 62 %, and the mean scale efficiency is 88 %, with nearly all units operating on the increasing returns to scale part of the production frontier. Moreover, based on the double bootstrap results, Irish nursing homes are less technically efficient, and more scale efficient than the conventional DEA estimates suggest. Regarding the efficiency determinants, in terms of ownership, we find that private facilities are less efficient than the public units. Furthermore, the size of the nursing home has a positive effect, and this reinforces our finding that Irish homes produce at increasing returns to scale. Also, notably, we find that a tendency towards quality improvements can lead to poorer technical efficiency performance.

  8. Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis.

    PubMed

    Kalhor, Rohollah; Amini, Saeed; Sokhanvar, Mobin; Lotfi, Farhad; Sharifi, Marziye; Kakemam, Edris

    2016-03-01

    Restrictions on resource accessibility and its optimal application is the main challenge in organizations nowadays. The aim of this research was to study the technical efficiency and its related factors in Tehran general hospitals. This descriptive analytical study was conducted retrospectively in 2014. Fifty-four hospitals with private, university, and social security ownerships from the total 110 general hospitals were randomly selected for inclusion into this study on the basis of the share of ownership. Data were collected using a checklist with three sections, including background variables, inputs, and outputs. Seventeen (31.48%) hospitals had an efficiency score of 1 (highest efficiency score). The highest average efficiency score was in social security hospitals (84.32). Private and university hospitals ranked next with an average of 84.29 and 79.64, respectively. Analytical results showed that there was a significant relationship between hospital ownership, hospital type in terms of duty and specialization, educational field of the chief executive officer, and technical efficiency. There was no significant relationship between education level of hospital manager and technical efficiency. Most of the studied hospitals were operating at low efficiency. Therefore, policymakers should plan to improve the hospital operations and promote hospitals to an optimal level of efficiency.

  9. Technical Efficiency and Productivity for Higher Education Institutions in Sweden

    ERIC Educational Resources Information Center

    Andersson, C.; Antelius, J.; Månsson, J.; Sund, K.

    2017-01-01

    This study investigates technical efficiency and productivity for Swedish higher education institutions (HEIs). One identified problem in previous research concerns adjusting efficiency scores for input quality. This problem is avoided using grades from upper-secondary schools. A second problem concerns heterogeneity with respect to subjects and…

  10. A study on technical efficiency of a DMU (review of literature)

    NASA Astrophysics Data System (ADS)

    Venkateswarlu, B.; Mahaboob, B.; Subbarami Reddy, C.; Sankar, J. Ravi

    2017-11-01

    In this research paper the concept of technical efficiency (due to Farell) [1] of a decision making unit (DMU) has been introduced and the measure of technical and cost efficiencies are derived. Timmer’s [2] deterministic approach to estimate the Cobb-Douglas production frontier has been proposed. The idea of extension of Timmer’s [2] method to any production frontier which is linear in parameters has been presented here. The estimation of parameters of Cobb-Douglas production frontier by linear programming approach has been discussed in this paper. Mark et al. [3] proposed a non-parametric method to assess efficiency. Nuti et al. [4] investigated the relationships among technical efficiency scores, weighted per capita cost and overall performance Gahe Zing Samuel Yank et al. [5] used Data envelopment analysis to assess technical assessment in banking sectors.

  11. Assessing overall, technical, and scale efficiency among home health care agencies.

    PubMed

    Valdmanis, Vivian G; Rosko, Michael D; Leleu, Hervé; Mukamel, Dana B

    2017-06-01

    While home health care agencies (HHAs) play a vital role in the production of health, little research has been performed gauging their efficiency. Employing a robust approach to data envelopment analysis (DEA) we assessed overall, technical, and scale efficiency on a nationwide sample of HHAs. After deriving the three efficiency measures, we regressed these scores on a variety of environmental factors. We found that HHAs, on average, could proportionally reduce inputs by 28 % (overall efficiency), 23 % (technical efficiency) and 6 % (scale efficiency). For-profit ownership was positively associated with improvements in overall efficiency and technical efficiency and chain ownership was positively associated with global efficiency. There were also state-by-state variations on all the efficiency measures. As home health becomes an increasingly important player in the health care system, and its share of national health expenditures increases, it has become important to understand the cost structure of the industry and the potential for efficiencies. Therefore, further research is recommended as this sector continues to grow.

  12. Does multi-functionality affect technical efficiency? A non-parametric analysis of the Scottish dairy industry.

    PubMed

    Barnes, A P

    2006-09-01

    Recent policy changes within the Common Agricultural Policy have led to a shift from a solely production-led agriculture towards the promotion of multi-functionality. Conversely, the removal of production-led supports would indicate that an increased concentration on production efficiencies would seem a critical strategy for a country's future competitiveness. This paper explores the relationship between the 'multi-functional' farming attitude desired by policy makers and its effect on technical efficiency within Scottish dairy farming. Technical efficiency scores are calculated by applying the non-parametric data envelopment analysis technique and then measured against causes of inefficiency. Amongst these explanatory factors is a constructed score of multi-functionality. This research finds that, amongst other factors, a multi-functional attitude has a significant positive effect on technical efficiency. Consequently, this seems to validate the promotion of a multi-functional approach to farming currently being championed by policy-makers.

  13. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

    PubMed Central

    Osei, Daniel; d'Almeida, Selassi; George, Melvill O; Kirigia, Joses M; Mensah, Ayayi Omar; Kainyu, Lenity H

    2005-01-01

    Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination) in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i) to estimate the relative technical efficiency (TE) and scale efficiency (SE) of a sample of public hospitals and health centres in Ghana; and (ii) to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA) approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47%) hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD) of 12%. Ten (59%) hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%). Out of the 17 health centres, 3 (18%) were technically inefficient, with a mean TE score of 49% (STD = 27%). Eight health centres (47%) were scale inefficient, with an average SE score of 84% (STD = 16%). Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres) in the course of the implementation of health sector reforms. PMID:16188021

  14. Technical efficiency of nursing homes: do five-star quality ratings matter?

    PubMed

    Dulal, Rajendra

    2017-02-28

    This study investigates associations between five-star quality ratings and technical efficiency of nursing homes. The sample consists of a balanced panel of 338 nursing homes in California from 2009 through 2013 and uses two-stage data envelopment (DEA) analysis. The first-stage applies an input oriented variable returns to scale DEA analysis. The second-stage uses a left censored random-effect Tobit regression model. The five-star quality ratings i.e., health inspections, quality measures, staffing available on the Nursing Home Compare website are divided into two categories: outcome and structure form of quality. Results show that quality measures ratings and health inspection ratings, used as outcome form of quality, are not associated with mean technical efficiency. These quality ratings, however, do affect the technical efficiency of a particular nursing home and hence alter the ranking of nursing homes based on efficiency scores. Staffing rating, categorized as a structural form of quality, is negatively associated with mean technical efficiency. These findings show that quality dimensions are associated with technical efficiency in different ways, suggesting that multiple dimensions of quality should be included in the efficiency analysis of nursing homes. They also suggest that patient care can be enhanced through investing more in improving care delivery rather than simply raising the number of staff per resident.

  15. Technical efficiency of Shiraz school of medicine in research and education domains: a data envelopment analysis.

    PubMed

    Delavari, Somayeh; Rezaee, Rita; Hatam, Nahid; Delavari, Sajad

    2016-01-01

    Efficiency evaluation of universities and faculties is one of the tools that help managers to identify the departments' strengths and weakness. The main objective of the present research was to measure and compare the technical efficiency of Shiraz school of medicine departments using Data Envelopment Analysis (DEA) technique. This cross-sectional and retrospective study was performed on clinical and non-clinical departments in research and education domains over the period of 2006 to 2011. Different inputs and outputs were considered for research and educational domain separately. Efficiency was measured based on the observed optimal performance. Findings showed that pathology and anatomy departments achieved the score of 100 in technical efficiency in education during 2006 to 2011. During this period, parasitology, psychiatric and pediatrics department's achieved the score of 100 for technical efficiency in research domain. The lowest mean of relative educational efficiency belonged to orthopedic department; as to relative research efficiency, the lowest mean was shown in orthopedics and genetics departments. The mean technical efficiency of non-medical departments in education and research domain was 91.93 and 76.08, respectively, while the mean technical efficiency of the clinical department in educational and research fields was 91.02 and 82.23, respectively. Using multiple input and output in DEA technique provided a comprehensive evaluation of efficiency in Shiraz school of medicine departments. The DEA could successfully estimate the technical efficiency of the departments in research and educational fields. Moreover, the deficiency in each department was found; this could help them to plan for improvement.

  16. Commercial Building Energy Asset Score System: Program Overview and Technical Protocol (Version 1.0)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang, Na; Gorrissen, Willy J.

    2013-01-11

    The U.S. Department of Energy (DOE) is developing a national voluntary energy asset score system that includes an energy asset score tool to help building owners evaluate their buildings with respect to the score system. The goal of the energy asset score system is to facilitate cost-effective investment in energy efficiency improvements of commercial buildings. The system will allow building owners and managers to compare their building infrastructure against peers and track building upgrade progress over time. The system can also help other building stakeholders (e.g., building operators, tenants, financiers, and appraisers) understand the relative efficiency of different buildings inmore » a way that is independent from their operations and occupancy. This report outlines the technical protocol used to generate the energy asset score, explains the scoring methodology, and provides additional details regarding the energy asset score tool. This report also describes alternative methods that were considered prior to developing the current approach. Finally, this report describes a few features of the program where alternative approaches are still under evaluation.« less

  17. Technical efficiency of women's health prevention programs in Bucaramanga, Colombia: a four-stage analysis.

    PubMed

    Ruiz-Rodriguez, Myriam; Rodriguez-Villamizar, Laura A; Heredia-Pi, Ileana

    2016-10-13

    Primary Health Care (PHC) is an efficient strategy to improve health outcomes in populations. Nevertheless, studies of technical efficiency in health care have focused on hospitals, with very little on primary health care centers. The objective of the present study was to use the Data Envelopment Analysis to estimate the technical efficiency of three women's health promotion and disease prevention programs offered by primary care centers in Bucaramanga, Colombia. Efficiency was measured using a four-stage data envelopment analysis with a series of Tobit regressions to account for the effect of quality outcomes and context variables. Input/output information was collected from the institutions' records, chart reviews and personal interviews. Information about contextual variables was obtained from databases from the primary health program in the municipality. A jackknife analysis was used to assess the robustness of the results. The analysis was based on data from 21 public primary health care centers. The average efficiency scores, after adjusting for quality and context, were 92.4 %, 97.5 % and 86.2 % for the antenatal care (ANC), early detection of cervical cancer (EDCC) and family planning (FP) programs, respectively. On each program, 12 of the 21 (57.1 %) health centers were found to be technically efficient; having had the best-practice frontiers. Adjusting for context variables changed the scores and reference rankings of the three programs offered by the health centers. The performance of the women's health prevention programs offered by the centers was found to be heterogeneous. Adjusting for context and health care quality variables had a significant effect on the technical efficiency scores and ranking. The results can serve as a guide to strengthen management and organizational and planning processes related to local primary care services operating within a market-based model such as the one in Colombia.

  18. Technical Efficiency of Automotive Industry Cluster in Chennai

    NASA Astrophysics Data System (ADS)

    Bhaskaran, E.

    2012-07-01

    Chennai is also called as Detroit of India due to its automotive industry presence producing over 40 % of the India's vehicle and components. During 2001-2002, diagnostic study was conducted on the Automotive Component Industries (ACI) in Ambattur Industrial Estate, Chennai and in SWOT analysis it was found that it had faced problems on infrastructure, technology, procurement, production and marketing. In the year 2004-2005 under the cluster development approach (CDA), they formed Chennai auto cluster, under public private partnership concept, received grant from Government of India, Government of Tamil Nadu, Ambattur Municipality, bank loans and stake holders. This results development in infrastructure, technology, procurement, production and marketing interrelationships among ACI. The objective is to determine the correlation coefficient, regression equation, technical efficiency, peer weights, slack variables and return to scale of cluster before and after the CDA. The methodology adopted is collection of primary data from ACI and analyzing using data envelopment analysis (DEA) of input oriented Banker-Charnes-Cooper model. There is significant increase in correlation coefficient and the regression analysis reveals that for one percent increase in employment and net worth, the gross output increases significantly after the CDA. The DEA solver gives the technical efficiency of ACI by taking shift, employment, net worth as input data and quality, gross output and export ratio as output data. From the technical score and ranking of ACI, it is found that there is significant increase in technical efficiency of ACI when compared to CDA. The slack variables obtained clearly reveals the excess employment and net worth and no shortage of gross output. To conclude there is increase in technical efficiency of not only Chennai auto cluster in general but also Chennai auto components industries in particular.

  19. Technical efficiency of public district hospitals in Madhya Pradesh, India: a data envelopment analysis.

    PubMed

    Jat, Tej Ram; Sebastian, Miguel San

    2013-09-24

    Scarcity of resources for healthcare is a well-acknowledged problem. In this context, efficient utilization of existing financial and human resources becomes crucial for strengthening the healthcare delivery. The assessment of efficiency of health facilities can guide decision makers in ensuring the optimum utilization of available resources. The objective of this study was to evaluate the technical efficiency (TE) of the public district hospitals in Madhya Pradesh, India, with special emphasis on maternal healthcare services, using data envelopment analysis (DEA). Data from 40 district hospitals from January to December 2010 were collected from the health management information system and other records of the department of health and family welfare of the state. DEA was performed with input orientation and variable returns to scale assumption. TE and scale efficiency scores of the district hospitals were 0.90 (SD = 0.14) and 0.88 (SD = 0.15), respectively. Of the total district hospitals in the study, 20 (50%) were technically efficient constituting the 'best practice frontier'. The other half were technically inefficient, with an average TE score of 0.79 (SD = 0.12) meaning that these hospitals could produce the same outputs by using 21% less inputs from current input levels. Twenty-six (65%) district hospitals were found to be scale inefficient, manifesting a mean score of 0.81 (SD = 0.16). Half of the district hospitals in the study were operating inefficiently. Decision makers and administrators in the state should identify the causes of the observed inefficiencies and take appropriate measures to increase efficiency of these hospitals.

  20. Measuring and Benchmarking Technical Efficiency of Public Hospitals in Tianjin, China: A Bootstrap-Data Envelopment Analysis Approach.

    PubMed

    Li, Hao; Dong, Siping

    2015-01-01

    China has long been stuck in applying traditional data envelopment analysis (DEA) models to measure technical efficiency of public hospitals without bias correction of efficiency scores. In this article, we have introduced the Bootstrap-DEA approach from the international literature to analyze the technical efficiency of public hospitals in Tianjin (China) and tried to improve the application of this method for benchmarking and inter-organizational learning. It is found that the bias corrected efficiency scores of Bootstrap-DEA differ significantly from those of the traditional Banker, Charnes, and Cooper (BCC) model, which means that Chinese researchers need to update their DEA models for more scientific calculation of hospital efficiency scores. Our research has helped shorten the gap between China and the international world in relative efficiency measurement and improvement of hospitals. It is suggested that Bootstrap-DEA be widely applied into afterward research to measure relative efficiency and productivity of Chinese hospitals so as to better serve for efficiency improvement and related decision making. © The Author(s) 2015.

  1. Technical and scale efficiency of public community hospitals in Eritrea: an exploratory study

    PubMed Central

    2013-01-01

    Background Eritrean gross national income of Int$610 per capita is lower than the average for Africa (Int$1620) and considerably lower than the global average (Int$6977). It is therefore imperative that the country’s resources, including those specifically allocated to the health sector, are put to optimal use. The objectives of this study were (a) to estimate the relative technical and scale efficiency of public secondary level community hospitals in Eritrea, based on data generated in 2007, (b) to estimate the magnitudes of output increases and/or input reductions that would have been required to make relatively inefficient hospitals more efficient, and (c) to estimate using Tobit regression analysis the impact of institutional and contextual/environmental variables on hospital inefficiencies. Methods A two-stage Data Envelopment Analysis (DEA) method is used to estimate efficiency of hospitals and to explain the inefficiencies. In the first stage, the efficient frontier and the hospital-level efficiency scores are first estimated using DEA. In the second stage, the estimated DEA efficiency scores are regressed on some institutional and contextual/environmental variables using a Tobit model. In 2007 there were a total of 20 secondary public community hospitals in Eritrea, nineteen of which generated data that could be included in the study. The input and output data were obtained from the Ministry of Health (MOH) annual health service activity report of 2007. Since our study employs data that are five years old, the results are not meant to uncritically inform current decision-making processes, but rather to illustrate the potential value of such efficiency analyses. Results The key findings were as follows: (i) the average constant returns to scale technical efficiency score was 90.3%; (ii) the average variable returns to scale technical efficiency score was 96.9%; and (iii) the average scale efficiency score was 93.3%. In 2007, the inefficient hospitals could

  2. Advanced scoring method of eco-efficiency in European cities.

    PubMed

    Moutinho, Victor; Madaleno, Mara; Robaina, Margarita; Villar, José

    2018-01-01

    This paper analyzes a set of selected German and French cities' performance in terms of the relative behavior of their eco-efficiencies, computed as the ratio of their gross domestic product (GDP) over their CO 2 emissions. For this analysis, eco-efficiency scores of the selected cities are computed using the data envelopment analysis (DEA) technique, taking the eco-efficiencies as outputs, and the inputs being the energy consumption, the population density, the labor productivity, the resource productivity, and the patents per inhabitant. Once DEA results are analyzed, the Malmquist productivity indexes (MPI) are used to assess the time evolution of the technical efficiency, technological efficiency, and productivity of the cities over the window periods 2000 to 2005 and 2005 to 2008. Some of the main conclusions are that (1) most of the analyzed cities seem to have suboptimal scales, being one of the causes of their inefficiency; (2) there is evidence that high GDP over CO 2 emissions does not imply high eco-efficiency scores, meaning that DEA like approaches are useful to complement more simplistic ranking procedures, pointing out potential inefficiencies at the input levels; (3) efficiencies performed worse during the period 2000-2005 than during the period 2005-2008, suggesting the possibility of corrective actions taken during or at the end of the first period but impacting only on the second period, probably due to an increasing environmental awareness of policymakers and governors; and (4) MPI analysis shows a positive technological evolution of all cities, according to the general technological evolution of the reference cities, reflecting a generalized convergence of most cities to their technological frontier and therefore an evolution in the right direction.

  3. The Technical Efficiency of Earthquake Medical Rapid Response Teams Following Disasters: The Case of the 2010 Yushu Earthquake in China.

    PubMed

    Liu, Xu; Tang, Bihan; Yang, Hongyang; Liu, Yuan; Xue, Chen; Zhang, Lulu

    2015-12-04

    Performance assessments of earthquake medical rapid response teams (EMRRTs), particularly the first responders deployed to the hardest hit areas following major earthquakes, should consider efficient and effective use of resources. This study assesses the daily technical efficiency of EMRRTs in the emergency period immediately following the 2010 Yushu earthquake in China. Data on EMRRTs were obtained from official daily reports of the general headquarters for Yushu earthquake relief, the emergency office of the National Ministry of Health, and the Health Department of Qinghai Province, for a sample of data on 15 EMRRTs over 62 days. Data envelopment analysis was used to examine the technical efficiency in a constant returns to scale model, a variable returns to scale model, and the scale efficiency of EMRRTs. Tobit regression was applied to analyze the effects of corresponding influencing factors. The average technical efficiency scores under constant returns to scale, variable returns to scale, and the scale efficiency scores of the 62 units of analysis were 77.95%, 89.00%, and 87.47%, respectively. The staff-to-bed ratio was significantly related to global technical efficiency. The date of rescue was significantly related to pure technical efficiency. The type of institution to which an EMRRT belonged and the staff-to-bed ratio were significantly related to scale efficiency. This study provides evidence that supports improvements to EMRRT efficiency and serves as a reference for earthquake emergency medical rapid assistance leaders and teams.

  4. Revisiting the utility of technical performance scores following tetralogy of Fallot repair.

    PubMed

    Lodin, Daud; Mavrothalassitis, Orestes; Haberer, Kim; Sunderji, Sherzana; Quek, Ruben G W; Peyvandi, Shabnam; Moon-Grady, Anita; Karamlou, Tara

    2017-08-01

    Although an important quality metric, current technical performance scores may not be generalizable and may omit operative factors that influence outcomes. We examined factors not included in current technical performance scores that may contribute to increased postoperative length of stay, major complications, and cost after primary repair of tetralogy of Fallot. This is a retrospective single site study of patients younger than age 2 years with tetralogy of Fallot undergoing complete repair between 2007 and 2015. Medical record data and discharge echocardiograms were reviewed to ascertain component and composite technical performance scores. Primary outcomes included postoperative length of stay, major complications, and total hospital costs. Multivariable logistic and linear regression identified determinants of each outcome. Patient population (n = 115) had a median postoperative length of stay of 8 days (interquartile range, 6-10 days), and a median total cost of $71,147. Major complications occurred in 33 patients (29%) with 1 death. Technical performance scores assigned were optimum in 28 patients (25%), adequate in 59 patients (52%), and inadequate in 26 patients (23%). Neither technical performance score components nor composite scores were associated with increased postoperative length of stay. Optimum or adequate repairs versus inadequate had equal risk of a complication (P = .79), and equivalent mean total cost ($100,000 vs $187,000; P = .25). Longer cardiopulmonary bypass time per 1-minute increase (P < .01) was associated with longer postoperative length of stay and reintervention (P = .02). The need to return to bypass also increased total cost (P < .01). Current tetralogy of Fallot technical performance scores were not associated with selected outcomes in our postoperative population. Although returning to bypass and bypass length are not included as components in the current score, these are important factors influencing

  5. Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: The RECHARGE score.

    PubMed

    Maeremans, Joren; Spratt, James C; Knaapen, Paul; Walsh, Simon; Agostoni, Pierfrancesco; Wilson, William; Avran, Alexandre; Faurie, Benjamin; Bressollette, Erwan; Kayaert, Peter; Bagnall, Alan J; Smith, Dave; McEntegart, Margaret B; Smith, William H T; Kelly, Paul; Irving, John; Smith, Elliot J; Strange, Julian W; Dens, Jo

    2018-02-01

    This study sought to create a contemporary scoring tool to predict technical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) from patients treated by hybrid operators with differing experience levels. Current scoring systems need regular updating to cope with the positive evolutions regarding materials, techniques, and outcomes, while at the same time being applicable for a broad range of operators. Clinical and angiographic characteristics from 880 CTO-PCIs included in the REgistry of CrossBoss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE) were analyzed by using a derivation and validation set (2:1 ratio). Variables significantly associated with technical failure in the multivariable analysis were incorporated in the score. Subsequently, the discriminatory capacity was assessed and the validation set was used to compare with the J-CTO score and PROGRESS scores. Technical success in the derivation and validation sets was 83% and 85%, respectively. Multivariate analysis identified six parameters associated with technical failure: blunt stump (beta coefficient (b) = 1.014); calcification (b = 0.908); tortuosity ≥45° (b = 0.964); lesion length 20 mm (b = 0.556); diseased distal landing zone (b = 0.794), and previous bypass graft on CTO vessel (b = 0.833). Score variables remained significant after bootstrapping. The RECHARGE score showed better discriminatory capacity in both sets (area-under-the-curve (AUC) = 0.783 and 0.711), compared to the J-CTO (AUC = 0.676) and PROGRESS (AUC = 0.608) scores. The RECHARGE score is a novel, easy-to-use tool for assessing the risk for technical failure in hybrid CTO-PCI and has the potential to perform well for a broad community of operators. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Technical Quality of Complete Dentures: Influence on Masticatory Efficiency and Quality of Life.

    PubMed

    Tôrres, Ana Clara Soares Paiva; Maciel, Amanda de Queiroz; de Farias, Danielle Bezerra; de Medeiros, Annie Karoline Bezerra; Vieira, Flávia Patrícia Tavares Veras; Carreiro, Adriana da Fonte Porto

    2017-11-09

    To evaluate the effect of the technical quality of conventional complete dentures (CD) on masticatory efficiency and quality of life (QoL) of denture wearers during a 1-year follow-up. A prospective clinical trial with 32 edentulous patients (mean age of 60.2 years) wearing mandibular and maxillary dentures was conducted. All patients were evaluated wearing their preexisting dentures and after 3, 6, and 12 months postinsertion of new dentures. A reproducible method for objective evaluation of the technical quality of CDs was employed. Masticatory efficiency was evaluated by the colorimetric method using beads as artificial testing food. The oral health impact on patient QoL was measured using the OHIP-EDENT (Oral Health Impact Profile in Edentulous Adults) questionnaire. The nonparametric Wilcoxon test was applied to reveal any differences in technical quality between the preexisting and new dentures. The Friedman test was used to detect differences in masticatory efficiency and oral health impact on QoL. Spearman's correlation was applied to reveal correlation between the variables. Comparing preexisting and new dentures, significant improvement was found in technical quality between the dentures (p < 0.001). There was no statistically significant difference in masticatory efficiency. A significant decrease was found in the total OHIP-EDENT scores after denture replacement. A positive correlation was found between technical quality and OHIP in the new denture wearers (p = 0.011). According to the results of this study, denture quality significantly improved patients' oral health-related QoL; however, insertion of new dentures did not influence masticatory efficiency. © 2017 by the American College of Prosthodontists.

  7. Technical efficiency of selected hospitals in Eastern Ethiopia.

    PubMed

    Ali, Murad; Debela, Megersa; Bamud, Tewfik

    2017-12-01

    This study examines the relative technical efficiency of 12 hospitals in Eastern Ethiopia. Using six-year-round panel data for the period between 2007/08 and 2012/13, this study examines the technical efficiency, total factor productivity, and determinants of the technical inefficiency of hospitals. Data envelopment analysis (DEA) and DEA- based Malmquist productivity index used to estimate relative technical efficiency, scale efficiency, and total factor productivity index of hospitals. Tobit model used to examine the determinants of the technical inefficiency of hospitals. The DEA Variable Returns to Scale (VRS) estimate indicated that 6 (50%), 5 (42%), 3 (25%), 3 (25%), 4 (33%), and 3 (25%) of the hospitals were technically inefficient while 9 (75%), 9 (75%), 7 (58%), 7 (58%), 7 (58%) and 8 (67%) of hospitals were scale inefficient between 2007/08 and 2012/13, respectively. On average, Malmquist Total Factor Productivity (MTFP) of the hospitals decreased by 3.6% over the panel period. The Tobit model shows that teaching hospital is less efficiency than other hospitals. The Tobit regression model further shows that medical doctor to total staff ratio, the proportion of outpatient visit to inpatient days, and the proportion of inpatients treated per medical doctor were negatively related with technical inefficiency of hospitals. Hence, policy interventions that help utilize excess capacity of hospitals, increase doctor to other staff ratio, and standardize number of inpatients treated per doctor would contribute to the improvement of the technical efficiency of hospitals.

  8. The contribution of collective attack tactics in differentiating handball score efficiency.

    PubMed

    Rogulj, Nenad; Srhoj, Vatromir; Srhoj, Ljerka

    2004-12-01

    The prevalence of 19 elements of collective tactics in score efficient and score inefficient teams was analyzed in 90 First Croatian Handball League--Men games during the 1998-1999 season. Prediction variables were used to describe duration, continuity, system, organization and spatial direction of attacks. Analysis of the basic descriptive and distribution statistical parameters revealed normal distribution of all variables and possibility to use multivariate methods. Canonic discrimination analysis and analysis of variance showed the use of collective tactics elements on attacks to differ statistically significantly between the winning and losing teams. Counter-attacks and uninterrupted attacks predominate in winning teams. Other types of attacks such as long position attack, multiply interrupted attack, attack with one circle runner attack player/pivot, attack based on basic principles, attack based on group cooperation, attack based on independent action, attack based on group maneuvering, rightward directed attack and leftward directed attack predominate in losing teams. Winning teams were found to be clearly characterized by quick attacks against unorganized defense, whereas prolonged, interrupted position attacks against organized defense along with frequent and diverse tactical actions were characteristic of losing teams. The choice and frequency of using a particular tactical activity in position attack do not warrant score efficiency but usually are consequential to the limited anthropologic potential and low level of individual technical-tactical skills of the players in low-quality teams.

  9. Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application

    PubMed Central

    Renner, Ade; Kirigia, Joses M; Zere, Eyob A; Barry, Saidou P; Kirigia, Doris G; Kamara, Clifford; Muthuri, Lenity HK

    2005-01-01

    Background The Data Envelopment Analysis (DEA) method has been fruitfully used in many countries in Asia, Europe and North America to shed light on the efficiency of health facilities and programmes. There is, however, a dearth of such studies in countries in sub-Saharan Africa. Since hospitals and health centres are important instruments in the efforts to scale up pro-poor cost-effective interventions aimed at achieving the United Nations Millennium Development Goals, decision-makers need to ensure that these health facilities provide efficient services. The objective of this study was to measure the technical efficiency (TE) and scale efficiency (SE) of a sample of public peripheral health units (PHUs) in Sierra Leone. Methods This study applied the Data Envelopment Analysis approach to investigate the TE and SE among a sample of 37 PHUs in Sierra Leone. Results Twenty-two (59%) of the 37 health units analysed were found to be technically inefficient, with an average score of 63% (standard deviation = 18%). On the other hand, 24 (65%) health units were found to be scale inefficient, with an average scale efficiency score of 72% (standard deviation = 17%). Conclusion It is concluded that with the existing high levels of pure technical and scale inefficiency, scaling up of interventions to achieve both global and regional targets such as the MDG and Abuja health targets becomes far-fetched. In a country with per capita expenditure on health of about US$7, and with only 30% of its population having access to health services, it is demonstrated that efficiency savings can significantly augment the government's initiatives to cater for the unmet health care needs of the population. Therefore, we strongly recommend that Sierra Leone and all other countries in the Region should institutionalise health facility efficiency monitoring at the Ministry of Health headquarter (MoH/HQ) and at each health district headquarter. PMID:16354299

  10. Oxford NOTECHS II: a modified theatre team non-technical skills scoring system.

    PubMed

    Robertson, Eleanor R; Hadi, Mohammed; Morgan, Lauren J; Pickering, Sharon P; Collins, Gary; New, Steve; Griffin, Damian; Griffin, Damien; McCulloch, Peter; Catchpole, Ken C

    2014-01-01

    We previously developed and validated the Oxford NOTECHS rating system for evaluating the non-technical skills of an entire operating theatre team. Experience with the scale identified the need for greater discrimination between levels of performance within the normal range. We report here the development of a modified scale (Oxford NOTECHS II) to facilitate this. The new measure uses an eight-point instead of a four point scale to measure each dimension of non-technical skills, and begins with a default rating of 6 for each element. We evaluated this new scale in 297 operations at five NHS sites in four surgical specialities. Measures of theatre process reliability (glitch count) and compliance with the WHO surgical safety checklist were scored contemporaneously, and relationships with NOTECHS II scores explored. Mean team Oxford NOTECHS II scores was 73.39 (range 37-92). The means for surgical, anaesthetic and nursing sub-teams were 24.61 (IQR 23, 27); 24.22 (IQR 23, 26) and 24.55 (IQR 23, 26). Oxford NOTECHS II showed good inter-rater reliability between human factors and clinical observers in each of the four domains. Teams with high WHO compliance had higher mean Oxford NOTECHS II scores (74.5) than those with low compliance (71.1) (p = 0.010). We observed only a weak correlation between Oxford NOTECHS II scores and glitch count; r = -0.26 (95% CI -0.36 to -0.15). Oxford NOTECHS II scores did not vary significantly between 5 different hospital sites, but a significant difference was seen between specialities (p = 0.001). Oxford NOTECHS II provides good discrimination between teams while retaining reliability and correlation with other measures of teamwork performance, and is not confounded by technical performance. It is therefore suitable for combined use with a technical performance scale to provide a global description of operating theatre team performance.

  11. The relative contribution of physical fitness to the technical execution score in youth rhythmic gymnastics.

    PubMed

    Donti, Olyvia; Bogdanis, Gregory C; Kritikou, Maria; Donti, Anastasia; Theodorakou, Kalliopi

    2016-06-01

    This study examined the association between physical fitness and a technical execution score in rhythmic gymnasts varying in the performance level. Forty-six young rhythmic gymnasts (age: 9.9 ±1.3 years) were divided into two groups (qualifiers, n=24 and non-qualifiers, n=22) based on the results of the National Championships. Gymnasts underwent a series of physical fitness tests and technical execution was evaluated in a routine without apparatus. There were significant differences between qualifiers and non-qualifiers in the technical execution score (p=0.01, d=1.0), shoulder flexion (p=0.01, d=0.8), straight leg raise (p=0.004, d=0.9), sideways leg extension (p=0.002, d=0.9) and body fat (p=.021, d=0.7), but no differences were found in muscular endurance and jumping performance. The technical execution score for the non-qualifiers was significantly correlated with shoulder extension (r=0.423, p<0.05), sideways leg extension (r=0.687, p<0.01), push ups (r=0.437, p<0.05) and body fat (r=0.642, p<0.01), while there was only one significant correlation with sideways leg extension (r=0.467, p<0.05) for the qualifiers. Multiple regression analysis revealed that sideways leg extension, body fat, and push ups accounted for a large part (62.9%) of the variance in the technical execution score for the non-qualifiers, while for the qualifiers, only 37.3% of the variance in the technical execution score was accounted for by sideways leg extension and spine flexibility. In conclusion, flexibility and body composition can effectively discriminate between qualifiers and non-qualifiers in youth rhythmic gymnastics. At the lower level of performance (non-qualifiers), physical fitness seems to have a greater effect on the technical execution score.

  12. Validity of GRE General Test Scores and TOEFL Scores for Graduate Admission to a Technical University in Western Europe

    ERIC Educational Resources Information Center

    Zimmermann, Judith; von Davier, Alina A.; Buhmann, Joachim M.; Heinimann, Hans R.

    2018-01-01

    Graduate admission has become a critical process in tertiary education, whereby selecting valid admissions instruments is key. This study assessed the validity of Graduate Record Examination (GRE) General Test scores for admission to Master's programmes at a technical university in Europe. We investigated the indicative value of GRE scores for the…

  13. Technical efficiency in milk production in underdeveloped production environment of India*.

    PubMed

    Bardhan, Dwaipayan; Sharma, Murari Lal

    2013-12-01

    The study was undertaken in Kumaon division of Uttarakhand state of India with the objective of estimating technical efficiency in milk production across different herd-size category households and factors influencing it. Total of 60 farm households having representation from different herd-size categories drawn from six randomly selected villages of plain and hilly regions of the division constituted the ultimate sampling units of the study. Stochastic frontier production function analysis was used to estimate the technical efficiency in milk production. Multivariate regression equations were fitted taking technical efficiency index as the regressand to identify the factors significantly influencing technical efficiency in milk production. The study revealed that variation in output across farms in the study area was due to difference in their technical efficiency levels. However, it was interesting to note that smallholder producers were more technically efficient in milk production than their larger counterparts, especially in the plains. Apart from herd size, intensity of market participation had significant and positive impact on technical efficiency in the plains. This provides definite indication that increasing the level of commercialization of dairy farms would have beneficial impact on their production efficiency.

  14. Building Energy Asset Score for Utilities and Energy Efficiency Program Administrators

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for utilities and energy efficiency program administrators.

  15. Efficiency in the European agricultural sector: environment and resources.

    PubMed

    Moutinho, Victor; Madaleno, Mara; Macedo, Pedro; Robaina, Margarita; Marques, Carlos

    2018-04-22

    This article intends to compute agriculture technical efficiency scores of 27 European countries during the period 2005-2012, using both data envelopment analysis (DEA) and stochastic frontier analysis (SFA) with a generalized cross-entropy (GCE) approach, for comparison purposes. Afterwards, by using the scores as dependent variable, we apply quantile regressions using a set of possible influencing variables within the agricultural sector able to explain technical efficiency scores. Results allow us to conclude that although DEA and SFA are quite distinguishable methodologies, and despite attained results are different in terms of technical efficiency scores, both are able to identify analogously the worst and better countries. They also suggest that it is important to include resources productivity and subsidies in determining technical efficiency due to its positive and significant exerted influence.

  16. The Uses and Misuses of Test Scores: Technical Assistance Perspective.

    ERIC Educational Resources Information Center

    Echternacht, Gary

    The uses and misuses of standardized test results used for program evaluation as seen by a staff member of an Elementary Secondary Education Act (ESEA) Title I Technical Assistance Center are described. In ESEA Title I, test scores are used to select students for the program. Although federal requirements do not require using standardized test…

  17. Validity of GRE General Test scores and TOEFL scores for graduate admission to a technical university in Western Europe

    NASA Astrophysics Data System (ADS)

    Zimmermann, Judith; von Davier, Alina A.; Buhmann, Joachim M.; Heinimann, Hans R.

    2018-01-01

    Graduate admission has become a critical process in tertiary education, whereby selecting valid admissions instruments is key. This study assessed the validity of Graduate Record Examination (GRE) General Test scores for admission to Master's programmes at a technical university in Europe. We investigated the indicative value of GRE scores for the Master's programme grade point average (GGPA) with and without the addition of the undergraduate GPA (UGPA) and the TOEFL score, and of GRE scores for study completion and Master's thesis performance. GRE scores explained 20% of the variation in the GGPA, while additional 7% were explained by the TOEFL score and 3% by the UGPA. Contrary to common belief, the GRE quantitative reasoning score showed only little explanatory power. GRE scores were also weakly related to study progress but not to thesis performance. Nevertheless, GRE and TOEFL scores were found to be sensible admissions instruments. Rigorous methodology was used to obtain highly reliable results.

  18. Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis.

    PubMed

    Hernández, Alison R; San Sebastián, Miguel

    2014-01-01

    Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Data envelopment analysis was used to measure health posts' technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization.

  19. Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis

    PubMed Central

    Hernández, Alison R.; Sebastián, Miguel San

    2014-01-01

    Introduction Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Methods Data envelopment analysis was used to measure health posts’ technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Results Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Conclusions Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization. PMID:24461356

  20. A stochastic frontier approach to study the relationship between gastrointestinal nematode infections and technical efficiency of dairy farms.

    PubMed

    van der Voort, Mariska; Van Meensel, Jef; Lauwers, Ludwig; Vercruysse, Jozef; Van Huylenbroeck, Guido; Charlier, Johannes

    2014-01-01

    The impact of gastrointestinal (GI) nematode infections in dairy farming has traditionally been assessed using partial productivity indicators. But such approaches ignore the impact of infection on the performance of the whole farm. In this study, efficiency analysis was used to study the association of the GI nematode Ostertagia ostertagi on the technical efficiency of dairy farms. Five years of accountancy data were linked to GI nematode infection data gained from a longitudinal parasitic monitoring campaign. The level of exposure to GI nematodes was based on bulk-tank milk ELISA tests, which measure the antibodies to O. ostertagi and was expressed as an optical density ratio (ODR). Two unbalanced data panels were created for the period 2006 to 2010. The first data panel contained 198 observations from the Belgian Farm Accountancy Data Network (Brussels, Belgium) and the second contained 622 observations from the Boerenbond Flemish farmers' union (Leuven, Belgium) accountancy system (Tiber Farm Accounting System). We used the stochastic frontier analysis approach and defined inefficiency effect models specified with the Cobb-Douglas and transcendental logarithmic (Translog) functional form. To assess the efficiency scores, milk production was considered as the main output variable. Six input variables were used: concentrates, roughage, pasture, number of dairy cows, animal health costs, and labor. The ODR of each individual farm served as an explanatory variable of inefficiency. An increase in the level of exposure to GI nematodes was associated with a decrease in technical efficiency. Exposure to GI nematodes constrains the productivity of pasture, health, and labor but does not cause inefficiency in the use of concentrates, roughage, and dairy cows. Lowering the level of infection in the interquartile range (0.271 ODR) was associated with an average milk production increase of 27, 19, and 9L/cow per year for Farm Accountancy Data Network farms and 63, 49, and

  1. [Technical efficiency in primary care for patients with diabetes].

    PubMed

    Salinas-Martínez, Ana María; Amaya-Alemán, María Agustina; Arteaga-García, Julio César; Núñez-Rocha, Georgina Mayela; Garza-Elizondo, María Eugenia

    2009-01-01

    To quantify the technical efficiency of diabetes care in family practice settings, characterize the provision of services and health results, and recognize potential sources of variation. We used data envelopment analysis with inputs and outputs for diabetes care from 47 family units within a social security agency in Nuevo Leon. Tobit regression models were also used. Seven units were technically efficient in providing services and nine in achieving health goals. Only two achieved both outcomes. The metropolitan location and the total number of consultations favored efficiency in the provision of services regardless of patient attributes; and the age of the doctor, the efficiency of health results. Performance varied within and among family units; some were efficient at providing services while others at accomplishing health goals. Sources of variation also differed. It is necessary to include both outputs in the study of efficiency of diabetes care in family practice settings.

  2. Efficiency of Australian Technical and Further Education Providers

    ERIC Educational Resources Information Center

    Fieger, Peter; Villano, Renato; Cooksey, Ray

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-02-01

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

  5. Streamlining Building Efficiency Evaluation with DOE's Asset Score Preview

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Goel, Supriya; Wang, Nora; Gonzalez, Juan

    2016-08-26

    Building Energy Asset Score (Asset Score), developed by the Pacific Northwest National Laboratory (PNNL) for the U.S. Department of Energy (DOE), is a tool to help building owners and managers assess the efficiency of a building's energy-related systems and encourage investment in cost-effective improvements. The Asset Score uses an EnergyPlus model to provide a quick assessment of building energy performance with minimum user inputs of building characteristics and identifies upgrade opportunities. Even with a reduced set of user inputs, data collection remains a challenge for wide-spread adoption, especially when evaluating a large number of buildings. To address this, Asset Scoremore » Preview was developed to allow users to enter as few as seven building characteristics to quickly assess their buildings before a more in-depth analysis. A streamlined assessment from Preview to full Asset Score provides an easy entry point and also enables users who manage a large number of buildings to screen and prioritize buildings that can benefit most from a more detailed evaluation and possible energy efficiency upgrades without intensive data collection.« less

  6. Cost and technical efficiency of physician practices: a stochastic frontier approach using panel data.

    PubMed

    Heimeshoff, Mareike; Schreyögg, Jonas; Kwietniewski, Lukas

    2014-06-01

    This is the first study to use stochastic frontier analysis to estimate both the technical and cost efficiency of physician practices. The analysis is based on panel data from 3,126 physician practices for the years 2006 through 2008. We specified the technical and cost frontiers as translog function, using the one-step approach of Battese and Coelli to detect factors that influence the efficiency of general practitioners and specialists. Variables that were not analyzed previously in this context (e.g., the degree of practice specialization) and a range of control variables such as a patients' case-mix were included in the estimation. Our results suggest that it is important to investigate both technical and cost efficiency, as results may depend on the type of efficiency analyzed. For example, the technical efficiency of group practices was significantly higher than that of solo practices, whereas the results for cost efficiency differed. This may be due to indivisibilities in expensive technical equipment, which can lead to different types of health care services being provided by different practice types (i.e., with group practices using more expensive inputs, leading to higher costs per case despite these practices being technically more efficient). Other practice characteristics such as participation in disease management programs show the same impact throughout both cost and technical efficiency: participation in disease management programs led to an increase in both, technical and cost efficiency, and may also have had positive effects on the quality of care. Future studies should take quality-related issues into account.

  7. Assessing the efficiency of hospital pharmacy services in Thai public district hospitals.

    PubMed

    Rattanachotphanit, Thananan; Limwattananon, Chulaporn; Limwattananon, Supon; Johns, Jeff R; Schommer, Jon C; Brown, Lawrence M

    2008-07-01

    The purpose of this study was to assess the efficiency of hospital pharmacy services and to determine the environmental factors affecting pharmacy service efficiency. The technical efficiency of a hospital pharmacy was assessed to evaluate the hospital's ability to use pharmacy manpower in order to produce the maximum output of the pharmacy service. Data Envelopment Analysis (DEA) was used as an efficiency measurement. The two labor inputs were pharmacists and support personnel and the ten outputs were from four pharmacy activities: drug dispensing, drug purchasing and inventory control, patient-oriented activities, and health consumer protection services. This was used to estimate technical efficiency. A Tobit regression model was used to determine the effect of the hospital size, location, input mix of pharmacy staff, working experience of pharmacists at the study hospitals, and use of technology on the pharmacy service efficiency. Data for pharmacy service input and output quantities were obtained from 155 respondents. Nineteen percent were found to have full efficiency with a technical efficiency score of 1.00. Thirty-six percent had a technical efficiency score of 0.80 or above and 27% had a low technical efficiency score (< 0.60). The average TE score increased in respect to the hospital size (0.60, 0.71, 0.75, and 0.83 in 10, 30, 60, and 90-120 bed hospitals, respectively). Hospital size and geographic location were significantly associated with pharmacy service efficiency.

  8. Building Efficiency Evaluation and Uncertainty Analysis with DOE's Asset Score Preview

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    2016-08-12

    Building Energy Asset Score Tool, developed by the U.S. Department of Energy (DOE), is a program to encourage energy efficiency improvement by helping building owners and managers assess a building's energy-related systems independent of operations and maintenance. Asset Score Tool uses a simplified EnergyPlus model to provide an assessment of building systems, through minimum user inputs of basic building characteristics. Asset Score Preview is a newly developed option that allows users to assess their building's systems and the potential value of a more in-depth analysis via an even more simplified approach. This methodology provides a preliminary approach to estimating amore » building's energy efficiency and potential for improvement. This paper provides an overview of the methodology used for the development of Asset Score Preview and the scoring methodology.« less

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

    PubMed

    Kontodimopoulos, Nick; Moschovakis, Giorgos; Aletras, Vassilis H; Niakas, Dimitris

    2007-11-17

    The purpose of this study was to compare technical and scale efficiency of primary care centers from the two largest Greek providers, the National Health System (NHS) and the Social Security Foundation (IKA) and to determine if, and how, efficiency is affected by various exogenous factors such as catchment population and location. The sample comprised of 194 units (103 NHS and 91 IKA). Efficiency was measured with Data Envelopment Analysis (DEA) using three inputs, -medical staff, nursing/paramedical staff, administrative/other staff- and two outputs, which were the aggregated numbers of scheduled/emergency patient visits and imaging/laboratory diagnostic tests. Facilities were categorized as small, medium and large (<15,000, 15,000-30,000 and >30,000 respectively) to reflect catchment population and as urban/semi-urban or remote/island to reflect location. In a second stage analysis, technical and scale efficiency scores were regressed against facility type (NHS or IKA), size and location using multivariate Tobit regression. Regarding technical efficiency, IKA performed better than the NHS (84.9% vs. 70.1%, Mann-Whitney P < 0.001), smaller units better than medium-sized and larger ones (84.2% vs. 72.4% vs. 74.3%, Kruskal-Wallis P < 0.01) and remote/island units better than urban centers (81.1% vs. 75.7%, Mann-Whitney P = 0.103). As for scale efficiency, IKA again outperformed the NHS (89.7% vs. 85.9%, Mann-Whitney P = 0.080), but results were reversed in respect to facility size and location. Specifically, larger units performed better (96.3% vs. 90.9% vs. 75.9%, Kruskal-Wallis P < 0.001), and urban units showed higher scale efficiency than remote ones (91.9% vs. 75.3%, Mann-Whitney P < 0.001). Interestingly 75% of facilities appeared to be functioning under increasing returns to scale. Within-group comparisons revealed significant efficiency differences between the two primary care providers. Tobit regression models showed that facility type, size and location

  10. Technical Efficiency and Organ Transplant Performance: A Mixed-Method Approach

    PubMed Central

    de-Pablos-Heredero, Carmen; Fernández-Renedo, Carlos; Medina-Merodio, Jose-Amelio

    2015-01-01

    Mixed methods research is interesting to understand complex processes. Organ transplants are complex processes in need of improved final performance in times of budgetary restrictions. As the main objective a mixed method approach is used in this article to quantify the technical efficiency and the excellence achieved in organ transplant systems and to prove the influence of organizational structures and internal processes in the observed technical efficiency. The results show that it is possible to implement mechanisms for the measurement of the different components by making use of quantitative and qualitative methodologies. The analysis show a positive relationship between the levels related to the Baldrige indicators and the observed technical efficiency in the donation and transplant units of the 11 analyzed hospitals. Therefore it is possible to conclude that high levels in the Baldrige indexes are a necessary condition to reach an increased level of the service offered. PMID:25950653

  11. Evaluating Technical Efficiency of Nursing Care Using Data Envelopment Analysis and Multilevel Modeling.

    PubMed

    Min, Ari; Park, Chang Gi; Scott, Linda D

    2016-05-23

    Data envelopment analysis (DEA) is an advantageous non-parametric technique for evaluating relative efficiency of performance. This article describes use of DEA to estimate technical efficiency of nursing care and demonstrates the benefits of using multilevel modeling to identify characteristics of efficient facilities in the second stage of analysis. Data were drawn from LTCFocUS.org, a secondary database including nursing home data from the Online Survey Certification and Reporting System and Minimum Data Set. In this example, 2,267 non-hospital-based nursing homes were evaluated. Use of DEA with nurse staffing levels as inputs and quality of care as outputs allowed estimation of the relative technical efficiency of nursing care in these facilities. In the second stage, multilevel modeling was applied to identify organizational factors contributing to technical efficiency. Use of multilevel modeling avoided biased estimation of findings for nested data and provided comprehensive information on differences in technical efficiency among counties and states. © The Author(s) 2016.

  12. Development and Validation of a Novel Scoring System for Predicting Technical Success of Chronic Total Occlusion Percutaneous Coronary Interventions: The PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Score.

    PubMed

    Christopoulos, Georgios; Kandzari, David E; Yeh, Robert W; Jaffer, Farouc A; Karmpaliotis, Dimitri; Wyman, Michael R; Alaswad, Khaldoon; Lombardi, William; Grantham, J Aaron; Moses, Jeffrey; Christakopoulos, Georgios; Tarar, Muhammad Nauman J; Rangan, Bavana V; Lembo, Nicholas; Garcia, Santiago; Cipher, Daisha; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

    2016-01-11

    This study sought to develop a novel parsimonious score for predicting technical success of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) performed using the hybrid approach. Predicting technical success of CTO PCI can facilitate clinical decision making and procedural planning. We analyzed clinical and angiographic parameters from 781 CTO PCIs included in PROGRESS CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) using a derivation and validation cohort (2:1 sampling ratio). Variables with strong association with technical success in multivariable analysis were assigned 1 point, and a 4-point score was developed from summing all points. The PROGRESS CTO score was subsequently compared with the J-CTO (Multicenter Chronic Total Occlusion Registry in Japan) score in the validation cohort. Technical success was 92.9%. On multivariable analysis, factors associated with technical success included proximal cap ambiguity (beta coefficient [b] = 0.88), moderate/severe tortuosity (b = 1.18), circumflex artery CTO (b = 0.99), and absence of "interventional" collaterals (b = 0.88). The resulting score demonstrated good calibration and discriminatory capacity in the derivation (Hosmer-Lemeshow chi-square = 2.633; p = 0.268, and receiver-operator characteristic [ROC] area = 0.778) and validation (Hosmer-Lemeshow chi-square = 5.333; p = 0.070, and ROC area = 0.720) subset. In the validation cohort, the PROGRESS CTO and J-CTO scores performed similarly in predicting technical success (ROC area 0.720 vs. 0.746, area under the curve difference = 0.026, 95% confidence interval = -0.093 to 0.144). The PROGRESS CTO score is a novel useful tool for estimating technical success in CTO PCI performed using the hybrid approach. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China

    PubMed Central

    Cheng, Zhaohui; Tao, Hongbing; Cai, Miao; Lin, Haifeng; Lin, Xiaojun; Shu, Qin; Zhang, Ru-ning

    2015-01-01

    Objectives Chinese county hospitals have been excessively enlarging their scale during the healthcare reform since 2009. The purpose of this paper is to examine the technical efficiency and productivity of county hospitals during the reform process, and to determine whether, and how, efficiency is affected by various factors. Setting and participants 114 sample county hospitals were selected from Henan province, China, from 2010 to 2012. Outcome measures Data envelopment analysis was employed to estimate the technical and scale efficiency of sample hospitals. The Malmquist index was used to calculate productivity changes over time. Tobit regression was used to regress against 4 environmental factors and 5 institutional factors that affected the technical efficiency. Results (1) 112 (98.2%), 112 (98.2%) and 104 (91.2%) of the 114 sample hospitals ran inefficiently in 2010, 2011 and 2012, with average technical efficiency of 0.697, 0.748 and 0.790, respectively. (2) On average, during 2010–2012, productivity of sample county hospitals increased by 7.8%, which was produced by the progress in technical efficiency changes and technological changes of 0.9% and 6.8%, respectively. (3) Tobit regression analysis indicated that government subsidy, hospital size with above 618 beds and average length of stay assumed a negative sign with technical efficiency; bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. Conclusions There was considerable space for technical efficiency improvement in Henan county hospitals. During 2010–2012, sample hospitals experienced productivity progress; however, the adverse change in pure technical efficiency should be emphasised. Moreover, according to the Tobit results, policy interventions that strictly supervise hospital bed scale, shorten the average length of stay and coordinate the proportion among physicians, nurses and beds, would benefit hospital efficiency

  14. Modeling technical efficiency of inshore fishery using data envelopment analysis

    NASA Astrophysics Data System (ADS)

    Rahman, Rahayu; Zahid, Zalina; Khairi, Siti Shaliza Mohd; Hussin, Siti Aida Sheikh

    2016-10-01

    Fishery industry contributes significantly to the economy of Malaysia. This study utilized Data Envelopment Analysis application in estimating the technical efficiency of fishery in Terengganu, a state on the eastern coast of Peninsular Malaysia, based on multiple output, i.e. total fish landing and income of fishermen with six inputs, i.e. engine power, vessel size, number of trips, number of workers, cost and operation distance. The data were collected by survey conducted between November and December 2014. The decision making units (DMUs) involved 100 fishermen from 10 fishery areas. The result showed that the technical efficiency in Season I (dry season) and Season II (rainy season) were 90.2% and 66.7% respectively. About 27% of the fishermen were rated to be efficient during Season I, meanwhile only 13% of the fishermen achieved full efficiency 100% during Season II. The results also found out that there was a significance difference in the efficiency performance between the fishery areas.

  15. The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada.

    PubMed

    Wang, Li; Grignon, Michel; Perry, Sheril; Chen, Xi-Kuan; Ytsma, Alison; Allin, Sara; Gapanenko, Katerina

    2018-04-17

    To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only). The double bootstrap procedure (Simar and Wilson 2007) is adopted in the regression. Information on inpatient episodes of care (number and quality of outcomes) was extracted from the DAD. The cost of the inpatient care was extracted from the CMDB. On average, acute hospitals in Canada are operating at about 75 percent efficiency, and this could thus potentially increase their level of outcomes (quantity and quality) by addressing inefficiencies. In some cases, such as for teaching hospitals, the factors significantly correlated with efficiency scores were not related to management but to the social composition of the caseload. In contrast, for large and medium nonteaching hospitals, efficiency related more to the ability to discharge patients to postacute care facilities. The efficiency of medium hospitals is also positively related to treating more clinically noncomplex patients. The main drivers of efficiency of acute inpatient care vary by hospital peer groups. Thus, the results provide different policy and managerial implications for teaching, large, and medium hospitals to achieve efficiency gains. © Health Research and Educational Trust.

  16. Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China.

    PubMed

    Cheng, Zhaohui; Tao, Hongbing; Cai, Miao; Lin, Haifeng; Lin, Xiaojun; Shu, Qin; Zhang, Ru-Ning

    2015-09-09

    Chinese county hospitals have been excessively enlarging their scale during the healthcare reform since 2009. The purpose of this paper is to examine the technical efficiency and productivity of county hospitals during the reform process, and to determine whether, and how, efficiency is affected by various factors. 114 sample county hospitals were selected from Henan province, China, from 2010 to 2012. Data envelopment analysis was employed to estimate the technical and scale efficiency of sample hospitals. The Malmquist index was used to calculate productivity changes over time. Tobit regression was used to regress against 4 environmental factors and 5 institutional factors that affected the technical efficiency. (1) 112 (98.2%), 112 (98.2%) and 104 (91.2%) of the 114 sample hospitals ran inefficiently in 2010, 2011 and 2012, with average technical efficiency of 0.697, 0.748 and 0.790, respectively. (2) On average, during 2010-2012, productivity of sample county hospitals increased by 7.8%, which was produced by the progress in technical efficiency changes and technological changes of 0.9% and 6.8%, respectively. (3) Tobit regression analysis indicated that government subsidy, hospital size with above 618 beds and average length of stay assumed a negative sign with technical efficiency; bed occupancy rate, ratio of beds to nurses and ratio of nurses to physicians assumed a positive sign with technical efficiency. There was considerable space for technical efficiency improvement in Henan county hospitals. During 2010-2012, sample hospitals experienced productivity progress; however, the adverse change in pure technical efficiency should be emphasised. Moreover, according to the Tobit results, policy interventions that strictly supervise hospital bed scale, shorten the average length of stay and coordinate the proportion among physicians, nurses and beds, would benefit hospital efficiency. Published by the BMJ Publishing Group Limited. For permission to use (where

  17. Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012.

    PubMed

    Rezapour, Aziz; Ebadifard Azar, Farbod; Yousef Zadeh, Negar; Roumiani, YarAllah; Bagheri Faradonbeh, Saeed

    2015-01-01

    Assessment of hospitals' performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved.

  18. Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012

    PubMed Central

    Rezapour, Aziz; Ebadifard Azar, Farbod; Yousef Zadeh, Negar; Roumiani, YarAllah; Bagheri Faradonbeh, Saeed

    2015-01-01

    Background: Assessment of hospitals’ performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. Methods: This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. Results: According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. Conclusion: This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved. PMID:26793657

  19. Developing HEAT Scores with H-Res Thermal Imagery to Support Urban Energy Efficiency

    NASA Astrophysics Data System (ADS)

    Hemachandran, Bharanidharan

    As part of The Calgary Community GHG Reduction Plan (2009) The City is seeking an implementation strategy to reduce GHGs and promote low-carbon living, with a focus on improving urban energy efficiency. The most cited obstacle to energy efficiency improvements is the lack of interest from consumers (CUI, 2008). However, Darby (2006) has shown that effective feedback significantly reduces energy consumption. To exploit these findings, the HEAT (Heat Energy Assessment Technologies) Geoweb project integrates high-resolution (H-Res) airborne thermal imagery (TABI 1800) to provide unique energy efficiency feedback to Calgary homeowners in the form of interactive HEAT Maps and Hot Spots (Hay et al., 2011). As a part of the HEAT Phase II program, the goal of this research is to provide enhanced feedback support for urban energy efficiency by meeting two key objectives: (i) develop an appropriate method to define HEAT Scores using TABI 1800 imagery that allows for the comparison of waste heat of one or more houses with all other mapped houses in the community and city, and (ii) develop a multi-scale interactive Geoweb interface that displays the HEAT Scores at City, Community and Residential scales. To achieve these goals, we describe the evolution of three novel HEAT Score techniques based on: (i) a Standardized Score, (ii) the WUFIRTM model and Logistic Regression and (iii ) a novel criteria weighted method that considers: (a) heat transfer through different roofing materials, (b) local climatic conditions and (c) house age and living area attributes. Furthermore, (d) removing or adding houses to analysis based on this 3rd technique, does not affect the HEAT Score of other houses and (e) HEAT Scores can be compared within and across different cities. We also describe how HEAT Scores are incorporated within the HEAT Geoweb architecture. It is envisioned that HEAT Scores will promote energy efficiency among homeowners and urban city planners, as they will quantify and

  20. Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?

    PubMed Central

    Krage, Ralf; Zwaan, Laura; Tjon Soei Len, Lian; Kolenbrander, Mark W; van Groeningen, Dick; Loer, Stephan A; Wagner, Cordula; Schober, Patrick

    2017-01-01

    Background Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stressful conditions when individuals are distracted from their tasks, and investigated the relationship between non-technical and technical skills under control conditions and when external stressors are present. Methods In this simulator-based randomised cross-over study, 30 anaesthesiologists and anaesthesia residents from the VU University Medical Center, Amsterdam, the Netherlands, participated in two different CPR scenarios in random order. In one scenario, external stressors (radio noise and a distractive scripted family member) were added, while the other scenario without stressors served as control condition. Non-technical performance of the team leader and technical performance of the team were measured using the ‘Anaesthetists’ Non-technical Skill’ score and a recently developed technical skills score. Analysis of variance and Pearson correlation coefficients were used for statistical analyses. Results Non-technical performance declined when external stressors were present (adjusted mean difference 3.9 points, 95% CI 2.4 to 5.5 points). A significant correlation between non-technical and technical performance scores was observed when external stressors were present (r=0.67, 95% CI 0.40 to 0.83, p<0.001), while no evidence for such a relationship was observed under control conditions (r=0.15, 95% CI −0.22 to 0.49, p=0.42). This was equally true for all individual domains of the non-technical performance score (task management, team

  1. Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

    PubMed Central

    Sheikhzadeh, Yaghoub; Roudsari, Abdul V.; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

    2012-01-01

    Background: The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. Methods: This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Results: Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). Conclusion: In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level. PMID:24688915

  2. Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

    PubMed

    Sheikhzadeh, Yaghoub; Roudsari, Abdul V; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

    2012-01-01

    The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

  3. Two essays on efficiency in the electric power industry: Measurement of technical and allocative efficiency

    NASA Astrophysics Data System (ADS)

    Gardiner, John Corby

    The electric power industry market structure has changed over the last twenty years since the passage of the Public Utility Regulatory Policies Act (PURPA). These changes include the entry by unregulated generator plants and, more recently, the deregulation of entry and price in the retail generation market. Such changes have introduced and expanded competitive forces on the incumbent electric power plants. Proponents of this deregulation argued that the enhanced competition would lead to a more efficient allocation of resources. Previous studies of power plant technical and allocative efficiency have failed to measure technical and allocative efficiency at the plant level. In contrast, this study uses panel data on 35 power plants over 59 years to estimate technical and allocative efficiency of each plant. By using a flexible functional form, which is not constrained by the assumption that regulation is constant over the 59 years sampled, the estimation procedure accounts for changes in both state and national regulatory/energy policies that may have occurred over the sample period. The empirical evidence presented shows that most of the power plants examined have operated more efficiently since the passage of PURPA and the resultant increase of competitive forces. Chapter 2 extends the model used in Chapter 1 and clarifies some issues in the efficiency literature by addressing the case where homogeneity does not hold. A more general model is developed for estimating both input and output inefficiency simultaneously. This approach reveals more information about firm inefficiency than the single estimation approach that has previously been used in the literature. Using the more general model, estimates are provided on the type of inefficiency that occurs as well as the cost of inefficiency by type of inefficiency. In previous studies, the ranking of firms by inefficiency has been difficult because of the cardinal and ordinal differences between different types of

  4. A stochastic frontier analysis of technical efficiency of fish cage culture in Peninsular Malaysia.

    PubMed

    Islam, Gazi Md Nurul; Tai, Shzee Yew; Kusairi, Mohd Noh

    2016-01-01

    Cage culture plays an important role in achieving higher output and generating more export earnings in Malaysia. However, the cost of fingerlings, feed and labour have increased substantially for cage culture in the coastal areas in Peninsular Malaysia. This paper uses farm level data gathered from Manjung, Perak and Kota Tinggi, Johor to investigate the technical efficiency of brackish water fish cage culture using the stochastic frontier approach. The technical efficiency was estimated and specifically the factors affecting technical inefficiencies of fish cage culture system in Malaysia was investigated. On average, 37 percent of the sampled fish cage farms are technically efficient. The results suggest very high degrees of technical inefficiency exist among the cage culturists. This implies that great potential exists to increase fish production through improved efficiency in cage culture management in Peninsular Malaysia. The results indicate that farmers obtained grouper fingerlings from other neighboring countries due to scarcity of fingerlings from wild sources. The cost of feeding for grouper (Epinephelus fuscoguttatus) requires relatively higher costs compared to seabass (Lates calcarifer) production in cage farms in the study areas. Initiatives to undertake extension programmes at the farm level are needed to help cage culturists in utilizing their resources more efficiently in order to substantially enhance their fish production.

