Science.gov

Sample records for aar improvement plan

  1. Continual improvement plan

    NASA Technical Reports Server (NTRS)

    1994-01-01

    NASA's approach to continual improvement (CI) is a systems-oriented, agency-wide approach that builds on the past accomplishments of NASA Headquarters and its field installations and helps achieve NASA's vision, mission, and values. The NASA of the future will fully use the principles of continual improvement in every aspect of its operations. This NASA CI plan defines a systematic approach and a model for continual improvement throughout NASA, stressing systems integration and optimization. It demonstrates NASA's constancy of purpose for improvement - a consistent vision of NASA as a worldwide leader in top-quality science, technology, and management practices. The CI plan provides the rationale, structures, methods, and steps, and it defines NASA's short term (1-year) objectives for improvement. The CI plan presents the deployment strategies necessary for cascading the goals and objectives throughout the agency. It also provides guidance on implementing continual improvement with participation from top leadership and all levels of employees.

  2. Development Planning for School Improvement.

    ERIC Educational Resources Information Center

    Hargreaves, David H., Ed.; Hopkins, David, Ed.

    Development planning has recently become a commonly adopted strategy for school improvement in the United Kingdom. Development planning is a description and more formal explication of the process and actions required to plan and manage change with the intention of improving the school. The chapters in this book report on the "state of the art" of…

  3. Software Engineering Improvement Plan

    NASA Technical Reports Server (NTRS)

    2006-01-01

    In performance of this task order, bd Systems personnel provided support to the Flight Software Branch and the Software Working Group through multiple tasks related to software engineering improvement and to activities of the independent Technical Authority (iTA) Discipline Technical Warrant Holder (DTWH) for software engineering. To ensure that the products, comments, and recommendations complied with customer requirements and the statement of work, bd Systems personnel maintained close coordination with the customer. These personnel performed work in areas such as update of agency requirements and directives database, software effort estimation, software problem reports, a web-based process asset library, miscellaneous documentation review, software system requirements, issue tracking software survey, systems engineering NPR, and project-related reviews. This report contains a summary of the work performed and the accomplishments in each of these areas.

  4. Professional Improvement Plans in Science.

    ERIC Educational Resources Information Center

    Sousa, David A., Comp.; And Others

    In 1982 the New Jersey Science Supervisors Association asked its members to submit samples of Professional Improvement Plans (PIPS) that they had developed for themselves as well as for their science teachers. Provided in this document, in chart format, are actual PIPS used by classroom teachers and science supervisors. The PIPS are divided into…

  5. 23 CFR 1200.25 - Improvement plan.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Improvement plan. 1200.25 Section 1200.25 Highways... Implementation and Management of the Highway Safety Program § 1200.25 Improvement plan. If a review of the Annual... improvement plan. This plan will detail strategies, program activities, and funding targets to meet...

  6. Using Strategic Planning To Improve Rural Schools.

    ERIC Educational Resources Information Center

    D'Amico, Joseph J.

    This paper describes the elements of strategic planning and applies them to educational reform and improvement. The paper also describes how a planning model, Strategic Planning for Educational Reform and Improvement (SPERI), was used by Rural Assistance Councils (RACs) in Pennsylvania and Delaware, with technical assistance from Research for…

  7. The Individualized Teacher Improvement Plan

    ERIC Educational Resources Information Center

    Hamlin, Erica

    2013-01-01

    This author states her belief that there must be an answer to devising an effective and credible way to link compensation to professional development and improved teaching. Such a model would need to be transparent, equitable, and financially manageable for the school. It would need to marry objectivity with the art of teaching, and have buy-in…

  8. A Wildlife Habitat Improvement Plan.

    ERIC Educational Resources Information Center

    Rogers, S. Elaine

    The document presents an overview of Stony Acres, a "sanctuary" for wildlife as well as a place for recreation enjoyment and education undertakings. A review of the history of wildlife habitat management at Stony Acres and the need for continued and improved wildlife habitat management for the property are discussed in Chapter I. Chapter II…

  9. SNF project engineering process improvement plan

    SciTech Connect

    DESAI, S.P.

    1999-07-13

    This Engineering Process Improvement Plan documents the activities and plans to be taken by the SNF Project to support its engineering process and to produce a consolidated set of engineering procedures that are fully compliant with the requirements of HNF-PRO-1819. All new procedures will be issued and implemented by September 30, 1999.

  10. Linking Planning, Quality Improvement, and Institutional Research

    ERIC Educational Resources Information Center

    Seymour, Daniel; Kelley, John M.; Jasinski, John

    2004-01-01

    External and internal forces are driving institutions not only to create departments and positions that specialize in planning, quality improvement, and institutional research but also to link them within a systems context.

  11. 24 Command Fire Improvement Action Program Plan

    SciTech Connect

    GRIFFIN, G.B.

    2000-12-01

    Fluor Hanford (FH) is responsible for providing support to the Department of Energy Richland Operations Office (RL) in the implementation of the Hanford Emergency Preparedness (EP) program. During fiscal year 2000, a number of program improvements were identified from various sources including a major range fire (24 Command Fire). Evaluations of the emergency preparedness program have confirmed that it currently meets all requirements and that performance of personnel involved is good, however the desire to effect continuous improvement resulted in the development of this improvement program plan. This program plan defines the activities that will be performed in order to achieve the desired performance improvements.

  12. Planning ahead: Improving escalation plans before the weekend.

    PubMed

    Zarkali, Angeliki; Black, Duncan; Smee, Elizabeth; Deshraj, Anshul; Smallwood, Nicholas

    2014-01-01

    Handover is the system by which responsibility for patient care is transferred between healthcare professionals. A significant aspect of handover is the existence of an escalation plan for each patient in case of deterioration over the weekend. According to the Royal College of Physicians, all patients should have a clear escalation plan documented in the notes before a weekend, since parent medical teams (Consultant team in charge of care) are best placed to make these decisions. If left to on-call teams, at a time of deterioration over a weekend, they might not have all available information, the patient might be unable to be involved in the decisions, and the family might not be consulted. With this is mind, we decided to analyse the existing handover process in a medium sized district general hospital, with the aim of improving the process and the documentation of escalation plans. The results from our retrospective analysis of the system in place revealed a significant lack of documentation of escalation plans in the medical notes. Three sample wards were selected to analyse the current handover system and test proposed measures before hospital-wide implementation. After trialling of a physical handover meeting in addition to the existing intranet system and a proforma for the Friday ward round, the documentation of escalation plans in the patients' notes improved from 9.1% to 41.1%. Based on these results, as well as formal feedback from junior doctors and informal feedback from other staff, the physical handover meeting and Friday ward round proforma will be implemented throughout the Trust. Our interventions led to an improvement in the documentation of escalation plans in our hospital, thus saving precious time in the event of a patient's deterioration. This also ensures that families and patients are involved in the decision making process and kept informed, and reduces the burden for the weekend on-call teams. PMID:26734241

  13. Software Engineering Improvement Activities/Plan

    NASA Technical Reports Server (NTRS)

    2003-01-01

    bd Systems personnel accomplished the technical responsibilities for this reporting period, as planned. A close working relationship was maintained with personnel of the MSFC Avionics Department Software Group (ED14). Work accomplishments included development, evaluation, and enhancement of a software cost model, performing literature search and evaluation of software tools available for code analysis and requirements analysis, and participating in other relevant software engineering activities. Monthly reports were submitted. This support was provided to the Flight Software Group/ED 1 4 in accomplishing the software engineering improvement engineering activities of the Marshall Space Flight Center (MSFC) Software Engineering Improvement Plan.

  14. 23 CFR 1200.25 - Improvement plan.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Improvement plan. 1200.25 Section 1200.25 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PROCEDURES FOR STATE HIGHWAY SAFETY PROGRAMS UNIFORM PROCEDURES FOR STATE HIGHWAY SAFETY PROGRAMS Implementation and Management of the...

  15. The Automated Aircraft Rework System (AARS): A system integration approach

    NASA Technical Reports Server (NTRS)

    Benoit, Michael J.

    1994-01-01

    The Mercer Engineering Research Center (MERC), under contract to the United States Air Force (USAF) since 1989, has been actively involved in providing the Warner Robins Air Logistics Center (WR-ALC) with a robotic workcell designed to perform rework automated defastening and hole location/transfer operations on F-15 wings. This paper describes the activities required to develop and implement this workcell, known as the Automated Aircraft Rework System (AARS). AARS is scheduled to be completely installed and in operation at WR-ALC by September 1994.

  16. Strategic planning to drive integrated continuous improvement.

    PubMed

    McChesney, H

    1995-11-01

    This case study describes how one company involved multiple levels of all functions to develop a comprehensive strategic plan that drives the continuous improvement initiative. The process involves clearly defining a mission, assessing the current situation, developing goals designed to achieve a preferred future status, and establishing the specific tactics to move toward that preferred future. The plan then drives integrated efforts throughout the organization to help manage the business of providing the highest quality products and services to meet current and anticipated customer requirements. PMID:10152530

  17. SNF project engineering process improvement plan

    SciTech Connect

    KELMENSON, R.L.

    1999-05-24

    This Engineering Process Improvement Plan documents the activities and plans to be taken by the SNF Project (the Project) to support its engineering process and to produce a consolidated set of engineering procedures that are fully compliant with the requirements of HNF-PRO-1819 (1819). These requirements are imposed on all engineering activities performed for the Project and apply to all life-cycle stages of the Project's systems, structures and components (SSCs). This Plan describes the steps that will be taken by the Project during the transition period to ensure that new procedures are effectively integrated into the Project's work process as these procedures are issued. The consolidated procedures will be issued and implemented by September 30, 1999.

  18. Learning to improve path planning performance

    SciTech Connect

    Chen, Pang C.

    1995-04-01

    In robotics, path planning refers to finding a short. collision-free path from an initial robot configuration to a desired configuratioin. It has to be fast to support real-time task-level robot programming. Unfortunately, current planning techniques are still too slow to be effective, as they often require several minutes, if not hours of computation. To remedy this situation, we present and analyze a learning algorithm that uses past experience to increase future performance. The algorithm relies on an existing path planner to provide solutions to difficult tasks. From these solutions, an evolving sparse network of useful robot configurations is learned to support faster planning. More generally, the algorithm provides a speedup-learning framework in which a slow but capable planner may be improved both cost-wise and capability-wise by a faster but less capable planner coupled with experience. The basic algorithm is suitable for stationary environments, and can be extended to accommodate changing environments with on-demand experience repair and object-attached experience abstraction. To analyze the algorithm, we characterize the situations in which the adaptive planner is useful, provide quantitative bounds to predict its behavior, and confirm our theoretical results with experiments in path planning of manipulators. Our algorithm and analysis are sufficiently, general that they may also be applied to other planning domains in which experience is useful.

  19. 76 FR 15791 - National Poultry Improvement Plan and Auxiliary Provisions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ...We are amending the National Poultry Improvement Plan (the Plan) and its auxiliary provisions by providing new or modified sampling and testing procedures for Plan participants and participating flocks. The changes were voted on and approved by the voting delegates at the Plan's 2008 National Plan Conference. These changes will keep the provisions of the Plan current with changes in the......

  20. Who plans for health improvement? SEA, HIA and the separation of spatial planning and health planning

    SciTech Connect

    Bond, Alan; Cave, Ben; Ballantyne, Rob

    2013-09-15

    This study examines whether there is active planning for health improvement in the English spatial planning system and how this varies across two regions using a combination of telephone surveys and focus group interviews in 2005 and 2010. The spatial planning profession was found to be ill-equipped to consider the health and well-being implications of its actions, whilst health professionals are rarely engaged and have limited understanding and aspirations when it comes to influencing spatial planning. Strategic Environmental Assessment was not considered to be successful in integrating health into spatial plans, given it was the responsibility of planners lacking the capacity to do so. For their part, health professionals have insufficient knowledge and understanding of planning and how to engage with it to be able to plan for health gains rather than simply respond to health impacts. HIA practice is patchy and generally undertaken by health professionals outside the statutory planning framework. Thus, whilst appropriate assessment tools exist, they currently lack a coherent context within which they can function effectively and the implementation of the Kiev protocol requiring the engagement of health professionals in SEA is not to likely improve the consideration of health in planning while there continues to be separation of functions between professions and lack of understanding of the other profession. -- Highlights: ► Health professionals have limited aspirations for health improvement through the planning system. ► Spatial planners are ill-equipped to understand the health and well-being implications of their activities. ► SEA and HIA currently do not embed health consideration in planning decisions. ► The separation of health and planning functions is problematic for the effective conduct of SEA and/or HIA.

  1. Use of After Action Reports (AARs) to Promote Organizational and Systems Learning in Emergency Preparedness

    PubMed Central

    Savoia, Elena; Agboola, Foluso; Biddinger, Paul D.

    2012-01-01

    Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The “lessons-learned” approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the “Lessons Learned Information Sharing (LLIS.gov)” system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strived to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed. PMID:23066408

  2. Use of after action reports (AARs) to promote organizational and systems learning in emergency preparedness.

    PubMed

    Savoia, Elena; Agboola, Foluso; Biddinger, Paul D

    2012-08-01

    Many public health and healthcare organizations use formal knowledge management practices to identify and disseminate the experiences gained over time. The "lessons-learned" approach is one such example of knowledge management practice applied to the wider concept of organizational learning. In the field of emergency preparedness, the lessons-learned approach stands on the assumption that learning from experience improves practice and minimizes avoidable deaths and negative economic and social consequences of disasters. In this project, we performed a structured review of AARs to analyze how lessons learned from the response to real-incidents may be used to maximize knowledge management and quality improvement practices such as the design of public health emergency preparedness (PHEP) exercises. We chose as a source of data the "Lessons Learned Information Sharing (LLIS.gov)" system, a joined program of the U.S. Department of Homeland Security DHS and FEMA that serves as the national, online repository of lessons learned, best practices, and innovative ideas. We identified recurring challenges reported by various states and local public health agencies in the response to different types of incidents. We also strove to identify the limitations of systematic learning that can be achieved due to existing weaknesses in the way AARs are developed. PMID:23066408

  3. Improving Plan Quality in SAT-Based Planning

    NASA Astrophysics Data System (ADS)

    Giunchiglia, Enrico; Maratea, Marco

    Planning as Satisfiability (SAT) is the best approach for optimally (wrt makespan) solving classical planning problems. SAT-based planners, like SATPLAN, can thus return plans having minimal makespan guaranteed. However, the returned plan does not take into account plan quality issues introduced in the last two International Planning Competitions (IPCs): such issues include minimal-actions plans and plans with "soft" goals, where a metric has to be optimized over actions/goals. Recently, an approach to address such issues has been presented, in the framework of planning as satisfiability with preferences: by modifying the heuristic of the underlying SAT solver, the related system (called SATPLAN(P)) is guaranteed to return plans with minimal number of actions, or with maximal number of soft goals satisfied. But, besides such feature, it is well-known that introducing ordering in SAT heuristics can lead to significant degradation in performances. In this paper, we present a generate-and-test approach to tackle the problem of dealing with such optimization issues: without imposing any ordering, a (candidate optimal) plan is first generated, and then a constraint is added imposing that the new plan (if any) has to be "better" than the last computed, i.e., the plan quality is increased at each iteration. We implemented this idea in SATPLAN, and compared the resulting systems wrt SATPLAN(P) and SGPlan on planning problems coming from IPCs. The analysis shows performance benefits for the new approach, in particular on planning problems with many preferences.

  4. Arkansas Consolidated School Improvement Planning (ACSIP): Handbook. 2005-06

    ERIC Educational Resources Information Center

    Arkansas Department of Education, 2005

    2005-01-01

    The Arkansas Consolidated School Improvement Planning model (ACSIP) is an annual comprehensive planning and fund distribution design that must be used by all Arkansas public schools. Using the ACSIP model, each school in Arkansas develops a comprehensive school improvement plan. The plan is used, also, as the school's application for all federal…

  5. SNF Project Engineering Process Improvement Plan

    SciTech Connect

    DESAI, S.P.

    2000-02-09

    This plan documents the SNF Project activities and plans to support its engineering process. It describes five SNF Project Engineering initiatives: new engineering procedures, qualification cards process; configuration management, engineering self assessments, and integrated schedule for engineering activities.

  6. Improving Work Life Through Effective Performance Planning

    ERIC Educational Resources Information Center

    Duemer, Walter C.; And Others

    1978-01-01

    The study suggests that the quality of life at work can be enhanced through effective performance planning by employees and that this planning can also reduce the amount of job-related stress employees experience. (Author/IRT)

  7. Crystallization and biochemical characterization of the human spliceosomal Aar2-Prp8(RNaseH) complex.

    PubMed

    Santos, Karine; Preussner, Marco; Heroven, Anna Christina; Weber, Gert

    2015-11-01

    In eukaryotes, the removal of nuclear noncoding sequences (pre-mRNA splicing) is catalyzed by the spliceosome, which consists of five ribonucleoprotein particles (U1, U2, U4, U5 and U6 snRNPs, each with a respective snRNA) and a plethora of protein factors that aid spliceosomal maturation, assembly, activation and disassembly. Recently, the U5 snRNP maturation factor Aar2p from baker's yeast has been characterized structurally and biochemically. Aar2p binds to the RNaseH (RH) and Jab1/MPN domains of the highly conserved U5-specific Prp8p, which forms a framework for the spliceosomal catalytic centre. Thereby, Aar2p sterically excludes Brr2p, a helicase essential for the catalytic activation of the spliceosome, from Prp8p binding. At the same time, Aar2p blocks U4/U6 di-snRNA binding to Prp8p. Aar2p therefore prevents premature spliceosome activation and its functions are regulated by reversible phosphorylation. To date, little is known about the hypothetical human Aar2 (hsAar2) orthologue C20ORF4. This study identifies C20ORF4 (i) as part of the HeLa proteome by Western blotting and (ii) as a true Aar2 orthologue which binds to the RH domain (hsRH) of Prp8 and corroborates an evolutionary link between yeast and human Aar2 function. An elaborate strategy was devised to crystallize hsAar2 in complex with hsRH. The analysis of initial weakly diffracting crystals obtained by in situ proteolysis and homology modelling guided the design of an hsAar2 construct in which an internal loop was replaced by three serines (hsAar2(Δloop)). A complex of hsAar2(Δloop) and hsRH crystallized in space group C2; the crystals diffracted to 2.35 Å resolution and were suitable for structure determination by molecular-replacement approaches. The study presented here suggests a connection between Aar2 and the spliceosome in human cells and paves the way for structural studies of human Aar2. PMID:26527271

  8. FASD -- De Aar mums get beyond the 'tippling point'.

    PubMed

    Bateman, Chris

    2010-11-01

    When most of the low-income folk in the 'ghost train' town of De Aar began remonstrating with any pregnant mother who was boozing, excited campaigners thought they'd broken through the 'tippling point'. However, their research colleagues proved they'd gone even further -- the dedicated local platoon of social workers, nurses, therapists and volunteers had in three short years reduced the prevalence of fetal alcohol spectrum disorder (FASD) by 30%. This is in a town with the worst recorded FASD prevalence in any single community in the world, where 120 out of every 1 000 residents suffer from FASD (12%). PMID:21081033

  9. 45 CFR 1355.35 - Program improvement plans.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... included in the annual reviews and progress reports related to the CFSP required in 45 CFR 1357.16. ... MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES GENERAL § 1355.35 Program improvement... conformity shall develop a program improvement plan. The program improvement plan must: (i) Be...

  10. 34 CFR 200.41 - School improvement plan.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 1 2011-07-01 2011-07-01 false School improvement plan. 200.41 Section 200.41... Basic Programs Operated by Local Educational Agencies Lea and School Improvement § 200.41 School improvement plan. (a)(1) Not later than three months after an LEA has identified a school for...

  11. 34 CFR 200.41 - School improvement plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false School improvement plan. 200.41 Section 200.41... Basic Programs Operated by Local Educational Agencies Lea and School Improvement § 200.41 School improvement plan. (a)(1) Not later than three months after an LEA has identified a school for...

  12. Improved Planning Time and Plan Quality Through Multicriteria Optimization for Intensity-Modulated Radiotherapy

    SciTech Connect

    Craft, David L.; Hong, Theodore S.; Shih, Helen A.; Bortfeld, Thomas R.

    2012-01-01

    Purpose: To test whether multicriteria optimization (MCO) can reduce treatment planning time and improve plan quality in intensity-modulated radiotherapy (IMRT). Methods and Materials: Ten IMRT patients (5 with glioblastoma and 5 with locally advanced pancreatic cancers) were logged during the standard treatment planning procedure currently in use at Massachusetts General Hospital (MGH). Planning durations and other relevant planning information were recorded. In parallel, the patients were planned using an MCO planning system, and similar planning time data were collected. The patients were treated with the standard plan, but each MCO plan was also approved by the physicians. Plans were then blindly reviewed 3 weeks after planning by the treating physician. Results: In all cases, the treatment planning time was vastly shorter for the MCO planning (average MCO treatment planning time was 12 min; average standard planning time was 135 min). The physician involvement time in the planning process increased from an average of 4.8 min for the standard process to 8.6 min for the MCO process. In all cases, the MCO plan was blindly identified as the superior plan. Conclusions: This provides the first concrete evidence that MCO-based planning is superior in terms of both planning efficiency and dose distribution quality compared with the current trial and error-based IMRT planning approach.

  13. Improved Virtual Planning for Bimaxillary Orthognathic Surgery.

    PubMed

    Hatamleh, Muhanad; Turner, Catherine; Bhamrah, Gurprit; Mack, Gavin; Osher, Jonas

    2016-09-01

    Conventional model surgery planning for bimaxillary orthognathic surgery can be laborious, time-consuming and may contain potential errors; hence three-dimensional (3D) virtual orthognathic planning has been proven to be an efficient, reliable, and cost-effective alternative. In this report, the 3D planning is described for a patient presenting with a Class III incisor relationship on a Skeletal III base with pan facial asymmetry complicated by reverse overjet and anterior open bite. A combined scan data of direct cone beam computer tomography and indirect dental scan were used in the planning. Additionally, a new method of establishing optimum intercuspation by scanning dental casts in final occlusion and positioning it to the composite-scans model was shown. Furthermore, conventional model surgery planning was carried out following in-house protocol. Intermediate and final intermaxillary splints were produced following the conventional method and 3D printing. Three-dimensional planning showed great accuracy and treatment outcome and reduced laboratory time in comparison with the conventional method. Establishing the final dental occlusion on casts and integrating it in final 3D planning enabled us to achieve the best possible intercuspation. PMID:27428909

  14. Planning, Conducting, and Documenting Data Analysis for Program Improvement

    ERIC Educational Resources Information Center

    Winer, Abby; Taylor, Cornelia; Derrington, Taletha; Lucas, Anne

    2015-01-01

    This 2015 document was developed to help technical assistance (TA) providers and state staff define and limit the scope of data analysis for program improvement efforts, including the State Systemic Improvement Plan (SSIP); develop a plan for data analysis; document alternative hypotheses and additional analyses as they are generated; and…

  15. Integrating Planning, Assessment, and Improvement in Higher Education

    ERIC Educational Resources Information Center

    Sherlock, Barbara J.

    2009-01-01

    Based on Penn State's popular "Innovation Insights" series, this book brings together in one handy reference nearly a decade of tried and true insights into continuous quality improvements in higher education. Their five-step model for integrating planning, assessment, and improvement moves plans off the shelf and into the weekly and daily…

  16. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a) Based on the results of a...

  17. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements. (a) Based on the results of a...

  18. 40 CFR 64.8 - Quality improvement plan (QIP) requirements.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Quality improvement plan (QIP) requirements. 64.8 Section 64.8 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) COMPLIANCE ASSURANCE MONITORING § 64.8 Quality improvement plan (QIP) requirements....

  19. School Improvement Planning: What's Missing? A Center Policy Report

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2005

    2005-01-01

    Few would argue against the idea of planning and implementing improvements to the nation's schools. This report contends, school improvement planning processes have frequently not been conceived in ways likely to produce desired learning outcomes for many students. The analyses presented in this report focus on a lack of attention to how schools…

  20. Improving Consumer Information for Higher Education Planning

    ERIC Educational Resources Information Center

    Herndon, M. Craig

    2012-01-01

    It is a historically held principle of microeconomics that in the presence of better information, consumers make better decisions. This chapter focuses on information to guide consumers in making decisions about higher education. It examines the development and implementation of a one-stop career and college planning tool that leverages existing…

  1. Improvements in disaster planning and directions for nursing management.

    PubMed

    Danna, Denise; Bernard, Marirose; Jones, John; Mathews, Pamela

    2009-10-01

    Since Hurricane Katrina, there have been numerous lessons learned and improvements in disaster planning and nursing management. The subsequent Hurricane Gustav allowed nurses and disaster planners to "test the system" and identify improvements that worked and did not. The authors outline those improvements and give direction for change and further improvements. PMID:19820524

  2. 75 FR 30387 - Improving Market and Planning Efficiency Through Improved Software; Notice of Agenda and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-01

    ... Federal Energy Regulatory Commission Improving Market and Planning Efficiency Through Improved Software... discuss issues related to power system expansion planning models and software. The technical conference..., Secretary. Agenda for AD10-12 Staff Technical Conference on Planning Models and Software Federal...

  3. Optimizing perioperative decision making: improved information for clinical workflow planning.

    PubMed

    Doebbeling, Bradley N; Burton, Matthew M; Wiebke, Eric A; Miller, Spencer; Baxter, Laurence; Miller, Donald; Alvarez, Jorge; Pekny, Joseph

    2012-01-01

    Perioperative care is complex and involves multiple interconnected subsystems. Delayed starts, prolonged cases and overtime are common. Surgical procedures account for 40-70% of hospital revenues and 30-40% of total costs. Most planning and scheduling in healthcare is done without modern planning tools, which have potential for improving access by assisting in operations planning support. We identified key planning scenarios of interest to perioperative leaders, in order to examine the feasibility of applying combinatorial optimization software solving some of those planning issues in the operative setting. Perioperative leaders desire a broad range of tools for planning and assessing alternate solutions. Our modeled solutions generated feasible solutions that varied as expected, based on resource and policy assumptions and found better utilization of scarce resources. Combinatorial optimization modeling can effectively evaluate alternatives to support key decisions for planning clinical workflow and improving care efficiency and satisfaction. PMID:23304284

  4. Optimizing Perioperative Decision Making: Improved Information for Clinical Workflow Planning

    PubMed Central

    Doebbeling, Bradley N.; Burton, Matthew M.; Wiebke, Eric A.; Miller, Spencer; Baxter, Laurence; Miller, Donald; Alvarez, Jorge; Pekny, Joseph

    2012-01-01

    Perioperative care is complex and involves multiple interconnected subsystems. Delayed starts, prolonged cases and overtime are common. Surgical procedures account for 40–70% of hospital revenues and 30–40% of total costs. Most planning and scheduling in healthcare is done without modern planning tools, which have potential for improving access by assisting in operations planning support. We identified key planning scenarios of interest to perioperative leaders, in order to examine the feasibility of applying combinatorial optimization software solving some of those planning issues in the operative setting. Perioperative leaders desire a broad range of tools for planning and assessing alternate solutions. Our modeled solutions generated feasible solutions that varied as expected, based on resource and policy assumptions and found better utilization of scarce resources. Combinatorial optimization modeling can effectively evaluate alternatives to support key decisions for planning clinical workflow and improving care efficiency and satisfaction. PMID:23304284

  5. Customer satisfaction: key to improved service planning

    SciTech Connect

    McAleer, L.J.; Dukich, T.

    1985-06-13

    This article focuses on the accurate measurement of customer needs and requirements for service-planning purposes. It is based on the assumption that providing maximum service value per dollar paid to the utility is a primary objective of utility managers. Using customer satisfaction and perceived service value as a basis for utility service and market planning offers several key benefits. However, in order to take advantage of these benefits, the process used to measure customer satisfaction must meet a number of criteria. A methodology that meets these requirements is the measurement of perceived value (MPV). This technique was developed by the Melior Group and has been successfully applied to more than 6000 consumers in a variety of service industries, including public utilities. The basics of MPV are described.

  6. Improved Planning Abilities in Binge Eating

    PubMed Central

    Neveu, Rémi; Neveu, Dorine; Barsumian, Franck; Fouragnan, Elsa; Carrier, Edouard; Lai, Massimo; Sultan, Jocelyne; Nicolas, Alain; Coricelli, Giorgio

    2014-01-01

    Objective The role of planning in binge eating episodes is unknown. We investigated the characteristics of planning associated with food cues in binging patients. We studied planning based on backward reasoning, reasoning that determines a sequence of actions back to front from the final outcome. Method A cross-sectional study was conducted with 20 healthy participants, 20 bulimia nervosa (BN), 22 restrictive (ANR) and 23 binging anorexia nervosa (ANB), without any concomitant impulsive disorder. In neutral/relaxing, binge food and stressful conditions, backward reasoning was assessed with the Race game, promotion of delayed large rewards with an intertemporal discounting task, attention with the Simon task, and repeating a dominant behavior with the Go/No-go task. Results BN and to a lower extent ANB patients succeeded more at the Race game in food than in neutral condition. This difference discriminated binging from non-binging participants. Backward reasoning in the food condition was associated with lower approach behavior toward food in BN patients, and higher food avoidance in ANB patients. Enhanced backward reasoning in the food condition related to preferences for delayed large rewards in BN patients. In BN and ANB patients the enhanced success rate at the Race game in the food condition was associated with higher attention paid to binge food. Conclusion These findings introduce a novel process underlying binges: planning based on backward reasoning is associated with binges. It likely aims to reduce craving for binge foods and extend binge refractory period in BN patients, and avoid binging in ANB patients. Shifts between these goals might explain shifts between eating disorder subtypes. PMID:25148580

  7. Adult Attachment Ratings (AAR): an item response theory analysis.

    PubMed

    Pilkonis, Paul A; Kim, Yookyung; Yu, Lan; Morse, Jennifer Q

    2014-01-01

    The Adult Attachment Ratings (AAR) include 3 scales for anxious, ambivalent attachment (excessive dependency, interpersonal ambivalence, and compulsive care-giving), 3 for avoidant attachment (rigid self-control, defensive separation, and emotional detachment), and 1 for secure attachment. The scales include items (ranging from 6-16 in their original form) scored by raters using a 3-point format (0 = absent, 1 = present, and 2 = strongly present) and summed to produce a total score. Item response theory (IRT) analyses were conducted with data from 414 participants recruited from psychiatric outpatient, medical, and community settings to identify the most informative items from each scale. The IRT results allowed us to shorten the scales to 5-item versions that are more precise and easier to rate because of their brevity. In general, the effective range of measurement for the scales was 0 to +2 SDs for each of the attachment constructs; that is, from average to high levels of attachment problems. Evidence for convergent and discriminant validity of the scales was investigated by comparing them with the Experiences of Close Relationships-Revised (ECR-R) scale and the Kobak Attachment Q-sort. The best consensus among self-reports on the ECR-R, informant ratings on the ECR-R, and expert judgments on the Q-sort and the AAR emerged for anxious, ambivalent attachment. Given the good psychometric characteristics of the scale for secure attachment, however, this measure alone might provide a simple alternative to more elaborate procedures for some measurement purposes. Conversion tables are provided for the 7 scales to facilitate transformation from raw scores to IRT-calibrated (theta) scores. PMID:24033268

  8. The Genesis of a Trauma Performance Improvement Plan.

    PubMed

    Pidgeon, Kristopher

    2015-01-01

    The purpose of this article is to assist the trauma medical and program director with developing a performance improvement and patients safety plan (PIPS), which is a required component of a successful trauma verification process by the American College of Surgeons. This article will review trauma quality standards and will describe in detail the required elements of a successful trauma center's performance improvement plan including a written comprehensive plan that outlines the mission and vision of the PIPS Program, authority of the PIPS Program, PIPS Program Committee reporting structure to the other hospital committees, list of required PIPS multidisciplinary team members, the operational components of the utilized data management system (trauma registry), list of indicators/audit filters, levels of review, peer determinations, corrective action plan with implementation, event resolution, and reevaluation. Strategies to develop a successful trauma performance improvement plan are presented. PMID:26574945

  9. Strategic Planning to Improve EHDI Programs

    ERIC Educational Resources Information Center

    White, Karl R.; Blaiser, Kristina M.