  5. Efficiency in the Community College Sector: Stochastic Frontier Analysis

    ERIC Educational Resources Information Center

    Agasisti, Tommaso; Belfield, Clive

    2017-01-01

    This paper estimates technical efficiency scores across the community college sector in the United States. Using stochastic frontier analysis and data from the Integrated Postsecondary Education Data System for 2003-2010, we estimate efficiency scores for 950 community colleges and perform a series of sensitivity tests to check for robustness. We…

  6. Efficiency of irrigation water application in sugarcane cultivation in Pakistan.

    PubMed

    Watto, Muhammad Arif; Mugera, Amin W

    2015-07-01

    Diminishing irrigation water supplies are threatening the sustainability of irrigated agriculture in Pakistan. Within the context of dwindling water resources and low agricultural water productivity, it is imperative to improve efficiency in agricultural production and to make efficient use of available water resources. This study employs a non-parametric approach to estimate the extent of technical and irrigation water efficiency in sugarcane cultivation in Pakistan. The mean technical efficiency score is 0.96 for tube-well owners whereas it is 0.94 for water buyers. The mean irrigation water efficiency score is 0.86 for tube-well owners whereas it is 0.72 for water buyers. We find that across all farms, 59% of the tube-well owners and 45% of the water buyers are fully technically efficient, whereas only 36% of the tube-well owners and 30% of the water buyer are fully efficient in irrigation water use. This study finds that sugarcane growers are operating at fairly high technical efficiency levels. But, there is considerable potential to improve irrigation water efficiency. This study proposes expanding the role of agricultural extension services from merely agronomic grounds to guide farmers to undertake cost benefit analysis of the available production technology, would help achieve higher efficiency levels. © 2014 Society of Chemical Industry.

  7. Impact of Medicare Advantage penetration and hospital competition on technical efficiency of nursing care in US intensive care units.

    PubMed

    Min, Ari; Scott, Linda D; Park, Chang; Vincent, Catherine; Ryan, Catherine J; Lee, Taewha

    2018-04-10

    This study aimed to evaluate technical efficiency of US intensive care units and determine the effects of environmental factors on technical efficiency in providing quality of nursing care. Data were obtained from the 2014 National Database of Nursing Quality Indicators and the Centers for Medicare and Medicaid Services. Data envelopment analysis was used to estimate technical efficiency for each intensive care unit. Multilevel modeling was used to determine the effects of environmental factors on technical efficiency. Overall, Medicare Advantage penetration and hospital competition in a market did not create pressure for intensive care units to become more efficient by reducing their inputs. However, these 2 environmental factors showed positive influences on technical efficiency in intensive care units with certain levels of technical efficiency. The implications of the study results for management strategies and health policy may vary according to the levels of technical efficiency in intensive care units. Further studies are needed to examine why and how intensive care units with particular levels of technical efficiency are differently affected by certain environmental factors. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Total Factor Productivity Growth, Technical Progress & Efficiency Change in Vietnam Coal Industry - Nonparametric Approach

    NASA Astrophysics Data System (ADS)

    Phuong, Vu Hung

    2018-03-01

    This research applies Data Envelopment Analysis (DEA) approach to analyze Total Factor Productivity (TFP) and efficiency changes in Vietnam coal mining industry from 2007 to 2013. The TFP of Vietnam coal mining companies decreased due to slow technological progress and unimproved efficiency. The decadence of technical efficiency in many enterprises proved that the coal mining industry has a large potential to increase productivity through technical efficiency improvement. Enhancing human resource training, technology and research & development investment could help the industry to improve efficiency and productivity in Vietnam coal mining industry.

  9. A data envelope analysis to assess factors affecting technical and economic efficiency of individual broiler breeder hens.

    PubMed

    Romero, L F; Zuidhof, M J; Jeffrey, S R; Naeima, A; Renema, R A; Robinson, F E

    2010-08-01

    This study evaluated the effect of feed allocation and energetic efficiency on technical and economic efficiency of broiler breeder hens using the data envelope analysis methodology and quantified the effect of variables affecting technical efficiency. A total of 288 Ross 708 pullets were placed in individual cages at 16 wk of age and assigned to 1 of 4 feed allocation groups. Three of them had feed allocated on a group basis with divergent BW targets: standard, high (standard x 1.1), and low (standard x 0.9). The fourth group had feed allocated on an individual bird basis following the standard BW target. Birds were classified in 3 energetic efficiency categories: low, average, and high, based on estimated maintenance requirements. Technical efficiency considered saleable chicks as output and cumulative ME intake and time as inputs. Economic efficiency of feed allocation treatments was analyzed under different cost scenarios. Birds with low feed allocation exhibited a lower technical efficiency (69.4%) than standard (72.1%), which reflected a reduced egg production rate. Feed allocation of the high treatment could have been reduced by 10% with the same chick production as the standard treatment. The low treatment exhibited reduced economic efficiency at greater capital costs, whereas high had reduced economic efficiency at greater feed costs. The average energetic efficiency hens had a lower technical efficiency in the low compared with the standard feed allocation. A 1% increment in estimated maintenance requirement changed technical efficiency by -0.23%, whereas a 1% increment in ME intake had a -0.47% effect. The negative relationship between technical efficiency and ME intake was counterbalanced by a positive correlation of ME intake and egg production. The negative relationship of technical efficiency and maintenance requirements was synergized by a negative correlation of hen maintenance and egg production. Economic efficiency methodologies are effective

  10. Returns and determinants of technical efficiency in small-scale Malabari goat production units in Kerala, India.

    PubMed

    Alex, Rani; Kunniyoor Cheemani, Raghavan; Thomas, Naicy

    2013-11-01

    A stochastic frontier production function was employed to measure technical efficiency and its determinants in smallholder Malabari goat production units in Kerala, India. Data were obtained from 100 goat farmers in northern Kerala, selected using multistage random sampling. The parameters of the stochastic frontier production function were estimated using the maximum likelihood method. Cost and return analysis showed that the major expenditure was feed and fodder, and veterinary expenses were secondary. The chief returns were the sale of live animals, milk and manure. Individual farm technical efficiency ranged from 0.34 to 0.97 with a mean of 0.88. The study found herd size (number of animal units) and centre (locality of farm) significantly affected technical efficiency, but sex of farmer, education, land size and family size did not. Technical efficiency decreased as herd size increased; half the units with five or more adult animals had technical efficiency below 60 %.

  11. Relationship between non-technical skills and technical performance during cardiopulmonary resuscitation: does stress have an influence?

    PubMed

    Krage, Ralf; Zwaan, Laura; Tjon Soei Len, Lian; Kolenbrander, Mark W; van Groeningen, Dick; Loer, Stephan A; Wagner, Cordula; Schober, Patrick

    2017-11-01

    Non-technical skills, such as task management, leadership, situational awareness, communication and decision-making refer to cognitive, behavioural and social skills that contribute to safe and efficient team performance. The importance of these skills during cardiopulmonary resuscitation (CPR) is increasingly emphasised. Nonetheless, the relationship between non-technical skills and technical performance is poorly understood. We hypothesise that non-technical skills become increasingly important under stressful conditions when individuals are distracted from their tasks, and investigated the relationship between non-technical and technical skills under control conditions and when external stressors are present. In this simulator-based randomised cross-over study, 30 anaesthesiologists and anaesthesia residents from the VU University Medical Center, Amsterdam, the Netherlands, participated in two different CPR scenarios in random order. In one scenario, external stressors (radio noise and a distractive scripted family member) were added, while the other scenario without stressors served as control condition. Non-technical performance of the team leader and technical performance of the team were measured using the 'Anaesthetists' Non-technical Skill' score and a recently developed technical skills score. Analysis of variance and Pearson correlation coefficients were used for statistical analyses. Non-technical performance declined when external stressors were present (adjusted mean difference 3.9 points, 95% CI 2.4 to 5.5 points). A significant correlation between non-technical and technical performance scores was observed when external stressors were present (r=0.67, 95% CI 0.40 to 0.83, p<0.001), while no evidence for such a relationship was observed under control conditions (r=0.15, 95% CI -0.22 to 0.49, p=0.42). This was equally true for all individual domains of the non-technical performance score (task management, team working, situation awareness, decision

  12. A cost and technical efficiency analysis of two alternative models for implementing the basic package of health services in Afghanistan.

    PubMed

    Blaakman, Aaron Philip; Salehi, Ahmad Shah; Boitard, Romain

    2014-01-01

    Since 2003, the Afghan Ministry of Public Health (MoPH) and international partners have directed a contracting-out model through which non-governmental organisations (NGOs) deliver the Basic Package of Health Services (BPHS) in 31 of the 34 Afghan provinces. The MoPH also managed health service delivery in three provinces under an alternative initiative entitled Strengthening Mechanisms (SM). In 2011, under the authority of the MoPH and Delegation of the European Union to Afghanistan, EPOS Health Management conducted a cost and technical efficiency study of the contracting-out and SM mechanisms in six provinces to examine economic trade-offs in the provision of the BPHS. The study provides analyses of all resource inputs and primary outputs of the BPHS in the six provinces during 2008 and 2009. The authors examined technical efficiency using Data Envelopment Analysis (DEA) at the BPHS facility level. Cost analysis results indicate that the weighted average cost per BPHS outpatient visit totalled $3.41 in the SM provinces and $5.39 in the NGO-led provinces in 2009. Furthermore, the data envelopment analyses (DEAs) indicate that facilities in the three NGO-led provinces scored 0.168 points higher on the DEA scale (0-1) than SM facilities. The authors conclude that an approximate 60% increase in costs yielded a 16.8% increase in technical efficiency in the delivery of the BPHS during 2009 in the six provinces.

  13. Simulated lumbar minimally invasive surgery educational model with didactic and technical components.

    PubMed

    Chitale, Rohan; Ghobrial, George M; Lobel, Darlene; Harrop, James

    2013-10-01

    The learning and development of technical skills are paramount for neurosurgical trainees. External influences and a need for maximizing efficiency and proficiency have encouraged advancements in simulator-based learning models. To confirm the importance of establishing an educational curriculum for teaching minimally invasive techniques of pedicle screw placement using a computer-enhanced physical model of percutaneous pedicle screw placement with simultaneous didactic and technical components. A 2-hour educational curriculum was created to educate neurosurgical residents on anatomy, pathophysiology, and technical aspects associated with image-guided pedicle screw placement. Predidactic and postdidactic practical and written scores were analyzed and compared. Scores were calculated for each participant on the basis of the optimal pedicle screw starting point and trajectory for both fluoroscopy and computed tomographic navigation. Eight trainees participated in this module. Average mean scores on the written didactic test improved from 78% to 100%. The technical component scores for fluoroscopic guidance improved from 58.8 to 52.9. Technical score for computed tomography-navigated guidance also improved from 28.3 to 26.6. Didactic and technical quantitative scores with a simulator-based educational curriculum improved objectively measured resident performance. A minimally invasive spine simulation model and curriculum may serve a valuable function in the education of neurosurgical residents and outcomes for patients.

  14. Final Technical Report: "Achieving Regional Energy Efficiency Potential in the Southeast”

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mahoney, Mandy

    The overall objective of this award was to facilitate sharing of DOE resources and best practices as well as provide technical assistance to key stakeholders to support greater compliance with energy efficiency standards and increased energy savings. The outcomes of this award include greater awareness among key stakeholders on energy efficiency topics, increased deployment and utilization of DOE resources, and effective policies and programs to support energy efficiency in the Southeast.

  15. Technical- and environmental-efficiency analysis of irrigated cotton-cropping systems in Punjab, Pakistan using data envelopment analysis.

    PubMed

    Ullah, Asmat; Perret, Sylvain R

    2014-08-01

    Cotton cropping in Pakistan uses substantial quantities of resources and adversely affects the environment with pollutants from the inputs, particularly pesticides. A question remains regarding to what extent the reduction of such environmental impact is possible without compromising the farmers' income. This paper investigates the environmental, technical, and economic performances of selected irrigated cotton-cropping systems in Punjab to quantify the sustainability of cotton farming and reveal options for improvement. Using mostly primary data, our study quantifies the technical, cost, and environmental efficiencies of different farm sizes. A set of indicators has been computed to reflect these three domains of efficiency using the data envelopment analysis technique. The results indicate that farmers are broadly environmentally inefficient; which primarily results from poor technical inefficiency. Based on an improved input mix, the average potential environmental impact reduction for small, medium, and large farms is 9, 13, and 11 %, respectively, without compromising the economic return. Moreover, the differences in technical, cost, and environmental efficiencies between small and medium and small and large farm sizes were statistically significant. The second-stage regression analysis identifies that the entire farm size significantly affects the efficiencies, whereas exposure to extension and training has positive effects, and the sowing methods significantly affect the technical and environmental efficiencies. Paradoxically, the formal education level is determined to affect the efficiencies negatively. This paper discusses policy interventions that can improve the technical efficiency to ultimately increase the environmental efficiency and reduce the farmers' operating costs.

  16. Cross-Validation of easyCBM Reading Cut Scores in Washington: 2009-2010. Technical Report #1109

    ERIC Educational Resources Information Center

    Irvin, P. Shawn; Park, Bitnara Jasmine; Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

    2011-01-01

    This technical report presents results from a cross-validation study designed to identify optimal cut scores when using easyCBM[R] reading tests in Washington state. The cross-validation study analyzes data from the 2009-2010 academic year for easyCBM[R] reading measures. A sample of approximately 900 students per grade, randomly split into two…

  17. Cross-Validation of easyCBM Reading Cut Scores in Oregon: 2009-2010. Technical Report #1108

    ERIC Educational Resources Information Center

    Park, Bitnara Jasmine; Irvin, P. Shawn; Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

    2011-01-01

    This technical report presents results from a cross-validation study designed to identify optimal cut scores when using easyCBM[R] reading tests in Oregon. The cross-validation study analyzes data from the 2009-2010 academic year for easyCBM[R] reading measures. A sample of approximately 2,000 students per grade, randomly split into two groups of…

  18. Vacuum boilers developed heating surfaces technic and economic efficiency evaluation

    NASA Astrophysics Data System (ADS)

    Slobodina, E. N.; Mikhailov, A. G.; Semenov, B. A.

    2018-01-01

    The vacuum boilers as manufacturing proto types application analysis was carried out, the possible directions for the heating surfaces development are identified with a view to improving the energy efficiency. Economic characteristics to evaluate the vacuum boilers application efficiency (Net Discounted Income (NDI), Internal Rate of Return (IRR), Profitability Index (PI) and Payback Period) are represented. The given type boilers application technic and economic efficiency criteria were established. NDI changing curves depending on the finning coefficient and operating pressure were obtained as a result of the conducted calculation studies.

  19. Technical-tactical analysis of youth olympic taekwondo combat.

    PubMed

    Tornello, Francesco; Capranica, Laura; Minganti, Carlo; Chiodo, Salvatore; Condello, Giancarlo; Tessitore, Antonio

    2014-04-01

    The purpose of this study was to define the technical and tactical profiles of official youth taekwondo competitions played under the most recent rules of the International Taekwondo Federation. Tactical actions (i.e., attack, defense, and block), technical executions (from 1- to 4-point scores), kicking legs (i.e., front/rear and right/left), and overall technical effectiveness were investigated in relation to match outcome of semifinal and final competitions (n = 50) of youth (aged 13-14 years) black belt athletes during the Italian Taekwondo Cadet Championship. Differences (p < 0.001) were found among all action typologies (Attack: 50.9 ± 2.2%; Defense: 27.7 ± 1.5%; Block: 21.3 ± 1.6%), with winners showing fewer (p = 0.005) offensive actions and more (p = 0.001) defensive actions with respect to non-winners. Independently from match outcome, technical exchanges showed differences (p < 0.001) for technical executions. Winners resulted more efficient (p < 0.001) for both technical and tactical variables. In general, these findings showed that Cadets tend to adopt an offensive strategy. In considering that the adoption of the new electronic system requires athletes to execute correct technical actions to have a score assigned, coaches should emphasize the effectiveness of scoring techniques and help athletes to effectively improve their defense and counterattack capabilities.

  20. 75 FR 27341 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference To Discuss Increasing Market and Planning Efficiency Through Improved Software May 7, 2010. Take notice that Commission... planning efficiency through improved software. [[Page 27342

  1. Technical and Tactical Aspects that Differentiate Winning and Losing Performances in Elite Male Karate Fighters.

    PubMed

    Vidranski, Tihomir; Sertić, Hrvoje; Jukić, Josefina

    2015-07-01

    The purpose of this research was to identify the fighters' technical and tactical activity indicators in order to determine indicator significance regarding situational efficiency and designation between winning and losing performances in a karate match. We scientifically observed a sample of 274 male contesters of 137 karate matches during the 2008 World Karate Championship in Tokyo. Each individual competitor was observed in maximum of three matches. The matches were recorded using a DVD camera in order to collect data for further analysis, and the sample was further described using 48 technical and tactical indicators of situational efficiency and match outcome variables. The obtained results indicate that a karate match is composed of 91% of non-scoring techniques and 9% of scoring techniques in the total technique frequency. On this basis a significant difference in the situational efficiency between the match winners and the losing contesters has been discovered. Those two groups of fighters exhibit a statistically significant difference (p<0.05) in 11 out of 21 observed variables of situational efficiency in the table of derived situational indicators. A prevalence of non-scoring techniques suggests that energy demand and technical and tactical requirements of a karate match are in the largest extent defined by non-scoring techniques. Therefore, it would be a grave mistake to disregard non-scoring karate techniques in any future situational efficiency studies. It has been discovered that the winners differ from the defeated contesters by a higher level of situational efficiency in their executed techniques, which incorporate versatility, biomechanical and structural complexity, topological diversity and a specific tactical concept of technique use in the attack phase.

  2. [Technical efficiency of traditional hospitals and public enterprises in Andalusia (Spain)].

    PubMed

    Herrero Tabanera, Luis; Martín Martín, José Jesús; López del Amo González, Ma del Puerto

    2015-01-01

    To assess the technical efficiency of traditional public hospitals without their own legal identity and subject to administrative law, and that of public enterprise hospitals, with their own legal identities and partly governed by private law, all of them belonging to the taxypayer-funded health system of Andalusia during the period 2005 -2008. The study included the 32 publicly-owned hospitals in Andalusia during the period 2005-2008. The method consisted of two stages. In the first stage, the indices of technical efficiency of the hospitals were calculated using Data Envelopment Analysis, and the change in total factor productivity was estimated using the Malmquist index. The results were compared according to perceived quality, and a sensitivity analysis was conducted through an auxiliary model and bootstrapping. In the second stage, a bivariate analysis was performed between hospital efficiency and organization type. Public enterprises were more efficient than traditional hospitals (on average by over 10%) in each of the study years. Nevertheless, a process of convergence was observed between the two types of organizations because, while the efficiency of traditional hospitals increased slightly (by 0.50%) over the study period, the performance of public enterprises declined by over 2%. The possible reasons for the greater efficiency of public enterprises include their greater budgetary and employment flexibility. However, the convergence process observed points to a process of mutual learning that is not necessarily efficient. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Development of an Itemwise Efficiency Scoring Method: Concurrent, Convergent, Discriminant, and Neuroimaging-Based Predictive Validity Assessed in a Large Community Sample

    PubMed Central

    Moore, Tyler M.; Reise, Steven P.; Roalf, David R.; Satterthwaite, Theodore D.; Davatzikos, Christos; Bilker, Warren B.; Port, Allison M.; Jackson, Chad T.; Ruparel, Kosha; Savitt, Adam P.; Baron, Robert B.; Gur, Raquel E.; Gur, Ruben C.

    2016-01-01

    Traditional “paper-and-pencil” testing is imprecise in measuring speed and hence limited in assessing performance efficiency, but computerized testing permits precision in measuring itemwise response time. We present a method of scoring performance efficiency (combining information from accuracy and speed) at the item level. Using a community sample of 9,498 youths age 8-21, we calculated item-level efficiency scores on four neurocognitive tests, and compared the concurrent, convergent, discriminant, and predictive validity of these scores to simple averaging of standardized speed and accuracy-summed scores. Concurrent validity was measured by the scores' abilities to distinguish men from women and their correlations with age; convergent and discriminant validity were measured by correlations with other scores inside and outside of their neurocognitive domains; predictive validity was measured by correlations with brain volume in regions associated with the specific neurocognitive abilities. Results provide support for the ability of itemwise efficiency scoring to detect signals as strong as those detected by standard efficiency scoring methods. We find no evidence of superior validity of the itemwise scores over traditional scores, but point out several advantages of the former. The itemwise efficiency scoring method shows promise as an alternative to standard efficiency scoring methods, with overall moderate support from tests of four different types of validity. This method allows the use of existing item analysis methods and provides the convenient ability to adjust the overall emphasis of accuracy versus speed in the efficiency score, thus adjusting the scoring to the real-world demands the test is aiming to fulfill. PMID:26866796

  4. 76 FR 28022 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference: Increasing Real-Time and Day- Ahead Market Efficiency Through Improved Software Take notice that Commission staff will... for increasing real-time and day-ahead market efficiency through improved software. This conference...

  5. Estimating technical efficiency in the hospital sector with panel data: a comparison of parametric and non-parametric techniques.

    PubMed

    Siciliani, Luigi

    2006-01-01

    Policy makers are increasingly interested in developing performance indicators that measure hospital efficiency. These indicators may give the purchasers of health services an additional regulatory tool to contain health expenditure. Using panel data, this study compares different parametric (econometric) and non-parametric (linear programming) techniques for the measurement of a hospital's technical efficiency. This comparison was made using a sample of 17 Italian hospitals in the years 1996-9. Highest correlations are found in the efficiency scores between the non-parametric data envelopment analysis under the constant returns to scale assumption (DEA-CRS) and several parametric models. Correlation reduces markedly when using more flexible non-parametric specifications such as data envelopment analysis under the variable returns to scale assumption (DEA-VRS) and the free disposal hull (FDH) model. Correlation also generally reduces when moving from one output to two-output specifications. This analysis suggests that there is scope for developing performance indicators at hospital level using panel data, but it is important that extensive sensitivity analysis is carried out if purchasers wish to make use of these indicators in practice.

  6. Necessity of creating digital tools to ensure efficiency of technical means

    NASA Astrophysics Data System (ADS)

    Rakov, V. I.; Zakharova, O. V.

    2018-05-01

    The authors estimated the problems of functioning of technical objects. The article notes that the increasing complexity of automation systems may lead to an increase of the redundant resource in proportion to the number of components and relationships in the system, and to the need of the redundant resource constant change that can make implementation of traditional structures with redundancy unnecessarily costly (Standby System, Fault Tolerance, High Availability). It proposes the idea of creating digital tools to ensure efficiency of technical facilities.

  7. 77 FR 19280 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... Market and Planning Efficiency Through Improved Software; Notice of Technical Conference: Increasing Real-Time and Day- Ahead Market Efficiency Through Improved Software Take notice that Commission staff will...-time and day-ahead market efficiency through improved software. A detailed agenda with the list of and...

  8. Productivity and technical efficiency of suckler beef production systems: trends for the period 1990 to 2012.

    PubMed

    Veysset, P; Lherm, M; Roulenc, M; Troquier, C; Bébin, D

    2015-12-01

    Over the past 23 years (1990 to 2012), French beef cattle farms have expanded in size and increased labour productivity by over 60%, chiefly, though not exclusively, through capital intensification (labour-capital substitution) and simplifying herd feeding practices (more concentrates used). The technical efficiency of beef sector production systems, as measured by the ratio of the volume value (in constant euros) of farm output excluding aids to volume of intermediate consumption, has fallen by nearly 20% while income per worker has held stable thanks to subsidies and the labour productivity gains made. This aggregate technical efficiency of beef cattle systems is positively correlated to feed self-sufficiency, which is in turn negatively correlated to farm and herd size. While volume of farm output per hectare of agricultural area has not changed, forage feed self-sufficiency decreased by 6 percentage points. The continual increase in farm size and labour productivity has come at a cost of lower production-system efficiency - a loss of technical efficiency that 20 years of genetic, technical, technological and knowledge-driven progress has barely managed to offset.

  9. [Analysis of the technical efficiency of hospitals in the Spanish National Health Service].

    PubMed

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    To analyse the technical efficiency and productivity of general hospitals in the Spanish National Health Service (NHS) (2010-2012) and identify explanatory hospital and regional variables. 230 NHS hospitals were analysed by data envelopment analysis for overall, technical and scale efficiency, and Malmquist index. The robustness of the analysis is contrasted with alternative input-output models. A fixed effects multilevel cross-sectional linear model was used to analyse the explanatory efficiency variables. The average rate of overall technical efficiency (OTE) was 0.736 in 2012; there was considerable variability by region. Malmquist index (2010-2012) is 1.013. A 23% variability in OTE is attributable to the region in question. Statistically significant exogenous variables (residents per 100 physicians, aging index, average annual income per household, essential public service expenditure and public health expenditure per capita) explain 42% of the OTE variability between hospitals and 64% between regions. The number of residents showed a statistically significant relationship. As regards regions, there is a statistically significant direct linear association between OTE and annual income per capita and essential public service expenditure, and an indirect association with the aging index and annual public health expenditure per capita. The significant room for improvement in the efficiency of hospitals is conditioned by region-specific characteristics, specifically aging, wealth and the public expenditure policies of each one. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Efficiency and productivity of hospitals in Vietnam.

    PubMed

    Pham, Thuy Linh

    2011-01-01

    The purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process. Data envelopment analyses method (DEA) with the input-oriented variable-returns-to-scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006. There was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently. The paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries

  11. The efficiency and budgeting of public hospitals: case study of iran.

    PubMed

    Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

    2013-05-01

    Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance.

  12. The Efficiency and Budgeting of Public Hospitals: Case Study of Iran

    PubMed Central

    Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

    2013-01-01

    Background Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. Objective The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. Materials and Methods This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. Results The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Conclusions Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance

  13. Comparing technical efficiency of farms with an automatic milking system and a conventional milking system.

    PubMed

    Steeneveld, W; Tauer, L W; Hogeveen, H; Oude Lansink, A G J M

    2012-12-01

    Changing from a conventional milking system (CMS) to an automatic milking system (AMS) necessitates a new management approach and a corresponding change in labor tasks. Together with labor savings, AMS farms have been found to have higher capital costs, primarily because of higher maintenance costs and depreciation. Therefore, it is hypothesized that AMS farms differ from CMS farms in capital:labor ratio and possibly their technical efficiency, at least during a transition learning period. The current study used actual farm accounting data from dairy farms in the Netherlands with an AMS and a CMS to investigate the empirical substitution of capital for labor in the AMS farms and to determine if the technical efficiency of the AMS farms differed from the CMS farms. The technical efficiency estimates were obtained with data envelopment analysis. The 63 AMS farms and the 337 CMS farms in the data set did not differ in general farm characteristics such as the number of cows, number of hectares, and the amount of milk quota. Farms with AMS have significantly higher capital costs (€12.71 per 100 kg of milk) than CMS farms (€10.10 per 100 kg of milk). Total labor costs and net outputs were not significantly different between AMS and CMS farms. A clear substitution of capital for labor with the adoption of an AMS could not be observed. Although the AMS farms have a slightly lower technical efficiency (0.76) than the CMS farms (0.78), a significant difference in these estimates was not observed. This indicates that the farms were not different in their ability to use inputs (capital, labor, cows, and land) to produce outputs (total farm revenues). The technical efficiency of farms invested in an AMS in 2008 or earlier was not different from the farms invested in 2009 or 2010, indicating that a learning effect during the transition period was not observed. The results indicate that the economic performance of AMS and CMS farms are similar. What these results show is that

  14. A Cobb Douglas stochastic frontier model on measuring domestic bank efficiency in Malaysia.

    PubMed

    Hasan, Md Zobaer; Kamil, Anton Abdulbasah; Mustafa, Adli; Baten, Md Azizul

    2012-01-01

    Banking system plays an important role in the economic development of any country. Domestic banks, which are the main components of the banking system, have to be efficient; otherwise, they may create obstacle in the process of development in any economy. This study examines the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur Stock Exchange (KLSE) market over the period 2005-2010. A parametric approach, Stochastic Frontier Approach (SFA), is used in this analysis. The findings show that Malaysian domestic banks have exhibited an average overall efficiency of 94 percent, implying that sample banks have wasted an average of 6 percent of their inputs. Among the banks, RHBCAP is found to be highly efficient with a score of 0.986 and PBBANK is noted to have the lowest efficiency with a score of 0.918. The results also show that the level of efficiency has increased during the period of study, and that the technical efficiency effect has fluctuated considerably over time.

  15. Research on the technical requirements standards of high efficiency precipitator in power industries for assessment

    NASA Astrophysics Data System (ADS)

    Jin, Huang; Ling, Lin; Jun, Guo; Jianguo, Li; Yongzhong, Wang

    2017-11-01

    Facing the increasingly severe situation of air pollution, China are now positively promoting the evaluation of high efficiency air pollution control equipments and the research of the relative national standards. This paper showed the significance and the effect of formulating the technical requirements of high efficiency precipitator equipments for assessment national standards in power industries as well as the research thoughts and principle of these standards. It introduce the qualitative and quantitative evaluation requirements of high efficiency precipitators using in power industries and the core technical content such as testing, calculating, evaluation methods and so on. The implementation of a series of national standards is in order to lead and promote the production and application of high efficiency precipitator equipments in the field of the prevention of air pollution in national power industries.

  16. A Cross-Validation of easyCBM[R] Mathematics Cut Scores in Oregon: 2009-2010. Technical Report #1104

    ERIC Educational Resources Information Center

    Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

    2011-01-01

    In this technical report, we document the results of a cross-validation study designed to identify optimal cut-scores for the use of the easyCBM[R] mathematics test in Oregon. A large sample, randomly split into two groups of roughly equal size, was used for this study. Students' performance classification on the Oregon state test was used as the…

  17. Farmers' Knowledge Attributes Contribute to Attaining Higher Farm Technical Efficiency: A Transition Economy Case

    ERIC Educational Resources Information Center

    Manevska-Tasevska, Gordana

    2013-01-01

    Purpose: This study sought to explore how farmers' knowledge attributes influence the technical efficiency of their farms. In addition, farm efficiency was compared to the actual Macedonian Rural Development Programme (RDP) (2007-2013) and instruments considered to improve Macedonian education potential were evaluated. Design/methodology/approach:…

  18. Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery

    PubMed Central

    Omondi Aduda, Dickens S.; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

    2015-01-01

    Background Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya’s context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. Objective To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Design Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Results Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350–5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959–4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Conclusions Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings

  19. Voluntary medical male circumcision scale-up in Nyanza, Kenya: evaluating technical efficiency and productivity of service delivery.

    PubMed

    Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

    2015-01-01

    Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya's context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350-5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959-4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of

  20. A Cross-Validation of easyCBM Mathematics Cut Scores in Washington State: 2009-2010 Test. Technical Report #1105

    ERIC Educational Resources Information Center

    Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

    2011-01-01

    In this technical report, we document the results of a cross-validation study designed to identify optimal cut-scores for the use of the easyCBM[R] mathematics test in the state of Washington. A large sample, randomly split into two groups of roughly equal size, was used for this study. Students' performance classification on the Washington state…

  1. Are large farms more efficient? Tenure security, farm size and farm efficiency: evidence from northeast China

    NASA Astrophysics Data System (ADS)

    Zhou, Yuepeng; Ma, Xianlei; Shi, Xiaoping

    2017-04-01

    How to increase production efficiency, guarantee grain security, and increase farmers' income using the limited farmland is a great challenge that China is facing. Although theory predicts that secure property rights and moderate scale management of farmland can increase land productivity, reduce farm-related costs, and raise farmer's income, empirical studies on the size and magnitude of these effects are scarce. A number of studies have examined the impacts of land tenure or farm size on productivity or efficiency, respectively. There are also a few studies linking farm size, land tenure and efficiency together. However, to our best knowledge, there are no studies considering tenure security and farm efficiency together for different farm scales in China. In addition, there is little study analyzing the profit frontier. In this study, we particularly focus on the impacts of land tenure security and farm size on farm profit efficiency, using farm level data collected from 23 villages, 811 households in Liaoning in 2015. 7 different farm scales have been identified to further represent small farms, median farms, moderate-scale farms, and large farms. Technical efficiency is analyzed with stochastic frontier production function. The profit efficiency is regressed on a set of explanatory variables which includes farm size dummies, land tenure security indexes, and household characteristics. We found that: 1) The technical efficiency scores for production efficiency (average score = 0.998) indicate that it is already very close to the production frontier, and thus there is little room to improve production efficiency. However, there is larger space to raise profit efficiency (average score = 0.768) by investing more on farm size expansion, seed, hired labor, pesticide, and irrigation. 2) Farms between 50-80 mu are most efficient from the viewpoint of profit efficiency. The so-called moderate-scale farms (100-150 mu) according to the governmental guideline show no

  2. Selected Private Higher Educational Institutions in Metro Manila: A DEA Efficiency Measurement

    ERIC Educational Resources Information Center

    de Guzman, Maria Corazon Gwendolyn N.; Cabana, Emilyn

    2009-01-01

    This paper measures the technical efficiency of 16 selected colleges and universities in Metro Manila, Philippines, using academic data for the SY 2001-2005. Using the data envelopment analysis (DEA), on average, schools posted 0.807 index score and need additional 19.3% efficiency growth to be efficient. Overall, there are top four efficient…

  3. Technical and Economic Aspects of Designing an Efficient Room Air-Conditioner Program in India

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Abhyankar, Nikit; Shah, Nihar; Phadke, Amol

    Several studies have projected a massive increase in the demand for air conditioners (ACs) over the next two decades in India. By 2030, room ACs could add 140 GW to the peak load, equivalent to over 30% of the total projected peak load. Therefore, there is significant interest among policymakers, regulators, and utilities in managing room AC demand by enhancing energy efficiency. Building on the historical success of the Indian Bureau of Energy Efficiency’s star-labeling program, Energy Efficiency Services Limited recently announced a program to accelerate the sale of efficient room ACs using bulk procurement, similar to their successful UJALAmore » light-emitting diode (LED) bulk procurement program. This report discusses some of the key considerations in designing a bulk procurement or financial incentive program for enhancing room AC efficiency in India. We draw upon our previous research to demonstrate the overall technical potential and price impact of room AC efficiency improvement and its technical feasibility in India. We also discuss the importance of using low global warming potential (GWP) refrigerants and smart AC equipment that is demand response (DR) ready.« less

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

    PubMed

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

    2015-03-01

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

  5. A Cobb Douglas Stochastic Frontier Model on Measuring Domestic Bank Efficiency in Malaysia

    PubMed Central

    Hasan, Md. Zobaer; Kamil, Anton Abdulbasah; Mustafa, Adli; Baten, Md. Azizul

    2012-01-01

    Banking system plays an important role in the economic development of any country. Domestic banks, which are the main components of the banking system, have to be efficient; otherwise, they may create obstacle in the process of development in any economy. This study examines the technical efficiency of the Malaysian domestic banks listed in the Kuala Lumpur Stock Exchange (KLSE) market over the period 2005–2010. A parametric approach, Stochastic Frontier Approach (SFA), is used in this analysis. The findings show that Malaysian domestic banks have exhibited an average overall efficiency of 94 percent, implying that sample banks have wasted an average of 6 percent of their inputs. Among the banks, RHBCAP is found to be highly efficient with a score of 0.986 and PBBANK is noted to have the lowest efficiency with a score of 0.918. The results also show that the level of efficiency has increased during the period of study, and that the technical efficiency effect has fluctuated considerably over time. PMID:22900009

  6. Procedural Influence on Internal and External Assessment Scores of Undergraduate Vocational and Technical Education Research Projects in Nigerian Universities

    ERIC Educational Resources Information Center

    A. C., John; Manabete, S. S.

    2015-01-01

    This study sought to determine the procedural influence on internal and external assessment scores of undergraduate research projects in vocational and technical education programmes in the university under study. A survey research design was used for the conduct of this study. The population consisted of 130 lecturers and 1,847 students in the…

  7. Estimation of Energy Efficiency of Means of Transport According to the Results of Technical Diagnostics

    NASA Astrophysics Data System (ADS)

    Shalkov, Anton; Mamaeva, Mariya

    2017-11-01

    The article considers the questions of application of nondestructive methods control of reducers of conveyor belts as a means of transport. Particular attention is paid to such types of diagnostics of technical condition as thermal control and analysis of the state of lubricants. The urgency of carrying out types of nondestructive testing presented in the article is determined by the increase of energy efficiency of transport systems of coal and mining enterprises, in particular, reducers of belt conveyors. Periodic in-depth spectral-emission diagnostics and monitoring of a temperature mode of operation oil in the operation of the control equipment and its technical condition and prevent the MTBF allows the monitoring of the actual technical condition of the gearbox of a belt conveyor. In turn, the thermal imaging diagnostics reveals defects at the earliest stage of their formation and development, which allows planning the volumes and terms of equipment repair. Presents diagnostics of the technical condition will allow monitoring in time the technical condition of the equipment and avoiding its premature failure. Thereby it will increase the energy efficiency of both the transport system and the enterprise as a whole, and also avoid unreasonable increases in operating and maintenance costs.

  8. Domestic Banks in Bangladesh Could Ensure Efficiency by Improving Human Resource Management Practices

    PubMed Central

    Muhammad Masum, Abdul Kadar; Azad, Md. Abul Kalam; Hoque, Kazi Enamul; Beh, Loo-See

    2015-01-01

    The paper aims to examine the influence of human resource management (HRM) practices on bank efficiency using Malmquist index of total factor productivity. The model comprises HRM index that represents the quality of HRM practices. The results are decomposed into three efficiency scores, namely, technical efficiency, pure efficiency, and scale efficiency. In this study, panel data for 44 banks in Bangladesh are used for the period 2008-2013. This paper reveals that foreign banks are ahead in converting the influence of HRM practices into efficiency scores (0.946>0.833). On the other hand, domestic banks performed better than foreign banks in terms of pure efficiency and scale efficiency. But, in terms of technical efficiency, the domestic banks are regressed by 6.7% annually whereas foreign banks are progressed with a yearly value of 5.8%. The results are robust, because the Mann-Whitney test and Kruskall-Wallis test (non-parametric tests) also confirm the same results. This study emphasizes HRM practices in the banking industry to ensure efficiency in the long-term scenario. Domestic banks are suggested to ensure continuous development in HRM practices in order to compete with foreign banks. PMID:26221727

  9. Domestic Banks in Bangladesh Could Ensure Efficiency by Improving Human Resource Management Practices.

    PubMed

    Masum, Abdul Kadar Muhammad; Azad, Md Abul Kalam; Hoque, Kazi Enamul; Beh, Loo-See

    2015-01-01

    The paper aims to examine the influence of human resource management (HRM) practices on bank efficiency using Malmquist index of total factor productivity. The model comprises HRM index that represents the quality of HRM practices. The results are decomposed into three efficiency scores, namely, technical efficiency, pure efficiency, and scale efficiency. In this study, panel data for 44 banks in Bangladesh are used for the period 2008-2013. This paper reveals that foreign banks are ahead in converting the influence of HRM practices into efficiency scores (0.946>0.833). On the other hand, domestic banks performed better than foreign banks in terms of pure efficiency and scale efficiency. But, in terms of technical efficiency, the domestic banks are regressed by 6.7% annually whereas foreign banks are progressed with a yearly value of 5.8%. The results are robust, because the Mann-Whitney test and Kruskall-Wallis test (non-parametric tests) also confirm the same results. This study emphasizes HRM practices in the banking industry to ensure efficiency in the long-term scenario. Domestic banks are suggested to ensure continuous development in HRM practices in order to compete with foreign banks.

  10. [Multilevel analysis of the technical efficiency of hospitals in the Spanish National Health System by property and type of management].

    PubMed

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    2018-05-11

    To analyze technical efficiency by type of property and management of general hospitals in the Spanish National Health System (2010-2012) and identify hospital and regional explanatory variables. 230 hospitals were analyzed combining data envelopment analysis and fixed effects multilevel linear models. Data envelopment analysis measured overall, technical and scale efficiency, and the analysis of explanatory factors was performed using multilevel models. The average rate of overall technical efficiency of hospitals without legal personality is lower than hospitals with legal personality (0.691 and 0.876 in 2012). There is a significant variability in efficiency under variable returns (TE) by direct, indirect and mixed forms of management. The 29% of the variability in TE es attributable to the Region. Legal personality increased the TE of the hospitals by 11.14 points. On the other hand, most of the forms of management (different to those of the traditional hospitals) increased TE in varying percentages. At regional level, according to the model considered, insularity and average annual income per household are explanatory variables of TE. Having legal personality favours technical efficiency. The regulatory and management framework of hospitals, more than public or private ownership, seem to explain technical efficiency. Regional characteristics explain the variability in TE. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Fundamental Aeronautics Program: Overview of Propulsion Work in the Supersonic Cruise Efficiency Technical Challenge

    NASA Technical Reports Server (NTRS)

    Castner, Ray

    2012-01-01

    The Supersonics Project, part of NASA's Fundamental Aeronautics Program, contains a number of technical challenge areas which include sonic boom community response, airport noise, high altitude emissions, cruise efficiency, light weight durable engines/airframes, and integrated multi-discipline system design. This presentation provides an overview of the current (2012) activities in the supersonic cruise efficiency technical challenge, and is focused specifically on propulsion technologies. The intent is to develop and validate high-performance supersonic inlet and nozzle technologies. Additional work is planned for design and analysis tools for highly-integrated low-noise, low-boom applications. If successful, the payoffs include improved technologies and tools for optimized propulsion systems, propulsion technologies for a minimized sonic boom signature, and a balanced approach to meeting efficiency and community noise goals. In this propulsion area, the work is divided into advanced supersonic inlet concepts, advanced supersonic nozzle concepts, low fidelity computational tool development, high fidelity computational tools, and improved sensors and measurement capability. The current work in each area is summarized.

  12. A procedural skills OSCE: assessing technical and non-technical skills of internal medicine residents.

    PubMed

    Pugh, Debra; Hamstra, Stanley J; Wood, Timothy J; Humphrey-Murto, Susan; Touchie, Claire; Yudkowsky, Rachel; Bordage, Georges

    2015-03-01

    Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal medicine (IM) residents to assess their technical and non-technical skills when performing procedures. Thirty-five first to third-year IM residents participated in a 5-station PS-OSCE, which combined partial task models, standardized patients, and allied health professionals. Formal blueprinting was performed and content experts were used to develop the cases and rating instruments. Examiners underwent a frame-of-reference training session to prepare them for their rater role. Scores were compared by levels of training, experience, and to evaluation data from a non-procedural OSCE (IM-OSCE). Reliability was calculated using Generalizability analyses. Reliabilities for the technical and non-technical scores were 0.68 and 0.76, respectively. Third-year residents scored significantly higher than first-year residents on the technical (73.5 vs. 62.2%) and non-technical (83.2 vs. 75.1%) components of the PS-OSCE (p < 0.05). Residents who had performed the procedures more frequently scored higher on three of the five stations (p < 0.05). There was a moderate disattenuated correlation (r = 0.77) between the IM-OSCE and the technical component of the PS-OSCE scores. The PS-OSCE is a feasible method for assessing multiple competencies related to performing procedures and this study provides validity evidence to support its use as an in-training examination.

  13. Diagnostic Efficiency of easyCBM[R] Math: Washington State. Technical Report #1008

    ERIC Educational Resources Information Center

    Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

    2010-01-01

    easyCBM[R] is an online benchmark and progress monitoring assessment system designed for use within a response to intervention framework. Educators using easyCBM[R] are often interested in using the results to predict students' state test performance. In the following technical document, we report diagnostic efficiency statistics using a sample…

  14. International comparisons of the technical efficiency of the hospital sector: panel data analysis of OECD countries using parametric and non-parametric approaches.

    PubMed

    Varabyova, Yauheniya; Schreyögg, Jonas

    2013-09-01

    There is a growing interest in the cross-country comparisons of the performance of national health care systems. The present work provides a comparison of the technical efficiency of the hospital sector using unbalanced panel data from OECD countries over the period 2000-2009. The estimation of the technical efficiency of the hospital sector is performed using nonparametric data envelopment analysis (DEA) and parametric stochastic frontier analysis (SFA). Internal and external validity of findings is assessed by estimating the Spearman rank correlations between the results obtained in different model specifications. The panel-data analyses using two-step DEA and one-stage SFA show that countries, which have higher health care expenditure per capita, tend to have a more technically efficient hospital sector. Whether the expenditure is financed through private or public sources is not related to the technical efficiency of the hospital sector. On the other hand, the hospital sector in countries with higher income inequality and longer average hospital length of stay is less technically efficient. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. Measuring technical efficiency of output quality in intensive care units.

    PubMed

    Junoy, J P

    1997-01-01

    Presents some examples of the implications derived from imposing the objective of maximizing social welfare, subject to limited resources, on ethical care patients management in respect of quality performance of health services. Conventional knowledge of health economics points out that critically ill patients are responsible for increased use of technological resources and that they receive a high proportion of health care resources. Attempts to answer, from the point of view of microeconomics, the question: how do we measure comparative efficiency in the management of intensive care units? Analyses this question through data from an international empirical study using micro-economic measures of productive efficiency in public services (data envelopment analysis). Results show a 28.8 per cent level of technical inefficiency processing data from 25 intensive care units in the USA.

  16. 2011 Residential Energy Efficiency Technical Update Meeting Summary Report: Denver, Colorado - August 9-11, 2011

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

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

  17. Determinants of School Efficiency: The Case of Primary Schools in the State of Geneva, Switzerland

    ERIC Educational Resources Information Center

    Huguenin, Jean-Marc

    2015-01-01

    Purpose: The purpose of this paper is: to measure school technical efficiency and to identify the determinants of primary school performance. Design/Methodology/Approach: A two-stage data envelopment analysis (DEA) of school efficiency is conducted. At the first stage, DEA is employed to calculate an individual efficiency score for each school. At…

  18. Anatomic severity grading score predicts technical difficulty, early outcomes, and hospital resource utilization of endovascular aortic aneurysm repair.

    PubMed

    Ahanchi, Sadaf S; Carroll, Megan; Almaroof, Babatunde; Panneton, Jean M

    2011-11-01

    -rendering software. The anatomic severity grading score correlates with the technical difficulty of EVAR and the extent of hospital resource utilization. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  19. Percutaneous Coronary Revascularization for Chronic Total Occlusions: A Novel Predictive Score of Technical Failure Using Advanced Technologies.

    PubMed

    Galassi, Alfredo R; Boukhris, Marouane; Azzarelli, Salvatore; Castaing, Marine; Marzà, Francesco; Tomasello, Salvatore D

    2016-05-09

    The aims of this study were to describe the 10-year experience of a single operator dedicated to chronic total occlusion (CTO) and to establish a model for predicting technical failure. During the last decade, the interest in percutaneous coronary interventions (PCIs) of chronic total occlusions (CTOs) has increased, allowing the improvement of success rate. One thousand nineteen patients with CTO underwent 1,073 CTO procedures performed by a single CTO-dedicated operator. The study population was subdivided into 2 groups by time period: period 1 (January 2005 to December 2009, n = 378) and period 2 (January 2010 to December 2014, n = 641). Observations were randomly assigned to a derivation set and a validation set (in a 2:1 ratio). A prediction score was established by assigning points for each independent predictor of technical failure in the derivation set according to the beta coefficient and summing all points accrued. Lesions attempted in period 2 were more complex in comparison with those in period 1. Compared with period 1, both technical and clinical success rates significantly improved (from 87.8% to 94.4% [p = 0.001] and from 77.6% to 89.9% [p < 0.001], respectively). A prediction score for technical failure including age ≥75 years (1 point), ostial location (1 point), and collateral filling Rentrop grade <2 (2 points) was established, stratifying procedures into 4 difficulty groups: easy (0), intermediate (1), difficult (2), and very difficult (3 or 4), with decreasing technical success rates. In derivation and validation sets, areas under the curve were comparable (0.728 and 0.772, respectively). With growing expertise, the success rate has increased despite increasing complexity of attempted lesions. The established model predicted the probability of technical failure and thus might be applied to grading the difficulty of CTO procedures. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights

  20. The impact of healthcare reform on the efficiency of public county hospitals in China.

    PubMed

    Jiang, Shuai; Min, Rui; Fang, Peng-Qian

    2017-12-20

    The new round of Healthcare Reform in China has implemented over 3 years since 2009, and promoted greatly the development of public county hospitals. The purpose of this study is to evaluate county hospitals efficiency before and after the healthcare reform, and further assess the reform effectiveness through the comparative analysis of the efficiency. Data envelopment analysis (DEA) was employed to calculate the efficiency of 1105 sample hospitals which were selected from 31 provinces of China, also, Tobit regression was used to regress against those main external environmental factors. Our results show that the scales and amounts of service of hospitals had increased sharply, however, the efficiency was relatively low and decreased slightly from 2008 to 2012. Thirteen (1.18%) in 2008 and six (0.54%) hospitals in 2012 were defined as technically efficient, and the average scores were 0.2916 and 0.2503. The technical efficiency average score of the post-reform was significantly less than that of the pre-reform (p < 0.001), and the score of eastern region was highest and the western was lowest among three regions of China. It suggests the reform had not well improved county hospital efficiency although hospitals have reached a fair developing scale, and the corresponding policies and measures should be put into effect for improving efficiency, especially in the level and structure of health investment, operation and supervision mechanism of county hospitals.

  1. Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis.

    PubMed

    Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

    2017-01-05

    Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. The study focused on all 72 health districts of Zambia. We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. 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/.

  2. Technical and scale efficiency in the delivery of child health services in Zambia: results from data envelopment analysis

    PubMed Central

    Achoki, Tom; Hovels, Anke; Masiye, Felix; Lesego, Abaleng; Leufkens, Hubert; Kinfu, Yohannes

    2017-01-01

    Objective Despite tremendous efforts to scale up key maternal and child health interventions in Zambia, progress has not been uniform across the country. This raises fundamental health system performance questions that require further investigation. Our study investigates technical and scale efficiency (SE) in the delivery of maternal and child health services in the country. Setting The study focused on all 72 health districts of Zambia. Methods We compiled a district-level database comprising health outcomes (measured by the probability of survival to 5 years of age), health outputs (measured by coverage of key health interventions) and a set of health system inputs, namely, financial resources and human resources for health, for the year 2010. We used data envelopment analysis to assess the performance of subnational units across Zambia with respect to technical and SE, controlling for environmental factors that are beyond the control of health system decision makers. Results Nationally, average technical efficiency with respect to improving child survival was 61.5% (95% CI 58.2% to 64.8%), which suggests that there is a huge inefficiency in resource use in the country and the potential to expand services without injecting additional resources into the system. Districts that were more urbanised and had a higher proportion of educated women were more technically efficient. Improved cooking methods and donor funding had no significant effect on efficiency. Conclusions With the pressing need to accelerate progress in population health, decision makers must seek efficient ways to deliver services to achieve universal health coverage. Understanding the factors that drive performance and seeking ways to enhance efficiency offer a practical pathway through which low-income countries could improve population health without necessarily seeking additional resources. PMID:28057650

  3. SEE Action Guide for States: Guidance on Establishing and Maintaining Technical Reference Manuals for Energy Efficiency Measures

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    2017-06-01

    The goal of this guide is to support the development, maintenance, and use of accurate and reliable Technical Reference Manuals (TRMs). TRMs provide information primarily used for estimating the energy and demand savings of end-use energy efficiency measures associated with utility customer-funded efficiency programs.

  4. Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana.

    PubMed

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Akazili, James; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

    2015-01-01

    Despite improvements in a number of health outcome indicators partly due to the National Health Insurance Scheme (NHIS), Ghana is unlikely to attain all its health-related millennium development goals before the end of 2015. Inefficient use of available limited resources has been cited as a contributory factor for this predicament. This study sought to explore efficiency levels of NHIS-accredited private and public health facilities; ascertain factors that account for differences in efficiency and determine the association between quality care and efficiency levels. The study is a cross-sectional survey of NHIS-accredited primary health facilities (n = 64) in two regions in southern Ghana. Data Envelopment Analysis was used to estimate technical efficiency of sampled health facilities while Tobit regression was employed to predict factors associated with efficiency levels. Spearman correlation test was performed to determine the association between quality care and efficiency. Overall, 20 out of the 64 health facilities (31 %) were optimally efficient relative to their peers. Out of the 20 efficient facilities, 10 (50 %) were Public/government owned facilities; 8 (40 %) were Private-for-profit facilities and 2 (10 %) were Private-not-for-profit/Mission facilities. Mission (Coef. = 52.1; p = 0.000) and Public (Coef. = 42.9; p = 0.002) facilities located in the Western region (predominantly rural) had higher odds of attaining the 100 % technical efficiency benchmark than those located in the Greater Accra region (largely urban). No significant association was found between technical efficiency scores of health facilities and many technical quality care proxies, except in overall quality score per the NHIS accreditation data (Coef. = -0.3158; p < 0.05) and SafeCare Essentials quality score on environmental safety for staff and patients (Coef. = -0.2764; p < 0.05) where the association was negative. The findings suggest some level of wastage of

  5. Technical Efficiency and Primary Education in South Africa: Evidence from Sub-National Level Analyses

    ERIC Educational Resources Information Center

    Boateng, Nana Adowaa

    2014-01-01

    The paper examines the extent to which sub-national public officials are efficient in delivering basic education services and argues that technical inefficiencies, especially in the management of public funds for education, could potentially contribute to poor education service delivery in South Africa. A conceptual framework is proposed to show…

  6. Knowing the Score

    ERIC Educational Resources Information Center

    Strouse, Lewis H.

    2009-01-01

    Before rehearsals begin, conductors need to thoroughly study the score. What elements go into a comprehensive score preparation? To learn music scores efficiently, having a detailed and systematic study method helps. The author has developed a score preparation guide that works for directors of bands, choruses, and orchestras, even when there's…

  7. Progress in Emission Efficiency of Organic Light-Emitting Diodes: Basic Understanding and Its Technical Application

    NASA Astrophysics Data System (ADS)

    Tsutsui, Tetsuo; Takada, Noriyuki

    2013-11-01

    The technical history of when and how the basic understanding of the emission efficiency of organic light-emitting diodes (OLEDs) was established over the last 50 years is described. At first, our understanding of emission efficiency in single-crystal and thin-film electroluminescence (EL) devices in the early stages before the Eastman-Kodak breakthrough, that is, the introduction of the concept of multilayer structures, is examined. Then our contemplation travels from the Eastman-Kodak breakthrough towards the presently widely accepted concept of emission efficiency. The essential issues concerning the emission efficiency of OLEDs are summarized to help readers to obtain a common understanding of OLED efficiency problems, and detailed discussions on the primary factors that determine emission efficiency are given. Finally, some comments on remaining issues are presented.

  8. Health systems: changes in hospital efficiency and profitability.

    PubMed

    Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas

    2016-06-01

    This study investigates potential changes in hospital performance after health system entry, while differentiating between hospital technical and cost efficiency and hospital profitability. In the first stage we obtained (bootstrapped) data envelopment analysis (DEA) efficiency scores. Then, genetic matching is used as a novel matching procedure in this context along with a difference-in-difference approach within a panel regression framework. With the genetic matching procedure, independent and health system hospitals are matched along a number of environmental and organizational characteristics. The results show that health system entry increases hospital technical and cost efficiency by between 0.6 and 3.4 % in four alternative post-entry periods, indicating that health system entry has not a transitory but rather a permanent effect on hospital efficiency. Regarding hospital profitability, the results reveal an increase in hospital profitability only 1 year after health system entry, and the estimations suggest that this effect is a transitional phenomenon. Overall, health system entry may serve as an appropriate management instrument for decision makers to increase hospital performance.

  9. Non-technical skills of surgical trainees and experienced surgeons.

    PubMed

    Gostlow, H; Marlow, N; Thomas, M J W; Hewett, P J; Kiermeier, A; Babidge, W; Altree, M; Pena, G; Maddern, G

    2017-05-01

    In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  10. Study on the removal efficiency of UF membranes using bacteriophages in bench-scale and semi-technical scale.

    PubMed

    Kreissel, K; Bösl, M; Lipp, P; Franzreb, M; Hambsch, B

    2012-01-01

    To determine the removal efficiency of ultrafiltration (UF) membranes for nano-particles in the size range of viruses the state of the art uses challenge tests with virus-spiked water. This work focuses on bench-scale and semi-technical scale experiments. Different experimental parameters influencing the removal efficiency of the tested UF membrane modules were analyzed and evaluated for bench- and semi-technical scale experiments. Organic matter in the water matrix highly influenced the removal of the tested bacteriophages MS2 and phiX174. Less membrane fouling (low ΔTMP) led to a reduced phage reduction. Increased flux positively affected phage removal in natural waters. The tested bacteriophages MS2 and phiX174 revealed different removal properties. MS2, which is widely used as a model organism to determine virus removal efficiencies of membranes, mostly showed a better removal than phiX174 for the natural water qualities tested. It seems that MS2 is possibly a less conservative surrogate for human enteric virus removal than phiX174. In bench-scale experiments log removal values (LRV) for MS2 of 2.5-6.0 and of 2.5-4.5 for phiX174 were obtained for the examined range of parameters. Phage removal obtained with differently fabricated semi-technical modules was quite variable for comparable parameter settings, indicating that module fabrication can lead to differing results. Potting temperature and module size were identified as influencing factors. In conclusion, careful attention has to be paid to the choice of experimental settings and module potting when using bench-scale or semi-technical scale experiments for UF membrane challenge tests.

  11. GPU acceleration of Dock6's Amber scoring computation.

    PubMed

    Yang, Hailong; Zhou, Qiongqiong; Li, Bo; Wang, Yongjian; Luan, Zhongzhi; Qian, Depei; Li, Hanlu

    2010-01-01

    Dressing the problem of virtual screening is a long-term goal in the drug discovery field, which if properly solved, can significantly shorten new drugs' R&D cycle. The scoring functionality that evaluates the fitness of the docking result is one of the major challenges in virtual screening. In general, scoring functionality in docking requires a large amount of floating-point calculations, which usually takes several weeks or even months to be finished. This time-consuming procedure is unacceptable, especially when highly fatal and infectious virus arises such as SARS and H1N1, which forces the scoring task to be done in a limited time. This paper presents how to leverage the computational power of GPU to accelerate Dock6's (http://dock.compbio.ucsf.edu/DOCK_6/) Amber (J. Comput. Chem. 25: 1157-1174, 2004) scoring with NVIDIA CUDA (NVIDIA Corporation Technical Staff, Compute Unified Device Architecture - Programming Guide, NVIDIA Corporation, 2008) (Compute Unified Device Architecture) platform. We also discuss many factors that will greatly influence the performance after porting the Amber scoring to GPU, including thread management, data transfer, and divergence hidden. Our experiments show that the GPU-accelerated Amber scoring achieves a 6.5× speedup with respect to the original version running on AMD dual-core CPU for the same problem size. This acceleration makes the Amber scoring more competitive and efficient for large-scale virtual screening problems.

  12. Building Energy Asset Score for Architects

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for architects.

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

    PubMed

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

    2016-01-01

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

  14. Commercial Building Energy Asset Score

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    This software (Asset Scoring Tool) is designed to help building owners and managers to gain insight into the as-built efficiency of their buildings. It is a web tool where users can enter their building information and obtain an asset score report. The asset score report consists of modeled building energy use (by end use and by fuel type), building systems (envelope, lighting, heating, cooling, service hot water) evaluations, and recommended energy efficiency measures. The intended users are building owners and operators who have limited knowledge of building energy efficiency. The scoring tool collects minimum building data (~20 data entries) frommore » users and build a full-scale energy model using the inference functionalities from Facility Energy Decision System (FEDS). The scoring tool runs real-time building energy simulation using EnergyPlus and performs life-cycle cost analysis using FEDS. An API is also under development to allow the third-party applications to exchange data with the web service of the scoring tool.« less

  15. Cognitive training for technical and non-technical skills in robotic surgery: a randomised controlled trial.

    PubMed

    Raison, Nicholas; Ahmed, Kamran; Abe, Takashige; Brunckhorst, Oliver; Novara, Giacomo; Buffi, Nicolò; McIlhenny, Craig; van der Poel, Henk; van Hemelrijck, Mieke; Gavazzi, Andrea; Dasgupta, Prokar

    2018-05-07

    To investigate the effectiveness of motor imagery (MI) for technical skill and non-technical skill (NTS) training in minimally invasive surgery (MIS). A single-blind, parallel-group randomised controlled trial was conducted at the Vattikuti Institute of Robotic Surgery, King's College London. Novice surgeons were recruited by open invitation in 2015. After basic robotic skills training, participants underwent simple randomisation to either MI training or standard training. All participants completed a robotic urethrovesical anastomosis task within a simulated operating room. In addition to the technical task, participants were required to manage three scripted NTS scenarios. Assessment was performed by five blinded expert surgeons and a NTS expert using validated tools for evaluating technical skills [Global Evaluative Assessment of Robotic Skills (GEARS)] and NTS [Non-Technical Skills for Surgeons (NOTSS)]. Quality of MI was assessed using a revised Movement Imagery Questionnaire (MIQ). In all, 33 participants underwent MI training and 29 underwent standard training. Interrater reliability was high, Krippendorff's α = 0.85. After MI training, the mean (sd) GEARS score was significantly higher than after standard training, at 13.1 (3.25) vs 11.4 (2.97) (P = 0.03). There was no difference in mean NOTSS scores, at 25.8 vs 26.4 (P = 0.77). MI training was successful with significantly higher imagery scores than standard training (mean MIQ score 5.1 vs 4.5, P = 0.04). Motor imagery is an effective training tool for improving technical skill in MIS even in novice participants. No beneficial effect for NTS was found. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  16. Neurosurgical Skills Assessment: Measuring Technical Proficiency in Neurosurgery Residents Through Intraoperative Video Evaluations.