    2011-01-01

    Because newborn hearing screening has become the standard of care in the United States, every state has established an early hearing detection and intervention (EHDI) program responsible for establishing, maintaining, and improving the system of services needed to serve children with hearing loss and their families. While significant developments…

  10. Planning School Improvement for Student Career Development.

    ERIC Educational Resources Information Center

    Lotto, Linda S.

    1986-01-01

    Presents recommendations for developing the content of career development activities in secondary schools, including basic academic skills, occupational skills, job-seeking skills, world of work knowledge, and work values. Also presents recommendations to improve the delivery of career development activities in secondary schools and discusses the…

  11. Evaluating School Improvement Plans and Their Affect on Academic Performance

    ERIC Educational Resources Information Center

    Fernandez, Kenneth E.

    2011-01-01

    The development of a school improvement plan (SIP) has become an integral part of many school reform efforts. However, there are almost no studies that empirically examine the effectiveness of SIPs. The few studies examining the planning activities of organizations have generally focused on the private sector and have not provided clear or…

  12. Columbia River Channel Improvement Project Rock Removal Blasting: Monitoring Plan

    SciTech Connect

    Carlson, Thomas J.; Johnson, Gary E.

    2010-01-29

    This document provides a monitoring plan to evaluate take as outlined in the National Marine Fisheries Service 2002 Biological Opinion for underwater blasting to remove rock from the navigation channel for the Columbia River Channel Improvement Project. The plan was prepared by the Pacific Northwest National Laboratory (PNNL) for the U.S. Army Corps of Engineers (USACE), Portland District.

  13. 76 FR 47612 - AAR Manufacturing, Inc.; Completion of Radiological Survey Activities at CSX Transportation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-05

    ... NRC informed AAR that radioactive thorium surface and subsurface contamination had been detected at... contamination on the CSXT property would result in doses well below NRC's criteria for unrestricted...

  14. Improvement plans for DECADE Module 1

    SciTech Connect

    Kortbawi, D.; Goyer, J.; Thompson, J.; Commisso, B.; Weber, B.; Ottinger, P.

    1996-12-31

    DECADE Module 1 (DM1) is a prototype module for the DECADE nuclear weapons effects simulator. It uses a Plasma Opening Switch (POS) with an inductive energy storage for the final stage of pulse compression. Current research is intended to improve operation of the prototype from the present level of 11 to 12 kRad(Si), projected to a 16 module DECADE system, to 20 kRad(Si). The primary limitation is losses in the switch/load system reducing the energy being delivered to the bremsstrahlung diode load. there are also secondary concerns with the reproducibility of the system which are important given the modular nature of DECADE. Preliminary results indicate significant time delays between the rise of POS impedance to the onset of production of X-rays from the load. the rise of voltage and current measured directly at the load is coincident with the rise of the X-ray pulse. there are also losses and delayed propagation of current through the MITL between the switch and the load. The data also indicate asymmetries in the current being delivered downstream of the POS. The modifications being considered to improve operation will depend on the results of the experiments with the expanded diagnostic set. Some of the options being considered include: tailoring of the geometric impedances between the switch and the load, optimizing of the load impedance, transparent electrodes to allow removal of plasma in the region downstream of the POS, providing bias currents to improve vacuum transport of the launched flow, improved uniformity of the injected switch plasma, and better conditioning/cleaning of the vacuum system.

  15. Improved genetic algorithm for fast path planning of USV

    NASA Astrophysics Data System (ADS)

    Cao, Lu

    2015-12-01

    Due to the complex constraints, more uncertain factors and critical real-time demand of path planning for USV(Unmanned Surface Vehicle), an approach of fast path planning based on voronoi diagram and improved Genetic Algorithm is proposed, which makes use of the principle of hierarchical path planning. First the voronoi diagram is utilized to generate the initial paths and then the optimal path is searched by using the improved Genetic Algorithm, which use multiprocessors parallel computing techniques to improve the traditional genetic algorithm. Simulation results verify that the optimal time is greatly reduced and path planning based on voronoi diagram and the improved Genetic Algorithm is more favorable in the real-time operation.

  16. 124. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: RAMP DETAILS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    124. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: RAMP DETAILS Sheet 6 of 11 (#3278) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  17. 120. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LAYOUT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    120. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LAYOUT OF EXISTING PIER Sheet 2 of 11 (#3274) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  18. 126. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: EXTENSION DETAILS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    126. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: EXTENSION DETAILS Sheet 7 of 11 (#3280) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  19. 127. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: FRAMING DETAILS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    127. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: FRAMING DETAILS Sheet 8 of 11 (#3281) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  20. 121. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LAYOUT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    121. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LAYOUT OF EXISTING PIER Sheet 3 of 11 (#3275) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  1. 122. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LAYOUT OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    122. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LAYOUT OF EXTENSION TO PIER Sheet 4 of 11 (#3276) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  2. 125. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: MODIFIED RAMP ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    125. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: MODIFIED RAMP DETAILS Sheet 6A of 11 (#3279) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  3. 128. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: BOAT LANDING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    128. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: BOAT LANDING DETAILS Sheet 9 of 11 (#3282) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  4. 123. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: REPAIR DETAILS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    123. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: REPAIR DETAILS Sheet 5 of 11 (#3277) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  5. A Trainer's Guide to Successful Productivity Improvement Planning.

    ERIC Educational Resources Information Center

    Smith, Judson

    1982-01-01

    Discusses the concept of productivity improvement which must be studied before selecting an approach. Concepts include increasing efficiency without decreasing quality; using employees to redefine the job; and planning for long-term effort. (JOW)

  6. Improving patient-centered care through advance care planning.

    PubMed

    Motley, Molly

    2013-06-01

    Advance care planning is crucial for patients confronting incurable, debilitating, or terminal disease. Discussing end-of-life issues can reduce overtreatment and undertreatment as defined by the patient, and improve satisfaction with care. PMID:23805592

  7. 130. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LIGHTING DETAILS. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    130. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LIGHTING DETAILS. Sheet 11 of 11 (#3284) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  8. 129. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LIGHTING DIAGRAM. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    129. PLAN OF IMPROVEMENT, HUNTINGTON BEACH MUNICIPAL PIER: LIGHTING DIAGRAM. Sheet lO of 11 (#3283) - Huntington Beach Municipal Pier, Pacific Coast Highway at Main Street, Huntington Beach, Orange County, CA

  9. Improved treatment planning for COMS eye plaques

    SciTech Connect

    Astrahan, Melvin A. . E-mail: astrahan@usc.edu

    2005-03-15

    Purpose: A recent reanalysis of the Collaborative Ocular Melanoma Study (COMS) medium tumor trial concluded that incorporating factors to account for anisotropy, line source approximation, the gold plaque, and attenuation in the Silastic seed carrier into the dose calculations resulted in a significant and consistent reduction of calculated doses to structures of interest within the eye. The authors concluded that future eye plaque dosimetry should be 'performed using the most up-to-date parameters available.' The reason these factors are important is attributable to the low energy {sup 125}I radiation (approximately 28 keV) that is primarily absorbed by the photoelectric process. Photoelectric absorption is quite dependent on the atomic composition of the absorbing material. Being 40% silicon by weight, the effective atomic number of Silastic is significantly greater than that of water. Although the AAPM TG43 brachytherapy formalism inherently addresses the issues of source anisotropy and geometry, its parameter that accounts for scatter and attenuation, the radial dose function g(r), assumes that the source is immersed in infinite homogeneous water. In this work, factors are proposed for {sup 125}I that correct for attenuation in the Silastic carrier and scatter deficits resulting from the gold plaque and nearby air. The implications of using {sup 103}Pd seeds in COMS plaques are also discussed. Methods and materials: An existing TG43-based ophthalmic plaque planning system was modified to incorporate additional scatter and attenuation correction factors that better account for the path length of primary radiation in the Silastic seed carrier and the distance between the dose calculation point and the eye-air interface. Results: Compared with homogeneous water, the dose-modifying effects of the Silastic and gold are greatest near the plaque surface and immediately adjacent to the plaque, while being least near the center of the eye. The calculated dose

  10. School Improvement Plans and Student Learning in Jamaica

    ERIC Educational Resources Information Center

    Lockheed, Marlaine; Harris, Abigail; Jayasundera, Tamara

    2010-01-01

    A school improvement program that provided support to poor-performing schools on the basis of needs identified in a school improvement plan was implemented in 72 government schools in Jamaica, from 1998 to 2005. In this independent evaluation of the program, we use propensity score matching to create, post hoc, a control group of schools that were…

  11. Using Online Student Polling for Continuous Improvement Planning

    ERIC Educational Resources Information Center

    Wingate, Julius Jason

    2010-01-01

    This study examines the use of Internet polling at schools to gain student input for the improvement of learning conditions to assist in the continuous improvement planning. The study consists of 2006 respondents and three different schools containing the middle school child. The grades included in the study were 5, 6, 7, and 8. Although two…

  12. Improving Agreement About Intervention Plans in Probation by Decision Support.

    PubMed

    Bosker, Jacqueline; Witteman, Cilia; Hermanns, Jo; Heij, Donnalee

    2015-12-01

    Reliability in decision making about intervention plans is a necessary condition for evidence-based probation work and equal treatment of offenders. Structuring decision making can improve agreement between clinical decision makers. In a former study however, we found that in Dutch probation practice structured risk and needs assessment did not result in acceptable agreement about intervention plans. The Dutch probation services subsequently introduced a tool for support in decision making on intervention plans. This article addresses the question whether the use of this tool results in better agreement between probation officers. A significant and meaningful improvement in agreement was found on all domains of the intervention plan. Implications for probation practice are discussed. PMID:24927740

  13. The Best Laid Plans: An Examination of School Plan Quality and Implementation in a School Improvement Initiative

    ERIC Educational Resources Information Center

    Strunk, Katharine O.; Marsh, Julie A.; Bush-Mecenas, Susan C.; Duque, Matthew R.

    2016-01-01

    Purpose: A common strategy used in school improvement efforts is a mandated process of formal planning, yet little is known about the quality of plans or the relationship between plan quality and implementation. This mixed-methods article investigates plan quality, factors associated with plan quality, and the relationship between plan quality and…

  14. Improving IMRT-plan quality with MLC leaf position refinement post plan optimization

    PubMed Central

    Niu, Ying; Zhang, Guowei; Berman, Barry L.; Parke, William C.; Yi, Byongyong; Yu, Cedric X.

    2012-01-01

    Purpose: In intensity-modulated radiation therapy (IMRT) planning, reducing the pencil-beam size may lead to a significant improvement in dose conformity, but also increase the time needed for the dose calculation and plan optimization. The authors develop and evaluate a postoptimization refinement (POpR) method, which makes fine adjustments to the multileaf collimator (MLC) leaf positions after plan optimization, enhancing the spatial precision and improving the plan quality without a significant impact on the computational burden. Methods: The authors’ POpR method is implemented using a commercial treatment planning system based on direct aperture optimization. After an IMRT plan is optimized using pencil beams with regular pencil-beam step size, a greedy search is conducted by looping through all of the involved MLC leaves to see if moving the MLC leaf in or out by half of a pencil-beam step size will improve the objective function value. The half-sized pencil beams, which are used for updating dose distribution in the greedy search, are derived from the existing full-sized pencil beams without need for further pencil-beam dose calculations. A benchmark phantom case and a head-and-neck (HN) case are studied for testing the authors’ POpR method. Results: Using a benchmark phantom and a HN case, the authors have verified that their POpR method can be an efficient technique in the IMRT planning process. Effectiveness of POpR is confirmed by noting significant improvements in objective function values. Dosimetric benefits of POpR are comparable to those of using a finer pencil-beam size from the optimization start, but with far less computation and time. Conclusions: The POpR is a feasible and practical method to significantly improve IMRT-plan quality without compromising the planning efficiency. PMID:22894437

  15. The small RNA Aar in Acinetobacter baylyi: a putative regulator of amino acid metabolism.

    PubMed

    Schilling, Dominik; Findeiss, Sven; Richter, Andreas S; Taylor, Jennifer A; Gerischer, Ulrike

    2010-09-01

    Small non-coding RNAs (sRNAs) are key players in prokaryotic metabolic circuits, allowing the cell to adapt to changing environmental conditions. Regulatory interference by sRNAs in cellular metabolism is often facilitated by the Sm-like protein Hfq. A search for novel sRNAs in A. baylyi intergenic regions was performed by a biocomputational screening. One candidate, Aar, encoded between trpS and sucD showed Hfq dependency in Northern blot analysis. Aar was expressed strongly during stationary growth phase in minimal medium; in contrast, in complex medium, strongest expression was in the exponential growth phase. Whereas over-expression of Aar in trans did not affect bacterial growth, seven mRNA targets predicted by two in silico approaches were upregulated in stationary growth phase. All seven mRNAs are involved in A. baylyi amino acid metabolism. A putative binding site for Lrp, the global regulator of branched-chain amino acids in E. coli, was observed within the aar gene. Both facts imply an Aar participation in amino acid metabolism. PMID:20559624

  16. Improved Surgery Planning Using 3-D Printing: a Case Study.

    PubMed

    Singhal, A J; Shetty, V; Bhagavan, K R; Ragothaman, Ananthan; Shetty, V; Koneru, Ganesh; Agarwala, M

    2016-04-01

    The role of 3-D printing is presented for improved patient-specific surgery planning. Key benefits are time saved and surgery outcome. Two hard-tissue surgery models were 3-D printed, for orthopedic, pelvic surgery, and craniofacial surgery. We discuss software data conversion in computed tomography (CT)/magnetic resonance (MR) medical image for 3-D printing. 3-D printed models save time in surgery planning and help visualize complex pre-operative anatomy. Time saved in surgery planning can be as much as two thirds. In addition to improved surgery accuracy, 3-D printing presents opportunity in materials research. Other hard-tissue and soft-tissue cases in maxillofacial, abdominal, thoracic, cardiac, orthodontics, and neurosurgery are considered. We recommend using 3-D printing as standard protocol for surgery planning and for teaching surgery practices. A quick turnaround time of a 3-D printed surgery model, in improved accuracy in surgery planning, is helpful for the surgery team. It is recommended that these costs be within 20 % of the total surgery budget. PMID:27303117

  17. 45 CFR 1355.35 - Program improvement plans.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Program improvement plans. 1355.35 Section 1355.35 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION...

  18. Developing a Chapter 1 Program Improvement Plan: A Guide.

    ERIC Educational Resources Information Center

    Thompson, Linda W.

    A new Chapter 1 law, P.L. 100-297, was passed in 1988. Chapter 1 schools must examine the program operated during the previous school year. Schools that fail to demonstrate overall achievement gains must develop a Program Improvement Plan (PIP), a document describing how the Chapter 1 program in that school will be modified. This guide provides a…

  19. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assurance and improvement plan. 441.474 Section 441.474 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Optional Self-Directed...

  20. 42 CFR 441.474 - Quality assurance and improvement plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assurance and improvement plan. 441.474 Section 441.474 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO SPECIFIC SERVICES Optional Self-Directed...

  1. 76 FR 22295 - National Poultry Improvement Plan and Auxiliary Provisions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection 9 CFR Part 145 RIN 0579-AD21 National Poultry Improvement Plan and Auxiliary Provisions Correction In rule document 2011-6539 appearing on pages 15791-15798 in the issue...

  2. Long-term management of AAR-affected structures - An international perspective

    SciTech Connect

    Charlwood, R.G.; Solymar, Z.V.

    1995-12-31

    The objective of the paper is to review international practice and comment on progress made in the long-term management of existing AAR-affected dams and hydroelectric plants. A updated detailed worldwide listing which now includes 104 AAR-affected structures constructed since 1900 will be presented. The listing gives summary data on the year of construction, the year that significant problems were noted, aggregate and cement types, measured expansion rates, test data, time to initial deterioration, duration of reaction, damage to the structures and effects on equipment, and repairs or replacement. A comprehensive bibliography will also be given. Analysis of the database and significant case histories will be used to identify issues affecting dam safety, plant operations, remedial measures and long-term performance of AAR-affected structures. The presentation will be illustrated by several case histories where remedial measures have been implemented.

  3. SU-D-BRD-03: Improving Plan Quality with Automation of Treatment Plan Checks

    SciTech Connect

    Covington, E; Younge, K; Chen, X; Lee, C; Matuszak, M; Kessler, M; Acosta, E; Orow, A; Filpansick, S; Moran, J; Keranen, W

    2015-06-15

    Purpose: To evaluate the effectiveness of an automated plan check tool to improve first-time plan quality as well as standardize and document performance of physics plan checks. Methods: The Plan Checker Tool (PCT) uses the Eclipse Scripting API to check and compare data from the treatment planning system (TPS) and treatment management system (TMS). PCT was created to improve first-time plan quality, reduce patient delays, increase efficiency of our electronic workflow, and to standardize and partially automate plan checks in the TPS. A framework was developed which can be configured with different reference values and types of checks. One example is the prescribed dose check where PCT flags the user when the planned dose and the prescribed dose disagree. PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user. A PDF report is created and automatically uploaded into the TMS. Prior to and during PCT development, errors caught during plan checks and also patient delays were tracked in order to prioritize which checks should be automated. The most common and significant errors were determined. Results: Nineteen of 33 checklist items were automated with data extracted with the PCT. These include checks for prescription, reference point and machine scheduling errors which are three of the top six causes of patient delays related to physics and dosimetry. Since the clinical roll-out, no delays have been due to errors that are automatically flagged by the PCT. Development continues to automate the remaining checks. Conclusion: With PCT, 57% of the physics plan checklist has been partially or fully automated. Treatment delays have declined since release of the PCT for clinical use. By tracking delays and errors, we have been able to measure the effectiveness of automating checks and are using this information to prioritize future development. This project was supported in part by P01CA059827.

  4. Project Hanford management contract quality improvement project management plan

    SciTech Connect

    ADAMS, D.E.

    1999-03-25

    On July 13, 1998, the U.S. Department of Energy, Richland Operations Office (DOE-RL) Manager transmitted a letter to Fluor Daniel Hanford, Inc. (FDH) describing several DOE-RL identified failed opportunities for FDH to improve the Quality Assurance (QA) Program and its implementation. In addition, DOE-RL identified specific Quality Program performance deficiencies. FDH was requested to establish a periodic reporting mechanism for the corrective action program. In a July 17, 1998 response to DOE-RL, FDH agreed with the DOE concerns and committed to perform a comprehensive review of the Project Hanford Management Contract (PHMC) QA Program during July and August, 1998. As a result, the Project Hanford Management Contract Quality Improvement Plan (QIP) (FDH-3508) was issued on October 21, 1998. The plan identified corrective actions based upon the results of an in-depth Quality Program Assessment. Immediately following the scheduled October 22, 1998, DOE Office of Enforcement and Investigation (EH-10) Enforcement Conference, FDH initiated efforts to effectively implement the QIP corrective actions. A Quality Improvement Project (QI Project) leadership team was assembled to prepare a Project Management Plan for this project. The management plan was specifically designed to engage a core team and the support of representatives from FDH and the major subcontractors (MSCs) to implement the QIP initiatives; identify, correct, and provide feedback as to the root cause for deficiency; and close out the corrective actions. The QI Project will manage and communicate progress of the process.

  5. 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

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Improving 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...

  6. 75 FR 30010 - Improving Market and Planning Efficiency Through Improved Software; Notice of Agenda and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-28

    ... Energy Regulatory Commission Improving Market and Planning Efficiency Through Improved Software; Notice... discuss issues related to unit commitment software. The technical conference will be held from 8 a.m. to 5..., Secretary. Agenda for AD10-12 Staff Technical Conference on Unit Commitment Software Federal...

  7. GAMMA DETECTOR RESPONSE/SOIL CONCENTRATION CORRELATION STUDY AT THE AAR MANUFACTURING, INC. SITE, LIVONIA, MICHIGAN

    SciTech Connect

    ALTIC, NICK A

    2013-03-22

    At the NRC's request, ORAU conducted surveys of the AAR Manufacturing site during the period of September 25 through September 27, 2012. The survey activities included walkover surveys and sampling activities. Once the survey team was onsite, the NRC personnel decided to forgo survey activities in the New Addition and the pickling area. Areas of the planned study boundary were inaccessible due to overgrowth/large pieces of concrete covering the soil surface; therefore, the study boundary was redefined. Gamma walkover scans of the site boundary and front yard identified multiple areas of elevated gamma radiation. As a result, two judgmental samples were collected. Sample results were above thorium background levels The answer to the PSQ relating to the relationship between thorium concentration in soil and NaI instrument response is Yes. NaI instrument response can be used as a predictor of Th-232 concentration in the 0 to 1 m layer. An R2 value of 0.79 was determined for the surface soil relationship, thus satisfying the DQOs. Moreover, the regression was cross-checked by comparing the predicted Th-232 soil core concentration to the average Th-232 concentration (Section 5.3.2). Based on the cross-check, the regression equation provides a reasonable estimate for the Th-232 concentration at the judgmental locations. Consideration must be given when applying this equation to other soil areas of the site. If the contamination was heterogeneously distributed, and not distributed in a discrete layer as it was in the study area, then using the regression equation to predict Th-232 concentration would not be applicable.

  8. Uphold "three stresses" to improve family planning implementation.

    PubMed

    1994-02-01

    Shandong Peninsula, China, includes 24 towns, 4 townships, and 1006 villages with a total 1992 population of 754,000. Due to the family planning program (instituted in the mid 1950s), and its emphasis on the "three stresses" since 1983, the rate of natural increase was maintained for the past decade at 6.59/1000. Marriage and childbirth has been deferred and the annual rate of planned births is 99%. Neonatal mortality is below 10/1000 and life expectancy is 76 years. There have been 260,000 births averted. In 1966, national commendation was given for the achievements in family planning. The city now ranks 12th among the top 100 counties that are the most economically developed. Success was linked with an effective IEC programs. Changing public opinion was accomplished by placing family planning slogans and cards in windows of public places and commercial centers. Contests were held, and performances publicized family planning. There are 1162 population schools in the county which have trained 10,000 family planning publicity workers and about 400,000 others since 1987. Radio and television stations have broadcast regular programs on family planning and population twice a week since 1987. Everyone has radio sets and 90% have televisions. IEC promotion has also been concerned with social security and alleviating poverty. Contraceptive prevalence among reproductive age women is now 91%. After 25 years of family planning operation, the "three stresses" were introduced and popularized in 1983. The goal was no early marriages, no early births, no induced abortions, and no unwanted births. The program strengthened family planning agencies, promoted women's services, oversaw birth quotas, and distributed contraceptives at the grassroots level. By 1991, the city began promoting control of population growth and improvement in human resources. The "four priorities" were formulated by the city for acceptors; housing sites, business licenses, recruitment of only-child parents

  9. IGFBP-1 hyperphosphorylation in response to leucine deprivation is mediated by the AAR pathway.

    PubMed

    Malkani, Niyati; Jansson, Thomas; Gupta, Madhulika B

    2015-09-01

    Insulin-like growth factor-1 (IGF-I) is the key regulator of fetal growth. IGF-I bioavailability is markedly diminished by IGF binding protein-1 (IGFBP-1) phosphorylation. Leucine deprivation strongly induces IGFBP-1 hyperphosphorylation, and plays an important role in fetal growth restriction (FGR). FGR is characterized by decreased amino acid availability, which activates the amino acid response (AAR) and inhibits the mechanistic target of rapamycin (mTOR) pathway. We investigated the role of AAR and mTOR in mediating IGFBP-1 secretion and phosphorylation in HepG2 cells in leucine deprivation. mTOR inhibition (rapamycin or raptor + rictor siRNA), or activation (DEPTOR siRNA) demonstrated a role of mTOR in leucine deprivation-induced IGFBP-1 secretion but not phosphorylation. When the AAR was blocked (U0126, or ERK/GCN2 siRNA), both IGFBP-1 secretion and hyperphosphorylation (pSer101/pSer119/pSer169) due to leucine deprivation were prevented. CK2 inhibition by TBB also attenuated IGFBP-1 phosphorylation in leucine deprivation. These results suggest that the AAR and mTOR independently regulate IGFBP-1 secretion and phosphorylation in response to decreased amino acid availability. PMID:25957086

  10. Results of the Capital Improvement Planning Process at Nova Southeastern University: 2000 to 2005. Research and Planning Report.

    ERIC Educational Resources Information Center

    MacFarland, Thomas W.

    This paper presents results of the first Capital Improvement Planning process at Nova Southeastern University (Florida) encompassing the years 2000 to 2005. The University established a committee to guide the development of the Capital Improvement Plan, and personnel from the University's Office of Research and Planning worked with the various…

  11. National plan to enhance aviation safety through human factors improvements

    NASA Technical Reports Server (NTRS)

    Foushee, Clay

    1990-01-01

    The purpose of this section of the plan is to establish a development and implementation strategy plan for improving safety and efficiency in the Air Traffic Control (ATC) system. These improvements will be achieved through the proper applications of human factors considerations to the present and future systems. The program will have four basic goals: (1) prepare for the future system through proper hiring and training; (2) develop a controller work station team concept (managing human errors); (3) understand and address the human factors implications of negative system results; and (4) define the proper division of responsibilities and interactions between the human and the machine in ATC systems. This plan addresses six program elements which together address the overall purpose. The six program elements are: (1) determine principles of human-centered automation that will enhance aviation safety and the efficiency of the air traffic controller; (2) provide new and/or enhanced methods and techniques to measure, assess, and improve human performance in the ATC environment; (3) determine system needs and methods for information transfer between and within controller teams and between controller teams and the cockpit; (4) determine how new controller work station technology can optimally be applied and integrated to enhance safety and efficiency; (5) assess training needs and develop improved techniques and strategies for selection, training, and evaluation of controllers; and (6) develop standards, methods, and procedures for the certification and validation of human engineering in the design, testing, and implementation of any hardware or software system element which affects information flow to or from the human.

  12. Plans for performance and model improvements in the LISE++ software

    NASA Astrophysics Data System (ADS)

    Kuchera, M. P.; Tarasov, O. B.; Bazin, D.; Sherrill, B. M.; Tarasova, K. V.

    2016-06-01

    The LISE++ software for fragment separator simulations is undergoing a major update. LISE++ is the standard software used at in-flight separator facilities for predicting beam intensity and purity. The code simulates nuclear physics experiments where fragments are produced and then selected with a fragment separator. A set of modifications to improve the functionality of the code is discussed in this work. These modifications include transportation to a modern graphics framework and updated compilers to aid in the performance and sustainability of the code. To accommodate the diversity of our users' computer platform preferences, we extend the software from Windows to a cross-platform application. The calculations of beam transport and isotope production are becoming more computationally intense with the new large scale facilities. Planned new features include new types of optimization, for example, optimization of ion optics, improvements in reaction models, and new event generator options. In addition, LISE++ interface with control systems are planned. Computational improvements as well as the schedule for updating this large package will be discussed.

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

    SciTech Connect

    Golder Associates, Inc.

    2003-04-22

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

  14. Performance Improvement Plan (PIP): A Conceptual Model for Instructional Improvement at Chemeketa Community College.

    ERIC Educational Resources Information Center

    Lopez, Faith

    This report summarizes the three-part Performance Improvement Plan (PIP) conducted by the Instructional Division of Chemeketa Community College from August, 1977 to June, 1979. Results of the first stage, a needs assessment completed in 1978, are summarized in terms of limitations and additional information needed, alternative strategies, and…

  15. Planned Improvements for the WB-57F Aircraft

    NASA Astrophysics Data System (ADS)

    Baccus, S.; Roberts, A.; Ross, M.

    2003-12-01

    NASA WB-57F aircraft have supported the atmospheric science community for over 30 years. Recent attention has focused on the chemistry and dynamics of the UTLS region of the atmosphere and several NASA sponsored field campaigns (ACCENT, CRYSTAL-FACE) have made critical use of the WB-57F's unique ability to carry large (3 ton) payloads during extended cruise at all altitudes from the lower troposphere to the lower stratosphere (20 km ceiling). In addition, the WB-57F's robust structure permits a large number and variety of instruments to be carried at inlet-favorable locations on the aircraft. In order to further improve the WB-57F's performance and unique utility to the atmospheric research and spacecraft validation communities, NASA is planning several upgrades to the WB-57F including state-of-the-art avionics and autopilot, landing gear replacement, maximum gross weight increase, engine replacement, and ultrapod installation. We will review the present WB-57F performance, plans for upcoming science campaigns, and plans for increased WB-57F payload, range, endurance, and ceiling resulting from the upgrades.

  16. Improving productivity and firm performance with enterprise resource planning

    NASA Astrophysics Data System (ADS)

    Beheshti, Hooshang M.; Beheshti, Cyrus M.

    2010-11-01

    Productivity is generally considered to be the efficient utilisation of organisational resources and is measured in terms of the efficiency of a worker, company or nation. Focusing on efficiency alone, however, can be harmful to the organisation's long-term success and competitiveness. The full benefits of productivity improvement measures are realised when productivity is examined from two perspectives: operational efficiency (output/input) of an individual worker or a business unit as well as performance (effectiveness) with regard to end user or customer satisfaction. Over the years, corporations have adopted new technology to integrate business activities in order to achieve both effectiveness and efficiency in their operations. In recent years, many firms have invested in enterprise resource planning (ERP) in order to integrate all business activities into a uniform system. The implementation of ERP enables the firm to reduce the transaction costs of the business and improve its productivity, customer satisfaction and profitability.

  17. 75 FR 27341 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... Software May 7, 2010. Take notice that Commission staff will convene technical conferences on the following dates to discuss increasing market and planning efficiency through improved software. ] The development... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software;...

  18. 75 FR 23222 - National Poultry Improvement Plan; General Conference Committee Meeting and 40th Biennial Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-03

    ... Animal and Plant Health Inspection Service National Poultry Improvement Plan; General Conference... of the National Poultry Improvement Plan (NPIP) and the NPIP's 40th Biennial Conference. DATES: The.... Andrew R. Rhorer, Senior Coordinator, National Poultry Improvement Plan, VS, APHIS, 1498 Klondike...