    PubMed

    Sarkiss, Christopher A; Philemond, Steven; Lee, James; Sobotka, Stanislaw; Holloway, Terrell D; Moore, Maximillian M; Costa, Anthony B; Gordon, Errol L; Bederson, Joshua B

    2016-05-01

    Although technical skills are fundamental in neurosurgery, there is little agreement on how to describe, measure, or compare skills among surgeons. The primary goal of this study was to develop a quantitative grading scale for technical surgical performance that distinguishes operator skill when graded by domain experts (residents, attendings, and nonsurgeons). Scores provided by raters should be highly reliable with respect to scores from other observers. Neurosurgery residents were fitted with a head-mounted video camera while performing craniotomies under attending supervision. Seven videos, 1 from each postgraduate year (PGY) level (1-7), were anonymized and scored by 16 attendings, 8 residents, and 7 nonsurgeons using a grading scale. Seven skills were graded: incision, efficiency of instrument use, cauterization, tissue handling, drilling/craniotomy, confidence, and training level. A strong correlation was found between skills score and PGY year (P < 0.001, analysis of variance). Junior residents (PGY 1-3) had significantly lower scores than did senior residents (PGY 4-7, P < 0.001, t test). Significant variation among junior residents was observed, and senior residents' scores were not significantly different from one another. Interrater reliability, measured against other observers, was high (r = 0.581 ± 0.245, Spearman), as was assessment of resident training level (r = 0.583 ± 0.278, Spearman). Both variables were strongly correlated (r = 0.90, Pearson). Attendings, residents, and nonsurgeons did not score differently (P = 0.46, analysis of variance). Technical skills of neurosurgery residents recorded during craniotomy can be measured with high interrater reliability. Surgeons and nonsurgeons alike readily distinguish different skill levels. This type of assessment could be used to coach residents, to track performance over time, and potentially to compare skill levels. Developing an objective tool to evaluate surgical performance would be useful

  17. Technical efficiency in the use of health care resources: a comparison of OECD countries.

    PubMed

    Retzlaff-Roberts, Donna; Chang, Cyril F; Rubin, Rose M

    2004-07-01

    Our paper analyzes technical efficiency in the production of aggregate health outcomes of reduced infant mortality and increased life expectancy, using Organization for Economic Cooperation and Development (OECD) health data. Application of data envelopment analysis (DEA) reveals that some countries achieve relative efficiency advantages, including those with good health outcomes (Japan, Sweden, Norway, and Canada) and those with modest health outcomes (Mexico and Turkey). We conclude the USA may learn from countries more economical in their allocation of healthcare resources that more is not necessarily better. Specifically, we find that the USA can substantially reduce inputs while maintaining the current level of life expectancy.

  18. Simulation-based ureteroscopy skills training curriculum with integration of technical and non-technical skills: a randomised controlled trial.

    PubMed

    Brunckhorst, Oliver; Shahid, Shahab; Aydin, Abdullatif; McIlhenny, Craig; Khan, Shahid; Raza, Syed Johar; Sahai, Arun; Brewin, James; Bello, Fernando; Kneebone, Roger; Khan, Muhammad Shamim; Dasgupta, Prokar; Ahmed, Kamran

    2015-09-01

    Current training modalities within ureteroscopy have been extensively validated and must now be integrated within a comprehensive curriculum. Additionally, non-technical skills often cause surgical error and little research has been conducted to combine this with technical skills teaching. This study therefore aimed to develop and validate a curriculum for semi-rigid ureteroscopy, integrating both technical and non-technical skills teaching within the programme. Delphi methodology was utilised for curriculum development and content validation, with a randomised trial then conducted (n = 32) for curriculum evaluation. The developed curriculum consisted of four modules; initially developing basic technical skills and subsequently integrating non-technical skills teaching. Sixteen participants underwent the simulation-based curriculum and were subsequently assessed, together with the control cohort (n = 16) within a full immersion environment. Both technical (Time to completion, OSATS and a task specific checklist) and non-technical (NOTSS) outcome measures were recorded with parametric and non-parametric analyses used depending on the distribution of our data as evaluated by a Shapiro-Wilk test. Improvements within the intervention cohort demonstrated educational value across all technical and non-technical parameters recorded, including time to completion (p < 0.01), OSATS scores (p < 0.001), task specific checklist scores (p = 0.011) and NOTSS scores (p < 0.001). Content validity, feasibility and acceptability were all demonstrated through curriculum development and post-study questionnaire results. The current developed curriculum demonstrates that integrating both technical and non-technical skills teaching is both educationally valuable and feasible. Additionally, the curriculum offers a validated simulation-based training modality within ureteroscopy and a framework for the development of other simulation-based programmes.

  19. Understanding Scoring Rubrics: A Guide for Teachers.

    ERIC Educational Resources Information Center

    Boston, Carol, Ed.

    This compilation provides an introduction to using scoring rubrics in the classroom. When good rubrics are used well, teachers and students receive extensive feedback on the quality and quantity of student learning. When scoring rubrics are used in large-scale assessment, technical questions related to interrater reliability tend to dominate the…

  20. Building Energy Asset Score for Building Owners

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for building owners.

  1. Confronting Regulatory Cost and Quality Expectations. An Exploration of Technical Change in Minimum Efficiency Performance Standards

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Taylor, Margaret; Spurlock, C. Anna; Yang, Hung-Chia

    The dual purpose of this project was to contribute to basic knowledge about the interaction between regulation and innovation and to inform the cost and benefit expectations related to technical change which are embedded in the rulemaking process of an important area of national regulation. The area of regulation focused on here is minimum efficiency performance standards (MEPS) for appliances and other energy-using products. Relevant both to U.S. climate policy and energy policy for buildings, MEPS remove certain product models from the market that do not meet specified efficiency thresholds.

  2. Evaluation on the efficiencies of county-level Centers for Disease Control and Prevention in China: results from a national survey.

    PubMed

    Li, Chengyue; Sun, Mei; Shen, Jay J; Cochran, Christopher R; Li, Xiaojiao; Hao, Mo

    2016-09-01

    The Chinese government has greatly increased funding for disease control and prevention since the 2003 Severe Acute Respiration Syndrome crisis, but it is also concerned whether these increased resources have been used efficiently to improve public health services. We aimed to assess the efficiency of county-level Centers for Disease Control and Prevention (CDCs) of China and to identify strategies for optimising their performance. A total of 446 county-level CDCs were selected based on systematic sampling throughout China. The data envelopment analysis framework was used to calculate the efficiency score of sampled CDCs in 2010. The Charnes, Cooper and Rhodes (CCR) model was applied to calculate the overall and scale efficiency, and the Banker, Charnes and Cooper (BCC) model was used to assess technical efficiency. Models included three inputs and seven outputs. A projection analysis was conducted to identify the difference between projection value and actual value for inputs and outputs. The average overall efficiency score of CDCs was 0.317, and the average technical efficiency score was 0.442 and 88.3% with decreasing returns to scale. Projection analysis indicated that all seven categories of outputs were underproduced. CDCs in the eastern region tended to perform better than CDCs in the middle and the western region. Most county-level CDCs in China were operated inefficiently. Emphasis should be put on increasing staff and general operating expenses through current governmental funding, upgrading healthcare providers' competencies and enhancing the standardisation of operational management, so that CDCs could utilise their resources more efficiently. © 2016 John Wiley & Sons Ltd.

  3. Efficiency measurement of the banking sector in the presence of non-performing loan

    NASA Astrophysics Data System (ADS)

    Hamid, Nurhayati; Ramli, Noor Asiah; Hussin, Siti Aida Sheikh

    2017-01-01

    Bank industry plays a vital role in a country's economic development. In the banking industry, the non-performing loans which are acknowledged as being undesirable outputs and usually ignored in most of the analysis should be taken into account since they are undesirable by-products of producing loans and may lead to the bank inefficiency. Modelling the efficiency measurement without undesirable outputs can provide misleading results and unfair assessment. The Directional Distance Function (DDF) approach which extended from the Data Envelopment Analysis (DEA) framework is one of the enhancement efficiency approaches to handle a situation when there is a joint production of the desirable and undesirable outputs. The comparison of both results between the domestic and foreign banks shows that the DEA technical efficiency score for domestic banks is marginally higher than the Malaysian foreign banks. However, when incorporating the undesirable output, the DDF technical efficiency for foreign banks is slightly higher than domestic banks.

  4. Impact of technical and technological changes on energy efficiency of production company - case study

    NASA Astrophysics Data System (ADS)

    Szwedzka, K.; Gruszka, J.; Szafer, P.

    2016-08-01

    Improving energy efficiency is one of the strategic objectives of the European Union for rational energy economy. To make efforts to improve energy efficiency have been obliged both small and large end-users. This article aims to show the possibilities of improving energy efficiency by introducing technical and technological process changes of pine lumber drying. The object of the research is process of drying lumber implemented in a production company, which is a key supplier of large furniture manufacturer. Pine lumber drying chamber consume about 45% of total electricity in sawmill. According to various sources, drying of 1m3 of lumber uses about 3060kWh and is dependent of inter alia: the drying process itself, the factors affecting the processing time and the desired output moisture content of the timber. The article proposals for changes in the process of drying lumber pine have been positively validated in the company, and as a result their energy consumption per 1 m3 of product declined by 18%.

  5. Measuring Efficiency of Health Systems of the Middle East and North Africa (MENA) Region Using Stochastic Frontier Analysis.

    PubMed

    Hamidi, Samer; Akinci, Fevzi

    2016-06-01

    The main purpose of this study is to measure the technical efficiency of twenty health systems in the Middle East and North Africa (MENA) region to inform evidence-based health policy decisions. In addition, the effects of alternative stochastic frontier model specification on the empirical results are examined. We conducted a stochastic frontier analysis to estimate the country-level technical efficiencies using secondary panel data for 20 MENA countries for the period of 1995-2012 from the World Bank database. We also tested the effect of alternative frontier model specification using three random-effects approaches: a time-invariant model where efficiency effects are assumed to be static with regard to time, and a time-varying efficiency model where efficiency effects have temporal variation, and one model to account for heterogeneity. The average estimated technical inefficiency of health systems in the MENA region was 6.9 % with a range of 5.7-7.9 % across the three models. Among the top performers, Lebanon, Qatar, and Morocco are ranked consistently high according to the three different inefficiency model specifications. On the opposite side, Sudan, Yemen and Djibouti ranked among the worst performers. On average, the two most technically efficient countries were Qatar and Lebanon. We found that the estimated technical efficiency scores vary substantially across alternative parametric models. Based on the findings reported in this study, most MENA countries appear to be operating, on average, with a reasonably high degree of technical efficiency compared with other countries in the region. However, there is evidence to suggest that there are considerable efficiency gains yet to be made by some MENA countries. Additional empirical research is needed to inform future health policies aimed at improving both the efficiency and sustainability of the health systems in the MENA region.

  6. Knowledge discovery from data and Monte-Carlo DEA to evaluate technical efficiency of mental health care in small health areas

    PubMed Central

    García-Alonso, Carlos; Pérez-Naranjo, Leonor

    2009-01-01

    Introduction Knowledge management, based on information transfer between experts and analysts, is crucial for the validity and usability of data envelopment analysis (DEA). Aim To design and develop a methodology: i) to assess technical efficiency of small health areas (SHA) in an uncertainty environment, and ii) to transfer information between experts and operational models, in both directions, for improving expert’s knowledge. Method A procedure derived from knowledge discovery from data (KDD) is used to select, interpret and weigh DEA inputs and outputs. Based on KDD results, an expert-driven Monte-Carlo DEA model has been designed to assess the technical efficiency of SHA in Andalusia. Results In terms of probability, SHA 29 is the most efficient being, on the contrary, SHA 22 very inefficient. 73% of analysed SHA have a probability of being efficient (Pe) >0.9 and 18% <0.5. Conclusions Expert knowledge is necessary to design and validate any operational model. KDD techniques make the transfer of information from experts to any operational model easy and results obtained from the latter improve expert’s knowledge.

  7. An Exploration of Alternative Scoring Methods Using Curriculum-Based Measurement in Early Writing

    ERIC Educational Resources Information Center

    Allen, Abigail A.; Poch, Apryl L.; Lembke, Erica S.

    2018-01-01

    This manuscript describes two empirical studies of alternative scoring procedures used with curriculum-based measurement in writing (CBM-W). Study 1 explored the technical adequacy of a trait-based rubric in first grade. Study 2 explored the technical adequacy of a trait-based rubric, production-dependent, and production-independent scores in…

  8. Technical performance score is associated with outcomes after the Norwood procedure.

    PubMed

    Nathan, Meena; Sleeper, Lynn A; Ohye, Richard G; Frommelt, Peter C; Caldarone, Christopher A; Tweddell, James S; Lu, Minmin; Pearson, Gail D; Gaynor, J William; Pizarro, Christian; Williams, Ismee A; Colan, Steven D; Dunbar-Masterson, Carolyn; Gruber, Peter J; Hill, Kevin; Hirsch-Romano, Jennifer; Jacobs, Jeffrey P; Kaltman, Jonathan R; Kumar, S Ram; Morales, David; Bradley, Scott M; Kanter, Kirk; Newburger, Jane W

    2014-11-01

    The technical performance score (TPS) has been reported in a single center study to predict the outcomes after congenital cardiac surgery. We sought to determine the association of the TPS with outcomes in patients undergoing the Norwood procedure in the Single Ventricle Reconstruction trial. We calculated the TPS (class 1, optimal; class 2, adequate; class 3, inadequate) according to the predischarge echocardiograms analyzed in a core laboratory and unplanned reinterventions that occurred before discharge from the Norwood hospitalization. Multivariable regression examined the association of the TPS with interval to first extubation, Norwood length of stay, death or transplantation, unplanned postdischarge reinterventions, and neurodevelopment at 14 months old. Of 549 patients undergoing a Norwood procedure, 356 (65%) had an echocardiogram adequate to assess atrial septal restriction or arch obstruction or an unplanned reintervention, enabling calculation of the TPS. On multivariable regression, adjusting for preoperative variables, a better TPS was an independent predictor of a shorter interval to first extubation (P=.019), better transplant-free survival before Norwood discharge (P<.001; odds ratio, 9.1 for inadequate vs optimal), shorter hospital length of stay (P<.001), fewer unplanned reinterventions between Norwood discharge and stage II (P=.004), and a higher Bayley II psychomotor development index at 14 months (P=.031). The TPS was not associated with transplant-free survival after Norwood discharge, unplanned reinterventions after stage II, or the Bayley II mental development index at 14 months. TPS is an independent predictor of important outcomes after Norwood and could serve as a tool for quality improvement. Copyright © 2014 The American Association for Thoracic Surgery. All rights reserved.

  9. Unresolved Technical Issues in Fair Interest Measurement.

    ERIC Educational Resources Information Center

    Cole, Nancy S.

    The problem of sex differences in interest measurement involves many technical issues and procedures. The purpose of this paper is to provide a description of the technical problems involved in construction, scoring, and interpretation of interest measures as related to sex differences and to suggest guidelines within these technical issues which…

  10. Building Energy Asset Score for Real Estate Managers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for real estate managers.

  11. Can the efficiency of modified Alvarado scoring system in the diagnosis acute appendicitis be increased with tenesmus?

    PubMed

    Bulus, Hakan; Tas, Adnan; Morkavuk, Baris; Koklu, Seyfettin; Soy, Derya; Coskun, Ali

    2013-01-01

    Acute appendicitis is one of the main pathological conditions requiring emergency surgical intervention. The most widely accepted scoring system is modified Alvarado scoring system (MASS). In this study we aimed to improve the efficiency of MASS by adding a new parameter and to evaluate its efficiency in the diagnosis of acute appendicitis. This study included 158 patients who underwent acute appendectomy in Keçiören Training and Research Hospital General Surgery Department. In addition to criteria of MASS, all patients were questioned about the presence of tenesmus. The validity of MASS and MASS with additional parameter was evaluated with respect to sensitivity, specificity and positive and negative predictive values. Accuracy rates of MASS, clinical findings, ultrasonography and MASS with additional parameter in the diagnosis of acute appendicitis were 64, 76, 85 and 80 %. False positivity rates for clinical findings, MASS and MASS with additional parameter in the diagnosis of acute appendicitis were 17, 26 and 10 %, respectively. Sensitivity and specificity of clinical findings in the diagnosis of acute appendicitis were 83 and 66 %, respectively. Sensitivity and specificity of MASS in the diagnosis of acute appendicitis were 74 and 39 %, respectively, and those of MASS with additional parameter were appendicitis increased to 83 and 66 %, respectively. MASS is a simple, cheap and objective scoring system and does not require expertise. When tenesmus is added to standard MASS, rates of accuracy, sensitivity and specificity become better than those in MASS in the diagnosis of acute appendicitis.

  12. Application of GIS in exploring spatial dimensions of Efficiency in Competitiveness of Regions

    NASA Astrophysics Data System (ADS)

    Rahmat, Shahid; Sen, Joy

    2017-04-01

    Infrastructure is an important component in building competitiveness of a region. Present global scenario of economic slowdown that is led by slump in demand of goods and services and decreasing capacity of government institutions in investing public infrastructure. Strategy of augmenting competitiveness of a region can be built around improving efficient distribution of public infrastructure in the region. This efficiency in the distribution of infrastructure will reduce the burden of government institution and improve the relative output of the region in relative lesser investment. A rigorous literature study followed by an expert opinion survey (RIDIT scores) reveals that Railway, Road, ICTs and Electricity infrastructure is very crucial for better competitiveness of a region. Discussion with Experts in ICTs, Railways and Electricity sectors were conducted to find the issues, hurdles and possible solution for the development of these sectors. In an underdeveloped country like India, there is a large constrain of financial resources, for investment in infrastructure sector. Judicious planning for allocation of resources for infrastructure provisions becomes very important for efficient and sustainable development. Data Envelopment Analysis (DEA) is the mathematical programming optimization tool that measure technical efficiency of the multiple-input and/or multiple-output case by constructing a relative technical efficiency score. This paper tries to utilize DEA to identify the efficiency at which present level of selected components of Infrastructure (Railway, Road, ICTs and Electricity) is utilized in order to build competitiveness of the region. This paper tries to identify a spatial pattern of efficiency of Infrastructure with the help of spatial auto-correlation and Hot-spot analysis in Arc GIS. This analysis leads to policy implications for efficient allocation of financial resources for the provision of infrastructure in the region and building a

  13. Implementing and Evaluating a National Certification Technical Skills Examination: The Colorectal Objective Structured Assessment of Technical Skill.

    PubMed

    de Montbrun, Sandra; Roberts, Patricia L; Satterthwaite, Lisa; MacRae, Helen

    2016-07-01

    To implement the Colorectal Objective Structured Assessment of Technical skill (COSATS) into American Board of Colon and Rectal Surgery (ABCRS) certification and build evidence of validity for the interpretation of the scores of this high stakes assessment tool. Currently, technical skill assessment is not a formal component of board certification. With the technical demands of surgical specialties, documenting competence in technical skill at the time of certification with a valid tool is ideal. In September 2014, the COSATS was a mandatory component of ABCRS certification. Seventy candidates took the examination, with their performance evaluated by expert colorectal surgeons using a task-specific checklist, global rating scale, and overall performance scale. Passing scores were set and compared using 2 standard setting methodologies, using a compensatory and conjunctive model. Inter-rater reliability and the reliability of the pass/fail decision were calculated using Cronbach alpha and Subkoviak methodology, respectively. Overall COSATS scores and pass/fail status were compared with results on the ABCRS oral examination. The pass rate ranged from 85.7% to 90%. Inter-rater reliability (0.85) and reliability of the pass/fail decision (0.87 and 0.84) were high. A low positive correlation (r= 0.25) was seen between the COSATS and oral examination. All individuals who failed the COSATS passed the ABCRS oral examination. COSATS is the first technical skill examination used in national surgical board certification. This study suggests that the current certification process may be failing to identify individuals who have demonstrated technical deficiencies on this standardized assessment tool.

  14. [Evaluating the efficiency of basic public health service project in Beijing rural areas based on data envelopment analysis].

    PubMed

    Zhang, Gui-lin; Pan, Xi-long

    2013-04-18

    To measure the efficiency changes of basic public health service in Beijing rural areas and to provide some suggestions for the basic public health service project throughout China. In the study, stratified random samples from 32 township health centers (THCs) were measured by data envelopment analysis (DEA) model with the panel data from 2007 to 2009. (1) The average total efficiency score of samples was 0.972. The TE non-efficient THCs were with excess in all input indicators and insufficient outputs in technology management, health promotion and chronic disease management. (2) The total factor productivity (TFP) from 2007 to 2008 increased 8.8%, which was attributed to technology change. The TFP decreased by 6.6% from 2008 to 2009, but the technical efficiency increased by 3.3%. There is room for improvemrnt in the basic public health service project in Beijing rural areas. Scale efficiency should be improved and the common development of technical efficiency and technology progress promoted in order to increase the project outputs.

  15. Technical efficiency of rural primary health care system for diabetes treatment in Iran: a stochastic frontier analysis.

    PubMed

    Qorbani, Mostafa; Farzadfar, Farshad; Majdzadeh, Reza; Mohammad, Kazem; Motevalian, Abbas

    2017-01-01

    Our aim was to explore the technical efficiency (TE) of the Iranian rural primary healthcare (PHC) system for diabetes treatment coverage rate using the stochastic frontier analysis (SFA) as well as to examine the strength and significance of the effect of human resources density on diabetes treatment. In the SFA model diabetes treatment coverage rate, as a output, is a function of health system inputs (Behvarz worker density, physician density, and rural health center density) and non-health system inputs (urbanization rate, median age of population, and wealth index) as a set of covariates. Data about the rate of self-reported diabetes treatment coverage was obtained from the Non-Communicable Disease Surveillance Survey, data about health system inputs were collected from the health census database and data about non-health system inputs were collected from the census data and household survey. In 2008, rate of diabetes treatment coverage was 67% (95% CI: 63%-71%) nationally, and at the provincial level it varied from 44% to 81%. The TE score at the national level was 87.84%, with considerable variation across provinces (from 59.65% to 98.28%).Among health system and non-health system inputs, only the Behvarz density (per 1000 population)was significantly associated with diabetes treatment coverage (β (95%CI): 0.50 (0.29-0.70), p  < 0.001). Our findings show that although the rural PHC system can considered efficient in diabetes treatment at the national level, a wide variation exists in TE at the provincial level. Because the only variable that is predictor of TE is the Behvarz density, the PHC system may extend the diabetes treatment coverage by using this group of health care workers.

  16. Environmental effects of dredging. Documentation of the dyecon module for ADDAMS: Determining the hydraulic retention and efficiency of confined disposal facilities. Technical note

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hayes, D.F.; Schroeder, P.R.; Engler, R.M.

    This technical note describes procedures for determining mean hydraulic retention time and efficiency of a confined disposal facility (CDF) from a dye tracer slug test. These parameters are required to properly design a CDF for solids retention and for effluent quality considerations. Detailed information on conduct and analysis of dye tracer studies can be found in Engineer Manual 1110-2-5027, Confined Dredged Material Disposal. This technical note documents the DYECON computer program which facilitates the analysis of dye tracer concentration data and computes the hydraulic efficiency of a CDF as part of the Automated Dredging and Disposal Alternatives Management System (ADDAMS).

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

    PubMed

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

    2018-02-01

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

  18. Simulation-Based Laparoscopic Surgery Crisis Resource Management Training-Predicting Technical and Nontechnical Skills.

    PubMed

    Goldenberg, Mitchell G; Fok, Kai H; Ordon, Michael; Pace, Kenneth T; Lee, Jason Y

    2017-12-19

    To develop a unique simulation-based assessment using a laparoscopic inferior vena cava (IVC) injury scenario that allows for the safe assessment of urology resident's technical and nontechnical skills, and investigate the effect of personality traits performance in a surgical crisis. Urology residents from our institution were recruited to participate in a simulation-based training laparoscopic nephrectomy exercise. Residents completed demographic and multidimensional personality questionnaires and were instructed to play the role of staff urologist. A vasovagal response to pneumoperitoneum and an IVC injury event were scripted into the scenario. Technical and nontechnical skills were assessed by expert laparoscopic surgeons using validated tools (task checklist, GOALS, and NOTSS). Ten junior and five senior urology residents participated. Five residents were unable to complete the exercise safely. Senior residents outperformed juniors on technical (checklist score 15.1 vs 9.9, p < 0.01, GOALS score 18.0 vs 13.3, p < 0.01) and nontechnical performance (NOTSS score 13.8 vs 10.1, p = 0.03). Technical performance scores correlated with NOTSS scores (p < 0.01) and pass/fail rating correlated with technical performance (p < 0.01 for both checklist and GOALS), NOTSS score (p = 0.02), and blood loss (p < 0.01). Only the conscientiousness dimension of the big five inventory correlated with technical score (p = 0.03) and pass/fail rating (p = 0.04). Resident level of training and laparoscopic experience correlated with technical performance during a simulation-based laparoscopic IVC injury crisis management scenario, as well as multiple domains of nontechnical performance. Personality traits of our surgical residents are similar and did not predict technical skill. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Frontier-based techniques in measuring hospital efficiency in Iran: a systematic review and meta-regression analysis

    PubMed Central

    2013-01-01

    Background In recent years, there has been growing interest in measuring the efficiency of hospitals in Iran and several studies have been conducted on the topic. The main objective of this paper was to review studies in the field of hospital efficiency and examine the estimated technical efficiency (TE) of Iranian hospitals. Methods Persian and English databases were searched for studies related to measuring hospital efficiency in Iran. Ordinary least squares (OLS) regression models were applied for statistical analysis. The PRISMA guidelines were followed in the search process. Results A total of 43 efficiency scores from 29 studies were retrieved and used to approach the research question. Data envelopment analysis was the principal frontier efficiency method in the estimation of efficiency scores. The pooled estimate of mean TE was 0.846 (±0.134). There was a considerable variation in the efficiency scores between the different studies performed in Iran. There were no differences in efficiency scores between data envelopment analysis (DEA) and stochastic frontier analysis (SFA) techniques. The reviewed studies are generally similar and suffer from similar methodological deficiencies, such as no adjustment for case mix and quality of care differences. The results of OLS regression revealed that studies that included more variables and more heterogeneous hospitals generally reported higher TE. Larger sample size was associated with reporting lower TE. Conclusions The features of frontier-based techniques had a profound impact on the efficiency scores among Iranian hospital studies. These studies suffer from major methodological deficiencies and were of sub-optimal quality, limiting their validity and reliability. It is suggested that improving data collection and processing in Iranian hospital databases may have a substantial impact on promoting the quality of research in this field. PMID:23945011

  20. Building Energy Asset Score for State and Local Governments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for state and local governments.

  1. A novel approach to assessing technical competence of colorectal surgery residents: the development and evaluation of the Colorectal Objective Structured Assessment of Technical Skill (COSATS).

    PubMed

    de Montbrun, Sandra L; Roberts, Patricia L; Lowry, Ann C; Ault, Glenn T; Burnstein, Marcus J; Cataldo, Peter A; Dozois, Eric J; Dunn, Gary D; Fleshman, James; Isenberg, Gerald A; Mahmoud, Najjia N; Reznick, Richard K; Satterthwaite, Lisa; Schoetz, David; Trudel, Judith L; Weiss, Eric G; Wexner, Steven D; MacRae, Helen

    2013-12-01

    To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.

  2. A Technical Description of the Procedures Used in Calculating School-Level Scaled Scores for the "Survey of Basic Skills: Grade 6."

    ERIC Educational Resources Information Center

    Mislevy, Robert J.; Bock, R. Darrell

    New legislation in 1972 shifted the emphasis of the California Assessment Program (CAP) from traditional every pupil achievement testing to a more efficient multiple-matrix testing design, under which a broad spectrum of skills could be surveyed without undue expenditure of educational resources. Scale score reporting was introduced to the grade 6…

  3. Genetic analysis of efficiency traits in Austrian dairy cattle and their relationships with body condition score and lameness.

    PubMed

    Köck, A; Ledinek, M; Gruber, L; Steininger, F; Fuerst-Waltl, B; Egger-Danner, C

    2018-01-01

    This study is part of a larger project whose overall objective was to evaluate the possibilities for genetic improvement of efficiency in Austrian dairy cattle. In 2014, a 1-yr data collection was carried out. Data from 6,519 cows kept on 161 farms were recorded. In addition to routinely recorded data (e.g., milk yield, fertility, disease data), data of novel traits [e.g., body weight (BW), body condition score (BCS), lameness score, body measurements] and individual feeding information and feed quality were recorded on each test-day. The specific objective of this study was to estimate genetic parameters for efficiency (related) traits and to investigate their relationships with BCS and lameness in Austrian Fleckvieh, Brown Swiss, and Holstein cows. The following efficiency (related) traits were considered: energy-corrected milk (ECM), BW, dry matter intake (DMI), energy intake (INEL), ratio of milk output to metabolic BW (ECM/BW 0.75 ), ratio of milk output to DMI (ECM/DMI), and ratio of milk energy output to total energy intake (LE/INEL, LE = energy in milk). For Fleckvieh, the heritability estimates of the efficiency (related) traits ranged from 0.11 for LE/INEL to 0.44 for BW. Heritabilities for BCS and lameness were 0.19 and 0.07, respectively. Repeatabilities were high and ranged from 0.30 for LE/INEL to 0.83 for BW. Heritability estimates were generally lower for Brown Swiss and Holstein, but repeatabilities were in the same range as for Fleckvieh. In all 3 breeds, more-efficient cows were found to have a higher milk yield, lower BW, slightly higher DMI, and lower BCS. Higher efficiency was associated with slightly fewer lameness problems, most likely due to the lower BW (especially in Fleckvieh) and higher DMI of the more-efficient cows. Body weight and BCS were positively correlated. Therefore, when selecting for a lower BW, BCS is required as additional information because, otherwise, no distinction between large animals with low BCS and smaller animals

  4. A study on operation efficiency evaluation based on firm's financial index and benchmark selection: take China Unicom as an example

    NASA Astrophysics Data System (ADS)

    Wu, Zu-guang; Tian, Zhan-jun; Liu, Hui; Huang, Rui; Zhu, Guo-hua

    2009-07-01

    Being the only listed telecom operators of A share market, China Unicom has always been attracted many institutional investors under the concept of 3G recent years,which itself is a great technical progress expectation.Do the institutional investors or the concept of technical progress have signficant effect on the improving of firm's operating efficiency?Though reviewing the documentary about operating efficiency we find that schoolars study this problem useing the regress analyzing based on traditional production function and data envelopment analysis(DEA) and financial index anayzing and marginal function and capital labor ratio coefficient etc. All the methods mainly based on macrodata. This paper we use the micro-data of company to evaluate the operating efficiency.Using factor analyzing based on financial index and comparing the factor score of three years from 2005 to 2007, we find that China Unicom's operating efficiency is under the averge level of benchmark corporates and has't improved under the concept of 3G from 2005 to 2007.In other words,institutional investor or the conception of technical progress expectation have faint effect on the changes of China Unicom's operating efficiency. Selecting benchmark corporates as post to evaluate the operating efficiency is a characteristic of this method ,which is basicallly sipmly and direct.This method is suit for the operation efficiency evaluation of agriculture listed companies because agriculture listed also face technical progress and marketing concept such as tax-free etc.

  5. The Effect of Crop Insurance on Technical Efficiency of Wheat Farmers in Kermanshah Province: A Corrected Ordinary Least Square Approach

    NASA Astrophysics Data System (ADS)

    Agahi, Hossein; Zarafshani, Kiumars; Behjat, Amir-Mohsen

    The purpose of this study was to describe the effect of crop insurance on agricultural production among dry wheat farmers in Kermanshah province. The population of this study consisted of dry wheat farmers. Data used in this study was collected using stratified multi-stage cluster sampling method and face to face interview with 251 farmers in three different climate regions: tropical, temperate and cold during 2003-2004 crop years. The procedures used for determining farmers' technical efficiency was Corrected Ordinary Least Square (COLS). Findings revealed that crop insurance has positive effect on temperate and tropical regions. However, the production difference between insured and uninsured farmers in cold region was non-significant. It is therefore concluded that technical efficiency of agricultural production in Kermanshah province is a function of crop insurance as well as other variables such as crop management practices, personal characteristics and fair distribution of agricultural inputs.

  6. Validity evidence for the Simulated Colonoscopy Objective Performance Evaluation scoring system.

    PubMed

    Trinca, Kristen D; Cox, Tiffany C; Pearl, Jonathan P; Ritter, E Matthew

    2014-02-01

    Low-cost, objective systems to assess and train endoscopy skills are needed. The aim of this study was to evaluate the ability of Simulated Colonoscopy Objective Performance Evaluation to assess the skills required to perform endoscopy. Thirty-eight subjects were included in this study, all of whom performed 4 tasks. The scoring system measured performance by calculating precision and efficiency. Data analysis assessed the relationship between colonoscopy experience and performance on each task and the overall score. Endoscopic trainees' Simulated Colonoscopy Objective Performance Evaluation scores correlated significantly with total colonoscopy experience (r = .61, P = .003) and experience in the past 12 months (r = .63, P = .002). Significant differences were seen among practicing endoscopists, nonendoscopic surgeons, and trainees (P < .0001). When the 4 tasks were analyzed, each showed significant correlation with colonoscopy experience (scope manipulation, r = .44, P = .044; tool targeting, r = .45, P = .04; loop management, r = .47, P = .032; mucosal inspection, r = .65, P = .001) and significant differences in performance between the endoscopist groups, except for mucosal inspection (scope manipulation, P < .0001; tool targeting, P = .002; loop management, P = .0008; mucosal inspection, P = .27). Simulated Colonoscopy Objective Performance Evaluation objectively assesses the technical skills required to perform endoscopy and shows promise as a platform for proficiency-based skills training. Published by Elsevier Inc.

  7. Continued Validation of the O-SCORE (Ottawa Surgical Competency Operating Room Evaluation): Use in the Simulated Environment.

    PubMed

    MacEwan, Matthew J; Dudek, Nancy L; Wood, Timothy J; Gofton, Wade T

    2016-01-01

    CONSTRUCT: The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) is a 9-item surgical evaluation tool designed to assess technical competence in surgical trainees using behavioral anchors. The initial development of the O-SCORE produced evidence for valid results. Further work is required to determine if the use of a single surgeon or an unblinded rater introduces bias. In addition, the relationship of the O-SCORE to other currently used technical assessment tools should be explored to provide validity evidence related to the relationship to other measures. We have designed this project to provide continued validity evidence for the O-SCORE related to these two issues. Nineteen residents and 2 staff Orthopedic Surgeons from the University of Ottawa volunteered to participate in a 2-part OSCE style station. Participants completed a written questionnaire followed by a videotaped 10-minute simulated open reduction and internal fixation of a midshaft radius fracture. Videos were rated individually by 2 blinded staff orthopedic surgeons using an Objective Structured Assessment of Technical Skills (OSATS) global rating scale, an OSATS checklist, and the O-SCORE in random order. O-SCORE results appeared sensitive to surgical training level even when raters were blinded. In addition, strong agreement between two independent observers using the O-SCORE suggests that the measure captures a performance easily recognized by surgical observers. Ratings on the O-SCORE also were strongly associated with global ratings on the currently most validated technical evaluation tool (OSATS). Collectively, these results suggest that the O-SCORE generates accurate, reproducible, and meaningful results when used in a randomized and blinded fashion, providing continued validity evidence for using this tool to evaluate surgical trainee competence. The O-SCORE was able to differentiate surgical trainee level using blinded raters providing further evidence of validity for the O-SCORE

  8. The Productivity and Technical Efficiency of Textile Industry Clusters in India

    NASA Astrophysics Data System (ADS)

    Bhaskaran, E.

    2013-09-01

    The Indian textile industry is one the largest and oldest sectors in the country and among the most important in the economy in terms of output, investment and employment (E). The sector employs nearly 35 million people and after agriculture, is the second-highest employer in the country. Its importance is underlined by the fact that it accounts for around 4 % of Gross Domestic Product, 14 % of industrial production, 9 % of excise collections, 18 % of E in the industrial sector, and 16 % of the country's total exports (Ex) earnings. For inclusive growth and sustainable development most of the Textile Manufacturers has adopted the Cluster Development Approach. The objective is to study the physical and financial performance, correlation, regression and Data Envelopment Analysis by measuring technical efficiency (Ø), peer weights (λi), input slacks (S-), output slacks (S+) and return to scale of four textile clusters (TCs) namely IchalKaranji Textile Cluster, Maharashtra; Ludhiana Textile Cluster, Punjab; Tirupur Textile Cluster, Tamilnadu and Panipat Textile Cluster, Haryana in India. The methodology adopted is using Data Envelopment Analysis of Output Oriented Banker Charnes Cooper Model by taking number of units (U) and number of E as inputs and sales (S) and Ex in crores as an outputs. The non-zero λi's represents the weights for efficient clusters. The S > 0 obtained for one TC reveals the excess U (S-) and E (S-) and shortage in sales (S+) and Ex (S+). To conclude, for inclusive growth and sustainable development, the inefficient TC should increase their S/turnover and Ex, as decrease in number of enterprises and E is practically not possible. Moreover for sustainable development, the TC should strengthen infrastructure interrelationships, technology interrelationships, procurement interrelationships, production interrelationships and marketing interrelationships to decrease cost, increase productivity and efficiency to compete in the world market.

  9. How Criterion Scores Predict the Overall Impact Score and Funding Outcomes for National Institutes of Health Peer-Reviewed Applications.

    PubMed

    Eblen, Matthew K; Wagner, Robin M; RoyChowdhury, Deepshikha; Patel, Katherine C; Pearson, Katrina

    2016-01-01

    Understanding the factors associated with successful funding outcomes of research project grant (R01) applications is critical for the biomedical research community. R01 applications are evaluated through the National Institutes of Health (NIH) peer review system, where peer reviewers are asked to evaluate and assign scores to five research criteria when assessing an application's scientific and technical merit. This study examined the relationship of the five research criterion scores to the Overall Impact score and the likelihood of being funded for over 123,700 competing R01 applications for fiscal years 2010 through 2013. The relationships of other application and applicant characteristics, including demographics, to scoring and funding outcomes were studied as well. The analyses showed that the Approach and, to a lesser extent, the Significance criterion scores were the main predictors of an R01 application's Overall Impact score and its likelihood of being funded. Applicants might consider these findings when submitting future R01 applications to NIH.

  10. How Criterion Scores Predict the Overall Impact Score and Funding Outcomes for National Institutes of Health Peer-Reviewed Applications

    PubMed Central

    Eblen, Matthew K.; Wagner, Robin M.; RoyChowdhury, Deepshikha; Patel, Katherine C.; Pearson, Katrina

    2016-01-01

    Understanding the factors associated with successful funding outcomes of research project grant (R01) applications is critical for the biomedical research community. R01 applications are evaluated through the National Institutes of Health (NIH) peer review system, where peer reviewers are asked to evaluate and assign scores to five research criteria when assessing an application’s scientific and technical merit. This study examined the relationship of the five research criterion scores to the Overall Impact score and the likelihood of being funded for over 123,700 competing R01 applications for fiscal years 2010 through 2013. The relationships of other application and applicant characteristics, including demographics, to scoring and funding outcomes were studied as well. The analyses showed that the Approach and, to a lesser extent, the Significance criterion scores were the main predictors of an R01 application’s Overall Impact score and its likelihood of being funded. Applicants might consider these findings when submitting future R01 applications to NIH. PMID:27249058

  11. The impact of New Public Management on efficiency: an analysis of Madrid's hospitals.

    PubMed

    Alonso, José M; Clifton, Judith; Díaz-Fuentes, Daniel

    2015-03-01

    Madrid has recently become the site of one of the most controversial cases of public healthcare reform in the European Union. Despite the fact that the introduction of New Public Management (NPM) into Madrid hospitals has been vigorous, little scholarship has been done to test whether NPM actually led to technical efficiency. This paper is one of the first attempts to do so. We deploy a bootstrapped data envelopment analysis to compare efficiency scores in traditionally managed hospitals and those operating with new management formulas. We do not find evidence that NPM hospitals are more efficient than traditionally managed ones. Moreover, our results suggest that what actually matters may be the management itself, rather than the management model. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Efficiency improved turboprop. Technical memo

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gearhart, W.S.

    1982-06-10

    Renewed attention has been focused on the efficiency of aircraft propulsion as the cost of fuel has risen. Studies conducted by NASA (1) to obtain fuel efficient aircraft have considered relatively highly-loaded turbo-prop systems. The disc loadings of these propellers are as much as four times higher than those on present turboprop aircraft. The higher disc loadings result in greater slipstream swirl and higher energy losses. Of primary importance is the radial distribution of the energy losses across the slipstream due to the tangential and axial velocities. This study presents the results of analysis defining the various sources of energymore » loss resulting from a swirling slipstream downstream of a propeller. Experimental data are presented demonstrating the presence of such losses and a propeller configuration discussed which offers improved propulsive performance when relatively highly-loaded propellers are employed.« less

  13. Sensitivity of the International Skating Union's Mathematical Criteria to Flag Potential Scoring Anomalies

    ERIC Educational Resources Information Center

    Looney, Marilyn A.; Howell, Steven M.

    2015-01-01

    This article describes the "mathematical criteria" employed by the International Skating Union (ISU) to identify potential judging anomalies within competitive figure skating. The mathematical criteria have greater sensitivity to identify scoring anomalies for technical element scores than for the program component scores. This article…

  14. Intraoperative adverse events can be compensated by technical performance in neonates and infants after cardiac surgery: a prospective study.

    PubMed

    Nathan, Meena; Karamichalis, John M; Liu, Hua; del Nido, Pedro; Pigula, Frank; Thiagarajan, Ravi; Bacha, Emile A

    2011-11-01

    Our objective was to define the relationship between surgical technical performance score, intraoperative adverse events, and major postoperative adverse events in complex pediatric cardiac repairs. Infants younger than 6 months were prospectively followed up until discharge from the hospital. Technical performance scores were graded as optimal, adequate, or inadequate based on discharge echocardiograms and need for reintervention after initial surgery. Case complexity was determined by Risk Adjustment in Congenital Heart Surgery (RACHS-1) category, and preoperative illness severity was assessed by Pediatric Risk of Mortality (PRISM) III score. Intraoperative adverse events were prospectively monitored. Outcomes were analyzed using nonparametric methods and a logistic regression model. A total of 166 patients (RACHS 4-6 [49%]), neonates [50%]) were observed. Sixty-one (37%) had at least 1 intraoperative adverse event, and 47 (28.3%) had at least 1 major postoperative adverse event. There was no correlation between intraoperative adverse events and RACHS, preoperative PRISM III, technical performance score, or postoperative adverse events on multivariate analysis. For the entire cohort, better technical performance score resulted in lower postoperative adverse events, lower postoperative PRISM, and lower length of stay and ventilation time (P < .001). Patients requiring intraoperative revisions fared as well as patients without, provided the technical score was at least adequate. In neonatal and infant open heart repairs, technical performance score is one of the main predictors of postoperative morbidity. Outcomes are not affected by intraoperative adverse events, including surgical revisions, provided technical performance score is at least adequate. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  15. New Mexico Standards Based Assessment (NMSBA) Technical Report: 2006 Spring Administration

    ERIC Educational Resources Information Center

    Griph, Gerald W.

    2006-01-01

    The purpose of the NMSBA technical report is to provide users and other interested parties with a general overview of and technical characteristics of the 2006 NMSBA. The 2006 technical report contains the following information: (1) Test development; (2) Scoring procedures; (3) Calibration, scaling, and equating procedures; (4) Standard setting;…

  16. Technical indicators of economic performance in dairy sheep farming.

    PubMed

    Theodoridis, A; Ragkos, A; Roustemis, D; Arsenos, G; Abas, Z; Sinapis, E

    2014-01-01

    In this study, the level of technical efficiency of 58 sheep farms rearing the Chios breed in Greece was measured through the application of the stochastic frontier analysis method. A Translog stochastic frontier production function was estimated using farm accounting data of Chios sheep farms and the impact of various socio-demographic and biophysical factors on the estimated efficiency of the farms was evaluated. The farms were classified into efficiency groups on the basis of the estimated level of efficiency and a technical and economic descriptive analysis was applied in order to illustrate an indicative picture of their structure and productivity. The results of the stochastic frontier model indicate that there are substantial production inefficiencies among the Chios sheep farms and that these farms could increase their production through the improvement of technical efficiency, whereas the results of the inefficiency effects model reveal that the farm-specific explanatory factors can partly explain the observed efficiency differentials. The measurement of technical inefficiency and the detection of its determinants can be used to form the basis of policy recommendations that could contribute to the development of the sector.

  17. Extension of the lod score: the mod score.

    PubMed

    Clerget-Darpoux, F

    2001-01-01

    In 1955 Morton proposed the lod score method both for testing linkage between loci and for estimating the recombination fraction between them. If a disease is controlled by a gene at one of these loci, the lod score computation requires the prior specification of an underlying model that assigns the probabilities of genotypes from the observed phenotypes. To address the case of linkage studies for diseases with unknown mode of inheritance, we suggested (Clerget-Darpoux et al., 1986) extending the lod score function to a so-called mod score function. In this function, the variables are both the recombination fraction and the disease model parameters. Maximizing the mod score function over all these parameters amounts to maximizing the probability of marker data conditional on the disease status. Under the absence of linkage, the mod score conforms to a chi-square distribution, with extra degrees of freedom in comparison to the lod score function (MacLean et al., 1993). The mod score is asymptotically maximum for the true disease model (Clerget-Darpoux and Bonaïti-Pellié, 1992; Hodge and Elston, 1994). Consequently, the power to detect linkage through mod score will be highest when the space of models where the maximization is performed includes the true model. On the other hand, one must avoid overparametrization of the model space. For example, when the approach is applied to affected sibpairs, only two constrained disease model parameters should be used (Knapp et al., 1994) for the mod score maximization. It is also important to emphasize the existence of a strong correlation between the disease gene location and the disease model. Consequently, there is poor resolution of the location of the susceptibility locus when the disease model at this locus is unknown. Of course, this is true regardless of the statistics used. The mod score may also be applied in a candidate gene strategy to model the potential effect of this gene in the disease. Since, however, it

  18. Some Conceptual Issues in Observed-Score Equating

    ERIC Educational Resources Information Center

    van der Linden, Wim J.

    2013-01-01

    In spite of all of the technical progress in observed-score equating, several of the more conceptual aspects of the process still are not well understood. As a result, the equating literature struggles with rather complex criteria of equating, lack of a test-theoretic foundation, confusing terminology, and ad hoc analyses. A return to Lord's…

  19. Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece.

    PubMed

    Oikonomou, Nikolaos; Tountas, Yannis; Mariolis, Argiris; Souliotis, Kyriakos; Athanasakis, Kostas; Kyriopoulos, John

    2016-12-01

    This is a study to measure the efficiency of the rural Health Centres (HCs) and their Regional Surgeries (RSs) of the 6th Health Prefecture (HP) of Greece, which covers Southern and Western Greece. Data Envelopment Analysis (DEA) was applied under Constant and Variable Returns to Scale, using a weight-restricted, output-oriented model, to calculate pure technical efficiency (PΤΕ), scale efficiency (SE) and total technical efficiency (TE). The selection of inputs, outputs and their relative weights in the model was based on two consecutive consensus panels of experts on Primary Health Care (PHC). Medical personnel, nursing personnel and technological equipment were chosen as inputs and were attributed appropriate weight restrictions. Acute, chronic and preventive consultations where chosen as outputs; each output was constructed by smaller subcategories of different relative importance. Data were collected through a questionnaire sent to all HCs of the covered area. From the 42 HCs which provided complete data, the study identified 9 as technical efficient, 5 as scale efficient and 2 as total efficient. The mean TE, PTE and SE scores of the HCs of the 6th Health Prefecture were 0.57, 0.67 and 0.87, respectively. The results demonstrate noteworthy variation in efficiency in the productive process of the HCs of Southern and Western Greece. The dominant form of inefficiency was technical inefficiency. The HCs of the 6th HP can theoretically produce 33 % more output on average, using their current production factors. These results indicated potential for considerable efficiency improvement in most rural health care units. Emphasis on prevention and chronic disease management, as well as wider structural and organisational reforms, are discussed from the viewpoint of how to increase efficiency.

  20. Technical Writing Redesign and Assessment: A Pilot Study

    ERIC Educational Resources Information Center

    Winter, Gaye Bush

    2010-01-01

    The purpose of this study was to compare scores on writing assignments from traditional, fully online courses in technical writing to pilot, hybrid courses at a southern university. A total of 232 students' assignments were compared in this study. All writing assignments were scored by six trained instructors of English using the same five point…

  1. Technical efficiency of teaching hospitals in Iran: the use of Stochastic Frontier Analysis, 1999–2011

    PubMed Central

    Goudarzi, Reza; Pourreza, Abolghasem; Shokoohi, Mostafa; Askari, Roohollah; Mahdavi, Mahdi; Moghri, Javad

    2014-01-01

    Background: Hospitals are highly resource-dependent settings, which spend a large proportion of healthcare financial resources. The analysis of hospital efficiency can provide insight into how scarce resources are used to create health values. This study examines the Technical Efficiency (TE) of 12 teaching hospitals affiliated with Tehran University of Medical Sciences (TUMS) between 1999 and 2011. Methods: The Stochastic Frontier Analysis (SFA) method was applied to estimate the efficiency of TUMS hospitals. A best function, referred to as output and input parameters, was calculated for the hospitals. Number of medical doctors, nurses, and other personnel, active beds, and outpatient admissions were considered as the input variables and number of inpatient admissions as an output variable. Results: The mean level of TE was 59% (ranging from 22 to 81%). During the study period the efficiency increased from 61 to 71%. Outpatient admission, other personnel and medical doctors significantly and positively affected the production (P< 0.05). Concerning the Constant Return to Scale (CRS), an optimal production scale was found, implying that the productions of the hospitals were approximately constant. Conclusion: Findings of this study show a remarkable waste of resources in the TUMS hospital during the decade considered. This warrants policy-makers and top management in TUMS to consider steps to improve the financial management of the university hospitals. PMID:25114947

  2. NFL Films music scoring stage and control room space

    NASA Astrophysics Data System (ADS)

    Berger, Russ; Schrag, Richard C.; Ridings, Jason J.

    2003-04-01

    NFL Films' new 200,000 sq. ft. corporate headquarters is home to an orchestral scoring stage used to record custom music scores to support and enhance their video productions. Part of the 90,000 sq. ft. of sound critical technical space, the music scoring stage and its associated control room are at the heart of the audio facilities. Driving the design were the owner's mandate for natural light, wood textures, and an acoustical environment that would support small rhythm sections, soloists, and a full orchestra. Being an industry leader in cutting-edge video and audio formats, the NFLF required that the technical spaces allow the latest in technology to be continually integrated into the infrastructure. Never was it more important for a project to hold true to the adage of ``designing from the inside out.'' Each audio and video space within the facility had to stand on its own with regard to user functionality, acoustical accuracy, sound isolation, noise control, and monitor presentation. A detailed look at the architectural and acoustical design challenges encountered and the solutions developed for the performance studio and the associated control room space will be discussed.

  3. [A study of the occupational stress norm and it' s application for the technical group and scientific research group].

    PubMed

    Yang, Xin-wei; Liu, Ze-jun; Zhao, Pei-qing; Bai, Shao-ying; Pang, Xing-huo; Wang, Zhi-ming; Jin, Tai-yi; Lan, Ya-jia

    2006-11-01

    A study of the occupational stress norm and it' s application for the technical group and scientific research group. In this study, cross-sectional study method is used, and a synthetic way of sorting and randomized sampling is adopted to deal with research targets(235 scientific research group, 857 technical group). Descriptive statistics for OSI-R scale scores for the technical group and scientific research group were modulated. Scale raw score to T-score conversion tables derived from the OSI-R normative sample for technical group and scientific research group were established. OSI-R profile from for technical group and scientific research group were established. For the ORQ and PSQ scales, scores at or above 70T indicate a strong levels of maladaptive stress and strain. Score in the range of 60T to 69T suggest middle levels of maladaptive stress and strain. Score in the range of 40T to 59T indicate normal levels of stress and strain. Score below 40T indicate a relative absence of occupational stress and strain. For the PRQ scales, score below 30T indicate a significant lack of coping resources. Score in the range of 30T to 39T suggest middle deficits in coping resources. Score in the range of 40T to 59T indicate average coping resources. Scores at or above 60T indicate a strong levels of coping resources. Different intervention measure should be take to reduce the occupational stress so as to improve the work ability.

  4. The roots of gender inequity in technical areas

    NASA Astrophysics Data System (ADS)

    Campbell, James Reed

    This article describes a study of the academic self-concepts, attributions and achievements of male and female Asian American and Caucasian students who won Westinghouse Awards in 1984 and 1985. The results of the study showed that fewer Caucasian female recipients anticipated college majors in the technical areas. Furthermore, this group of females scored lower on both parts of the SAT, scored lower on all of the self-concept scales, and also scored lower on both attribution scales. In contrast, the Asian females optimized courses for the gifted and specialized research courses to distance themselves from the American females in almost all areas. The author linked these ethnic, gender differences to underlying psychological and sociological forces that are responsible for the self-concept and attribution differences. It is these forces that must be altered for Caucasian females to rectify the gender inequalities that exist in the technical areas.

  5. Develop a Comprehensive Technical Training and Data Collection Program for Structural Welders and Fitters: Technical Proposal

    DTIC Science & Technology

    2006-05-30

    implementation Final Report 4 TECHNICAL PLAN AND RESULTS Task 1: Initiate the Project Management System Two senior NGSS production management...1 Technical Plan and Results...Third the system is hosted on a handheld unit which provides the foremen with an efficient daily planning tool. The Pilot System which entails

  6. An efficient sampling strategy for selection of biobank samples using risk scores.

    PubMed

    Björk, Jonas; Malmqvist, Ebba; Rylander, Lars; Rignell-Hydbom, Anna

    2017-07-01

    The aim of this study was to suggest a new sample-selection strategy based on risk scores in case-control studies with biobank data. An ongoing Swedish case-control study on fetal exposure to endocrine disruptors and overweight in early childhood was used as the empirical example. Cases were defined as children with a body mass index (BMI) ⩾18 kg/m 2 ( n=545) at four years of age, and controls as children with a BMI of ⩽17 kg/m 2 ( n=4472 available). The risk of being overweight was modelled using logistic regression based on available covariates from the health examination and prior to selecting samples from the biobank. A risk score was estimated for each child and categorised as low (0-5%), medium (6-13%) or high (⩾14%) risk of being overweight. The final risk-score model, with smoking during pregnancy ( p=0.001), birth weight ( p<0.001), BMI of both parents ( p<0.001 for both), type of residence ( p=0.04) and economic situation ( p=0.12), yielded an area under the receiver operating characteristic curve of 67% ( n=3945 with complete data). The case group ( n=416) had the following risk-score profile: low (12%), medium (46%) and high risk (43%). Twice as many controls were selected from each risk group, with further matching on sex. Computer simulations showed that the proposed selection strategy with stratification on risk scores yielded consistent improvements in statistical precision. Using risk scores based on available survey or register data as a basis for sample selection may improve possibilities to study heterogeneity of exposure effects in biobank-based studies.

  7. Comparing Two CBM Maze Selection Tools: Considering Scoring and Interpretive Metrics for Universal Screening

    ERIC Educational Resources Information Center

    Ford, Jeremy W.; Missall, Kristen N.; Hosp, John L.; Kuhle, Jennifer L.

    2016-01-01

    Advances in maze selection curriculum-based measurement have led to several published tools with technical information for interpretation (e.g., norms, benchmarks, cut-scores, classification accuracy) that have increased their usefulness for universal screening. A range of scoring practices have emerged for evaluating student performance on maze…

  8. Non-technical skills of surgeons and anaesthetists in simulated operating theatre crises.

    PubMed

    Doumouras, A G; Hamidi, M; Lung, K; Tarola, C L; Tsao, M W; Scott, J W; Smink, D S; Yule, S

    2017-07-01

    Deficiencies in non-technical skills (NTS) have been increasingly implicated in avoidable operating theatre errors. Accordingly, this study sought to characterize the impact of surgeon and anaesthetist non-technical skills on time to crisis resolution in a simulated operating theatre. Non-technical skills were assessed during 26 simulated crises (haemorrhage and airway emergency) performed by surgical teams. Teams consisted of surgeons, anaesthetists and nurses. Behaviour was assessed by four trained raters using the Non-Technical Skills for Surgeons (NOTSS) and Anaesthetists' Non-Technical Skills (ANTS) rating scales before and during the crisis phase of each scenario. The primary endpoint was time to crisis resolution; secondary endpoints included NTS scores before and during the crisis. A cross-classified linear mixed-effects model was used for the final analysis. Thirteen different surgical teams were assessed. Higher NTS ratings resulted in significantly faster crisis resolution. For anaesthetists, every 1-point increase in ANTS score was associated with a decrease of 53·50 (95 per cent c.i. 31·13 to 75·87) s in time to crisis resolution (P < 0·001). Similarly, for surgeons, every 1-point increase in NOTSS score was associated with a decrease of 64·81 (26·01 to 103·60) s in time to crisis resolution in the haemorrhage scenario (P = 0·001); however, this did not apply to the difficult airway scenario. Non-technical skills scores were lower during the crisis phase of the scenarios than those measured before the crisis for both surgeons and anaesthetists. A higher level of NTS of surgeons and anaesthetists led to quicker crisis resolution in a simulated operating theatre environment. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  9. Impact of Digital Tooth Preparation Evaluation Technology on Preclinical Dental Students' Technical and Self-Evaluation Skills.

    PubMed

    Gratton, David G; Kwon, So Ran; Blanchette, Derek; Aquilino, Steven A

    2016-01-01

    The aim of this study was to evaluate the effect of digital tooth preparation imaging and evaluation technology on dental students' technical abilities, self-evaluation skills, and the assessment of their simulated clinical work. A total of 80 second-year students at one U.S. dental school were assigned to one of three groups: control (n=40), E4D Compare (n=20), and Sirona prepCheck (n=20). Students in the control group were taught by traditional teaching methodologies, and the technology-assisted groups received both traditional training and supplementary feedback from the corresponding digital system. Three outcomes were measured: faculty technical score, self-evaluation score, and E4D Compare scores at 0.30 mm tolerance. Correlations were determined between the groups' scores from visual assessment and self-evaluation and between the visual assessment and digital scores. The results showed that the visual assessment and self-evaluation scores did not differ among groups (p>0.05). Overall, correlations between visual and digital assessment scores were modest though statistically significant (5% level of significance). These results suggest that the use of digital tooth preparation evaluation technology did not impact the students' prosthodontic technical and self-evaluation skills. Visual scores given by faculty and digital assessment scores correlated moderately in only two instances.

  10. The examination assessment of technical competence in vascular surgery.

    PubMed

    Pandey, V A; Wolfe, J H N; Liapis, C D; Bergqvist, D

    2006-09-01

    The European Board of Surgery Qualification in Vascular Surgery is a pan-European examination for vascular surgeons who have attained a national certificate of completion of specialist training. A 2-year study was conducted before the introduction of a technical skills assessment in the examination. The study included 30 surgeons: 22 candidates and eight examiners. They were tested on dissection (on a synthetic saphenofemoral junction model), anastomosis (on to anterior tibial artery of a synthetic leg model) and dexterity (a knot-tying simulator with electromagnetic motion analysis). Validated rating scales were used by two independent examiners. Composite knot-tying scores were calculated for the computerized station. The stations were weighted 35, 45 and 20 percent, respectively. Examiners performed better than candidates in the dissection (P<0.001), anastomosis (P=0.002) and dexterity (P=0.005) stations. Participants performed consistently in the examination (dissection versus anastomosis: r=0.79, P<0.001; dexterity versus total operative score: r=-0.73, P<0.001). Interobserver reliability was high (alpha=0.91). No correlation was seen between a candidate's technical skill and oral examination performance or logbook-accredited scores. Current surgical examinations do not address technical competence. This model appears to be a valid assessment of technical skills in an examination setting. The standards are set at a level appropriate for a specialist vascular surgeon. Copyright (c) 2006 British Journal of Surgery Society Ltd.

  11. Fully laparoscopic left hepatectomy - a technical reference proposed for standard practice compared to the open approach: a retrospective propensity score model.

    PubMed

    Valente, Roberto; Sutcliffe, Robert; Levesque, Eric; Costa, Mara; De' Angelis, Nicola; Tayar, Claude; Cherqui, Daniel; Laurent, Alexis

    2018-04-01

    Laparoscopic left hemihepatectomy (LLH) may be an alternative to open (OLH). There are several original variations in the technical aspects of LLH, and no accepted standard. The aim of this study is to assess the safety and effectiveness of the technique developed at Henri Mondor Hospital since 1996. The technique of LLH was conceived for safety and training of two mature generations of lead surgeons. The technique includes full laparoscopy, ventral approach to the common trunk, extrahepatic pedicle dissection, CUSA ® parenchymal transection, division of the left hilar plate laterally to the Arantius ligament, and ventral transection of the left hepatic vein. The outcomes of LLH and OLH were compared. Perioperative analysis included intra- and postoperative, and histology variables. Propensity Score Matching was undertaken of background covariates including age, ASA, BMI, fibrosis, steatosis, tumour size, and specimen weight. 17 LLH and 51 OLH were performed from 1996 to 2014 with perioperative mortality rates of 0% and 6%, respectively. In the LLH group, two patients underwent conversion to open surgery. Propensity matching selected 10 LLH/OLH pairs. The LLH group had a higher proportion of procedures for benign disease. LLH was associated with longer operating time and less blood loss. Perioperative complications occurred in 30% (LLH) and 10% (OLH) (p = 1). Mortality and ITU stay were similar. This technique is recommended as a possible technical reference for standard LLH. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  12. A National Study of Efficiency for Dialysis Centers: An Examination of Market Competition and Facility Characteristics for Production of Multiple Dialysis Outputs

    PubMed Central

    Ozgen, Hacer; A. Ozcan, Yasar

    2002-01-01

    Objective To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model. Study Setting Freestanding dialysis facilities that operated in 1997 submitted cost report forms to the Health Care Financing Administration (HCFA), and offered all three outputs—outpatient dialysis, dialysis training, and home program dialysis. Data Sources The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple-output facilities. Information regarding population characteristics was obtained from the Area Resources File. Study Design Cross-sectional data for the year 1997 were utilized to obtain facility-specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis. Principal Findings The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for-profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government-owned facilities are more likely than their for-profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for-profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient

  13. A national study of efficiency for dialysis centers: an examination of market competition and facility characteristics for production of multiple dialysis outputs.

    PubMed

    Ozgen, Hacer; Ozcan, Yasar A

    2002-06-01

    To examine market competition and facility characteristics that can be related to technical efficiency in the production of multiple dialysis outputs from the perspective of the industrial organization model. Freestanding dialysis facilities that operated in 1997 submitted cost report fonns to the Health Care Financing Administration (HCFA), and offered all three outputs--outpatient dialysis, dialysis training, and home program dialysis. The Independent Renal Facility Cost Report Data file (IRFCRD) from HCFA was utilized to obtain information on output and input variables and market and facility features for 791 multiple-output facilities. Information regarding population characteristics was obtained from the Area Resources File. Cross-sectional data for the year 1997 were utilized to obtain facility-specific technical efficiency scores estimated through Data Envelopment Analysis (DEA). A binary variable of efficiency status was then regressed against its market and facility characteristics and control factors in a multivariate logistic regression analysis. The majority of the facilities in the sample are functioning technically inefficiently. Neither the intensity of market competition nor a policy of dialyzer reuse has a significant effect on the facilities' efficiency. Technical efficiency is significantly associated, however, with type of ownership, with the interaction between the market concentration of for-profits and ownership type, and with affiliations with chains of different sizes. Nonprofit and government-owned Facilities are more likely than their for-profit counterparts to become inefficient producers of renal dialysis outputs. On the other hand, that relationship between ownership form and efficiency is reversed as the market concentration of for-profits in a given market increases. Facilities that are members of large chains are more likely to be technically inefficient. Facilities do not appear to benefit from joint production of a variety of

  14. Technical Analysis of Scores on the "Self-Efficacy Self-Report Scale"

    ERIC Educational Resources Information Center

    Erford, Bradley T.; Schein, Hallie; Duncan, Kelly

    2011-01-01

    The purpose of this study was to provide preliminary analysis of reliability and validity of scores on the "Self-Efficacy Self-Report Scale", which was designed to assess general self-efficacy in students aged 10 to 17 years. Confirmatory factor analysis on cross-validated samples was conducted revealing a marginal fit of the data to the…

  15. The Relationship Between Technical And Nontechnical Skills Within A Simulation-Based Ureteroscopy Training Environment.