  19. 77 FR 46374 - National Poultry Improvement Plan; General Conference Committee Meeting and 41st Biennial Conference

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-03

    ... Animal and Plant Health Inspection Service National Poultry Improvement Plan; General Conference... of the National Poultry Improvement Plan (NPIP) and the NPIP's 41st Biennial Conference. DATES: The..., National Poultry Improvement Plan, VS, APHIS, 1506 Klondike Road, Suite 300, Conyers, GA 30094-5173,...

  20. 77 FR 59888 - General Conference Committee of the National Poultry Improvement Plan

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... National Poultry Improvement Plan AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Notice... to renew the charter of the General Conference Committee of the National Poultry Improvement Plan..., National Poultry Improvement Plan, VS, APHIS, USDA, 1506 Klondike Road, Suite 300, Conyers, GA 30094;...

  1. 78 FR 12221 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010, in the Federal Register (77 FR 4688... Certification Continuous Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010 AGENCY: Food... performance benchmarks and to develop and implement continuous improvement plans if they fail to do so....

  2. Voxel model in BNCT treatment planning: performance analysis and improvements

    NASA Astrophysics Data System (ADS)

    González, Sara J.; Carando, Daniel G.; Santa Cruz, Gustavo A.; Zamenhof, Robert G.

    2005-02-01

    In recent years, many efforts have been made to study the performance of treatment planning systems in deriving an accurate dosimetry of the complex radiation fields involved in boron neutron capture therapy (BNCT). The computational model of the patient's anatomy is one of the main factors involved in this subject. This work presents a detailed analysis of the performance of the 1 cm based voxel reconstruction approach. First, a new and improved material assignment algorithm implemented in NCTPlan treatment planning system for BNCT is described. Based on previous works, the performances of the 1 cm based voxel methods used in the MacNCTPlan and NCTPlan treatment planning systems are compared by standard simulation tests. In addition, the NCTPlan voxel model is benchmarked against in-phantom physical dosimetry of the RA-6 reactor of Argentina. This investigation shows the 1 cm resolution to be accurate enough for all reported tests, even in the extreme cases such as a parallelepiped phantom irradiated through one of its sharp edges. This accuracy can be degraded at very shallow depths in which, to improve the estimates, the anatomy images need to be positioned in a suitable way. Rules for this positioning are presented. The skin is considered one of the organs at risk in all BNCT treatments and, in the particular case of cutaneous melanoma of extremities, limits the delivered dose to the patient. Therefore, the performance of the voxel technique is deeply analysed in these shallow regions. A theoretical analysis is carried out to assess the distortion caused by homogenization and material percentage rounding processes. Then, a new strategy for the treatment of surface voxels is proposed and tested using two different irradiation problems. For a parallelepiped phantom perpendicularly irradiated with a 5 keV neutron source, the large thermal neutron fluence deviation present at shallow depths (from 54% at 0 mm depth to 5% at 4 mm depth) is reduced to 2% on average

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

    NASA Astrophysics Data System (ADS)

    Sprau Coulter, Tabitha L.

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

  4. NOAA Plans for Improving Public Access to Science Research (Invited)

    NASA Astrophysics Data System (ADS)

    de la Beaujardiere, J.

    2013-12-01

    The White House Office of Science and Technology Policy (OSTP) issued a memorandum on 2013 February 22 calling for federal agencies to enhance public access to research results (PARR), and required agencies to submit, within 6 months of the memo, draft plans explaining how they would implement the requirements. For the National Oceanic and Atmospheric Administration (NOAA), research results include digital data about the Earth's environment and publications based on those data. Regarding environmental data, NOAA is already very active in ensuring and improving public access. Indeed, National Weather Service (NWS) data was highlighted as one of the good examples in the OSTP memo. More generally, the NOAA National Data Centers, the Environmental Data Management Committee (EDMC), and scientific and technical personnel across the agency are striving to ensure NOAA data are discoverable and accessible on-line, well-documented and formatted for usability, and preserved for future generations as a national asset. This presentation will describe current and potential activities in support of public access to NOAA and NOAA-funded environmental data. Regarding publications, there is greater uncertainty. The fundamental issue is how to ensure no-cost access (after an embargo period) to publications that typically require subscriptions. That issue must be addressed at the interagency level with the journal publishers. The plan indicates that NOAA will adopt shared mechanisms and agreements to the extent possible rather than building new systems. Some elements remain under discussion; this presentation will be limited to those aspects on which there is general agreement.

  5. Improving Remedial Planning Performance: The Rattlesnake Creek Experience

    SciTech Connect

    Rieman, C.R.; Spector, H.L.; Andrews, S.M.; Durham, L. A.; Johnson, R. L.; Racino, R. R.

    2006-07-01

    The U.S. Army Corps of Engineers (USACE), Buffalo District, has responsibility for characterizing and remediating radiologically contaminated properties under the Formerly Utilized Sites Remedial Action Program (FUSRAP). Most of these FUSRAP sites include radionuclide contamination in soils where excavation and offsite disposal is the selected remedial action. For many FUSRAP soil remediation projects completed to date, the excavated contaminated soil volumes have significantly exceeded the pre-excavation volume estimates that were developed for project planning purposes. The exceedances are often attributed to limited and sparse datasets that are used to calculate the initial volume estimates. These volume exceedances complicate project budgeting and planning. Building on these experiences, the USACE took a different approach in the remediation of Rattlesnake Creek, located adjacent to the Ashland 2 site, in Tonawanda, New York. This approach included a more extensive pre-design data collection effort to improve and reduce the uncertainty in the pre-excavation volume estimates, in addition to formalizing final status survey data collection strategies prior to excavation. The final status survey sampling was fully integrated with the pre-design data collection, allowing dual use of the pre-design data that was collected (i.e., using the data to close out areas where contamination was not found, and feeding the data into volume estimates when contamination was encountered). The use of real-time measurement techniques (e.g., X-ray fluorescence [XRF] and gamma walkover surveys) during pre-excavation data collection allowed the USACE to identify and respond to unexpected contamination by allocating additional data collection to characterizing new areas of concern. The final result was an estimated soil volume and excavation footprint with a firm technical foundation and a reduction in uncertainty. However, even with extensive pre-design data collection, additional

  6. Dosimetric Evaluation of a Simple Planning Technique for Improving Intensity-Modulated Radiotherapy for Nasopharyngeal Cancer

    PubMed Central

    Xie, Wen-Jia; Xie, Liang-Xi

    2015-01-01

    Purpose To evaluate the dosimetric outcomes of a simple planning technique for improving intensity-modulated radiotherapy (IMRT) for nasopharyngeal cancer (NPC). Methods For 39 NPC cases, generally acceptable original plans were generated and were improved by the two planning techniques, respectively: (1) a basal-dose-compensation (BDC) technique, in which the treatment plans were re-optimized based on the original plans; (2) a local-dose-control (LDC) technique, in which the original plans were re-optimized with constraints for hot and cold spots. The BDC, original, and LDC plans were then compared regarding homogeneity index (HI) and conformity index (CI) of planning target volumes (PTVs), organ-at-risk (OAR) sparing and monitor units (MUs) per fraction. The whole planning times were also compared between the BDC and LDC plans. Results The BDC plans had superior HIs / CIs, by 13-24% / 3-243%, respectively, over the original plans. Compared to the LDC plans, the BDC plans provided better HIs only for PTVnx (the PTV of nasopharyngeal primary tumor) by 11% and better CIs for all PTVs by 2-134%. The BDC technique spared most OARs, by 1-9%. The average MUs of the BDC, original, and LDC plans were 2149, 2068 and 2179, respectively. The average whole planning times were 48 and 69 minutes for the BDC and LDC plans, respectively. Conclusions For the IMRT of nasopharyngeal cancer, the BDC planning technique can improve target dose homogeneity, conformity and OAR sparing, with better planning efficiency. PMID:26132167

  7. aarC, an essential gene involved in density-dependent regulation of the 2'-N-acetyltransferase in Providencia stuartii.

    PubMed Central

    Rather, P N; Solinsky, K A; Paradise, M R; Parojcic, M M

    1997-01-01

    The 2'-N-acetyltransferase [AAC(2')-Ia] in Providencia stuartii has a dual function where it is involved in the acetylation of peptidoglycan and certain aminoglycosides. A search for negative regulators of the aac(2')-Ia gene has resulted in the identification of aarC. A missense allele (aarC1) resulted in an 8.9-fold increase in beta-galactosidase accumulation from an aac(2')-lacZ transcriptional fusion. Northern blot analysis demonstrated an increase in aac(2')-Ia mRNA accumulation that was specific to cells at high density. In addition, the aarC1 allele also resulted in a substantial increase in the expression of aarP, a transcriptional activator of the aac(2')-Ia gene. The wild-type aarC gene was isolated by complementation and encodes a predicted protein of 365 amino acids with a molecular mass of 39,815 Da. The predicted AarC protein exhibited 88% amino acid homology to the previously identified GcpE protein of Escherichia coli and 86% homology to a gene product from Haemophilus influenzae. The E. coli gcpE gene was able to functionally complement the aarC1 allele in P. stuartii. The aarC1 allele was identified as a T to G transversion that resulted in a valine to glycine substitution at position 136 in the AarC protein. The aarC gene appears to be essential for cell viability as construction of a disrupted copy (aarC::lacZ) was possible only in cells that carried an episomal copy of aarC or gcpE. PMID:9079912

  8. School Site Strategic Planning To Improve District Performance.

    ERIC Educational Resources Information Center

    Lytle, James H.

    This paper describes the evolution of a school-based planning model that accommodates independent approaches to School District of Philadelphia goals. The description centers on key strategic planning decisions made during a 6-year period and three components of the planning model: the organizational monitoring and feedback system; organizational…

  9. School Board Improvement Plans in Relation to the AIP Model of Educational Accountability: A Content Analysis

    ERIC Educational Resources Information Center

    van Barneveld, Christina; Stienstra, Wendy; Stewart, Sandra

    2006-01-01

    For this study we analyzed the content of school board improvement plans in relation to the Achievement-Indicators-Policy (AIP) model of educational accountability (Nagy, Demeris, & van Barneveld, 2000). We identified areas of congruence and incongruence between the plans and the model. Results suggested that the content of the improvement plans,…

  10. Program planning for future improvement in managing ORNL's radioactive wastes

    NASA Astrophysics Data System (ADS)

    1982-01-01

    This is intended to serve as a reference document and guide in developing the long-term improvements section of ORNL's radioactive waste management plan. The report reviews ORNL's operations and future program needs in terms of currently applicable DOE regulations and also in terms of regulations and accepted practices of the commercial sector of the nuclear power industry so that the impact of potential future adoption of these regulations and standards on ORNL's operations can be fully evaluated. The principal conclusion reached after reviewing ORNL's waste management operations is that these operations are currently being conducted in a manner that does not endanger the health or safety of workers or the general public and that does not have an adverse effect on the environment. Although nineteen specific problem areas have been identified all of these problems can be attributed to one of the following: (1) the legacy of past practices; (2): gradual deterioration of systems which have reached (or are near to reaching) the end of their reasonable design lives; and (3) potential changes in regulations applicable to ORNL.

  11. Digital Radiography and Computed Tomography (DRCT) Product Improvement Plan (PIP)

    SciTech Connect

    Tim Roney; Bob Pink; Karen Wendt; Robert Seifert; Mike Smith

    2010-12-01

    The Idaho National Laboratory (INL) has been developing and deploying x-ray inspection systems for chemical weapons containers for the past 12 years under the direction of the Project Manager for Non-Stockpile Chemical Materiel (PMNSCM). In FY-10 funding was provided to advance the capabilities of these systems through the DRCT (Digital Radiography and Computed Tomography) Product Improvement Plan (PIP), funded by the PMNSCM. The DRCT PIP identified three research tasks; end user study, detector evaluation and DRCT/PINS integration. Work commenced in February, 2010. Due to the late start and the schedule for field inspection of munitions at various sites, it was not possible to spend sufficient field time with operators to develop a complete end user study. We were able to interact with several operators, principally Mr. Mike Rowan who provided substantial useful input through several discussions and development of a set of field notes from the Pueblo, CO field mission. We will be pursuing ongoing interactions with field personnel as opportunities arise in FY-11.

  12. 77 FR 33240 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: The following Water Management Plans are available for review: Contra Costa Water District. City of Santa Barbara. Tulare Irrigation...

  13. Improved Path Planning Onboard the Mars Exploration Rovers

    NASA Technical Reports Server (NTRS)

    Stentz, Anthony; Ferguson, David; Carsten, Joseph; Rankin, Arturo

    2007-01-01

    A revised version of the AutoNav (autonomous navigation with hazard avoidance) software running onboard each Mars Exploration Rover (MER) affords better obstacle avoidance than does the previous version. Both versions include GESTALT (Grid-based Estimation of Surface Traversability Applied to Local Terrain), a navigation program that generates local-terrain models from stereoscopic image pairs captured by onboard rover cameras; uses this information to evaluate candidate arcs that extend across the terrain from the current rover location; ranks the arcs with respect to hazard avoidance, minimization of steering time, and the direction towards the goal; and combines the rankings in a weighted vote to select an arc, along which the rover is then driven. GESTALT works well in navigating around small isolated obstacles, but tends to fail when the goal is on the other side of a large obstacle or multiple closely spaced small obstacles. When that occurs, the goal seeking votes and hazard avoidance votes conflict severely. The hazard avoidance votes will not allow the rover to drive through the unsafe area, and the waypoint votes will not allow enough deviation from the straight-line path for the rover to get around the hazard. The rover becomes stuck and is unable to reach the goal. The revised version of AutoNav utilizes a global path-planning program, Field D*, to evaluate the cost of traveling from the end of each GESTALT arc to the goal. In the voting process, Field D* arc votes supplant GESTALT goal-seeking arc votes. Hazard avoidance, steering bias, and Field D* votes are merged and the rover is driven a preset distance along the arc with the highest vote. Then new images are acquired and the process as described is repeated until the goal is reached. This new technology allows the rovers to autonomously navigate around much more complex obstacle arrangements than was previously possible. In addition, this improved autonomy enables longer traverses per Sol (a day

  14. Amino acid deprivation induces CREBZF/Zhangfei expression via an AARE-like element in the promoter.

    PubMed

    Zhang, Yani; Jin, Yaping; Williams, Tegan A; Burtenshaw, Sally M; Martyn, Amanda C; Lu, Rui

    2010-01-15

    CREBZF (also called ZF or Zhangfei) is a basic region-leucine zipper transcription factor that has been implicated in the herpesvirus infection cycle and related cellular processes. Since ATF4 is known to play a key role in cellular responses to various ER stresses as well as amino acid deprivation, we sought to examine the potential involvement of CREBZF in the amino acid response (AAR). We found that the CREBZF protein was induced by amino acid deprivation in the canine MDCK cells. We subsequently cloned a canine CREBZF promoter region (-1767bp to +1bp) that responds to amino acid limitation. Using deletion mapping and site-directed mutagenesis, we identified a 9-bp sequence 5'-ATTCACTCA-3' in the promoter (-1227 to -1219), deletion of which resulted in a complete loss of inducibility by amino acid deprivation. This sequence is similar to the known amino acid response elements (AAREs) found in other AAR-inducible genes, such as CHOP (C/EBP homologous protein, also known as GADD153). These results suggest that CREBZF may be an amino acid stress sensor. Considering the AARE-like sequence found in CREBZF and other similarities between CREBZF and CHOP, we postulate that CREBZF and CHOP may be two sensors that regulate different yet related signaling pathways governing the AAR. PMID:20026304

  15. Family Planning: Improving Opportunities for Women. Report Number 18.

    ERIC Educational Resources Information Center

    Victor-Bostrom Fund Committee, Washington, DC.

    This report contains eight articles on the importance of the role of women in family planning. An Assistant Secretary General for Social Development and Humanitarian Affairs, United Nations, calls for increased female participation in national development. The Secretary General of The International Planned Parenthood Federation observes that women…

  16. Improved Lesson Planning with Universal Design for Learning (UDL)

    ERIC Educational Resources Information Center

    Courey, Susan Joan; Tappe, Phyllis; Siker, Jody; LePage, Pam

    2013-01-01

    Efficient lesson planning with universal design for learning (UDL) enables teachers to more effectively meet students' individual needs. In this study, a comparison of lesson plans by teacher candidates in a teacher preparation program before and after UDL training is presented. After training, teachers (n = 45) incorporated more differentiated…

  17. A regulatory cascade involving AarG, a putative sensor kinase, controls the expression of the 2'-N-acetyltransferase and an intrinsic multiple antibiotic resistance (Mar) response in Providencia stuartii.

    PubMed

    Rather, P N; Paradise, M R; Parojcic, M M; Patel, S

    1998-06-01

    A recessive mutation, aarG1, has been identified that resulted in an 18-fold increase in the expression of beta-galactosidase from an aac(2')-lacZ fusion. Transcriptional fusions and Northern blot analysis demonstrated that the aarG1 allele also resulted in a large increase in the expression of aarP, a gene encoding a transcriptional activator of aac(2')-Ia. The effects of aarG1 on aac(2')-Ia expression were mediated by aarP-dependent and -independent mechanisms. The aarG1 allele also resulted in a multiple antibiotic resistance (Mar) phenotype, which included increased chloramphenicol, tetracycline and fluoroquinolone resistance. This Mar phenotype also resulted from aarP-dependent and -independent mechanisms. Sequence analysis of the aarG locus revealed the presence of two open reading frames, designated aarR and aarG, organized in tandem. The putative AarR protein displayed 75% amino acid identity to the response regulator PhoP, and the AarG protein displayed 57% amino acid identity to the sensor kinase PhoQ. The aarG1 mutation, a C to T substitution, resulted in a threonine to isoleucine substitution at position 279 (T279I) in the putative sensor kinase. The AarG product was functionally similar to PhoQ, as it was able to restore wild-type levels of maganin resistance to a Salmonella typhimurium phoQ mutant. However, expression of the aarP and aac(2')-Ia genes was not significantly affected by the levels of Mg2+ or Ca2+, suggesting that aarG senses a signal other than divalent cations. PMID:9680222

  18. 75 FR 38114 - [Docket ID FEMA-2010-0008

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ...) After Action Report (AAR) Improvement Plan (IP). SUMMARY: The Federal Emergency Management Agency (FEMA... SECURITY Federal Emergency Management Agency Agency Information Collection Activities: Submission for OMB...) After Action Report (AAR) Improvement Plan (IP) AGENCY: Federal Emergency Management Agency, DHS....

  19. FY 2013 Educational Facilities Master Plan and the FY 2013-2018 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2012

    2012-01-01

    The FY 2013 Educational Facilities Master Plan (Master Plan) and the FY 2013-2018 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the Board of…

  20. FY 2011 Educational Facilities Master Plan & the FY 2011-2016 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2010

    2010-01-01

    The FY 2011 Educational Facilities Master Plan (Master Plan) and FY 2011-2016 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the Board of Education…

  1. Flexible and Inexpensive: Improving Learning Transfer and Program Evaluation through Participant Action Plans

    ERIC Educational Resources Information Center

    Cowan, Chris A.; Goldman, Ellen F.; Hook, Melissa

    2010-01-01

    Action plans have been shown to improve transfer of learning and have proven an effective tool in training evaluation. This study describes how action planning was simply and successfully adapted to a preexisting curriculum with few additional resources. The decision to use participant action planning, the administration of it, and the…

  2. FY 2012 Educational Facilities Master Plan and the Amended FY 2011-2016 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2011

    2011-01-01

    The FY 2012 Educational Facilities Master Plan (Master Plan) and Amendments to the FY 2011-2016 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the…

  3. FY 2007 Educational Facilities Master Plan and the FY 2007-2012 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2006

    2006-01-01

    The FY 2007 Educational Facilities Master Plan (Master Plan) and FY 2007-2012 Capital Improvements Program (CIP) reflect the adopted actions of the Montgomery County (Maryland) Council and integrate the facilities planning process with the annual capital budget and the six-year CIP. The CIP is developed in accordance with the Board of Education…

  4. 78 FR 31916 - Increasing Market and Planning Efficiency Through Improved Software; Supplemental Agenda Notice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-28

    ... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software... improved software. A detailed agenda with the list of times for the selected speakers and presentation... diverse experts from public utilities, the software industry, government, research centers and...

  5. Quantitative assessment of alkali-reactive aggregate mineral content through XRD using polished sections as a supplementary tool to RILEM AAR-1 (petrographic method)

    SciTech Connect

    Castro, Nelia; Sorensen, Bjorn E.; Broekmans, Maarten A.T.M.

    2012-11-15

    The mineral content of 5 aggregate samples from 4 different countries, including reactive and non-reactive aggregate types, was assessed quantitatively by X-ray diffraction (XRD) using polished sections. Additionally, electron probe microanalyzer (EPMA) mapping and cathodoluminescence (CL) were used to characterize the opal-CT identified in one of the aggregate samples. Critical review of results from polished sections against traditionally powdered specimen has demonstrated that for fine-grained rocks without preferred orientation the assessment of mineral content by XRD using polished sections may represent an advantage over traditional powder specimens. Comparison of data on mineral content and silica speciation with expansion data from PARTNER project confirmed that the presence of opal-CT plays an important role in the reactivity of one of the studied aggregates. Used as a complementary tool to RILEM AAR-1, the methodology suggested in this paper has the potential to improve the strength of the petrographic method.

  6. A Plan for Improving F. W. Holbein Middle School

    ERIC Educational Resources Information Center

    Rakszawski, Roy A.

    2014-01-01

    This executive position paper proposes recommendations for improving F. W. Holbein Middle School using the New Jersey Department of Education's research-based turnaround principles as a framework for school improvement. With input from staff, the author identified the turnaround principles found to be most relevant in improving the school. In…

  7. The SILC School Improvement Planning Process. The SILC Road.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Education, Denver. Special Education Services Unit.

    This guide outlines a school-improvement process to help schools develop an information system that improves services to students and their families. It looks at ways to build a leadership team that can orchestrate the work of families, school professionals, administrators, and students through the school-improvement process. It describes how to…

  8. Perceptions of the Purpose and Value of the School Improvement Plan Process

    ERIC Educational Resources Information Center

    Dunaway, David M.; Kim, Do-Hong; Szad, Elizabeth R.

    2012-01-01

    The purpose of this research was to determine how teachers and administrators in a successful North Carolina district perceived the purpose and value of a school improvement plan (SIP) and the planning process. The SIP is the accepted best practice for school-wide improvement, and the perceptions of the purpose and value of the process…

  9. 77 FR 42257 - General Conference Committee of the National Poultry Improvement Plan; Solicitation for Membership

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-18

    ... Animal and Plant Health Inspection Service General Conference Committee of the National Poultry... National Poultry Improvement Plan. DATES: Consideration will be given to nominations received on or before..., National Poultry Improvement Plan, VS, APHIS, 1506 Klondike Road, Suite 300, Conyers, GA 30094-5173,...

  10. 78 FR 33799 - National Poultry Improvement Plan; General Conference Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-05

    ... Animal and Plant Health Inspection Service National Poultry Improvement Plan; General Conference.... SUMMARY: We are giving notice of a meeting of the General Conference Committee of the National Poultry... Poultry Improvement Plan, VS, APHIS, 1506 Klondike Road, Suite 101, Conyers, GA 30094; (770)...

  11. 75 FR 70712 - General Conference Committee of the National Poultry Improvement Plan; Reestablishment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ... Animal and Plant Health Inspection Service General Conference Committee of the National Poultry... Conference Committee of the National Poultry Improvement Plan (Committee) for a 2-year period. The Secretary... INFORMATION CONTACT: Mr. Andrew R. Rhorer, Senior Coordinator, National Poultry Improvement Plan, VS,...

  12. 76 FR 1592 - National Poultry Improvement Plan; General Conference Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... Animal and Plant Health Inspection Service National Poultry Improvement Plan; General Conference.... SUMMARY: We are giving notice of a meeting of the General Conference Committee of the National Poultry..., Senior Coordinator, National Poultry Improvement Plan, VS, APHIS, 1498 Klondike Road, Suite 101,...

  13. Recommended Resources for Planning to Evaluate Program Improvement Efforts (Including the SSIP)

    ERIC Educational Resources Information Center

    National Center for Systemic Improvement at WestEd, 2015

    2015-01-01

    This document provides a list of recommended existing resources for state Part C and Part B 619 staff and technical assistance (TA) providers to utilize to support evaluation planning for program improvement efforts (including the State Systemic Improvement Plan, SSIP). There are many resources available related to evaluation and evaluation…

  14. Superintendents' Perceptions of the School Improvement Planning Process in the Southeastern USA

    ERIC Educational Resources Information Center

    Dunaway, David M.; Bird, James J.; Wang, Chuang; Hancock, Dawson

    2014-01-01

    The purpose of this study of school improvement planning in the southeastern USA was to establish the current view of the process through the eyes of the district superintendents. The answers to the questions were consistently mixed. Generally, the presence of school improvement planning is prevalent in the large majority of districts. However,…

  15. 78 FR 40625 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-08

    ... Certification Continuous Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010; Approval of... ``National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the Healthy... February 22, 2013 at 78 FR 12221 was approved by OMB on April 10, 2013, under OMB Control Number...

  16. School Improvement Planning in East Tennessee Middle Schools: A Content Analysis and Perceptions Study

    ERIC Educational Resources Information Center

    Vincent, Anfara A., Jr.; Patterson, Faye; Buehler, Alison; Gearity, Brian

    2006-01-01

    This mixed-methods study focuses on school improvement planning in middle schools in east Tennessee. Utilizing the improvement plans of 17 middle schools and surveys that were administered to 493 teachers and 35 administrators, this study found that there was (A) an overemphasis on academic goals, (B) an overreliance on the use of "homemade" data…

  17. State Dissemination Planning as Part of Program Improvement.

    ERIC Educational Resources Information Center

    Wall, James E.

    Knowing and understanding the principles and tenets underlying dissemination, utilization, and impact collection facilitate the "how." Dissemination is a communication process involving interactional relationships among individuals. Involvement of multiple agencies gives rise to networking. Disseminating is also a major facet of planned change,…

  18. The Planning and Implementation of Test Facility Improvements

    NASA Technical Reports Server (NTRS)

    Oberlander, Larry

    2008-01-01

    As engineering programs develop, and product testing begins, ideas for process improvement soon become obvious. Engineers envision new holding and handling fixtures. Additional custom-made support equipment may be needed. Perhaps modifications to the building or modifications to facility hardware are the order of the day. This is where a flexible creative test organization is needed. We need not be content with the status quo. All of these desired test innovations can make the difficult easy and improve the work flow. At times, implementing these new ideas demands more time or specialized expertise than test team members have. Through the coordinated use of labor resources, the needed improvements can still be made and in a timely fashion that supports program schedules. This presentation provides practical advice and a method whereby test personnel can creatively develop facility improvements and manage them from start to finish. You can control just how much time you invest and what part of your concepts you will personally design. By wisely defining the requirements and presenting them to the appropriate help sources (vendors, contractors, coworkers, and support departments), you can get the help you need to bring the improvements you have conceived, into fruition. Aspects of this presentation include defining requirements for test facility improvements, choosing labor resources, writing a statement of work, determining cost and benefits, securing department approval, coordinating procurement, managing the project, and training the end users. The process of successfully implementing test facility improvements is thoroughly explained. It has been tried, proven and improved over nearly 25 years of use. Whether considering a $50 improvement or a $50 million dollar improvement, this discussion will provide helpful pointers. Examples of improvements made through this process and their illustration will be included.

  19. An Action Plan for Improving Mediocre or Stagnant Student Achievement

    ERIC Educational Resources Information Center

    Redmond, Kimberley B.

    2013-01-01

    Although all of the schools in the target school system adhere to a school improvement process, achievement scores remain mediocre or stagnant within the overseas school in Italy that serves children of United States armed service members. To address this problem, this study explored the target school's improvement process to discover how…

  20. A Plan to Improve School and Library Environments.

    ERIC Educational Resources Information Center

    Hawaii State Dept. of Education, Honolulu. Office of Planning and Budget.

    A framework of goals, policy statements, and implementing activites is set forth aimed at integrating the different kinds of environment improvement activities now underway in the Hawaii Department of Education; expanding and improving those activities in orderly ways in the future; and suggesting new directions. Five areas are targeted for…

  1. Methods and computer readable medium for improved radiotherapy dosimetry planning

    DOEpatents

    Wessol, Daniel E.; Frandsen, Michael W.; Wheeler, Floyd J.; Nigg, David W.

    2005-11-15

    Methods and computer readable media are disclosed for ultimately developing a dosimetry plan for a treatment volume irradiated during radiation therapy with a radiation source concentrated internally within a patient or incident from an external beam. The dosimetry plan is available in near "real-time" because of the novel geometric model construction of the treatment volume which in turn allows for rapid calculations to be performed for simulated movements of particles along particle tracks therethrough. The particles are exemplary representations of alpha, beta or gamma emissions emanating from an internal radiation source during various radiotherapies, such as brachytherapy or targeted radionuclide therapy, or they are exemplary representations of high-energy photons, electrons, protons or other ionizing particles incident on the treatment volume from an external source. In a preferred embodiment, a medical image of a treatment volume irradiated during radiotherapy having a plurality of pixels of information is obtained.

  2. FIM FRAME: a method for assessing and improving emergency plans for floods

    NASA Astrophysics Data System (ADS)

    Lumbroso, D. M.; Di Mauro, M.; Tagg, A. F.; Vinet, F.; Stone, K.

    2012-05-01

    Over the past decade Europe has been hit by a number of severe flood events. Reviews of recent large flood events in England and France have indicated that there is room for improvement in the emergency planning for floods. Methods that can be used for the systematic assessment and improvement of emergency plans are extensively documented in readily available literature. However, those that do exist are often limited to appraising the content of the plans rather than the process that the plan should guide. This paper describes research to develop a systematic method for assessing and improving emergency plans, which is called the FIM FRAME method. The development of the method was informed by research carried out with stakeholders in France, the Netherlands and England, as well as an appraisal of available tools that can be used to develop and improve plans, and an analysis of a selection of flood emergency plans from the three countries. One of the fundamental requirements of the FIM FRAME method was that it should be able to be applied by the relevant stakeholders to a range of emergency plans that mainly focus on flooding. The method comprises a series of steps (known as Appraise, Tackle and Implement) that can assist stakeholders with assessing and improving emergency plans. The method was piloted in the three countries and then refined following feedback from end users. This paper describes the development of the FIM FRAME method and its application in three case studies affected by different types of floods.

  3. Classroom HVAC: Improving ventilation and saving energy -- field study plan

    SciTech Connect

    Apte, Michael G.; Faulkner, David; Hodgson, Alfred T.; Sullivan, Douglas P.

    2004-10-14

    The primary goals of this research effort are to develop, evaluate, and demonstrate a very practical HVAC system for classrooms that consistently provides classrooms (CRs) with the quantity of ventilation in current minimum standards, while saving energy, and reducing HVAC-related noise levels. This research is motivated by the public benefits of energy efficiency, evidence that many CRs are under-ventilated, and public concerns about indoor environmental quality in CRs. This document provides a summary of the detailed plans developed for the field study that will take place in 2005 to evaluate the energy and IAQ performance of a new classroom HVAC technology. The field study will include measurements of HVAC energy use, ventilation rates, and IEQ conditions in 10 classrooms with the new HVAC technology and in six control classrooms with a standard HVAC system. Energy use and many IEQ parameters will be monitored continuously, while other IEQ measurements will be will be performed seasonally. Continuously monitored data will be remotely accessed via a LonWorks network. Instrument calibration plans that vary with the type of instrumentation used are established. Statistical tests will be employed to compare energy use and IEQ conditions with the new and standard HVAC systems. Strengths of this study plan include the collection of real time data for a full school year, the use of high quality instrumentation, the incorporation of many quality control measures, and the extensive collaborations with industry that limit costs to the sponsors.

  4. Responses to the AAR-Teagle White Paper: "The Religious Studies Major in a Post-9/11 World"

    ERIC Educational Resources Information Center

    Webster, Jane S.; Buckley, James J.; Jensen, Tim; Floyd-Thomas, Stacey

    2011-01-01

    In October 2008 The American Academy of Religion published the findings of an eighteen month study (conducted with funding from the Teagle Foundation) on "The Religious Studies Major in a Post-9/11 World: New Challenges, New Opportunities." Re-published here, this AAR-Teagle White Paper provides the opportunity for four respondents to raise issues…

  5. Genome analysis of Excretory/Secretory proteins in Taenia solium reveals their Abundance of Antigenic Regions (AAR).

    PubMed

    Gomez, Sandra; Adalid-Peralta, Laura; Palafox-Fonseca, Hector; Cantu-Robles, Vito Adrian; Soberón, Xavier; Sciutto, Edda; Fragoso, Gladis; Bobes, Raúl J; Laclette, Juan P; Yauner, Luis del Pozo; Ochoa-Leyva, Adrián

    2015-01-01

    Excretory/Secretory (ES) proteins play an important role in the host-parasite interactions. Experimental identification of ES proteins is time-consuming and expensive. Alternative bioinformatics approaches are cost-effective and can be used to prioritize the experimental analysis of therapeutic targets for parasitic diseases. Here we predicted and functionally annotated the ES proteins in T. solium genome using an integration of bioinformatics tools. Additionally, we developed a novel measurement to evaluate the potential antigenicity of T. solium secretome using sequence length and number of antigenic regions of ES proteins. This measurement was formalized as the Abundance of Antigenic Regions (AAR) value. AAR value for secretome showed a similar value to that obtained for a set of experimentally determined antigenic proteins and was different to the calculated value for the non-ES proteins of T. solium genome. Furthermore, we calculated the AAR values for known helminth secretomes and they were similar to that obtained for T. solium. The results reveal the utility of AAR value as a novel genomic measurement to evaluate the potential antigenicity of secretomes. This comprehensive analysis of T. solium secretome provides functional information for future experimental studies, including the identification of novel ES proteins of therapeutic, diagnosis and immunological interest. PMID:25989346

  6. Genome analysis of Excretory/Secretory proteins in Taenia solium reveals their Abundance of Antigenic Regions (AAR)

    PubMed Central

    Gomez, Sandra; Adalid-Peralta, Laura; Palafox-Fonseca, Hector; Cantu-Robles, Vito Adrian; Soberón, Xavier; Sciutto, Edda; Fragoso, Gladis; Bobes, Raúl J.; Laclette, Juan P.; Yauner, Luis del Pozo; Ochoa-Leyva, Adrián

    2015-01-01

    Excretory/Secretory (ES) proteins play an important role in the host-parasite interactions. Experimental identification of ES proteins is time-consuming and expensive. Alternative bioinformatics approaches are cost-effective and can be used to prioritize the experimental analysis of therapeutic targets for parasitic diseases. Here we predicted and functionally annotated the ES proteins in T. solium genome using an integration of bioinformatics tools. Additionally, we developed a novel measurement to evaluate the potential antigenicity of T. solium secretome using sequence length and number of antigenic regions of ES proteins. This measurement was formalized as the Abundance of Antigenic Regions (AAR) value. AAR value for secretome showed a similar value to that obtained for a set of experimentally determined antigenic proteins and was different to the calculated value for the non-ES proteins of T. solium genome. Furthermore, we calculated the AAR values for known helminth secretomes and they were similar to that obtained for T. solium. The results reveal the utility of AAR value as a novel genomic measurement to evaluate the potential antigenicity of secretomes. This comprehensive analysis of T. solium secretome provides functional information for future experimental studies, including the identification of novel ES proteins of therapeutic, diagnosis and immunological interest. PMID:25989346

  7. A NASA F/A-18, participating in the Automated Aerial Refueling (AAR) project, flies over the Dryden

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A NASA F/A-18 is participating in the Automated Aerial Refueling (AAR) project. The 300-gallon aerial refueling store seen on the belly of the aircraft carries fuel and a refueling drogue. This aircraft acts as a tanker in the study to develop an aerodynamic model for future automated aerial refueling, especially of unmanned vehicles.

  8. 75 FR 13775 - Agency Information Collection Activities: Proposed Collection; Comment Request, 1660-NEW...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-23

    ... (AAR) Improvement Plan (IP) AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice; 60-day... Security Exercise and Evaluation Program (HSEEP) After Action Report (AAR) Improvement Plan (IP). SUMMARY... Security Exercise and Evaluation Program (HSEEP) After Action Report (AAR) Improvement Plan (IP)....

  9. Halogen and trace element geochemistry in Mid-Ocean Ridge basalts from the Australian-Antarctic Ridge (AAR)

    NASA Astrophysics Data System (ADS)

    Yang, Y. S.; Seo, J. H.; Park, S. H.; Kim, T.

    2015-12-01

    Australian-Antarctic Ridge (AAR) is an extension of easternmost SE Indian Mid-Ocean Ridge (MOR).We collected volcanic glasses from the "in-axis" of the KR1 and KR2 MOR, and the overlapping zones of the KR1 MOR and the nearby seamounts ("KR1 mixing"). We determined trace and halogen elements in the glasses. Halogen concentrations and its ratios in the glasses are important to understand the mantle metasomatism and volatile recycling. 52 of the collected glasses are "primitive" (higher than 6 wt% MgO), while 3 of them have rather "evolved" composition (MgO wt% of 1.72, 2.95 and 4.15). K2O concentrations and Th/Sc ratios in the glasses show a negative correlation with its MgO concentration. Incompatible element ratios such as La/Sm are rather immobile during a magma differentiation so the ratios are important to understand mantle composition (Hofmann et al. 2003). La/Sm ratios in the glasses are 0.95 ~ 3.28 suggesting that the AAR basalts can be classified into T-MORB and E-MORB (Schilling et al., 1983). La/Sm ratios are well-correlated with incompatible elements such as U, Ba, Nb, and negatively correlated with compatible elements such as Sc, Eu2+, Mg. The AAR glasses contain detectable halogen elements. The "KR1 mixing" glasses in halogen elements are more abundant than "in-axis" the glasses. Cl is the least variable element compared to the other halogens such as Br and I in the AAR. The "KR1 mixing" glasses have the largest variations of Br/Cl ratios compared to the "in-axis" glasses. The Cl/Br and Th/Sc ratios in the "in-axis" glasses and in the "KR1 mixing" glasses show positive and negative correlations, respectively. The Br-rich glasses in the "KR1 mixing" zone might be explained by a recycled Br-rich oceanic slab of paleo-subduction or by a hydrothermal alteration in the AAR. I composition in the glasses does not show a correlation other trace elements. The K/Cl and K/Ti ratios in the AAR glasses are similar to the basalts from the Galapagos Spreading Center

  10. The Front of the Aar Massif: A Crustal-Scale Ramp Anticline?

    NASA Astrophysics Data System (ADS)

    Herwegh, Marco; Mock, Samuel; Wehrens, Philip; Baumberger, Roland; Berger, Alfons; Wangenheim, Cornelia; Glotzbach, Christoph; Kissling, Edi

    2015-04-01

    The front of the Aar Massif (Swiss Central Alps) is characterized by Paleozoic basement rocks exposed at altitudes of more than 4600m above sea level, followed by a steeply north dipping Mesozoic sedimentary cover and overlying Helvetic nappes. The sediments turn into subhorizontal orientations just few kilometers to the N, where the top of the basement is situated at depths of about 7000m below sea level. What is the origin of this vertical jump of about 12000m of the basement rocks over such short horizontal distances? Recent structural investigations at the Basement-Cover contact indicate a complex structural evolution involving reactivation of extensional faults and inversion of half-grabens during early compressional stages. In the internal parts of the Aar Massif a general steepening of the faults resulted with progressive compression. In the northern frontal part, however, a new spaced cleavage evolved, which is dipping with 20-30° to the SE. In places, the new cleavage in the basement rocks is intense and pervasive and correlates with a steepening of the basement-cover contact and its offsets of several tens to hundreds of meters. Hence strain is strongly partitioned in a large number of high strain zones, which cover a cumulative thickness of at least 2000m, eventually even much more considering subsurface continuation. The Mesozoic sediments affected by this large-scale deformation zone are either intensely ductile folded in the case of limestones or faulted and imbricated in the case of dolomites. These differences in deformation style result from the deformation conditions of about < 250-300°C, where calcite still deforms in a ductile manner, while dolomite and crystalline basement preferentially undergo brittle deformation in combination of dissolution-precipitation processes. In a large-scale point of view, we suggest that the high strain domain in the crystalline basement in fact represents a crustal-scale several kilometers wide shear zone, which

  11. 34 CFR 200.41 - School improvement plan.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... for participating in that professional development; and (iii) Incorporates teacher mentoring... school improvement status, for the purpose of providing high-quality professional development to the school's teachers, principal, and, as appropriate, other instructional staff, consistent with...

  12. 34 CFR 200.41 - School improvement plan.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... for participating in that professional development; and (iii) Incorporates teacher mentoring... school improvement status, for the purpose of providing high-quality professional development to the school's teachers, principal, and, as appropriate, other instructional staff, consistent with...

  13. 34 CFR 200.41 - School improvement plan.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... for participating in that professional development; and (iii) Incorporates teacher mentoring... school improvement status, for the purpose of providing high-quality professional development to the school's teachers, principal, and, as appropriate, other instructional staff, consistent with...

  14. Improving Gas Storage Development Planning Through Simulation-Optimization

    SciTech Connect

    Johnson, V.M.; Ammer, J.; Trick, M.D.

    2000-07-25

    This is the first of two papers describing the application of simulator-optimization methods to a natural gas storage field development planning problem. The results presented here illustrate the large gains in cost-effectiveness that can be made by employing the reservoir simulator as the foundation for a wide-ranging search for solutions to management problems. The current paper illustrates the application of these techniques given a deterministic view of the reservoir. A companion paper will illustrate adaptations needed to accommodate uncertainties regarding reservoir properties.

  15. Performance Improvement in 503A Compounding Pharmacies: A PLAN FOR ASSESSMENT, IMPLEMENTATION, AND SUSTAINED SUCCESS.

    PubMed

    Pritchett, Jon; Mixon, William; O'Connell, Kevin

    2016-01-01

    Performance improvement is the continual effort to objectively assess current performance and then restructure the practices that support it to more closely achieve desired performance. A plan for performance improvement, unlike other approaches to correcting problems in job fulfillment, is a systematic method used to first find the root causes of areas of concern and then apply corrections to remedy those deficits. Implementing a performance improvement plan that can be easily adapted to ensure compliance with evolving and increasingly complex state and federal regulations is crucial to a successful compounding practice. In this article, we discuss the need for performance improvement in 503A compounding pharmacies, list the steps necessary to develop such a plan, and present three case reports of performance improvement plans in differing compounding settings. PMID:27125054

  16. 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

    ... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software; Notice... discuss opportunities for increasing real-time and day- ahead market efficiency through improved software... improved software, 76 Fed. Reg. 28,022 (2011). Parties wishing to submit written comments regarding...

  17. Studying Space: Improving Space Planning with User Studies

    ERIC Educational Resources Information Center

    Pierard, Cindy; Lee, Norice

    2011-01-01

    How can libraries best assess and improve user space, even if they are not in a position to undertake new construction or a major renovation? Staff at New Mexico State University used a variety of ethnographic methods to learn how our spaces were being used as well as what our users considered to be ideal library space. Our findings helped us make…

  18. Cyberbullying: Assessment of Student Experience for Continuous Improvement Planning

    ERIC Educational Resources Information Center

    Strom, Paris S.; Strom, Robert D.; Wingate, Julius J.; Kraska, Marie F.; Beckert, Troy E.

    2012-01-01

    This study examines the use of polling students to improve conditions of learning in their school. Students from three schools (N = 2,006) in Grades 5, 6, 7, and 8 completed an online poll about how cyberbullying affects their personal lives. Principals' impressions about the benefits of student polling are explained along with the Cyberbullying…

  19. Planning, Evaluating and Improving Tiers of Support in Beginning Reading

    ERIC Educational Resources Information Center

    Mercier Smith, Jean L.; Fien, Hank; Basaraba, Deni; Travers, Patricia

    2009-01-01

    This article describes a data-based continuous-improvement framework that can help school teams use what the authors call "systems-level data" to support teachers in achieving successful beginning reading outcomes for all students. The authors also furnish an example of an elementary school in the Pacific Northwest that uses such a framework to…

  20. Administrative Plans. STIP II (Skill Training Improvement Programs Round II).

    ERIC Educational Resources Information Center

    Los Angeles Community Coll. District, CA.

    Personnel policies, job responsibilities, and accounting procedures are summarized for the Los Angeles Community College District's Skill Training Improvement Programs (STIP II). This report first cites references to the established personnel and affirmative action procedures governing the program and then presents an organizational chart for the…

  1. Improving the Slum Planning Through Geospatial Decision Support System

    NASA Astrophysics Data System (ADS)

    Shekhar, S.

    2014-11-01

    In India, a number of schemes and programmes have been launched from time to time in order to promote integrated city development and to enable the slum dwellers to gain access to the basic services. Despite the use of geospatial technologies in planning, the local, state and central governments have only been partially successful in dealing with these problems. The study on existing policies and programmes also proved that when the government is the sole provider or mediator, GIS can become a tool of coercion rather than participatory decision-making. It has also been observed that local level administrators who have adopted Geospatial technology for local planning continue to base decision-making on existing political processes. In this juncture, geospatial decision support system (GSDSS) can provide a framework for integrating database management systems with analytical models, graphical display, tabular reporting capabilities and the expert knowledge of decision makers. This assists decision-makers to generate and evaluate alternative solutions to spatial problems. During this process, decision-makers undertake a process of decision research - producing a large number of possible decision alternatives and provide opportunities to involve the community in decision making. The objective is to help decision makers and planners to find solutions through a quantitative spatial evaluation and verification process. The study investigates the options for slum development in a formal framework of RAY (Rajiv Awas Yojana), an ambitious program of Indian Government for slum development. The software modules for realizing the GSDSS were developed using the ArcGIS and Community -VIZ software for Gulbarga city.

  2. Improving effectiveness of systematic conservation planning with density data.

    PubMed

    Veloz, Samuel; Salas, Leonardo; Altman, Bob; Alexander, John; Jongsomjit, Dennis; Elliott, Nathan; Ballard, Grant

    2015-08-01

    Systematic conservation planning aims to design networks of protected areas that meet conservation goals across large landscapes. The optimal design of these conservation networks is most frequently based on the modeled habitat suitability or probability of occurrence of species, despite evidence that model predictions may not be highly correlated with species density. We hypothesized that conservation networks designed using species density distributions more efficiently conserve populations of all species considered than networks designed using probability of occurrence models. To test this hypothesis, we used the Zonation conservation prioritization algorithm to evaluate conservation network designs based on probability of occurrence versus density models for 26 land bird species in the U.S. Pacific Northwest. We assessed the efficacy of each conservation network based on predicted species densities and predicted species diversity. High-density model Zonation rankings protected more individuals per species when networks protected the highest priority 10-40% of the landscape. Compared with density-based models, the occurrence-based models protected more individuals in the lowest 50% priority areas of the landscape. The 2 approaches conserved species diversity in similar ways: predicted diversity was higher in higher priority locations in both conservation networks. We conclude that both density and probability of occurrence models can be useful for setting conservation priorities but that density-based models are best suited for identifying the highest priority areas. Developing methods to aggregate species count data from unrelated monitoring efforts and making these data widely available through ecoinformatics portals such as the Avian Knowledge Network will enable species count data to be more widely incorporated into systematic conservation planning efforts. PMID:25873240

  3. 76 FR 58840 - Central Valley Project Improvement Act; Refuge Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... Bureau of Reclamation Central Valley Project Improvement Act; Refuge Water Management Plans AGENCY... Refuge Water Management Plans (Refuge Criteria). Several entities have each developed a Refuge Water... requirements of these Refuge Criteria (see list in Supplementary Information below). Willow Creek Mutual...

  4. QUEST: An Integrated Approach for Institutional Planning, Assessment and Quality Improvement.

    ERIC Educational Resources Information Center

    Pensacola Junior Coll., FL. Office of Institutional Research and Effectiveness.

    This is a report on the Qualitative Use of Evaluative Systems and Techniques (QUEST) program used by Pensacola Junior College (PJC) (Florida) to assess, integrate, and improve institutional effectiveness. The program focuses on 12 major institutional functions: strategic planning, academic programming, facilities planning, college operations,…

  5. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... or maintain the delivery of services and patient care. (2) Develop and implement plans of action to... 42 Public Health 4 2012-10-01 2012-10-01 false Quality assessment and performance improvement plan. 460.132 Section 460.132 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

  6. 75 FR 70020 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-16

    ... Bureau of Reclamation Central Valley Project Improvement Act, Water Management Plans AGENCY: Bureau of Reclamation, Interior ACTION: Notice of Availability. SUMMARY: The following Water Management Plans are available for review: Orland-Artois Water District Kern Tulare Water District To meet the requirements...

  7. 75 FR 45623 - Increasing Market and Planning Efficiency Through Improved Software; Notice Establishing Date for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... Software, 75 FR 27,341 (2010). June 2-3 Enhanced Unit-Commitment Models. June 9-10 Enhanced Wide-Area... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software; Notice... conferences regarding models and software related to wholesale electricity markets and planning: \\1\\...

  8. Job Development Plans. STIP II (Skill Training Improvement Programs Round II).

    ERIC Educational Resources Information Center

    Los Angeles Community Coll. District, CA.

    Four reports are presented detailing the plans for obtaining employment and ensuring job retention for students who have completed a course of study in the Los Angeles Community College District's Skill Training Improvement Programs (STIP II). Job development plans are submitted for: Los Angeles Southwest College's computer programming program;…

  9. 14. Site D57C, Improved NIKEHercules System, Grading Plan, U.S. Army ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Site D-57-C, Improved NIKE-Hercules System, Grading Plan, U.S. Army Corps of Engineers, 18 January 1962. - Newport NIKE Missile Battery D-57/58, Integrated Fire Control Area, Newport Road, Carleton, Monroe County, MI

  10. 75 FR 69698 - Central Valley Project Improvement Act, Criteria for Developing Refuge Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    .../District managers, biologists, water conservation specialists, engineers, the CALFED Bay-Delta Program, and... Bureau of Reclamation Central Valley Project Improvement Act, Criteria for Developing Refuge Water... ``Criteria for Developing Refuge Water Management Plans'' (Refuge Criteria) are now available for...

  11. Improved Results for Route Planning in Stochastic Transportation Networks

    NASA Technical Reports Server (NTRS)

    Boyan, Justin; Mitzenmacher, Michael

    2000-01-01

    In the bus network problem, the goal is to generate a plan for getting from point X to point Y within a city using buses in the smallest expected time. Because bus arrival times are not determined by a fixed schedule but instead may be random. the problem requires more than standard shortest path techniques. In recent work, Datar and Ranade provide algorithms in the case where bus arrivals are assumed to be independent and exponentially distributed. We offer solutions to two important generalizations of the problem, answering open questions posed by Datar and Ranade. First, we provide a polynomial time algorithm for a much wider class of arrival distributions, namely those with increasing failure rate. This class includes not only exponential distributions but also uniform, normal, and gamma distributions. Second, in the case where bus arrival times are independent and geometric discrete random variable,. we provide an algorithm for transportation networks of buses and trains, where trains run according to a fixed schedule.

  12. The Good, the Bad, and the Ugly: An Analysis of the Chicago Public Schools' Capital Improvement Plan.

    ERIC Educational Resources Information Center

    Ryan, Matt; Schwartz, Chris

    This report examines the Chicago Public School System's need for capital improvement, and it highlights action plans for the future. The report reveals that many planned school improvements projects are unfunded and that there is about $229 million worth of projects that no longer appear in the city's capital improvements plan. Overcrowding…

  13. Melanoma screening: A plan for improving early detection.

    PubMed

    Shellenberger, Richard; Nabhan, Mohammed; Kakaraparthi, Sweta

    2016-05-01

    Malignant melanoma ranks fifth in the number of new cases annually in the United States (US). Despite increasing incidence and lack of recent improvement in mortality, national melanoma screening guidelines are currently not in existence. Our purpose was to review the evidence regarding screening whole-body skin examinations for early detection and a possible mortality benefit for malignant melanoma. Data sources for our review were MEDLINE Complete, PubMed, Cochrane Library, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov. Study selection included: epidemiologic data from the US and European cancer surveillance registries, population-based case-control screening trials, computer-simulated Markov model trials, and survey trials. Studies were limited to those published in the English language. Data was extracted using a dual extraction method. Data from studies have shown that the mortality of malignant melanoma is highly predicated on the tumor thickness at the time of diagnosis. Our data review is in support of the implementation of whole-body skin examinations, performed by primary care physicians, for the purpose of early detection of melanoma. A large national population-based, case-control, skin cancer screening trial in Germany has shown a reduction in melanoma-specific mortality. In conclusion, our review of the evidence supports physicians performed whole-body skin examination can lead to the detection of earlier stage melanomas as well as to a reduction in disease-specific mortality. We found a paucity of randomized trials to be a limitation of screening studies for many cancers, including melanoma. To improve screening rates and early detection of malignant melanoma, we propose making skin cancer education part of the curriculum in US primary care residency programs to become the genesis for widespread melanoma screening. Our study had no funding. Key messages Malignant melanoma is the fifth leading cancer in the United States (US). In the

  14. Can Plan Recommendations Improve the Coverage Decisions of Vulnerable Populations in Health Insurance Marketplaces?

    PubMed Central

    Barnes, Andrew J.; Hanoch, Yaniv; Rice, Thomas

    2016-01-01

    Objective The Affordable Care Act’s marketplaces present an important opportunity for expanding coverage but consumers face enormous challenges in navigating through enrollment and re-enrollment. We tested the effectiveness of a behaviorally informed policy tool—plan recommendations—in improving marketplace decisions. Study Setting Data were gathered from a community sample of 656 lower-income, minority, rural residents of Virginia. Study Design We conducted an incentive-compatible, computer-based experiment using a hypothetical marketplace like the one consumers face in the federally-facilitated marketplaces, and examined their decision quality. Participants were randomly assigned to a control condition or three types of plan recommendations: social normative, physician, and government. For participants randomized to a plan recommendation condition, the plan that maximized expected earnings, and minimized total expected annual health care costs, was recommended. Data Collection Primary data were gathered using an online choice experiment and questionnaire. Principal Findings Plan recommendations resulted in a 21 percentage point increase in the probability of choosing the earnings maximizing plan, after controlling for participant characteristics. Two conditions, government or providers recommending the lowest cost plan, resulted in plan choices that lowered annual costs compared to marketplaces where no recommendations were made. Conclusions As millions of adults grapple with choosing plans in marketplaces and whether to switch plans during open enrollment, it is time to consider marketplace redesigns and leverage insights from the behavioral sciences to facilitate consumers’ decisions. PMID:27028008

  15. School Improvement Plans and Student Achievement: Preliminary Evidence from the Quality and Merit Project in Italy

    ERIC Educational Resources Information Center

    Caputo, Andrea; Rastelli, Valentina

    2014-01-01

    This study provides preliminary evidence from an Italian in-service training program addressed to lower secondary school teachers which supports school improvement plans (SIPs). It aims at exploring the association between characteristics/contents of SIPs and student improvement in math achievement. Pre-post standardized tests and text analysis of…

  16. State Board of Education Guidelines for a School Improvement Planning Process

    ERIC Educational Resources Information Center

    Washington State Board of Education, 2004

    2004-01-01

    Beginning with the 2003-2004 school year, school districts are required to assure the State Board of Education (SBE) that each school in their district has in place a school improvement plan/process (SIP) that includes a continuous improvement process. This assurance is noted on the Minimum Basic Education Requirement Compliance Report, that…

  17. 76 FR 28022 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software; Notice... Software Take notice that Commission staff will convene a technical conference on June 28-30, 2011, from 8... efficiency through improved software. This conference will bring together diverse experts from ISOs/RTOs,...

  18. Summary of strategies for planning Productivity Improvement and Quality Enhancement (PIQE)

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The Summary of NASA Strategies for Productivity Improvement and Quality Enhancement respond to NASA's eighth top goal: Establish NASA as a leader in the development and application of advanced technology and management practices which contribute to significant increases in both Agency and national productivity. The Strategies provide the framework for development of the agency-wide Productivity Improvement and Quality Enhancement (PIQE) Plans.

  19. Lake Biel Holocene sediment record before and after the Aare river deviation (1878 AD)

    NASA Astrophysics Data System (ADS)

    Jeannet, Alice; Corella, Juan Pablo; Kremer, Katrina; Girardclos, Stéphanie

    2014-05-01

    Lake sediments are excellent archives of environmental and climate changes as well as human impact on lake- and river-systems. Lake Biel is a medium-sized peri-alpine lake in Switzerland, with a maximum depth of 74 m, and lies at an altitude of 429 m a.s.l. Lake Biel, which formed during the Pleistocene by glacial erosion, is part of the Aare river system. Our study focuses on the south-west part of the lake basin where the lake sedimentation was originally (i.e. naturally) mainly controlled by autochthonous sedimentation. This area is currently under a strong influence of water and sediment input from this river catchment since the Aare river deviation through the Hagneck canal in 1878. A 10.05 m long composite sediment sequence, cored from a 52 m water depth in September 2011, was built from two long cores retrieved with the ETH Zurich/Eawag Uwitec system. A radiocarbon age model indicates that the retrieved sedimentary sequence spans the last 7500 years. The upper sediments were correlated to previous short core radionuclide stratigraphy for the 1.5 m upper part (Thevenon et al., 2013). Magnetic susceptibility and density were measured by Geotek MultiSensor Core Logger at 0.5 cm resolution. Granulometry was measured with a CILAS grain sizer every 10 cm, and X-ray fluorescence (XRF) was carried out using an Avaatech core scanner at 1-cm resolution. This technique provides semi-quantitative information of the sediment elemental composition and shows how runoff and river input (Ti, Al, Si) or redox conditions (Fe/Mn) vary through time. Lake Biel sediment record suggests marked environmental changes with runoff decrease linked to climate and vegetation change during Atlantic chronobiozone, as well as a complex climate-human impact during the 'La Tène' and Roman cultural times. The most prominent recorded feature is the 10-times increase of sediment rate that occurred after the Aare river deviation through the Hagneck canal into Lake Biel in 1878. This artificial

  20. A NASA F/A-18, participating in the Automated Aerial Refueling (AAR) project, flies over the Dryden

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A NASA F/A-18 flies over the Dryden Flight Research Center and Rogers Dry Lake on December 11, 2002. The aircraft is participating in the Automated Aerial Refueling (AAR) project. The 300-gallon aerial refueling store seen on the belly of the aircraft carries fuel and a refueling drogue. This aircraft acts as a tanker in the study to develop an aerodynamic model for future automated aerial refueling, especially of unmanned vehicles.

  1. NASA's Plan for Improving Public Access to Federally Funded Scientific Research (Invited)

    NASA Astrophysics Data System (ADS)

    Allen, G.

    2013-12-01

    In February, 2013, OSTP issued a policy to all Federal agencies directing those that engage in $100 million or greater of federally funded research and development expenditures to develop an agency public access plan. The plan must consider both digital scientific data and scientific publications. This talk will review how NASA is currently complying with this OSTP directive, and NASA's plan for improving the public's ability to locate and access digital data and scientific publications resulting from NASA funded research. Updating NASA's policy will occur during FY 2014 and implementation of new policies and guidance will be in place by FY 2015.

  2. Structural Evolution in the Aar Massif (Central Alps): First attempts of linking the micron- to the kilometer-scale

    NASA Astrophysics Data System (ADS)

    Wehrens, P.; Baumberger, R.; Herwegh, M.

    2012-04-01

    The Aar massif belongs to the external massifs of the Alps and is mainly composed of granitoids and gneisses. Despite numerous detailed studies in the past decades, the overall exhumation history and the associated massif internal deformation (internal strain distribution and its evolution in time, kinematics etc.) are largely unknown at present. In this project, we aim to investigate the role of shear zones in the deformation history at a variety of scales. In this context it is important to understand their microstructural evolution, the involved deformation processes, kinematics and relative ages as well as the associated changes in rheology. A GIS-based remote-sensing structural map, verified by fieldwork, (see Baumberger et al., this volume) served as base for our investigations. Lithological differences between the units (Central Aare granite, ZAGr; Grimsel granodiorte, GrGr and gneisses) cause strain to localize along these contacts. Furthermore, the initial magmatic differentiation in the granitoids locally controls the Alpine deformational overprint because of differences in effective viscosity during solid-state deformation. This behavior is illustrated by the increase of foliation intensity and the number of shear zones per rock volume from ZAGr to GrGr. Preliminary results show that deformation at the N boundary of the Aar massif has to be distinguished from the central and the southern part. In the North steep NE-SW trending foliations and shear zones with subvertical lineations represent the major structures. The shear zones acted both as normal faults and as reverse faults, which mostly used pre-existing lithological boundaries between the different gneiss units. In a later stage, E-W trending shear zones and shear bands with moderate dipping angles cross cut the earlier structures. They always show a top to the North component and might be related to the late north directed movements of the Aar massif. Yet, no absolute age dating has been performed

  3. A knowledge-based approach to improving optimization techniques in system planning

    NASA Technical Reports Server (NTRS)

    Momoh, J. A.; Zhang, Z. Z.

    1990-01-01

    A knowledge-based (KB) approach to improve mathematical programming techniques used in the system planning environment is presented. The KB system assists in selecting appropriate optimization algorithms, objective functions, constraints and parameters. The scheme is implemented by integrating symbolic computation of rules derived from operator and planner's experience and is used for generalized optimization packages. The KB optimization software package is capable of improving the overall planning process which includes correction of given violations. The method was demonstrated on a large scale power system discussed in the paper.