    PubMed

    Brunckhorst, Oliver; Shahid, Shahab; Aydin, Abdullatif; Khan, Shahid; McIlhenny, Craig; Brewin, James; Sahai, Arun; Bello, Fernando; Kneebone, Roger; Shamim Khan, Muhammad; Dasgupta, Prokar; Ahmed, Kamran

    2015-01-01

    Little integration of technical and nontechnical skills (e.g., situational awareness, communication, decision making, teamwork, and leadership) teaching exists within surgery. We therefore aimed to (1) evaluate the relationship between these 2 skill sets within a simulation-based environment and (2) assess if certain nontechnical skill components are of particular relevance to technical performance. A prospective analysis of data acquired from a comparative study of simulation vs nonsimulation training was conducted. Half of the participants underwent training of technical and nontechnical skills within ureteroscopy, with the remaining half undergoing no training. All were assessed within a full immersion environment against both technical (time to completion, Objective Structured Assessment of Technical Skills, and task-specific checklist scores) and nontechnical parameters (Nontechnical Skills for Surgeons [NOTSS] rating scale). The data of whole and individual cohorts were analyzed using Pearson correlation coefficient. The trial took place within the Simulation and Interactive Learning Centre at Guy's Hospital, London, UK. In total, 32 novice participants with no prior practical ureteroscopy experience were included within the data analysis. A correlation was found within all outcome measures analyzed. For the whole cohort, a strong negative correlation was found between time to completion and NOTSS scores (r = -0.75, p < 0.001), with strong positive correlations identified when NOTSS scores were compared with Objective Structured Assessment of Technical Skills (r = 0.89, p < 0.001) and task-specific checklist scores (r = 0.91, p < 0.001). Similar results were observed when each cohort was analyzed separately. Finally, all individual nontechnical skill components demonstrated a strong correlation with all technical skill parameters, regardless of training. A strong correlation between technical and nontechnical performance exists, which was demonstrated to be

  16. 75 FR 2860 - Hydrogen and Fuel Cell Technical Advisory Committee (HTAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-19

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Hydrogen and Fuel Cell Technical Advisory Committee (HTAC) AGENCY: Department of Energy, Office of Energy Efficiency and Renewable Energy. ACTION: Notice of Open Meeting. SUMMARY: The Hydrogen and Fuel Cell Technical Advisory Committee...

  17. Financial performance monitoring of the technical efficiency of critical access hospitals: a data envelopment analysis and logistic regression modeling approach.

    PubMed

    Wilson, Asa B; Kerr, Bernard J; Bastian, Nathaniel D; Fulton, Lawrence V

    2012-01-01

    From 1980 to 1999, rural designated hospitals closed at a disproportionally high rate. In response to this emergent threat to healthcare access in rural settings, the Balanced Budget Act of 1997 made provisions for the creation of a new rural hospital--the critical access hospital (CAH). The conversion to CAH and the associated cost-based reimbursement scheme significantly slowed the closure rate of rural hospitals. This work investigates which methods can ensure the long-term viability of small hospitals. This article uses a two-step design to focus on a hypothesized relationship between technical efficiency of CAHs and a recently developed set of financial monitors for these entities. The goal is to identify the financial performance measures associated with efficiency. The first step uses data envelopment analysis (DEA) to differentiate efficient from inefficient facilities within a data set of 183 CAHs. Determining DEA efficiency is an a priori categorization of hospitals in the data set as efficient or inefficient. In the second step, DEA efficiency is the categorical dependent variable (efficient = 0, inefficient = 1) in the subsequent binary logistic regression (LR) model. A set of six financial monitors selected from the array of 20 measures were the LR independent variables. We use a binary LR to test the null hypothesis that recently developed CAH financial indicators had no predictive value for categorizing a CAH as efficient or inefficient, (i.e., there is no relationship between DEA efficiency and fiscal performance).

  18. 24 CFR 902.25 - Physical condition scoring and thresholds.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... circumstances, HUD may determine it is appropriate to review the results of a PHA's physical inspection which... section are not those addressed by the technical review process in § 902.68.) (ii) To adjust a physical... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Physical condition scoring and...

  19. An efficient and accurate molecular alignment and docking technique using ab initio quality scoring

    PubMed Central

    Füsti-Molnár, László; Merz, Kenneth M.

    2008-01-01

    An accurate and efficient molecular alignment technique is presented based on first principle electronic structure calculations. This new scheme maximizes quantum similarity matrices in the relative orientation of the molecules and uses Fourier transform techniques for two purposes. First, building up the numerical representation of true ab initio electronic densities and their Coulomb potentials is accelerated by the previously described Fourier transform Coulomb method. Second, the Fourier convolution technique is applied for accelerating optimizations in the translational coordinates. In order to avoid any interpolation error, the necessary analytical formulas are derived for the transformation of the ab initio wavefunctions in rotational coordinates. The results of our first implementation for a small test set are analyzed in detail and compared with published results of the literature. A new way of refinement of existing shape based alignments is also proposed by using Fourier convolutions of ab initio or other approximate electron densities. This new alignment technique is generally applicable for overlap, Coulomb, kinetic energy, etc., quantum similarity measures and can be extended to a genuine docking solution with ab initio scoring. PMID:18624561

  20. Technical proficiency in cytopathology: assessment through external quality assurance.

    PubMed

    Cummings, M C; Greaves, J; Shukor, R A; Perkins, G; Ross, J

    2017-04-01

    To assess both the feasibility and value of conducting an external quality assurance programme concerning technical aspects of cytopathology laboratory practice, and the interest by laboratories in enrolling in such a programme. Six technical surveys, comprising staining exercises and questionnaires relating to laboratory practice, were distributed over a 4-year period to the approximately 220 laboratories enrolled in the RCPAQAP Cytopathology slide survey modules. Staining exercises using the Papanicolaou and Romanowsky techniques, the preparation of urine and body fluid specimens and immunocytochemistry on the cell block material were assessed. Accompanying relevant questionnaires were included, and one survey comprised a questionnaire alone concerning the collection of urinary tract and body fluid samples. Provision of an external cytopathology technical module was feasible for the RCPAQAP and participation rates (maximum of 87% per survey; average 68% for stained slides and 66% for questionnaires) were commendable, particularly considering these were optional undertakings with some exercises not applicable to all laboratories. The great majority of submitted slides were scored as satisfactory, and there was an especially high standard for the immunocytochemical staining exercise with 95% considered satisfactory, including 50.6% with a perfect score. Reasons for suboptimal scores were provided for potential quality improvement for interested laboratories. A wealth of information relating to laboratory practice was provided to the RCPAQAP which was collated and summarised for laboratory use. The provision of a technical module in cytopathology is both a feasible and valuable undertaking of interest to laboratories which should become standard practice for cytopathology external quality assurance providers. © 2016 John Wiley & Sons Ltd.

  1. CBM Maze-Scores as Indicators of Reading Level and Growth for Seventh-Grade Students

    ERIC Educational Resources Information Center

    Chung, Siuman; Espin, Christine A.; Stevenson, Claire E.

    2018-01-01

    The technical adequacy of CBM maze-scores as indicators of reading level and growth for seventh-grade secondary-school students was examined. Participants were 452 Dutch students who completed weekly maze measures over a period of 23 weeks. Criterion measures were school level, dyslexia status, scores and growth on a standardized reading test.…

  2. Data envelopment analysis for estimating efficiency of intensive care units: a case study in Iran.

    PubMed

    Bahrami, Mohammad Amin; Rafiei, Sima; Abedi, Mahdieh; Askari, Roohollah

    2018-05-14

    Purpose As hospitals are the most costly service providers in every healthcare systems, special attention should be given to their performance in terms of resource allocation and consumption. The purpose of this paper is to evaluate technical, allocative and economic efficiency in intensive care units (ICUs) of hospitals affiliated by Yazd University of Medical Sciences (YUMS) in 2015. Design/methodology/approach This was a descriptive, analytical study conducted in ICUs of seven training hospitals affiliated by YUMS using data envelopment analysis (DEA) in 2015. The number of physicians, nurses, active beds and equipment were regarded as input variables and bed occupancy rate, the number of discharged patients, economic information such as bed price and physicians' fees were mentioned as output variables of the study. Available data from study variables were retrospectively gathered and analyzed through the Deap 2.1 software using the variable returns to scale methodology. Findings The study findings revealed the average scores of allocative, economic, technical, managerial and scale efficiency to be relatively 0.956, 0.866, 0.883, 0.89 and 0.913. Regarding to latter three types of efficiency, five hospitals had desirable performance. Practical implications Given that additional costs due to an extra number of manpower or unnecessary capital resources impose economic pressure on hospitals also the fact that reduction of surplus production plays a major role in reducing such expenditures in hospitals, it is suggested that departments with low efficiency reduce their input surpluses to achieve the optimal level of performance. Originality/value The authors applied a DEA approach to measure allocative, economic, technical, managerial and scale efficiency of under-study hospitals. This is a helpful linear programming method which acts as a powerful and understandable approach for comparative performance assessment in healthcare settings and a guidance for healthcare

  3. Surgical management of congenital heart disease: evaluation according to the Aristotle score.

    PubMed

    Heinrichs, Jutta; Sinzobahamvya, Nicodème; Arenz, Claudia; Kallikourdis, Antonios; Photiadis, Joachim; Schindler, Ehrenfried; Hraska, Vicktor; Asfour, Boulos

    2010-01-01

    The Aristotle basic complexity (ABC) score (1.5-15 points) is the sum of potentials for early mortality, morbidity and anticipated surgical technique difficulty. The Aristotle comprehensive complexity (ACC) score (1.5-25 points) is the sum of ABC score and patient-adjusted complexity score; it comprises six complexity levels. We used the ACC score to evaluate quality in surgical management of congenital heart disease. Procedures performed in year 2002 and 2007 were analysed. Proportion of procedures requiring at least 1 week of stay in the intensive care unit was chosen as the marker of morbidity. We adopted threshold duration of 120 min for cardio-pulmonary bypass (CPB) cases and the same duration for operations without CPB as surrogate of surgical technical difficulty. The ACC scores were correlated to mortality, morbidity and technical difficulty. This study included 758 patients who underwent 787 primary procedures. The mean ABC and ACC scores amounted to 7.61+/-2.46 and 9.51+/-3.84. Early mortality was 3.05% (24/787), 95% confidence interval (CI): 1.97-4.51%. Zero at ACC levels 1 and 2, it increased from 1.2% (2/161) for level 3 up to 22.2% (2/9) for level 6. Morbidity index was evaluated at 25.9% (204/787), 95% CI: 22.9-29.1%. 1.9% at level 1, it escalated up to 77.8% at level 6. Index of technique difficulty was estimated at 35.2% (277/787), 95% CI: 31.8-38.6%, ranging from 4.8% for level 1 to 66.7% for level 6. A high correlation was found between the ACC scores and mortality, indices of morbidity and technique difficulty, Spearman's correlation coefficient r being 0.9856, 1 and 0.9429, respectively. Mortality (p=0.037) and morbidity (p=0.041) were lower in year 2007 than in 2002 with ABC (p=0.18) and ACC (p=0.37) surgical performance being not significantly different. The Aristotle score is still under development. Morbidity evaluation should be ideally based on observed postoperative complications; estimation of surgical technical difficulty chosen in

  4. Technical Assistance | NREL

    Science.gov Websites

    Multi-Wind Heat Smart Grid Project. Advancing Energy Solutions in Alaska NREL provides analysis mission to transfer knowledge and innovation to solve the nation's energy challenges. The goal of this transportation energy efficiency and reduce transportation energy costs State Technical Assistance-solar market

  5. The efficiency of the public dental services (PDS) in Cyprus and selected determinants.

    PubMed

    Charalambous, Chrystalla; Maniadakis, Nikolaos; Polyzos, Nikolaos; Fragoulakis, Vassilis; Theodorou, Mamas

    2013-10-18

    Currently there is a dual system of oral healthcare delivery in Cyprus: the public dental system (PDS) run by the Government and the private system provided by private dental practitioners. Although 83% of the population is entitled to free treatment by the PDS only 10% of the population make use of them. As Cyprus faces now the challenges of the introduction of a new health care system and rising healthcare costs in general, surveys that examine, among other things, the efficiency of the PDS become very important as tools to make important cost savings. The aims of this study are to assess trends regarding the number of visits and the age distribution of patients using PDS from 2004 to 2007, to measure the technical efficiency of the PDS and to investigate various factors that may affect it. Non-parametric Data Envelopment Analysis (DEA) was employed to assess technical efficiency. Two separate cases were examined. Efficiency was calculated, firstly using as inputs the wages and the working hours of the personnel, and secondly the working hours of the personnel and the cost of the materials. As outputs, in both cases, the treatment offered (divided into primary, secondary and tertiary care) and the numbers of visits were used. In the second stage Tobit analysis was used to explore various predictors of efficiency (time per patient, location, age of dentists, age of patients and age of assistants). The study showed that whilst there was an increase in the number of patients using the PDS from 2004 to 2007, only a small proportion of the population (10%) make use of them. Women, middle and older aged patients, make more use of the PDS. Regarding efficiency, there were large differences between the units. The average Technical Efficiency score was 68% in the first model and 81% in the second. Urban areas and low time per patient are predictors of increased efficiency. The results suggest that many of the rural PDS are underperforming. Given that the option of

  6. The efficiency of the public dental services (PDS) in Cyprus and selected determinants

    PubMed Central

    2013-01-01

    Background Currently there is a dual system of oral healthcare delivery in Cyprus: the public dental system (PDS) run by the Government and the private system provided by private dental practitioners. Although 83% of the population is entitled to free treatment by the PDS only 10% of the population make use of them. As Cyprus faces now the challenges of the introduction of a new health care system and rising healthcare costs in general, surveys that examine, among other things, the efficiency of the PDS become very important as tools to make important cost savings. The aims of this study are to assess trends regarding the number of visits and the age distribution of patients using PDS from 2004 to 2007, to measure the technical efficiency of the PDS and to investigate various factors that may affect it. Methods Non-parametric Data Envelopment Analysis (DEA) was employed to assess technical efficiency. Two separate cases were examined. Efficiency was calculated, firstly using as inputs the wages and the working hours of the personnel, and secondly the working hours of the personnel and the cost of the materials. As outputs, in both cases, the treatment offered (divided into primary, secondary and tertiary care) and the numbers of visits were used. In the second stage Tobit analysis was used to explore various predictors of efficiency (time per patient, location, age of dentists, age of patients and age of assistants). Results The study showed that whilst there was an increase in the number of patients using the PDS from 2004 to 2007, only a small proportion of the population (10%) make use of them. Women, middle and older aged patients, make more use of the PDS. Regarding efficiency, there were large differences between the units. The average Technical Efficiency score was 68% in the first model and 81% in the second. Urban areas and low time per patient are predictors of increased efficiency. Conclusion The results suggest that many of the rural PDS are

  7. 24 CFR 902.68 - Technical review of results of PHAS Indicators #1 or #4.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... both reviews, a request for technical review must be submitted in writing to the Director of the Real... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Technical review of results of PHAS... HOUSING AND URBAN DEVELOPMENT PUBLIC HOUSING ASSESSMENT SYSTEM PHAS Scoring § 902.68 Technical review of...

  8. Notional Scoring for Technical Review Weighting As Applied to Simulation Credibility Assessment

    NASA Technical Reports Server (NTRS)

    Hale, Joseph Peter; Hartway, Bobby; Thomas, Danny

    2008-01-01

    NASA's Modeling and Simulation Standard requires a credibility assessment for critical engineering data produced by models and simulations. Credibility assessment is thus a "qualifyingfactor" in reporting results from simulation-based analysis. The degree to which assessors should be independent of the simulation developers, users and decision makers is a recurring question. This paper provides alternative "weighting algorithms" for calculating the value-added for independence of the levels of technical review defined for the NASA Modeling and Simulation Standard.

  9. Technical challenges and future direction for high-efficiency metal hydride thermal energy storage systems

    NASA Astrophysics Data System (ADS)

    Ward, Patrick A.; Corgnale, Claudio; Teprovich, Joseph A.; Motyka, Theodore; Hardy, Bruce; Sheppard, Drew; Buckley, Craig; Zidan, Ragaiy

    2016-04-01

    Recently, there has been increasing interest in thermal energy storage (TES) systems for concentrated solar power (CSP) plants, which allow for continuous operation when sunlight is unavailable. Thermochemical energy storage materials have the advantage of much higher energy densities than latent or sensible heat materials. Furthermore, thermochemical energy storage systems based on metal hydrides have been gaining great interest for having the advantage of higher energy densities, better reversibility, and high enthalpies. However, in order to achieve higher efficiencies desired of a thermal storage system by the US Department of Energy, the system is required to operate at temperatures >600 °C. Operation at temperatures >600 °C presents challenges including material selection, hydrogen embrittlement and permeation of containment vessels, appropriate selection of heat transfer fluids, and cost. Herein, the technical difficulties and proposed solutions associated with the use of metal hydrides as TES materials in CSP applications are discussed and evaluated.

  10. Balancing Score Adjusted Targeted Minimum Loss-based Estimation

    PubMed Central

    Lendle, Samuel David; Fireman, Bruce; van der Laan, Mark J.

    2015-01-01

    Adjusting for a balancing score is sufficient for bias reduction when estimating causal effects including the average treatment effect and effect among the treated. Estimators that adjust for the propensity score in a nonparametric way, such as matching on an estimate of the propensity score, can be consistent when the estimated propensity score is not consistent for the true propensity score but converges to some other balancing score. We call this property the balancing score property, and discuss a class of estimators that have this property. We introduce a targeted minimum loss-based estimator (TMLE) for a treatment-specific mean with the balancing score property that is additionally locally efficient and doubly robust. We investigate the new estimator’s performance relative to other estimators, including another TMLE, a propensity score matching estimator, an inverse probability of treatment weighted estimator, and a regression-based estimator in simulation studies. PMID:26561539

  11. On the Cognitive Interpretation of Performance Assessment Scores. CSE Technical Report 546.

    ERIC Educational Resources Information Center

    Ayala, Carlos Cuauhtemoc; Shavelson, Richard; Ayala, Mary Ann

    This study explored some aspects of reasoning needed to complete science performance assessments, i.e., students' hands-on investigations scored for the scientific justifiability of the findings. The reasoning demands of science performance assessments were studied focusing on three dimensions identified from a previous analysis of data from the…

  12. Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005.

    PubMed

    Gai, Ruoyan Y; Zhou, Chengchao C; Xu, Lingzhong Z; Zhu, Min; Wang, Xingzhou Z; Li, Shixue X; Zheng, Wengui G; Song, Peipei P; Yang, Xuelai L; Fang, Liyi Y; Zhen, Yancheng C; Tang, Wei

    2010-10-01

    This study aims to assess trends in the productive efficiency of China's county hospitals during the economic transition using data from 1993 to 2005. A data envelopment analysis (DEA) framework was used to calculate the efficiency score of county hospitals in all 31 provinces. A C²R model and a BC² model were devised to respectively calculate overall and scale efficiency and pure technical efficiency at the hospital's current scale. Models included four inputs (number of medical staff; number of beds; value of fixed capital; and hospital expenditures) and three outputs (outpatient and emergency visits, number of inpatients, and hospital revenue) in total. As the results, geographical disparities in health resource allocation and county hospital productivity were noted. From 1993 to 2005, the number of county hospitals increased and their inputs, e.g. fixed capital in particular, grew rapidly. However, the amount of both outpatient and inpatient services declined somewhat especially in the middle and the western regions. The overall efficiency at the national level decreased slightly. County hospitals in the eastern region tended to have better overall, scale, and technical efficiency in comparison to the middle and the western regions. In conclusion, county hospitals are inefficient due to their enlarged scale and the reduced amount of health care services they provide. This issue should be addressed especially in the middle and the western regions, where health resources are far more limited and yet wasted. The effects of ongoing health sector reform on the productivity of county hospitals must be monitored and evaluated.

  13. Comparison of simplified score with the revised original score for the diagnosis of autoimmune hepatitis: a new or a complementary diagnostic score?

    PubMed

    Gatselis, Nikolaos K; Zachou, Kalliopi; Papamichalis, Panagiotis; Koukoulis, George K; Gabeta, Stella; Dalekos, George N; Rigopoulou, Eirini I

    2010-11-01

    The International Autoimmune Hepatitis Group developed a simplified score for autoimmune hepatitis. We assessed this "new scoring system" and compared it with the International Autoimmune Hepatitis Group original revised score. 502 patients were evaluated namely, 428 had liver diseases of various etiology [hepatitis B (n=109), hepatitis C (n=100), hepatitis D (n=4), alcoholic liver disease (n=28), non-alcoholic fatty liver disease (n=55), autoimmune cholestatic diseases (n=77), liver disorders of undefined origin (n=32) and miscellaneous hepatic disorders (n=23)], 13 had autoimmune hepatitis/overlap syndromes, 18 had autoimmune hepatitis/concurrent with other liver diseases and 43 had autoimmune hepatitis. The specificity of the simplified score was similar to that of the revised score (97% vs. 97.9%). The sensitivity in unmasking autoimmune hepatitis in autoimmune hepatitis/overlap syndromes was also similar in both systems (53.8% and 61.5%). However, the sensitivity for autoimmune hepatitis diagnosis in autoimmune hepatitis patients with concurrent liver disorders was lower by the new score (p=0.001). Liver biopsy proved to be the only independent factor for unmasking autoimmune hepatitis component among patients (p=0.003). The simplified score is a reliable and simple tool for excluding autoimmune hepatitis. However, both systems cannot unmask autoimmune hepatitis component efficiently in autoimmune hepatitis patients with concurrent autoimmune or non-autoimmune liver diseases. This study also strongly reiterates the importance of liver biopsy in the work-up of patients. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  14. Integrating technical and non-technical skills coaching in an acute trauma surgery team training: Is it too much?

    PubMed

    Alken, Alexander; Luursema, Jan-Maarten; Weenk, Mariska; Yauw, Simon; Fluit, Cornelia; van Goor, Harry

    2017-08-25

    Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training. Coaching activities of 12 surgical teachers were recorded on audio and video. Six teachers were primed on non-technical skills coaching prior to the training. Six others received no priming and served as controls. Blind observers reviewed the recordings of 2 training scenario's and scored whether the observed behaviors were directed on technical or non-technical skills. We compared the frequency of the non-technical skills coaching between the primed and the non-primed teachers and analyzed for differences according to the trainees' level of experience. Surgical teachers coached trainees during the highly realistic DSATC integrated acute trauma surgery team training. Trainees performed damage control surgery in operating teams on anesthetized porcine models during 6 training scenario's. Twelve experienced surgical teachers participated in this study. Coaching on non-technical skills was limited to about 5%. The primed teachers did not coach more often on non-technical skills than the non-primed teachers. We found no differences in the frequency of non-technical skills coaching based on the trainees' level of experience. Priming experienced surgical teachers does not increase the coaching on non-technical skills. The current DSATC acute trauma surgery team training seems too complex for integrating training on technical and non-technical skills. Patient care, Practice based learning and improvement. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. [Efficient packaging retrovirus and construction of transgenic chicken technical platform].

    PubMed

    Man, Chaolai; Zhang, Qing; Chen, Yan; Zhu, Dahai

    2007-10-01

    Transgenic chicken and oviduct bioreactor are growing to be one of the hotspot of scientific study in the field of biology. The most successful method of producing transgenic chicken is pseudotyped retrovirus vector system, but no one has reported the production of transgenic chicken by retrovirus system recently in our country. In order to accelerate our study in this field, we introduced the relevant technical methods such as packaging retrovirus and vesicular stomatitis virus G glycoprotein (VSV-G) pseudotyped retrovirus, optimizing the conditions of packaging retrovirus, concentrating VSV-G pseudotyped retrovirus, helper virus assays, and microinjection of retrovirus. Furthermore, we successfully conducted in vivo study for detecting the marker gene EGFP of chicken embryo as well as in vitro study for detecting that gene of chicken embryo myoblast (CFM), thus we have provided an applied technical platform for studies of transgenic chicken in the future.

  16. LODVIEW: a computer program for the graphical evaluation of lod score results in exclusion mapping of human disease genes.

    PubMed

    Hildebrandt, F; Pohlmann, A; Omran, H

    1993-12-01

    For linkage analysis projects aimed at mapping hereditary disease genes in humans, hundreds of highly polymorphic microsatellite markers which can be typed by PCR (PCR markers) have become available. With this technical improvement, the availability of a technique allowing for transparency in the handling of rapidly generated lod score data is becoming important. We present a computer program LODVIEW for the graphical representation of lod score data. It is designed for the input of lod score data generated with the LINKAGE package or similar programs. LODVIEW consists of 24 preformatted files, one for each chromosome. Each file contains a table for the input of lod score data and a file for the graphical representation of the data, which will show automatically any entry that is made in the respective input table. The program provides the user with published PCR marker information pre-entered into a table and graph at the correct positions corresponding to the genetic distances between markers. The graphical display of LODVIEW allows for the rapid evaluation of lod score results calculated from PCR markers on each chromosome. The following information can be obtained from the graphical display at one glance: (i) Regions of exclusion (Z(theta) < -2) and nonexclusion, (ii) markers with positive lod scores, (iii) the distribution of positive and negative lod scores among the families examined (indication of genetic heterogeneity), (iv) multipoint lod scores, and (v) the availability of PCR markers in regions of interest. The program is continually updated for novel PCR marker information from the literature. The program will help to efficiently monitor and direct the progress of exclusion mapping projects.

  17. Setting Meaningful Criterion-Reference Cut Scores as an Effective Professional Development

    ERIC Educational Resources Information Center

    Munyofu, Paul

    2010-01-01

    The state of Pennsylvania, like many organizations interested in performance improvement, routinely engages in professional development activities. Educators in this hands-on activity engaged in setting meaningful criterion-referenced cut scores for career and technical education assessments using two methods. The main purposes of this study were…

  18. Urology technical and non-technical skills development: the emerging role of simulation.

    PubMed

    Rashid, Prem; Gianduzzo, Troy R J

    2016-04-01

    To review the emerging role of technical and non-technical simulation in urological education and training. A review was conducted to examine the current role of simulation in urology training. A PUBMED search of the terms 'urology training', 'urology simulation' and 'urology education' revealed 11,504 titles. Three hundred and fifty-seven abstracts were identified as English language, peer reviewed papers pertaining to the role of simulation in urology and related topics. Key papers were used to explore themes. Some cross-referenced papers were also included. There is an ongoing need to ensure that training time is efficiently utilised while ensuring that optimal technical and non-technical skills are achieved. Changing working conditions and the need to minimise patient harm by inadvertent errors must be taken into account. Simulation models for specific technical aspects have been the mainstay of graduated step-wise low and high fidelity training. Whole scenario environments as well as non-technical aspects can be slowly incorporated into the curriculum. Doing so should also help define what have been challenging competencies to teach and evaluate. Dedicated time, resources and trainer up-skilling are important. Concurrent studies are needed to help evaluate the effectiveness of introducing step-wise simulation for technical and non-technical competencies. Simulation based learning remains the best avenue of progressing surgical education. Technical and non-technical simulation could be used in the selection process. There are good economic, logistic and safety reasons to pursue the process of ongoing development of simulation co-curricula. While the role of simulation is assured, its progress will depend on a structured program that takes advantage of what can be delivered via this medium. Overall, simulation can be developed further for urological training programs to encompass technical and non-technical skill development at all stages, including

  19. ITC Guidelines on Quality Control in Scoring, Test Analysis, and Reporting of Test Scores

    ERIC Educational Resources Information Center

    Allalouf, Avi

    2014-01-01

    The Quality Control (QC) Guidelines are intended to increase the efficiency, precision, and accuracy of the scoring, analysis, and reporting process of testing. The QC Guidelines focus on large-scale testing operations where multiple forms of tests are created for use on set dates. However, they may also be used for a wide variety of other testing…

  20. Technical feasibility and validation of a coronary artery calcium scoring system using CT coronary angiography images.

    PubMed

    Pavitt, Christopher W; Harron, Katie; Lindsay, Alistair C; Zielke, Sayeh; Ray, Robin; Gordon, Daniel; Rubens, Michael B; Padley, Simon P; Nicol, Edward D

    2016-05-01

    We validate a novel CT coronary angiography (CCTA) coronary calcium scoring system. Calcium was quantified on CCTA images using a new patient-specific attenuation threshold: mean + 2SD of intra-coronary contrast density (HU). Using 335 patient data sets a conversion factor (CF) for predicting CACS from CCTA scores (CCTAS) was derived and validated in a separate cohort (n = 168). Bland-Altman analysis and weighted kappa for MESA centiles and Agatston risk groupings were calculated. Multivariable linear regression yielded a CF: CACS = (1.185 × CCTAS) + (0.002 × CCTAS × attenuation threshold). When applied to CCTA data sets there was excellent correlation (r = 0.95; p < 0.0001) and agreement (mean difference -10.4 [95% limits of agreement -258.9 to 238.1]) with traditional calcium scores. Agreement was better for calcium scores below 500; however, MESA percentile agreement was better for high risk patients. Risk stratification was excellent (Agatston groups k = 0.88 and MESA centiles k = 0.91). Eliminating the dedicated CACS scan decreased patient radiation exposure by approximately one-third. CCTA calcium scores can accurately predict CACS using a simple, individualized, semiautomated approach reducing acquisition time and radiation exposure when evaluating patients for CAD. This method is not affected by the ROI location, imaging protocol, or tube voltage strengthening its clinical applicability. • Coronary calcium scores can be reliably determined on contrast-enhanced cardiac CT • This score can accurately risk stratify patients • Elimination of a dedicated calcium scan reduces patient radiation by a third.

  1. Interventional Radiologists: a Necessary Evaluation of Technical, Protective and Technological Operation.

    PubMed

    Rahimi, Sayed Ali; Pourkaveh, Maryam

    2016-02-01

    To present the results of occupational radiation doses investigated through a Hospitals of Mazandaran Medical Science Universities in north of Iran. Radiology unit has an important role in diagnosis of many disorders with providing suitable and high quality pictures. A good picture was provided using correct technical criteria and suitable circumstance of patient. Finally, operation and knowledge of radiology personnel directly has a primary role in determining quality of radiography. This study was done in order to determine personnel operation in the units of hospitals radiologist related to University of Mazandaran Medical Science. Data collection tools are made of a researcher check list that was used after obtaining suitable letter and validity indexes. All of the 73 personnel of radiology unit related to Mazandaran Medical Science were studied. 35 operations (in technical, protective and technological fields) of any personnel, in three distinct shifts were observed and recorded. All of them were tested regarding these three fields with a total of 40 questions. The total scores received from personnel in technical part in the morning, evening and night shift were 66.4, 53.9 and 60.2 percent respectively. Received scores from personnel in the protective fields were 68.1, 59.5 and 60.2 percent. Moreover, received scores from personnel in the technological operation fields were 47.8, 39.95 and 43.65 percent respectively. Comparison of these three scores in technical, protective and technological operation fields showed a meaningful difference (p<0.05). The overall quality of personnel operations were nearly desirable and in need of continuous education, supervision and evaluation. Emphasizing protection to beams, accessibility of necessary tools, continuous supervision regarding the usage of these equipments and respecting the other security points have an important role in decreasing patients absorbed doses.

  2. Interventional Radiologists: a Necessary Evaluation of Technical, Protective and Technological Operation

    PubMed Central

    Rahimi, Sayed Ali; Pourkaveh, Maryam

    2016-01-01

    Background and purpose: To present the results of occupational radiation doses investigated through a Hospitals of Mazandaran Medical Science Universities in north of Iran. Radiology unit has an important role in diagnosis of many disorders with providing suitable and high quality pictures. A good picture was provided using correct technical criteria and suitable circumstance of patient. Finally, operation and knowledge of radiology personnel directly has a primary role in determining quality of radiography. Materials and Methods: This study was done in order to determine personnel operation in the units of hospitals radiologist related to University of Mazandaran Medical Science. Data collection tools are made of a researcher check list that was used after obtaining suitable letter and validity indexes. All of the 73 personnel of radiology unit related to Mazandaran Medical Science were studied. 35 operations (in technical, protective and technological fields) of any personnel, in three distinct shifts were observed and recorded. All of them were tested regarding these three fields with a total of 40 questions. Results: The total scores received from personnel in technical part in the morning, evening and night shift were 66.4, 53.9 and 60.2 percent respectively. Received scores from personnel in the protective fields were 68.1, 59.5 and 60.2 percent. Moreover, received scores from personnel in the technological operation fields were 47.8, 39.95 and 43.65 percent respectively. Comparison of these three scores in technical, protective and technological operation fields showed a meaningful difference (p<0.05). Conclusion: The overall quality of personnel operations were nearly desirable and in need of continuous education, supervision and evaluation. Emphasizing protection to beams, accessibility of necessary tools, continuous supervision regarding the usage of these equipments and respecting the other security points have an important role in decreasing patients

  3. Extended score interval in the assessment of basic surgical skills.

    PubMed

    Acosta, Stefan; Sevonius, Dan; Beckman, Anders

    2015-01-01

    The Basic Surgical Skills course uses an assessment score interval of 0-3. An extended score interval, 1-6, was proposed by the Swedish steering committee of the course. The aim of this study was to analyze the trainee scores in the current 0-3 scored version compared to a proposed 1-6 scored version. Sixteen participants, seven females and nine males, were evaluated in the current and proposed assessment forms by instructors, observers, and learners themselves during the first and second day. In each assessment form, 17 tasks were assessed. The inter-rater reliability between the current and the proposed score sheets were evaluated with intraclass correlation (ICC) with 95% confidence intervals (CI). The distribution of scores for 'knot tying' at the last time point and 'bowel anastomosis side to side' given by the instructors in the current assessment form showed that the highest score was given in 31 and 62%, respectively. No ceiling effects were found in the proposed assessment form. The overall ICC between the current and proposed score sheets after assessment by the instructors increased from 0.38 (95% CI 0.77-0.78) on Day 1 to 0.83 (95% CI 0.51-0.94) on Day 2. A clear ceiling effect of scores was demonstrated in the current assessment form, questioning its validity. The proposed score sheet provides more accurate scores and seems to be a better feedback instrument for learning technical surgical skills in the Basic Surgical Skills course.

  4. Neurointerventional Treatment in Acute Stroke. Whom to Treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fjetland, Lars, E-mail: lars.fjetland@lyse.net; Roy, Sumit, E-mail: sumit.roy@sus.no; Kurz, Kathinka D., E-mail: kathinka.dehli.kurz@sus.no

    2013-10-15

    Purpose: Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT. Methods: Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high agemore » and evaluated the scores in respect of technical efficacy. Results: Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome. Conclusions: Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged {>=}80 years.« less

  5. Estimation of High-Dimensional Graphical Models Using Regularized Score Matching

    PubMed Central

    Lin, Lina; Drton, Mathias; Shojaie, Ali

    2017-01-01

    Graphical models are widely used to model stochastic dependences among large collections of variables. We introduce a new method of estimating undirected conditional independence graphs based on the score matching loss, introduced by Hyvärinen (2005), and subsequently extended in Hyvärinen (2007). The regularized score matching method we propose applies to settings with continuous observations and allows for computationally efficient treatment of possibly non-Gaussian exponential family models. In the well-explored Gaussian setting, regularized score matching avoids issues of asymmetry that arise when applying the technique of neighborhood selection, and compared to existing methods that directly yield symmetric estimates, the score matching approach has the advantage that the considered loss is quadratic and gives piecewise linear solution paths under ℓ1 regularization. Under suitable irrepresentability conditions, we show that ℓ1-regularized score matching is consistent for graph estimation in sparse high-dimensional settings. Through numerical experiments and an application to RNAseq data, we confirm that regularized score matching achieves state-of-the-art performance in the Gaussian case and provides a valuable tool for computationally efficient estimation in non-Gaussian graphical models. PMID:28638498

  6. Estimating returns to scale and scale efficiency for energy consuming appliances

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Blum, Helcio; Okwelum, Edson O.

    Energy consuming appliances accounted for over 40% of the energy use and $17 billion in sales in the U.S. in 2014. Whether such amounts of money and energy were optimally combined to produce household energy services is not straightforwardly determined. The efficient allocation of capital and energy to provide an energy service has been previously approached, and solved with Data Envelopment Analysis (DEA) under constant returns to scale. That approach, however, lacks the scale dimension of the problem and may restrict the economic efficient models of an appliance available in the market when constant returns to scale does not hold.more » We expand on that approach to estimate returns to scale for energy using appliances. We further calculate DEA scale efficiency scores for the technically efficient models that comprise the economic efficient frontier of the energy service delivered, under different assumptions of returns to scale. We then apply this approach to evaluate dishwashers available in the market in the U.S. Our results show that (a) for the case of dishwashers scale matters, and (b) the dishwashing energy service is delivered under non-decreasing returns to scale. The results further demonstrate that this method contributes to increase consumers’ choice of appliances.« less

  7. Materials Technical Team Roadmap

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    none,

    2013-08-01

    Roadmap identifying the efforts of the Materials Technical Team (MTT) to focus primarily on reducing the mass of structural systems such as the body and chassis in light-duty vehicles (including passenger cars and light trucks) which enables improved vehicle efficiency regardless of the vehicle size or propulsion system employed.

  8. An Efficiency Analysis of U.S. Business Schools

    ERIC Educational Resources Information Center

    Sexton, Thomas R.

    2010-01-01

    In the current economic climate, business schools face crucial decisions. As resources become scarcer, schools must either streamline operations or limit them. An efficiency analysis of U.S. business schools is presented that computes, for each business school, an overall efficiency score and provides separate factor efficiency scores, indicating…

  9. A scoring system for ascertainment of incident stroke; the Risk Index Score (RISc).

    PubMed

    Kass-Hout, T A; Moyé, L A; Smith, M A; Morgenstern, L B

    2006-01-01

    The main objective of this study was to develop and validate a computer-based statistical algorithm that could be translated into a simple scoring system in order to ascertain incident stroke cases using hospital admission medical records data. The Risk Index Score (RISc) algorithm was developed using data collected prospectively by the Brain Attack Surveillance in Corpus Christi (BASIC) project, 2000. The validity of RISc was evaluated by estimating the concordance of scoring system stroke ascertainment to stroke ascertainment by physician and/or abstractor review of hospital admission records. RISc was developed on 1718 randomly selected patients (training set) and then statistically validated on an independent sample of 858 patients (validation set). A multivariable logistic model was used to develop RISc and subsequently evaluated by goodness-of-fit and receiver operating characteristic (ROC) analyses. The higher the value of RISc, the higher the patient's risk of potential stroke. The study showed RISc was well calibrated and discriminated those who had potential stroke from those that did not on initial screening. In this study we developed and validated a rapid, easy, efficient, and accurate method to ascertain incident stroke cases from routine hospital admission records for epidemiologic investigations. Validation of this scoring system was achieved statistically; however, clinical validation in a community hospital setting is warranted.

  10. Estimation of mean response via effective balancing score

    PubMed Central

    Hu, Zonghui; Follmann, Dean A.; Wang, Naisyin

    2015-01-01

    Summary We introduce effective balancing scores for estimation of the mean response under a missing at random mechanism. Unlike conventional balancing scores, the effective balancing scores are constructed via dimension reduction free of model specification. Three types of effective balancing scores are introduced: those that carry the covariate information about the missingness, the response, or both. They lead to consistent estimation with little or no loss in efficiency. Compared to existing estimators, the effective balancing score based estimator relieves the burden of model specification and is the most robust. It is a near-automatic procedure which is most appealing when high dimensional covariates are involved. We investigate both the asymptotic and the numerical properties, and demonstrate the proposed method in a study on Human Immunodeficiency Virus disease. PMID:25797955

  11. Techno-economical efficiency and productivity change of wastewater treatment plants: the role of internal and external factors.

    PubMed

    Hernández-Sancho, F; Molinos-Senante, M; Sala-Garrido, R

    2011-12-01

    Efficiency and productivity are important measures for identifying best practice in businesses and optimising resource-use. This study analyses how these two measures change across the period 2003-2008 for 196 wastewater treatment plants (WWTPs) in Spain, by using the benchmarking methods of Data Envelopment Analysis and the Malmquist Productivity Index. To identify which variables contribute to the sustainability of the WWTPs, differences in efficiency scores and productivity indices for external factors are also investigated. Our results indicate that both efficiency and productivity decreased over the five years. We verify that the productivity drop is primarily explained by technical change. Furthermore, certain external variables affected WWTP efficiency, including plant size, treatment technology and energy consumption. However, plants with low energy consumption are the only ones which improve their productivity. Finally, the benchmarking analyses proved to be useful as management tools in the wastewater sector, by providing vital information for improving the sustainability of plants.

  12. A model of cardiopulmonary bypass staged training integrating technical and non-technical skills dedicated to cardiac trainees.

    PubMed

    Fouilloux, V; Doguet, F; Kotsakis, A; Dubrowski, A; Berdah, S

    2015-03-01

    To develop a standardized simulation-based curriculum to teach medical knowledge and technical, communication and critical thinking skills necessary to initiate and wean from cardiopulmonary bypass (CPB) to junior cardiac trainees (CTs) in France. Performance on post-curricular tests was compared between CTs who participated in the new curriculum to those who did not. The simulation-based curriculum was developed by content and education experts. Simulations sequentially taught the skills necessary for initiating and weaning from CPB as well as managing crises by adding fidelity and complexity to scenarios. Nine CTs were randomly assigned to the new curriculum (n=5) or the traditional curriculum (n=4). Skills were assessed using tests of medical knowledge and technical, communication (GRS) and critical thinking (SCT) skills. A two-sample Wilcoxon rank-sum test compared average scores between the two groups. Alpha of 0.05 was set to indicate statistically significant differences. The resutls revealed that CTs in the new curriculum significantly outperformed CTs in the traditional curriculum on technical (18.2 vs 14.8, p=0.05) and communication (3.5 vs 2.2, p=0.013) skills. There was no significant difference between CTs in the new curriculum in the Script Concordance Test (16.5 vs 14.8, p=0.141) and knowledge tests (26.9 vs 24.6, p=0.14) compared to CTs in the traditional curriculum. Our new curriculum teaches communication and technical skills necessary for CPB. The results of this pilot study are encouraging and relevant. They give grounds for future research with a larger panel of trainees. Based on the current distribution of scores, a sample size of 12 CTs per group should yield significant results for all tests. © The Author(s) 2014.

  13. The Efficiency of Public Schools: The Case of Kuwait

    ERIC Educational Resources Information Center

    Burney, Nadeem A.; Johnes, Jill; Al-Enezi, Mohammed; Al-Musallam, Marwa

    2013-01-01

    This paper investigates the technical, and allocative efficiencies of public schools in Kuwait over four levels of schooling (kindergartens, primary, intermediate and secondary) and two periods (1999/2000 and 2004/2005) using data envelopment analysis. Mean pure technical efficiency varies between 0.695 and 0.852 across all levels of education;…

  14. 76 FR 36102 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-21

    ... DEPARTMENT OF ENERGY Energy Efficiency and Renewable Energy Biomass Research and Development... vacancies on the Biomass Research and Development Technical Advisory Committee (Technical Advisory Committee... 20585; (202) 586-7766; E-mail: [email protected] . SUPPLEMENTARY INFORMATION: The Biomass Research...

  15. Extended score interval in the assessment of basic surgical skills.

    PubMed

    Acosta, Stefan; Sevonius, Dan; Beckman, Anders

    2015-01-01

    Introduction The Basic Surgical Skills course uses an assessment score interval of 0-3. An extended score interval, 1-6, was proposed by the Swedish steering committee of the course. The aim of this study was to analyze the trainee scores in the current 0-3 scored version compared to a proposed 1-6 scored version. Methods Sixteen participants, seven females and nine males, were evaluated in the current and proposed assessment forms by instructors, observers, and learners themselves during the first and second day. In each assessment form, 17 tasks were assessed. The inter-rater reliability between the current and the proposed score sheets were evaluated with intraclass correlation (ICC) with 95% confidence intervals (CI). Results The distribution of scores for 'knot tying' at the last time point and 'bowel anastomosis side to side' given by the instructors in the current assessment form showed that the highest score was given in 31 and 62%, respectively. No ceiling effects were found in the proposed assessment form. The overall ICC between the current and proposed score sheets after assessment by the instructors increased from 0.38 (95% CI 0.77-0.78) on Day 1 to 0.83 (95% CI 0.51-0.94) on Day 2. Discussion A clear ceiling effect of scores was demonstrated in the current assessment form, questioning its validity. The proposed score sheet provides more accurate scores and seems to be a better feedback instrument for learning technical surgical skills in the Basic Surgical Skills course.

  16. Evaluation of railway transportation efficiency based on super-cross efficiency

    NASA Astrophysics Data System (ADS)

    Kuang, Xiuyuan

    2018-01-01

    The efficiency of railway transportation is an important index. It can measure the development of railway transportation enterprises, and the efficiency of railway transportation has become a hot issue in the study of railway development. Data envelopment analysis (DEA) has been widely applied to railway efficiency analysis. In this paper, BBC model and super-cross efficiency model are constructed by using DEA theory, taking the 18 Railway Bureau as the research object, with the mileage, the number of employees, locomotive number, average daily loading number as input indicators, the passenger turnover, freight turnover and transport income as output indicators, then calculated and evaluated comprehensive efficiency, pure technical efficiency and scale efficiency. We get that the super-cross efficiency is more in line with the actual situation. Getting the super-cross efficiency is more in line with the actual situation.

  17. 77 FR 42298 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... DEPARTMENT OF ENERGY Energy Efficiency and Renewable Energy Biomass Research and Development...: Notice of Solicitation of Nominations for Appointment as a Member of the Biomass Research and Development... Biomass Research and Development Technical Advisory Committee (Technical Advisory Committee). DATES: The...

  18. 78 FR 35877 - Applications for New Awards; Native Hawaiian Career and Technical Education Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-14

    ... attain career and technical skills; (7) The use of student assessment and evaluation data to improve... the industry the student is preparing to enter; (iv) Activities, during the formative stages of the... students' technical assessments, by type and scores, if available; (vii) The rates of attainment of a...

  19. Competition and Efficiency: Overseas Students and Technical Efficiency in Australian and New Zealand Universities

    ERIC Educational Resources Information Center

    Abbott, Malcolm; Doucouliagos, Chris

    2009-01-01

    Economic theory suggests that competitive pressures will impact on organisational efficiency. In recent years, universities in Australia and New Zealand have faced increased competition for students. The aim of this paper is to explore the efficiency of Australian and New Zealand public universities and to investigate the impact of competition for…

  20. Setting Performance Standards for Technical and Nontechnical Competence in General Surgery.

    PubMed

    Szasz, Peter; Bonrath, Esther M; Louridas, Marisa; Fecso, Andras B; Howe, Brett; Fehr, Adam; Ott, Michael; Mack, Lloyd A; Harris, Kenneth A; Grantcharov, Teodor P

    2017-07-01

    The objectives of this study were to (1) create a technical and nontechnical performance standard for the laparoscopic cholecystectomy, (2) assess the classification accuracy and (3) credibility of these standards, (4) determine a trainees' ability to meet both standards concurrently, and (5) delineate factors that predict standard acquisition. Scores on performance assessments are difficult to interpret in the absence of established standards. Trained raters observed General Surgery residents performing laparoscopic cholecystectomies using the Objective Structured Assessment of Technical Skill (OSATS) and the Objective Structured Assessment of Non-Technical Skills (OSANTS) instruments, while as also providing a global competent/noncompetent decision for each performance. The global decision was used to divide the trainees into 2 contrasting groups and the OSATS or OSANTS scores were graphed per group to determine the performance standard. Parametric statistics were used to determine classification accuracy and concurrent standard acquisition, receiver operator characteristic (ROC) curves were used to delineate predictive factors. Thirty-six trainees were observed 101 times. The technical standard was an OSATS of 21.04/35.00 and the nontechnical standard an OSANTS of 22.49/35.00. Applying these standards, competent/noncompetent trainees could be discriminated in 94% of technical and 95% of nontechnical performances (P < 0.001). A 21% discordance between technically and nontechnically competent trainees was identified (P < 0.001). ROC analysis demonstrated case experience and trainee level were both able to predict achieving the standards with an area under the curve (AUC) between 0.83 and 0.96 (P < 0.001). The present study presents defensible standards for technical and nontechnical performance. Such standards are imperative to implementing summative assessments into surgical training.

  1. Some technical writing skills industry needs

    NASA Technical Reports Server (NTRS)

    Smith, F. R.

    1981-01-01

    It is suggested that engineers and other technical students be taught three classes of skills in technical writing. First, "Big Picture Things", which includes: the importance of clear writing, the wide scope of writing, the wide scope of writing tasks that will be faced in industry, and the principles of organization of technical materials such as; how to analyze, classify, partition, and interpret. Second, "Writing Procedures", which encompasses: how to get words on paper efficiently and team-write. Third, "Writing Details", in which two considerations are important: how to achieve precision in the use of language and the aspects of style. Three problems in style are cited: the problem of sentence transition, overuse of attributive adjectives, and verbosity in paragraph structure. The most important thing in technical writing is considered to be functionality, economy and clarity.

  2. Surgeons' and trainees' perceived self-efficacy in operating theatre non-technical skills.

    PubMed

    Pena, G; Altree, M; Field, J; Thomas, M J W; Hewett, P; Babidge, W; Maddern, G J

    2015-05-01

    An important factor that may influence an individual's performance is self-efficacy, a personal judgement of capability to perform a particular task successfully. This prospective study explored newly qualified surgeons' and surgical trainees' self-efficacy in non-technical skills compared with their non-technical skills performance in simulated scenarios. Participants undertook surgical scenarios challenging non-technical skills in two simulation sessions 6 weeks apart. Some participants attended a non-technical skills workshop between sessions. Participants completed pretraining and post-training surveys about their perceived self-efficacy in non-technical skills, which were analysed and compared with their performance in surgical scenarios in two simulation sessions. Change in performance between sessions was compared with any change in participants' perceived self-efficacy. There were 40 participants in all, 17 of whom attended the non-technical skills workshop. There was no significant difference in participants' self-efficacy regarding non-technical skills from the pretraining to the post-training survey. However, there was a tendency for participants with the highest reported self-efficacy to adjust their score downwards after training and for participants with the lowest self-efficacy to adjust their score upwards. Although there was significant improvement in non-technical skills performance from the first to second simulation sessions, a correlation between participants' self-efficacy and performance in scenarios in any of the comparisons was not found. The results suggest that new surgeons and surgical trainees have poor insight into their non-technical skills. Although it was not possible to correlate participants' self-belief in their abilities directly with their performance in a simulation, in general they became more critical in appraisal of their abilities as a result of the intervention. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

  3. Visual scoring of non cavitated caries lesions and clinical trial efficiency, testing xylitol in caries-active adults.

    PubMed

    Brown, John P; Amaechi, Bennett T; Bader, James D; Gilbert, Gregg H; Makhija, Sonia K; Lozano-Pineda, Juanita; Leo, Michael C; Chen, Chuhe; Vollmer, William M

    2014-06-01

    To better understand the effectiveness of xylitol in caries prevention in adults and to attempt improved clinical trial efficiency. As part of the Xylitol for Adult Caries Trial (X-ACT), non cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 g/day of xylitol, consumed by dissolving in the mouth five 1 g lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21-80, with complete data for four dental examinations, were selected from the 691 randomized into the 3-year trial, conducted at three sites. Acceptable inter- and intra-examiner reliability before and during the trial was quantified using the kappa statistic. The mean annualized noncavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically nonsignificant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non cavitated lesion assessment in this full-scale, placebo-controlled, multisite, randomized, double-blinded clinical trial in adults experiencing dental caries did not achieve added trial efficiency or demonstrate practical benefit of xylitol. ClinicalTrials.Gov NCT00393055. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Visual scoring of non-cavitated caries lesions and clinical trial efficiency, testing xylitol in caries active adults

    PubMed Central

    Brown, JP; Amaechi, BT; Bader, JD; Gilbert, GH; Makhija, SK; Lozano-Pineda, J; Leo, MC; Chuhe, C; Vollmer, WM

    2013-01-01

    Objectives To better understand the effectiveness of xylitol in caries prevention in adults, and to attempt improved clinical trial efficiency. Methods As part of the Xylitol for Adult Caries Trial (X-ACT), non-cavitated and cavitated caries lesions were assessed in subjects who were experiencing the disease. The trial was a test of the effectiveness of 5 grams/day of xylitol, consumed by dissolving in the mouth five 1 gram lozenges spaced across each day, compared with a sucralose placebo. For this analysis, seeking trial efficiency, 538 subjects aged 21–80, with complete data for four dental examinations were selected from the 691 randomized into the three year trial, conducted at three sites. Acceptable inter and intra examiner reliability before and during the trial was quantified using the kappa statistic. Results The mean annualized non-cavitated plus cavitated lesion transition scores in coronal and root surfaces, from sound to carious favoured xylitol over placebo, during the three cumulative periods of 12, 24, and 33 months, but these clinically and statistically non-significant differences declined in magnitude over time. Restricting the present assessment to those subjects with a higher baseline lifetime caries experience showed possible but inconsistent benefit. Conclusions There was no clear and clinically relevant preventive effect of xylitol on caries in adults with adequate fluoride exposure when non-cavitated plus cavitated lesions were assessed. This conformed to the X-ACT trial result assessing cavitated lesions. Including non-cavitated lesion assessment in this full scale, placebo controlled, multi site, randomized, double blinded clinical trial in adults experiencing dental caries, did not achieve added trial efficiency or demonstrate practical benefit of xylitol. Trial Registration ClinicalTrials.Gov NCT00393055 PMID:24205951

  5. Technical analysis of the Slosson Written Expression Test.

    PubMed

    Erford, Bradley T; Hofler, Donald B

    2004-06-01

    The Slosson Written Expression Test was designed to assess students ages 8-17 years at risk for difficulties in written expression. Scores from three independent samples were used to evaluate the test's reliability and validity for measuring students' written expression. Test-retest reliability of the SWET subscales ranged from .80 to .94 (n = 151), and .95 for the Written Expression Total Standard Scores. The median alternate-form reliability for students' Written Expression Total Standard Scores was .81 across the three forms. Scores on the Slosson test yielded concurrent validity coefficients (n = 143) of .60 with scores from the Woodcock-Johnson: Tests of Achievement-Third Edition Broad Written Language Domain and .49 with scores on the Test of Written Language-Third Edition Spontaneous Writing Quotient. Exploratory factor analytic procedures suggested the Slosson test is comprised of two dimensions, Writing Mechanics and Writing Maturity (47.1% and 20.1% variance accounted for, respectively). In general, the Slosson Written Expression Test presents with sufficient technical characteristics to be considered a useful written expression screening test.

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

    PubMed

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

    2014-08-01

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

  7. The Technical Efficiency of Specialised Milk Farms: A Regional View

    PubMed Central

    Špička, Jindřich; Smutka, Luboš

    2014-01-01

    The aim of the article is to evaluate production efficiency and its determinants of specialised dairy farming among the EU regions. In the most of European regions, there is a relatively high significance of small specialised farms including dairy farms. The DEAVRS method (data envelopment analysis with variable returns to scale) reveals efficient and inefficient regions including the scale efficiency. In the next step, the two-sample t-test determines differences of economic and structural indicators between efficient and inefficient regions. The research reveals that substitution of labour by capital/contract work explains the variability of the farm net value added per AWU (annual work unit) income indicator by more than 30%. The significant economic determinants of production efficiency in specialised dairy farming are farm size, herd size, crop output per hectare, productivity of energy, and capital (at α = 0.01). Specialised dairy farms in efficient regions have significantly higher farm net value added per AWU than inefficient regions. Agricultural enterprises in inefficient regions have a more extensive structure and produce more noncommodity output (public goods). Specialised dairy farms in efficient regions have a slightly higher milk yield, specific livestock costs of feed, bedding, and veterinary services per livestock unit. PMID:25050408

  8. Environmental efficiency of alternative dairy systems: a productive efficiency approach.

    PubMed

    Toma, L; March, M; Stott, A W; Roberts, D J

    2013-01-01

    Agriculture across the globe needs to produce "more with less." Productivity should be increased in a sustainable manner so that the environment is not further degraded, management practices are both socially acceptable and economically favorable, and future generations are not disadvantaged. The objective of this paper was to compare the environmental efficiency of 2 divergent strains of Holstein-Friesian cows across 2 contrasting dairy management systems (grazing and nongrazing) over multiple years and so expose any genetic × environment (G × E) interaction. The models were an extension of the traditional efficiency analysis to account for undesirable outputs (pollutants), and estimate efficiency measures that allow for the asymmetric treatment of desirable outputs (i.e., milk production) and undesirable outputs. Two types of models were estimated, one considering production inputs (land, nitrogen fertilizers, feed, and cows) and the other not, thus allowing the assessment of the effect of inputs by comparing efficiency values and rankings between models. Each model type had 2 versions, one including 2 types of pollutants (greenhouse gas emissions, nitrogen surplus) and the other 3 (greenhouse gas emissions, nitrogen surplus, and phosphorus surplus). Significant differences were found between efficiency scores among the systems. Results indicated no G × E interaction; however, even though the select genetic merit herd consuming a diet with a higher proportion of concentrated feeds was most efficient in the majority of models, cows of the same genetic merit on higher forage diets could be just as efficient. Efficiency scores for the low forage groups were less variable from year to year, which reflected the uniformity of purchased concentrate feeds. The results also indicate that inputs play an important role in the measurement of environmental efficiency of dairy systems and that animal health variables (incidence of udder health disorders and body condition

  9. Simulated spinal cerebrospinal fluid leak repair: an educational model with didactic and technical components.

    PubMed

    Ghobrial, George M; Anderson, Paul A; Chitale, Rohan; Campbell, Peter G; Lobel, Darlene A; Harrop, James

    2013-10-01

    In the era of surgical resident work hour restrictions, the traditional apprenticeship model may provide fewer hours for neurosurgical residents to hone technical skills. Spinal dura mater closure or repair is 1 skill that is infrequently encountered, and persistent cerebrospinal fluid leaks are a potential morbidity. To establish an educational curriculum to train residents in spinal dura mater closure with a novel durotomy repair model. The Congress of Neurological Surgeons has developed a simulation-based model for durotomy closure with the ongoing efforts of their simulation educational committee. The core curriculum consists of didactic training materials and a technical simulation model of dural repair for the lumbar spine. Didactic pretest scores ranged from 4/11 (36%) to 10/11 (91%). Posttest scores ranged from 8/11 (73%) to 11/11 (100%). Overall, didactic improvements were demonstrated by all participants, with a mean improvement between pre- and posttest scores of 1.17 (18.5%; P = .02). The technical component consisted of 11 durotomy closures by 6 participants, where 4 participants performed multiple durotomies. Mean time to closure of the durotomy ranged from 490 to 546 seconds in the first and second closures, respectively (P = .66), whereby the median leak rate improved from 14 to 7 (P = .34). There were also demonstrative technical improvements by all. Simulated spinal dura mater repair appears to be a potentially valuable tool in the education of neurosurgery residents. The combination of a didactic and technical assessment appears to be synergistic in terms of educational development.

  10. The Ability of Standardized Test Instruments to Differentiate Membership in Different Vocational-Technical Curricula. Project MINI-SCORE, Final Technical Report.

    ERIC Educational Resources Information Center

    Pucel, David J.; And Others

    Using post-secondary vocational education students as the populations, these two sub-studies of the Project MINI-SCORE sought to determine the extent to which pre-enrollment standardized test data can be used to predict vocational success. For the purpose of the study, vocational success was defined either as successful graduation or successful…

  11. Video Coaching as an Efficient Teaching Method for Surgical Residents-A Randomized Controlled Trial.

    PubMed

    Soucisse, Mikael L; Boulva, Kerianne; Sideris, Lucas; Drolet, Pierre; Morin, Michel; Dubé, Pierre

    As surgical training is evolving and operative exposure is decreasing, new, effective, and experiential learning methods are needed to ensure surgical competency and patient safety. Video coaching is an emerging concept in surgery that needs further investigation. In this randomized controlled trial conducted at a single teaching hospital, participating residents were filmed performing a side-to-side intestinal anastomosis on cadaveric dog bowel for baseline assessment. The Surgical Video Coaching (SVC) group then participated in a one-on-one video playback coaching and debriefing session with a surgeon, during which constructive feedback was given. The control group went on with their normal clinical duties without coaching or debriefing. All participants were filmed making a second intestinal anastomosis. This was compared to their first anastomosis using a 7-category-validated technical skill global rating scale, the Objective Structured Assessment of Technical Skills. A single independent surgeon who did not participate in coaching or debriefing to the SVC group reviewed all videos. A satisfaction survey was then sent to the residents in the coaching group. Department of Surgery, HôpitalMaisonneuve-Rosemont, tertiary teaching hospital affiliated to the University of Montreal, Canada. General surgery residents from University of Montreal were recruited to take part in this trial. A total of 28 residents were randomized and completed the study. After intervention, the SVC group (n = 14) significantly increased their Objective Structured Assessment of Technical Skills score (mean of differences 3.36, [1.09-5.63], p = 0.007) when compared to the control group (n = 14) (mean of differences 0.29, p = 0.759). All residents agreed or strongly agreed that video coaching was a time-efficient teaching method. Video coaching is an effective and efficient teaching intervention to improve surgical residents' technical skills. Crown Copyright © 2017. Published by Elsevier

  12. BASIC Computer Scoring Program for the Leadership Scale for Sports.

    ERIC Educational Resources Information Center

    Garland, Daniel J.

    This paper describes a computer scoring program, written in Commodore BASIC, that offers an efficient approach to the scoring of the Leadership Scale for Sports (LSS). The LSS measures: (1) the preferences of athletes for specific leader behaviors from the coach; (2) the perception of athletes regarding the actual leader behavior of their coach;…

  13. Movement evaluation of front crawl swimming: Technical skill versus aesthetic quality

    PubMed Central

    2017-01-01

    The study aim was to compare expert with non-expert swimmers’ rating of the aesthetic and technical qualities of front crawl in video-taped recordings of swimmers with low, middle, and high level proficiency. The results suggest that: i) observers’ experience affects their judgment: only the expert observers correctly rated the swimmers’ proficiency level; ii) evaluation of movement (technical and aesthetic scores) is correlated with the level of skill as expressed in the kinematics of the observed action (swimming speed, stroke frequency, and stroke length); iii) expert and non-expert observers use different strategies to rate the aesthetic and technical qualities of movement: equating the technical skill with the aesthetic quality is a general rule non-expert observers follow in the evaluation of human movement. PMID:28886063

  14. Interpretation and Utilization of Scores on the Air Force Officer Qualifying Test.

    ERIC Educational Resources Information Center

    Miller, Robert E.