  4. Uranium Mill Tailings Remedial Action Project: Cost Reduction and Productivity Improvement Program Project Plan

    SciTech Connect

    Not Available

    1991-11-01

    The purpose of the Cost Reduction/Productivity Improvement Program Plan is to formalize and improve upon existing efforts to control costs which have been underway since project inception. This program plan has been coordinated with the Department of Energy (DOE) Office of Environmental Management (EM) and the DOE Field Office, Albuquerque (AL). It incorporates prior Uranium Mill Tallings Remedial Action (UMTRA) Project Office guidance issued on the subject. The opportunities for reducing cosh and improving productivity are endless. The CR/PIP has these primary objectives: Improve productivity and quality; heighten the general cost consciousness of project participants, at all levels of their organizations; identify and implement specific innovative employee ideas that extend beyond what is required through existing processes and procedures; emphasize efforts that create additional value for the money spent by maintaining the project Total Estimated Cost (TEC) at the lowest possible level.

  5. Uranium Mill Tailings Remedial Action Project: Cost Reduction and Productivity Improvement Program Project Plan. Revised

    SciTech Connect

    Not Available

    1991-11-01

    The purpose of the Cost Reduction/Productivity Improvement Program Plan is to formalize and improve upon existing efforts to control costs which have been underway since project inception. This program plan has been coordinated with the Department of Energy (DOE) Office of Environmental Management (EM) and the DOE Field Office, Albuquerque (AL). It incorporates prior Uranium Mill Tallings Remedial Action (UMTRA) Project Office guidance issued on the subject. The opportunities for reducing cosh and improving productivity are endless. The CR/PIP has these primary objectives: Improve productivity and quality; heighten the general cost consciousness of project participants, at all levels of their organizations; identify and implement specific innovative employee ideas that extend beyond what is required through existing processes and procedures; emphasize efforts that create additional value for the money spent by maintaining the project Total Estimated Cost (TEC) at the lowest possible level.

  6. Obstacle avoidance planning of space manipulator end-effector based on improved ant colony algorithm.

    PubMed

    Zhou, Dongsheng; Wang, Lan; Zhang, Qiang

    2016-01-01

    With the development of aerospace engineering, the space on-orbit servicing has been brought more attention to many scholars. Obstacle avoidance planning of space manipulator end-effector also attracts increasing attention. This problem is complex due to the existence of obstacles. Therefore, it is essential to avoid obstacles in order to improve planning of space manipulator end-effector. In this paper, we proposed an improved ant colony algorithm to solve this problem, which is effective and simple. Firstly, the models were established respectively, including the kinematic model of space manipulator and expression of valid path in space environment. Secondly, we described an improved ant colony algorithm in detail, which can avoid trapping into local optimum. The search strategy, transfer rules, and pheromone update methods were all adjusted. Finally, the improved ant colony algorithm was compared with the classic ant colony algorithm through the experiments. The simulation results verify the correctness and effectiveness of the proposed algorithm. PMID:27186473

  7. Improving IMRT delivery efficiency with reweighted L1-minimization for inverse planning

    SciTech Connect

    Kim, Hojin; Becker, Stephen; Lee, Rena; Lee, Soonhyouk; Shin, Sukyoung; Candes, Emmanuel; Xing Lei; Li Ruijiang

    2013-07-15

    Purpose: This study presents an improved technique to further simplify the fluence-map in intensity modulated radiation therapy (IMRT) inverse planning, thereby reducing plan complexity and improving delivery efficiency, while maintaining the plan quality.Methods: First-order total-variation (TV) minimization (min.) based on L1-norm has been proposed to reduce the complexity of fluence-map in IMRT by generating sparse fluence-map variations. However, with stronger dose sparing to the critical structures, the inevitable increase in the fluence-map complexity can lead to inefficient dose delivery. Theoretically, L0-min. is the ideal solution for the sparse signal recovery problem, yet practically intractable due to its nonconvexity of the objective function. As an alternative, the authors use the iteratively reweighted L1-min. technique to incorporate the benefits of the L0-norm into the tractability of L1-min. The weight multiplied to each element is inversely related to the magnitude of the corresponding element, which is iteratively updated by the reweighting process. The proposed penalizing process combined with TV min. further improves sparsity in the fluence-map variations, hence ultimately enhancing the delivery efficiency. To validate the proposed method, this work compares three treatment plans obtained from quadratic min. (generally used in clinic IMRT), conventional TV min., and our proposed reweighted TV min. techniques, implemented by a large-scale L1-solver (template for first-order conic solver), for five patient clinical data. Criteria such as conformation number (CN), modulation index (MI), and estimated treatment time are employed to assess the relationship between the plan quality and delivery efficiency.Results: The proposed method yields simpler fluence-maps than the quadratic and conventional TV based techniques. To attain a given CN and dose sparing to the critical organs for 5 clinical cases, the proposed method reduces the number of segments

  8. Improving Therapeutic Relationships: Joint Crisis Planning for Individuals With Psychotic Disorders.

    PubMed

    Farrelly, Simone; Lester, Helen; Rose, Diana; Birchwood, Max; Marshall, Max; Waheed, Waquas; Henderson, R Claire; Szmukler, George; Thornicroft, Graham

    2015-12-01

    Outcomes for individuals with psychosis remain far from acceptable. Recently, prominent psychiatrists have called for an improved understanding of the impact of social contexts, and how social contexts might influence the development and maintenance of mental health problems. A key social context for individuals with psychosis is the therapeutic relationship. As part of a trial of joint crisis planning in England, this qualitative study aimed to determine the mechanism through which joint crisis planning might affect the therapeutic relationship. Results suggest that routine processes in mental health care are affected by policy and organizational requirements for risk mitigation-aspects that undermine person-centered approaches. In contrast, strong therapeutic relationships are characterized by individualized care and reliable and respectful treatment. The Joint Crisis Plan intervention partially succeeded in reducing contextual influences on routine role enactments, facilitating the demonstration of respect and improving the therapeutic relationship. PMID:25583956

  9. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Quality assessment and performance improvement plan. 460.132 Section 460.132 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)...

  10. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assessment and performance improvement plan. 460.132 Section 460.132 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)...

  11. Using COPE To Improve Quality of Care: The Experience of the Family Planning Association of Kenya.

    ERIC Educational Resources Information Center

    Bradley, Janet

    1998-01-01

    COPE (Client-Oriented, Provider-Efficient) methodology, a self-assessment tool that has been used in 35 countries around the world, was used to improve the quality of care in family planning clinics in Kenya. COPE involves a process that legitimately invests power with providers and clinic-level staff. It gives providers more control over their…

  12. Transition Plan for Improving Facility Accessibility by Handicapped Students at Amarillo College.

    ERIC Educational Resources Information Center

    Amarillo Coll., TX.

    In compliance with the Rehabilitation Act of 1973, Section 504, this transition report identifies architectural barriers at two Amarillo College campuses, recommends modifications to improve facility accessibility for the handicapped, presents an implementation schedule and estimated costs for the modifications, and provides a plan for publicizing…

  13. 77 FR 3435 - General Conference Committee of the National Poultry Improvement Plan; Cancellation of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-24

    ... INFORMATION: In a document published in the Federal Register on January 9, 2012 (77 FR 1051-1052, Docket No... Animal and Plant Health Inspection Service General Conference Committee of the National Poultry... Conference Committee of the National Poultry Improvement Plan scheduled for January 25, 2012, has...

  14. 78 FR 18974 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... including electric system operators, software developers, government, research centers and academia for the... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software; Notice... Software Take notice that Commission staff will convene a technical conference on June 24, 25, and 26,...

  15. Coming Together through Comprehensive Professional Development: Key to Statewide Improvement Plans.

    ERIC Educational Resources Information Center

    Rude, Harvey; Murray, Karl; Stockhouse, Judy

    The 1997 reauthorization of the Individuals with Disabilities Education Act (IDEA) requires states to develop state improvement plans (SIPs) that include provisions supporting the professional development of all persons who work with disabled children. The National Association of State Directors of Special Education is establishing a professional…

  16. 42 CFR 441.745 - State plan HCBS administration: State responsibilities and quality improvement.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false State plan HCBS administration: State responsibilities and quality improvement. 441.745 Section 441.745 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: REQUIREMENTS AND LIMITS APPLICABLE TO...

  17. How Schools Can Effectively Plan to Meet the Goal of Improving Student Learning

    ERIC Educational Resources Information Center

    Grumdahl, Constance Rae

    2010-01-01

    Purpose. The purpose of the study was to identify the impact on achievement when schools implement a continuous improvement model using Total Quality Management (TQM) principles aligned to strategic planning and the culture of the school. Data collection and analysis. The study combined qualitative and quantitative methods and was conducted in two…

  18. Developing Quality Strategic Plan in Secondary Schools for Successful School Improvement

    ERIC Educational Resources Information Center

    Chukwumah, Fides Okwukweka

    2015-01-01

    The study examined the extent to which development of quality strategic plans for Anambra State secondary schools' improvement had been done by schools. The research design used was a descriptive survey. Respondents comprised 217 principals. There was no sampling since all the principals were used. Data were collected using "Schools'…

  19. Problems of Implementation of Strategic Plans for Secondary Schools' Improvement in Anambra State

    ERIC Educational Resources Information Center

    Chukwumah, Fides Okwukweka; Ezeugbor, Carol Obiageli

    2015-01-01

    This study investigated the extent of problems of strategic plans implementation for secondary schools' improvement in Anambra State, Nigeria for quality education provision. The study used a descriptive survey design paradigm. Respondents comprised 217 principals. There was no sampling. All the principals were used. Data were collected using…

  20. Coupling the Biophysical and Social Dimensions of Wildfire Risk to Improve Wildfire Mitigation Planning.

    PubMed

    Ager, Alan A; Kline, Jeffrey D; Fischer, A Paige

    2015-08-01

    We describe recent advances in biophysical and social aspects of risk and their potential combined contribution to improve mitigation planning on fire-prone landscapes. The methods and tools provide an improved method for defining the spatial extent of wildfire risk to communities compared to current planning processes. They also propose an expanded role for social science to improve understanding of community-wide risk perceptions and to predict property owners' capacities and willingness to mitigate risk by treating hazardous fuels and reducing the susceptibility of dwellings. In particular, we identify spatial scale mismatches in wildfire mitigation planning and their potential adverse impact on risk mitigation goals. Studies in other fire-prone regions suggest that these scale mismatches are widespread and contribute to continued wildfire dwelling losses. We discuss how risk perceptions and behavior contribute to scale mismatches and how they can be minimized through integrated analyses of landscape wildfire transmission and social factors that describe the potential for collaboration among landowners and land management agencies. These concepts are then used to outline an integrated socioecological planning framework to identify optimal strategies for local community risk mitigation and improve landscape-scale prioritization of fuel management investments by government entities. PMID:25968881

  1. 77 FR 19280 - Increasing Market and Planning Efficiency Through Improved Software; Notice of Technical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-30

    ... Energy Regulatory Commission Increasing Market and Planning Efficiency Through Improved Software; Notice... Software Take notice that Commission staff will convene a technical conference on June 25, 26, and 27, 2012... software. A detailed agenda with the list of and times for the selected speakers will be published on...

  2. Planning and Financing School Improvement and Construction Projects. NOLPE Monograph Series, No. 57.

    ERIC Educational Resources Information Center

    Bittle, Edgar H., Ed.

    Suggestions and guidelines to help school administrators, business officials, board members, and others interested in improving school facilities are presented in this book. Chapter 1, "School Building Programs, Equipment Acquisition: The Anatomy of School Debt Financing" (Edgar H. Bittle), provides an overview of the legal and planning issues…

  3. Family planning's benefits include improved child health and nutrition: new data from Bangladesh.

    PubMed

    Greenspan, A

    1993-09-01

    2 recent studies from the Matlab in Bangladesh confirm that family planning promotes child survival. The 1st study is a longitudinal analysis of 3370 births in 1985 to women living in 70 villages who were served by the International Centre for Diarrhoeal Disease Research, Bangladesh's Matlab Family Planning and Health Services Project. The 2nd is a study of 12-26 month old children and 24-36 month old children, all of whom were born in the same 70 villages between July 1985 and June 1986. The 1st study demonstrates that family planning improves child survival by lengthening the birth interval. In fact, if women delay a subsequent birth by about 2 years, child survival improves at all ages up to 5 years. Longer birth intervals result in a reduction of very high order births. The same study also reveals that family planning improves child survival indirectly by granting mothers access to integrated maternal and child health services. The 2nd study indicates that a child is 3 times more likely to suffer malnutrition, even at age 3, than a child whose mother gives birth again at an interval greater than 24 months. Specifically, the mother removes the index child from the breast prematurely, thereby adversely affecting the index child's nutrition. The birth interval prior to the index child does not adversely affect the index child's nutritional status, however. The 2nd study's result suggest that birth spacing, as promoted by family planning programs, improves child health and nutrition. The findings from these studies show the importance of continued investments in family planning programs in developing countries. PMID:12345277

  4. Parent Involvement Activities in School Improvement Plans in the Northwest Region. Summary. Issues & Answers. REL 2008-No. 064

    ERIC Educational Resources Information Center

    Speth, Timothy; Saifer, Steffen; Forehand, Gregory

    2008-01-01

    This document presents a summary of the larger report, "Parent Involvement Activities in School Improvement Plans in the Northwest Region." Although the No Child Left Behind Act of 2001 (NCLB) spells out parent involvement requirements for schools in need of improvement, the majority of the Northwest Region school improvement plans reviewed failed…

  5. Strategic planning as a focus for continuous improvement. A case study

    NASA Technical Reports Server (NTRS)

    Oneill, John W.; Gordon-Winkler, Lyn

    1992-01-01

    What do most of the successful people and organizations in our world have in common? Instead of worrying about the future, they work to create it. They have a plan, or a vision of what they want to accomplish and they focus their efforts on success. Strategic planning has been described as a disciplined, ongoing process to produce fundamental decisions and actions that shape what an organization is, what it does, and how it will respond to a changing environment. This case study discussion will evaluate the relationship between strategic planning and Total Quality Management (TQM), or continuous improvement, through the experience of the NASA Johnson Space Center in developing a strategy for the future. That experience clearly illustrates the value of strategic planning in setting the framework and establishing the overall thrust of continuous improvement initiatives. Equally significant, the fundamentals of a quality culture such as strong customer and supplier partnerships, participative involvement, open communications, and ownership were essential in overcoming the challenges inherent in the planning process. A reinforced management commitment to the quality culture was a clear, long-term benefit.

  6. Improvements in manual dexterity relate to improvements in cognitive planning after assisted cycling therapy (ACT) in adolescents with down syndrome.

    PubMed

    Holzapfel, Simon D; Ringenbach, Shannon D R; Mulvey, Genna M; Sandoval-Menendez, Amber M; Cook, Megan R; Ganger, Rachel O; Bennett, Kristen

    2015-01-01

    We have previously reported beneficial effects of acute (i.e., single session) Assisted Cycling Therapy (ACT) on manual dexterity and cognitive planning ability in adolescents with Down syndrome (DS). In the present study, we report the chronic effects of eight weeks of ACT, voluntary cycling (VC), and no cycling (NC), on the same measures in adolescents with DS. Participants completed 8 weeks of ACT, VC, or NC. Those in the ACT and VC groups completed 30min sessions three times per week on a stationary bicycle. During ACT, the mechanical motor of the bicycle augmented the cadence to a rate which was on average 79% faster than the voluntary cadence. During VC, the participants pedaled at a self-selected rate. Unimanual dexterity scores as measured with the Purdue Pegboard test (PPT) improved significantly more for the ACT and VC groups compared to the NC group. ACT lead to greater improvements than VC and NC in the assembly sub-test, which is a task that requires more advanced temporal and spatial processing. The ACT group improved significantly more than the VC group and non-significantly more than the NC group in cognitive planning ability as measured by the Tower of London test (ToL). There were also significant correlations between the assembly subtest of the PPT and all measures of the ToL. These correlations were stronger during post-testing than pre-testing. Pre-post changes in the combined PPT score and ToL number of correct moves correlated positively in the ACT group. These results support the efficacy of the salutary effects of ACT on global fine motor function and executive function in DS. Additionally, the performance on complex bimanual dexterity tasks appears to be related to the capacity of cognitive planning ability. This research has important implications for persons with movement deficits that affect activities of daily living. PMID:26280691

  7. [How to expand and improve the coverage of family planning services: a Latin American viewpoint].

    PubMed

    Trias, M

    1992-12-01

    It is probably not possible to implant a family planning program that will have a reasonable demographic impact in areas lacking awareness of the disadvantages of overly high fertility. Rural-urban migration, increasing educational levels, women's labor force participation, and declining infant mortality are all factors that have been found to correlate with demand for family planning services. It has been recognized since the Bucharest World Population Conference in 1974 that development and family planning are both required for the fertility transition to begin. Where these conditions exist, a family planning program appropriate to the needs, limitations, preferences, and expectations of the target population has an excellent chance of success. Expanded and improved coverage results from tailoring programs to the specific groups served. Most programs are directed toward women. It has been found most effective to provide services for men in separate sessions. It is also useful to distinguish between services for adolescents, who require more information and fewer services, for mature women who require more services than information, and for premenopausal women whose needs for information and services are both declining. Contraceptive preferences vary with social class, but family planning programs in developing countries should concentrate on the lower middle and lower classes which comprise 80% of the population. Rural areas and marginal urban areas require special attention. In order to provide services that will attract all potential users, the maximum possible variety of methods should be available. A family planning program offering a variety of methods throughout the country and financially accessible to the population should be successful. Family planning programs, whether public or private, require adequate financial resources and the support or at least tolerance of the government. Knowledge of contraception is now almost universal. A major challenge of

  8. Improving outpatient diabetes management through a collaboration of six competing, capitated Medicare managed care plans.

    PubMed

    Marshall, C L; Bluestein, M; Briere, E; Chapin, C; Darling, B; Davis, K; Davis, T; Gersten, J; Harris, C; Hodgin, A; Larsen, W; Mabb, D; Rigberg, H; Watson, D; Krishnaswami, V

    2000-01-01

    This report addresses diabetes care in the managed care setting and improvement in care brought about by collaboration between 6 Medicare managed care plans (MCPs) and a Peer Review Organization (PRO). The objective was to improve the quality of care of outpatient diabetes patients provided by primary care physicians through the mutual collaboration of 6 Medicare managed care plans and a Medicare Peer Review Organization. The design involved pre-post intervention trial based on 2 random samples, a baseline sample drawn in 1995 and a remeasurement sample drawn in 1996. Medical records of patients in both samples were reviewed by the PRO to determine provision of 14 quality indicator services over a 1-year period. The setting was 6 Arizona Medicare managed care plans comprising approximately 40% of the Arizona Medicare population. Two random samples were drawn from type 2 diabetes patients continuously enrolled in the same managed care plan for at least 1 year. The intervention was comparative feedback of baseline data by the PRO, enabling each plan to compare itself to any other plan on any or all indicators. Each plan developed and implemented its own intervention in response to the 1995 baseline results. The main outcome measures were mean HbA1c, the proportion of HbA1c values below 8%, and positive change in provision of 14 quality indicator services. At postintervention remeasurement, mean HbA1c values fell from 8.9 +/- 2.2 to 7.9% +/- 2.1, and the proportion of patients with HbA1c values below 8.0% rose from 40% to 61.6%. The proportion of the 14 indicator services provided to patients rose from 35% to 55%. The mean number of physician office visits fell 13% and the number of services provided per visit doubled. We conclude that improving the process of care improves glycemic control. Better outpatient diabetes management in competing, capitated managed care plans is an attainable goal when mediated through a neutral third party such as a PRO. PMID:10763220

  9. Evaluation of standardized teaching plans for hospitalized pediatric patients: a performance improvement project.

    PubMed

    Blagojevic, Joanne; Stephens, Sigrid

    2008-01-01

    Discharge teaching in a pediatric hospital setting is difficult because the situation involves multiple learners, time constraints, and differing skill levels of nurse teachers. Shortened length of stay forces nurses to complete patient education efficiently. Unstructured education can lead to failed learning, as evidenced by readmissions and postdischarge feedback. A performance improvement project was conducted to evaluate the effectiveness of standardized teaching plans for diabetes mellitus and infant cardiopulmonary resuscitation. Preliminary data indicated a passing score of at least 90% on posttests by all learners, suggesting that standardized teaching plans may help nurses complete prescribed discharge teaching. PMID:18507236

  10. Internal structure of the Aar Massif: What can we learn in terms of exploration for deep geothermal energy?

    NASA Astrophysics Data System (ADS)

    Herwegh, Marco; Baumberger, Roland; Wehrens, Philip; Schubert, Raphael; Berger, Alfons; Maeder, Urs; Spillmann, Thomas

    2014-05-01

    The successful use of deep geothermal energy requires 3D flow paths, which allow an efficient heat exchange between the surrounding host rocks and the circulating fluids. Recent attempts to exploit this energy resource clearly demonstrate that the new technology is facing sever problems. Some major problems are related to the prediction of permeability, the 3D structure of the flow paths and the mechanical responses during elevated fluid pressures at depths of several kilometers. Although seemingly new in a technical perspective, nature is facing and solving similar problems since the beginning of the Alpine orogeny. Based on detailed studies in the Hasli Valley (Aar Massif) we can demonstrate that deformation and fluid flow are strongly localized along mechanical anisotropies (e.g. lithological variations, brittle and ductile faults). Some of them already evolved during Variscan and post-Variscan times. Interestingly, these inherited structures are reactivated over and over again during the Alpine orogeny. Their reactivation occurred at depths of ~13-15 km with elevated temperatures (400-475°C) and involved both ductile and brittle deformation processes. Brittle deformation in form of hydrofracking was always present due to the circulating fluids. It is this process, which was and still is responsible for seismic activity. With progressive uplift and exhumation of the Aar Massif, ductile deformation structures became replaced by brittle cataclasites and fault gouges during fault activity at shallower crustal levels. Existing hydrotest data from the Grimsel Test Site (Nagra's underground research laboratory) indicate that these brittle successors of the ductile shear zones are domains of enhanced recent fluid percolation. Note that although being exposed today, the continuation of these fault structures are still active at depth in both brittle and ductile deformation modes, a fact that can be inferred from recent uplift rates and the active seismicity. On the

  11. Effectiveness of Improvement Plans in Primary Care Practice Accreditation: A Clustered Randomized Trial

    PubMed Central

    Nouwens, Elvira; van Lieshout, Jan; Bouma, Margriet; Braspenning, Jozé; Wensing, Michel

    2014-01-01

    Background Accreditation of healthcare organizations is a widely used method to assess and improve quality of healthcare. Our aim was to determine the effectiveness of improvement plans in practice accreditation of primary care practices, focusing on cardiovascular risk management (CVRM). Method A two-arm cluster randomized controlled trial with a block design was conducted with measurements at baseline and follow-up. Primary care practices allocated to the intervention group (n = 22) were instructed to focus improvement plans during the intervention period on CVRM, while practices in the control group (n = 23) could focus on any domain except on CVRM and diabetes mellitus. Primary outcomes were systolic blood pressure <140 mmHg, LDL cholesterol <2.5 mmol/l and prescription of antiplatelet drugs. Secondary outcomes were 17 indicators of CVRM and physician's perceived goal attainment for the chosen improvement project. Results No effect was found on the primary outcomes. Blood pressure targets were reached in 39.8% of patients in the intervention and 38.7% of patients in the control group; cholesterol target levels were reached in 44.5% and 49.0% respectively; antiplatelet drugs were prescribed in 82.7% in both groups. Six secondary outcomes improved: smoking status, exercise control, diet control, registration of alcohol intake, measurement of waist circumference, and fasting glucose. Participants' perceived goal attainment was high in both arms: mean scores of 7.9 and 8.2 on the 10-point scale. Conclusions The focus of improvement plans on CVRM in the practice accreditation program led to some improvements of CVRM, but not on the primary outcomes. ClinicalTrials.gov NCT00791362 PMID:25463149

  12. Monitoring Commission for Desegregation Implementation's Analysis of the Level of Compliance of Project CANAL's School Improvement Plans (1989-90).

    ERIC Educational Resources Information Center

    Davidson, Mary E.; And Others

    This evaluation analyzes the School Improvement Plans (SIPs) produced by the core planning teams of Project Creating a New Approach to Learning (CANAL), part of a court-mandated desegregation plan to reduce inequities in predominantly Black and Hispanic American schools in Chicago (Illinois). CANAL's goal is to organize and train core planning…

  13. Quality initiatives: planning, setting up, and carrying out radiology process improvement projects.

    PubMed

    Tamm, Eric P; Szklaruk, Janio; Puthooran, Leejo; Stone, Danna; Stevens, Brian L; Modaro, Cathy

    2012-01-01

    In the coming decades, those who provide radiologic imaging services will be increasingly challenged by the economic, demographic, and political forces affecting healthcare to improve their efficiency, enhance the value of their services, and achieve greater customer satisfaction. It is essential that radiologists master and consistently apply basic process improvement skills that have allowed professionals in many other fields to thrive in a competitive environment. The authors provide a step-by-step overview of process improvement from the perspective of a radiologic imaging practice by describing their experience in conducting a process improvement project: to increase the daily volume of body magnetic resonance imaging examinations performed at their institution. The first step in any process improvement project is to identify and prioritize opportunities for improvement in the work process. Next, an effective project team must be formed that includes representatives of all participants in the process. An achievable aim must be formulated, appropriate measures selected, and baseline data collected to determine the effects of subsequent efforts to achieve the aim. Each aspect of the process in question is then analyzed by using appropriate tools (eg, flowcharts, fishbone diagrams, Pareto diagrams) to identify opportunities for beneficial change. Plans for change are then established and implemented with regular measurements and review followed by necessary adjustments in course. These so-called PDSA (planning, doing, studying, and acting) cycles are repeated until the aim is achieved or modified and the project closed. PMID:22745219

  14. Amino acid racemization analysis (AAR) as a successful tool for dating Holocene coastal sediments: Stratigraphy of a barrier island spit (Southern Sylt/North Sea)

    NASA Astrophysics Data System (ADS)

    Tillmann, Tanja; Ziehe, Daniel

    2014-05-01

    Dating of Holocene sediments in shallow coastal areas of the German North Sea by conventional techniques is commonly problematic. In particular the marine reservoir effect of radiocarbon means that radiocarbon dating cannot be applied to sediments younger than about 400 years. Amino acid racemization dating (AAR) is a viable alternative for dating young sediments. The method is based on the determination of ratios of D and L amino acid enantiomers in organic matrices of biogenic carbonates. In this study we use AAR as a tool for dating Holocene barrier islands sediments. Based on an AAR derived chronological framework we develop a model of barrier spit accretion which describes the interaction between extreme events, fair weather coastal processes and sedimentary development that constrains the major episodes of barrier island evolution. The stratigraphy was defined using ground-penetrating radar (GPR) surveys complemented by sedimentological coring data. The stratigraphy is then conceptualised in a AAR chronostratigraphic framework to define a chronological order and allow the development of a stratigraphic model of the evolution of Southern Sylt. The AAR data provide high temporal resolution and have been used for dating stages of barrier spit accretion. The time lines are marked as storm surge generated erosion unconformities in the stratigraphic profile. Individual shells and shell fragments of Cerastoderma edule, Mya arenaria, Mytilus edulis and Scrobicularia plana have been accumulated by short-term storm events as shell layers associated with the erosion unconformities and have been dated by AAR. Time lines reveal that the barrier spit accretion occurred episodically, and is dependant on the provided rate of sand delivery. The general trend is that sequences young to the. South. The AAR derived time lines have been verified and correlated by historic maps and sea charts. It is apparent that spit enlargement at this site increased significantly during the

  15. Performance of and planned improvements to a mountain altitude cosmic ray mass spectrometer

    NASA Technical Reports Server (NTRS)

    Jones, J. J.; Barber, H. B.; Bowen, T.; Delise, D. A.; Jenkins, E. W.; Kalbach, R. M.; Pifer, A. E.; Rothschild, R. E.; Thompson, N. A.

    1975-01-01

    A cosmic ray mass spectrometer with superconducting magnet, wire spark chambers, and time-of-flight scintillation counters has been operated at an altitude of 2750 meters. Various specifications of the spectrometer are presented and the method of event analysis described. Corrections to the data, resolutions and efficiencies of the spark chambers, and momentum resolution are discussed. Recent and planned improvements of the apparatus are indicated.

  16. New York State Board of Regents Action Plan to Improve Elementary and Secondary Education Results in New York.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany.

    This report presents a comprehensive plan to improve teaching and learning in New York State's public and private schools. After surveying school improvement efforts since 1977, characteristics of New York education, and the state Board of Regents' recent goals review, the report states the regents' goals underlying this action plan. These…

  17. Identification of trends and patterns in sediment geochemistry from the Aare delta plain, Swiss Alps.

    NASA Astrophysics Data System (ADS)

    Carvalho, Filipe; Schulte, Lothar

    2015-04-01

    The study of fluvial systems by means of sediment cores is one of the most interesting approaches to understand the spatial and temporal pattern of river dynamics under the influence of different driving forces such as climate variability and human activities. This work focuses on the analysis of the geochemistry of fluvial sediments from the Aare delta plain in the Swiss Alps.The analysis of sediment cores allowed the identification of trends and patterns in sediment geochemistry. It was possible to identify diverse sedimentation phases in the delta plain, marked by differences in sedimentation processes and characterized by decreasing grain size sequences. It is worth mentioning the importance of peat formations in this sedimentary environment, reaching several centimeters thick in some cases. These horizons are normally associated with very low concentrations of chemical elements from the mineral fraction, such as Si, Al, Fe, and K. The general trends in geochemistry indicate the dominance of elements such as Al and Si, which have similar variability in all cores. It is noted that these elements have a reasonably good correlation with grain size and inverse relation with organic matter content. Factor analysis was used to study the geochemical data set of 3 sediment cores. This analysis is based on a statistical description of the variability of the correlated data where a smaller number of not observed variables are obtained (factors). Factor analysis attempts to find joint variation of the data series and presents that response as unobservable latent variables. In this study, factor analysis was conducted with the major chemical elements: Al, Si, P, K, Ca, Ti, Mn, Fe, Cu, Zn, Pb and also the percentage of TOC. Variations of these 12 inorganic and organic elements are reflected in two unobserved variables, factor 1 and factor 2. Factor analysis has enabled the recognition of two clusters: 1) a group of elements that include the TOC and metals, which are

  18. A System for Continual Quality Improvement of Normal Tissue Delineation for Radiation Therapy Treatment Planning

    SciTech Connect

    Breunig, Jennifer; Hernandez, Sophy; Lin, Jeffrey; Alsager, Stacy; Dumstorf, Christine; Price, Jennifer; Steber, Jennifer; Garza, Richard; Nagda, Suneel; Melian, Edward; Emami, Bahman; Roeske, John C.