    The report summarizes a large body of data relevant to the proper interpretation and use of aptitude scores on the Air Force Officer Qualifying Test (AFOQT). Included are descriptions of the AFOQT testing program and the test itself. Technical data include an extensive sampling of validation studies covering predictors of success in pilot…

  15. Efficiency in Resource Utilization in Education. Education and Development Technical Reports.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France). Directorate for Scientific Affairs.

    This volume consists of papers presented at a meeting of scientific and technical personnel who examined and evaluated applications of systems analysis and operational research, and who related techniques to practical educational planning. Topics represent a variety of new management techniques available to educational administrators including…

  16. Spatial abilities and technical skills performance in health care: a systematic review.

    PubMed

    Langlois, Jean; Bellemare, Christian; Toulouse, Josée; Wells, George A

    2015-11-01

    The aim of this study was to conduct a systematic review and meta-analysis of the relationship between spatial abilities and technical skills performance in health care in beginners and to compare this relationship with those in intermediate and autonomous learners. Search criteria included 'spatial abilities' and 'technical skills'. Keywords related to these criteria were defined. A literature search was conducted to 20 December, 2013 in Scopus (including MEDLINE) and in several databases on EBSCOhost platforms (CINAHL Plus with Full Text, ERIC, Education Source and PsycINFO). Citations were obtained and reviewed by two independent reviewers. Articles related to retained citations were reviewed and a final list of eligible articles was determined. Articles were assessed for quality using the Scottish Intercollegiate Guidelines Network-50 assessment instrument. Data were extracted from articles in a systematic way. Correlations between spatial abilities test scores and technical skills performance were identified. A series of 8289 citations was obtained. Eighty articles were retained and fully reviewed, yielding 36 eligible articles. The systematic review found a tendency for spatial abilities to be negatively correlated with the duration of technical skills and positively correlated with the quality of technical skills performance in beginners and intermediate learners. Pooled correlations of studies were -0.46 (p = 0.03) and -0.38 (95% confidence interval [CI] -0.53 to -0.21) for duration and 0.33 (95% CI 0.20-0.44) and 0.41 (95% CI 0.26-0.54) for quality of technical skills performance in beginners and intermediate learners, respectively. However, correlations between spatial abilities test scores and technical skills performance were not statistically significant in autonomous learners. Spatial abilities are an important factor to consider in selecting and training individuals in technical skills in health care. © 2015 John Wiley & Sons Ltd.

  17. Data Envelopment Analysis: Measurement of Educational Efficiency in Texas

    ERIC Educational Resources Information Center

    Carter, Lacy

    2012-01-01

    The purpose of this study was to examine the efficiency of Texas public school districts through Data Envelopment Analysis. The Data Envelopment Analysis estimation method calculated and assigned efficiency scores to each of the 931 school districts considered in the study. The efficiency scores were utilized in two phases. First, the school…

  18. Effects of measurement method and transcript availability on inexperienced raters' stuttering frequency scores.

    PubMed

    Chakraborty, Nalanda; Logan, Kenneth J

    To examine the effects of measurement method and transcript availability on the accuracy, reliability, and efficiency of inexperienced raters' stuttering frequency measurements. 44 adults, all inexperienced at evaluating stuttered speech, underwent 20 min of preliminary training in stuttering measurement and then analyzed a series of sentences, with and without access to transcripts of sentence stimuli, using either a syllable-based analysis (SBA) or an utterance-based analysis (UBA). Participants' analyses were compared between groups and to a composite analysis from two experienced evaluators. Stuttering frequency scores from the SBA and UBA groups differed significantly from the experienced evaluators' scores; however, UBA scores were significantly closer to the experienced evaluators' scores and were completed significantly faster than the SBA scores. Transcript availability facilitated scoring accuracy and efficiency in both groups. The internal reliability of stuttering frequency scores was acceptable for the SBA and UBA groups; however, the SBA group demonstrated only modest point-by-point agreement with ratings from the experienced evaluators. Given its accuracy and efficiency advantages over syllable-based analysis, utterance-based fluency analysis appears to be an appropriate context for introducing stuttering frequency measurement to raters who have limited experience in stuttering measurement. To address accuracy gaps between experienced and inexperienced raters, however, use of either analysis must be supplemented with training activities that expose inexperienced raters to the decision-making processes used by experienced raters when identifying stuttered syllables. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Comparing the efficiency of Fib-4, Egy-score, APRI, and GUCI in liver fibrosis staging in Egyptians with chronic hepatitis C.

    PubMed

    Cordie, Ahmed; Salama, Ahmed; El-Sharkawy, Marwa; El-Nahaas, Saeed M; Khairy, Marwa; Elsharkawy, Aisha; Hassany, Mohamed; Esmat, Gamal

    2018-06-01

    Assessment of hepatic fibrosis in chronic hepatitis C virus patients by liver biopsy is not widely accepted despite its accuracy, being invasive, carrying complications, and adding cost. This paved the way to development and use of non-invasive markers of fibrosis in diagnosis of hepatic fibrosis. We aimed at evaluating the efficiency of Fib-4, Egy-score, Aspartate-to-platelet ratio index (APRI), and Göteborg University Cirrhosis Index (GUCI) in comparison to liver biopsy, in the assessment of hepatic fibrosis in chronic hepatitis C patients. This was a cross sectional study including 200 chronic HCV patients were divided into two groups according to stage of fibrosis (Metavir score) into non-significant fibrosis (1.27, APRI >0.48, Egy-score >0.73, and GUCI >0.57 significantly predict significant fibrosis (P < 0.01). Fib-4 carries the best performance and significant reliability with AUROC 0.783, sensitivity 74%, specificity 69%, PPV 0.55, and NPV 0.86. The addition of BMI to Fib-4 improved the significant fibrosis AUROC curve performance but did not reach statistical significant improvement. We concluded that age and BMI are good predictors of hepatic fibrosis. Fib-4 (>1.27) is the best method of prediction of significant fibrosis compared to Egy-score, APRI, and GUCI. Addition of BMI to Fib-4 did not improve diagnostic value of Fib-4. © 2018 Wiley Periodicals, Inc.

  20. A Summary Score for the Framingham Heart Study Neuropsychological Battery

    PubMed Central

    Downer, Brian; Fardo, David W.; Schmitt, Frederick A.

    2015-01-01

    Objective To calculate three summary scores of the Framingham Heart Study neuropsychological battery and determine which score best differentiates between subjects classified as having normal cognition, test-based impaired learning and memory, test-based multidomain impairment, and dementia. Method The final sample included 2,503 participants. Three summary scores were assessed: (a) composite score that provided equal weight to each subtest, (b) composite score that provided equal weight to each cognitive domain assessed by the neuropsychological battery, and (c) abbreviated score comprised of subtests for learning and memory. Receiver operating characteristic analysis was used to determine which summary score best differentiated between the four cognitive states. Results The summary score that provided equal weight to each subtest best differentiated between the four cognitive states. Discussion A summary score that provides equal weight to each subtest is an efficient way to utilize all of the cognitive data collected by a neuropsychological battery. PMID:25804903

  1. A Summary Score for the Framingham Heart Study Neuropsychological Battery.

    PubMed

    Downer, Brian; Fardo, David W; Schmitt, Frederick A

    2015-10-01

    To calculate three summary scores of the Framingham Heart Study neuropsychological battery and determine which score best differentiates between subjects classified as having normal cognition, test-based impaired learning and memory, test-based multidomain impairment, and dementia. The final sample included 2,503 participants. Three summary scores were assessed: (a) composite score that provided equal weight to each subtest, (b) composite score that provided equal weight to each cognitive domain assessed by the neuropsychological battery, and (c) abbreviated score comprised of subtests for learning and memory. Receiver operating characteristic analysis was used to determine which summary score best differentiated between the four cognitive states. The summary score that provided equal weight to each subtest best differentiated between the four cognitive states. A summary score that provides equal weight to each subtest is an efficient way to utilize all of the cognitive data collected by a neuropsychological battery. © The Author(s) 2015.

  2. A Strategy for Replacing Sum Scoring

    ERIC Educational Resources Information Center

    Ramsay, James O.; Wiberg, Marie

    2017-01-01

    This article promotes the use of modern test theory in testing situations where sum scores for binary responses are now used. It directly compares the efficiencies and biases of classical and modern test analyses and finds an improvement in the root mean squared error of ability estimates of about 5% for two designed multiple-choice tests and…

  3. Technical writing versus technical writing

    NASA Technical Reports Server (NTRS)

    Dillingham, J. W.

    1981-01-01

    Two terms, two job categories, 'technical writer' and 'technical author' are discussed in terms of industrial and business requirements and standards. A distinction between 'technical writing' and technical 'writing' is made. The term 'technical editor' is also considered. Problems inherent in the design of programs to prepare and train students for these jobs are discussed. A closer alliance between industry and academia is suggested as a means of preparing students with competent technical communication skills (especially writing and editing skills) and good technical skills.

  4. An examination of competition and efficiency for hospital industry in Turkey.

    PubMed

    Özgen Narcı, Hacer; Ozcan, Yasar A; Şahin, İsmet; Tarcan, Menderes; Narcı, Mustafa

    2015-12-01

    The two particular reforms that have been undertaken under the Health Transformation Program in Turkey are enhancing efficiency and increasing competition. However, there is a lack of information about the relationship between competition and hospital efficiency. The purpose of this paper is to analyze the effect of competition on technical efficiency for the hospital industry in Turkey. The target population included all public and private general hospitals that were open in 2010 in Turkey (n = 1,224). From these, 1,103 hospitals met the selection criteria and were included in the study. Data were obtained from the Turkish Statistical Institute, the Ministry of Health, and through a field survey. Technical efficiency of hospitals was estimated using Data Envelopment Analysis with five outputs and five inputs. The intensity of competition among hospitals was measured by objective and subjective measures. Objective competition was measured using the Hirschman-Herfindahl Index, and subjective competition was measured based on the perceptions of top level hospital managers. Multivariate Tobit regression was used to investigate the relationship between competition and efficiency while controlling the effects of demand and supply characteristics of the market and the hospital traits. Efficiency results showed that 17% of hospitals were technically efficient. Regression analyses portrayed that the degree of competition among general hospitals did not have a statistically significant relationship with hospitals' technical efficiency. To conclude, hospital efficiency in Turkey does not seem to be affected by the intensity of competition among hospitals.

  5. 75 FR 59705 - Hydrogen and Fuel Cell Technical Advisory Committee (HTAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    ... DEPARTMENT OF ENERGY Hydrogen and Fuel Cell Technical Advisory Committee (HTAC) AGENCY: Department of Energy, Office of Energy Efficiency and Renewable Energy. ACTION: Notice of open meeting. SUMMARY: The Hydrogen and Fuel Cell Technical Advisory Committee (HTAC) was established under section 807 of...

  6. 75 FR 26743 - Hydrogen and Fuel Cell Technical Advisory Committee (HTAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... DEPARTMENT OF ENERGY Hydrogen and Fuel Cell Technical Advisory Committee (HTAC) AGENCY: Department of Energy, Office of Energy Efficiency and Renewable Energy. ACTION: Notice of Open Meeting. SUMMARY: The Hydrogen and Fuel Cell Technical Advisory Committee (HTAC) was established under section 807 of...

  7. Technical skills acquisition in surgery-bound senior medical students: an evaluation of student assertiveness.

    PubMed

    Talbott, Vanessa A; Marks, Joshua A; Bodzin, Adam S; Comeau, Jason A; Maxwell, Pinckney J; Isenberg, Gerald A; Martin, Niels D

    2012-01-01

    To prepare students pursuing surgical careers, we devised a senior subinternship curriculum supplement that focused on the acquisition of technical skills required of surgical residents. We hypothesized that more assertive students, those that accomplished more of the curriculum, would perform better on a technical skills Objective Structured Clinical Examination (OSCE). Senior medical students rotating on their first general surgery subinternship were administered a 6-station OSCE on the first day of their subinternship and again during the final week of the month-long rotation. A self-directed, 38-task "scavenger hunt" representing common intern level clinical skills, procedures, and patient care activities was provided to each student. The study was performed at Jefferson Medical College, a large, private medical school in Philadelphia, PA. Forty-nine senior students completed surgical subinternships between July 2009 and September 2010, and participated both in the pre-/post-OSCEs and the scavenger hunt. Students performed significantly better on the post-rotation OSCE than on the pre-rotation OSCE; 70.2% ± 8.1% vs. 60.4% ± 12.0%, p < 0.0001. Assertiveness scores from the "scavenger hunt" did not correlate with final OSCE scores (r = -0.328, p = 0.25), and were negatively correlated with the change between pre- and post-OSCE scores (r = -0.573, p < 0.04). Individual student assertiveness scores were determined by the number of tasks completed over the course of the rotation. As surgical education becomes more streamlined with evolving work hour restrictions, medical school education is playing an increasingly pivotal role in preparing students for internship. In our study, individual assertiveness in completing structured self-directed learning tasks did not directly predict the acquisition of proficiency in technical skills. We feel assertiveness is overshadowed by other factors that may carry more weight in terms of technical skills acquisition. Further

  8. Diagnostic Efficiency of easyCBM[R] Math: Oregon. Technical Report #1009

    ERIC Educational Resources Information Center

    Anderson, Daniel; Alonzo, Julie; Tindal, Gerald

    2010-01-01

    The easyCBM[R] assessment system is an online benchmark and progress monitoring assessment system designed for use within a response to intervention framework. Educators using easyCBM[R] are often interested in using the results to predict students' state test performance. In the following technical document, we report diagnostic efficiency…

  9. Measuring Technical Vocational Education and Training (TVET) Efficiency: Developing a Framework

    ERIC Educational Resources Information Center

    Liu, Guimei; Clayton, John

    2016-01-01

    The growing demand for an increasingly skilled competitive workforce and the associated demand for change and responsiveness in the provision of technical vocational education and training (TVET) has led to the development of stronger links between New Zealand and the People's Republic of China. A collaborative model programme project aims to…

  10. Performance scores and standings during the 43rd Artistic Gymnastics World Championships, 2011.

    PubMed

    Massidda, Myosotis; Calò, Carla M

    2012-01-01

    Scores in artistic gymnastics are subject to changes in the rules that occur each Olympic cycle as outlined in the Code of Points, because rules influence the composition of routines and therefore performance. The aim of this study was to identify the most important routine apparatus for success in a World competition. The data were the official results for the 478 gymnasts (262 men, 216 women) who competed in the 43rd Artistic Gymnastic World Championships in 2011 in Tokyo, Japan. The factors least influenced by the technical standard of competitors were performance scores on uneven bars and balance beam for women, and those on pommel horse for men. For uneven bars, balance beam, and pommel horse, scores were consistently good predictors of final standing. Our results suggest that high scores on these apparatus have a greater influence on overall performance than scores on the other apparatus, regardless of the competitors' standard.

  11. Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia.

    PubMed

    Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael

    2015-01-01

    The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20-1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24-1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings. QA/QI tools can be used to assess performance at health facilities and determine readiness for

  12. Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia

    PubMed Central

    Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael

    2015-01-01

    Introduction The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Methods Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. Results 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20–1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24–1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29–7.86) and in both rural and urban settings. Conclusions QA/QI tools can be used to assess performance at

  13. 77 FR 2714 - Hydrogen and Fuel Cell Technical Advisory Committee (HTAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-19

    ... DEPARTMENT OF ENERGY Hydrogen and Fuel Cell Technical Advisory Committee (HTAC) AGENCY: Department of Energy, Office of Energy Efficiency and Renewable Energy. ACTION: Notice of open meeting, Webinar. SUMMARY: This notice announces an open meeting of the Hydrogen and Fuel Cell Technical Advisory Committee...

  14. 78 FR 18578 - Hydrogen and Fuel Cell Technical Advisory Committee (HTAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Hydrogen and Fuel Cell... and Fuel Cell Technical Advisory Committee (HTAC). The Federal Advisory Committee Act, Public Law 92... Cell Technical Advisory Committee (HTAC) was established under section 807 of the Energy Policy Act of...

  15. The MoCA-Memory Index Score: An Efficient Alternative to Paragraph Recall for the Detection of Amnestic Mild Cognitive Impairment.

    PubMed

    Kaur, Antarpreet; Edland, Steven D; Peavy, Guerry M

    2018-01-01

    To compare ability of 2 measures of delayed memory (word list, story paragraph) to discriminate Normal Control (NC) subjects from those with amnestic mild cognitive impairment (aMCI). Demographic, neuropsychological, and diagnostic data contributed by 34 Alzheimer's Disease Centers to the National Alzheimer's Coordinating Center characterized 2717 individuals with a diagnosis of either NC (n=2205) or aMCI (n=512). The Montreal Cognitive Assessment-Memory Index Score (MoCA-MIS) assessed delayed word recall, and the Craft Story 21, delayed story recall. Logistic regression and receiver operator characteristic curves controlling for age, sex, and education assessed the ability of each test to differentiate NCs from subjects with aMCI. The MoCA-MIS had significantly better sensitivity and specificity (area under the receiver operator characteristic curve 0.83 vs. 0.80, P=0.004). At sensitivity 80%, the specificity of the MoCA-MIS was 69.1%, compared with 62.8% for the Craft Story. These data suggest that the MoCA-MIS, a recall score from items within the MoCA, is better at discriminating NCs from subjects with aMCI than the Craft Story. Word recall may be an efficient alternative to paragraph recall for diagnostic screening within clinical practice and research settings.

  16. Measuring efficiency of cotton cultivation in Pakistan: a restricted production frontier study.

    PubMed

    Watto, Muhammad Arif; Mugera, Amin

    2014-11-01

    Massive groundwater pumping for irrigation has started lowering water tables rapidly in different regions of Pakistan. Declining water tables have thus prompted research efforts to improve agricultural productivity and efficiency to make efficient use of scarce water resources. This study employs a restricted stochastic production frontier to estimate the level of, and factors affecting, technical efficiency of groundwater-irrigated cotton farms in the Punjab province of Pakistan. The mean technical efficiency estimates indicate substantial technical inefficiencies among cotton growers. On average, tube-well owners and water buyers can potentially increase cotton production by 19% and 28%, respectively, without increasing the existing input level. The most influential factors affecting technical efficiency positively are the use of improved quality seed, consultation with extension field staff and farmers' perceptions concerning the availability of groundwater resources for irrigation in the future. This study proposes that adopting improved seed for new cotton varieties and providing better extension services regarding cotton production technology would help to achieve higher efficiency in cotton farming. Within the context of falling water tables, educating farmers about the actual crop water requirements and guiding them about groundwater resource availability may also help to achieve higher efficiencies. © 2014 Society of Chemical Industry. © 2014 Society of Chemical Industry.

  17. Predictors of surgeons' efficiency in the operating rooms.

    PubMed

    Nakata, Yoshinori; Watanabe, Yuichi; Narimatsu, Hiroto; Yoshimura, Tatsuya; Otake, Hiroshi; Sawa, Tomohiro

    2017-02-01

    The sustainability of the Japanese healthcare system is questionable because of a huge fiscal debt. One of the solutions is to improve the efficiency of healthcare. The purpose of this study is to determine what factors are predictive of surgeons' efficiency scores. The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30 in 2013-2015. Output-oriented Charnes-Cooper-Rhodes model of data envelopment analysis was employed to calculate each surgeon's efficiency score. Seven independent variables that may predict their efficiency scores were selected: experience, medical school, surgical volume, gender, academic rank, surgical specialty, and the surgical fee schedule. Multiple regression analysis using random-effects Tobit model was used for our panel data. The data from total 8722 surgical cases were obtained in 18-month study period. The authors analyzed 134 surgeons. The only statistically significant coefficients were surgical specialty and surgical fee schedule (p = 0.000 and p = 0.016, respectively). Experience had some positive association with efficiency scores but did not reach statistical significance (p = 0.062). The other coefficients were not statistically significant. These results demonstrated that the surgical reimbursement system, not surgeons' personal characteristics, is a significant predictor of surgeons' efficiency.

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

    PubMed

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

    2017-03-01

    The number of patients using the internet to obtain health information is growing. This material is unregulated and heterogeneous and can influence patient decisions. To compare the quality, readability, and technical aspects of online information about neck-lifts provided by private practice websites vs academic medical centers and reference sources. In this cross-sectional analysis conducted between November 2015 and January 2016, a Google search of the term neck-lift was performed, and the first 45 websites were evaluated. The websites were categorized as private practice vs other. Private websites (PWs) included sites created by private practice physicians. Other websites (OWs) were created by academic medical centers or reference sources. Quality, readability, and technical aspects of online websites related to neck-lifts. Quality was assessed using the DISCERN criteria and the Health on the Net principles (HONcode). Readability was assessed using 7 validated and widely used criteria. Consensus US reading grade level readability was provided by a website (readabilityformulas.com). Twelve technical aspects were evaluated based on criteria specified by medical website creators. Forty-five websites (8 OWs [18%] and 37 PWs [82%]) were analyzed. There was a significant difference in quality between OWs and PWs based on the DISCERN criteria and HONcode principles. The DISCERN overall mean (SD) scores were 2.3 (0.5) for OWs and 1.3 (0.3) for PWs (P < .001). Of a total possible score of 14 using the HONcode analysis, the mean (SD) was 8.6 (1.8) (range, 5-11) for OW, and the mean (SD) was 5.8 (1.7) (range, 2-9) for PW. The mean (SD) readability consensus reading grade level scores were 11.7 (1.9) for OWs and 10.6 (1.9) for PWs. Of a total possible score of 12, the mean (SD) technical scores were 6.3 (1.8) (range, 4-9) for OWs and 6.4 (1.5) (range, 3-9) for PWs. Compared with PWs, OWs had a significantly higher quality score based on both the DISCERN criteria and

  19. Cathy Zoi on the new Home Energy Score pilot program

    ScienceCinema

    Zoi, Cathy

    2018-05-16

    Acting Under Secretary Cathy Zoi talks about the new Home Energy Score pilot program that was announced today by Vice President Biden and U.S. Department of Energy Secretary Steven Chu. The Home Energy Score will offer homeowners straightforward, reliable information about their homes' energy efficiency. A report provides consumers with a home energy score between 1 and 10, and shows them how their home compares to others in their region. The report also includes customized, cost-effective recommendations that will help to reduce their energy costs and improve the comfort of their homes.

  20. Some Characteristics and Writing Problems of Technically Oriented Students.

    ERIC Educational Resources Information Center

    Ruehr, Ruthann

    An understanding of the writing problems and personalities of some of the technically oriented students at Michigan Technological University may help others who teach similar students. Although their scores on aptitude tests are high, these students have had very little experience in writing. In addition, the majority of the students have had very…

  1. Technical and physical determinants of soccer match-play performance in elite youth soccer players.

    PubMed

    Rowat, Owain; Fenner, Jonathan; Unnithan, Viswanath

    2017-04-01

    The aim of this study was to evaluate whether physical performance characteristics could be a better predictor than technical skills in determining the technical level of county soccer players in a match situation. With institutional ethics approval, 25 male youth soccer players aged 16-18.5 years from a professional soccer academy in South East Asia were selected and height and body mass were recorded. Players were tested for sexual maturity (pubertal development scale [PDS] self-assessment), aerobic capacity (yo-yo intermittent recovery test level 1 [YYIR1]), repeated sprint ability (7 x 35 m sprints) acceleration (15 m sprint) and four soccer skills tests (dribble with pass, dribbling speed, passing and shooting accuracy). Players' technical ability during match play was assessed in small-sided games of soccer (5 v 5) using a novel game technical scoring chart (scoring chart completed by coaches to assess technical performance in a match situation) developed from criteria (e.g., first touch, dribbling and two footedness) used by youth soccer coaches for talent identification. A Spearman's rank correlation showed the YYIR1 test and 15 m sprint test were limited in predicting technical match performance (r=0.03, P=0.88, r=-0.23, P=0.32 respectively). A Pearson product moment correlation showed that the repeated sprint test was also limited in predicting technical match performance (r=-0.34, P=0.14). A dribbling skill with a pass was found to be the best determinant of a player's technical ability in a match (r=-0.57, P=0.00). Talent identification and selection programs in Asian youth soccer should include a dribbling skill performed with a pass.

  2. Assessing Technical Performance and Determining the Learning Curve in Cleft Palate Surgery Using a High-Fidelity Cleft Palate Simulator.

    PubMed

    Podolsky, Dale J; Fisher, David M; Wong Riff, Karen W; Szasz, Peter; Looi, Thomas; Drake, James M; Forrest, Christopher R

    2018-06-01

    This study assessed technical performance in cleft palate repair using a newly developed assessment tool and high-fidelity cleft palate simulator through a longitudinal simulation training exercise. Three residents performed five and one resident performed nine consecutive endoscopically recorded cleft palate repairs using a cleft palate simulator. Two fellows in pediatric plastic surgery and two expert cleft surgeons also performed recorded simulated repairs. The Cleft Palate Objective Structured Assessment of Technical Skill (CLOSATS) and end-product scales were developed to assess performance. Two blinded cleft surgeons assessed the recordings and the final repairs using the CLOSATS, end-product scale, and a previously developed global rating scale. The average procedure-specific (CLOSATS), global rating, and end-product scores increased logarithmically after each successive simulation session for the residents. Reliability of the CLOSATS (average item intraclass correlation coefficient (ICC), 0.85 ± 0.093) and global ratings (average item ICC, 0.91 ± 0.02) among the raters was high. Reliability of the end-product assessments was lower (average item ICC, 0.66 ± 0.15). Standard setting linear regression using an overall cutoff score of 7 of 10 corresponded to a pass score for the CLOSATS and the global score of 44 (maximum, 60) and 23 (maximum, 30), respectively. Using logarithmic best-fit curves, 6.3 simulation sessions are required to reach the minimum standard. A high-fidelity cleft palate simulator has been developed that improves technical performance in cleft palate repair. The simulator and technical assessment scores can be used to determine performance before operating on patients.

  3. Dump the pump: manual aspiration thrombectomy (MAT) with a syringe is technically effective, expeditious, and cost-efficient.

    PubMed

    Gross, Bradley A; Jadhav, Ashutosh P; Jovin, Tudor G; Jankowitz, Brian Thomas

    2018-04-01

    Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. To present in vitro and clinical results of MAT with a syringe. An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration. This was then complemented with prospective clinical data providing details of angiographic and clinical outcomes for syringe MAT. The in vitro analysis demonstrated that equal to slightly greater vacuum pressures were generated by a 60 cc syringe as compared with the pump in both static and partial flow conditions. In our clinical series, 106/113 acute stroke thrombectomies over a 6-month period were performed with syringe MAT on the first pass. Syringe usage instead of pump tubing and a canister led to a total savings of $58 300. The rate of Thrombolysis in Cerebral Infarction 2b/3 recanalization was 93%. Adjunctive stentriever usage was performed in 23% of cases. Median puncture to reperfusion time was 25 min; mean change in National Institute of Health Stroke Scale score at 24 hours was an improvement of 5.1 (median 6). The in-hospital mortality rate was 10%. Seventy percent of patients were discharged to home (modified Rankin Scale (mRS) score 0-2) or a rehabilitation facility (mRS score 2-4). MAT using a syringe is a safe, fast, and more cost-effective approach than using an aspiration pump. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. The Relation between Factor Score Estimates, Image Scores, and Principal Component Scores

    ERIC Educational Resources Information Center

    Velicer, Wayne F.

    1976-01-01

    Investigates the relation between factor score estimates, principal component scores, and image scores. The three methods compared are maximum likelihood factor analysis, principal component analysis, and a variant of rescaled image analysis. (RC)

  5. A Theory of Sex Differences in Technical Aptitude and Some Supporting Evidence.

    PubMed

    Schmidt, Frank L

    2011-11-01

    In this article, I present a theory that explains the origin of sex differences in technical aptitudes. The theory takes as proven that there are no sex differences in general mental ability (GMA), and it postulates that sex differences in technical aptitude (TA) stem from differences in experience in technical areas, which is in turn based on sex differences in technical interests. Using a large data set, I tested and found support for four predictions made by this theory: (a) the construct level correlation between technical aptitude and GMA is larger for females than males, (b) the observed and true score variability of technical aptitude is greater among males than females, (c) at every level of GMA females have lower levels of technical aptitude, and (d) technical aptitude measures used as estimates of GMA for decision purposes would result in underestimation of GMA levels for girls and women. Given that GMA carries the weight of prediction of job performance, the support found for this last prediction suggests that, for many jobs, technical aptitude tests may underpredict the job performance of female applicants and employees. Future research should examine this question. © Association for Psychological Science 2011.

  6. Data-Driven Benchmarking of Building Energy Efficiency Utilizing Statistical Frontier Models

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kavousian, A; Rajagopal, R

    2014-01-01

    Frontier methods quantify the energy efficiency of buildings by forming an efficient frontier (best-practice technology) and by comparing all buildings against that frontier. Because energy consumption fluctuates over time, the efficiency scores are stochastic random variables. Existing applications of frontier methods in energy efficiency either treat efficiency scores as deterministic values or estimate their uncertainty by resampling from one set of measurements. Availability of smart meter data (repeated measurements of energy consumption of buildings) enables using actual data to estimate the uncertainty in efficiency scores. Additionally, existing applications assume a linear form for an efficient frontier; i.e.,they assume that themore » best-practice technology scales up and down proportionally with building characteristics. However, previous research shows that buildings are nonlinear systems. This paper proposes a statistical method called stochastic energy efficiency frontier (SEEF) to estimate a bias-corrected efficiency score and its confidence intervals from measured data. The paper proposes an algorithm to specify the functional form of the frontier, identify the probability distribution of the efficiency score of each building using measured data, and rank buildings based on their energy efficiency. To illustrate the power of SEEF, this paper presents the results from applying SEEF on a smart meter data set of 307 residential buildings in the United States. SEEF efficiency scores are used to rank individual buildings based on energy efficiency, to compare subpopulations of buildings, and to identify irregular behavior of buildings across different time-of-use periods. SEEF is an improvement to the energy-intensity method (comparing kWh/sq.ft.): whereas SEEF identifies efficient buildings across the entire spectrum of building sizes, the energy-intensity method showed bias toward smaller buildings. The results of this research are expected to

  7. Measuring and explaining multi-directional inefficiency in the Malaysian dairy industry.

    PubMed

    Mohd Suhaimi, Nurul Aisyah Binti; de Mey, Yann; Oude Lansink, Alfons

    2017-01-01

    The purpose of this paper is to measure the technical inefficiency of dairy farms and subsequently investigate the factors affecting technical inefficiency in the Malaysian dairy industry. This study uses multi-directional efficiency analysis to measure the technical inefficiency scores on a sample of 200 farm observations and single-bootstrap truncated regression model to define factors affecting technical inefficiency. Managerial and program inefficiency scores are presented for intensive and semi-intensive production systems. The results reveal marked differences in the inefficiency scores across inputs and between production systems. Intensive systems generally have lowest managerial and program inefficiency scores in the Malaysian dairy farming sector. Policy makers could use this information to advise dairy farmers to convert their farming system to the intensive system. The results suggest that the Malaysian Government should redefine its policy for providing farm finance and should target young farmers when designing training and extension programs in order to improve the performance of the dairy sector. The existing literature on Southeast Asian dairy farming has neither focused on investigating input-specific efficiency nor on comparing managerial and program efficiency. This paper aims to fill this gap.

  8. Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

    PubMed

    Palter, Vanessa N; Grantcharov, Teodor P

    2014-03-01

    The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. Training on VR simulators has been shown to improve technical performance in the operating room (OR). Currently described VR curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether the individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate into the OR. This single-blinded prospective trial randomized 16 novice surgical residents to a deliberate practice (DP) group and a conventional residency training group. Both groups performed a laparoscopic cholecystectomy in the OR that was video-recorded. Technical performance of DP group residents in the OR was assessed using 3 validated assessment tools. A score of less than 60% on any component of the assessment tool resulted in the trainee practicing a specific task on the VR simulator. The DP group practiced on the simulator as per their individualized schedule. Both groups then performed another laparoscopic cholecystectomy. A blinded expert assessed the OR recordings using a validated global rating scale. Although both groups had similar technical abilities preintervention [DP: median score, 13.5 (9.3-15.0); control: median score, 14.5 (9.3-17.8); P = 0.45], the DP residents had a superior technical performance postintervention [DP: median score, 17.0 (15.3-18.5); control: median score, 12.5 (7.5-14.0); P = 0.03]. Of 8 DP residents, 6 practiced 5 basic VR tasks (median 1 trial to pass), and 7 of 8 practiced 2 advanced tasks (median 4 trials to pass). A curriculum of deliberate individualized practice on a VR simulator improves technical performance in the OR. This has implications to greatly improve the feasibility of implementing simulation-based curricula in residency training

  9. Investigating the technical adequacy of curriculum-based measurement in written expression for students who are deaf or hard of hearing.

    PubMed

    Cheng, Shu-Fen; Rose, Susan

    2009-01-01

    This study investigated the technical adequacy of curriculum-based measures of written expression (CBM-W) in terms of writing prompts and scoring methods for deaf and hard-of-hearing students. Twenty-two students at the secondary school-level completed 3-min essays within two weeks, which were scored for nine existing and alternative curriculum-based measurement (CBM) scoring methods. The technical features of the nine scoring methods were examined for interrater reliability, alternate-form reliability, and criterion-related validity. The existing CBM scoring method--number of correct minus incorrect word sequences--yielded the highest reliability and validity coefficients. The findings from this study support the use of the CBM-W as a reliable and valid tool for assessing general writing proficiency with secondary students who are deaf or hard of hearing. The CBM alternative scoring methods that may serve as additional indicators of written expression include correct subject-verb agreements, correct clauses, and correct morphemes.

  10. Do technical skills correlate with non-technical skills in crisis resource management: a simulation study.

    PubMed

    Riem, N; Boet, S; Bould, M D; Tavares, W; Naik, V N

    2012-11-01

    Both technical skills (TS) and non-technical skills (NTS) are key to ensuring patient safety in acute care practice and effective crisis management. These skills are often taught and assessed separately. We hypothesized that TS and NTS are not independent of each other, and we aimed to evaluate the relationship between TS and NTS during a simulated intraoperative crisis scenario. This study was a retrospective analysis of performances from a previously published work. After institutional ethics approval, 50 anaesthesiology residents managed a simulated crisis scenario of an intraoperative cardiac arrest secondary to a malignant arrhythmia. We used a modified Delphi approach to design a TS checklist, specific for the management of a malignant arrhythmia requiring defibrillation. All scenarios were recorded. Each performance was analysed by four independent experts. For each performance, two experts independently rated the technical performance using the TS checklist, and two other experts independently rated NTS using the Anaesthetists' Non-Technical Skills score. TS and NTS were significantly correlated to each other (r=0.45, P<0.05). During a simulated 5 min resuscitation requiring crisis resource management, our results indicate that TS and NTS are related to one another. This research provides the basis for future studies evaluating the nature of this relationship, the influence of NTS training on the performance of TS, and to determine whether NTS are generic and transferrable between crises that require different TS.

  11. Efficiency disparities among community hospitals in Tennessee: do size, location, ownership, and network matter?

    PubMed

    Roh, Chul-Young; Moon, M Jae; Jung, Kwangho

    2013-11-01

    This study examined the impact of ownership, size, location, and network on the relative technical efficiency of community hospitals in Tennessee for the 2002-2006 period, by applying data envelopment analysis (DEA) to measure technical efficiency (decomposed into scale efficiency and pure technical efficiency). Data envelopment analysis results indicate that medium-size hospitals (126-250 beds) are more efficient than their counterparts. Interestingly, public hospitals are significantly more efficient than private and nonprofit hospitals in Tennessee, and rural hospitals are more efficient than urban hospitals. This is the first study to investigate whether hospital networks with other health care providers affect hospital efficiency. Results indicate that community hospitals with networks are more efficient than non-network hospitals. From a management and policy perspective, this study suggests that public policies should induce hospitals to downsize or upsize into optional size, and private hospitals and nonprofit hospitals should change their organizational objectives from profit-driven to quality-driven.

  12. Measuring energy efficiency in economics: Shadow value approach

    NASA Astrophysics Data System (ADS)

    Khademvatani, Asgar

    For decades, academic scholars and policy makers have commonly applied a simple average measure, energy intensity, for studying energy efficiency. In contrast, we introduce a distinctive marginal measure called energy shadow value (SV) for modeling energy efficiency drawn on economic theory. This thesis demonstrates energy SV advantages, conceptually and empirically, over the average measure recognizing marginal technical energy efficiency and unveiling allocative energy efficiency (energy SV to energy price). Using a dual profit function, the study illustrates how treating energy as quasi-fixed factor called quasi-fixed approach offers modeling advantages and is appropriate in developing an explicit model for energy efficiency. We address fallacies and misleading results using average measure and demonstrate energy SV advantage in inter- and intra-country energy efficiency comparison. Energy efficiency dynamics and determination of efficient allocation of energy use are shown through factors impacting energy SV: capital, technology, and environmental obligations. To validate the energy SV, we applied a dual restricted cost model using KLEM dataset for the 35 US sectors stretching from 1958 to 2000 and selected a sample of the four sectors. Following the empirical results, predicted wedges between energy price and the SV growth indicate a misallocation of energy use in stone, clay and glass (SCG) and communications (Com) sectors with more evidence in the SCG compared to the Com sector, showing overshoot in energy use relative to optimal paths and cost increases from sub-optimal energy use. The results show that energy productivity is a measure of technical efficiency and is void of information on the economic efficiency of energy use. Decomposing energy SV reveals that energy, capital and technology played key roles in energy SV increases helping to consider and analyze policy implications of energy efficiency improvement. Applying the marginal measure, we also

  13. Technical Assistance to Developers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rockward, Tommy; Borup, Rodney L.; Garzon, Fernando H.

    2012-07-17

    This task supports the allowance of technical assistance to fuel-cell component and system developers as directed by the DOE. This task includes testing of novel materials and participation in the further development and validation of single cell test protocols. This task also covers technical assistance to DOE Working Groups, the U.S. Council for Automotive Research (USCAR) and the USCAR/DOE Driving Research and Innovation for Vehicle efficiency and Energy sustainability (U.S. Drive) Fuel Cell Technology Team. Assistance includes technical validation of new fuel cell materials and methods, single cell fuel cell testing to support the development of targets and test protocols,more » and regular advisory participation in other working groups and reviews. This assistance is made available to PEM fuel cell developers by request and DOE Approval. The objectives are to: (1) Support technically, as directed by DOE, fuel cell component and system developers; (2) Assess fuel cell materials and components and give feedback to developers; (3) Assist the DOE Durability Working Group with the development of various new material durability Testing protocols; and (4) Provide support to the U.S. Council for Automotive Research (USCAR) and the USCAR/DOE Fuel Cell Technology Team. FY2012 specific technical objectives are: (1) Evaluate novel MPL materials; (2) Develop of startup/ shutdown protocol; (3) Test the impact of hydrophobic treatment on graphite bi-polar plates; (4) Perform complete diagnostics on metal bi-polar plates for corrosion; and (5) Participate and lead efforts in the DOE Working Groups.« less

  14. Energy Efficiency Roadmap for Uganda, Making Energy Efficiency Count. Executive Summary

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    de la Rue du Can, Stephane; Pudleiner, David; Jones, David

    Like many countries in Sub-Saharan Africa, Uganda has focused its energy sector investments largely on increasing energy access by increasing energy supply. The links between energy efficiency and energy access, the importance of energy efficiency in new energy supply, and the multiple benefits of energy efficiency for the level and quality of energy available, have been largely overlooked. Implementing energy efficiency in parallel with expanding both the electricity grid and new clean energy generation reduces electricity demand and helps optimize the power supply so that it can serve more customers reliably at minimum cost. Ensuring efficient appliances are incorporated intomore » energy access efforts provides improved energy services to customers. Energy efficiency is an important contributor to access to modern energy. This Energy Efficiency Roadmap for Uganda (Roadmap) is a response to the important role that electrical energy efficiency can play in meeting Uganda’s energy goals. Power Africa and the United Nations Sustainable Energy for All (SEforALL) initiatives collaborated with more than 24 stakeholders in Uganda to develop this document. The document estimates that if the most efficient technologies on the market were adopted, 2,224 gigawatt hours could be saved in 2030 across all sectors, representing 31% of the projected load. This translates into 341 megawatts of peak demand reductions, energy access to an additional 6 million rural customers and reduction of carbon dioxide emissions by 10.6 million tonnes in 2030. The Roadmap also finds that 91% of this technical potential is cost-effective, and 47% is achievable under conservative assumptions. The Roadmap prioritizes recommendations for implementing energy efficiency and maximizing benefits to meet the goals and priorities established in Uganda’s 2015 SEforALL Action Agenda. One important step is to create and increase demand for efficiency through long-term enabling policies and financial

  15. Scoring ligand similarity in structure-based virtual screening.

    PubMed

    Zavodszky, Maria I; Rohatgi, Anjali; Van Voorst, Jeffrey R; Yan, Honggao; Kuhn, Leslie A

    2009-01-01

    Scoring to identify high-affinity compounds remains a challenge in virtual screening. On one hand, protein-ligand scoring focuses on weighting favorable and unfavorable interactions between the two molecules. Ligand-based scoring, on the other hand, focuses on how well the shape and chemistry of each ligand candidate overlay on a three-dimensional reference ligand. Our hypothesis is that a hybrid approach, using ligand-based scoring to rank dockings selected by protein-ligand scoring, can ensure that high-ranking molecules mimic the shape and chemistry of a known ligand while also complementing the binding site. Results from applying this approach to screen nearly 70 000 National Cancer Institute (NCI) compounds for thrombin inhibitors tend to support the hypothesis. EON ligand-based ranking of docked molecules yielded the majority (4/5) of newly discovered, low to mid-micromolar inhibitors from a panel of 27 assayed compounds, whereas ranking docked compounds by protein-ligand scoring alone resulted in one new inhibitor. Since the results depend on the choice of scoring function, an analysis of properties was performed on the top-scoring docked compounds according to five different protein-ligand scoring functions, plus EON scoring using three different reference compounds. The results indicate that the choice of scoring function, even among scoring functions measuring the same types of interactions, can have an unexpectedly large effect on which compounds are chosen from screening. Furthermore, there was almost no overlap between the top-scoring compounds from protein-ligand versus ligand-based scoring, indicating the two approaches provide complementary information. Matchprint analysis, a new addition to the SLIDE (Screening Ligands by Induced-fit Docking, Efficiently) screening toolset, facilitated comparison of docked molecules' interactions with those of known inhibitors. The majority of interactions conserved among top-scoring compounds for a given scoring

  16. Evaluation of performance and impacts of maternal and child health hospital services using Data Envelopment Analysis in Guangxi Zhuang Autonomous Region, China: a comparison study among poverty and non-poverty county level hospitals.

    PubMed

    Wang, Xuan; Luo, Hongye; Qin, Xianjin; Feng, Jun; Gao, Hongda; Feng, Qiming

    2016-08-23

    As the core of the county-level Maternal and Child Health Hospitals (MCHH) in rural areas of China, the service efficiency affects the fairness and availability of healthcare services. This study aims to identify the determinants of hospital efficiency and explore how to improve the performance of MCHH in terms of productivity and efficiency. Data was collected from a sample of 32 county-level MCHHs of Guangxi in 2014. Firstly, we specified and measured the indicators of the inputs and outputs which represent hospital resources expended and its profiles respectively. Then we estimated the efficiency scores using Data Envelopment Analysis (DEA) for each hospital. Efficiency scores were decomposed into technical, scale and congestion components, and the potential output increases and/or input reductions were also estimated in this model, which would make relatively inefficient hospitals more efficient. In the second stage, the estimated efficiency scores are regressed against hospital external and internal environment factors using a Tobit model. We used DEAP (V2.1) and R for data analysis. The average scores of technical efficiency, net technical efficiency (managerial efficiency) and scale efficiency of the hospitals were 0.875, 0.922 and 0.945, respectively. Half of the hospitals were efficient, and 9.4 % and 40.6 % were weakly efficient and inefficient, respectively. Among the low-productiveness hospitals, 61.1 % came from poor counties (Poor counties in this article are in the list of key poverty-stricken counties at the national level, published by The State Council Leading Group Office of Poverty Alleviation and Development, 2012). The total input indicated that redundant medical resources in poverty areas were significantly higher than those in non-poverty areas. The Tobit regression model showed that the technical efficiency was proportional to the total annual incomes, the number of discharge patients, and the number of outpatient and emergency visits

  17. Scoring best-worst data in unbalanced many-item designs, with applications to crowdsourcing semantic judgments.

    PubMed

    Hollis, Geoff

    2018-04-01

    Best-worst scaling is a judgment format in which participants are presented with a set of items and have to choose the superior and inferior items in the set. Best-worst scaling generates a large quantity of information per judgment because each judgment allows for inferences about the rank value of all unjudged items. This property of best-worst scaling makes it a promising judgment format for research in psychology and natural language processing concerned with estimating the semantic properties of tens of thousands of words. A variety of different scoring algorithms have been devised in the previous literature on best-worst scaling. However, due to problems of computational efficiency, these scoring algorithms cannot be applied efficiently to cases in which thousands of items need to be scored. New algorithms are presented here for converting responses from best-worst scaling into item scores for thousands of items (many-item scoring problems). These scoring algorithms are validated through simulation and empirical experiments, and considerations related to noise, the underlying distribution of true values, and trial design are identified that can affect the relative quality of the derived item scores. The newly introduced scoring algorithms consistently outperformed scoring algorithms used in the previous literature on scoring many-item best-worst data.

  18. Stochastic Frontier Model Approach for Measuring Stock Market Efficiency with Different Distributions

    PubMed Central

    Hasan, Md. Zobaer; Kamil, Anton Abdulbasah; Mustafa, Adli; Baten, Md. Azizul

    2012-01-01

    The stock market is considered essential for economic growth and expected to contribute to improved productivity. An efficient pricing mechanism of the stock market can be a driving force for channeling savings into profitable investments and thus facilitating optimal allocation of capital. This study investigated the technical efficiency of selected groups of companies of Bangladesh Stock Market that is the Dhaka Stock Exchange (DSE) market, using the stochastic frontier production function approach. For this, the authors considered the Cobb-Douglas Stochastic frontier in which the technical inefficiency effects are defined by a model with two distributional assumptions. Truncated normal and half-normal distributions were used in the model and both time-variant and time-invariant inefficiency effects were estimated. The results reveal that technical efficiency decreased gradually over the reference period and that truncated normal distribution is preferable to half-normal distribution for technical inefficiency effects. The value of technical efficiency was high for the investment group and low for the bank group, as compared with other groups in the DSE market for both distributions in time- varying environment whereas it was high for the investment group but low for the ceramic group as compared with other groups in the DSE market for both distributions in time-invariant situation. PMID:22629352

  19. Stochastic frontier model approach for measuring stock market efficiency with different distributions.

    PubMed

    Hasan, Md Zobaer; Kamil, Anton Abdulbasah; Mustafa, Adli; Baten, Md Azizul

    2012-01-01

    The stock market is considered essential for economic growth and expected to contribute to improved productivity. An efficient pricing mechanism of the stock market can be a driving force for channeling savings into profitable investments and thus facilitating optimal allocation of capital. This study investigated the technical efficiency of selected groups of companies of Bangladesh Stock Market that is the Dhaka Stock Exchange (DSE) market, using the stochastic frontier production function approach. For this, the authors considered the Cobb-Douglas Stochastic frontier in which the technical inefficiency effects are defined by a model with two distributional assumptions. Truncated normal and half-normal distributions were used in the model and both time-variant and time-invariant inefficiency effects were estimated. The results reveal that technical efficiency decreased gradually over the reference period and that truncated normal distribution is preferable to half-normal distribution for technical inefficiency effects. The value of technical efficiency was high for the investment group and low for the bank group, as compared with other groups in the DSE market for both distributions in time-varying environment whereas it was high for the investment group but low for the ceramic group as compared with other groups in the DSE market for both distributions in time-invariant situation.

  20. Selected Technical and Economic Comparisons of Synfuel Options

    DOT National Transportation Integrated Search

    1981-04-01

    This study is a comparative technical and economic assessment of selected synfuel technologies. It contains papers written for Office of Technology Assessment (OTA) to assist in preparation of the report "Increased Automobile Fuel Efficiency and Synt...

  1. [Definition of the Diagnosis Osteomyelitis-Osteomyelitis Diagnosis Score (ODS)].

    PubMed

    Schmidt, H G K; Tiemann, A H; Braunschweig, R; Diefenbeck, M; Bühler, M; Abitzsch, D; Haustedt, N; Walter, G; Schoop, R; Heppert, V; Hofmann, G O; Glombitza, M; Grimme, C; Gerlach, U-J; Flesch, I

    2011-08-01

    The disease "osteomyelitis" is characterised by different symptoms and parameters. Decisive roles in the development of the disease are played by the causative bacteria, the route of infection and the individual defense mechanisms of the host. The diagnosis is based on different symptoms and findings from the clinical history, clinical symptoms, laboratory results, diagnostic imaging, microbiological and histopathological analyses. While different osteomyelitis classifications have been published, there is to the best of our knowledge no score that gives information how sure the diagnosis "osteomyelitis" is in general. For any scientific study of a disease a valid definition is essential. We have developed a special osteomyelitis diagnosis score for the reliable classification of clinical, laboratory and technical findings. The score is based on five diagnostic procedures: 1) clinical history and risk factors, 2) clinical examination and laboratory results, 3) diagnostic imaging (ultrasound, radiology, CT, MRI, nuclear medicine and hybrid methods), 4) microbiology, and 5) histopathology. Each diagnostic procedure is related to many individual findings, which are weighted by a score system, in order to achieve a relevant value for each assessment. If the sum of the five diagnostic criteria is 18 or more points, the diagnosis of osteomyelitis can be viewed as "safe" (diagnosis class A). Between 8-17 points the diagnosis is "probable" (diagnosis class B). Less than 8 points means that the diagnosis is "possible, but unlikely" (class C diagnosis). Since each parameter can score six points at a maximum, a reliable diagnosis can only be achieved if at least 3 parameters are scored with 6 points. The osteomyelitis diagnosis score should help to avoid the false description of a clinical presentation as "osteomyelitis". A safe diagnosis is essential for the aetiology, treatment and outcome studies of osteomyelitis. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

    NASA Astrophysics Data System (ADS)

    Gatot, D.; Mardia, A. I.

    2018-03-01

    Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

  3. Using the EZ-Diffusion Model to Score a Single-Category Implicit Association Test of Physical Activity

    PubMed Central

    Rebar, Amanda L.; Ram, Nilam; Conroy, David E.

    2014-01-01

    Objective The Single-Category Implicit Association Test (SC-IAT) has been used as a method for assessing automatic evaluations of physical activity, but measurement artifact or consciously-held attitudes could be confounding the outcome scores of these measures. The objective of these two studies was to address these measurement concerns by testing the validity of a novel SC-IAT scoring technique. Design Study 1 was a cross-sectional study, and study 2 was a prospective study. Method In study 1, undergraduate students (N = 104) completed SC-IATs for physical activity, flowers, and sedentary behavior. In study 2, undergraduate students (N = 91) completed a SC-IAT for physical activity, self-reported affective and instrumental attitudes toward physical activity, physical activity intentions, and wore an accelerometer for two weeks. The EZ-diffusion model was used to decompose the SC-IAT into three process component scores including the information processing efficiency score. Results In study 1, a series of structural equation model comparisons revealed that the information processing score did not share variability across distinct SC-IATs, suggesting it does not represent systematic measurement artifact. In study 2, the information processing efficiency score was shown to be unrelated to self-reported affective and instrumental attitudes toward physical activity, and positively related to physical activity behavior, above and beyond the traditional D-score of the SC-IAT. Conclusions The information processing efficiency score is a valid measure of automatic evaluations of physical activity. PMID:25484621

  4. Genetic response to selection for weaning weight or yearling weight or yearling weight and muscle score in Hereford cattle: efficiency of gain, growth, and carcass characteristics.

    PubMed

    Koch, R M; Cundiff, L V; Gregory, K E; Van Vleck, L D

    2004-03-01

    An experiment involving crosses among selection and control lines was conducted to partition direct and maternal additive genetic response to 20 yr of selection for 1) weaning weight, 2) yearling weight, and 3) index of yearling weight and muscle score. Selection response was evaluated for efficiency of gain, growth from birth through market weight, and carcass characteristics. Heritability and genetic correlations among traits were estimated using animal model analyses. Over a time-constant interval, selected lines were heavier, gained more weight, consumed more ME, and had more gain/ME than the control. Over a weight-constant interval, selected lines required fewer days, consumed less ME, had more efficient gains, and required less energy for maintenance than control. Direct and maternal responses were estimated from reciprocal crosses among unselected sires and dams of control and selection lines. Most of the genetic response to selection in all three lines was associated with direct genetic effects, and the highest proportion was from postweaning gain. Indirect responses of carcass characteristics to selection over the 20 yr were increased weight of carcasses that had more lean meat, produced with less feed per unit of gain. At a constant carcass weight, selected lines had 1.32 to 1.85% more retail product and 1.62 to 2.24% less fat trim and 10/100 to 25/100 degrees less marbling than control. At a constant age, heritability of direct and maternal effects and correlations between them were as follows: market weight, 0.36, 0.14, and 0.10; carcass weight, 0.26, 0.15, and 0.03; longissimus muscle area, 0.33, 0.00, and 0.00; marbling, 0.36, 0.07, and -0.35; fat thickness, 0.41, 0.05, and -0.18; percentage of kidney, pelvic, and heart fat, 0.12, 0.08, and -0.76; percentage of retail product, 0.46, 0.05, and -0.29; retail product weight, 0.44, 0.08, -0.14; and muscle score, 0.37, 0.14, and -0.54. Selection criteria in all lines improved efficiency of postweaning gain

  5. 76 FR 28759 - Hydrogen and Fuel Cell Technical Advisory Committee (HTAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-18

    ... Advisory Committee (HTAC) was established under section 807 of the Energy Policy Act of 2005 (EPACT... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Hydrogen and Fuel Cell Technical Advisory Committee (HTAC) AGENCY: Office of Energy Efficiency and Renewable Energy, Department of...

  6. Firm Efficiency and Returns-to-Scale in the Honey Bee Pollination Services Industry.

    PubMed

    Jones Ritten, Chian; Peck, Dannele; Ehmke, Mariah; Patalee, M A Buddhika

    2018-04-03

    While the demand for pollination services have been increasing, continued declines in honey bee, Apis mellifera L. (Hymenoptera: Apidae), colonies have put the cropping sector and the broader health of agro-ecosystems at risk. Economic factors may play a role in dwindling honey bee colony supply in the United States, but have not been extensively studied. Using data envelopment analysis (DEA), we measure technical efficiency, returns to scale, and factors influencing the efficiency of those apiaries in the northern Rocky Mountain region participating in the pollination services market. We find that, although over 25% of apiaries are technically efficient, many experience either increasing or decreasing returns to scale. Smaller apiaries (under 80 colonies) experience increasing returns to scale, but a lack of available financing may hinder them from achieving economically sustainable colony levels. Larger apiaries (over 1,000 colonies) experience decreasing returns to scale. Those beekeepers may have economic incentivizes to decrease colony numbers. Using a double bootstrap method, we find that apiary location and off-farm employment influence apiary technical efficiency. Apiaries in Wyoming are found to be more efficient than those in Utah or Montana. Further, engagement in off-farm employment increases an apiary's technical efficiency. The combined effects of efficiency gains through off-farm employment and diseconomies of scale may explain, in part, the historical decline in honey bee numbers.

  7. Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method.

    PubMed

    Sultan, Wasim I M; Crispim, José

    2018-05-29

    While health needs and expenditure in the Occupied Palestinian Territories (OPT) are growing, the international donations are declining and the economic situation is worsening. The purpose of this paper is twofold, to evaluate the productive efficiency of public hospitals in West Bank and to study contextual factors contributing to efficiency differences. This study examined technical efficiency among 11 public hospitals in West Bank from 2010 through 2015 targeting a total of 66 observations. Nationally representative data were extracted from the official annual health reports. We applied input-oriented Data Envelopment Analysis (DEA) models to estimate efficiency scores. To elaborate further on performance, we used Tobit regression to identify contextual factors whose impact on inefficient performance is statistically significant. Despite the increase in efficiency mean scores by 4% from 2010 to 2015, findings show potential savings of 14.5% of resource consumption without reducing the volume of the provided services. The significant Tobit model showed four predictors explaining the inefficient performance of a hospital (p <  0.01) are: bed occupancy rate (BOR); the outpatient-inpatient ratio (OPIPR); hospital's size (SIZE); and the availability of primary healthcare centers within the hospital's catchment area (PRC). There is a strong effect of OPIPR on efficiency differences between hospitals: A one unit increase in OPIPR will lead a decrease of 19.7% in the predicted inefficiency level holding all other factors constant. To date, no previous studies have examined the efficiency of public hospitals in the OPT. Our work identified their efficiency levels for potential improvements and the determinants of efficient performance. Based on the measurement of efficiency, the generated information may guide hospitals' managers, policymakers, and international donors improving the performance of the main national healthcare provider. The scope of this study is

  8. Correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) scores with legacy patient-reported outcome scores in patients undergoing rotator cuff repair.

    PubMed

    Patterson, Brendan M; Orvets, Nathan D; Aleem, Alexander W; Keener, Jay D; Calfee, Ryan P; Nixon, Devon C; Chamberlain, Aaron M

    2018-06-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS) is being used to assess outcomes in many patient populations despite limited validation. The purpose of this study was to investigate the relationship between American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) scores and PROMIS Physical Function (PF) and Upper Extremity (UE) function scores collected preoperatively in patients undergoing rotator cuff repair. This cross-sectional study analyzed 164 consecutive patients undergoing arthroscopic rotator cuff repair. Study inclusion required preoperative completion of the ASES and SST evaluations, as well as the PROMIS PF, UE, and Pain Interference computerized adaptive tests. Descriptive statistics were produced, and Pearson correlation coefficients were calculated between each of the outcome measures. Average PROMIS UE scores indicated greater impairment than PROMIS PF scores (34 vs 44). Three percent of patients reached the PROMIS UE ceiling score of 56. PROMIS PF scores demonstrated a weak correlation with ASES scores (r = 0.43, P < .001) and a moderate correlation with SST scores (r = 0.51, P < .001). PROMIS UE scores demonstrated a moderate correlation with both ASES scores (r = 0.59, P < .001) and SST scores (r = 0.62, P < .001). PROMIS Pain Interference scores demonstrated weak negative correlations with both ASES scores (r = -0.43, P < .001) and SST scores (r = -0.41, P < .001). Patients answered fewer questions on average using the PROMIS PF and UE instruments as compared with the ASES and SST instruments. PROMIS UE scores indicate greater impairment and demonstrate a stronger correlation with the legacy shoulder scores than PROMIS PF scores in patients with symptomatic rotator cuff tears. PROMIS computerized adaptive tests allow for more efficient patient-reported outcome data collection compared with traditional outcome scores. Copyright © 2018 Journal of Shoulder and

  9. Boiler MACT Technical Assistance (Fact Sheet)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    2012-03-01

    Fact sheet describing the changes to Environmental Protection Act process standards. The DOE will offer technical assistance to ensure that major sources burning coal and oil have information on cost-effective, clean energy strategies for compliance, and to promote cleaner, more efficient boiler burning to cut harmful pollution and reduce operational costs. The U.S. Environmental Protection Agency (EPA) is expected to finalize the reconsideration process for its Clean Air Act pollution standards National Emissions Standards for Hazardous Air Pollutants for Major Sources: Industrial, Commercial, and Institutional Boilers and Process Heaters (known as Boiler Maximum Achievable Control Technology (MACT)), in Spring 2012.more » This rule applies to large and small boilers in a wide range of industrial facilities and institutions. The U.S. Department of Energy (DOE) will offer technical assistance to ensure that major sources burning coal or oil have information on cost-effective clean energy strategies for compliance, including combined heat and power, and to promote cleaner, more efficient boilers to cut harmful pollution and reduce operational costs.« less

  10. Using qualitative methods to understand non-technological aspects of domestic energy efficiency

    NASA Astrophysics Data System (ADS)

    Ambrose, Aimee Rebecca

    The overall aim of the collected published works is to investigate how different policy interventions in the field of energy efficiency (including zero carbon homes, low carbon heat networks, and domestic energy efficiency schemes) are experienced and made sense of by a range of key actors. A further aim is to understand these interventions in the context of existing theories within the field of domestic energy efficiency including socio-technical theory and Actor Network Theory. More specifically, this research advances existing knowledge in the following areas: The nature of the socio-technical challenges encountered in the introduction of more energy efficient buildings, and the importance of achieving a balance between socially acceptable and technically optimal environments. (Papers 2, 3, 4, 6 and 8). The value of qualitative research in gaining a more nuanced understanding of our relationship with the home and the implications of this for domestic energy efficiency interventions and the design of low energy buildings (all papers). The influence of tenure as determinant of access to a more energy efficient home and in particular, the stubborn and complex barriers to achieving higher standards of energy performance within the private rented sector. (Papers 1, 2, 3 and 4). The significance of identity, setting and notions of home in the context of domestic energy efficiency interventions. (Papers 1 and 4). As these themes suggest, this PhD is not just concerned with carbon reduction and energy saving as technical objects, but as a way of life. More specifically, it considers the interactions between the two and contends that technical or policy instruments, no matter how sophisticated, cannot succeed if they are not compatible with our ways of life (and ways of doing businesss) or if our ways of life cannot be reasonably adapted to acoomodate them.

  11. Bootstrapping data envelopment analysis of efficiency and productivity of county public hospitals in Eastern, Central, and Western China after the public hospital reform.

    PubMed

    Wang, Man-Li; Fang, Hai-Qing; Tao, Hong-Bing; Cheng, Zhao-Hui; Lin, Xiao-Jun; Cai, Miao; Xu, Chang; Jiang, Shuai

    2017-10-01

    China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals (39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012-2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency (PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012-2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012-2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county

  12. A Bayesian Scoring Technique for Mining Predictive and Non-Spurious Rules

    PubMed Central

    Batal, Iyad; Cooper, Gregory; Hauskrecht, Milos

    2015-01-01

    Rule mining is an important class of data mining methods for discovering interesting patterns in data. The success of a rule mining method heavily depends on the evaluation function that is used to assess the quality of the rules. In this work, we propose a new rule evaluation score - the Predictive and Non-Spurious Rules (PNSR) score. This score relies on Bayesian inference to evaluate the quality of the rules and considers the structure of the rules to filter out spurious rules. We present an efficient algorithm for finding rules with high PNSR scores. The experiments demonstrate that our method is able to cover and explain the data with a much smaller rule set than existing methods. PMID:25938136

  13. A Bayesian Scoring Technique for Mining Predictive and Non-Spurious Rules.

    PubMed

    Batal, Iyad; Cooper, Gregory; Hauskrecht, Milos

    Rule mining is an important class of data mining methods for discovering interesting patterns in data. The success of a rule mining method heavily depends on the evaluation function that is used to assess the quality of the rules. In this work, we propose a new rule evaluation score - the Predictive and Non-Spurious Rules (PNSR) score. This score relies on Bayesian inference to evaluate the quality of the rules and considers the structure of the rules to filter out spurious rules. We present an efficient algorithm for finding rules with high PNSR scores. The experiments demonstrate that our method is able to cover and explain the data with a much smaller rule set than existing methods.