    2012-08-01

    Purpose: To implement the 'plan-do-check-act' (PDCA) cycle for the continual quality improvement of normal tissue contours used for radiation therapy treatment planning. Methods and Materials: The CT scans of patients treated for tumors of the brain, head and neck, thorax, pancreas and prostate were selected for this study. For each scan, a radiation oncologist and a diagnostic radiologist, outlined the normal tissues ('gold' contours) using Radiation Therapy Oncology Group (RTOG) guidelines. A total of 30 organs were delineated. Independently, 5 board-certified dosimetrists and 1 trainee then outlined the same organs. Metrics used to compare the agreement between the dosimetrists' contours and the gold contours included the Dice Similarity Coefficient (DSC), and a penalty function using distance to agreement. Based on these scores, dosimetrists were re-trained on those organs in which they did not receive a passing score, and they were subsequently re-tested. Results: Passing scores were achieved on 19 of 30 organs evaluated. These scores were correlated to organ volume. For organ volumes <8 cc, the average DSC was 0.61 vs organ volumes {>=}8 cc, for which the average DSC was 0.91 (P=.005). Normal tissues that had the lowest scores included the lenses, optic nerves, chiasm, cochlea, and esophagus. Of the 11 organs that were considered for re-testing, 10 showed improvement in the average score, and statistically significant improvement was noted in more than half of these organs after education and re-assessment. Conclusions: The results of this study indicate the feasibility of applying the PDCA cycle to assess competence in the delineation of individual organs, and to identify areas for improvement. With testing, guidance, and re-evaluation, contouring consistency can be obtained across multiple dosimetrists. Our expectation is that continual quality improvement using the PDCA approach will ensure more accurate treatments and dose assessment in radiotherapy

  19. The Best Laid Plans: Examining the Conditions under Which a Planning Intervention Improves Learning and Reduces Attrition

    ERIC Educational Resources Information Center

    Sitzmann, Traci; Johnson, Stefanie K.

    2012-01-01

    Planning plays an instrumental role in prominent self-regulation theories (e.g., action regulation, control, goal setting), yet as a scientific community we know little about how people carry out their learning plans. Using an experimental field study, we implemented a repeated-measures intervention requiring trainees to create a plan for when,…

  20. Integrating family planning into postpartum care through modern quality improvement: experience from Afghanistan

    PubMed Central

    Tawfik, Youssef; Rahimzai, Mirwais; Ahmadzai, Malalah; Clark, Phyllis Annie; Kamgang, Evelyn

    2014-01-01

    To address low contraceptive use in Afghanistan, we supported 2 large public maternity hospitals and 3 private hospitals in Kabul to use modern quality improvement (QI) methods to integrate family planning into postpartum care. In 2012, QI teams comprising hospital staff applied root cause analysis to identify barriers to integrated postpartum family planning (PPFP) services and to develop solutions for how to integrate services. Changes made to service provision to address identified barriers included creating a private counseling space near the postpartum ward, providing PPFP counseling training and job aids to staff, and involving husbands and mothers-in-law in counseling in person or via mobile phones. After 10 months, the proportion of postpartum women who received family planning counseling before discharge in the 5 hospitals increased from 36% to 55%, and the proportion of women who received family planning counseling with their husbands rose from 18% to 90%. In addition, the proportion of postpartum women who agreed to use family planning and left the hospital with their preferred method increased from 12% to 95%. Follow-up telephone surveys with a random sample of women who had received PPFP services in the 2 public hospitals and a control group of postpartum women who had received routine hospital services found significant differences in the proportion of women with self-reported pregnancies: 3% vs. 15%, respectively, 6 months after discharge; 6% vs. 22% at 12 months; and 14% vs. 35% at 18 months (P < .001). Applying QI methods helped providers recognize and overcome barriers to integration of family planning and postpartum services by testing changes they deemed feasible. PMID:25276580

  1. Can particle beam therapy be improved using helium ions? - a planning study focusing on pediatric patients.

    PubMed

    Knäusl, Barbara; Fuchs, Hermann; Dieckmann, Karin; Georg, Dietmar

    2016-06-01

    Aim To explore the potential of scanned helium ion beam therapy ((4)He) compared to proton therapy in a comparative planning study focusing on pediatric patients. This was motivated by the superior biological and physical characteristics of (4)He. Material and methods For eleven neuroblastoma (NB), nine Hodgkin lymphoma (HL), five Wilms tumor (WT), five ependymoma (EP) and four Ewing sarcoma (EW) patients, treatment plans were created for protons and (4)He. Dose prescription to the planning target volume (PTV) was 21 Gy [relative biological effectiveness (RBE)] (NB), 19.8 Gy (RBE) (HL), 25.2 Gy (RBE) for the WT boost volume and 54 Gy (RBE) for EP and EW patients. A pencil beam algorithm for protons (constant RBE = 1.1) and (4)He was implemented in the treatment planning system Hyperion. For (4)He the relative biological effectiveness (RBE) was calculated with a 'zonal' model based on different linear energy transfer regions. Results Target constraints were fulfilled for all indications. For NB patients differences for kidneys and liver were observed for all dose-volume areas, except the high-dose volume. The body volume receiving up to 12.6 Gy (RBE) was reduced by up to 10% with (4)He. For WT patients the mean and high-dose volume for the liver was improved when using (4)He. For EP normal tissue dose was reduced using (4)He with 12.7% of the voxels receiving higher doses using protons. For HL and EW sarcoma patients the combination of large PTV volumes with the position of the organs at risk (OARs) obliterated the differences between the two particle species, while patients with the heart close to the PTV could benefit from (4)He. Conclusion Treatment plan quality improved with (4)He compared to proton plans, but advantages in OAR sparing were depending on indication and tumor geometries. These first results of scanned (4)He therapy motivate comprehensive research on (4)He, including acquisition of experimental data to improve modeling of (4)He. PMID

  2. Middle Fork and Upper Salmon River Habitat Improvement Implementation Plan, FY 1988-1992.

    SciTech Connect

    Andrews, John; Everson, Larry B.

    1988-02-01

    This document presents an implementation plan for completing the phase II portion of the Middle Fork and Upper Salmon River Habitat Improvement Agreement. Underseeding of spawning adult salmon and steelhead, high instream sediment levels, a lack of habitat diversity in the form of overhanging riparian vegetation and edge, and barriers to both adult and juvenile anadromous fish migration were identified as the principal factors limiting anadromous fish production in the project area. Underseeding is being addressed in other projects sponsored and funded by the Bonneville Power Administration while this implementation plan lays out a schedule for resolving the other identified limiting factors. The primary goal of this program is to increase the quality and quantity of anadromous fish habitat (spring chinook and summer steelhead) with an emphasis on the survival of the wild stocks. This goal will be achieved by reducing the impact of sediment loading, improving riparian vegetation, eliminating passage barriers, and increasing habitat diversity. Meeting the above goal will provide off-site mitigation under the manadate of the pacific northwest electric power planning and conservation act of 1980. Project implementation will follow measures in the Northwest Power Council's Columbia River Fish and Wildlife Program. 9 refs., 3 figs., 5 tabs.

  3. The Planning and Scheduling of HST: Improvements and Enhancements since Launch

    NASA Astrophysics Data System (ADS)

    Taylor, D. K.; Chance, D. R.; Jordan, I. J. E.; Patterson, A. P.; Stanley, M.; Taylor, D. C.

    2001-12-01

    The planning and scheduling (P&S) systems used in operating the Hubble Space Telescope (HST) have undergone such substantial and pervasive re-engineering that today they dimly resemble those used when HST was launched. Processes (i.e., software, procedures, networking, etc.) which allow program implementation, the generation of a Long Range Plan (LRP), and the scheduling of science and mission activities have improved drastically in nearly 12 years, resulting in a consistently high observing efficiency, a stable LRP that principal investigators can use, exceptionally clean command loads uplinked to the spacecraft, and the capability of a very fast response time due to onboard anomalies or targets of opportunity. In this presentation we describe many of the systems which comprise the P&S ("front-end") system for HST, how and why they were improved, and what benefits have been realized by either the HST user community or the STScI staff. The systems include the Guide Star System, the Remote Proposal Submission System - 2 (RPS2), Artificial Intelligence (AI) planning tools such as Spike, and the science and mission scheduling software. We also describe how using modern software languages such as Python and better development practices allow STScI staff to do more with HST (e.g., to handle much more science data when ACS is installed) without increasing the cost to HST operations.

  4. Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives

    PubMed Central

    Grol, Richard PTM; Bosch, Marije C; Hulscher, Marlies EJL; Eccles, Martin P; Wensing, Michel

    2007-01-01

    A consistent finding in articles on quality improvement in health care is that change is difficult to achieve. According to the research literature, the majority of interventions are targeted at health care professionals. But success in achieving change may be influenced by factors other than those relating to individual professionals, and theories may help explain whether change is possible. This article argues for a more systematic use of theories in planning and evaluating quality-improvement interventions in clinical practice. It demonstrates how different theories can be used to generate testable hypotheses regarding factors that influence the implementation of change, and it shows how different theoretical assumptions lead to different quality-improvement strategies. PMID:17319808

  5. Action plans for COPD: strategies to manage exacerbations and improve outcomes.

    PubMed

    Jalota, Leena; Jain, Vipul V

    2016-01-01

    COPD is the third-largest killer in the world, and certainly takes a toll on the health care system. Recurrent COPD exacerbations accelerate lung-function decline, worsen mortality, and consume over US$50 billion in health care spending annually. This has led to a tide of payment reforms eliciting interest in strategies reducing preventable COPD exacerbations. In this review, we analyze and discuss the evidence for COPD action plan-based self-management strategies. Although action plans may provide stabilization of acute symptomatology, there are several limitations. These include patient-centered attributes, such as comprehension and adherence, and nonadherence of health care providers to established guidelines. While no single intervention can be expected independently to translate into improved outcomes, structured together within a comprehensive integrated disease-management program, they may provide a robust paradigm. PMID:27330286

  6. Contingency plan improvement for managing oil spills in the coastal waters of Thailand.

    PubMed

    Singkran, Nuanchan

    2014-12-15

    The estimated risks of being impacted by oil spills in the coastal waters were used to improve the oil spill contingency plan of Thailand. Functional roles of local agencies are integrated into the plan. Intensive measures are suggested for the coastal provinces located in high-very high risk zones, whereas light and moderate measures are suggested for the coastal provinces located in low and moderate risk zones, respectively. The estimated percentage risks due to simulated oil slicks hitting the coast and/or important resources (PRoilspill) were used to guide the year-round water activities that should be carefully handled at a certain radius with a low-moderate PRoilspill, whereas they should be avoided at a certain radius with a high-very high PRoilspill. Important measures before, during, and post periods of an oil spill incident are suggested to prevent and monitor oil spill incidents and mitigate their impacts on the environment. PMID:25455821

  7. Action plans for COPD: strategies to manage exacerbations and improve outcomes

    PubMed Central

    Jalota, Leena; Jain, Vipul V

    2016-01-01

    COPD is the third-largest killer in the world, and certainly takes a toll on the health care system. Recurrent COPD exacerbations accelerate lung-function decline, worsen mortality, and consume over US$50 billion in health care spending annually. This has led to a tide of payment reforms eliciting interest in strategies reducing preventable COPD exacerbations. In this review, we analyze and discuss the evidence for COPD action plan-based self-management strategies. Although action plans may provide stabilization of acute symptomatology, there are several limitations. These include patient-centered attributes, such as comprehension and adherence, and nonadherence of health care providers to established guidelines. While no single intervention can be expected independently to translate into improved outcomes, structured together within a comprehensive integrated disease-management program, they may provide a robust paradigm. PMID:27330286

  8. Use of validation dosimetry, in source rack load planning, to improve cobalt irradiation plant efficiency

    NASA Astrophysics Data System (ADS)

    Pyne, C. H.; Comben, M. J.

    2002-03-01

    Source load planning is an important part of optimising the performance of cobalt-60 gamma irradiation plants. The best results are achieved using a complex algorithm to accurately model the radiation profile of the source. In this way operational plant performance may be predicted as a function of changes in activity distribution within the source rack. This paper describes an approach to the prediction of plant performance that is numerically simpler than attempting to calculate actual doses from first principles. It shows how validation dosimetry results can be used to validate the software-predicted dose distribution and details how this enables the load plan to be tailored to meet the specific objectives of the plant operator. Improvements in product throughput and reduced maximum to minimum dose ratios are typical.

  9. Reactivity of fluoride dentifrices with artificial caries. III. Quantitative aspects of acquired acid resistance (AAR): F uptake, retention, surface hardening and remineralization.

    PubMed

    White, D J

    1991-01-01

    A pH cycling remineralization/dimineralization model has been used to compare remineralization and acid resistance benefits provided by commercial MFP and NaF dentifrices. Test results show that fluoride dentifrice systems were effective in enhancing lesion remineralization and providing acquired acid resistance (AAR) to carious lesions, with AAR benefits considerably greater in magnitude. Fluoride uptake into the carious lesions was associated with remineralization and AAR benefits. Dentifrices containing the highest levels of soluble ionic fluoride were found most effective in this protocol with MFP dentifrices showing significantly less activity. MFP dentifrice efficacy was enhanced slightly in calcium abrasives. The enhanced activity could be explained by increased levels of background ionic fluoride in the formulations. In contrast to the latter effects, a dual-active NaF+MFP dentifrice in a calcium abrasive system exhibited decreased efficacy relative to a silica abrasive formulation due to incompatibility of free fluoride ion. Comparison of analytical techniques for measurement of AAR in shallow lesions demonstrates that surface microhardness methods match radiographic measures and are thus adequate for ICT measurement of cariogenicity and F remineralization. PMID:1812910

  10. Projecting technology change to improve space technology planning and systems management

    NASA Astrophysics Data System (ADS)

    Walk, Steven Robert

    2011-04-01

    Projecting technology performance evolution has been improving over the years. Reliable quantitative forecasting methods have been developed that project the growth, diffusion, and performance of technology in time, including projecting technology substitutions, saturation levels, and performance improvements. These forecasts can be applied at the early stages of space technology planning to better predict available future technology performance, assure the successful selection of technology, and improve technology systems management strategy. Often what is published as a technology forecast is simply scenario planning, usually made by extrapolating current trends into the future, with perhaps some subjective insight added. Typically, the accuracy of such predictions falls rapidly with distance in time. Quantitative technology forecasting (QTF), on the other hand, includes the study of historic data to identify one of or a combination of several recognized universal technology diffusion or substitution patterns. In the same manner that quantitative models of physical phenomena provide excellent predictions of system behavior, so do QTF models provide reliable technological performance trajectories. In practice, a quantitative technology forecast is completed to ascertain with confidence when the projected performance of a technology or system of technologies will occur. Such projections provide reliable time-referenced information when considering cost and performance trade-offs in maintaining, replacing, or migrating a technology, component, or system. This paper introduces various quantitative technology forecasting techniques and illustrates their practical application in space technology and technology systems management.

  11. Analysis of power sector efficiency improvements for an integrated utility planning process in Costa Rica

    SciTech Connect

    Waddle, D.B.; MacDonald, J.M.

    1990-01-01

    In an effort to analyze and document the potential for power sector efficiency improvements from generation to end-use, the Agency for International Development and the Government of Costa Rica are jointly conducting an integrated power sector efficiency analysis. Potential for energy and cost savings in power plants, transmission and distribution, and demand-side management programs are being evaluated. The product of this study will be an integrated investment plan for the Instituto Costarricense de Electricidad, incorporating both supply and demand side investment options. This paper presents the methodology employed in the study, as well as preliminary estimates of the results of the study. 14 refs., 4 figs., 5 tabs.

  12. An improved ant colony optimization approach for optimization of process planning.

    PubMed

    Wang, JinFeng; Fan, XiaoLiang; Ding, Haimin

    2014-01-01

    Computer-aided process planning (CAPP) is an important interface between computer-aided design (CAD) and computer-aided manufacturing (CAM) in computer-integrated manufacturing environments (CIMs). In this paper, process planning problem is described based on a weighted graph, and an ant colony optimization (ACO) approach is improved to deal with it effectively. The weighted graph consists of nodes, directed arcs, and undirected arcs, which denote operations, precedence constraints among operation, and the possible visited path among operations, respectively. Ant colony goes through the necessary nodes on the graph to achieve the optimal solution with the objective of minimizing total production costs (TPCs). A pheromone updating strategy proposed in this paper is incorporated in the standard ACO, which includes Global Update Rule and Local Update Rule. A simple method by controlling the repeated number of the same process plans is designed to avoid the local convergence. A case has been carried out to study the influence of various parameters of ACO on the system performance. Extensive comparative experiments have been carried out to validate the feasibility and efficiency of the proposed approach. PMID:25097874

  13. An Improved Ant Colony Optimization Approach for Optimization of Process Planning

    PubMed Central

    Wang, JinFeng; Fan, XiaoLiang; Ding, Haimin

    2014-01-01

    Computer-aided process planning (CAPP) is an important interface between computer-aided design (CAD) and computer-aided manufacturing (CAM) in computer-integrated manufacturing environments (CIMs). In this paper, process planning problem is described based on a weighted graph, and an ant colony optimization (ACO) approach is improved to deal with it effectively. The weighted graph consists of nodes, directed arcs, and undirected arcs, which denote operations, precedence constraints among operation, and the possible visited path among operations, respectively. Ant colony goes through the necessary nodes on the graph to achieve the optimal solution with the objective of minimizing total production costs (TPCs). A pheromone updating strategy proposed in this paper is incorporated in the standard ACO, which includes Global Update Rule and Local Update Rule. A simple method by controlling the repeated number of the same process plans is designed to avoid the local convergence. A case has been carried out to study the influence of various parameters of ACO on the system performance. Extensive comparative experiments have been carried out to validate the feasibility and efficiency of the proposed approach. PMID:25097874

  14. Improving productivity and profitability of a bioanalytical business through sales and operation planning.

    PubMed

    Islam, Rafiqul

    2013-07-01

    Today's bioanalytical CROs face increasing global competition, highly variable demand, high fixed costs, pricing pressure, and increasing demand for quality and speed. Most bioanalytical laboratories have responded to these challenges by implementing automation and by implementing process improvement methodologies (e.g., Six Sigma). These solutions have not resulted in a significant improvement in productivity and profitability since none of them are able to predict the upturn or downturn in demand. High volatility of demand causes long lead times and high costs during peak demand and poor productivity during trough demand. Most bioanalytical laboratories lack the tools to align supply efficiently to meet changing demand. In this paper, sales and operation planning (S&OP) has been investigated as a tool to balance supply and demand. The S&OP process, when executed effectively, can be the single greatest determinant of profitability for a bioanalytical business. PMID:23862711

  15. 76 FR 11681 - Improving Public Safety Communications in the 800 MHz Band; New 800 MHz Band Plan for Puerto Rico...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-03

    ...This document summarizes the Fourth Report and Order, which establishes a new 800 MHz band plan for the U.S. Virgin Islands (USVI). This action is necessary to meet the Commission's goals to improve public safety communications in the 800 MHz band. The effect of this order ensures an orderly and efficient transition to the new 800 MHz band plan in the...

  16. 76 FR 16818 - Central Valley Project Improvement Act, Standard Criteria for Ag and Urban Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... Management Plans are considered the same as Water Conservation Plans. DATES: Submit written comments by April... water conservation best management practices (BMPs) that shall develop Criteria for evaluating the... Bureau of Reclamation Central Valley Project Improvement Act, Standard Criteria for Ag and Urban...

  17. Affirmative Action Plan for Improvement of Equal Opportunities for Members of Minority Groups, Women, and Physically Handicapped.

    ERIC Educational Resources Information Center

    Black Hawk Coll., Moline, IL.

    This document presents the affirmative action plan developed by Black Hawk College to assure the development and maintenance of educational programs, services, and employment practices that are sensitive to the needs of minorities, women, and the physically handicapped. Part I deals with employment, outlining a specific plan for improving equal…

  18. Exploring Asperger's Syndrome, Schlossberg's Transition Theory and Federally Mandated Transition Planning: Seeking Improvements

    ERIC Educational Resources Information Center

    Spencer, Tracy Lynne Wright Lyons

    2013-01-01

    Federally mandated transition planning has done little to improve the postsecondary outcomes of people with Asperger's syndrome. Current high school transition planning for students with Asperger's attempts to address some of these areas through family involvement, community inclusion, and the active participation of the student in…

  19. Using the Theory of Planned Behavior to Improve Treatment Adherence in Mexican Americans with Schizophrenia

    PubMed Central

    Kopelowicz, Alex; Zarate, Roberto; Wallace, Charles J.; Liberman, Robert Paul; Lopez, Steven R.; Mintz, Jim

    2015-01-01

    Objective Failure to adhere to treatment with antipsychotic medication is the most common cause of relapse among patients with schizophrenia. A novel multi-family group (MFG) intervention, informed by the Theory of Planned Behavior (TPB), demonstrated efficacy in increasing medication adherence and decreasing re-hospitalizations in schizophrenia patients. This report explores the hypothesis that the improved outcomes obtained through the MFG approach were mediated by changes in the patients’ attitudes towards medications, subjective norms-social influences, and perceived behavioral control of resources. Method Data from a recently completed, randomized controlled trial of MFG was used to test the hypothesis that the improvement in adherence was mediated by the three TPB factors. Subjects were 174 Mexican American adults with schizophrenia-spectrum disorder who had participated in a study of MFG focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18 and 24 months. Results Path analysis revealed that the increased adherence associated with MFG was mediated by improvements in subjective norms but not attitudes towards medications nor perceived behavioral control. Conclusion An MFG treatment specifically tailored to increase medication adherence among Mexican Americans with schizophrenia achieved its benefits by leveraging social influences through teaching family members how to support medication adherence in their ill relatives. PMID:26030760

  20. Dwell time modulation restrictions do not necessarily improve treatment plan quality for prostate HDR brachytherapy

    NASA Astrophysics Data System (ADS)

    Balvert, Marleen; Gorissen, Bram L.; den Hertog, Dick; Hoffmann, Aswin L.

    2015-01-01

    Inverse planning algorithms for dwell time optimisation in interstitial high-dose-rate (HDR) brachytherapy may produce solutions with large dwell time variations within catheters, which may result in undesirable selective high-dose subvolumes. Extending the dwell time optimisation model with a dwell time modulation restriction (DTMR) that limits dwell time differences between neighboring dwell positions has been suggested to eliminate this problem. DTMRs may additionally reduce the sensitivity for uncertainties in dwell positions that inevitably result from catheter reconstruction errors and afterloader source positioning inaccuracies. This study quantifies the reduction of high-dose subvolumes and the robustness against these uncertainties by applying a DTMR to template-based prostate HDR brachytherapy implants. Three different DTMRs were consecutively applied to a linear dose-based penalty model (LD) and a dose-volume based model (LDV), both obtained from literature. The models were solved with DTMR levels ranging from no restriction to uniform dwell times within catheters in discrete steps. Uncertainties were simulated on clinical cases using in-house developed software, and dose-volume metrics were calculated in each simulation. For the assessment of high-dose subvolumes, the dose homogeneity index (DHI) and the contiguous dose volume histogram were analysed. Robustness was measured by the improvement of the lowest D90% of the planning target volume (PTV) observed in the simulations. For (LD), a DTMR yields an increase in DHI of approximately 30% and reduces the size of the largest high-dose volume by 2-5 cc. However, this comes at a cost of a reduction in D90% of the PTV of 10%, which often implies that it drops below the desired minimum of 100%. For (LDV), none of the DTMRs were able to improve high-dose volume measures. DTMRs were not capable of improving robustness of PTV D90% against uncertainty in dwell positions for both models.

  1. Improved cost, health, and satisfaction with a health home benefit plan for self-insured employers and small physician practices.

    PubMed

    Reeves, Jerry; Kapp, Brian

    2013-01-01

    We compared the impacts on total costs, health, and satisfaction among 615 adults enrolled 2 years in an employer's health home benefit plan to their baseline year in a standard preferred provider organization plan. The new plan combined strong continuity care incentives with nurse coaching support. After 24 months, total medical costs were 23% lower than the baseline year, biometric measures improved for more than 85% of members, and patient satisfaction exceeded 85%. Emergency department visits decreased by 16% and hospital days decreased by 48%. Health home benefit plans engaging small primary care physician practices and members in coordinated continuity care can deliver high value. PMID:23448916

  2. Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning.

    PubMed

    Savarino, Jeffrey R; Kaplan, Jess L; Winter, Harland S; Moran, Christopher J; Israel, Esther J

    2016-01-01

    Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammatory disease of the intestine which can lead to malnutrition, poor quality of life, and colon cancer.(1-4) Although there is no cure for the disease, clinical remission is the primary goal.(5) The Center for Inflammatory Bowel Disease at MassGeneral Hospital for Children (MGHfC) adopted a Previsit Planning (PVP) model to identify and discuss symptomatic patients prior to their appointments to identify specific issues that impact disease management.(6-8) The Registry from ImproveCareNow (ICN), the international Quality Improvement Collaborative for the management of Crohn's Disease and Ulcerative Colitis in pediatric and adolescent patients, was used to capture information from each ambulatory visit and hospitalization. Using the Model for Improvement framework, the team began a weekly review and made care recommendations of patients with active disease who were cared for by one physician. Interventions were modified over multiple Plan-Do-Study-Act (PDSA) improvement cycles to increase the number of providers and to include patients with mild or moderate disease activity.(9) Feedback from the providers regarding this process was elicited via a REDCap survey and the clinical remission rate was tracked using the ICN Registry. The clinical remission rate for the Center's patients increased from 77% (n=597) in September 2014 to 83% (n=585) in August 2015 and has been maintained. 78% of responding providers indicated that they found the PVP recommendations helpful "all of the time". One hundred percent who responded to the survey said that they have used at least one recommendation provided to them. PVP for management of a chronic disease in pediatrics is feasible, even in a high volume practice. This process at MGHfC has resulted in the improvement of clinical remission rate. PDSA cycles were used to document successes and failures to help guide the work. Ongoing expansion of this PVP practice to all

  3. Improving Clinical Remission Rates in Pediatric Inflammatory Bowel Disease with Previsit Planning

    PubMed Central

    Savarino, Jeffrey R.; Kaplan, Jess L.; Winter, Harland S.; Moran, Christopher J.; Israel, Esther J.

    2016-01-01

    Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammatory disease of the intestine which can lead to malnutrition, poor quality of life, and colon cancer.1–4 Although there is no cure for the disease, clinical remission is the primary goal.5 The Center for Inflammatory Bowel Disease at MassGeneral Hospital for Children (MGHfC) adopted a Previsit Planning (PVP) model to identify and discuss symptomatic patients prior to their appointments to identify specific issues that impact disease management.6–8 The Registry from ImproveCareNow (ICN), the international Quality Improvement Collaborative for the management of Crohn's Disease and Ulcerative Colitis in pediatric and adolescent patients, was used to capture information from each ambulatory visit and hospitalization. Using the Model for Improvement framework, the team began a weekly review and made care recommendations of patients with active disease who were cared for by one physician. Interventions were modified over multiple Plan-Do-Study-Act (PDSA) improvement cycles to increase the number of providers and to include patients with mild or moderate disease activity.9 Feedback from the providers regarding this process was elicited via a REDCap survey and the clinical remission rate was tracked using the ICN Registry. The clinical remission rate for the Center's patients increased from 77% (n=597) in September 2014 to 83% (n=585) in August 2015 and has been maintained. 78% of responding providers indicated that they found the PVP recommendations helpful “all of the time”. One hundred percent who responded to the survey said that they have used at least one recommendation provided to them. PVP for management of a chronic disease in pediatrics is feasible, even in a high volume practice. This process at MGHfC has resulted in the improvement of clinical remission rate. PDSA cycles were used to document successes and failures to help guide the work. Ongoing expansion of this PVP practice to all

  4. Location-allocation and accessibility models for improving the spatial planning of public health services.

    PubMed

    Polo, Gina; Acosta, C Mera; Ferreira, Fernando; Dias, Ricardo Augusto

    2015-01-01

    This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA) model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra's algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources. PMID:25775411

  5. Mobile phone diabetes project led to improved glycemic control and net savings for Chicago plan participants.

    PubMed

    Nundy, Shantanu; Dick, Jonathan J; Chou, Chia-Hung; Nocon, Robert S; Chin, Marshall H; Peek, Monica E

    2014-02-01

    Even with the best health care available, patients with chronic illnesses typically spend no more than a few hours a year in a health care setting, while their outcomes are largely determined by their activities during the remaining 5,000 waking hours of the year. As a widely available, low-cost technology, mobile phones are a promising tool to use in engaging patients in behavior change and facilitating self-care between visits. We examined the impact of a six-month mobile health (mHealth) demonstration project among adults with diabetes who belonged to an academic medical center's employee health plan. In addition to pre-post improvements in glycemic control (p=0.01) and patients' satisfaction with overall care (p=0.04), we observed a net cost savings of 8.8 percent. Those early results suggest that mHealth programs can support health care organizations' pursuit of the triple aim of improving patients' experiences with care, improving population health, and reducing the per capita cost of health care PMID:24493770

  6. Facilitating participatory steps for planning and implementing low-cost improvements in small workplaces.

    PubMed

    Kogi, Kazutaka

    2008-07-01

    In this paper, practical means of facilitating participatory steps taken in workplace improvement programs in small workplaces were reviewed. The reviewed programs included those organized by partners of our Asian inter-country network for small enterprises, construction sites, home workplaces and agricultural farms. Trainers who commonly acted as facilitators were found to play multiple roles in helping managers, workers and farmers take initiative and achieve immediate improvements. The participatory steps were more successfully facilitated when the trainers supported (a) building on local good practice, (b) focusing on a range of basic ergonomics principles, and (c) stepwise progress through feedback of achievements. The use of action-oriented toolkits comprising low-cost action checklists and group work guides was commonly helpful. The locally adjusted nature of the toolkits seemed essential. Trainers could thus help people build local initiative, plan and implement low-cost ideas through serial group work steps and confirm benefits in a stepwise manner. The review of the results suggested that a local network of trainers trained in the use of locally adjusted toolkits was vital for facilitating effective improvements in different small workplaces. PMID:18417097

  7. Location-Allocation and Accessibility Models for Improving the Spatial Planning of Public Health Services

    PubMed Central

    Polo, Gina; Acosta, C. Mera; Ferreira, Fernando; Dias, Ricardo Augusto

    2015-01-01

    This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA) model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra’s algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources. PMID:25775411

  8. Progress Made on a Plan To Integrate Planning, Budgeting, Assessment and Quality Principles To Achieve Institutional Improvement. First Year Report. AIR 1996 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Griffith, Susan R.; And Others

    This paper describes first year implementation efforts of Southwest Texas (SWT) State University to develop a system to integrate planning, budgeting, assessment, and quality to improve the delivery of education and other services to all the institution's customers. The document addresses the common situation when an organization already has…

  9. Improving radiotherapy planning, delivery accuracy, and normal tissue sparing using cutting edge technologies

    PubMed Central

    Glide-Hurst, Carri K.

    2014-01-01

    In the United States, more than half of all new invasive cancers diagnosed are non-small cell lung cancer, with a significant number of these cases presenting at locally advanced stages, resulting in about one-third of all cancer deaths. While the advent of stereotactic ablative radiation therapy (SABR, also known as stereotactic body radiotherapy, or SBRT) for early-staged patients has improved local tumor control to >90%, survival results for locally advanced stage lung cancer remain grim. Significant challenges exist in lung cancer radiation therapy including tumor motion, accurate dose calculation in low density media, limiting dose to nearby organs at risk, and changing anatomy over the treatment course. However, many recent technological advancements have been introduced that can meet these challenges, including four-dimensional computed tomography (4DCT) and volumetric cone-beam computed tomography (CBCT) to enable more accurate target definition and precise tumor localization during radiation, respectively. In addition, advances in dose calculation algorithms have allowed for more accurate dosimetry in heterogeneous media, and intensity modulated and arc delivery techniques can help spare organs at risk. New delivery approaches, such as tumor tracking and gating, offer additional potential for further reducing target margins. Image-guided adaptive radiation therapy (IGART) introduces the potential for individualized plan adaptation based on imaging feedback, including bulky residual disease, tumor progression, and physiological changes that occur during the treatment course. This review provides an overview of the current state of the art technology for lung cancer volume definition, treatment planning, localization, and treatment plan adaptation. PMID:24688775

  10. Applying national survey results for strategic planning and program improvement: the National Diabetes Education Program.

    PubMed

    Griffey, Susan; Piccinino, Linda; Gallivan, Joanne; Lotenberg, Lynne Doner; Tuncer, Diane

    2015-02-01

    Since the 1970s, the federal government has spearheaded major national education programs to reduce the burden of chronic diseases in the United States. These prevention and disease management programs communicate critical information to the public, those affected by the disease, and health care providers. The National Diabetes Education Program (NDEP), the leading federal program on diabetes sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), uses primary and secondary quantitative data and qualitative audience research to guide program planning and evaluation. Since 2006, the NDEP has filled the gaps in existing quantitative data sources by conducting its own population-based survey, the NDEP National Diabetes Survey (NNDS). The NNDS is conducted every 2–3 years and tracks changes in knowledge, attitudes and practice indicators in key target audiences. This article describes how the NDEP has used the NNDS as a key component of its evaluation framework and how it applies the survey results for strategic planning and program improvement. The NDEP's use of the NNDS illustrates how a program evaluation framework that includes periodic population-based surveys can serve as an evaluation model for similar national health education programs. PMID:25463016

  11. Interactive computer graphics system improves planning of directionally drilled wells in the East Wilmington field

    SciTech Connect

    Lutz, T.S.; Kendle, D.W.

    1988-06-01

    The Long Beach Unit of the East Wilmington field contains more than 1,200 wells directionally drilled from four manmade islands and five land-based drilling sites. Planning new wells that avoid interference with existing wells becomes more difficult and time-consuming as the density of wells in the Unit increases. Improvements and modifications in design procedures have culminated in the interactive computer graphics system now in use. The interactive computer-graphics system (ICGS) permits the viewing of a proposed new well or redrill well course, together with all existing well surveys and other proposed well courses in the area of interest. Plan, section, and traveling cylinder views can be displayed to allow the identification of design problems. The significance of the problems is then minimized by use of the interactive features of the system to refine the design parameters. The system's interactive features are also used to create, edit, and plot the finalized design. Reductions in design and drilling costs and many other less-direct benefits have been realized as a result of the system's use. The step-by-step use of the system from the user's point of view is described and examples of its graphic output are presented. To the best of our knowledge, this is the most advanced system of its kind in use today.

  12. Planning phase for the New Mexico Improved Oil Recovery Project. Final report

    SciTech Connect

    Martin, F.D.; Weiss, W.W.

    1991-06-01

    This project is a collaborative effort with Los Alamos National Laboratory, Sandia National Laboratories, and a number of universities throughout the country. Field and laboratory tests were proposed to investigate advanced technologies in reservoir characterization, reservoir simulation, and recovery enhancement. Basically, the approach was to acquire an oilfield property for experimental purposes where interdisciplinary testing could be performed. Several researchers, especially in the academic area, would like to have access to field data and have expressed interest in participating in the project. A standardized dataset from a well-characterized site could be made available to anyone who is developing and validating new simulators. The data-gathering phase should be coordinated fully with the principal users of the data, and all data should be stored in an easily accessible form. A database for the New Mexico Improved Oil Recovery Project (NMIORP) could be established which would be designed for access by various computer networks. Initially, this project provided for a planning phase for the NMIORP. A field site, the Sulimar Queen Unit, has been acquired by New Mexico Tech, and the activities specified in the planning phase have been completed. A data acquisition well was drilled, logged, and cored. Geological and reservoir studies for the Sulimar Queen Unit were conducted. Results of these studies indicate that the Sulimar Queen Unit is a suitable field site for the NMIORP. This report describes the results of the studies that were conducted and outlines possible future tests that could be performed at the field site.

  13. A plan for application system verification tests: The value of improved meteorological information, volume 1. [economic consequences of improved meteorological information

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The framework within which the Applications Systems Verification Tests (ASVTs) are performed and the economic consequences of improved meteorological information demonstrated is described. This framework considers the impact of improved information on decision processes, the data needs to demonstrate the economic impact of the improved information, the data availability, the methodology for determining and analyzing the collected data and demonstrating the economic impact of the improved information, and the possible methods of data collection. Three ASVTs are considered and program outlines and plans are developed for performing experiments to demonstrate the economic consequences of improved meteorological information. The ASVTs are concerned with the citrus crop in Florida, the cotton crop in Mississippi and a group of diverse crops in Oregon. The program outlines and plans include schedules, manpower estimates and funding requirements.

  14. Development of urban planning guidelines for improving emergency response capacities in seismic areas of Iran.

    PubMed

    Hosseini, Kambod Amini; Jafari, Mohammad Kazem; Hosseini, Maziar; Mansouri, Babak; Hosseinioon, Solmaz

    2009-10-01

    This paper presents the results of research carried out to improve emergency response activities in earthquake-prone areas of Iran. The research concentrated on emergency response operations, emergency medical care, emergency transportation, and evacuation-the most important issues after an earthquake with regard to saving the lives of victims. For each topic, some guidelines and criteria are presented for enhancing emergency response activities, based on evaluations of experience of strong earthquakes that have occurred over the past two decades in Iran, notably Manjil (1990), Bam (2003), Firouz Abad-Kojour (2004), Zarand (2005) and Broujerd (2006). These guidelines and criteria are applicable to other national contexts, especially countries with similar seismic and social conditions as Iran. The results of this study should be incorporated into comprehensive plans to ensure sustainable development or reconstruction of cities as well as to augment the efficiency of emergency response after an earthquake. PMID:19500324

  15. Building Consistency between Title, Problem Statement, Purpose, & Research Questions to Improve the Quality of Research Plans and Reports

    ERIC Educational Resources Information Center

    Newman, Isadore; Covrig, Duane M.

    2013-01-01

    Consistency in the title, problem, purpose, and research question improve the logic and transparency of research. When these components of research are aligned research design and planning are more coherent and research reports are more readable. This article reviews the process for checking for and improving consistency. Numerous examples of…

  16. Parent Involvement Activities in School Improvement Plans in the Northwest Region. Issues & Answers. REL 2008-No. 064

    ERIC Educational Resources Information Center

    Speth, Timothy; Saifer, Steffen; Forehand, Gregory

    2008-01-01

    Although the No Child Left Behind Act of 2001 (NCLB) spells out parent involvement requirements for schools in need of improvement, the majority of the Northwest Region school improvement plans reviewed failed to include such provisions. Reported findings include: (1) Despite a wide range of parent involvement practices discussed in legislation…

  17. An attempt to validate the ultra-accelerated microbar and the concrete performance test with the degree of AAR-induced damage observed in concrete structures

    SciTech Connect

    Leemann, Andreas; Merz, Christine

    2013-07-15

    There is little knowledge about the relation between AAR-induced damage observed in structures and the expansion potential obtained with accelerated tests. In this study, aggregates used in structures damaged by AAR were tested with the microbar test (MBT/AFNOR XP 18-594) and the concrete performance test (CPT/AFNOR P18-454). After the tests, the samples were examined using optical and scanning electron microscopy. Based on the results, the significance of the microbar test has to be examined very critically. The agreement of measured expansion, reacted rock types and the composition of the reaction products between the on-site concrete and the reproduced concrete subjected to the CPT clearly indicates that the reaction mechanisms in the structure and in the concrete performance test are comparable. As such, the concrete performance test seems to be an appropriate tool to test the potential reactivity of specific concrete mixtures.

  18. A one- and two-dimensional cross-section sensitivity and uncertainty path of the AARE (Advanced Analysis for Reactor Engineering) modular code system

    SciTech Connect

    Davidson, J.W.; Dudziak, D.J.; Higgs, C.E.; Stepanek, J.

    1988-01-01

    AARE, a code package to perform Advanced Analysis for Reactor Engineering, is a linked modular system for fission reactor core and shielding, as well as fusion blanket, analysis. Its cross-section sensitivity and uncertainty path presently includes the cross-section processing and reformatting code TRAMIX, cross-section homogenization and library reformatting code MIXIT, the 1-dimensional transport code ONEDANT, the 2-dimensional transport code TRISM, and the 1- and 2- dimensional cross-section sensitivity and uncertainty code SENSIBL. IN the present work, a short description of the whole AARE system is given, followed by a detailed description of the cross-section sensitivity and uncertainty path. 23 refs., 2 figs.

  19. The Public Health Service action plan to improve access to immunization services. The Interagency Committee to Improve Access to Immunization Services.

    PubMed Central

    1992-01-01

    The Public Health Service's Interagency Committee to Improve Access to Immunization Services (ICI) has responsibility for improving the immunization protection of the nation's children and other vulnerable populations. ICI's Action Plan to Improve Access to Immunization Services sets 14 goals with 120 action steps for improving immunization services nationwide by (a) increasing coordination among Federal health, income, housing, education, and nutrition programs; (b) reducing policy and management barriers that limit access to delivery systems, and (c) strengthening the delivery infrastructure. To accomplish the goals of the plan, there is a $72.0 million increase in funding appropriated in fiscal year 1992 specifically for this purpose. The President's Budget for fiscal year 1993 includes a $24.5 million increase for continued program implementation. The additional resources will be used to address delivery and access problems, which have been determined to be the primary factors limiting immunization for many children. PMID:1594732

  20. Improving the effectiveness of planning EIA (PEIA) in China: Integrating planning and assessment during the preparation of Shenzhen's Master Urban Plan

    SciTech Connect

    Che Xiuzhen; English, Alex; Lu Jia; Chen, Yongqin David

    2011-11-15

    The enactment and implementation of the 2003 EIA Law in China institutionalised the role of plan environmental impact assessment (PEIA). While the philosophy, methodology and mechanisms of PEIA have gradually permeated through the various levels of government with a positive effect on the process and outcome of urban planning, only a few cities in China have so far carried out PEIA as a Strategic Environmental Assessment (SEA)-type procedure. One such case is the southern city of Shenzhen. During the past three decades, Shenzhen has grown from a small town to a large and booming city as China has successfully and rapidly developed its economy by adopting the 'reform and open door' policy. In response to the challenges arising from the generally divergent processes of rapid urbanisation, economic transformation and environment protection, Shenzhen has incrementally adopted the SEA concept in developing the city's Master Urban Plan. As such, this paper reviews the effectiveness of PEIA in three ways: {center_dot}as a tool and process for achieving more sustainable and strategic planning; {center_dot}to determine the level of integration of SEA within the planning system; and, {center_dot}its effectiveness vis-a-vis implementation. The implementation of PEIA within Shenzhen's Master Urban Plan offers important insights into the emergence of innovative practices in undertaking PEIA as well as theoretical contributions to the field, especially in exploring the relationship between PEIA and SEA and highlighting the central role of local governing institutions in SEA development.

  1. This NASA Dryden F/A-18 is participating in the Automated Aerial Refueling (AAR) project. F/A-18 (No

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A NASA Dryden F/A-18 is participating in the Automated Aerial Refueling (AAR) project. F/A-18 (No. 847) is acting as an in-flight refueling tanker in the study to develop analytical models for an automated aerial refueling system for unmanned vehicles. A 300-gallon aerodynamic pod containing air-refueling equipment is seen beneath the fuselage. The hose and refueling basket are extended during an assessment of their dynamics on the F/A-18A.

  2. New Perspectives on Planning, Management, and Evaluation in School Improvement: A Report on the 1979 Far West Laboratory Summer Workshop on Educational Dissemination and School Improvement.

    ERIC Educational Resources Information Center

    Hood, Paul D., Ed.

    This paper is the result of a 1979 workshop that examined potential applications of new perspectives on organizational planning, management, and evaluation as they apply to school improvement efforts. Section 1 reproduces an orientation paper mailed to conference participants. Section 2 contains an informal report of the proceedings reconstructed…

  3. Radiotherapy planning for glioblastoma based on a tumor growth model: improving target volume delineation.

    PubMed

    Unkelbach, Jan; Menze, Bjoern H; Konukoglu, Ender; Dittmann, Florian; Le, Matthieu; Ayache, Nicholas; Shih, Helen A

    2014-02-01

    Glioblastoma differ from many other tumors in the sense that they grow infiltratively into the brain tissue instead of forming a solid tumor mass with a defined boundary. Only the part of the tumor with high tumor cell density can be localized through imaging directly. In contrast, brain tissue infiltrated by tumor cells at low density appears normal on current imaging modalities. In current clinical practice, a uniform margin, typically two centimeters, is applied to account for microscopic spread of disease that is not directly assessable through imaging. The current treatment planning procedure can potentially be improved by accounting for the anisotropy of tumor growth, which arises from different factors: anatomical barriers such as the falx cerebri represent boundaries for migrating tumor cells. In addition, tumor cells primarily spread in white matter and infiltrate gray matter at lower rate. We investigate the use of a phenomenological tumor growth model for treatment planning. The model is based on the Fisher-Kolmogorov equation, which formalizes these growth characteristics and estimates the spatial distribution of tumor cells in normal appearing regions of the brain. The target volume for radiotherapy planning can be defined as an isoline of the simulated tumor cell density. This paper analyzes the model with respect to implications for target volume definition and identifies its most critical components. A retrospective study involving ten glioblastoma patients treated at our institution has been performed. To illustrate the main findings of the study, a detailed case study is presented for a glioblastoma located close to the falx. In this situation, the falx represents a boundary for migrating tumor cells, whereas the corpus callosum provides a route for the tumor to spread to the contralateral hemisphere. We further discuss the sensitivity of the model with respect to the input parameters. Correct segmentation of the brain appears to be the most

  4. Radiotherapy planning for glioblastoma based on a tumor growth model: improving target volume delineation

    NASA Astrophysics Data System (ADS)

    Unkelbach, Jan; Menze, Bjoern H.; Konukoglu, Ender; Dittmann, Florian; Le, Matthieu; Ayache, Nicholas; Shih, Helen A.

    2014-02-01

    Glioblastoma differ from many other tumors in the sense that they grow infiltratively into the brain tissue instead of forming a solid tumor mass with a defined boundary. Only the part of the tumor with high tumor cell density can be localized through imaging directly. In contrast, brain tissue infiltrated by tumor cells at low density appears normal on current imaging modalities. In current clinical practice, a uniform margin, typically two centimeters, is applied to account for microscopic spread of disease that is not directly assessable through imaging. The current treatment planning procedure can potentially be improved by accounting for the anisotropy of tumor growth, which arises from different factors: anatomical barriers such as the falx cerebri represent boundaries for migrating tumor cells. In addition, tumor cells primarily spread in white matter and infiltrate gray matter at lower rate. We investigate the use of a phenomenological tumor growth model for treatment planning. The model is based on the Fisher-Kolmogorov equation, which formalizes these growth characteristics and estimates the spatial distribution of tumor cells in normal appearing regions of the brain. The target volume for radiotherapy planning can be defined as an isoline of the simulated tumor cell density. This paper analyzes the model with respect to implications for target volume definition and identifies its most critical components. A retrospective study involving ten glioblastoma patients treated at our institution has been performed. To illustrate the main findings of the study, a detailed case study is presented for a glioblastoma located close to the falx. In this situation, the falx represents a boundary for migrating tumor cells, whereas the corpus callosum provides a route for the tumor to spread to the contralateral hemisphere. We further discuss the sensitivity of the model with respect to the input parameters. Correct segmentation of the brain appears to be the most

  5. Improvements to Strategic Planning and Implementation through Enhanced Correlation with Decision-Making Frameworks

    ERIC Educational Resources Information Center

    McCready, John W.

    2010-01-01

    The purpose of this study was to examine use of decision-making tools and feedback in strategic planning in order to develop a rigorous process that would promote the efficiency of strategic planning for acquisitions in the United States Coast Guard (USCG). Strategic planning is critical to agencies such as the USCG in order to be effective…

  6. Improvement of Experiment Planning as an Important Precondition for the Quality of Educational Research

    ERIC Educational Resources Information Center

    Rutkiene, Ausra; Tereseviciene, Margarita

    2010-01-01

    The article presents the stages of the experiment planning that are necessary to ensure the validity and reliability of it. The research data reveal that doctoral students of Educational Research approach the planning of the experiment as the planning of the whole dissertation research; and the experiment as a research method is often confused…

  7. Three-Dimensional Path Planning and Guidance of Leg Vascular Based on Improved Ant Colony Algorithm in Augmented Reality.

    PubMed

    Gao, Ming-ke; Chen, Yi-min; Liu, Quan; Huang, Chen; Li, Ze-yu; Zhang, Dian-hua

    2015-11-01

    Preoperative path planning plays a critical role in vascular access surgery. Vascular access surgery has superior difficulties and requires long training periods as well as precise operation. Yet doctors are on different leves, thus bulky size of blood vessels is usually chosen to undergo surgery and other possible optimal path is not considered. Moreover, patients and surgeons will suffer from X-ray radiation during the surgical procedure. The study proposed an improved ant colony algorithm to plan a vascular optimal three-dimensional path with overall consideration of factors such as catheter diameter, vascular length, diameter as well as the curvature and torsion. To protect the doctor and patient from exposing to X-ray long-term, the paper adopted augmented reality technology to register the reconstructed vascular model and physical model meanwhile, locate catheter by the electromagnetic tracking system and used Head Mounted Display to show the planning path in real time and monitor catheter push procedure. The experiment manifests reasonableness of preoperative path planning and proves the reliability of the algorithm. The augmented reality experiment real time and accurately displays the vascular phantom model, planning path and the catheter trajectory and proves the feasibility of this method. The paper presented a useful and feasible surgical scheme which was based on the improved ant colony algorithm to plan vascular three-dimensional path in augmented reality. The study possessed practical guiding significance in preoperative path planning, intraoperative catheter guiding and surgical training, which provided a theoretical method of path planning for vascular access surgery. It was a safe and reliable path planning approach and possessed practical reference value. PMID:26319273

  8. Plan for Quality to Improve Patient Safety at the Point of Care

    PubMed Central

    Ehrmeyer, Sharon S.

    2011-01-01

    The U.S. Institute of Medicine (IOM) much publicized report in “To Err is Human” (2000, National Academy Press) stated that as many as 98 000 hospitalized patients in the U.S. die each year due to preventable medical errors. This revelation about medical error and patient safety focused the public and the medical community's attention on errors in healthcare delivery including laboratory and point-of-care-testing (POCT). Errors introduced anywhere in the POCT process clearly can impact quality and place patient's safety at risk. While POCT performed by or near the patient reduces the potential of some errors, the process presents many challenges to quality with its multiple tests sites, test menus, testing devices and non-laboratory analysts, who often have little understanding of quality testing. Incoherent or no regulations and the rapid availability of test results for immediate clinical intervention can further amplify errors. System planning and management of the entire POCT process are essential to reduce errors and improve quality and patient safety. PMID:21808107

  9. A cluster randomized trial of an organizational process improvement intervention for improving the assessment and case planning of offenders: a Study Protocol

    PubMed Central

    Shafer, Michael S; Prendergast, Michael; Melnick, Gerald; Stein, Lynda A; Welsh, Wayne N

    2014-01-01

    Background The Organizational Process Improvement Intervention (OPII), conducted by the NIDA-funded Criminal Justice Drug Abuse Treatment Studies consortium of nine research centers, examined an organizational intervention to improve the processes used in correctional settings to assess substance abusing offenders, develop case plans, transfer this information to community-based treatment agencies, and monitor the services provided by these community based treatment agencies. Methods/Design A multi-site cluster randomized design was used to evaluate an inter-agency organizational process improvement intervention among dyads of correctional agencies and community based treatment agencies. Linked correctional and community based agencies were clustered among nine (9) research centers and randomly assigned to an early or delayed intervention condition. Participants included administrators, managers, and line staff from the participating agencies; some participants served on interagency change teams while other participants performed agency tasks related to offender services. A manualized organizational intervention that includes the use of external organizational coaches was applied to create and support interagency change teams that proceeded through a four-step process over a planned intervention period of 12 months. The primary outcome of the process improvement intervention was to improve processes associated with the assessment, case planning, service referral and service provision processes within the linked organizations. Discussion Providing substance abuse offenders with coordinated treatment and access to community-based services is critical to reducing offender recidivism. Results from this study protocol will provide new and critical information on strategies and processes that improve the assessment and case planning for such offenders as they transition between correctional and community based systems and settings. Further, this study extends current

  10. Dosimetric evaluation of a simple planning method for improving intensity-modulated radiotherapy for stage III lung cancer

    PubMed Central

    Lu, Jia-Yang; Lin, Zhu; Zheng, Jing; Lin, Pei-Xian; Cheung, Michael Lok-Man; Huang, Bao-Tian

    2016-01-01

    This study aimed to evaluate the dosimetric outcomes of a base-dose-plan-compensation (BDPC) planning method for improving intensity-modulated radiotherapy (IMRT) for stage III lung cancer. For each of the thirteen included patients, three types of planning methods were applied to obtain clinically acceptable plans: (1) the conventional optimization method (CO); (2) a split-target optimization method (STO), in which the optimization objectives were set higher dose for the target with lung density; (3) the BDPC method, which compensated for the optimization-convergence error by further optimization based on the CO plan. The CO, STO and BDPC methods were then compared regarding conformity index (CI), homogeneity index (HI) of the target, organs at risk (OARs) sparing and monitor units (MUs). The BDPC method provided better HI/CI by 54%/7% on average compared to the CO method and by 38%/3% compared to the STO method. The BDPC method also spared most of the OARs by up to 9%. The average MUs of the CO, STO and BDPC plans were 890, 937 and 1023, respectively. Our results indicated that the BDPC method can effectively improve the dose distribution in IMRT for stage III lung cancer, at the expense of more MUs. PMID:27009235

  11. Dosimetric evaluation of a simple planning method for improving intensity-modulated radiotherapy for stage III lung cancer.

    PubMed

    Lu, Jia-Yang; Lin, Zhu; Zheng, Jing; Lin, Pei-Xian; Cheung, Michael Lok-Man; Huang, Bao-Tian

    2016-01-01

    This study aimed to evaluate the dosimetric outcomes of a base-dose-plan-compensation (BDPC) planning method for improving intensity-modulated radiotherapy (IMRT) for stage III lung cancer. For each of the thirteen included patients, three types of planning methods were applied to obtain clinically acceptable plans: (1) the conventional optimization method (CO); (2) a split-target optimization method (STO), in which the optimization objectives were set higher dose for the target with lung density; (3) the BDPC method, which compensated for the optimization-convergence error by further optimization based on the CO plan. The CO, STO and BDPC methods were then compared regarding conformity index (CI), homogeneity index (HI) of the target, organs at risk (OARs) sparing and monitor units (MUs). The BDPC method provided better HI/CI by 54%/7% on average compared to the CO method and by 38%/3% compared to the STO method. The BDPC method also spared most of the OARs by up to 9%. The average MUs of the CO, STO and BDPC plans were 890, 937 and 1023, respectively. Our results indicated that the BDPC method can effectively improve the dose distribution in IMRT for stage III lung cancer, at the expense of more MUs. PMID:27009235

  12. SU-E-T-622: Identification and Improvement of Patients Eligible for Dose Escalation with Matched Plans

    SciTech Connect

    Bush, K; Holcombe, C; Kapp, D; Buyyounouski, M; Hancock, S; Xing, L; Atwood, T; King, M

    2014-06-15

    Purpose: Radiation-therapy dose-escalation beyond 80Gy may improve tumor control rates for patients with localized prostate cancer. Since toxicity remains a concern, treatment planners must achieve dose-escalation while still adhering to dose-constraints for surrounding structures. Patientmatching is a machine-learning technique that identifies prior patients that dosimetrically match DVH parameters of target volumes and critical structures prior to actual treatment planning. We evaluated the feasibility of patient-matching in (1)identifying candidates for safe dose-escalation; and (2)improving DVH parameters for critical structures in actual dose-escalated plans. Methods: We analyzed DVH parameters from 319 historical treatment plans to determine which plans could achieve dose-escalation (8640cGy) without exceeding Zelefsky dose-constraints (rectal and bladder V47Gy<53%, and V75.6Gy<30%, max-point dose to rectum of 8550cGy, max dose to PTV< 9504cGy). We then estimated the percentage of cases that could achieve safe dose-escalation using software that enables patient matching (QuickMatch, Siris Medical, Mountain View, CA). We then replanned a case that had violated DVH constraints with DVH parameters from patient matching, in order to determine whether this previously unacceptable plan could be made eligible with this automated technique. Results: Patient-matching improved the percentage of patients eligible for dose-escalation from 40% to 63% (p=4.7e-4, t-test). Using a commercial optimizer augmented with patient-matching, we demonstrated a case where patient-matching improved the toxicity-profile such that dose-escalation would have been possible; this plan was rapidly achieved using patientmatching software. In this patient, all lower-dose constraints were met with both the denovo and patient-matching plan. In the patient-matching plan, maximum dose to the rectum was 8385cGy, while the denovo plan failed to meet the maximum rectal constraint at 8571c

  13. Improved efficiency of multi-criteria IMPT treatment planning using iterative resampling of randomly placed pencil beams

    NASA Astrophysics Data System (ADS)

    van de Water, S.; Kraan, A. C.; Breedveld, S.; Schillemans, W.; Teguh, D. N.; Kooy, H. M.; Madden, T. M.; Heijmen, B. J. M.; Hoogeman, M. S.

    2013-10-01

    This study investigates whether ‘pencil beam resampling’, i.e. iterative selection and weight optimization of randomly placed pencil beams (PBs), reduces optimization time and improves plan quality for multi-criteria optimization in intensity-modulated proton therapy, compared with traditional modes in which PBs are distributed over a regular grid. Resampling consisted of repeatedly performing: (1) random selection of candidate PBs from a very fine grid, (2) inverse multi-criteria optimization, and (3) exclusion of low-weight PBs. The newly selected candidate PBs were added to the PBs in the existing solution, causing the solution to improve with each iteration. Resampling and traditional regular grid planning were implemented into our in-house developed multi-criteria treatment planning system ‘Erasmus iCycle’. The system optimizes objectives successively according to their priorities as defined in the so-called ‘wish-list’. For five head-and-neck cancer patients and two PB widths (3 and 6 mm sigma at 230 MeV), treatment plans were generated using: (1) resampling, (2) anisotropic regular grids and (3) isotropic regular grids, while using varying sample sizes (resampling) or grid spacings (regular grid). We assessed differences in optimization time (for comparable plan quality) and in plan quality parameters (for comparable optimization time). Resampling reduced optimization time by a factor of 2.8 and 5.6 on average (7.8 and 17.0 at maximum) compared with the use of anisotropic and isotropic grids, respectively. Doses to organs-at-risk were generally reduced when using resampling, with median dose reductions ranging from 0.0 to 3.0 Gy (maximum: 14.3 Gy, relative: 0%-42%) compared with anisotropic grids and from -0.3 to 2.6 Gy (maximum: 11.4 Gy, relative: -4%-19%) compared with isotropic grids. Resampling was especially effective when using thin PBs (3 mm sigma). Resampling plans contained on average fewer PBs, energy layers and protons than anisotropic

  14. SEA monitoring in Swedish regional transport infrastructure plans - Improvement opportunities identified in practical experience

    SciTech Connect

    Lundberg, K.; Balfors, B.; Folkeson, L.; Nilsson, M.

    2010-11-15

    Strategic Environmental Assessment (SEA) requires monitoring in order to identify unforeseen adverse effects and to enable appropriate remedial action to be taken. Guidelines on how to monitor significant environmental impacts have been developed but experience from practice is limited. This paper presents a study of environmental monitoring in Swedish regional transport infrastructure planning. The result shows that essentially no environmental monitoring is currently performed. Monitoring of the plans merely involves checking the implementation of projects and performing an economic account. At present, a new planning period has commenced for the regional transport infrastructure plans. To obtain an iterative SEA process for the new plan with integrated SEA monitoring, the following means are suggested: reinforcement of practitioners' incentives to plan and perform monitoring; integration of monitoring in the SEA process; pre-determined impact thresholds that prompt remedial action; and more efficient use of monitoring results.

  15. Magnetic resonance spectroscopic imaging for improved treatment planning of prostate cancer

    NASA Astrophysics Data System (ADS)

    Venugopal, Niranjan

    . Results from the in vivo study were verified with post-histopathological data. Lastly, 1H-MRSI data was incorporated into the radiation treatment planning software and used to assess tumour control by escalating the radiation to prostate lesions that were identified by 1H-MRSI. In summary, this thesis demonstrates the clinical feasibility of using advanced spectroscopic imaging techniques for improved diagnosis and treatment of prostate cancer.

  16. The Holgarth School Improvement Experience Part II: Developing the School Improvement Plan and Preparing for the Peer Review Visit.

    ERIC Educational Resources Information Center

    Bitter, David; Heath, Jay A.; Boris, Greg; Baron, Mark

    2001-01-01

    Describes the process of implementation of the North Central Association Commission on Accreditation and School Improvement's Performance Accreditation Framework and School Improvement Process at Holgarth Middle School (South Dakota). Includes sections on essence of goals, assessment of program, interventions and strategies, selection of peer…

  17. The Role of Teams in Implementing School Improvement Plans. The School Improvement Leader: Four Perspectives on Change in Schools.

    ERIC Educational Resources Information Center

    Eiseman, Jeffrey W.; And Others

    School improvement teams are assembled to share leadership responsibility with the principal. Differing from advisory councils in that they have more involvement in decision making, and differing from management teams in that they include role groups other than administrators, school improvement teams may be composed of teachers and the principal…

  18. The Role of Need for Contraception in the Evaluation of Interventions to Improve Access to Family-Planning Methods

    ERIC Educational Resources Information Center

    Leon, Federico R.; Lundgren, Rebecka; Sinai, Irit; Jennings, Victoria

    2011-01-01

    A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on…

  19. Parent Involvement and Extended Learning Activities in School Improvement Plans in the Midwest Region. Issues & Answers. REL 2011-No. 115

    ERIC Educational Resources Information Center

    Kochanek, Julie Reed; Wraight, Sara; Wan, Yinmei; Nylen, Leslie; Rodriguez, Sheila

    2011-01-01

    According to the reauthorized Elementary and Secondary Education Act of 2001 (Public Law 107-110), commonly referred to as the No Child Left Behind (NCLB) Act, Title I schools that fail to make adequate yearly progress for two consecutive years are required to develop or revise school improvement plans aimed at boosting student achievement.…

  20. Improving plan quality and consistency by standardization of dose constraints in prostate cancer patients treated with CyberKnife.