  14. The efficiency of parameter estimation of latent path analysis using summated rating scale (SRS) and method of successive interval (MSI) for transformation of score to scale

    NASA Astrophysics Data System (ADS)

    Solimun, Fernandes, Adji Achmad Rinaldo; Arisoesilaningsih, Endang

    2017-12-01

    Research in various fields generally investigates systems and involves latent variables. One method to analyze the model representing the system is path analysis. The data of latent variables measured using questionnaires by applying attitude scale model yields data in the form of score, before analyzed should be transformation so that it becomes data of scale. Path coefficient, is parameter estimator, calculated from scale data using method of successive interval (MSI) and summated rating scale (SRS). In this research will be identifying which data transformation method is better. Path coefficients have smaller varieties are said to be more efficient. The transformation method that produces scaled data and used in path analysis capable of producing path coefficients (parameter estimators) with smaller varieties is said to be better. The result of analysis using real data shows that on the influence of Attitude variable to Intention Entrepreneurship, has relative efficiency (ER) = 1, where it shows that the result of analysis using data transformation of MSI and SRS as efficient. On the other hand, for simulation data, at high correlation between items (0.7-0.9), MSI method is more efficient 1.3 times better than SRS method.

  15. Repositioning the Facilities in Technical College Workshops for Efficiency: A Case Study of North Central Nigeria

    ERIC Educational Resources Information Center

    Umar, Ibrahim Y.; Ma'aji, Abdullahi S.

    2010-01-01

    This article focuses on assessing the facilities in Government Technical College workshops in the context of a developing country. A descriptive survey design was adopted. Two research questions and a hypothesis were formulated to guide the study. A 35-item questionnaire was developed based on the National Board for Technical Education (NBTE)…

  16. Further Simplification of the Simple Erosion Narrowing Score With Item Response Theory Methodology.

    PubMed

    Oude Voshaar, Martijn A H; Schenk, Olga; Ten Klooster, Peter M; Vonkeman, Harald E; Bernelot Moens, Hein J; Boers, Maarten; van de Laar, Mart A F J

    2016-08-01

    To further simplify the simple erosion narrowing score (SENS) by removing scored areas that contribute the least to its measurement precision according to analysis based on item response theory (IRT) and to compare the measurement performance of the simplified version to the original. Baseline and 18-month data of the Combinatietherapie Bij Reumatoide Artritis (COBRA) trial were modeled using longitudinal IRT methodology. Measurement precision was evaluated across different levels of structural damage. SENS was further simplified by omitting the least reliably scored areas. Discriminant validity of SENS and its simplification were studied by comparing their ability to differentiate between the COBRA and sulfasalazine arms. Responsiveness was studied by comparing standardized change scores between versions. SENS data showed good fit to the IRT model. Carpal and feet joints contributed the least statistical information to both erosion and joint space narrowing scores. Omitting the joints of the foot reduced measurement precision for the erosion score in cases with below-average levels of structural damage (relative efficiency compared with the original version ranged 35-59%). Omitting the carpal joints had minimal effect on precision (relative efficiency range 77-88%). Responsiveness of a simplified SENS without carpal joints closely approximated the original version (i.e., all Δ standardized change scores were ≤0.06). Discriminant validity was also similar between versions for both the erosion score (relative efficiency = 97%) and the SENS total score (relative efficiency = 84%). Our results show that the carpal joints may be omitted from the SENS without notable repercussion for its measurement performance. © 2016, American College of Rheumatology.

  17. The impact of fatigue on the non-technical skills performance of critical care air ambulance clinicians.

    PubMed

    Myers, J A; Powell, D M C; Aldington, S; Sim, D; Psirides, A; Hathaway, K; Haney, M F

    2017-11-01

    The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design). Trained assessors blinded to participants' fatigue status performed detailed structured assessments based on expected behaviours in four non-technical skills domains: teamwork, situational awareness, task management, and decision making. Participants also provided self-ratings of their performance. The primary endpoint was the sum score of overall non-technical performance. The main finding, the overall non-technical skills performance rating of the clinicians, was better in rested than fatigued states (mean difference with 95% CI, 2.8 [2.2-3.4]). The findings remained consistent across individual non-technical skills domains; also when controlling for an order effect and examining the impact of a number of possible covariates. There was no difference in self-ratings of clinical performance between rested and fatigued states. Non-technical performance of critical care air transfer clinicians is degraded when they are fatigued. Fatigued clinicians may fail to recognise the degree to which their performance is compromised. These findings represent risk to clinical care quality and patient safety in the dynamic and isolated environment of air ambulance transfer. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. Effects of the Sports Level, Format of the Game and Task Condition on Heart Rate Responses, Technical and Tactical Performance of Youth Basketball Players

    PubMed Central

    Clemente, Filipe Manuel; González-Víllora, Sixto; Delextrat, Anne; Martins, Fernando Manuel Lourenço; Vicedo, Juan Carlos Pastor

    2017-01-01

    Abstract The aim of this study was to analyze the effect of different small-sided and conditioning games (SSCG) with different tactical contents on heart rate responses, technical performance and collective organization of youth basketball players of different performance levels. Twenty male basketball players from U14 (13.7 ± 0.8 years old; 4.2 ± 1.4 years of practice) and U16 (15.3 ± 1.1 years old; 6.4 ± 2.1 years of practice) participated in this research study. The two-way MANOVA revealed that the sports level (p = 0.009; ηp2 = 0.151), format (p = 0.001; ηp2 = 0.246) and task condition (p = 0.023; ηp2 = 0.104; small effect size) had significant main effects on heart rate responses. It was also found that the format (p = 0.001; ηp2 = 0.182) had significant main effects on technical performance. A smaller format significantly increased the heart rate, volume of play, efficiency index and collective density during attacking plays. The SSCG with attacking content statistically increased the heart rate, efficiency index and performance score. Therefore, this study revealed that different SSCGs with tactical content influenced the physiological responses of youth players. PMID:28828085

  19. Technical Performance as a Predictor of Clinical Outcomes in Laparoscopic Gastric Cancer Surgery.

    PubMed

    Fecso, Andras B; Bhatti, Junaid A; Stotland, Peter K; Quereshy, Fayez A; Grantcharov, Teodor P

    2018-03-23

    The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery. Laparoscopic gastrectomy for cancer is an advanced procedure with high rate of postoperative morbidity and mortality. Many variables including patient, disease, and perioperative management factors have been shown to impact postoperative outcomes; however, the role of surgical performance is insufficiently investigated. A retrospective review was performed for all patients who had undergone laparoscopic gastrectomy for cancer at 3 teaching institutions between 2009 and 2015. Patients with available, unedited video-recording of their procedure were included in the study. Video files were rated for technical performance, using Objective Structured Assessments of Technical Skills (OSATS) and Generic Error Rating Tool instruments. The main outcome variable was major short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy. Sixty-one patients with available video recordings were included in the study. The overall complication rate was 29.5%. The mean Charlson comorbidity index, type of procedure, and the global OSATS score were included in the final predictive model. Lower performance score (OSATS ≤29) remained an independent predictor for major short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure. Intraoperative technical performance predicts major short-term outcomes in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills using modern, evidence-based strategies might improve short-term patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery.

  20. Production efficiencies of U.S. electric generation plants: Effects of data aggregation and greenhouse gas and renewable energy policy

    NASA Astrophysics Data System (ADS)

    Lynes, Melissa Kate

    Over the last few decades there has been a shift in electricity production in the U.S. Renewable energy sources are becoming more widely used. In addition, electric generation plants that use coal inputs are more heavily regulated than a couple decades ago. This shift in electricity production was brought on by changes in federal policy -- a desire for electricity produced in the U.S. which led to policies being adopted that encourage the use of renewable energy. The change in production practices due to policies may have led to changes in the productivity of electric generation plants. Multiple studies have examined the most efficient electric generation plants using the data envelopment analysis (DEA) approach. This study builds on past research to answer three questions: 1) Does the level of aggregation of fuel input variables affect the plant efficiency scores and how does the efficiency of renewable energy input compare to nonrenewable energy inputs; 2) Are policies geared toward directly or indirectly reducing greenhouse gas emissions affecting the production efficiencies of greenhouse gas emitting electric generation plants; and 3) Do renewable energy policies and the use of intermittent energy sources (i.e. wind and solar) affect the productivity growth of electric generation plants. All three analysis, presented in three essays, use U.S. plant level data obtained from the Energy Information Administration to answer these questions. The first two essays use DEA to determine the pure technical, overall technical, and scale efficiencies of electric generation plants. The third essay uses DEA within the Malmquist index to assess the change in productivity over time. Results indicate that the level of aggregation does matter particularly for scale efficiency. This implies that valuable information is likely lost when fuel inputs are aggregated together. Policies directly focused on reducing greenhouse gas emissions may improve the production efficiencies of

  1. Simulation in Urology to Train Non-Technical Skills in Ward Rounds.

    PubMed

    Somasundram, K; Spence, H; Colquhoun, A J; Mcilhenny, C; Biyani, C S; Jain, S

    2018-05-19

    We have designed an exercise to train newly appointed Urology trainees in non-technical skills on ward rounds as a part of a simulation 'boot camp'. This paper reports our experience, including a qualitative analysis of participant feedback on the utility of this method of training. The simulations took place in a high-fidelity simulated ward bay. Forty-eight doctors with formal Urology training ranging between 2-60 months (mean 19.1 ± 11.6 months) took part. Thirty-one participants were on a formal Urology specialty training pathway. The remaining participants were core (pre-specialty) surgical trainees. The entry requirement was that participants must be junior-level urologists, ideally at the beginning of specialty training. Participants individually led a simulated ward round, which was devised using actors to play as patients and a simulated 'switchboard' for telephone conversations. Distractions were introduced deliberately for participants to manage an emergent urology-related scenario. 'Freeze-frames' were used to 'pause' the ward-round, whereby observing consultants provided feedback on performance. Following the simulated exercises, a whole-group structured debrief took place. Non-technical skills for surgeons (NOTSS) scores were generated for participants by seven consultant urologists. Participants completed a two-part feedback form. Part-one involved nine questions scored on a Likert scale, and part-two required free-text responses. The mean itemised NOTSS scores for situational awareness, decision-making, communication and teamwork and leadership were 3.01 (SD ± 0.15), 2.95 (SD ± 0.16), 3.05 (SD ± 0.19), 2.98 (SD ± 0.15), respectively. From the thematic analysis, participants commented positively on the number of scenarios per participant, the use of real patient-actors and staff, and the use of 'freeze-frames' for immediate feedback. Residents also provided suggestions for distractions to be considered in the future. This simulated ward round

  2. Microsurgical Bypass Training Rat Model, Part 1: Technical Nuances of Exposure of the Aorta and Iliac Arteries.

    PubMed

    Tayebi Meybodi, Ali; Lawton, Michael T; Mokhtari, Pooneh; Yousef, Sonia; Gandhi, Sirin; Benet, Arnau

    2017-11-01

    Animal models using rodents are frequently used for practicing microvascular anastomosis-an essential technique in cerebrovascular surgery. However, safely and efficiently exposing rat's target vessels is technically difficult. Such difficulty may lead to excessive hemorrhage and shorten animal survival. This limits the ability to perform multiple anastomoses on a single animal and may increase the overall training time and costs. We report our model for microsurgical bypass training in rodents in 2 consecutive articles. In part 1, we describe the technical nuances for a safe and efficient exposure of the rat abdominal aorta and common iliac arteries (CIAs) for bypass. Over a 2-year period, 50 Sprague-Dawley rats underwent inhalant anesthesia for practicing microvascular anastomosis on the abdominal aorta and CIAs. Lessons learned regarding the technical nuances of vessel exposure were recorded. Several technical nuances were important for avoiding intraoperative bleeding and preventing animal demise while preparing an adequate length of vessels for bypass. The most relevant technical nuances include (1) generous subcutaneous dissection; (2) use of cotton swabs for the blunt dissection of the retroperitoneal fat; (3) combination of sharp and blunt dissection to isolate the aorta and iliac arteries from the accompanying veins; (4) proper control of the posterior branches of the aorta; and (5) efficient division and mobilization of the left renal pedicle. Applying the aforementioned technical nuances enables safe and efficient preparation of the rat abdominal aorta and CIAs for microvascular anastomosis. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. High Efficiency Centrifugal Compressor for Rotorcraft Applications

    NASA Technical Reports Server (NTRS)

    Medic, Gorazd; Sharma, Om P.; Jongwook, Joo; Hardin, Larry W.; McCormick, Duane C.; Cousins, William T.; Lurie, Elizabeth A.; Shabbir, Aamir; Holley, Brian M.; Van Slooten, Paul R.

    2017-01-01

    A centrifugal compressor research effort conducted by United Technologies Research Center under NASA Research Announcement NNC08CB03C is documented. The objectives were to identify key technical barriers to advancing the aerodynamic performance of high-efficiency, high work factor, compact centrifugal compressor aft-stages for turboshaft engines; to acquire measurements needed to overcome the technical barriers and inform future designs; to design, fabricate, and test a new research compressor in which to acquire the requisite flow field data. A new High-Efficiency Centrifugal Compressor stage -- splittered impeller, splittered diffuser, 90 degree bend, and exit guide vanes -- with aerodynamically aggressive performance and configuration (compactness) goals were designed, fabricated, and subquently tested at the NASA Glenn Research Center.

  4. HBCU Efficiency and Endowments: An Exploratory Analysis

    ERIC Educational Resources Information Center

    Coupet, Jason; Barnum, Darold

    2010-01-01

    Discussions of efficiency among Historically Black Colleges and Universities (HBCUs) are often missing in academic conversations. This article seeks to assess efficiency of individual HBCUs using Data Envelopment Analysis (DEA), a non-parametric technique that can synthesize multiple inputs and outputs to determine a single efficiency score for…

  5. Testing the performance of technical trading rules in the Chinese markets based on superior predictive test

    NASA Astrophysics Data System (ADS)

    Wang, Shan; Jiang, Zhi-Qiang; Li, Sai-Ping; Zhou, Wei-Xing

    2015-12-01

    Technical trading rules have a long history of being used by practitioners in financial markets. The profitable ability and efficiency of technical trading rules are yet controversial. In this paper, we test the performance of more than seven thousand traditional technical trading rules on the Shanghai Securities Composite Index (SSCI) from May 21, 1992 through June 30, 2013 and China Securities Index 300 (CSI 300) from April 8, 2005 through June 30, 2013 to check whether an effective trading strategy could be found by using the performance measurements based on the return and Sharpe ratio. To correct for the influence of the data-snooping effect, we adopt the Superior Predictive Ability test to evaluate if there exists a trading rule that can significantly outperform the benchmark. The result shows that for SSCI, technical trading rules offer significant profitability, while for CSI 300, this ability is lost. We further partition the SSCI into two sub-series and find that the efficiency of technical trading in sub-series, which have exactly the same spanning period as that of CSI 300, is severely weakened. By testing the trading rules on both indexes with a five-year moving window, we find that during the financial bubble from 2005 to 2007, the effectiveness of technical trading rules is greatly improved. This is consistent with the predictive ability of technical trading rules which appears when the market is less efficient.

  6. Influence of body mass index on movement efficiency among firefighter recruits.

    PubMed

    Cornell, David J; Gnacinski, Stacy L; Zamzow, Aaron; Mims, Jason; Ebersole, Kyle T

    2016-06-04

    Previous research has demonstrated links between musculoskeletal injury risk and measures of obesity and movement efficiency among the firefighter population. However, the influence of obesity on movement efficiency among firefighter recruits remains uninvestigated. To investigate the influence of obesity on movement efficiency measures among firefighter recruits. Measures of obesity were collected among 73 male firefighter recruits. Participants were grouped into standard body mass index (BMI) categories (normal, overweight, obese). Differences in Total Functional Movement Screen (FMS) scores and Y-Balance Test (YBT) composite scores were examined between BMI categories. In addition, the relationships between measures of obesity and movement efficiency were also examined. No significant differences in movement efficiency measures were identified between BMI categories (p > 0.05). However, significant bivariate correlations were identified between BMI (kg/m2) and Total FMS score (r = -0.235, p = 0.045), as well as between fat-free mass (FFM) and Total FMS score (r = -0.231, p = 0.049), when examined among all participants. BMI may influence measures of movement efficiency among firefighter recruits to a lesser extent than among other previously examined populations. Future research should examine the influence of other unexamined physiological variables on movement efficiency.

  7. Two Simple and Efficient Algorithms to Compute the SP-Score Objective Function of a Multiple Sequence Alignment.

    PubMed

    Ranwez, Vincent

    2016-01-01

    Multiple sequence alignment (MSA) is a crucial step in many molecular analyses and many MSA tools have been developed. Most of them use a greedy approach to construct a first alignment that is then refined by optimizing the sum of pair score (SP-score). The SP-score estimation is thus a bottleneck for most MSA tools since it is repeatedly required and is time consuming. Given an alignment of n sequences and L sites, I introduce here optimized solutions reaching O(nL) time complexity for affine gap cost, instead of O(n2L), which are easy to implement.

  8. Artificial metaplasticity neural network applied to credit scoring.

    PubMed

    Marcano-Cedeño, Alexis; Marin-de-la-Barcena, A; Jimenez-Trillo, J; Piñuela, J A; Andina, D

    2011-08-01

    The assessment of the risk of default on credit is important for financial institutions. Different Artificial Neural Networks (ANN) have been suggested to tackle the credit scoring problem, however, the obtained error rates are often high. In the search for the best ANN algorithm for credit scoring, this paper contributes with the application of an ANN Training Algorithm inspired by the neurons' biological property of metaplasticity. This algorithm is especially efficient when few patterns of a class are available, or when information inherent to low probability events is crucial for a successful application, as weight updating is overemphasized in the less frequent activations than in the more frequent ones. Two well-known and readily available such as: Australia and German data sets has been used to test the algorithm. The results obtained by AMMLP shown have been superior to state-of-the-art classification algorithms in credit scoring.

  9. The Effectiveness of Contextual Learning on Physics Achievement in Career Technical Education

    NASA Astrophysics Data System (ADS)

    Arcand, Scott Andrew

    The purpose of this casual-comparative study was to determine if students being taught the Minnesota Science Physics Standards via contextual learning methods in Project Lead the Way (PLTW) Principles of Engineering or the PLTW Aerospace Engineering courses, taught by a Career Technical Education (CTE) teacher, achieve at the same rate as students in a physics course taught by a science teacher. The PLTW courses only cover the standards taught in the first trimester of physics. The PLTW courses are two periods long for one trimester. Students who successfully pass the PLTW Principles of Engineering course or the PLTW Engineering Aerospace course earn one-half credit in physics and one-half elective credit. The instrument used to measure student achievement was the district common summative assessment for physics. The Common Summative Assessment scores were pulled from the data warehouse from the first trimester of the 2013-2014 school year. Implications of the research address concepts of contextual learning especially in the Career Technical Education space. The mean score for Physics students (30.916) and PLTW Principles of Engineering students (32.333) was not statistically significantly different. Students in PLTW Principles of Engineering achieved at the same rate as students in physics. Due to the low rate of students participating in the Common Summative Assessment in PTLW Aerospace (four out of seven students), there is not enough data to determine if there is a significant difference in the Physics A scores and PLTW Aerospace Engineering scores.

  10. Southwest Energy Efficiency Project (SWEEP) Final Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Geller, Howard; Meyers, Jim

    SWEEP worked with Energy Efficiency and Renewable Energy (EERE) programs to foster greater energy efficiency throughout the Southwest. SWEEP accomplished this through a combination of analysis and support; preparation and distribution of materials on best practice technologies, policies and programs; and technical assistance and information dissemination to states and municipalities in the southwest supporting BTO, AMO, OWIP for advancement of efficiency in products and practices. These efforts were accomplished during the period 2012 through 2017.

  11. Managing for efficiency in health care: the case of Greek public hospitals.

    PubMed

    Mitropoulos, Panagiotis; Mitropoulos, Ioannis; Sissouras, Aris

    2013-12-01

    This paper evaluates the efficiency of public hospitals with two alternative conceptual models. One model targets resource usage directly to assess production efficiency, while the other model incorporates financial results to assess economic efficiency. Performance analysis of these models was conducted in two stages. In stage one, we utilized data envelopment analysis to obtain the efficiency score of each hospital, while in stage two we took into account the influence of the operational environment on efficiency by regressing those scores on explanatory variables that concern the performance of hospital services. We applied these methods to evaluate 96 general hospitals in the Greek national health system. The results indicate that, although the average efficiency scores in both models have remained relatively stable compared to past assessments, internal changes in hospital performances do exist. This study provides a clear framework for policy implications to increase the overall efficiency of general hospitals.

  12. Engineering Technical Support Center Annual Report Fiscal ...

    EPA Pesticide Factsheets

    The United States Environmental Protection Agency (EPA or Agency) Office of Research and Development (ORD) created the Engineering Technical Support Center (ETSC) in 1987, one of several technical support centers created as part of the Technical Support Project (TSP). ETSC provides engineering expertise to Agency program and regional offices and remediation teams working at contaminated sites across the country. The ETSC is operated within ORD’s Land Remediation and Pollution Control Division (LRPCD) of the National Risk Management Research Laboratory (NRMRL) in Cincinnati, Ohio. The ETSC’s mission is to provide site-specific scientific and engineering technical support to Remedial Project Managers, On-Scene Coordinators, and other remediation personnel at contaminated sites. This allows local, regional, or national authorities to work more quickly, efficiently, and cost effectively, while also increasing the technical experience of the remediation team. Since its inception, the ETSC has supported countless projects across all EPA Regions in almost all states and territories. This report highlights significant projects the ETSC supported in fiscal year 2015 (FY15). These projects addressed an array of environmental scenarios, such as remote mining contamination, expansive landfill waste, cumulative impacts from multiple contamination sources, and persistent threats from abandoned industrial sites. Constructing and testing new and innovative treatment technol

  13. CT-Guided Microwave Ablation of 45 Renal Tumors: Analysis of Procedure Complexity Utilizing a Percutaneous Renal Ablation Complexity Scoring System.

    PubMed

    Mansilla, Alberto V; Bivins, Eugene E; Contreras, Francisco; Hernandez, Manuel A; Kohler, Nathan; Pepe, Julie W

    2017-02-01

    To develop a scoring system that stratifies complexity of percutaneous ablation of renal tumors. Analysis was performed of 36 consecutive patients (mean age, 64 y; range, 30-89 y) who underwent CT-guided microwave (MW) ablation of 45 renal tumors (mean tumor diameter, 2.4 cm; range, 1.2-4.0 cm). Technical success and effectiveness were determined based on intraprocedural and follow-up imaging studies. The RENAL score and the proposed percutaneous renal ablation complexity (P-RAC) score were calculated for each tumor. Technical success was 93.3% (n = 42). Biopsy of 38 of 45 renal tumors revealed 23 renal cell carcinomas. Median follow-up period was 9.7 months (range, 2.9-46.8 months). There were no tumor recurrences. One major complication, ureteropelvic junction stricture, occurred (2.6%). The P-RAC score was found to differ statistically from the RENAL score (t = 3.754, df = 44, P = .001). A positive correlation was found between the P-RAC score and number of antenna insertions (r = .378, n = 45, P = .011) and procedure duration (r = .328, n = 45, P = .028). No correlation was found between the RENAL score and number of MW antenna insertions (r = .110, n = 45, P = .472) or procedure duration (r = .263, n = 45, P = .081). Hydrodissection was significantly more common in the P-RAC high-complexity category than in low-complexity category (χ 2 = 12.073, df = 2, P = .002). The P-RAC score may be useful in stratifying percutaneous renal ablation complexity. Further studies with larger sample sizes are necessary to validate the P-RAC score and to determine if it can predict risk of complications. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  14. Evaluation of colonoscopy technical skill levels by use of an objective kinematic-based system.

    PubMed

    Obstein, Keith L; Patil, Vaibhav D; Jayender, Jagadeesan; San José Estépar, Raúl; Spofford, Inbar S; Lengyel, Balazs I; Vosburgh, Kirby G; Thompson, Christopher C

    2011-02-01

    Colonoscopy requires training and experience to ensure accuracy and safety. Currently, no objective, validated process exists to determine when an endoscopist has attained technical competence. Kinematics data describing movements of laparoscopic instruments have been used in surgical skill assessment to define expert surgical technique. We have developed a novel system to record kinematics data during colonoscopy and quantitatively assess colonoscopist performance. To use kinematic analysis of colonoscopy to quantitatively assess endoscopic technical performance. Prospective cohort study. Tertiary-care academic medical center. This study involved physicians who perform colonoscopy. Application of a kinematics data collection system to colonoscopy evaluation. Kinematics data, validated task load assessment instrument, and technical difficulty visual analog scale. All 13 participants completed the colonoscopy to the terminal ileum on the standard colon model. Attending physicians reached the terminal ileum quicker than fellows (median time, 150.19 seconds vs 299.86 seconds; p<.01) with reduced path lengths for all 4 sensors, decreased flex (1.75 m vs 3.14 m; P=.03), smaller tip angulation, reduced absolute roll, and lower curvature of the endoscope. With performance of attending physicians serving as the expert reference standard, the mean kinematic score increased by 19.89 for each decrease in postgraduate year (P<.01). Overall, fellows experienced greater mental, physical, and temporal demand than did attending physicians. Small cohort size. Kinematic data and score calculation appear useful in the evaluation of colonoscopy technical skill levels. The kinematic score appears to consistently vary by year of training. Because this assessment is nonsubjective, it may be an improvement over current methods for determination of competence. Ongoing studies are establishing benchmarks and characteristic profiles of skill groups based on kinematics data. Copyright © 2011

  15. Factors affecting the technical efficiency of health systems: A case study of Economic Cooperation Organization (ECO) countries (2004-10).

    PubMed

    Ravangard, Ramin; Hatam, Nahid; Teimourizad, Abedin; Jafari, Abdosaleh

    2014-07-01

    Improving efficiency of health sector is of particular importance in all countries. To reach this end, it is paramount to measure the efficiency. On the other hand, there are many factors that affect the efficiency of health systems. This study aimed to measure the Technical Efficiency (TE) of health systems in Economic Cooperation Organization (ECO) countries during 2004-10 and to determine the factors affecting their TE. This was a descriptive-analytical and panel study. The required data were gathered using library and field studies, available statistics and international websites through completing data collection forms. In this study, the TE of health systems in 10 ECO countries was measured using their available data and Data Envelopment Analysis (DEA) through two approaches. The first approach used GDP per capita, education and smoking as its inputs and life expectancy and infant mortality rates as the outputs. The second approach, also, used the health expenditures per capita, the number of physicians per thousand people, and the number of hospital beds per thousand people as its inputs and life expectancy and under-5 mortality rates as the outputs. Then, the factors affecting the TE of health systems were determined using the panel data logit model. Excel 2010, Win4Deap 1.1.2 and Stata 11.0 were used to analyze the collected data. According to the first approach, the mean TE of health systems was 0.497 and based on the second one it was 0.563. Turkey and Turkmenistan had, respectively, the highest and lowest mean of efficiency. Also, the results of panel data logit model showed that only GDP per capita and health expenditures per capita had significant relationships with the TE of health systems. In order to maximize the TE of health systems, health policy-makers should pay special attention to the proper use of healthcare resources according to the people's needs, the appropriate management of the health system resources, allocating adequate budgets to

  16. 78 FR 29125 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-17

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Biomass Research and... Biomass Research and Development Technical Advisory Committee. The Federal Advisory Committee Act (Pub. L... contact (Departments of [[Page 29126

  17. Efficiency of Secondary Education in Selected OIC Countries

    ERIC Educational Resources Information Center

    Arshad, Mohd Nahar Mohd

    2014-01-01

    The purpose of this study is to investigate the level of technical efficiency of secondary education in 16 selected Organisation of Islamic Conference (OIC) countries (including West Bank and Gaza). Educational efficiency has become an important issue given many countries' pressing levels of public deficit and debt. Since the educational sector…

  18. Qualification and Development Needs for Technical Education.

    ERIC Educational Resources Information Center

    El Tell, Khalaf; Al-Maaitah, Ayman

    Vast and rapid changes in global technologies have made development of a sound and efficient system of technical education (TE) critical for Oman and the other Arab Gulf countries. Producing TE graduates with the skills needed for success in today's global economy requires TE teachers with the following qualifications: mastery of the core skills…

  19. A New Strategy to Evaluate Technical Efficiency in Hospitals Using Homogeneous Groups of Casemix : How to Evaluate When There is Not DRGs?

    PubMed

    Villalobos-Cid, Manuel; Chacón, Max; Zitko, Pedro; Instroza-Ponta, Mario

    2016-04-01

    The public health system has restricted economic resources. Because of that, it is necessary to know how the resources are being used and if they are properly distributed. Several works have applied classical approaches based in Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA) for this purpose. However, if we have hospitals with different casemix, this is not the best approach. In order to avoid biases in the comparisons, other works have recommended the use of hospital production data corrected by the weights from Diagnosis Related Groups (DRGs), to adjust the casemix of hospitals. However, not all countries have this tool fully implemented, which limits the efficiency evaluation. This paper proposes a new approach for evaluating the efficiency of hospitals. It uses a graph-based clustering algorithm to find groups of hospitals that have similar production profiles. Then, DEA is used to evaluate the technical efficiency of each group. The proposed approach is tested using the production data from 2014 of 193 Chilean public hospitals. The results allowed to identify different performance profiles of each group, that differs from other studies that employs data from partially implemented DRGs. Our results are able to deliver a better description of the resource management of the different groups of hospitals. We have created a website with the results ( bioinformatic.diinf.usach.cl/publichealth ). Data can be requested to the authors.

  20. Improving HCAHPS Scores with Advances in Digital Radiography.

    PubMed

    Matthews, Marianne; Cretella, Gregg; Nicholas, William

    2016-01-01

    The imaging department can be instrumental in contributing to a healthcare facility's ability to succeed in this new era of competition. Advances in DR technology can improve patient perceptions in the imaging department by improving efficiencies and outcomes which, in turn, can ultimately bolster overall HCAHPS scores. Specific areas for improved scores by utilization of DR include nurse communication, doctor communication, pain management, and communication about medication. Value based purchasing brought with it a mandate for hospitals to track key metrics, which requires an investment in time, tools, and human resources. However, this mandate also presents hospitals and imaging departments, with an opportunity to leverage those very metrics to better market their facilities.

  1. Improvements in State and Local Planning for Mass Dispensing of Medical Countermeasures: The Technical Assistance Review Program, United States, 2007-2014.

    PubMed

    Renard, Paul G; Vagi, Sara J; Reinold, Chris M; Silverman, Brenda L; Avchen, Rachel N

    2017-09-01

    To evaluate and describe outcomes of state and local medical countermeasure preparedness planning, which is critical to ensure rapid distribution and dispensing of a broad spectrum of life-saving medical assets during a public health emergency. We used 2007 to 2014 state and local data collected from the Centers for Disease Control and Prevention's Technical Assistance Review. We calculated descriptive statistics from 50 states and 72 local Cities Readiness Initiative jurisdictions that participated in the Technical Assistance Review annually. From 2007 to 2014, the average overall Technical Assistance Review score increased by 13% for states and 41% for Cities Readiness Initiative jurisdictions. In 2014, nearly half of states achieved the maximum possible overall score (100), and 94% of local Cities Readiness Initiative jurisdictions achieved a score of 90 or more. Despite challenges, effective and timely medical countermeasure distribution and dispensing is possible with appropriate planning, staff, and resources. However, vigilance in training, exercising, and improving plans from lessons learned in a sustained, coordinated way is critical to ensure continued public health preparedness success.

  2. Technical Data Interoperability (TDI) Pathfinder Via Emerging Standards

    NASA Technical Reports Server (NTRS)

    Conroy, Mike; Gill, Paul; Hill, Bradley; Ibach, Brandon; Jones, Corey; Ungar, David; Barch, Jeffrey; Ingalls, John; Jacoby, Joseph; Manning, Josh; hide

    2014-01-01

    The TDI project (TDI) investigates trending technical data standards for applicability to NASA vehicles, space stations, payloads, facilities, and equipment. TDI tested COTS software compatible with a certain suite of related industry standards for capabilities of individual benefits and interoperability. These standards not only esnable Information Technology (IT) efficiencies, but also address efficient structures and standard content for business processes. We used source data from generic industry samples as well as NASA and European Space Agency (ESA) data from space systems.

  3. Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System.

    PubMed

    Punjabi, Naresh M; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N

    2015-10-01

    Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Clinical sleep laboratories. A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90-0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91-0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two human scorers. In light of the burden associated with manual scoring, automated

  4. D-score: a search engine independent MD-score.

    PubMed

    Vaudel, Marc; Breiter, Daniela; Beck, Florian; Rahnenführer, Jörg; Martens, Lennart; Zahedi, René P

    2013-03-01

    While peptides carrying PTMs are routinely identified in gel-free MS, the localization of the PTMs onto the peptide sequences remains challenging. Search engine scores of secondary peptide matches have been used in different approaches in order to infer the quality of site inference, by penalizing the localization whenever the search engine similarly scored two candidate peptides with different site assignments. In the present work, we show how the estimation of posterior error probabilities for peptide candidates allows the estimation of a PTM score called the D-score, for multiple search engine studies. We demonstrate the applicability of this score to three popular search engines: Mascot, OMSSA, and X!Tandem, and evaluate its performance using an already published high resolution data set of synthetic phosphopeptides. For those peptides with phosphorylation site inference uncertainty, the number of spectrum matches with correctly localized phosphorylation increased by up to 25.7% when compared to using Mascot alone, although the actual increase depended on the fragmentation method used. Since this method relies only on search engine scores, it can be readily applied to the scoring of the localization of virtually any modification at no additional experimental or in silico cost. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  5. Efficiency of inpatient orthopedic surgery in Japan: a medical claims database analysis.

    PubMed

    Nakata, Yoshinori; Yoshimura, Tatsuya; Watanabe, Yuichi; Otake, Hiroshi; Oiso, Giichiro; Sawa, Tomohiro

    2017-07-10

    Purpose The purpose of this paper is to determine the characteristics of healthcare facilities that produce the most efficient inpatient orthopedic surgery using a large-scale medical claims database in Japan. Design/methodology/approach Reimbursement claims data were obtained from April 1 through September 30, 2014. Input-oriented Banker-Charnes-Cooper model of data envelopment analysis (DEA) was employed. The decision-making unit was defined as a healthcare facility where orthopedic surgery was performed. Inputs were defined as the length of stay, the number of beds, and the total costs of expensive surgical devices. Output was defined as total surgical fees for each surgery. Efficiency scores of healthcare facilities were compared among different categories of healthcare facilities. Findings The efficiency scores of healthcare facilities with a diagnosis-procedure combination (DPC) reimbursement were significantly lower than those without DPC ( p=0.0000). All the efficiency scores of clinics with beds were 1. Their efficiency scores were significantly higher than those of university hospitals, public hospitals, and other hospitals ( p=0.0000). Originality/value This is the first research that applied DEA for orthopedic surgery in Japan. The healthcare facilities with DPC reimbursement were less efficient than those without DPC. The clinics with beds were the most efficient among all types of management bodies of healthcare facilities.

  6. Use of an Objective Structured Assessment of Technical Skill After a Sports Medicine Rotation.

    PubMed

    Dwyer, Tim; Slade Shantz, Jesse; Kulasegaram, Kulamakan Mahan; Chahal, Jaskarndip; Wasserstein, David; Schachar, Rachel; Devitt, Brian; Theodoropoulos, John; Hodges, Brian; Ogilvie-Harris, Darrell

    2016-12-01

    The purpose of this study was to determine if the use of an Objective Structured Assessment of Technical skill (OSATS), using dry models, would be a valid method of assessing residents' ability to perform sports medicine procedures after training in a competency-based model. Over 18 months, 27 residents (19 junior [postgraduate year (PGY) 1-3] and 8 senior [PGY 4-5]) sat the OSATS after their rotation, in addition to 14 sports medicine staff and fellows. Each resident was provided a list of 10 procedures in which they were expected to show competence. At the end of the rotation, each resident undertook an OSATS composed of 6 stations sampled from the 10 procedures using dry models-faculty used the Arthroscopic Surgical Skill Evaluation Tool (ASSET), task-specific checklists, as well as an overall 5-point global rating scale (GRS) to score each resident. Each procedure was videotaped for blinded review. The overall reliability of the OSATS (0.9) and the inter-rater reliability (0.9) were both high. A significant difference by year in training was seen for the overall GRS, the total ASSET score, and the total checklist score, as well as for each technical procedure (P < .001). Further analysis revealed a significant difference in the total ASSET score between junior (mean 18.4, 95% confidence interval [CI] 16.8 to 19.9) and senior residents (24.2, 95% CI 22.7 to 25.6), senior residents and fellows (30.1, 95% CI 28.2 to 31.9), as well as between fellows and faculty (37, 95% CI 36.1 to 27.8) (P < .05). The results of this study show that an OSATS using dry models shows evidence of validity when used to assess performance of technical procedures after a sports medicine rotation. However, junior residents were not able to perform as well as senior residents, suggesting that overall surgical experience is as important as intensive teaching. As postgraduate medical training shifts to a competency-based model, methods of assessing performance of technical procedures become

  7. Decomposition of potential efficiency gains from hospital mergers in Greece.

    PubMed

    Flokou, Angeliki; Aletras, Vassilis; Niakas, Dimitris

    2017-12-01

    This paper evaluates the technical efficiency of 71 Greek public hospitals and examines potential efficiency gains from 13 candidate mergers among them. Efficiency assessments are performed using bootstrapped Data Envelopment Analysis (DEA) whilst merger analysis is conducted by applying the Bogetoft and Wang methodology which allows the overall potential merger gains to be decomposed into three main components of inefficiency, namely technical (or learning), scope (or harmony) and scale (or size) effects. Thus, the analysis provides important insights not only on the magnitude of the potential total efficiency gains but also on their sources. The overall analysis is conducted in the context of a complete methodological framework where methods for outlier detection, returns to scale identification, and bias corrections for DEA estimations are also applied. Mergers are analyzed under the assumptions of constant, variable and non-decreasing returns to scale in an input oriented DEA model with three inputs and three outputs. The main finding of the study indicates that almost all mergers show substantial potential room for efficiency improvement, which is mainly attributed to the pre-merger technical inefficiencies of the individual hospitals and therefore it might be possible to be achieved without the need of implementing full-scale mergers. The same -though, at a lower extent- applies to the harmony effect whilst the size effect shows marginal or even negative gains.

  8. Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan.

    PubMed

    Yamauchi, Yasuhiro

    2015-07-12

    Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care.

  9. Decomposing Cost Efficiency in Regional Long-term Care Provision in Japan

    PubMed Central

    Yamauchi, Yasuhiro

    2016-01-01

    Many developed countries face a growing need for long-term care provision because of population ageing. Japan is one such example, given its population's longevity and low birth rate. In this study, we examine the efficiency of Japan's regional long-term care system in FY2010 by performing a data envelopment analysis, a non-parametric frontier approach, on prefectural data and separating cost efficiency into technical, allocative, and price efficiencies under different average unit costs across regions. In doing so, we elucidate the structure of cost inefficiency by incorporating a method for restricting weight flexibility to avoid unrealistic concerns arising from zero optimal weight. The results indicate that technical inefficiency accounts for the highest share of losses, followed by price inefficiency and allocation inefficiency. Moreover, the majority of technical inefficiency losses stem from labor costs, particularly those for professional caregivers providing institutional services. We show that the largest share of allocative inefficiency losses can also be traced to labor costs for professional caregivers providing institutional services, while the labor provision of in-home care services shows an efficiency gain. However, although none of the prefectures gains efficiency by increasing the number of professional caregivers for institutional services, quite a few prefectures would gain allocative efficiency by increasing capital inputs for institutional services. These results indicate that preferred policies for promoting efficiency might vary from region to region, and thus, policy implications should be drawn with care. PMID:26493427

  10. Does Field Reliability for Static-99 Scores Decrease as Scores Increase?

    PubMed Central

    Rice, Amanda K.; Boccaccini, Marcus T.; Harris, Paige B.; Hawes, Samuel W.

    2015-01-01

    This study examined the field reliability of Static-99 (Hanson & Thornton, 2000) scores among 21,983 sex offenders and focused on whether rater agreement decreased as scores increased. As expected, agreement was lowest for high-scoring offenders. Initial and most recent Static-99 scores were identical for only about 40% of offenders who had been assigned a score of 6 during their initial evaluations, but for more than 60% of offenders who had been assigned a score of 2 or lower. In addition, the size of the difference between scores increased as scores increased, with pairs of scores differing by 2 or more points for about 30% of offenders scoring in the high-risk range. Because evaluators and systems use high Static-99 scores to identify sexual offenders who may require intensive supervision or even postrelease civil commitment, it is important to recognize that there may be more measurement error for high scores than low scores and to consider adopting procedures for minimizing or accounting for measurement error. PMID:24932647

  11. Improving results for carotid artery stenting by validation of the anatomic scoring system for carotid artery stenting with patient-specific simulated rehearsal.

    PubMed

    Willaert, Willem I M; Cheshire, Nicholas J; Aggarwal, Rajesh; Van Herzeele, Isabelle; Stansby, Gerard; Macdonald, Sumaira; Vermassen, Frank E

    2012-12-01

    Carotid artery stenting (CAS) is a technically demanding procedure with a risk of periprocedural stroke. A scoring system based on anatomic criteria has been developed to facilitate patient selection for CAS. Advancements in simulation science also enable case evaluation through patient-specific virtual reality (VR) rehearsal on an endovascular simulator. This study aimed to validate the anatomic scoring system for CAS using the patient-specific VR technology. Three patients were selected and graded according to the CAS scoring system (maximum score, 9): one easy (score, <4.9), one intermediate (score, 5.0-5.9), and one difficult (score, >7.0). The three cases were performed on the simulator in random order by 20 novice interventionalists pretrained in CAS. Technical performances were assessed using simulator-based metrics and expert-based ratings. The interventionalists took significantly longer to perform the difficult CAS case (median, 31.6 vs 19.7 vs 14.6 minutes; P<.0001) compared with the intermediate and easy cases; similarly, more fluoroscopy time (20.7 vs 12.1 vs 8.2 minutes; P<.0001), contrast volume (56.5 vs 51.5 vs 50.0 mL; P=.0060), and roadmaps (10 vs 9 vs 9; P=.0040) were used. The quality of performance declined significantly as the cases became more challenging (score, 24 vs 22 vs 19; P<.0001). The anatomic scoring system for CAS can predict the difficulty of a CAS procedure as measured by patient-specific VR. This scoring system, with or without the additional use of patient-specific VR, can guide novice interventionalists in selecting appropriate patients for CAS. This may reduce the perioperative stroke risk and enhance patient safety. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  12. Credit scoring analysis using kernel discriminant

    NASA Astrophysics Data System (ADS)

    Widiharih, T.; Mukid, M. A.; Mustafid

    2018-05-01

    Credit scoring model is an important tool for reducing the risk of wrong decisions when granting credit facilities to applicants. This paper investigate the performance of kernel discriminant model in assessing customer credit risk. Kernel discriminant analysis is a non- parametric method which means that it does not require any assumptions about the probability distribution of the input. The main ingredient is a kernel that allows an efficient computation of Fisher discriminant. We use several kernel such as normal, epanechnikov, biweight, and triweight. The models accuracy was compared each other using data from a financial institution in Indonesia. The results show that kernel discriminant can be an alternative method that can be used to determine who is eligible for a credit loan. In the data we use, it shows that a normal kernel is relevant to be selected for credit scoring using kernel discriminant model. Sensitivity and specificity reach to 0.5556 and 0.5488 respectively.

  13. Improvements in State and Local Planning for Mass Dispensing of Medical Countermeasures: The Technical Assistance Review Program, United States, 2007–2014

    PubMed Central

    Vagi, Sara J.; Reinold, Chris M.; Silverman, Brenda L.; Avchen, Rachel N.

    2017-01-01

    Objectives. To evaluate and describe outcomes of state and local medical countermeasure preparedness planning, which is critical to ensure rapid distribution and dispensing of a broad spectrum of life-saving medical assets during a public health emergency. Methods. We used 2007 to 2014 state and local data collected from the Centers for Disease Control and Prevention’s Technical Assistance Review. We calculated descriptive statistics from 50 states and 72 local Cities Readiness Initiative jurisdictions that participated in the Technical Assistance Review annually. Results. From 2007 to 2014, the average overall Technical Assistance Review score increased by 13% for states and 41% for Cities Readiness Initiative jurisdictions. In 2014, nearly half of states achieved the maximum possible overall score (100), and 94% of local Cities Readiness Initiative jurisdictions achieved a score of 90 or more. Conclusions. Despite challenges, effective and timely medical countermeasure distribution and dispensing is possible with appropriate planning, staff, and resources. However, vigilance in training, exercising, and improving plans from lessons learned in a sustained, coordinated way is critical to ensure continued public health preparedness success. PMID:28892441

  14. Development of Cooperative Planning for Technical-Vocational Programs.

    ERIC Educational Resources Information Center

    Cisco Junior Coll., TX.

    During the past decade vocational-technical education in Texas has grown so rapidly that now attention must be given to enrollments, employment projections, and more efficient utilization of the limited resources available. Cisco and Ranger Junior Colleges serve essentially the same population and a plan for close cooperation and coordination is…

  15. The effect of dietary garlic supplementation on body weight gain, feed intake, feed conversion efficiency, faecal score, faecal coliform count and feeding cost in crossbred dairy calves.

    PubMed

    Ghosh, Sudipta; Mehla, Ram K; Sirohi, S K; Roy, Biswajit

    2010-06-01

    Thirty-six crossbred calves (Holstein cross) of 5 days of age were used to study the effect of garlic extract feeding on their performance up to the age of 2 months (pre-ruminant stage). They were randomly allotted into treatment and control groups (18 numbers in each group). Performance was evaluated by measuring average body weight (BW) gain, feed intake (dry matter (DM), total digestible nutrient (TDN) and crude protein (CP)), feed conversion efficiency (FCE; DM, TDN and CP), faecal score, faecal coliform count and feeding cost. Diets were the same for the both groups. In addition, treatment group received garlic extract supplementation at 250 mg/kg BW per day per calf. Body weight measured weekly, feed intake measured twice daily, proximate analysis of feeds and fodders analysed weekly, faecal scores monitored daily and faecal coliform count done weekly. There was significant increase in average body weight gain, feed intake and FCE and significant decrease in severity of scours as measured by faecal score and faecal coliform count in the treatment group compared to the control group (P < 0.01). Feed cost per kilogramme BW gain was significantly lower in the treatment group compared to control group (P < 0.01). The results suggest that garlic extract can be supplemented to the calves for better performance.

  16. Univariate and Bivariate Loglinear Models for Discrete Test Score Distributions.

    ERIC Educational Resources Information Center

    Holland, Paul W.; Thayer, Dorothy T.

    2000-01-01

    Applied the theory of exponential families of distributions to the problem of fitting the univariate histograms and discrete bivariate frequency distributions that often arise in the analysis of test scores. Considers efficient computation of the maximum likelihood estimates of the parameters using Newton's Method and computationally efficient…

  17. Forging the Basis for Developing Protein-Ligand Interaction Scoring Functions.

    PubMed

    Liu, Zhihai; Su, Minyi; Han, Li; Liu, Jie; Yang, Qifan; Li, Yan; Wang, Renxiao

    2017-02-21

    In structure-based drug design, scoring functions are widely used for fast evaluation of protein-ligand interactions. They are often applied in combination with molecular docking and de novo design methods. Since the early 1990s, a whole spectrum of protein-ligand interaction scoring functions have been developed. Regardless of their technical difference, scoring functions all need data sets combining protein-ligand complex structures and binding affinity data for parametrization and validation. However, data sets of this kind used to be rather limited in terms of size and quality. On the other hand, standard metrics for evaluating scoring function used to be ambiguous. Scoring functions are often tested in molecular docking or even virtual screening trials, which do not directly reflect the genuine quality of scoring functions. Collectively, these underlying obstacles have impeded the invention of more advanced scoring functions. In this Account, we describe our long-lasting efforts to overcome these obstacles, which involve two related projects. On the first project, we have created the PDBbind database. It is the first database that systematically annotates the protein-ligand complexes in the Protein Data Bank (PDB) with experimental binding data. This database has been updated annually since its first public release in 2004. The latest release (version 2016) provides binding data for 16 179 biomolecular complexes in PDB. Data sets provided by PDBbind have been applied to many computational and statistical studies on protein-ligand interaction and various subjects. In particular, it has become a major data resource for scoring function development. On the second project, we have established the Comparative Assessment of Scoring Functions (CASF) benchmark for scoring function evaluation. Our key idea is to decouple the "scoring" process from the "sampling" process, so scoring functions can be tested in a relatively pure context to reflect their quality. In our

  18. 76 FR 33332 - Announcement of Funding Awards for the Technical Assistance and Capacity Building under the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-08

    ... of key Departmental objectives, including but not limited to, energy efficiency and green building... Awards for the Technical Assistance and Capacity Building under the Transformation Initiative Program...) for the Technical Assistance and Capacity Building under the Transformation Initiative program for...

  19. [Primary care: decentralization and efficiency].

    PubMed

    Pinillos, M; Antoñanzas, F

    2002-01-01

    The purpose of this study was to evaluate whether the productive behavior of health centers in autonomous communities with competence in health is more efficient than that among centers belonging to Spanish public health system (INSALUD). The technical efficiency of 66 health centers in Alava, Navarre and La Rioja was analyzed. Centers in autonomous communities that in 1997 had been granted complete authority from the central government to manage their healthcare services were compared with centers whose administration, in the same year, was still in the hands of INSALUD. The method used to measure and quantify the efficiency of these centers was data envelopment analysis. Nonparametric contrast of the health centers' mean efficiency rates revealed no significant differences in the (in)efficiency of centers from La Rioja, Navarre and Alava. The results obtained from the model of efficiency measurement used did not indicate that decentralization improves the productive efficiency of primary care centers.

  20. Assessment in health care education - modelling and implementation of a computer supported scoring process.

    PubMed

    Alfredsson, Jayne; Plichart, Patrick; Zary, Nabil

    2012-01-01

    Research on computer supported scoring of assessments in health care education has mainly focused on automated scoring. Little attention has been given to how informatics can support the currently predominant human-based grading approach. This paper reports steps taken to develop a model for a computer supported scoring process that focuses on optimizing a task that was previously undertaken without computer support. The model was also implemented in the open source assessment platform TAO in order to study its benefits. Ability to score test takers anonymously, analytics on the graders reliability and a more time efficient process are example of observed benefits. A computer supported scoring will increase the quality of the assessment results.

  1. Integrating Genetics and Social Science: Genetic Risk Scores

    PubMed Central

    Belsky, Daniel W.; Israel, Salomon

    2014-01-01

    The sequencing of the human genome and the advent of low-cost genome-wide assays that generate millions of observations of individual genomes in a matter of hours constitute a disruptive innovation for social science. Many public-use social science datasets have or will soon add genome-wide genetic data. With these new data come technical challenges, but also new possibilities. Among these, the lowest hanging fruit and the most potentially disruptive to existing research programs is the ability to measure previously invisible contours of health and disease risk within populations. In this article, we outline why now is the time for social scientists to bring genetics into their research programs. We discuss how to select genetic variants to study. We explain how the polygenic architecture of complex traits and the low penetrance of individual genetic loci pose challenges to research integrating genetics and social science. We introduce genetic risk scores as a method of addressing these challenges and provide guidance on how genetic risk scores can be constructed. We conclude by outlining research questions that are ripe for social science inquiry. PMID:25343363

  2. Impact of sleep deprivation on anaesthesia residents' non-technical skills: a pilot simulation-based prospective randomized trial.

    PubMed

    Neuschwander, A; Job, A; Younes, A; Mignon, A; Delgoulet, C; Cabon, P; Mantz, J; Tesniere, A

    2017-07-01

    Sleep deprivation is common in anaesthesia residents, but its impact on performance remains uncertain. Non-technical skills (team working, situation awareness, decision making, and task management) are key components of quality of care in anaesthesia, particularly in crisis situations occurring in the operating room. The impact of sleep deprivation on non-technical skills is unknown. We tested the hypothesis that in anaesthesia residents sleep deprivation is associated with impaired non-technical skills. Twenty anaesthesia residents were randomly allocated to undergo a simulation session after a night shift [sleep-deprived (SLD) group, n =10] or after a night of rest [rested (R) group, n =10] from January to March 2015. The simulated scenario was a situation of crisis management in the operating room. The primary end point was a composite score of anaesthetists' non-technical skills (ANTS) assessed by two blinded evaluators. Non-technical skills were significantly impaired in the SLD group [ANTS score 12.2 (interquartile range 10.5-13)] compared with the R group [14.5 (14-15), P <0.02]. This difference was mainly accounted for by a difference in the team working item. On the day of simulation, the SLD group showed increased sleepiness and decreased confidence in anaesthesia skills. In this randomized pilot trial, sleep deprivation was associated with impaired non-technical skills of anaesthesia residents in a simulated anaesthesia intraoperative crisis scenario. NCT02622217. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  3. Computer-Assisted Automated Scoring of Polysomnograms Using the Somnolyzer System

    PubMed Central

    Punjabi, Naresh M.; Shifa, Naima; Dorffner, Georg; Patil, Susheel; Pien, Grace; Aurora, Rashmi N.

    2015-01-01

    Study Objectives: Manual scoring of polysomnograms is a time-consuming and tedious process. To expedite the scoring of polysomnograms, several computerized algorithms for automated scoring have been developed. The overarching goal of this study was to determine the validity of the Somnolyzer system, an automated system for scoring polysomnograms. Design: The analysis sample comprised of 97 sleep studies. Each polysomnogram was manually scored by certified technologists from four sleep laboratories and concurrently subjected to automated scoring by the Somnolyzer system. Agreement between manual and automated scoring was examined. Sleep staging and scoring of disordered breathing events was conducted using the 2007 American Academy of Sleep Medicine criteria. Setting: Clinical sleep laboratories. Measurements and Results: A high degree of agreement was noted between manual and automated scoring of the apnea-hypopnea index (AHI). The average correlation between the manually scored AHI across the four clinical sites was 0.92 (95% confidence interval: 0.90–0.93). Similarly, the average correlation between the manual and Somnolyzer-scored AHI values was 0.93 (95% confidence interval: 0.91–0.96). Thus, interscorer correlation between the manually scored results was no different than that derived from manual and automated scoring. Substantial concordance in the arousal index, total sleep time, and sleep efficiency between manual and automated scoring was also observed. In contrast, differences were noted between manually and automated scored percentages of sleep stages N1, N2, and N3. Conclusion: Automated analysis of polysomnograms using the Somnolyzer system provides results that are comparable to manual scoring for commonly used metrics in sleep medicine. Although differences exist between manual versus automated scoring for specific sleep stages, the level of agreement between manual and automated scoring is not significantly different than that between any two

  4. The Kid-Short Marfan Score (Kid-SMS) - an easy executable risk score for suspected paediatric patients with Marfan syndrome.

    PubMed

    Mueller, Goetz C; Stark, Veronika; Steiner, Kristoffer; Weil, Jochen; von Kodolitsch, Yskert; Mir, Thomas S

    2013-02-01

    Due to age-dependent manifestations, diagnosis of Marfan syndrome (MFS) in children and adolescents is sophisticated. Although revised Ghent criteria is a major step forward, its utility in children is still restricted due to expensive and technically advanced diagnostics. As early diagnosis submits long-term benefits concerning prognosis, the need of an appropriate diagnostic tool for risk stratification of suspected paediatric patients with Marfan is justified. Sixty paediatric patients with Marfan were subject to a standardized diagnostic programme. All clinical symptoms of the revised Ghent nosology were analysed concerning age at first clinical manifestation, prevalence and likelihood ratio for MFS. Symptoms with early onset, high prevalence and high positive likelihood ratio were identified and combined for a risk score called Kid-Short Marfan Score (Kid-SMS). Three risk categories for suspicion of Marfan syndrome were developed. Finally, the Kid-SMS was operated in 130 paediatric patients with suspected MFS. Kid-SMS identified significantly more suspected patients with Marfan compared with Ghent nosology, revised Ghent and genetics alone without oversensitivity. Whereas diagnosis of MFS in childhood is sophisticated, Kid-SMS is a useful tool for risk stratification of suspected paediatric patients with Marfan by easy executable diagnostics, especially for paediatricians and paediatric cardiologists. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

  5. Technical and Regulatory Guidance Document for Constructed Treatment Wetlands

    DTIC Science & Technology

    2003-12-01

    leachate and acid mine drainage. The purpose of this document is to provide technical and regulatory guidance to help regulators, industry, consultants...Contaminants at Industrial Facilities .....................41 Table 4-12 Typical Landfill Leachate Characteristics and Removal Efficiencies...43 Table 4-14 Landfill Leachate Characteristics

  6. The value of Bayes' theorem for interpreting abnormal test scores in cognitively healthy and clinical samples.

    PubMed

    Gavett, Brandon E

    2015-03-01

    The base rates of abnormal test scores in cognitively normal samples have been a focus of recent research. The goal of the current study is to illustrate how Bayes' theorem uses these base rates--along with the same base rates in cognitively impaired samples and prevalence rates of cognitive impairment--to yield probability values that are more useful for making judgments about the absence or presence of cognitive impairment. Correlation matrices, means, and standard deviations were obtained from the Wechsler Memory Scale--4th Edition (WMS-IV) Technical and Interpretive Manual and used in Monte Carlo simulations to estimate the base rates of abnormal test scores in the standardization and special groups (mixed clinical) samples. Bayes' theorem was applied to these estimates to identify probabilities of normal cognition based on the number of abnormal test scores observed. Abnormal scores were common in the standardization sample (65.4% scoring below a scaled score of 7 on at least one subtest) and more common in the mixed clinical sample (85.6% scoring below a scaled score of 7 on at least one subtest). Probabilities varied according to the number of abnormal test scores, base rates of normal cognition, and cutoff scores. The results suggest that interpretation of base rates obtained from cognitively healthy samples must also account for data from cognitively impaired samples. Bayes' theorem can help neuropsychologists answer questions about the probability that an individual examinee is cognitively healthy based on the number of abnormal test scores observed.

  7. The Zhongshan Score

    PubMed Central

    Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

    2015-01-01

    Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P < 0.05). For ZS score, patients with moderate and high scores had longer warm ischemia time (WIT) and greater increase in SCr compared with low score (all P < 0.05). What is more, the differences between moderate and high scores classified by ZS score were borderline but trending toward significance in WIT (P = 0.064) and increase in SCr (P = 0.052). Interestingly, RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P < 0.05). As for RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P < 0.05). Patients with a high or moderate score of PADUA had 2.3-fold or 2.8-fold higher risk of surgical complications, respectively (all P < 0.05). In the ROC curve analysis, ZS score had the greatest AUC for surgical complications (AUC = 0.632) and the conversion to radical nephrectomy (AUC = 0.845) (all P < 0.05). In conclusion, the ability of ZS score to predict the surgical complexity and surgical

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jayaweera, Tina; Velonis, Aquila; Haeri, Hossein

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

  9. Safety in Trade and Industrial and Technical Education.

    ERIC Educational Resources Information Center

    Thomas, John C.

    Intended to serve as a resource guide to assist trade, industrial, and technical teachers in maintaining an effective and efficient safety program, the document does not contain information concerning the many specific operations of the various trades. The materials serve as a background for teachers as they develop their own units of instruction…

  10. Application of independent component analysis for speech-music separation using an efficient score function estimation

    NASA Astrophysics Data System (ADS)

    Pishravian, Arash; Aghabozorgi Sahaf, Masoud Reza

    2012-12-01

    In this paper speech-music separation using Blind Source Separation is discussed. The separating algorithm is based on the mutual information minimization where the natural gradient algorithm is used for minimization. In order to do that, score function estimation from observation signals (combination of speech and music) samples is needed. The accuracy and the speed of the mentioned estimation will affect on the quality of the separated signals and the processing time of the algorithm. The score function estimation in the presented algorithm is based on Gaussian mixture based kernel density estimation method. The experimental results of the presented algorithm on the speech-music separation and comparing to the separating algorithm which is based on the Minimum Mean Square Error estimator, indicate that it can cause better performance and less processing time

  11. Energy Efficiency Program Administrators and Building Energy Codes

    EPA Pesticide Factsheets

    Explore how energy efficiency program administrators have helped advance building energy codes at federal, state, and local levels—using technical, institutional, financial, and other resources—and discusses potential next steps.

  12. Private Technical and Vocational Education in Sub-Saharan Africa: Provision Patterns and Policy Issues. New Trends in Technical and Vocational Education.

    ERIC Educational Resources Information Center

    Atchoarena, David; Esquieu, Paul

    The private provision trend in technical and vocational education (TVE) in sub-Saharan Africa occurred as the deterioration of state-run TVE systems in the region created a market niche for private providers. While advocates of deregulation believe the adoption of market principles in TVE will lead to greater efficiency and effectiveness, private…

  13. Church ownership and hospital efficiency.

    PubMed

    White, K R; Ozcan, Y A

    1996-01-01

    Using a sample of California hospitals, the effect of church ownership was examined as it relates to nonprofit hospital efficiency. Efficiency scores were computed using a nonparametric method called data envelopment analysis (DEA). Controlling for hospital size, location, system membership, and type of church ownership, church-owned hospitals were found to be more frequently in the efficient category than their secular nonprofit counterparts. The outcomes have policy implications for reducing healthcare expenditures by focusing on increasing outputs or decreasing inputs, as appropriate, and bolstering the case for church-sponsored hospitals to retain the tax-exempt status due to their ability to manage their resources as efficiently as (or more efficiently than) secular hospitals.

  14. The Limpopo Non-Metropolitan Drinking Water Supplier Response to a Diagnostic Tool for Technical Compliance

    PubMed Central

    Nefale, Avhashoni D.; Kamika, Ilunga; Obi, Chikwelu L.

    2017-01-01

    Water services providers should supply water that is fit for human consumption, taking into account multi-barrier approaches and technical aspects such as design aspects, operation monitoring, final water quality compliance monitoring, plant monitoring practices, maintenance, and risk management practices. Against this background, this study focused on applying the diagnostic tool for technical compliance as well as assessing the compliance of water treatment plants with management norms. Six plants in the Vhembe District Municipality were selected; the Vondo, Malamulele, Mutshedzi, and Mutale plants (conventional), and the Dzingahe and Tshedza package plants. During the first assessment, four (Malamulele, Mutshedzi, Mutale and Dzingahe) plants scored between 44% and 49% and achieved Class 3 certification, revealing serious challenges requiring immediate intervention. Two water plants (Vondo and Tshedza, scoring 53% and 63%, respectively) were in the Class 2 category, revealing serious challenges requiring attention and improvement. During the second assessment, all plants scored between 63% and 87% (Class 2 category). The greatest improvement (30%) was noted for the Dzingahe and Tshedza plants, followed by the Malamulele plant, while the Mutale, Vondo, and Mutshedzi plants improved their scores by 20%, 17% and 14%, respectively. After corrective actions and re-measurement, no plant complied. It is recommended that Water Services Providers (WSPs) regularly apply the diagnostic tools and water safety plans as developed in order to comply with applicable standards. PMID:28753964

  15. The Limpopo Non-Metropolitan Drinking Water Supplier Response to a Diagnostic Tool for Technical Compliance.

    PubMed

    Nefale, Avhashoni D; Kamika, Ilunga; Obi, Chikwelu L; Momba, Maggy Nb

    2017-07-19

    Water services providers should supply water that is fit for human consumption, taking into account multi-barrier approaches and technical aspects such as design aspects, operation monitoring, final water quality compliance monitoring, plant monitoring practices, maintenance, and risk management practices. Against this background, this study focused on applying the diagnostic tool for technical compliance as well as assessing the compliance of water treatment plants with management norms. Six plants in the Vhembe District Municipality were selected; the Vondo, Malamulele, Mutshedzi, and Mutale plants (conventional), and the Dzingahe and Tshedza package plants. During the first assessment, four (Malamulele, Mutshedzi, Mutale and Dzingahe) plants scored between 44% and 49% and achieved Class 3 certification, revealing serious challenges requiring immediate intervention. Two water plants (Vondo and Tshedza, scoring 53% and 63%, respectively) were in the Class 2 category, revealing serious challenges requiring attention and improvement. During the second assessment, all plants scored between 63% and 87% (Class 2 category). The greatest improvement (30%) was noted for the Dzingahe and Tshedza plants, followed by the Malamulele plant, while the Mutale, Vondo, and Mutshedzi plants improved their scores by 20%, 17% and 14%, respectively. After corrective actions and re-measurement, no plant complied. It is recommended that Water Services Providers (WSPs) regularly apply the diagnostic tools and water safety plans as developed in order to comply with applicable standards.

  16. Introduction of the non-technical skills for surgeons (NOTSS) system in a Japanese cancer center.

    PubMed

    Tsuburaya, Akira; Soma, Takahiro; Yoshikawa, Takaki; Cho, Haruhiko; Miki, Tamotsu; Uramatsu, Masashi; Fujisawa, Yoshikazu; Youngson, George; Yule, Steven

    2016-12-01

    Non-technical skills rating systems, which are designed to support surgical performance, have been introduced worldwide, but not officially in Japan. We performed a pilot study to evaluate the "non-technical skills for surgeons" (NOTSS) rating system in a major Japanese cancer center. Upper gastrointestinal surgeons were selected as trainers or trainees. The trainers attended a master-class on NOTSS, which included simulated demo-videos, to promote consistency across the assessments. The trainers thereafter commenced observing the trainees and whole teams, utilizing the NOTSS and "observational teamwork assessment for surgery" (OTAS) rating systems, before and after their education. Four trainers and six trainees were involved in this study. Test scores for understanding human factors and the NOTSS system were 5.89 ± 1.69 and 8.00 ± 1.32 before and after the e-learning, respectively (mean ± SD, p = 0.010). The OTAS scores for the whole team improved significantly after the trainees' education in five out of nine stages (p < 0.05). There were no differences in the NOTSS scores before and after education, with a small improvement in the total scores for the "teamwork and communication" and "leadership" categories. These findings demonstrate that implementing the NOTSS system is feasible in Japan. Education of both surgical trainers and trainees would contribute to better team performance.

  17. Energy Efficiency: Transportation and Buildings

    NASA Astrophysics Data System (ADS)

    Lubell, Michael S.; Richter, Burton

    2011-11-01

    We present a condensed version of the American Physical Society's 2008 analysis of energy efficiency in the transportation and buildings sectors in the United States with updated numbers. In addition to presenting technical findings, we include the report's recommendations for policy makers that we believe are in the best interests of the nation.

  18. College Math Assessment: SAT Scores vs. College Math Placement Scores

    ERIC Educational Resources Information Center

    Foley-Peres, Kathleen; Poirier, Dawn

    2008-01-01

    Many colleges and university's use SAT math scores or math placement tests to place students in the appropriate math course. This study compares the use of math placement scores and SAT scores for 188 freshman students. The student's grades and faculty observations were analyzed to determine if the SAT scores and/or college math assessment scores…

  19. The Stanford Microsurgery and Resident Training (SMaRT) Scale: validation of an on-line global rating scale for technical assessment.

    PubMed

    Satterwhite, Thomas; Son, Ji; Carey, Joseph; Echo, Anthony; Spurling, Terry; Paro, John; Gurtner, Geoffrey; Chang, James; Lee, Gordon K

    2014-05-01

    We previously reported results of our on-line microsurgery training program, showing that residents who had access to our website significantly improved their cognitive and technical skills. In this study, we report an objective means for expert evaluators to reliably rate trainees' technical skills under the microscope, with the use of our novel global rating scale. "Microsurgery Essentials" (http://smartmicrosurgery.com) is our on-line training curriculum. Residents were randomly divided into 2 groups: 1 group reviewed this online resource and the other did not. Pre- and post-tests consisted of videotaped microsurgical sessions in which the trainee performed "microsurgery" on 3 different models: latex glove, penrose drain, and the dorsal vessel of a chicken foot. The SMaRT (Stanford Microsurgery and Resident Training) scale, consisting of 9 categories graded on a 5-point Likert scale, was used to assess the trainees. Results were analyzed with ANOVA and Student t test, with P less than 0.05 indicating statistical significance. Seventeen residents participated in the study. The SMaRT scale adequately differentiated the performance of more experienced senior residents (PGY-4 to PGY-6, total average score=3.43) from less experienced junior residents (PGY-1 to PGY-3, total average score=2.10, P<0.0001). Residents who viewed themselves as being confident received a higher score on the SMaRT scale (average score 3.5), compared to residents who were not as confident (average score 2.1) (P<0.001). There were no significant differences in scoring among all 3 evaluators (P>0.05). Additionally, junior residents who had access to our website showed a significant increase in their graded technical performance by 0.7 points when compared to residents who did not have access to the website who showed an improvement of only 0.2 points (P=0.01). Our SMaRT scale is valid and reliable in assessing the microsurgical skills of residents and other trainees. Current trainees are more

  20. Technical Assessment of Maglev System Concepts

    DTIC Science & Technology

    1998-10-01

    pressurizes the loop but retains sufficient heat capacity for the day’s cooling needs. Magneplane uses a cryorefrigerator to keep its supercritical helium in...comparative baselines. the technical and economic viability of maglev in * Apply this process to alternative U.S. maglev the U.S. and to recommend...output/joules- heat the same data as in Figure 119 with the aforemen- input). In effect, applying this factor implies that tioned efficiencies applied

  1. Meta-Storms: efficient search for similar microbial communities based on a novel indexing scheme and similarity score for metagenomic data.

    PubMed

    Su, Xiaoquan; Xu, Jian; Ning, Kang

    2012-10-01

    It has long been intriguing scientists to effectively compare different microbial communities (also referred as 'metagenomic samples' here) in a large scale: given a set of unknown samples, find similar metagenomic samples from a large repository and examine how similar these samples are. With the current metagenomic samples accumulated, it is possible to build a database of metagenomic samples of interests. Any metagenomic samples could then be searched against this database to find the most similar metagenomic sample(s). However, on one hand, current databases with a large number of metagenomic samples mostly serve as data repositories that offer few functionalities for analysis; and on the other hand, methods to measure the similarity of metagenomic data work well only for small set of samples by pairwise comparison. It is not yet clear, how to efficiently search for metagenomic samples against a large metagenomic database. In this study, we have proposed a novel method, Meta-Storms, that could systematically and efficiently organize and search metagenomic data. It includes the following components: (i) creating a database of metagenomic samples based on their taxonomical annotations, (ii) efficient indexing of samples in the database based on a hierarchical taxonomy indexing strategy, (iii) searching for a metagenomic sample against the database by a fast scoring function based on quantitative phylogeny and (iv) managing database by index export, index import, data insertion, data deletion and database merging. We have collected more than 1300 metagenomic data from the public domain and in-house facilities, and tested the Meta-Storms method on these datasets. Our experimental results show that Meta-Storms is capable of database creation and effective searching for a large number of metagenomic samples, and it could achieve similar accuracies compared with the current popular significance testing-based methods. Meta-Storms method would serve as a suitable

  2. Automated Essay Scoring versus Human Scoring: A Comparative Study

    ERIC Educational Resources Information Center

    Wang, Jinhao; Brown, Michelle Stallone

    2007-01-01

    The current research was conducted to investigate the validity of automated essay scoring (AES) by comparing group mean scores assigned by an AES tool, IntelliMetric [TM] and human raters. Data collection included administering the Texas version of the WriterPlacer "Plus" test and obtaining scores assigned by IntelliMetric [TM] and by…

  3. Storying energy consumption: Collective video storytelling in energy efficiency social marketing.

    PubMed

    Gordon, Ross; Waitt, Gordon; Cooper, Paul; Butler, Katherine

    2018-05-01

    Despite calls for more socio-technical research on energy, there is little practical advice to how narratives collected through qualitative research may be melded with technical knowledge from the physical sciences such as engineering and then applied in energy efficiency social action strategies. This is despite established knowledge in the environmental management literature about domestic energy use regarding the utility of social practice theory and narrative framings that socialise everyday consumption. Storytelling is positioned in this paper both as a focus for socio-technical energy research, and as one potential practical tool that can arguably enhance energy efficiency interventions. We draw upon the literature on everyday social practices, and storytelling, to present our framework called 'collective video storytelling' that combines scientific and lay knowledge about domestic energy use to offer a practical tool for energy efficiency management. Collective video storytelling is discussed in the context of Energy+Illawarra, a 3-year cross-disciplinary collaboration between social marketers, human geographers, and engineers to target energy behavioural change within older low-income households in regional NSW, Australia. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Key Technical Aspects Influencing the Accuracy of Tablet Subdivision.

    PubMed

    Teixeira, Maíra T; Sá-Barreto, Lívia C L; Gratieri, Taís; Gelfuso, Guilherme M; Silva, Izabel C R; Cunha-Filho, Marcílio S S

    2017-05-01

    Tablet subdivision is a common practice used mainly for dose adjustment. The aim of this study was to investigate how the technical aspects of production as well as the method of tablets subdivision (employing a tablet splitter or a kitchen knife) influence the accuracy of this practice. Five drugs commonly used as subdivided tablets were selected. For each drug, the innovator drug product, a scored-generic and a non-scored generic were investigated totalizing fifteen drug products. Mechanical and physical tests, including image analysis, were performed. Additionally, comparisons were made between tablet subdivision method, score, shape, diluent composition and coating. Image analysis based on surface area was a useful tool as an alternative assay to evaluate the accuracy of tablet subdivision. The tablet splitter demonstrates an advantage relative to a knife as it showed better results in weight loss and friability tests. Oblong, coated and scored tablets had better results after subdivision than round, uncoated and non-scored tablets. The presence of elastic diluents such as starch and dibasic phosphate dehydrate conferred a more appropriate behaviour for the subdivision process than plastic materials such as microcrystalline cellulose and lactose. Finally, differences were observed between generics and their innovator products in all selected drugs with regard the quality control assays in divided tablet, which highlights the necessity of health regulations to consider subdivision performance at least in marketing authorization of generic products.

  5. Managing Information On Technical Requirements

    NASA Technical Reports Server (NTRS)

    Mauldin, Lemuel E., III; Hammond, Dana P.

    1993-01-01

    Technical Requirements Analysis and Control Systems/Initial Operating Capability (TRACS/IOC) computer program provides supplemental software tools for analysis, control, and interchange of project requirements so qualified project members have access to pertinent project information, even if in different locations. Enables users to analyze and control requirements, serves as focal point for project requirements, and integrates system supporting efficient and consistent operations. TRACS/IOC is HyperCard stack for use on Macintosh computers running HyperCard 1.2 or later and Oracle 1.2 or later.

  6. Trade-offs between effectiveness and efficiency in stroke rehabilitation.

    PubMed

    Koh, Gerald Choon-Huat; Chen, Cynthia; Cheong, Angela; Choo, Tai Bee; Pui, Choi Kwok; Phoon, Fong Ngan; Ming, Chan Kin; Yeow, Tan Boon; Petrella, Robert; Thind, Amardeep; Koh, David; Seng, Chia Kee

    2012-12-01

    Most stroke research has studied rehabilitation effectiveness and rehabilitation efficiency separately and not investigated the potential trade-offs between these two indices of rehabilitation. To determine whether there is a trade-off between independent factors of rehabilitation effectiveness and rehabilitation efficiency. Using a retrospective cohort study design, we studied all stroke patients (n = 2810) from two sub-acute rehabilitation hospitals from 1996 to 2005, representing 87·5% of national bed-years during the same period. Independent predictors of poorer rehabilitation effectiveness and log rehabilitation efficiency were • older age • race-ethnicity • caregiver availability • ischemic stroke • longer time to admission • dementia • admission Barthel Index score, and • length of stay. Rehabilitation effectiveness was lower in females, and the gender differences were significantly lower in those aged ≤70 years (β -4·7 (95% confidence interval -7·4 to -2·0)). There were trade-offs between effectiveness and efficiency with respect to admission Barthel Index score and length of stay. An increase of 10 in admission Barthel Index score predicted an increase of 3·6% (95% confidence interval 3·2-4·0) in effectiveness but a decrease of 0·04 (95% confidence interval -0·05 to -0·02) in log efficiency (a reduction of efficiency by 1·0 per 30 days). An increase in log length of stay by 1 (length of stay of 2·7 days) predicted an increase of 8·0% (95% confidence interval 5·7-10·3) in effectiveness but a decrease of 0·82 (95% confidence interval -0·90 to -0·74) in log efficiency (equivalent to a reduction in efficiency by 2·3 per 30 days). For optimal rehabilitation effectiveness and rehabilitation efficiency, the admission Barthel Index score was 30-62 and length of stay was 37-41 days. There are trade-offs between effectiveness and efficiency during inpatient sub-acute stroke rehabilitation with respect to admission functional

  7. Comparison of the goals and MISTELS scores for the evaluation of surgeons on training benches.

    PubMed

    Wolf, Rémi; Medici, Maud; Fiard, Gaëlle; Long, Jean-Alexandre; Moreau-Gaudry, Alexandre; Cinquin, Philippe; Voros, Sandrine

    2018-01-01

    Evaluation of surgical technical abilities is a major issue in minimally invasive surgery. Devices such as training benches offer specific scores to evaluate surgeons but cannot transfer in the operating room (OR). A contrario, several scores measure performance in the OR, but have not been evaluated on training benches. Our aim was to demonstrate that the GOALS score, which can effectively grade in the OR the abilities involved in laparoscopy, can be used for evaluation on a laparoscopic testbench (MISTELS). This could lead to training systems that can identify more precisely the skills that have been acquired or must still be worked on. 32 volunteers (surgeons, residents and medical students) performed the 5 tasks of the MISTELS training bench and were simultaneously video-recorded. Their performance was evaluated with the MISTELS score and with the GOALS score based on the review of the recording by two experienced, blinded laparoscopic surgeons. The concurrent validity of the GOALS score was assessed using Pearson and Spearman correlation coefficients with the MISTELS score. The construct validity of the GOALS score was assessed with k-means clustering and accuracy rates. Lastly, abilities explored by each MISTELS task were identified with multiple linear regression. GOALS and MISTELS scores are strongly correlated (Pearson correlation coefficient = 0.85 and Spearman correlation coefficient = 0.82 for the overall score). The GOALS score proves to be valid for construction for the tasks of the training bench, with a better accuracy rate between groups of level after k-means clustering, when compared to the original MISTELS score (accuracy rates, respectively, 0.75 and 0.56). GOALS score is well suited for the evaluation of the performance of surgeons of different levels during the completion of the tasks of the MISTELS training bench.

  8. The application of DEA (Data Envelopment Analysis) window analysis in the assessment of influence on operational efficiencies after the establishment of branched hospitals.

    PubMed

    Jia, Tongying; Yuan, Huiyun

    2017-04-12

    Many large-scaled public hospitals have established branched hospitals in China. This study is to provide evidence for strategy making on the management and development of multi-branched hospitals by evaluating and comparing the operational efficiencies of different hospitals before and after their establishment of branched hospitals. DEA (Data Envelopment Analysis) window analysis was performed on a 7-year data pool from five public hospitals provided by health authorities and institutional surveys. The operational efficiencies of sample hospitals measured in this study (including technical efficiency, pure technical efficiency and scale efficiency) had overall trends towards increase during this 7-year period of time, however, a temporary downturn occurred shortly after the establishment of branched hospitals; pure technical efficiency contributed more to the improvement of technical efficiency compared to scale efficiency. The establishment of branched-hospitals did not lead to a long-term negative effect on hospital operational efficiencies. Our data indicated the importance of improving scale efficiency via the optimization of organizational management, as well as the advantage of a different form of branch-establishment, merging and reorganization. This study brought an insight into the practical application of DEA window analysis on the assessment of hospital operational efficiencies.

  9. 77 FR 64970 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-24

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Biomass Research and... Biomass Research and Development Technical Advisory Committee. The Federal Advisory Committee Act (Pub. L... Meeting: To provide advice and guidance that promotes research and development leading to the production...

  10. 76 FR 46781 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-03

    ... DEPARTMENT OF ENERGY Energy Efficiency and Renewable Energy Biomass Research and Development...: Notice of open meeting. SUMMARY: This notice announces an open meeting of the Biomass Research and... meeting of the Biomass Research and Development Technical Advisory Committee. DATES and Times: August 23...

  11. 78 FR 8500 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Biomass Research and... Biomass Research and Development Technical Advisory Committee. The Federal Advisory Committee Act (Pub. L... fuels and biobased products. Tentative Agenda: Agenda will include the following: Update on USDA Biomass...

  12. INDOT Technical Training Plan : [Technical Summary

    DOT National Transportation Integrated Search

    2012-01-01

    A wide range of job classifications, increasing technical : performance expectations, licensing and certification requirements, : budget restrictions and frequent department : reorganization has made technical training of employees : more difficult, ...

  13. Exploring a Source of Uneven Score Equity across the Test Score Range

    ERIC Educational Resources Information Center

    Huggins-Manley, Anne Corinne; Qiu, Yuxi; Penfield, Randall D.

    2018-01-01

    Score equity assessment (SEA) refers to an examination of population invariance of equating across two or more subpopulations of test examinees. Previous SEA studies have shown that score equity may be present for examinees scoring at particular test score ranges but absent for examinees scoring at other score ranges. No studies to date have…

  14. The relative efficiency of Iranian's rural traffic police: a three-stage DEA model.

    PubMed

    Rahimi, Habibollah; Soori, Hamid; Nazari, Seyed Saeed Hashemi; Motevalian, Seyed Abbas; Azar, Adel; Momeni, Eskandar; Javartani, Mehdi

    2017-10-13

    Road traffic Injuries (RTIs) as a health problem imposes governments to implement different interventions. Target achievement in this issue required effective and efficient measures. Efficiency evaluation of traffic police as one of the responsible administrators is necessary for resource management. Therefore, this study conducted to measure Iran's rural traffic police efficiency. This was an ecological study. To obtain pure efficiency score, three-stage DEA model was conducted with seven inputs and three output variables. At the first stage, crude efficiency score was measured with BCC-O model. Next, to extract the effects of socioeconomic, demographic, traffic count and road infrastructure as the environmental variables and statistical noise, the Stochastic Frontier Analysis (SFA) model was applied and the output values were modified according to similar environment and statistical noise conditions. Then, the pure efficiency score was measured using modified outputs and BCC-O model. In total, the efficiency score of 198 police stations from 24 provinces of 31 provinces were measured. The annual means (standard deviation) of damage, injury and fatal accidents were 247.7 (258.4), 184.9 (176.9), and 28.7 (19.5), respectively. Input averages were 5.9 (3.0) patrol teams, 0.5% (0.2) manpower proportions, 7.5 (2.9) patrol cars, 0.5 (1.3) motorcycles, 77,279.1 (46,794.7) penalties, 90.9 (2.8) cultural and educational activity score, 0.7 (2.4) speed cameras. The SFA model showed non-significant differences between police station performances and the most differences attributed to the environmental and random error. One-way main road, by road, traffic count and the number of household owning motorcycle had significant positive relations with inefficiency score. The length of freeway/highway and literacy rate variables had negative relations, significantly. Pure efficiency score was with mean of 0.95 and SD of 0.09. Iran's traffic police has potential opportunity to reduce

  15. Effects of technical editing in biomedical journals: a systematic review.

    PubMed

    Wager, Elizabeth; Middleton, Philippa

    2002-06-05

    Technical editing supposedly improves the accuracy and clarity of journal articles. We examined evidence of its effects on research reports in biomedical journals. Subset of a systematic review using Cochrane methods, searching MEDLINE, EMBASE, and other databases from earliest entries to February 2000 by using inclusive search terms; hand searching relevant journals. We selected comparative studies of the effects of editorial processes on original research articles between acceptance and publication in biomedical journals. Two reviewers assessed each study and performed independent data extraction. The 11 studies on technical editing indicate that it improves the readability of articles slightly (as measured by Gunning Fog and Flesch reading ease scores), may improve other aspects of their quality, can increase the accuracy of references and quotations, and raises the quality of abstracts. Supplying authors with abstract preparation instructions had no discernible effect. Considering the time and resources devoted to technical editing, remarkably little is know about its effects or the effects of imposing different house styles. Studies performed at 3 journals employing relatively large numbers of professional technical editors suggest that their editorial processes are associated with increases in readability and quality of articles, but these findings may not be generalizable to other journals.

  16. Objective structured assessment of technical skills evaluation of theoretical compared with hands-on training of shoulder dystocia management: a randomized controlled trial.

    PubMed

    Buerkle, Bernd; Pueth, Julia; Hefler, Lukas A; Tempfer-Bentz, Eva-Katrin; Tempfer, Clemens B

    2012-10-01

    To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores. Hands-on training helps to achieve a significant

  17. 78 FR 66375 - Announcement of Funding Awards for the OneCPD Plus: Technical Assistance and Capacity Building...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... of key Departmental objectives, including but not limited to, energy efficiency and green building... Awards for the OneCPD Plus: Technical Assistance and Capacity Building Under the Transformation... Notice of Funding Availability (NOFA) for the OneCPD Plus: Technical Assistance and Capacity Building...

  18. Developing non-technical ward-round skills.

    PubMed

    Harvey, Rachel; Mellanby, Edward; Dearden, Effie; Medjoub, Karima; Edgar, Simon

    2015-10-01

    Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform. There is evidence that newly qualified doctors are not adequately prepared by their undergraduate experiences for this task. The aim of this study was to analyse the challenges pertaining to non-technical skills that students would face during ward rounds, and to create a model that facilitates the transition from medical student to doctor. A total of 217 final-year medical students completed a simulated ward round. Free-text responses were analysed using template analysis applying an a priori template developed from the literature by the research team. This drew on the generic categories of non-technical skills suggested by Flin et al. Ninety-seven per cent of students agreed or strongly agreed that the simulated ward round improved their insight into the challenges of ward rounds and their perceived ability to work efficiently as an active member of the ward round. The responding students (206) submitted written feedback describing the learning that they planned to use: 800 learning points were recorded, and all could be categorised into one of seven non-technical skills. Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform We believe that improved task efficiency and insight into the challenges of the ward round gained by medical students will lead to an enhancement in performance during clinical rounds, and will have a positive impact on patient safety. We would suggest that undergraduate medical schools consider this model in the preparation for the clinical practice element of the curriculum. © 2015 John Wiley & Sons Ltd.

  19. Technical intelligence and culture: Nut cracking in humans and chimpanzees.

    PubMed

    Boesch, Christophe; Bombjaková, Daša; Boyette, Adam; Meier, Amelia

    2017-06-01

    According to the technical intelligence hypothesis, humans are superior to all other animal species in understanding and using tools. However, the vast majority of comparative studies between humans and chimpanzees, both proficient tool users, have not controlled for the effects of age, prior knowledge, past experience, rearing conditions, or differences in experimental procedures. We tested whether humans are superior to chimpanzees in selecting better tools, using them more dexteriously, achieving higher performance and gaining access to more resource as predicted under the technical intelligence hypothesis. Aka and Mbendjele hunter-gatherers in the rainforest of Central African Republic and the Republic of Congo, respectively, and Taï chimpanzees in the rainforest of Côte d'Ivoire were observed cracking hard Panda oleosa nuts with different tools, as well as the soft Coula edulis and Elaeis guinensis nuts. The nut-cracking techniques, hammer material selection and two efficiency measures were compared. As predicted, the Aka and the Mbendjele were able to exploit more species of hard nuts in the forest than chimpanzees. However, the chimpanzees were sometimes more efficient than the humans. Social roles differed between the two species, with the Aka and especially the Mbendjele exhibiting cooperation between nut-crackers whereas the chimpanzees were mainly individualistic. Observations of nut-cracking by humans and chimpanzees only partially supported the technical intelligence hypothesis as higher degrees of flexibility in tool selection seen in chimpanzees compensated for use of less efficient tool material than in humans. Nut cracking was a stronger social undertaking in humans than in chimpanzees. © 2017 Wiley Periodicals, Inc.

  20. Radiographic technical quality of root canal treatment performed ex vivo by dental students at Valencia University Medical and Dental School, Spain

    PubMed Central

    Faus-Matoses, Vicente; Alegre-Domingo, Teresa; Faus-Llácer, Vicente J.

    2014-01-01

    Objectives: To evaluate radiographically the quality of root canal fillings and compare manual and rotary preparation performed on extracted teeth by undergraduate dental students. Study Design: A total of 561 premolars and molars extracted teeth were prepared using nickel-titanium rotary files or manual instrumentation and filled with gutta-percha using a cold lateral condensation technique, by 4th grade undergraduate students. Periapical radiographs were used to assess the technical quality of the root canal filling, evaluating three variables: length, density and taper. These data were recorded, scored and used to study the “technical success rate” and the “overall score”. The length of each root canal filling was classified as acceptable, short and overfilled, based on their relationship with the radiographic apex. Density and taper of filling were evaluated based on the presence of voids and the uniform tapering of the filling, respectively. Statistical analysis was used to evaluate the quality of root canal treatment, considering p < 0.05 as a statistical significant level. Results: The percentage of technical success was 44% and the overall score was 7.8 out of 10. Technical success and overall score were greater with rotary instruments (52% against 28% with a manual one, p < 0.001; 8.3 against 6.7 respectively, p < 0.001). Conclusions: It appears that inexperienced operators perform better root canal treatment (RCT) with the use of rotary instrumentation. Key words:Dental education, endodontics, rotary instrumentation, radiographs, root canal treatment, undergraduate students. PMID:24121911

  1. Sustainable hydropower in Lower Mekong Countries: Technical assessment and training travel report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hadjerioua, Boualem; Witt, Adam M.

    The U.S. Agency for International Development (USAID), through their partnership with the U.S. Department of the Interior (DOI), requested the support of Oak Ridge National Laboratory (ORNL) to provide specialized technical assistance as part of the Smart Infrastructure for the Mekong (SIM) Program in Thailand. Introduced in July 2013 by U.S. Secretary of State John Kerry, SIM is a U.S. Government Inter-Agency program that provides Lower Mekong partner countries with targeted, demand-driven technical and scientific assistance to support environmentally sound, climate conscious and socially equitable infrastructure, clean energy development, and water resources optimization. The U.S. Government is committed to supportingmore » sustainable economic development within the region by providing tools, best practices, technical assistance, and lessons learned for the benefit of partner countries. In response to a request from the Electricity Generating Authority of Thailand (EGAT), a SIM project was developed with two main activities: 1) to promote hydropower sustainability and efficiency through technical assessment training at two existing hydropower assets in Thailand, and 2) the design and implementation of one national and two or three regional science and policy workshops, to be co-hosted with EGAT, to build common understanding of and commitment to environmental and social safeguards for Mekong Basin hydropower projects. The U.S. Department of Energy (DOE) is leading the technical assessment (Activity 1), and has contracted ORNL to provide expert technical assistance focused on increasing efficiency at existing projects, with the goal of increasing renewable energy generation at little to no capital cost. ORNL is the leading national laboratory in hydropower analysis, with a nationally recognized and highly qualified team of scientists addressing small to large-scale systems (basin-, regional-, and national-scale) energy generation optimization analysis for DOE

  2. Technical Assistance Program: Off to a Running Start (Newsletter)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Not Available

    This newsletter describes key activities of the DOE Office of Indian Energy Policy and Programs for Winter 2012. Between December 2, 2011, and January 15, 2012, 46 American Indian and Alaska Native Tribes submitted applications to receive technical assistance through the program, which provides Tribes with on-the-ground technical support from DOE and National Renewable Energy Laboratory (NREL) staff to help move tribal energy efficiency and renewable energy projects forward. The applications are being considered through the Strategic Technical Assistance Response Team (START) selection process, which incorporates expert reviews and outreach to Tribes who present a need for assistance with theirmore » community-based energy efficiency and renewable energy projects. The final successful applicants will be selected based on the clarity of their requests for technical assistance and the ability of START to successfully work with each unique project or community. At least three selected Tribes in Alaska will receive technical assistance between March and May 2012, and up to five selected Tribes in the contiguous United States will receive technical assistance between March and August 2012. During the months of START Program activity, DOE and NREL experts will work in the two locations. In Alaska, START experts will work directly with community-based project teams to analyze local energy issues and provide assistance with energy projects and cost savings initiatives. This effort will be bolstered by DOE-IE's partnership with the Denali Commission, which will provide further assistance and expertise. In the lower 48 states, NREL experts will work with the selected renewable energy START projects to evaluate financial and technical feasibility and provide early development technical assistance to better position the projects for financing and construction. This on-the-ground technical assistance is part of a broader DOE-IE effort to make reliable, accurate technical

  3. IT Labs Proof-of-Concept Project: Technical Data Interoperability (TDI) Pathfinder Via Emerging Standards

    NASA Technical Reports Server (NTRS)

    Conroy, Mike; Gill, Paul; Ingalls, John; Bengtsson, Kjell

    2014-01-01

    No known system is in place to allow NASA technical data interoperability throughout the whole life cycle. Life Cycle Cost (LCC) will be higher on many developing programs if action isn't taken soon to join disparate systems efficiently. Disparate technical data also increases safety risks from poorly integrated elements. NASA requires interoperability and industry standards, but breaking legacy ways is a challenge.

  4. Hypothesis Testing Using Factor Score Regression

    PubMed Central

    Devlieger, Ines; Mayer, Axel; Rosseel, Yves

    2015-01-01

    In this article, an overview is given of four methods to perform factor score regression (FSR), namely regression FSR, Bartlett FSR, the bias avoiding method of Skrondal and Laake, and the bias correcting method of Croon. The bias correcting method is extended to include a reliable standard error. The four methods are compared with each other and with structural equation modeling (SEM) by using analytic calculations and two Monte Carlo simulation studies to examine their finite sample characteristics. Several performance criteria are used, such as the bias using the unstandardized and standardized parameterization, efficiency, mean square error, standard error bias, type I error rate, and power. The results show that the bias correcting method, with the newly developed standard error, is the only suitable alternative for SEM. While it has a higher standard error bias than SEM, it has a comparable bias, efficiency, mean square error, power, and type I error rate. PMID:29795886

  5. Assessing eco-efficiency: A metafrontier directional distance function approach using life cycle analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Beltrán-Esteve, Mercedes, E-mail: mercedes.beltran@uv.es; Reig-Martínez, Ernest; Estruch-Guitart, Vicent

    Sustainability analysis requires a joint assessment of environmental, social and economic aspects of production processes. Here we propose the use of Life Cycle Analysis (LCA), a metafrontier (MF) directional distance function (DDF) approach, and Data Envelopment Analysis (DEA), to assess technological and managerial differences in eco-efficiency between production systems. We use LCA to compute six environmental and health impacts associated with the production processes of nearly 200 Spanish citrus farms belonging to organic and conventional farming systems. DEA is then employed to obtain joint economic-environmental farm's scores that we refer to as eco-efficiency. DDF allows us to determine farms' globalmore » eco-efficiency scores, as well as eco-efficiency scores with respect to specific environmental impacts. Furthermore, the use of an MF helps us to disentangle technological and managerial eco-inefficiencies by comparing the eco-efficiency of both farming systems with regards to a common benchmark. Our core results suggest that the shift from conventional to organic farming technology would allow a potential reduction in environmental impacts of 80% without resulting in any decline in economic performance. In contrast, as regards farmers' managerial capacities, both systems display quite similar mean scores.« less

  6. Energy efficiency of high-rise buildings

    NASA Astrophysics Data System (ADS)

    Zhigulina, Anna Yu.; Ponomarenko, Alla M.

    2018-03-01

    The article is devoted to analysis of tendencies and advanced technologies in the field of energy supply and energy efficiency of tall buildings, to the history of the emergence of the concept of "efficiency" and its current interpretation. Also the article show the difference of evaluation criteria of the leading rating systems LEED and BREEAM. Authors reviewed the latest technologies applied in the construction of energy efficient buildings. Methodological approach to the design of tall buildings taking into account energy efficiency needs to include the primary energy saving; to seek the possibility of production and accumulation of alternative electric energy by converting energy from the sun and wind with the help of special technical devices; the application of regenerative technologies.

  7. Overview of NASA's Supersonic Cruise Efficiency - Propulsion Research

    NASA Technical Reports Server (NTRS)

    DeBonis, James R.

    2009-01-01

    The research in Supersonic Cruise Efficiency Propulsion (SCE-P) Technical Challenge area of NASA's Supersonics project is discussed. The research in SCE-P is being performed to enable efficient supersonic flight over land. Research elements in this area include: Advance Inlet Concepts, High Performance/Wider Operability Fan and Compressor, Advanced Nozzle Concepts, and Intelligent Sensors/Actuators. The research under each of these elements is briefly discussed.

  8. 76 FR 9339 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Biomass Research and... Biomass Research and Development Technical Advisory Committee under Section 9008(d) of the Food.... Tentative Agenda: Agenda will include the following: Update on USDA Biomass R&D Activities. Update on DOE...

  9. 77 FR 20377 - Biomass Research and Development Technical Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Biomass Research and... Biomass Research and Development Technical Advisory Committee under Section 9008(d) of the Food... procedures, members of the public are welcome to observe the business of the Biomass Research and Development...

  10. Technical Nuances of Exposing Rat Common Carotid Arteries for Practicing Microsurgical Anastomosis.

    PubMed

    Tayebi Meybodi, Ali; Aklinski, Joseph; Gandhi, Sirin; Lawton, Michael T; Preul, Mark C

    2018-04-17

    Animal models are commonly used in training protocols for microsurgical vascular anastomosis. Rat common carotid arteries (CCAs) are frequently used for this purpose. Much attention has been paid to the technical details of various anastomosis configurations using these arteries. However, technical nuances of exposing rat CCAs have been understudied. The purpose of this study is to describe nuances of technique for safely and efficiently exposing rat CCAs in preparation for a vascular anastomosis. Bilateral CCAs were exposed and prepared for anastomosis in 10 anesthetized Sprague-Dawley rats through a midline cervical incision. The exposed length of the CCA was measured. Additionally, technical nuances of exposure and surgically relevant anatomic details were recorded. The CCAs were exposed from the sternoclavicular joint to their bifurcation (average length, 19.1 ± 2.8 mm). Tenets important for a safe and efficient exposure of the CCAs included 1) generous subcutaneous dissection to expose the external jugular veins (EJVs), 2) avoiding injury to or compression of the EJVs, 3) superior mobilization of the salivary glands, 4) division of internal jugular veins, 5) opening the carotid sheath at its midlevel and from medial to lateral, and 6) avoiding injury to the vagus nerve or sympathetic trunk. Using the principles introduced in this study, trainees may safely and efficiently expose rat CCAs in preparation for a bypass. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. [Assessment and comparison of hospital operating efficiency under different management systems].

    PubMed

    2017-06-18

    To assess and analyze the operation efficiency of 8 commission general public hospitals managed directly by National Health and Family Planning Commission and 8 municipal general hospitals managed directly by Beijing Municipal Administration of Hospitals in Beijing and to provide suggestions on improving service capacity and designing relevant health policy. Input and output data of 8 commission hospitals and 8 municipal hospitals were obtained from Beijing Direct-Reported Health Statistics data from 2011 to 2014. Data envelopment analysis was used as the hospital operation efficiency measurement tool. The CCR and BCC models were built to calculate technical efficiency (TE), pure technical efficiency (PTE), scale efficiency (SE) and the status of scale efficiency of 16 hospitals in 2011 and 2014; the Malmquist index model was built to analyze the total factor productivity change (TFPC), technological change (TC), technical efficiency change, pure technical efficiency change and scale efficiency change of the 16 hospitals from 2011 to 2014. In 2011, the TE, PTE and SE of the commission hospitals were higher than those of the municipal hospitals, and the TEs of the commission hospitals and the municipal hospitals were 0.918 and 0.873 respectively. In 2014, the TE, PTE and SE of commission hospitals were lower than those of the municipal hospitals, and the TE of the commission hospitals and the municipal hospitals were 0.906 and 0.951, respectively, which was contrary to the results in 2011. According to the Malmquist index model, the average of TFPC of the municipal hospitals was larger than that of the commission hospitals, the former increased 5.9% and the latter increased 2.8% per year; the average of TC was greater than the one in both the municipal hospitals and the commission hospitals, with a growth of 3.2% and 2.9% per year, respectively; the average growth of PTE in the commission hospitals was lower than that of the municipal hospitals, and the average

  12. Integrated system links cost data, patient satisfaction scores for the first time.

    PubMed

    1999-10-01

    Linking cost data, patient satisfaction scores. HBS International and The Picker Institute have joined forces to make integrated data available that directly links operational efficiency and patient satisfaction. Find out how the systems lets providers know when reducing expenses compromises care.

  13. Wearable PPG sensor based alertness scoring system.

    PubMed

    Dey, Jishnu; Bhowmik, Tanmoy; Sahoo, Saswata; Tiwari, Vijay Narayan

    2017-07-01

    Quantifying mental alertness in today's world is important as it enables the person to adopt lifestyle changes for better work efficiency. Miniaturized sensors in wearable devices have facilitated detection/monitoring of mental alertness. Photoplethysmography (PPG) sensors through Heart Rate Variability (HRV) offer one such opportunity by providing information about one's daily alertness levels without requiring any manual interference from the user. In this paper, a smartwatch based alertness estimation system is proposed. Data collected from PPG sensor of smartwatch is processed and fed to machine learning based model to get a continuous alertness score. Utility functions are designed based on statistical analysis to give a quality score on different stages of alertness such as awake, long sleep and short duration power nap. An intelligent data collection approach is proposed in collaboration with the motion sensor in the smartwatch to reduce battery drainage. Overall, our proposed wearable based system provides a detailed analysis of alertness over a period in a systematic and optimized manner. We were able to achieve an accuracy of 80.1% for sleep/awake classification along with alertness score. This opens up the possibility for quantifying alertness levels using a single PPG sensor for better management of health related activities including sleep.

  14. Non-technical skills assessment for prelicensure nursing students: An integrative review.

    PubMed

    Pires, Sara; Monteiro, Sara; Pereira, Anabela; Chaló, Daniela; Melo, Elsa; Rodrigues, Alexandre

    2017-11-01

    In nursing, non-technical skills are recognized as playing an important role to increase patient safety and successful clinical outcomes (Pearson and McLafferty, 2011). Non-technical skills are cognitive and social resource skills that complement technical skills and contribute to safe and efficient task performance (Flin et al., 2008). In order to effectively provide non-technical skills training, it is essential to have an instrument to measure these skills. An online search was conducted. Articles were selected if they referred to and/or described instruments assessing non-technical skills for nurses and/or prelicensure nursing students in educational, clinical and/or simulated settings with validation evidence (inclusion criteria). Of the 53 articles located, 26 met the inclusion criteria. Those referred to and/or described 16 instruments with validation evidence developed to assess non-technical skills in multidisciplinary teams including nurses. Although articles have shown 16 valid and reliable instruments, to our knowledge, no instrument has been published or developed and validated for the assessment of non-technical skills of only nurses in general, relevant for use in high-fidelity simulation-based training for prelicensure nursing students. Therefore, there is a need for the development of such an instrument. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Closed anterior scoring for prominent-ear correction revisited.

    PubMed

    Thomas, S S; Fatah, F

    2001-10-01

    The closed-anterior-scoring technique has been used over the past 3 years to correct 56 prominent ears in 32 patients at the West Midlands Regional Plastic Surgery Unit at Wordsley Hospital. A review was carried out to assess the result of this surgical procedure. We briefly discuss the historical development of other surgical techniques for prominent-ear correction, and describe in detail the operative technique for this procedure, which includes closed scoring and suturing of the cartilage. We used this technique to treat 24 patients with bilateral prominent ears and eight patients with unilateral prominent ears. The series comprised 20 females and 12 males, 26 children and six adults. The age range was from 4 to 24 years old. There were two complications (an upper-pole recurrence and protrusion of a buried prolene suture). Patients were followed up for between 6 months and 3 years (mean: 1.5 years). This procedure is quick and technically easy to learn, with no anterior scars or posterior cartilage overlap. Minimal dissection is involved, leading to a low rate of complications. The learning curve is rapid; this paper represents the experience of a specialist trainee (SST) after he was taught the technique by the senior author. Copyright 2001 The British Association of Plastic Surgeons.

  16. Validation of the grown-ups with congenital heart disease score.

    PubMed

    Hörer, Jürgen; Roussin, Régine; LeBret, Emanuel; Ly, Mohamed; Abdullah, Jarrah; Marzullo, Rafaella; Pabst von Ohain, Jelena; Belli, Emre

    2018-06-01

    Adults with congenital heart disease in need of heart surgery frequently present with significant comorbidity. Furthermore, additional technical difficulties often related to redo operations increase the risk for postoperative mortality and morbidity. Hence, next to the type of the procedure, additional procedure-dependent and procedure-independent factors have to be considered for risk evaluation. The recently proposed grown-ups with congenital heart disease (GUCH) mortality and morbidity scores account for these additional risk factors. We sought to validate their predictive power in a large population operated in a single centre. Data of all consecutive patients aged 18 years or more, who underwent surgery for congenital heart disease between 2005 and 2016, were collected. Mortality was defined as hospital mortality or mortality within 30 days following surgery. Morbidity was defined as occurrence of one or more of the following complications: renal failure requiring dialysis, neurologic deficit persisting at discharge, atrioventricular block requiring permanent pacemaker implantation, mechanical circulatory support, phrenic nerve injury and unplanned reoperation. The discriminatory power of the GUCH scores was assessed using the area under the receiver operating characteristics curve (c-index, including 95% CI). Eight hundred and twenty-four operations were evaluated. Additional procedure-dependent and procedure-independent factors, as defined in the GUCH scores, were present in 165 patients (20.0%) and 544 patients (66.0%), respectively. Hospital mortality and morbidity was 3.4% and 10.0%, respectively. C-index for GUCH mortality score was 0.809 (0.742-0.877). C-index for GUCH morbidity score was 0.676 (0.619-0.734). We could confirm the good predictive power of the GUCH mortality score for postoperative mortality in a large population of adults with congenital heart disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

  17. AutoIHC-scoring: a machine learning framework for automated Allred scoring of molecular expression in ER- and PR-stained breast cancer tissue.

    PubMed

    Tewary, S; Arun, I; Ahmed, R; Chatterjee, S; Chakraborty, C

    2017-11-01

    In prognostic evaluation of breast cancer Immunohistochemical (IHC) markers namely, oestrogen receptor (ER) and progesterone receptor (PR) are widely used. The expert pathologist investigates qualitatively the stained tissue slide under microscope to provide the Allred score; which is clinically used for therapeutic decision making. Such qualitative judgment is time-consuming, tedious and more often suffers from interobserver variability. As a result, it leads to imprecise IHC score for ER and PR. To overcome this, there is an urgent need of developing a reliable and efficient IHC quantifier for high throughput decision making. In view of this, our study aims at developing an automated IHC profiler for quantitative assessment of ER and PR molecular expression from stained tissue images. We propose here to use CMYK colour space for positively and negatively stained cell extraction for proportion score. Also colour features are used for quantitative assessment of intensity scoring among the positively stained cells. Five different machine learning models namely artificial neural network, Naïve Bayes, K-nearest neighbours, decision tree and random forest are considered for learning the colour features using average red, green and blue pixel values of positively stained cell patches. Fifty cases of ER- and PR-stained tissues have been evaluated for validation with the expert pathologist's score. All five models perform adequately where random forest shows the best correlation with the expert's score (Pearson's correlation coefficient = 0.9192). In the proposed approach the average variation of diaminobenzidine (DAB) to nuclear area from the expert's score is found to be 7.58%, as compared to 27.83% for state-of-the-art ImmunoRatio software. © 2017 The Authors Journal of Microscopy © 2017 Royal Microscopical Society.

  18. Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room.

    PubMed

    Kundhal, Pavi S; Grantcharov, Teodor P

    2009-03-01

    This study was conducted to validate the role of virtual reality computer simulation as an objective method for assessing laparoscopic technical skills. The authors aimed to investigate whether performance in the operating room, assessed using a modified Objective Structured Assessment of Technical Skill (OSATS), correlated with the performance parameters registered by a virtual reality laparoscopic trainer (LapSim). The study enrolled 10 surgical residents (3 females) with a median of 5.5 years (range, 2-6 years) since graduation who had similar limited experience in laparoscopic surgery (median, 5; range, 1-16 laparoscopic cholecystectomies). All the participants performed three repetitions of seven basic skills tasks on the LapSim laparoscopic trainer and one laparoscopic cholecystectomy in the operating room. The operating room procedure was video recorded and blindly assessed by two independent observers using a modified OSATS rating scale. Assessment in the operating room was based on three parameters: time used, error score, and economy of motion score. During the tasks on the LapSim, time, error (tissue damage and millimeters of tissue damage [tasks 2-6], error score [incomplete target areas, badly placed clips, and dropped clips [task 7]), and economy of movement parameters (path length and angular path) were registered. The correlation between time, economy, and error parameters during the simulated tasks and the operating room procedure was statistically assessed using Spearman's test. Significant correlations were demonstrated between the time used to complete the operating room procedure and time used for task 7 (r (s) = 0.74; p = 0.015). The error score demonstrated during the laparoscopic cholecystectomy correlated well with the tissue damage in three of the seven tasks (p < 0.05), the millimeters of tissue damage during two of the tasks, and the error score in task 7 (r (s) = 0.67; p = 0.034). Furthermore, statistically significant correlations were

  19. Predictive validity of a selection centre testing non-technical skills for recruitment to training in anaesthesia.

    PubMed

    Gale, T C E; Roberts, M J; Sice, P J; Langton, J A; Patterson, F C; Carr, A S; Anderson, I R; Lam, W H; Davies, P R F

    2010-11-01

    Assessment centres are an accepted method of recruitment in industry and are gaining popularity within medicine. We describe the development and validation of a selection centre for recruitment to speciality training in anaesthesia based on an assessment centre model incorporating the rating of candidate's non-technical skills. Expert consensus identified non-technical skills suitable for assessment at the point of selection. Four stations-structured interview, portfolio review, presentation, and simulation-were developed, the latter two being realistic scenarios of work-related tasks. Evaluation of the selection centre focused on applicant and assessor feedback ratings, inter-rater agreement, and internal consistency reliability coefficients. Predictive validity was sought via correlations of selection centre scores with subsequent workplace-based ratings of appointed trainees. Two hundred and twenty-four candidates were assessed over two consecutive annual recruitment rounds; 68 were appointed and followed up during training. Candidates and assessors demonstrated strong approval of the selection centre with more than 70% of ratings 'good' or 'excellent'. Mean inter-rater agreement coefficients ranged from 0.62 to 0.77 and internal consistency reliability of the selection centre score was high (Cronbach's α=0.88-0.91). The overall selection centre score was a good predictor of workplace performance during the first year of appointment. An assessment centre model based on the rating of non-technical skills can produce a reliable and valid selection tool for recruitment to speciality training in anaesthesia. Early results on predictive validity are encouraging and justify further development and evaluation.

  20. The Aristotle score: a complexity-adjusted method to evaluate surgical results.

    PubMed

    Lacour-Gayet, F; Clarke, D; Jacobs, J; Comas, J; Daebritz, S; Daenen, W; Gaynor, W; Hamilton, L; Jacobs, M; Maruszsewski, B; Pozzi, M; Spray, T; Stellin, G; Tchervenkov, C; Mavroudis And, C

    2004-06-01

    Quality control is difficult to achieve in Congenital Heart Surgery (CHS) because of the diversity of the procedures. It is particularly needed, considering the potential adverse outcomes associated with complex cases. The aim of this project was to develop a new method based on the complexity of the procedures. The Aristotle project, involving a panel of expert surgeons, started in 1999 and included 50 pediatric surgeons from 23 countries, representing the EACTS, STS, ECHSA and CHSS. The complexity was based on the procedures as defined by the STS/EACTS International Nomenclature and was undertaken in two steps: the first step was establishing the Basic Score, which adjusts only the complexity of the procedures. It is based on three factors: the potential for mortality, the potential for morbidity and the anticipated technical difficulty. A questionnaire was completed by the 50 centers. The second step was the development of the Comprehensive Aristotle Score, which further adjusts the complexity according to the specific patient characteristics. It includes two categories of complexity factors, the procedure dependent and independent factors. After considering the relationship between complexity and performance, the Aristotle Committee is proposing that: Performance = Complexity x Outcome. The Aristotle score, allows precise scoring of the complexity for 145 CHS procedures. One interesting notion coming out of this study is that complexity is a constant value for a given patient regardless of the center where he is operated. The Aristotle complexity score was further applied to 26 centers reporting to the EACTS congenital database. A new display of centers is presented based on the comparison of hospital survival to complexity and to our proposed definition of performance. A complexity-adjusted method named the Aristotle Score, based on the complexity of the surgical procedures has been developed by an international group of experts. The Aristotle score

  1. Comparing Human and Automated Essay Scoring for Prospective Graduate Students with Learning Disabilities and/or ADHD

    ERIC Educational Resources Information Center

    Buzick, Heather; Oliveri, Maria Elena; Attali, Yigal; Flor, Michael

    2016-01-01

    Automated essay scoring is a developing technology that can provide efficient scoring of large numbers of written responses. Its use in higher education admissions testing provides an opportunity to collect validity and fairness evidence to support current uses and inform its emergence in other areas such as K-12 large-scale assessment. In this…

  2. Mathematics Technical Report: Exercise Volume. National Assessment of Educational Progress. Report No. 04-MA-20.

    ERIC Educational Resources Information Center

    Education Commission of the States, Denver, CO. National Assessment of Educational Progress.

    Included in Chapter 1 of this report are background information on the 1972-73 mathematics assessment; details of the computational formulas used in reporting results; and explanations of the technical documentation, exercise presentation, documentation pages, scoring guides, and data tables for released and unreleased exercises. The remainder of…

  3. The Effects of Curriculum Integration on the Academic Achievement of Secondary Career and Technical Students

    ERIC Educational Resources Information Center

    Jones, Patricia Anders

    2012-01-01

    Using a causal-comparative design, this quantitative study investigated whether or not the curriculum integration of academic subjects with career and technical education classes affected secondary students' academic performance as assessed by scores on standardized tests. The purposive sample was drawn from students in Trade and Industry classes…

  4. An Estimation of Technical Efficiency for Florida Public Elementary Schools

    ERIC Educational Resources Information Center

    Conroy, Stephen J.; Arguea, Nestor M.

    2008-01-01

    We use a frontier production function estimation technique to analyze whether elementary schools in Florida are operating at an efficient level and to explain any inefficiencies. A motivation for this analysis comes from recent state and federal level educational initiatives designed to improve school accountability and reduce class sizes. Results…

  5. Are the Best Scores the Best Scores for Predicting College Success?

    ERIC Educational Resources Information Center

    Patterson, Brian F.; Mattern, Krista D.; Swerdzewski, Peter

    2012-01-01

    The College Board's SAT[R] Score Choice[TM] policy allows students to choose which set(s) of scores to send to colleges and universities to which they plan to apply. Based on data gathered before the implementation of that policy, the following study evaluated the predictive validity of the various sets of SAT scores. The value of five score sets…

  6. Modified PADSS (Post Anaesthetic Discharge Scoring System) for monitoring outpatients discharge.

    PubMed

    Palumbo, Piergaspare; Tellan, Guglielmo; Perotti, Bruno; Pacilè, Maria Antonietta; Vietri, Francesco; Illuminati, Giulio

    2013-01-01

    The decision to discharge a patient undergoing day surgery is a major step in the hospitalization pathway, because it must be achieved without compromising the quality of care, thus ensuring the same assistance and wellbeing as for a long-term stay. Therefore, the use of an objective assessment for the management of a fair and safe discharge is essential. The authors propose the Post Anaesthetic Discharge Scoring System (PADSS), which considers six criteria: vital signs, ambulation, nausea/vomiting, pain, bleeding and voiding. Each criterion is given a score ranging from 0 to 2. Only patients who achieve a score of 9 or more are considered ready for discharge. Furthermore, PADSS has been modified to ensure a higher level of safety, thus the "vital signs" criteria must never score lower than 2, and none of the other five criteria must ever be equal to 0, even if the total score reaches 9. The effectiveness of PADSS was analyzed on 2432 patients, by recording the incidence of postoperative complications and the readmission to hospital. So far PADDS has proved to be an efficient system that guarantees safe discharge.

  7. Purely Structural Protein Scoring Functions Using Support Vector Machine and Ensemble Learning.

    PubMed

    Mirzaei, Shokoufeh; Sidi, Tomer; Keasar, Chen; Crivelli, Silvia

    2016-08-24

    The function of a protein is determined by its structure, which creates a need for efficient methods of protein structure determination to advance scientific and medical research. Because current experimental structure determination methods carry a high price tag, computational predictions are highly desirable. Given a protein sequence, computational methods produce numerous 3D structures known as decoys. However, selection of the best quality decoys is challenging as the end users can handle only a few ones. Therefore, scoring functions are central to decoy selection. They combine measurable features into a single number indicator of decoy quality. Unfortunately, current scoring functions do not consistently select the best decoys. Machine learning techniques offer great potential to improve decoy scoring. This paper presents two machine-learning based scoring functions to predict the quality of proteins structures, i.e., the similarity between the predicted structure and the experimental one without knowing the latter. We use different metrics to compare these scoring functions against three state-of-the-art scores. This is a first attempt at comparing different scoring functions using the same non-redundant dataset for training and testing and the same features. The results show that adding informative features may be more significant than the method used.

  8. Technical and physical analysis of the 2014 FIFA World Cup Brazil: winners vs. losers.

    PubMed

    Rumpf, Michael C; Silva, Joao R; Hertzog, Maxime; Farooq, Abdulaziz; Nassis, George

    2017-10-01

    The purpose of the present study was to investigate the technical and physical performance parameters that distinguish between teams winning and losing matches in the 2014 FIFA World Cup Brazil. Data were derived from the FIFA website and from live-statistics provided during each game of the world cup. Twelve physical (such as total distance covered in meters (TD), TD in distinct locomotor categories: low-intensity running (LIR; <11 km/h), moderate-intensity running (MIR; 11 to 14 km/h) and high-intensity-running (HIR; >14 km/h)) and 21 technical parameters (total passes, short-, medium- and long-distance passes, total pass completion rate, dangerous attacks, attacking attempts, delivery in penalty area, ball possession, goals, goals from set-pieces, goals per shot on goal, defending saves, shots, shots on goal, shot accuracy, set-pieces, crosses, corners, clearances, yellow cards) were analyzed. Forty-two games in which a winner and consequently a loser were presented after 90 minutes of game time were investigated with independent t-tests. A binary-logistic regression was utilized to investigate whether the significant variables predicted success of the winning teams. The winning teams scored significantly (P<0.05) greater amount of goals, goals per set-pieces, goals per shots on goals, shots on goal and shot accuracy and received significantly lower yellow cards. The binary-logistic regression utilized showed that shot accuracy was the best predictor for success. The physical parameters did not differ between teams winning and losing a match. Technical performance related to goal scoring parameters play a decisive role in World Cup games. Furthermore, scoring efficacy from open-play as well as from set-pieces are crucial to win matches in a World Cup tournament. At this level, physical performance was not the factor to discriminate between winners and losers.

  9. Scaling production and improving efficiency in DEA: an interactive approach

    NASA Astrophysics Data System (ADS)

    Rödder, Wilhelm; Kleine, Andreas; Dellnitz, Andreas

    2017-10-01

    DEA models help a DMU to detect its (in-)efficiency and to improve activities, if necessary. Efficiency is only one economic aim for a decision-maker; however, up- or downsizing might be a second one. Improving efficiency is the main topic in DEA; the long-term strategy towards the right production size should attract our attention as well. Not always the management of a DMU primarily focuses on technical efficiency but rather is interested in gaining scale effects. In this paper, a formula for returns to scale (RTS) is developed, and this formula is even applicable for interior points of technology. Particularly, technical and scale inefficient DMUs need sophisticated instruments to improve their situation. Considering RTS as well as efficiency, in this paper, we give an advice for each DMU to find an economically reliable path from its actual situation to better activities and finally to most productive scale size (mpss), perhaps. For realizing this path, we propose an interactive algorithm, thus harmonizing the scientific findings and the interests of the management. Small numerical examples illustrate such paths for selected DMUs; an empirical application in theatre management completes the contribution.

  10. Pavement scores synthesis.

    DOT National Transportation Integrated Search

    2009-02-01

    The purpose of this synthesis was to summarize the use of pavement scores by the states, including the : rating methods used, the score scales, and descriptions; if the scores are used for recommending pavement : maintenance and rehabilitation action...

  11. Innovative methods of popularizing technical education

    NASA Astrophysics Data System (ADS)

    Shkitsa, L. Y.; Panchuk, V. G.; Kornuta, V. A.

    2017-05-01

    There have been analyzed reasons of the loss of technical education’s popularity. Also, the analysis of known educational and production methods, oriented at the innovative model of development of society, was performed. It is stated that the acquisition of 21st century’s skills as a result of competition of technical education are natural for the DIY ideology, which was realized in the institutions like Fab Lab. The new educational strategy, based on project-based learning, is proposed to be implemented as a special laboratory with equipment, which would be a center of innovative development for students at the Technical University. Moreover, the list of projects planned for implementation, that includes not only projects, specific to a particular university, but also projects, demanded by society as a whole, is specified. It is worth to implement trendy projects in the laboratory, such as toy-like, ecological projects; projects of the energy dependence decrease or the energy efficiency increase, modern digital or innovative projects etc. The student should gain knowledge, skills and, possibly, equipment that are available for immediate usage on the labor market or for the realization of his own projects or the community’s projects in everyday life after the realization of the particular project at the laboratory

  12. An Efficiency Comparison of MBA Programs: Top 10 versus Non-Top 10

    ERIC Educational Resources Information Center

    Hsu, Maxwell K.; James, Marcia L.; Chao, Gary H.

    2009-01-01

    The authors compared the cohort group of the top-10 MBA programs in the United States with their lower-ranking counterparts on their value-added efficiency. The findings reveal that the top-10 MBA programs in the United States are associated with statistically higher average "technical and scale efficiency" and "scale efficiency", but not with a…

  13. Predictors of employer satisfaction: technical and non-technical skills.

    PubMed

    Danielson, Jared A; Wu, Tsui-Feng; Fales-Williams, Amanda J; Kirk, Ryan A; Preast, Vanessa A

    2012-01-01

    Employers of 2007-2009 graduates from Iowa State University College of Veterinary Medicine were asked to respond to a survey regarding their overall satisfaction with their new employees as well as their new employees' preparation in several technical and non-technical skill areas. Seventy-five responses contained complete data and were used in the analysis. Four technical skill areas (data collection, data interpretation, planning, and taking action) and five non-technical skill areas (interpersonal skills, ability to deal with legal issues, business skills, making referrals, and problem solving) were identified. All of the skill area subscales listed above had appropriate reliability (Cronbach's alpha>0.70) and were positively and significantly correlated with overall employer satisfaction. Results of two simultaneous regression analyses indicated that of the four technical skill areas, taking action is the most salient predictor of employer satisfaction. Of the five non-technical skill areas, interpersonal skills, business skills, making referrals, and problem solving were the most important skills in predicting employer satisfaction. Hierarchical regression analysis revealed that all technical skills explained 25% of the variation in employer satisfaction; non-technical skills explained an additional 42% of the variation in employer satisfaction.

  14. 77 FR 65542 - Hydrogen and Fuel Cell Technical Advisory Committee (HTAC)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-29

    ... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Hydrogen and Fuel Cell... Energy. ACTION: Notice of Open Meeting. SUMMARY: The Hydrogen and Fuel Cell Technical Advisory Committee... Updates Congressional Fuel Cell Caucuses NREL Reports on Hydrogen in Natural Gas Pipelines and...

  15. Efficiency Management in Spaceflight Systems

    NASA Technical Reports Server (NTRS)

    Murphy, Karen

    2016-01-01

    Efficiency in spaceflight is often approached as “faster, better, cheaper – pick two”. The high levels of performance and reliability required for each mission suggest that planners can only control for two of the three. True efficiency comes by optimizing a system across all three parameters. The functional processes of spaceflight become technical requirements on three operational groups during mission planning: payload, vehicle, and launch operations. Given the interrelationships among the functions performed by the operational groups, optimizing function resources from one operational group to the others affects the efficiency of those groups and therefore the mission overall. This paper helps outline this framework and creates a context in which to understand the effects of resource trades on the overall system, improving the efficiency of the operational groups and the mission as a whole. This allows insight into and optimization of the controlling factors earlier in the mission planning stage.

  16. Relationship between lower urinary tract symptoms and cardiovascular risk scores including Framingham risk score and ACC/AHA risk score.

    PubMed

    Lee, Bora; Lee, Sang Wook; Kang, Hye Rim; Kim, Dae In; Sun, Hwa Yeon; Kim, Jae Heon

    2018-01-01

    This study attempted to investigate the association between lower urinary tract symptoms (LUTS) and cardiovascular disease (CVD) risk using International Prostate Symptom Score (IPSS) and CVD risk scores and to overcome the limitations of previous relevant studies. A total of 2994 ostensibly healthy males, who participated in a voluntary health check in a health promotion center from January 2010 to December 2014, were reviewed. CVD risk scores were calculated using Framingham risk score and American College of Cardiology (ACC)/American Heart Association (AHA) score. Correlation and multivariate logistic regression analysis to predict the CVD risk severity were performed. Correlation between total IPSS with CVD risk scores demonstrated significant positive associations, which showed higher correlation with ACC/AHA score than the Framingham score (r = 0.18 vs 0.09, respectively). For ACC/AHA score, the partial correlation after adjustment of body mass index (BMI) showed significant positive correlations between all LUTS parameters and PSA. For the Framingham score, all variables, except IPSS Q2 and IPSS Q6, showed significant positive correlations. After adjustment of BMI, prostate volume and PSA, only the severe LUTS group showed significant relationship with intermediate-high CVD risk severity, as compared with normal LUTS group (OR = 2.97, 95%CI (1.35-6.99)). Using two validated CVD risk calculators, we observed that LUTS is closely associated with future CVD risk. To predict the intermediate-high CVD risk severity, severe LUTS was a sentinel sign, the presence of which warrants the importance of an earlier screening for CVD. © 2017 Wiley Periodicals, Inc.

  17. Do Mathematics and Reading Competencies Integrated into Career and Technical Education Courses Improve High School Student State Assessment Scores?

    ERIC Educational Resources Information Center

    Pierce, Kristin B.; Hernandez, Victor M.

    2015-01-01

    A quasi experimental study tested a contextual teaching and learning model for integrating reading and mathematics competencies through 13 introductory career and technical education (CTE) courses. The treatment group consisted of students in the 13 introductory courses taught by the CTE teachers who designed the units and the control group…

  18. Do Examinees Understand Score Reports for Alternate Methods of Scoring Computer Based Tests?

    ERIC Educational Resources Information Center

    Whittaker, Tiffany A.; Williams, Natasha J.; Dodd, Barbara G.

    2011-01-01

    This study assessed the interpretability of scaled scores based on either number correct (NC) scoring for a paper-and-pencil test or one of two methods of scoring computer-based tests: an item pattern (IP) scoring method and a method based on equated NC scoring. The equated NC scoring method for computer-based tests was proposed as an alternative…

  19. Score tests for independence in semiparametric competing risks models.

    PubMed

    Saïd, Mériem; Ghazzali, Nadia; Rivest, Louis-Paul

    2009-12-01

    A popular model for competing risks postulates the existence of a latent unobserved failure time for each risk. Assuming that these underlying failure times are independent is attractive since it allows standard statistical tools for right-censored lifetime data to be used in the analysis. This paper proposes simple independence score tests for the validity of this assumption when the individual risks are modeled using semiparametric proportional hazards regressions. It assumes that covariates are available, making the model identifiable. The score tests are derived for alternatives that specify that copulas are responsible for a possible dependency between the competing risks. The test statistics are constructed by adding to the partial likelihoods for the individual risks an explanatory variable for the dependency between the risks. A variance estimator is derived by writing the score function and the Fisher information matrix for the marginal models as stochastic integrals. Pitman efficiencies are used to compare test statistics. A simulation study and a numerical example illustrate the methodology proposed in this paper.

  20. Risk score to predict the outcome of patients with cerebral vein and dural sinus thrombosis.

    PubMed

    Ferro, José M; Bacelar-Nicolau, Helena; Rodrigues, Teresa; Bacelar-Nicolau, Leonor; Canhão, Patrícia; Crassard, Isabelle; Bousser, Marie-Germaine; Dutra, Aurélio Pimenta; Massaro, Ayrton; Mackowiack-Cordiolani, Marie-Anne; Leys, Didier; Fontes, João; Stam, Jan; Barinagarrementeria, Fernando

    2009-01-01

    Around 15% of patients die or become dependent after cerebral vein and dural sinus thrombosis (CVT). We used the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) sample (624 patients, with a median follow-up time of 478 days) to develop a Cox proportional hazards regression model to predict outcome, dichotomised by a modified Rankin Scale score >2. From the model hazard ratios, a risk score was derived and a cut-off point selected. The model and the score were tested in 2 validation samples: (1) the prospective Cerebral Venous Thrombosis Portuguese Collaborative Study Group (VENOPORT) sample with 91 patients; (2) a sample of 169 consecutive CVT patients admitted to 5 ISCVT centres after the end of the ISCVT recruitment period. Sensitivity, specificity, c statistics and overall efficiency to predict outcome at 6 months were calculated. The model (hazard ratios: malignancy 4.53; coma 4.19; thrombosis of the deep venous system 3.03; mental status disturbance 2.18; male gender 1.60; intracranial haemorrhage 1.42) had overall efficiencies of 85.1, 84.4 and 90.0%, in the derivation sample and validation samples 1 and 2, respectively. Using the risk score (range from 0 to 9) with a cut-off of >or=3 points, overall efficiency was 85.4, 84.4 and 90.1% in the derivation sample and validation samples 1 and 2, respectively. Sensitivity and specificity in the combined samples were 96.1 and 13.6%, respectively. The CVT risk score has a good estimated overall rate of correct classifications in both validation samples, but its specificity is low. It can be used to avoid unnecessary or dangerous interventions in low-risk patients, and may help to identify high-risk CVT patients. (c) 2009 S. Karger AG, Basel.

  1. A Human Factors Analysis of Technical and Team Skills Among Surgical Trainees During Procedural Simulations in a Simulated Operating Theatre

    PubMed Central

    Moorthy, Krishna; Munz, Yaron; Adams, Sally; Pandey, Vikas; Darzi, Ara

    2005-01-01

    Background: High-risk organizations such as aviation rely on simulations for the training and assessment of technical and team performance. The aim of this study was to develop a simulated environment for surgical trainees using similar principles. Methods: A total of 27 surgical trainees carried out a simulated procedure in a Simulated Operating Theatre with a standardized OR team. Observation of OR events was carried out by an unobtrusive data collection system: clinical data recorder. Assessment of performance consisted of blinded rating of technical skills, a checklist of technical events, an assessment of communication, and a global rating of team skills by a human factors expert and trained surgical research fellows. The participants underwent a debriefing session, and the face validity of the simulated environment was evaluated. Results: While technical skills rating discriminated between surgeons according to experience (P = 0.002), there were no differences in terms of the checklist and team skills (P = 0.70). While all trainees were observed to gown/glove and handle sharps correctly, low scores were observed for some key features of communication with other team members. Low scores were obtained by the entire cohort for vigilance. Interobserver reliability was 0.90 and 0.89 for technical and team skills ratings. Conclusions: The simulated operating theatre could serve as an environment for the development of surgical competence among surgical trainees. Objective, structured, and multimodal assessment of performance during simulated procedures could serve as a basis for focused feedback during training of technical and team skills. PMID:16244534

  2. Apgar score

    MedlinePlus

    ... infant cries well, the respiratory score is 2. Heart rate is evaluated by stethoscope. This is the most important assessment: If there is no heartbeat, the infant scores 0 for heart rate. If heart rate is less than 100 ...

  3. SKATE: a docking program that decouples systematic sampling from scoring.

    PubMed

    Feng, Jianwen A; Marshall, Garland R

    2010-11-15

    SKATE is a docking prototype that decouples systematic sampling from scoring. This novel approach removes any interdependence between sampling and scoring functions to achieve better sampling and, thus, improves docking accuracy. SKATE systematically samples a ligand's conformational, rotational and translational degrees of freedom, as constrained by a receptor pocket, to find sterically allowed poses. Efficient systematic sampling is achieved by pruning the combinatorial tree using aggregate assembly, discriminant analysis, adaptive sampling, radial sampling, and clustering. Because systematic sampling is decoupled from scoring, the poses generated by SKATE can be ranked by any published, or in-house, scoring function. To test the performance of SKATE, ligands from the Asetex/CDCC set, the Surflex set, and the Vertex set, a total of 266 complexes, were redocked to their respective receptors. The results show that SKATE was able to sample poses within 2 A RMSD of the native structure for 98, 95, and 98% of the cases in the Astex/CDCC, Surflex, and Vertex sets, respectively. Cross-docking accuracy of SKATE was also assessed by docking 10 ligands to thymidine kinase and 73 ligands to cyclin-dependent kinase. 2010 Wiley Periodicals, Inc.

  4. Efficiency and Productivity Analysis of Multidivisional Firms

    NASA Astrophysics Data System (ADS)

    Gong, Binlei

    Multidivisional firms are those who have footprints in multiple segments and hence using multiple technologies to convert inputs to outputs, which makes it difficult to estimate the resource allocations, aggregated production functions, and technical efficiencies of this type of companies. This dissertation aims to explore and reveal such unobserved information by several parametric and semiparametric stochastic frontier analyses and some other structural models. In the empirical study, this dissertation analyzes the productivity and efficiency for firms in the global oilfield market.

  5. Why simulation can be efficient: on the preconditions of efficient learning in complex technology based practices.

    PubMed

    Hofmann, Bjørn

    2009-07-23

    It is important to demonstrate learning outcomes of simulation in technology based practices, such as in advanced health care. Although many studies show skills improvement and self-reported change to practice, there are few studies demonstrating patient outcome and societal efficiency. The objective of the study is to investigate if and why simulation can be effective and efficient in a hi-tech health care setting. This is important in order to decide whether and how to design simulation scenarios and outcome studies. Core theoretical insights in Science and Technology Studies (STS) are applied to analyze the field of simulation in hi-tech health care education. In particular, a process-oriented framework where technology is characterized by its devices, methods and its organizational setting is applied. The analysis shows how advanced simulation can address core characteristics of technology beyond the knowledge of technology's functions. Simulation's ability to address skilful device handling as well as purposive aspects of technology provides a potential for effective and efficient learning. However, as technology is also constituted by organizational aspects, such as technology status, disease status, and resource constraints, the success of simulation depends on whether these aspects can be integrated in the simulation setting as well. This represents a challenge for future development of simulation and for demonstrating its effectiveness and efficiency. Assessing the outcome of simulation in education in hi-tech health care settings is worthwhile if core characteristics of medical technology are addressed. This challenges the traditional technical versus non-technical divide in simulation, as organizational aspects appear to be part of technology's core characteristics.

  6. Successful technical trading agents using genetic programming.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Othling, Andrew S.; Kelly, John A.; Pryor, Richard J.

    2004-10-01

    Genetic programming (GP) has proved to be a highly versatile and useful tool for identifying relationships in data for which a more precise theoretical construct is unavailable. In this project, we use a GP search to develop trading strategies for agent based economic models. These strategies use stock prices and technical indicators, such as the moving average convergence/divergence and various exponentially weighted moving averages, to generate buy and sell signals. We analyze the effect of complexity constraints on the strategies as well as the relative performance of various indicators. We also present innovations in the classical genetic programming algorithm thatmore » appear to improve convergence for this problem. Technical strategies developed by our GP algorithm can be used to control the behavior of agents in economic simulation packages, such as ASPEN-D, adding variety to the current market fundamentals approach. The exploitation of arbitrage opportunities by technical analysts may help increase the efficiency of the simulated stock market, as it does in the real world. By improving the behavior of simulated stock markets, we can better estimate the effects of shocks to the economy due to terrorism or natural disasters.« less

  7. Understanding Building Infrastructure and Building Operation through DOE Asset Score Model: Lessons Learned from a Pilot Project

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wang, Na; Goel, Supriya; Gorrissen, Willy J.

    2013-06-24

    The U.S. Department of Energy (DOE) is developing a national voluntary energy asset score system to help building owners to evaluate the as-built physical characteristics (including building envelope, the mechanical and electrical systems) and overall building energy efficiency, independent of occupancy and operational choices. The energy asset score breaks down building energy use information by simulating building performance under typical operating and occupancy conditions for a given use type. A web-based modeling tool, the energy asset score tool facilitates the implementation of the asset score system. The tool consists of a simplified user interface built on a centralized simulation enginemore » (EnergyPlus). It is intended to reduce both the implementation cost for the users and increase modeling standardization compared with an approach that requires users to build their own energy models. A pilot project with forty-two buildings (consisting mostly offices and schools) was conducted in 2012. This paper reports the findings. Participants were asked to collect a minimum set of building data and enter it into the asset score tool. Participants also provided their utility bills, existing ENERGY STAR scores, and previous energy audit/modeling results if available. The results from the asset score tool were compared with the building energy use data provided by the pilot participants. Three comparisons were performed. First, the actual building energy use, either from the utility bills or via ENERGY STAR Portfolio Manager, was compared with the modeled energy use. It was intended to examine how well the energy asset score represents a building’s system efficiencies, and how well it is correlated to a building’s actual energy consumption. Second, calibrated building energy models (where they exist) were used to examine any discrepancies between the asset score model and the pilot participant buildings’ [known] energy use pattern. This comparison examined

  8. High educational impact of a national simulation-based urological curriculum including technical and non-technical skills.

    PubMed

    de Vries, Anna H; Schout, Barbara M A; van Merriënboer, Jeroen J G; Pelger, Rob C M; Koldewijn, Evert L; Muijtjens, Arno M M; Wagner, Cordula

    2017-02-01

    Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical and non-technical basic urological skills in the local hospital setting. This study aims to assess the educational impact of implementing the D-UPS curriculum in the Netherlands and to provide focus points for improvement of the D-UPS curriculum according to the participants. Educational impact was assessed by means of qualitative individual module-specific feedback and a quantitative cross-sectional survey among residents and supervisors. Twenty out of 26 Dutch teaching hospitals participated. The survey focussed on practical aspects, the D-UPS curriculum in general, and the impact of the D-UPS curriculum on the development of technical and non-technical skills. A considerable survey response of 95 % for residents and 76 % for supervisors was obtained. Modules were attended by junior and senior residents, supervised by a urologist, and peer teaching was used. Ninety percent of supervisors versus 67 % of residents judged the D-UPS curriculum as an important addition to current residency training (p = 0.007). Participants' aggregated general judgement of the modules showed a substantial percentage favorable score (M ± SE: 57 ± 4 %). The impact of training on, e.g., knowledge of materials/equipment and ability to anticipate on complications was high, especially for junior residents (77 ± 5 and 71 ± 7 %, respectively). Focus points for improvement of the D-UPS curriculum according to the participants include adaptation of the training level to residents' level of experience and focus on logistics. The simulation-based D-UPS curriculum has a high educational impact. Residents and supervisors consider the curriculum to be an important addition to current residency

  9. Efficient Computational Prototyping of Mixed Technology Microfluidic Components and Systems

    DTIC Science & Technology

    2002-08-01

    AFRL-IF-RS-TR-2002-190 Final Technical Report August 2002 EFFICIENT COMPUTATIONAL PROTOTYPING OF MIXED TECHNOLOGY MICROFLUIDIC...SUBTITLE EFFICIENT COMPUTATIONAL PROTOTYPING OF MIXED TECHNOLOGY MICROFLUIDIC COMPONENTS AND SYSTEMS 6. AUTHOR(S) Narayan R. Aluru, Jacob White...Aided Design (CAD) tools for microfluidic components and systems were developed in this effort. Innovative numerical methods and algorithms for mixed

  10. Learning curves for transapical transcatheter aortic valve replacement in the PARTNER-I trial: Technical performance, success, and safety.

    PubMed

    Suri, Rakesh M; Minha, Sa'ar; Alli, Oluseun; Waksman, Ron; Rihal, Charanjit S; Satler, Lowell P; Greason, Kevin L; Torguson, Rebecca; Pichard, Augusto D; Mack, Michael; Svensson, Lars G; Rajeswaran, Jeevanantham; Lowry, Ashley M; Ehrlinger, John; Mick, Stephanie L; Tuzcu, E Murat; Thourani, Vinod H; Makkar, Raj; Holmes, David; Leon, Martin B; Blackstone, Eugene H

    2016-09-01

    Introduction of hybrid techniques, such as transapical transcatheter aortic valve replacement (TA-TAVR), requires skills that a heart team must master to achieve technical efficiency: the technical performance learning curve. To date, the learning curve for TA-TAVR remains unknown. We therefore evaluated the rate at which technical performance improved, assessed change in occurrence of adverse events in relation to technical performance, and determined whether adverse events after TA-TAVR were linked to acquiring technical performance efficiency (the learning curve). From April 2007 to February 2012, 1100 patients, average age 85.0 ± 6.4 years, underwent TA-TAVR in the PARTNER-I trial. Learning curves were defined by institution-specific patient sequence number using nonlinear mixed modeling. Mean procedure time decreased from 131 to 116 minutes within 30 cases (P = .06) and device success increased to 90% by case 45 (P = .0007). Within 30 days, 354 patients experienced a major adverse event (stroke in 29, death in 96), with possibly decreased complications over time (P ∼ .08). Although longer procedure time was associated with more adverse events (P < .0001), these events were associated with change in patient risk profile, not the technical performance learning curve (P = .8). The learning curve for TA-TAVR was 30 to 45 procedures performed, and technical efficiency was achieved without compromising patient safety. Although fewer patients are now undergoing TAVR via nontransfemoral access, understanding TA-TAVR learning curves and their relationship with outcomes is important as the field moves toward next-generation devices, such as those to replace the mitral valve, delivered via the left ventricular apex. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  11. Scoring Package

    National Institute of Standards and Technology Data Gateway

    NIST Scoring Package (PC database for purchase)   The NIST Scoring Package (Special Database 1) is a reference implementation of the draft Standard Method for Evaluating the Performance of Systems Intended to Recognize Hand-printed Characters from Image Data Scanned from Forms.

  12. A Comparison of Two Scoring Methods for an Automated Speech Scoring System

    ERIC Educational Resources Information Center

    Xi, Xiaoming; Higgins, Derrick; Zechner, Klaus; Williamson, David

    2012-01-01

    This paper compares two alternative scoring methods--multiple regression and classification trees--for an automated speech scoring system used in a practice environment. The two methods were evaluated on two criteria: construct representation and empirical performance in predicting human scores. The empirical performance of the two scoring models…

  13. Models for Scoring Missing Responses to Multiple-Choice Items. Program Statistics Research Technical Report No. 94-1.

    ERIC Educational Resources Information Center

    Longford, Nicholas T.

    This study is a critical evaluation of the roles for coding and scoring of missing responses to multiple-choice items in educational tests. The focus is on tests in which the test-takers have little or no motivation; in such tests omitting and not reaching (as classified by the currently adopted operational rules) is quite frequent. Data from the…

  14. Measuring the efficiencies of visiting nurse service agencies using data envelopment analysis.

    PubMed

    Kuwahara, Yuki; Nagata, Satoko; Taguchi, Atsuko; Naruse, Takashi; Kawaguchi, Hiroyuki; Murashima, Sachiyo

    2013-09-01

    This study develops a measure of the efficiency of visiting nurse (VN) agencies in Japan, examining the issues related to the measurement of efficiency, and identifying the characteristics that influence efficiency. We have employed a data envelopment analysis to measure the efficiency of 108 VN agencies, using the numbers of 5 types of staff as the input variables and the numbers of 3 types of visits as the output variables. The median efficiency scores of the VN agencies were found to be 0.80 and 1.00 according to the constant returns to scale (CRS) and variable returns to scale (VRS) models, respectively, and the median scale efficiency score was 0.95. This study supports using both the CRS and VRS models to measure the scale efficiency of VN service agencies. We also found that relatively efficient VN agencies filled at least 30 % of staff positions with experienced workers, and so concluded that this characteristic has a direct influence on the length of visits.

  15. Causal Effects of Career-Technical Education on Postsecondary Work Outcomes of Individuals with High-Incidence Disabilities

    ERIC Educational Resources Information Center

    Lee, Heok In; Rojewski, Jay W.; Gregg, Noel

    2016-01-01

    Using data from the National Longitudinal Transition Study-2, a propensity score analysis revealed significant causal effects for a secondary career and technical education (CTE) concentration on the postsecondary work outcomes of adolescents with high-incidence disabilities. High school students identified as CTE concentrators (three or more high…

  16. Structural Analysis of Technical-Tactical Elements in Table Tennis and their Role in Different Playing Zones

    PubMed Central

    Munivrana, Goran; Petrinović, Lidija Zekan; Kondrič, Miran

    2015-01-01

    For the purpose of determining the overall structure of technical-tactical elements in table tennis and evaluating their role in different playing zones around the table, a new measuring instrument (a questionnaire) was formulated that took advantage of the expert knowledge of top, world class table tennis coaches. The results of the hierarchical taxonomic (cluster) analysis showed that the overall structure of the technical-tactical elements forming the table tennis technique could be divided into three basic groups; a group of technical-tactical elements (A) used in the phase of preparing one’s own and disabling the opponent’s attack; a group of technical-tactical elements (B) used in the phase of attack and counterattack; and a group of technical-tactical elements (C) used in the phase of defense. The differences among the obtained groups of table tennis elements were determined by applying the Kruskal-Wallis test, while relations between the groups and their role in different playing zones around the table were analyzed by comparing the average values of the experts’ scores. PMID:26557204

  17. Structural Analysis of Technical-Tactical Elements in Table Tennis and their Role in Different Playing Zones.

    PubMed

    Munivrana, Goran; Petrinović, Lidija Zekan; Kondrič, Miran

    2015-09-29

    For the purpose of determining the overall structure of technical-tactical elements in table tennis and evaluating their role in different playing zones around the table, a new measuring instrument (a questionnaire) was formulated that took advantage of the expert knowledge of top, world class table tennis coaches. The results of the hierarchical taxonomic (cluster) analysis showed that the overall structure of the technical-tactical elements forming the table tennis technique could be divided into three basic groups; a group of technical-tactical elements (A) used in the phase of preparing one's own and disabling the opponent's attack; a group of technical-tactical elements (B) used in the phase of attack and counterattack; and a group of technical-tactical elements (C) used in the phase of defense. The differences among the obtained groups of table tennis elements were determined by applying the Kruskal-Wallis test, while relations between the groups and their role in different playing zones around the table were analyzed by comparing the average values of the experts' scores.

  18. Measuring Efficiency of Knowledge Production in Health Research Centers Using Data Envelopment Analysis (DEA): A Case Study in Iran

    PubMed Central

    Amiri, Mohammad Meskarpour; Nasiri, Taha; Saadat, Seyed Hassan; Anabad, Hosein Amini; Ardakan, Payman Mahboobi

    2016-01-01

    Introduction Efficiency analysis is necessary in order to avoid waste of materials, energy, effort, money, and time during scientific research. Therefore, analyzing efficiency of knowledge production in health areas is necessary, especially for developing and in-transition countries. As the first step in this field, the aim of this study was the analysis of selected health research center efficiency using data envelopment analysis (DEA). Methods This retrospective and applied study was conducted in 2015 using input and output data of 16 health research centers affiliated with a health sciences university in Iran during 2010–2014. The technical efficiency of health research centers was evaluated based on three basic data envelopment analysis (DEA) models: input-oriented, output-oriented, and hyperbolic-oriented. The input and output data of each health research center for years 2010–2014 were collected from the Iran Ministry of Health and Medical Education (MOHE) profile and analyzed by R software. Results The mean efficiency score in input-oriented, output-oriented, and hyperbolic-oriented models was 0.781, 0.671, and 0.798, respectively. Based on results of the study, half of the health research centers are operating below full efficiency, and about one-third of them are operating under the average efficiency level. There is also a large gap between health research center efficiency relative to each other. Conclusion It is necessary for health research centers to improve their efficiency in knowledge production through better management of available resources. The higher level of efficiency in a significant number of health research centers is achievable through more efficient management of human resources and capital. Further research is needed to measure and follow the efficiency of knowledge production by health research centers around the world and over a period of time. PMID:28344756

  19. Measuring Efficiency of Knowledge Production in Health Research Centers Using Data Envelopment Analysis (DEA): A Case Study in Iran.

    PubMed

    Amiri, Mohammad Meskarpour; Nasiri, Taha; Saadat, Seyed Hassan; Anabad, Hosein Amini; Ardakan, Payman Mahboobi

    2016-11-01

    Efficiency analysis is necessary in order to avoid waste of materials, energy, effort, money, and time during scientific research. Therefore, analyzing efficiency of knowledge production in health areas is necessary, especially for developing and in-transition countries. As the first step in this field, the aim of this study was the analysis of selected health research center efficiency using data envelopment analysis (DEA). This retrospective and applied study was conducted in 2015 using input and output data of 16 health research centers affiliated with a health sciences university in Iran during 2010-2014. The technical efficiency of health research centers was evaluated based on three basic data envelopment analysis (DEA) models: input-oriented, output-oriented, and hyperbolic-oriented. The input and output data of each health research center for years 2010-2014 were collected from the Iran Ministry of Health and Medical Education (MOHE) profile and analyzed by R software. The mean efficiency score in input-oriented, output-oriented, and hyperbolic-oriented models was 0.781, 0.671, and 0.798, respectively. Based on results of the study, half of the health research centers are operating below full efficiency, and about one-third of them are operating under the average efficiency level. There is also a large gap between health research center efficiency relative to each other. It is necessary for health research centers to improve their efficiency in knowledge production through better management of available resources. The higher level of efficiency in a significant number of health research centers is achievable through more efficient management of human resources and capital. Further research is needed to measure and follow the efficiency of knowledge production by health research centers around the world and over a period of time.

  20. Shapley value-based multi-objective data envelopment analysis application for assessing academic efficiency of university departments

    NASA Astrophysics Data System (ADS)

    Abing, Stephen Lloyd N.; Barton, Mercie Grace L.; Dumdum, Michael Gerard M.; Bongo, Miriam F.; Ocampo, Lanndon A.

    2018-02-01

    This paper adopts a modified approach of data envelopment analysis (DEA) to measure the academic efficiency of university departments. In real-world case studies, conventional DEA models often identify too many decision-making units (DMUs) as efficient. This occurs when the number of DMUs under evaluation is not large enough compared to the total number of decision variables. To overcome this limitation and reduce the number of decision variables, multi-objective data envelopment analysis (MODEA) approach previously presented in the literature is applied. The MODEA approach applies Shapley value as a cooperative game to determine the appropriate weights and efficiency score of each category of inputs. To illustrate the performance of the adopted approach, a case study is conducted in a university in the Philippines. The input variables are academic staff, non-academic staff, classrooms, laboratories, research grants, and department expenditures, while the output variables are the number of graduates and publications. The results of the case study revealed that all DMUs are inefficient. DMUs with efficiency scores close to the ideal efficiency score may be emulated by other DMUs with least efficiency scores.

  1. Pretreatment of woody biomass for biofuel production: energy efficiency, technologies, and recalcitrance

    Treesearch

    J.Y. Zhu; Xuejun Pan; Ronald S. Jr. Zalesny

    2010-01-01

    This mini review discusses several key technical issues associated with cellulosic ethanol production from woody biomass: energy consumption for woody biomass pretreatment, pretreatment energy efficiency, woody biomass pretreatment technologies, and quantification of woody biomass recalcitrance. Both total sugar yield and pretreatment energy efficiency, defined as the...

  2. Technical Performance Scores are strongly associated with early mortality, postoperative adverse events, and intensive care unit length of stay-analysis of consecutive discharges for 2 years.

    PubMed

    Nathan, Meena; Karamichalis, John; Liu, Hua; Gauvreau, Kimberley; Colan, Steven; Saia, Matthew; Pigula, Frank; Fynn-Thompson, Francis; Emani, Sitaram; Baird, Christopher; Mayer, John E; del Nido, Pedro J

    2014-01-01

    Previous work in our institution has indicated that the Technical Performance Score (TPS) is highly associated with early outcomes in select subsets of procedures and age groups. We hypothesized that the TPS could predict early outcomes in a wide range of diagnoses and age groups. Consecutive patients discharged from January 2011 to March 2013 were prospectively evaluated. The TPS was assigned according to the discharge echocardiographic findings and the need for reinterventions in the anatomic area of interest. Case complexity was determined using Risk Adjustment for Congenital Heart Surgery (RACHS-1) categories. Early mortality and postoperative adverse events were recorded. Relationships between the TPS and outcomes were assessed after adjusting for the baseline patient characteristics. The median age of the 1926 patients was 1.8 years (range, 0 days to 68 years). Bypass was used in 1740 (90%); 322 (17%) were neonates, 520 (27%) infants, 873 (45%) children, 211 (11%) adults. TPS was class 1 (optimal) in 956 (50%), class 2 (adequate) in 584 (30%), and class 3 (inadequate) in 226 (12%); 160 patients (8%) could not be scored. A total of 51 early deaths (2.6%) and 111 adverse events (5.7%) occurred. On univariate analysis, age, RACHS-1 category, and TPS were significantly associated with mortality and the occurrence of adverse events. On multivariate modeling, class 3 (inadequate) TPS was strongly associated with mortality (odds ratio, 16.9; 95% confidence interval, 6.7-42.9; P < .001), adverse events (odds ratio, 6.9; 95% confidence interval, 4.1-11.6; P < .001), and postoperative intensive care unit length of stay (coefficient, 2.3; 95% confidence interval, 2.0-2.6; P < .001) after adjusting for other covariates. The TPS is strongly associated with early outcomes across a wide range of ages and disease complexity and can serve as important tool for self-assessment and quality improvement. Copyright © 2014 The American Association for Thoracic Surgery

  3. Trends in Department of Defense hospital efficiency.

    PubMed

    Ozcan, Y A; Bannick, R R

    1994-04-01

    This study employs a simple cross sectional design using longitudinal data to explore the underlying factors associated with differences in hospital technical efficiency using data envelopment analysis (DEA) in the Department of Defense (DOD) sector across three service components, the Army, Air Force and Navy. The results suggest that the services do not differ significantly in hospital efficiency. Nor does hospital efficiency appear to differ over time. With respect to the efficient use of input resources, the services experienced a general decline in excessive usage of various inputs over the three years. Analysis of the returns to scale captures opportunities for planners of changing the relative mix of output to input slacks for increasing a hospital's efficiency. That is, policy makers would get more immediate "bang per buck" with emphasis on improving the efficiencies of hospitals with higher returns to scale than other hospitals. Findings also suggest a significant degree of comparability between the DEA measure and these measures often used to indicate efficiency.

  4. Match score affects activity profile and skill performance in professional Australian Football players.

    PubMed

    Sullivan, Courtney; Bilsborough, Johann C; Cianciosi, Michael; Hocking, Joel; Cordy, Justin; Coutts, Aaron J

    2014-05-01

    To examine the influence of quarter outcome and the margin of the score differential on both the physical activity profile and skill performance of players during professional Australian Football matches. Prospective, longitudinal. Physical activity profiles were assessed via microtechnology (Global Positioning System and accelerometer) from 40 professional AF players from the same team during 15 Australian Football League games. Skill performance measures (involvement and effectiveness) and player rank scores (Champion Data(©) Rank) were provided by a commercial statistical provider. The physical performance variables, skill involvements and individual player performance scores were expressed relative to playing time for each quarter. The influence of the quarter result (i.e. win vs. loss) and score margin (i.e. small: <9 points, moderate: 10-18 points, and large: >19 points) on activity profile and skill involvements and skill efficiency performance of players were examined. Skill involvements (total disposals/min, long kicks/min, marks/min, running bounces/min and player rank/min) were greater in quarters won (all p<0.01). In contrast, the players high speed running distance per minute (>14.5 km h(-1), HSR/min), sprints/min and peak speed were higher in losing quarters (all p<0.01). Smaller score margins were associated with increased physical activity (m/min, HSR/min, and body load/min, all p<0.05) and decreased skill efficiency (handball clangers/min and player rank/min, all p<0.05). Professional AF players are likely to have an increased physical activity profile and decreased skill involvement and proficiency when their team is less successful. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  5. [The study of establishment of the " Chinese provincial Blindness prevention technical guidance group performance evaluation system"].

    PubMed

    Lu, L N; He, X G; Zhu, J F; Xu, X; Zhang, R; Hu, X; Zou, H D

    2016-11-11

    Objective: To establish an assessment system, including indexes and scoring methods, that can be used for performance evaluation of the provincial blindness prevention technical guidance group properly and effectively . Methods: The indexes and scoring methods were set based on the core content of The " National Plan of Prevention and Treatment of Blindness (2012-2015)" , the specific requirement and target of the World Health Organization (WHO) "For the General Eye Health: Global plan of Action (2014-2019)" , and the current situation of the China's provinces and autonomous regions. These indexes should be of effectiveness, feasibility, comparability, guidance and advancing. Formed by a literature review of candidate indicators, the framework of the system is built by qualitative assessment. With the Delphi method, the system was further revised and improved. Empirical pilot study was then used to prove the feasibility, followed by the final qualitative analysis that establish the " Chinese provincial Blindness prevention technical guidance group performance evaluation system" . Results: Through the literature review and qualitative assessment, a six dimensional system framework was built, including 6 first-level indicators, 16 second-level indicators, and 29 third-level indicators through Delphi method evaluation. With the variation coefficient method, the coeffiences of the first-level index weight were calculated as: Organization and management 0.15, Development and implementation of blindness prevention plans 0.15, Implementation of blindness prevention projects 0.14, Training 0.17, Health education 0.18, and Cooperation and exchanges 0.21. The specific scoring method for this system is confirmed as: data and files check, field interview, and record interview, sampling investigation. Empirical pilot study was conducted in the Jilin, Guizhou and Gansu provinces, and the self-assessment results from local experts were consistent with the scores from the systems

  6. Nursing activities score.

    PubMed

    Miranda, Dinis Reis; Nap, Raoul; de Rijk, Angelique; Schaufeli, Wilmar; Iapichino, Gaetano

    2003-02-01

    The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and cost-effectiveness studies require the accurate evaluation of nursing activities. The aim of the study was to determine the nursing activities that best describe workload in the intensive care unit and to attribute weights to these activities so that the score describes average time consumption instead of severity of illness. To define by consensus a list of nursing activities, to determine the average time consumption of these activities by use of a 1-wk observational cross-sectional study, and to compare these results with those of the Therapeutic Intervention Scoring System-28. A total of 99 intensive care units in 15 countries. Consecutive admissions to the intensive care units. Daily recording of nursing activities at a patient level and random multimoment recording of these activities. A total of five new items and 14 subitems describing nursing activities in the intensive care unit (e.g., monitoring, care of relatives, administrative tasks) were added to the list of therapeutic interventions in Therapeutic Intervention Scoring System-28. Data from 2,041 patients (6,451 nursing days and 127,951 multimoment recordings) were analyzed. The new activities accounted for 60% of the average nursing time; the new scoring system (Nursing Activities Score) explained 81% of the nursing time (vs. 43% in Therapeutic Intervention Scoring System-28). The weights in the Therapeutic Intervention Scoring System-28 are not derived from the use of nursing time. Our study suggests that the Nursing Activities Score measures the consumption of nursing time in the intensive care unit. These results should be validated in independent databases.

  7. 76 FR 41790 - Increasing Market and Planning Efficiency Through Improved Software; Notice Establishing Date for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... Market and Planning Efficiency Through Improved Software; Notice Establishing Date for Comments From June... real-time and day- ahead market efficiency through improved software.\\1\\ \\1\\ Notice of technical conference: increasing real-time and day-ahead market efficiency through improved software, 76 Fed. Reg. 28...

  8. Fire-tube boiler optimization criteria and efficiency indicators rational values defining

    NASA Astrophysics Data System (ADS)

    Batrakov, P. A.; Mikhailov, A. G.; Ignatov, V. Yu

    2018-01-01

    Technical and economic calculations problems solving with the aim of identifying the opportunity to recommend the project for industrial implementation are represented in the paper. One of the main determining factors impacting boiler energy efficiency is the exhaust gases temperature, as well as the furnace volume thermal stress. Fire-tube boilers with different types of furnaces are considered in the study. The fullest analysis of the boiler performance thermal and technical indicators for the following engineering problem: Q=idem, M=idem and evaluation according to η, B is presented. The furnace with the finned ellipse profile application results in the fuel consumption decrease due to a more efficient heat exchange surface of the furnace compared to other examined ones.

  9. The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group.

    PubMed

    Østergaard, Mikkel; Peterfy, Charles G; Bird, Paul; Gandjbakhch, Frédérique; Glinatsi, Daniel; Eshed, Iris; Haavardsholm, Espen A; Lillegraven, Siri; Bøyesen, Pernille; Ejbjerg, Bo; Foltz, Violaine; Emery, Paul; Genant, Harry K; Conaghan, Philip G

    2017-11-01

    The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS. MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined. Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research. Updated 2016 RAMRIS recommendations and a research agenda were developed.

  10. Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system.

    PubMed

    Shan, Lingtong; Ge, Wen; Pu, Yiwei; Cheng, Hong; Cang, Zhengqiang; Zhang, Xing; Li, Qifan; Xu, Anyang; Wang, Qi; Gu, Chang; Zhang, Yangyang

    2018-01-01

    To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age <70) used for comparison. The outcome of interest in this study was in-hospital mortality. The entire cohort and subsets of patients were analyzed. The calibration and discrimination in total and in subsets were assessed by the Hosmer-Lemeshow and the C statistics respectively. Institutional overall mortality was 2.52%. The expected mortality rates of SinoSCORE, EuroSCORE II and the STS risk evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

  11. Assessment of Technical Skills Competence in the Operating Room: A Systematic and Scoping Review.

    PubMed

    Fahim, Christine; Wagner, Natalie; Nousiainen, Markku T; Sonnadara, Ranil

    2018-05-01

    While academic accreditation bodies continue to promote competency-based medical education (CBME), the feasibility of conducting regular CBME assessments remains challenging. The purpose of this study was to identify evidence pertaining to the practical application of assessments that aim to measure technical competence for surgical trainees in a nonsimulated, operative setting. In August 2016, the authors systematically searched Medline, Embase, and the Cochrane Database of Systematic Reviews for English-language, peer-reviewed articles published in or after 1996. The title, abstract, and full text of identified articles were screened. Data regarding study characteristics, psychometric and measurement properties, implementation of assessment, competency definitions, and faculty training were extracted. The findings from the systematic review were supplemented by a scoping review to identify key strategies related to faculty uptake and implementation of CBME assessments. A total of 32 studies were included. The majority of studies reported reasonable scores of interrater reliability and internal consistency. Seven articles identified minimum scores required to establish competence. Twenty-five articles mentioned faculty training. Many of the faculty training interventions focused on timely completion of assessments or scale calibration. There are a number of diverse tools used to assess competence for intraoperative technical skills and a lack of consensus regarding the definition of technical competence within and across surgical specialties. Further work is required to identify when and how often trainees should be assessed and to identify strategies to train faculty to ensure timely and accurate assessment.

  12. An Analysis of Home Energy Score and REM/Rate Energy Simulation Results for Homes in Three Climates

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Merket, Noel D

    Energy ratings and scores for homes attempt to give homeowners a understandable metric to compare the energy efficiency of homes. Two rating systems in the marketplace include RESNET's Home Energy Rating System (HERS) and DOE's Home Energy Score (HEScore) and include differing energy calculation methodologies. This report compares the energy predictions from both REM/Rate and Home Energy Score for populations of real homes in three climates and determines some features of homes that lead to the greatest differences between energy predictions.

  13. Scored Discussions.

    ERIC Educational Resources Information Center

    Zola, John

    1992-01-01

    Suggests a classroom strategy to help students learn to analyze and discuss significant issues from history and current policy debates. Describes scored discussions in which small groups of students receive points for participation. Provides an example of a discussion on gold mining. Includes an agenda. Explores uses of scored discussions and…

  14. Efficiency and quality of care in nursing homes: an Italian case study.

    PubMed

    Garavaglia, Giulia; Lettieri, Emanuele; Agasisti, Tommaso; Lopez, Silvano

    2011-03-01

    This study investigates efficiency and quality of care in nursing homes. By means of Data Envelopment Analysis (DEA), the efficiency of 40 nursing homes that deliver their services in the north-western area of the Lombardy Region was assessed over a 3-year period (2005-2007). Lombardy is a very peculiar setting, since it is the only Region in Italy where the healthcare industry is organised as a quasi-market, in which the public authority buys health and nursing services from independent providers-establishing a reimbursement system for this purpose. The analysis is conducted by generating bootstrapped DEA efficiency scores for each nursing home (stage one), then regressing those scores on explanatory variables (stage two). Our DEA model employed two input (i.e. costs for health and nursing services and costs for residential services) and three output variables (case mix, extra nursing hours and residential charges). In the second-stage analysis, Tobit regressions and the Kruskall-Wallis tests of hypothesis to the efficiency scores were applied to define what are the factors that affect efficiency: (a) the ownership (private nursing houses outperform their public counterparts); and (b) the capability to implement strategies for labour cost and nursing costs containment, since the efficiency heavily depends upon the alignment of the costs to the public reimbursement system. Lastly, even though the public institutions are less efficient than the private ones, the results suggest that public nursing homes are moving towards their private counterparts, and thus competition is benefiting efficiency.

  15. Technical Desiderata for the Integration of Genomic Data into Electronic Health Records

    PubMed Central

    Masys, Daniel R.; Jarvik, Gail P.; Abernethy, Neil F.; Anderson, Nicholas R.; Papanicolaou, George J.; Paltoo, Dina N.; Hoffman, Mark A.; Kohane, Isaac S.; Levy, Howard P.

    2012-01-01

    The era of “Personalized Medicine,” guided by individual molecular variation in DNA, RNA, expressed proteins and other forms of high volume molecular data brings new requirements and challenges to the design and implementation of Electronic Health Records (EHRs). In this article we describe the characteristics of biomolecular data that differentiate it from other classes of data commonly found in EHRs, enumerate a set of technical desiderata for its management in healthcare settings, and offer a candidate technical approach to its compact and efficient representation in operational systems. PMID:22223081

  16. Are general surgeons able to accurately self-assess their level of technical skills?

    PubMed

    Rizan, C; Ansell, J; Tilston, T W; Warren, N; Torkington, J

    2015-11-01

    Self-assessment is a way of improving technical capabilities without the need for trainer feedback. It can identify areas for improvement and promote professional medical development. The aim of this review was to identify whether self-assessment is an accurate form of technical skills appraisal in general surgery. The PubMed, MEDLINE(®), Embase(™) and Cochrane databases were searched for studies assessing the reliability of self-assessment of technical skills in general surgery. For each study, we recorded the skills assessed and the evaluation methods used. Common endpoints between studies were compared to provide recommendations based on the levels of evidence. Twelve studies met the inclusion criteria from 22,292 initial papers. There was no level 1 evidence published. All papers compared the correlation between self-appraisal versus an expert score but differed in the technical skills assessment and the evaluation tools used. The accuracy of self-assessment improved with increasing experience (level 2 recommendation), age (level 3 recommendation) and the use of video playback (level 3 recommendation). Accuracy was reduced by stressful learning environments (level 2 recommendation), lack of familiarity with assessment tools (level 3 recommendation) and in advanced surgical procedures (level 3 recommendation). Evidence exists to support the reliability of self-assessment of technical skills in general surgery. Several variables have been shown to affect the accuracy of self-assessment of technical skills. Future work should focus on evaluating the reliability of self-assessment during live operating procedures.

  17. A didactic and hands-on module enhances resident microsurgical knowledge and technical skill.

    PubMed

    El Ahmadieh, Tarek Y; Aoun, Salah G; El Tecle, Najib E; Nanney, Allan D; Daou, Marc R; Harrop, James; Batjer, Hunt H; Bendok, Bernard R

    2013-10-01

    Simulation has been adopted as a powerful training tool in many areas of health care. However, it has not yet been systematically embraced in neurosurgery because of the absence of validated tools, assessment scales, and curricula. To use our validated microanastomosis module and scale to evaluate the effects of an educational intervention on the performance of neurosurgery residents at the 2012 Congress of Neurological Surgeons Annual Meeting. The module consisted of an end-to-end microanastomosis of a 3-mm vessel and was divided into 3 phases: (1) a cognitive and microsuture prelecture testing phase, (2) a didactic lecture, and (3) a cognitive and microsuture postlecture testing phase. We compared resident knowledge and technical proficiency from the pretesting and posttesting phases. One neurosurgeon and 7 neurosurgery residents participated in the study. None had previous experience in microsurgery. The average score on the microsuture prelecture and postlecture tests, as measured by our assessment scale, was 32.50 and 39.75, respectively (P = .001). The number of completed sutures at the end of each procedure was higher for 75% of participants in the postlecture testing phase (P = .03). The average score on the cognitive postlecture test (12.75) was significantly better than that of the cognitive prelecture test (8.38; P = .001). Simulation has the potential to enhance resident education and to elevate proficiency levels. Our data suggest that a focused microsurgical module that incorporates a didactic component and a technical component can enhance resident knowledge and technical proficiency in microsurgical anastomosis.

  18. DEVELOPMENT OF METRICS FOR PROTOCOLS AND OTHER TECHNICAL PRODUCTS.

    PubMed

    Veiga, Daniela Francescato; Ferreira, Lydia Masako

    2015-01-01

    To develop a proposal for metrics for protocols and other technical products to be applied in assessing the Postgraduate Programs of Medicine III - Capes. The 2013 area documents of all the 48 Capes areas were read. From the analysis of the criteria used by the areas at the 2013's Triennal Assessment, a proposal for metrics for protocols and other technical products was developed to be applied in assessing the Postgraduate Programs of Medicine III. This proposal was based on the criteria of Biological Sciences I and Interdisciplinary areas. Only seven areas have described a scoring system for technical products. The products considered and the scoring varied widely. Due to the wide range of different technical products which could be considered relevant, and that would not be punctuated if they were not previously specified, it was developed, for the Medicine III, a proposal for metrics in which five specific criteria to be analyzed: Demand, Relevance/Impact, Scope, Complexity and Adherence to the Program. Based on these criteria, each product can receive 10 to 100 points. This proposal can be applied to the item Intellectual Production of the evaluation form, in subsection "Technical production, patents and other relevant production". The program will be scored as Very Good when it reaches mean ≥150 points/permanent professor/quadrennium; Good, mean between 100 and 149 points; Regular, mean between 60 and 99 points; Weak mean between 30 and 59 points; Insufficient, up to 29 points/permanent professor/quadrennium. Desenvolver proposta de métricas para protocolos e outras produções técnicas a serem aplicadas na avaliação dos Programas de Pós-Graduação da Área Medicina III da Capes. Foram lidos os documentos de área de 2013 de todas as 48 Áreas da Capes. A partir da análise dos critérios utilizados por elas na avaliação trienal 2013, foi desenvolvida uma proposta de métricas para protocolos e outras produções técnicas. Esta proposta foi baseada

  19. Internal Consistency of the easyCBM© CCSS Reading Measures: Grades 3-8. Technical Report #1407

    ERIC Educational Resources Information Center

    Guerreiro, Meg; Alonzo, Julie; Tindal, Gerald

    2014-01-01

    This technical report documents findings from a study of the internal consistency and split-half reliability of the easyCBM© CCSS Reading measures, grades 3-8. Data, drawn from an extant data set gathered in school year 2013-2014, include scores from over 150,000 students' fall and winter benchmark assessments. Findings suggest that the easyCBM©…

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

    PubMed

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

    2018-04-10

    The transition to surgical training can be a stressful time for trainees and is most evident during national handover periods where new graduates start and senior trainees rotate to new programmes. During this time, patient mortality can increase and Hospital efficiency reduces. This influence is compounded by the impact of working time directives. Intensive, simulation rich training programmes or "Boot Camps" have been postulated as a solution. This article highlights the development of a surgical boot camp for novice surgical trainees and the impact this can have on training. A novel surgical boot camp was developed for all trainees within a surgical training region including nine acute NHS trusts. Participating cohort of trainees completed pre and post course questionnaires to assess technical and non-technical skills. 25 trainees attended and completed the pre and post boot camp questionnaire. Significant improvements were seen with technical skills (p = 0.0429), overall non-technical skills (p < 0.001) including leadership (p = 0.022), communication (p = 0.010), situational awareness (p = 0.022), patient handover (p = 0.003), ward round skills (p = 0.005) and outpatient skill (p = 0.002). Trainees reported significantly increased ability to assess and manage a critically unwell patient (p = 0.001) and a trauma patient (p = 0.001). 96% of trainees have utilised the skills they learnt on Boot Camp and all trainees would recommend it as an induction programme. Surgical Boot Camps offer a timely chance to develop technical and non-technical skills whilst enhancing a trainee's confidence and knowledge and reduce the patient safety impact of the handover period. Copyright © 2018. Published by Elsevier Ltd.

  1. Energy efficiency in light-frame wood construction

    Treesearch

    Gerald E. Sherwood; Gunard Hans

    1979-01-01

    This report presents information needed for design and construction of energy-efficient light-frame wood structures. The opening section discusses improving the thermal performance of a house by careful planning and design. A second section of the report provides technical information on the thermal properties of construction materials, and on the basic engineering...

  2. The health sector reforms and the efficiency of public hospitals in Turkey: provincial markets.

    PubMed

    Sulku, Seher Nur

    2012-10-01

    Turkey initiated the 'Health Transformation Programme' (HTP) in 2003 to align its health care system with the European Union and OECD countries. This study investigates the impact of these reforms on the efficiency of public hospitals. Our study would contribute to the existing literature with a comprehensive analysis of the health system in a developing country. We employ the data envelopment approach and the Malmquist index to comparatively examine before and after the reform years. Our analyses compare the performances of public hospitals served in provincial markets. Inputs of number of beds, number of primary care physician, and number of specialists, and how they are used to produce outputs of inpatient discharges, outpatient visits and surgical operations are investigated. Indeed, as the performance indicators dead rate, hospital bed occupation rate and average length of stay are considered. The HTP was generally successful in boosting productivity due to advancements in technology and technical efficiency but in the socio-economically disadvantaged provinces productivity gains have not been achieved. The average technical efficiency gains took place because of the significantly improved scale efficiencies, as the average pure technical efficiency slightly improved. Lastly, the hospital performance indicators have not improved in the short run. It appears that the expected benefits from the health reforms in Turkey have been partially achieved in the short run.

  3. Water-oil separation performance of technical textiles used for marine pollution disasters.

    PubMed

    Seddighi, Mahdi; Hejazi, Sayyed Mahdi

    2015-07-15

    Oil is principally one of the most important energy sources in the world. However, as long as oil is explored and transported for being used, there will be the risk of the spillage into the marine environment. The use of technical textiles, i.e. fibrous beds, is a conventional separation technique for oil/water emulsion since it is efficient and easy to design. In this paper, the recovery of oil by technical textiles was mathematically modeled based on the structural parameters of textile and the capillary mechanism. Eleven types of commercial technical textiles with different properties were prepared for the experimental program. The experimental design included fiber type (polypropylene and polyester), fabric type (woven and/or nonwoven), fabric thickness and fabric areal density. Consequently, the absorption capacities of different technical textile samples were derived by the use of theoretical and experimental methods. The results show that there is a well fitness between theoretical outputs and experimental data. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Algorithm improvement program nuclide identification algorithm scoring criteria and scoring application.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Enghauser, Michael

    2016-02-01

    The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

  5. Technical features of curriculum-based measures for beginning writers.

    PubMed

    McMaster, Kristen L; Xiaoqing Du; Pétursdóttir, Anna-Lind

    2009-01-01

    The purpose of the two studies reported in this article was to examine technical features of curriculum-based measures for beginning writers. In Study 1, 50 first graders responded to word copying, sentence copying, and story prompts. In Study 2, 50 additional first graders responded to letter, picture-word, picture-theme, and photo prompts. In both studies, 3- to 5-minute prompts were administered in winter and spring and scored using a variety of quantitative procedures. Students were also administered the Test of Written Language-Third Edition , and teacher ratings and scores on a district rubric for writing were collected. Test-retest (Study 1 only) and alternate-form reliability, criterion validity, and winter-to-spring growth were examined for each measure. Sentence-copying, story, picture-word, and photo prompts emerged as promising beginning-writing measures. Findings have implications for monitoring student progress within a seamless and flexible system across ages and skill levels.

  6. The efficiency of life insurance and family Takaful in Malaysia: Relative efficiency using the stochastic cost frontier analysis

    NASA Astrophysics Data System (ADS)

    Baharin, Roziana; Isa, Zaidi

    2013-04-01

    This paper focuses on the Stochastic cost Frontier Analysis (SFA) approach, in an attempt to measure the relationship between efficiency and organizational structure for Takaful and insurance operators in Malaysia's dual financial system. This study applied a flexible cost functional form i.e., Fourier Flexible Functional Form, for a sample consisting of 19 firms, chosen between 2002 and 2010, by employing the Battese and Coelli invariant efficiency model. The findings show that on average, there is a significant difference in cost efficiency between the Takaful industry and the insurance industry. It was found that Takaful has lower cost efficiency than conventional insurance, which shows that the organization form has an influence on efficiency. Overall, it was observed that the level of efficiency scores for both life insurance and family Takaful do not vary across time.

  7. More Efficient e-Learning through Design: Color of Text and Background

    ERIC Educational Resources Information Center

    Zufic, Janko; Kalpic, Damir

    2009-01-01

    Background: The area of research aimed for a more efficient e-learning is slowly widening from purely technical to the areas of psychology, didactics and methodology. The question is whether the text or background color influence the efficiency of memory, i.e. learning. If the answer to that question is positive, then another question arises which…

  8. Database of Renewable Energy and Energy Efficiency Incentives and Policies Final Technical Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lips, Brian

    The Database of State Incentives for Renewables and Efficiency (DSIRE) is an online resource that provides summaries of all financial incentives and regulatory policies that support the use of renewable energy and energy efficiency across all 50 states. This project involved making enhancements to the database and website, and the ongoing research and maintenance of the policy and incentive summaries.

  9. Automated Essay Scoring versus Human Scoring: A Correlational Study

    ERIC Educational Resources Information Center

    Wang, Jinhao; Brown, Michelle Stallone

    2008-01-01

    The purpose of the current study was to analyze the relationship between automated essay scoring (AES) and human scoring in order to determine the validity and usefulness of AES for large-scale placement tests. Specifically, a correlational research design was used to examine the correlations between AES performance and human raters' performance.…

  10. Insulated Concrete Homes Increase Durability and Energy Efficiency

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Building America; Hendron, B.; Poole, L.

    2001-06-05

    New houses designed by Mercedes Homes in Melbourne, Florida, with technical support from the U.S. Department of Energy's Building America Program, save their homeowners money by using energy efficient features such as a high performance heat pump and solar control glazing to reduce cooling costs.

  11. Technical notes published in BJOMS over a 2-year period--should we be doing it differently?

    PubMed

    Singh, M; Shekar, K; Shelley, M; Mackenzie, N; Spencer, H; Kiani, H; Brennan, P A

    2009-06-01

    Between January 2007 and December 2008, 44 technical notes or related publications (such as letters) were published in the British Journal of Oral and Maxillofacial Surgery (BJOMS). These covered most of the remit of the specialty and ranged from operative surgical techniques to the use of digital photographs to orientate surgical specimens. However, there would seem to be very little feedback on the value of these articles in everyday practice. We reviewed these technical notes and assessed readability, the value and use of illustrations, the possible expense and/or equipment required in their use, and finally the frequency that the techniques could be used. The anonymised publications were read and scored by a minimum of two dentally qualified senior house officers, two doubly qualified specialist registrars, an SAS grade and two consultants in oral and maxillofacial surgery. The six techniques that gained the highest mean average score are briefly discussed. Although we used a relatively small number of assessors who might not be representative of the whole BJOMS readership, this study would suggest that some sort of change in the way that these technical notes are published should be considered. Options might include inviting a commentary from the reviewers who have tried the technique and also encouraging colleagues to report their experiences of these techniques in the 'letters to the editor' section.

  12. What is the quickest scoring system to predict percutaneous nephrolithotomy outcomes? A comparative study among S.T.O.N.E score, guy's stone score and croes nomogram.

    PubMed

    Vicentini, Fabio C; Serzedello, Felipe R; Thomas, Kay; Marchini, Giovanni S; Torricelli, Fabio C M; Srougi, Miguel; Mazzucchi, Eduardo

    2017-01-01

    To compare the application time and the capacity of the nomograms to predict the success of Guy's Stone Score (GSS), S.T.O.N.E. Nephrolithometry (STONE) and Clinical Research Office of the Endourological Society nephrolithometric nomogram (CROES) of percutaneous nephrolithotomy (PCNL), evaluating the most efficient one for clinical use. We studied 48 patients who underwent PCNL by the same surgeon between 2010 and 2011. We calculated GSS, STONE and CROES based on preoperative non-contrast computed tomography (CT) images and clinical data. A single observer, blinded to the outcomes, reviewed all images and assigned scores. We compared the application time of each nomogram. We used an analysis of variance for repeated measures and multiple comparisons by the Tukey test. We compared the area under the ROC curve (AUC) of the three nomograms two by two to determine the most predictive scoring system. The immediate success rate was 66.7% and complications occurred in 16.7% of cases. The average operative time was 122 minutes. Mean application time was significantly lower for the GSS (27.5 seconds) when compared to 300.6 seconds for STONE and 213.4 seconds for CROES (p<0.001). There was no significant difference among the GSS (AUC=0.653), STONE (AUC=0.563) and CROES (AUC=0.641) in the ability to predict immediate success of PCNL. All three nomograms showed similar ability to predict success of PCNL, however the GSS was the quickest to be applied, what is an important issue for routine clinical use when counseling patients who are candidates to PCNL. Copyright® by the International Brazilian Journal of Urology.

  13. Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation

    PubMed Central

    Sefton, Gerri; Lane, Steven; Killen, Roger; Black, Stuart; Lyon, Max; Ampah, Pearl; Sproule, Cathryn; Loren-Gosling, Dominic; Richards, Caitlin; Spinty, Jean; Holloway, Colette; Davies, Coral; Wilson, April; Chean, Chung Shen; Carter, Bernie; Carrol, E.D.

    2017-01-01

    Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined “norm.” Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team. PMID:27832032

  14. Accuracy and Efficiency of Recording Pediatric Early Warning Scores Using an Electronic Physiological Surveillance System Compared With Traditional Paper-Based Documentation.

    PubMed

    Sefton, Gerri; Lane, Steven; Killen, Roger; Black, Stuart; Lyon, Max; Ampah, Pearl; Sproule, Cathryn; Loren-Gosling, Dominic; Richards, Caitlin; Spinty, Jean; Holloway, Colette; Davies, Coral; Wilson, April; Chean, Chung Shen; Carter, Bernie; Carrol, E D

    2017-05-01

    Pediatric Early Warning Scores are advocated to assist health professionals to identify early signs of serious illness or deterioration in hospitalized children. Scores are derived from the weighting applied to recorded vital signs and clinical observations reflecting deviation from a predetermined "norm." Higher aggregate scores trigger an escalation in care aimed at preventing critical deterioration. Process errors made while recording these data, including plotting or calculation errors, have the potential to impede the reliability of the score. To test this hypothesis, we conducted a controlled study of documentation using five clinical vignettes. We measured the accuracy of vital sign recording, score calculation, and time taken to complete documentation using a handheld electronic physiological surveillance system, VitalPAC Pediatric, compared with traditional paper-based charts. We explored the user acceptability of both methods using a Web-based survey. Twenty-three staff participated in the controlled study. The electronic physiological surveillance system improved the accuracy of vital sign recording, 98.5% versus 85.6%, P < .02, Pediatric Early Warning Score calculation, 94.6% versus 55.7%, P < .02, and saved time, 68 versus 98 seconds, compared with paper-based documentation, P < .002. Twenty-nine staff completed the Web-based survey. They perceived that the electronic physiological surveillance system offered safety benefits by reducing human error while providing instant visibility of recorded data to the entire clinical team.

  15. 75 FR 34734 - Improving Market and Planning Efficiency Through Improved Software; Notice of Agenda and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-18

    ... Market and Planning Efficiency Through Improved Software; Notice of Agenda and Procedures for Staff Technical Conference June 10, 2010. This notice establishes the agenda and procedures for the staff[email protected] . Kimberly D. Bose, Secretary. Agenda for AD10-12 Staff Technical Conference on Enhanced Power...

  16. Aggregate National Early Warning Score (NEWS) values are more important than high scores for a single vital signs parameter for discriminating the risk of adverse outcomes.

    PubMed

    Jarvis, Stuart; Kovacs, Caroline; Briggs, Jim; Meredith, Paul; Schmidt, Paul E; Featherstone, Peter I; Prytherch, David R; Smith, Gary B

    2015-02-01

    The Royal College of Physicians (RCPL) National Early Warning Score (NEWS) escalates care to a doctor at NEWS values of ≥5 and when the score for any single vital sign is 3. We calculated the 24-h risk of serious clinical outcomes for vital signs observation sets with NEWS values of 3, 4 and 5, separately determining risks when the score did/did not include a single score of 3. We compared workloads generated by the RCPL's escalation protocol and for aggregate NEWS value alone. Aggregate NEWS values of 3 or 4 (n=142,282) formed 15.1% of all vital signs sets measured; those containing a single vital sign scoring 3 (n=36,207) constituted 3.8% of all sets. Aggregate NEWS values of either 3 or 4 with a component score of 3 have significantly lower risks (OR: 0.26 and 0.53) than an aggregate value of 5 (OR: 1.0). Escalating care to a doctor when any single component of NEWS scores 3 compared to when aggregate NEWS values ≥5, would have increased doctors' workload by 40% with only a small increase in detected adverse outcomes from 2.99 to 3.08 per day (a 3% improvement in detection). The recommended NEWS escalation protocol produces additional work for the bedside nurse and responding doctor, disproportionate to a modest benefit in increased detection of adverse outcomes. It may have significant ramifications for efficient staff resource allocation, distort patient safety focus and risk alarm fatigue. Our findings suggest that the RCPL escalation guidance warrants review. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Primeau, Francois William

    2016-02-11

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

  18. The Effect of Capstone Cooperative Education Experiences, and Related Factors, on Career and Technical Education Secondary Student Summative Assessment Scores

    ERIC Educational Resources Information Center

    Richard, Elizabeth D.; Walter, Richard A.; Yoder, Edgar P.

    2013-01-01

    Research has discussed the benefits of cooperative education experiences for secondary career and technical education students. Yet, in this era of high stakes testing and program accountability, the amount of time that students are permitted to participate in cooperative education has diminished, fearing that time spent out of the classroom would…

  19. A robust collagen scoring method for human liver fibrosis by second harmonic microscopy.

    PubMed

    Guilbert, Thomas; Odin, Christophe; Le Grand, Yann; Gailhouste, Luc; Turlin, Bruno; Ezan, Frédérick; Désille, Yoann; Baffet, Georges; Guyader, Dominique

    2010-12-06

    Second Harmonic Generation (SHG) microscopy offers the opportunity to image collagen of type I without staining. We recently showed that a simple scoring method, based on SHG images of histological human liver biopsies, correlates well with the Metavir assessment of fibrosis level (Gailhouste et al., J. Hepatol., 2010). In this article, we present a detailed study of this new scoring method with two different objective lenses. By using measurements of the objectives point spread functions and of the photomultiplier gain, and a simple model of the SHG intensity, we show that our scoring method, applied to human liver biopsies, is robust to the objective's numerical aperture (NA) for low NA, the choice of the reference sample and laser power, and the spatial sampling rate. The simplicity and robustness of our collagen scoring method may open new opportunities in the quantification of collagen content in different organs, which is of main importance in providing diagnostic information and evaluation of therapeutic efficiency.

  20. Relationship between intraoperative non-technical performance and technical events in bariatric surgery.

    PubMed

    Fecso, A B; Kuzulugil, S S; Babaoglu, C; Bener, A B; Grantcharov, T P

    2018-03-30

    The operating theatre is a unique environment with complex team interactions, where technical and non-technical performance affect patient outcomes. The correlation between technical and non-technical performance, however, remains underinvestigated. The purpose of this study was to explore these interactions in the operating theatre. A prospective single-centre observational study was conducted at a tertiary academic medical centre. One surgeon and three fellows participated as main operators. All patients who underwent a laparoscopic Roux-en-Y gastric bypass and had the procedures captured using the Operating Room Black Box ® platform were included. Technical assessment was performed using the Objective Structured Assessment of Technical Skills and Generic Error Rating Tool instruments. For non-technical assessment, the Non-Technical Skills for Surgeons (NOTSS) and Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) tools were used. Spearman rank-order correlation and N-gram statistics were conducted. Fifty-six patients were included in the study and 90 procedural steps (gastrojejunostomy and jejunojejunostomy) were analysed. There was a moderate to strong correlation between technical adverse events (r s  = 0·417-0·687), rectifications (r s  = 0·380-0·768) and non-technical performance of the surgical and nursing teams (NOTSS and SPLINTS). N-gram statistics showed that after technical errors, events and prior rectifications, the staff surgeon and the scrub nurse exhibited the most positive non-technical behaviours, irrespective of operator (staff surgeon or fellow). This study demonstrated that technical and non-technical performances are related, on both an individual and a team level. Valuable data can be obtained around intraoperative errors, events and rectifications. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.