    PubMed

    Descovich, Martina; Carrara, Mauro; Morlino, Sara; Pinnaduwage, Dilini S; Saltiel, Daniel; Pouliot, Jean; Nash, Marc B; Pignoli, Emanuele; Valdagni, Riccardo; Roach, Mack; Gottschalk, Alexander R

    2013-01-01

    Treatment plans for prostate cancer patients undergoing stereotactic body radiation therapy (SBRT) are often challenging due to the proximity of organs at risk. Today, there are no objective criteria to determine whether an optimal treatment plan has been achieved, and physicians rely on their personal experience to evaluate the plan's quality. In this study, we propose a method for determining rectal and bladder dose constraints achievable for a given patient's anatomy. We expect that this method will improve the overall plan quality and consistency, and facilitate comparison of clinical outcomes across different institutions. The 3D proximity of the organs at risk to the target is quantified by means of the expansion-intersection volume (EIV), which is defined as the intersection volume between the target and the organ at risk expanded by 5 mm. We determine a relationship between EIV and relevant dosimetric parameters, such as the volume of bladder and rectum receiving 75% of the prescription dose (V75%). This relationship can be used to establish institution-specific criteria to guide the treatment planning and evaluation process. A database of 25 prostate patients treated with CyberKnife SBRT is used to validate this approach. There is a linear correlation between EIV and V75% of bladder and rectum, confirming that the dose delivered to rectum and bladder increases with increasing extension and proximity of these organs to the target. This information can be used during the planning stage to facilitate the plan optimization process, and to standardize plan quality and consistency. We have developed a method for determining customized dose constraints for prostate patients treated with robotic SBRT. Although the results are technology specific and based on the experience of a single institution, we expect that the application of this method by other institutions will result in improved standardization of clinical practice. PMID:24036869

  1. Crisis Planning: Survey Results from Hurricane Katrina and Implications for Performance Improvement Professionals

    ERIC Educational Resources Information Center

    Hutchins, Holly M.; Annulis, Heather; Gaudet, Cyndi

    2008-01-01

    Modern organizations constantly face unparalleled changes and uncertainty in the competitive world, thus requiring strategic planning to mitigate crisis conditions. Underscoring crisis plans are performance interventions that prepare employees, technological systems, and the organizational culture to effectively respond to a crisis event. However,…

  2. The Highland Park Environmental Health Plan: Evaluation and Recommendations for Improving the Urban Environment.

    ERIC Educational Resources Information Center

    Michigan State Dept. of Commerce, Lansing. Community Planning Div.

    The Highland Park environmental health plan includes the following components: Legal and administrative and programmatic relationships, planning studies, residential environment, disease vector control, water and sewage systems, sanitation, air pollution, food protection, industrial and radiological health, and solid waste facilities. (JR)

  3. Nevada Master Plan: Providing for Improved Educational Opportunities. Report of a Study.

    ERIC Educational Resources Information Center

    Howard, Edward H.; Ogg, Thomas E.

    This report discusses significant recent developments in the Nevada State Department of Education, describes a Department reorganization study, and discusses the development and implementation of a State master plan for education. According to the report, Nevada's master plan contains sections on (1) the organization and administration of the…

  4. Improving Educational Planning for Students with Severe Disabilities: An Evaluation of School-Based Professional Learning

    ERIC Educational Resources Information Center

    Stephenson, Jennifer; Carter, Mark

    2015-01-01

    The components of quality educational planning for students with moderate and severe intellectual disability are well established, but schools and special educators may not always achieve a desirable standard. This article reports on the change in quality of documentation related to individual planning and programming over a span of 4 years in a…

  5. No Light at the End of Tunnel Vision: Steps for Improving Lesson Plans

    ERIC Educational Resources Information Center

    Dunn, Rita; Craig, Martin; Favre, Lois; Markus, Doron; Pedota, Paul; Sookdeo, Gale; Stock, Jessica; Terry, Brian

    2010-01-01

    The authors of this article believe that the current structure of lesson plans impede differentiation, individualization, and innovation and offer little in assessing the quality of teaching and learning. Concrete steps will be offered for planning to better respond to student diversity in meeting lesson objectives. (Contains 1 figure.)

  6. Options for improving computing and data system support for HQ USTRANSCOM (Headquarters, US Transportation Command) deployment planning

    SciTech Connect

    Not Available

    1988-08-01

    The Decision Systems Research Section of the Oak Ridge National Laboratory (ORNL) is assisting the Deployment Systems Division of the Headquarters, US Transportation Command (HQ USTRANSCOM) with an evaluation of options for improving the computing and data systems support for deliberate and time-critical joint deployment planning. USTRANSCOM, which is a unified command (i.e., personnel are drawn from all the services), was created in the fall of 1987 to consolidate the functions of the former military transportation operating agencies (the Military Airlift Command, the Military Traffic Management Command, and the Military Sealift Command). An important factor in the creation of USTRANSCOM was the possibility of achieving more efficient joint deployment planning through consolidation of the computing and data systems used by the command's strategic mobility planners and operation center personnel. This report, the third in a series to be produced in the course of ORNL studies for USTRANSCOM, presents options for improving automation support for HQ USTRANSCOM deployment planning. The study covered methods for improving data concepts used in deployment databases, recommendations for extending the life of the Joint Deployment system, and alternatives for integrating HQ USTRANSCOM planning support with systems at MAC, MTMC, and MSC. 36 refs.

  7. Improving our legacy: Incorporation of adaptive management into state wildlife action plans

    USGS Publications Warehouse

    Fontaine, J.J.

    2011-01-01

    The loss of biodiversity is a mounting concern, but despite numerous attempts there are few large scale conservation efforts that have proven successful in reversing current declines. Given the challenge of biodiversity conservation, there is a need to develop strategic conservation plans that address species declines even with the inherent uncertainty in managing multiple species in complex environments. In 2002, the State Wildlife Grant program was initiated to fulfill this need, and while not explicitly outlined by Congress follows the fundamental premise of adaptive management, 'Learning by doing'. When action is necessary, but basic biological information and an understanding of appropriate management strategies are lacking, adaptive management enables managers to be proactive in spite of uncertainty. However, regardless of the strengths of adaptive management, the development of an effective adaptive management framework is challenging. In a review of 53 State Wildlife Action Plans, I found a keen awareness by planners that adaptive management was an effective method for addressing biodiversity conservation, but the development and incorporation of explicit adaptive management approaches within each plan remained elusive. Only ???25% of the plans included a framework for how adaptive management would be implemented at the project level within their state. There was, however, considerable support across plans for further development and implementation of adaptive management. By furthering the incorporation of adaptive management principles in conservation plans and explicitly outlining the decision making process, states will be poised to meet the pending challenges to biodiversity conservation. ?? 2010 .

  8. Acute social stress before the planning phase improves memory performance in a complex real life-related prospective memory task.

    PubMed

    Glienke, Katharina; Piefke, Martina

    2016-09-01

    Successful execution of intentions, but also the failure to recall are common phenomena in everyday life. The planning, retention, and realization of intentions are often framed as the scientific concept of prospective memory. The current study aimed to examine the influence of acute stress on key dimensions of complex "real life" prospective memory. To this end, we applied a prospective memory task that involved the planning, retention, and performance of intentions during a fictional holiday week. Forty healthy males participated in the study. Half of the subjects were stressed with the Socially Evaluated Cold Pressor Test (SECPT) before the planning of intentions, and the other half of the participants underwent a control procedure at the same time. Salivary cortisol was used to measure the effectiveness of the SECPT stress induction. Stressed participants did not differ from controls in planning accuracy. However, when we compared stressed participants with controls during prospective memory retrieval, we found statistically significant differences in PM across the performance phase. Participants treated with the SECPT procedure before the planning phase showed improved prospective memory retrieval over time, while performance of controls declined. Particularly, there was a significant difference between the stress and control group for the last two days of the holiday week. Interestingly, control participants showed significantly better performance for early than later learned items, which could be an indicator of a primacy effect. This differential effect of stress on performance was also found in time- and event-dependent prospective memory. Our results demonstrate for the first time, that acute stress induced before the planning phase may improve prospective memory over the time course of the performance phase in time- and event-dependent prospective memory. Our data thus indicate that prospective memory can be enhanced by acute stress. PMID:27370532

  9. Use of a Modified Reproductive Life Plan to Improve Awareness of Preconception Health in Women with Chronic Disease

    PubMed Central

    Mittal, Pooja; Dandekar, Aparna; Hessler, Danielle

    2014-01-01

    Objective: Chronic diseases such as hypertension, diabetes, and obesity pose unique reproductive challenges for women. Preconception health results in improved reproductive outcomes. We designed an interventional study testing the use of a reproductive life plan to improve knowledge of preconception and contraception health in women with chronic diseases. Methods: Primarily underserved, English-and Spanish-speaking women aged 18 to 40 years with active diabetes, hypertension, or obesity were recruited. We developed a revised reproductive life plan specific to these diseases. Two resident physicians performed reproductive plan counseling. Pre- and postcounseling surveys were administered to evaluate knowledge and attitudes about chronic disease and the effects on a potential pregnancy. Results: Twenty-seven women (average age = 31 years) were surveyed. Of the subjects, 85.2% were obese, 29.6% had hypertension, and 7.4% had diabetes. Significant increases were reported in understanding risks of pregnancy associated with diabetes (p < 0.001), hypertension (p < 0.001), and obesity (p < 0.01). After counseling, women increased their knowledge about a reproductive plan (p < 0.001) and increased support and information to make reproductive health choices (p = 0.001 and p < 0.01, respectively). The largest improvements in postcounseling variables occurred in women with the lowest precounseling test scores and in women without children. Conclusion: A reproductive life plan is a brief, cost-effective preconception and contraception counseling tool in the primary care setting for women with chronic diseases. This tool increases knowledge about reproductive health and enables women with chronic diseases to make informed decisions about their reproductive future. PMID:24867547

  10. Improving the Operations of the Earth Observing One Mission via Automated Mission Planning

    NASA Technical Reports Server (NTRS)

    Chien, Steve A.; Tran, Daniel; Rabideau, Gregg; Schaffer, Steve; Mandl, Daniel; Frye, Stuart

    2010-01-01

    We describe the modeling and reasoning about operations constraints in an automated mission planning system for an earth observing satellite - EO-1. We first discuss the large number of elements that can be naturally represented in an expressive planning and scheduling framework. We then describe a number of constraints that challenge the current state of the art in automated planning systems and discuss how we modeled these constraints as well as discuss tradeoffs in representation versus efficiency. Finally we describe the challenges in efficiently generating operations plans for this mission. These discussions involve lessons learned from an operations model that has been in use since Fall 2004 (called R4) as well as a newer more accurate operations model operational since June 2009 (called R5). We present analysis of the R5 software documenting a significant (greater than 50%) increase in the number of weekly observations scheduled by the EO-1 mission. We also show that the R5 mission planning system produces schedules within 15% of an upper bound on optimal schedules. This operational enhancement has created value of millions of dollars US over the projected remaining lifetime of the EO-1 mission.

  11. Animal health and welfare planning improves udder health and cleanliness but not leg health in Austrian dairy herds.

    PubMed

    Tremetsberger, Lukas; Leeb, Christine; Winckler, Christoph

    2015-10-01

    Animal health and welfare planning is considered an important tool for herd management; however, its effectiveness is less well known. The aim of this study was to conduct animal health and welfare planning on 34 Austrian dairy farms and to evaluate changes in health and welfare after 1 yr. After an initial assessment using the Welfare Quality protocol (Welfare Quality Consortium, Lelystad, the Netherlands), results were reported back to the farmers. Health and welfare area(s) in which both the farmer and the researcher regarded improvement as important were discussed. Management practices and husbandry measures were chosen according to the respective farm situation. One year after interventions had been initiated, farms were reassessed, and the degree of implementation of improvement measures was recorded. The average implementation rate was 57% and thus relatively high when compared with other studies. High degrees of implementation were achieved related to cleanliness and udder health, at 77 and 63%, respectively. Intervention measures addressing udder health were mostly easy to incorporate in the daily routine and led to a reduced somatic cell score, whereas this score increased in herds without implementation of measures. The decrease in cows with dirty teats was more pronounced when measures were implemented compared with control farms. The implementation rate regarding leg health (46%) was comparably low in the present study, and leg health did not improve even when measures were implemented. Lying comfort, social behavior, and human-animal relationship did not require interventions and were therefore seldom chosen by farmers as part of health and welfare plans. In conclusion, the structured, participatory process of animal health and welfare planning appears to be a promising way to improve at least some animal health and welfare issues. PMID:26233459

  12. Applying an improved rapid impact assessment matrix method to strategic environmental assessment of urban planning in China

    SciTech Connect

    Li, Wei Xie, Yuanbo Hao, Fanghua

    2014-04-01

    Strategic environmental assessment (SEA) has become an increasingly important decision-support tool for providing information on the environmental implications of a policy, plan, or program. The goal is to safeguard the environment and promote sustainable development at the strategic level. Despite major progress in implementing SEA practices internationally, developing countries, such as China, often lag behind in applying SEA methodology. Lack of available data and time constraints arising from tight schedules create problems. The rapid impact assessment matrix (RIAM) is a potential resource for breaking through such difficulties. Our analysis of RIAM applications suggested that it could become a tool for evaluating strategic alternatives because of its applicability in interdisciplinary settings, its transparency, and its short implementation timeframe. To make it more suitable for the SEA context, we have developed two major improvements to the conventional RIAM process: assignment of weights to assessment indicators and the development of an integrated environmental assessment score (IES). The improved RIAM process was employed in an SEA of the development plan for the Nansha District in Guangzhou, the capital city of Guangdong Province in China. It was used to assess five alternatives for development in Wanqingsha (WQS), a subunit of Nansha, where important ecological resources are located and where industrial development could impact the air quality in the neighboring Hong Kong Special Administrative Region (HKSAR). The evaluation identified WQS-A04 as the preferred alternative. This alternative involved a minimal amount of industrial development – 10% compared with the most intense development alternative – and included important wetland preservation plans. The assessment results have been incorporated into the officially approved development plan for Nansha. The improved RIAM methodology is well adapted to the technical aims of SEA and decision

  13. A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia)

    PubMed Central

    Vallès-Fernandez, Roser; Rosell-Murphy, Magdalena; Correcher-Aventin, Olga; Mengual-Martínez, Lucas; Aznar-Martínez, Núria; Prieto-De Lamo, Gemma; Franzi-Sisó, Alícia; Puig-Manresa, Jordi; Ma Bonet-Simó, Josep

    2009-01-01

    Background Different studies have shown insufficient blood pressure (BP) control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT) with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. Methods and design Design: multicentric study quasi-experimental before – after with control group. The non-randomised allocation of the intervention will be done at PHCT level. Setting: 18 PHCT in the Barcelona province (Spain). Sample: all patients with a diagnosis of hypertension (population based study). Exclusion criteria: patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. Intervention: a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. Measurements: age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure). The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Analysis: Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non-normally distributed variables

  14. A patient/family-centered strategic plan can drive significant improvement.

    PubMed

    Brilli, Richard J; Crandall, Wallace V; Berry, Janet C; Stoverock, Linda; Rosen, Kerry; Budin, Lee; Kelleher, Kelly J; Gleeson, Sean P; Davis, J Terrance

    2014-08-01

    The use of a PFCSP, as a road map to operationalize the hospital's vision, has been a compelling paradigm to achieve significant QI results. The framework is simple yet directly aligns with the IOM domains of quality. It has inspired and helped actively engage hospital personnel in the work required to achieve the goals and vision of the hospital system. Five years after initiating this type of plan, activity is flourishing in each of the domains and midterm results are substantial. We think that the nature of this strategic plan has been an important aspect of our success to date. PMID:25037128

  15. Possible improvement in quality of human progeny by maternal dietary intervention: implications for programs of family planning and food production.

    PubMed

    Hsu, S C

    1973-05-01

    A report is made on the family planning program in Taiwan which emphasizes the integrated problems of population growth, nutrition and health, and food supplies. Nutrition and food supply have greatly improved in Taiwan since 1950, particularly in increases in food energy and protein availability. There has been a corresponding, though not necessarily resultant, decline in maternal and infant mortalities and deaths from gastrointestinal diseases. An official family planning program was instituted in Taiwan in 1964 with the goal of reducing the rate of natural increase from 3.0% to 1.5%. In 1971 the rate was 2.1%. Legalizing sterilization and abortion has been an important part of this program. A major goal is improvement in the quality of people. Reducing the size of the population results in more and better food and educational opportunities. A government study in Sui-Lin Township of Taiwan is investigating the effect of improved maternal health and nutrition on the quality of the offspring. The study is seeking to determine the minimum maternal food intake for proper health and which phase of the maternal diet (pre-pregnancy, pregnancy, lactation) or of the infant' diet is the most important to offspring quality. Also being studied is the possible existence of a maximum level of maternal nourishment beyond which detrimental effects might occur. The answers to these questions may provide important information for national nutrition policies, which are important factors in the family planning program. PMID:12276465

  16. Current and planned numerical development for improving computing performance for long duration and/or low pressure transients

    SciTech Connect

    Faydide, B.

    1997-07-01

    This paper presents the current and planned numerical development for improving computing performance in case of Cathare applications needing real time, like simulator applications. Cathare is a thermalhydraulic code developed by CEA (DRN), IPSN, EDF and FRAMATOME for PWR safety analysis. First, the general characteristics of the code are presented, dealing with physical models, numerical topics, and validation strategy. Then, the current and planned applications of Cathare in the field of simulators are discussed. Some of these applications were made in the past, using a simplified and fast-running version of Cathare (Cathare-Simu); the status of the numerical improvements obtained with Cathare-Simu is presented. The planned developments concern mainly the Simulator Cathare Release (SCAR) project which deals with the use of the most recent version of Cathare inside simulators. In this frame, the numerical developments are related with the speed up of the calculation process, using parallel processing and improvement of code reliability on a large set of NPP transients.

  17. Community Alert: Using Text Messaging and Social Media to Improve Campus Emergency Planning

    ERIC Educational Resources Information Center

    Connolly, Maureen

    2014-01-01

    This article describes emergency management and the part that social media technologies and mobile messaging have made when they are included as part of the campus emergency plan. Administrators have found that ample notification and preparedness must be built into campus communication systems. Social media platforms such as Twitter and Facebook…

  18. The Assessment Interaction Plan--A Tool for Driving Performance Improvement through Analysis to Application

    ERIC Educational Resources Information Center

    Christensen, Brett; Barr, Jason

    2009-01-01

    The assessment interaction plan (AIP) is a performance support tool developed by members of the Canadian Defence Academy's Directorate of Learning Innovation. This article provides a brief overview of the performance gap that led to the creation of the AIP, its function within the overall courseware design process, a description of its components,…

  19. How One School District Implemented Site-Based School Improvement Planning Teams.

    ERIC Educational Resources Information Center

    McBee, Maridyth M.; Fink, John S.

    Recent educational literature has stressed the benefits of site-based management and parental involvement in school programs. To capitalize on these benefits, site-based planning teams designed to involve perents, teachers, administrators, students, and community members were developed by the Institute for the Development of Educational Activities…

  20. Improving Collaborative Planning and Reflection Practices at International Baccalaureate Diploma Schools in Amman

    ERIC Educational Resources Information Center

    Saa'd AlDin, Kawther

    2014-01-01

    In 2010, the International Baccalaureate (IB) Organization mandated that all its schools, including Diploma (DP) schools, adhere to the collaborative planning and reflection requirements, which emphasized the importance of integrating its theory of knowledge (TOK) core component into all disciplines. Many schools officials and educations in Amman…

  1. Improving Training in Enterprise Resource Planning Systems Implementation through Communities of Practice

    ERIC Educational Resources Information Center

    Kerr, Don; Burgess, Kevin J.; Houghton, Luke; Murray, Peter A.

    2012-01-01

    The Enterprise Resource Planning (ERP) literature suggests that effective training is one of the key reasons for success in ERP implementations. However, limited research has been conducted on what constitutes effective training in an ERP environment. A case study approach was used to explore the effectiveness of traditional training and to…

  2. Improving Collaborative School-Agency Transition Planning: A Statewide DBMS Approach.

    ERIC Educational Resources Information Center

    Peterson, Randolph L.; Roessler, Richard T.

    1997-01-01

    Describes the development and components of a referral database management system developed by the Arkansas Transition Project. The system enables individualized-education-plan team members to refer students with disabilities directly to adult agencies and to receive a monitoring report describing the agency response to the referral. The system is…

  3. Improving DOE Project Performance Using the DOD Integrated Master Plan - 12481

    SciTech Connect

    Alleman, Glen B.; Nosbisch, Michael R.

    2012-07-01

    DOE O 413 measures a project's progress to plan by the consumption of funding, the passage of time, and the meeting of milestones. In March of 2003, then Under Secretary, Energy, Science, Card received a memo directing the implementation of Project Management and the Project Management Manual, including the Integrated Master Plan and Integrated Master Schedule. This directive states 'the integrated master plan and schedule tie together all project tasks by showing their logical relationships and any constraints controlling the start or finish of each task. This process results in a hierarchy of related functional and layered schedules derived from the Work Breakdown Structure that can be used for monitoring and controlling project progress'. This paper shows how restoring the IMP/IMS paradigm to DOE program management increases the probability of program success in ways not currently available using DOD O 413 processes alone. Using DOE O 413 series guidance, adding the Integrated Master Plan and Integrated Master Schedule paradigm would provide a hierarchical set of performance measures for each 'package of work,' that provides measurable visibility to the increasing maturity of the project. This measurable maturity provides the mechanism to forecast future performance of cost, schedule, and technical outcomes in ways not available using just the activities in DOE O 413. With this information project managers have another tool available to address the issues identified in GAO-07-336 and GAO-09-406. (authors)

  4. Measuring Business Process Learning with Enterprise Resource Planning Systems to Improve the Value of Education

    ERIC Educational Resources Information Center

    Monk, Ellen F.; Lycett, Mark

    2016-01-01

    Enterprise Resource Planning Systems (ERP) are very large and complex software packages that run every aspect of an organization. Increasingly, ERP systems are being used in higher education as one way to teach business processes, essential knowledge for students competing in today's business environment. Past research attempting to measure…

  5. Improving Strategic Planning and Implementation in Universities through Competitive Intelligence Tools: A Means to Gaining Relevance

    ERIC Educational Resources Information Center

    Hughes, Stephanie; White, Rebecca J.

    2005-01-01

    Institutions of higher education can use competitive intelligence (CI) techniques to become more relevant to their communities. In Stepping Forward as Stewards of Place the American Association of State Colleges and Universities (AASCU) provides a model for public engagement that emphasizes internal strategic planning, implementation, and…

  6. Proposed Plan for the Improvement of Foster Care and Adoption Services.

    ERIC Educational Resources Information Center

    Mott-McDonald Associates, Inc., Washington, DC.

    This paper describes the five-year Florida Foster Care and Adoption Plan which was developed to facilitate the provision of more effective services to children needing full time care outside the parental home. The paper is divided into five chapters plus an introduction and summary. The introduction outlines the problems facing the social service…

  7. Automatic computation for optimum height planning of apartment buildings to improve solar access

    SciTech Connect

    Seong, Yoon-Bok; Kim, Yong-Yee; Seok, Ho-Tae; Choi, Jeong-Min; Yeo, Myoung-Souk; Kim, Kwang-Woo

    2011-01-15

    The objective of this study is to suggest a mathematical model and an optimal algorithm for determining the height of apartment buildings to satisfy the solar rights of survey buildings or survey housing units. The objective is also to develop an automatic computation model for the optimum height of apartment buildings and then to clarify the performance and expected effects. To accomplish the objective of this study, the following procedures were followed: (1) The necessity of the height planning of obstruction buildings to satisfy the solar rights of survey buildings or survey housing units is demonstrated by analyzing through a literature review the recent trend of disputes related to solar rights and to examining the social requirements in terms of solar rights. In addition, the necessity of the automatic computation system for height planning of apartment buildings is demonstrated and a suitable analysis method for this system is chosen by investigating the characteristics of analysis methods for solar rights assessment. (2) A case study on the process of height planning of apartment buildings will be briefly described and the problems occurring in this process will then be examined carefully. (3) To develop an automatic computation model for height planning of apartment buildings, geometrical elements forming apartment buildings are defined by analyzing the geometrical characteristics of apartment buildings. In addition, design factors and regulations required in height planning of apartment buildings are investigated. Based on this knowledge, the methodology and mathematical algorithm to adjust the height of apartment buildings by automatic computation are suggested and probable problems and the ways to resolve these problems are discussed. Finally, the methodology and algorithm for the optimization are suggested. (4) Based on the suggested methodology and mathematical algorithm, the automatic computation model for optimum height of apartment buildings is

  8. Reforming primary care in England--again. Plans for improving the quality of care.

    PubMed

    Baker, R

    2000-06-01

    An extensive programme of health service reform has begun in England. Improvement in the quality of care is a key objective of the reforms, and several initiatives are being introduced in response. These include systems to provide national guidance about appropriate treatment and services, a local system to support quality improvement and arrangements to monitor performance, including a new performance framework, an inspection agency and an annual survey of patients. The local quality improvement system has features of particular interest. These include arrangements for setting objectives for quality improvement, the use of various quality improvement methods tailored to local needs and a new system to provide accountability to both the health service and the public. The introduction of clinical governance and all the other reforms presents primary care practitioners with a major challenge. However, if sufficient time is allowed and adequate resources are made available, the reforms do have the potential to improve health care in England. PMID:10944059

  9. Modeling Study on Air Quality Improvement due to Mobile Source Emission control Plan in Seoul Metropolitan Area

    NASA Astrophysics Data System (ADS)

    Kim, Y. J.; Sunwoo, Y.; Hwang, I.; Song, S.; Sin, J.; Kim, D.

    2015-12-01

    A very high population and corresponding high number of vehicles in the Seoul Metropolitan Area (SMA) are aggravating the air quality of this region. The Korean government continues to make concerted efforts to improve air quality. One of the major policies that the Ministry of Environment of Korea enforced is "The Special Act for Improvement of Air Quality in SMA" and "The 1st Air Quality Management Plan of SMA". Mobile Source emission controls are an important part of the policy. Thus, it is timely to evaluate the air quality improvement due to the controls. Therefore, we performed a quantitative analysis of the difference in air quality using the Community Multiscale Air Quality (CMAQ) model and December, 2011 was set as the target period to capture the impact of the above control plans. We considered four fuel-type vehicle emission scenarios and compared the air quality improvement differences between them. The scenarios are as follows: no-control, gasoline vehicle control only, diesel vehicle control only, and control of both; utilizing the revised mobile source emissions from the Clean Air Policy Support System (CAPSS), which is the national emission inventory reflecting current policy.In order to improve the accuracy of the modeling data, we developed new temporal allocation coefficients based on traffic volume observation data and spatially reallocated the mobile source emissions using vehicle flow survey data. Furthermore, we calculated the PM10 and PM2.5 emissions of gasoline vehicles which is omitted in CAPSS.The results of the air quality modeling shows that vehicle control plans for both gasoline and diesel lead to a decrease of 0.65ppb~8.75ppb and 0.02㎍/㎥~7.09㎍/㎥ in NO2 and PM10 monthly average concentrations, respectively. The large percentage decreases mainly appear near the center of the metropolis. However, the largest NO2 decrease percentages are found in the northeast region of Gyeonggi-do, which is the province that surrounds the

  10. Office of Student Financial Aid Quality Improvement Program: Design and Implementation Plan.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    The purpose and direction of the quality improvement program of the U.S. Department of Education's Office of Student Financial Aid (OSFA) are described. The improvement program was designed to develop a systematic approach to identify, measure, and correct errors in the student aid delivery system. Information is provided on the general approach…

  11. Office of Student Financial Aid Quality Improvement Program: Design and Implementation Plan.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Reston, VA.

    The purpose and direction of the Office of Student Financial Aid (OSFA) quality improvement program are described. The background and context for the Pell Grant quality control (QC) design study and the meaning of QC are reviewed. The general approach to quality improvement consists of the following elements: a strategic approach that enables OSFA…

  12. The Role of Staff Development in Long Range Planning for School Improvement.

    ERIC Educational Resources Information Center

    Wallace, Richard C., Jr.

    School administrators in the 1980's must learn to provide stronger instructional leadership to improve student achievement and restore public confidence in education. School improvement will occur, however, only as a result of changes in attitudes, perceptions, and behaviors. Only when teachers have worked out their own concerns regarding a given…

  13. Employability Planning Process. STIP II (Skill Training Improvement Programs Round II).

    ERIC Educational Resources Information Center

    Los Angeles Community Coll. District, CA.

    Four reports are presented detailing procedures for improving the employability of students enrolled in the Los Angeles Community College District's Skill Training Improvement Programs (STIP II). Each report was submitted by one of the four STIP II programs: Los Angeles Southwest College's program for computer programming; the programs for…

  14. Strategic foresight: how planning for the unpredictable can improve environmental decision-making.

    PubMed

    Cook, Carly N; Inayatullah, Sohail; Burgman, Mark A; Sutherland, William J; Wintle, Brendan A

    2014-09-01

    Advanced warning of potential new opportunities and threats related to biodiversity allows decision-makers to act strategically to maximize benefits or minimize costs. Strategic foresight explores possible futures, their consequences for decisions, and the actions that promote more desirable futures. Foresight tools, such as horizon scanning and scenario planning, are increasingly used by governments and business for long-term strategic planning and capacity building. These tools are now being applied in ecology, although generally not as part of a comprehensive foresight strategy. We highlight several ways foresight could play a more significant role in environmental decisions by: monitoring existing problems, highlighting emerging threats, identifying promising new opportunities, testing the resilience of policies, and defining a research agenda. PMID:25097098

  15. Auditing the health care enterprise. Evaluation research can improve strategic planning and implementation in hospitals.

    PubMed

    Woodside, A G; Montelepre, P

    1994-01-01

    Financial audits that focus on the recent past have been criticized for not answering questions concerning whether or not the enterprise will survive and thrive during the next few years. Strategic management/marketing audits (SMMAs) are designed to respond to these concerns. In conducting an SMMA for a long-term care hospital, the authors found critical differences in the beliefs held by key executives and staff members regarding the strategic goals, planning, and actions of the hospital. PMID:10154634

  16. Mixed integer programming improves comprehensibility and plan quality in inverse optimization of prostate HDR brachytherapy.

    PubMed

    Gorissen, Bram L; den Hertog, Dick; Hoffmann, Aswin L

    2013-02-21

    Current inverse treatment planning methods that optimize both catheter positions and dwell times in prostate HDR brachytherapy use surrogate linear or quadratic objective functions that have no direct interpretation in terms of dose-volume histogram (DVH) criteria, do not result in an optimum or have long solution times. We decrease the solution time of the existing linear and quadratic dose-based programming models (LP and QP, respectively) to allow optimizing over potential catheter positions using mixed integer programming. An additional average speed-up of 75% can be obtained by stopping the solver at an early stage, without deterioration of the plan quality. For a fixed catheter configuration, the dwell time optimization model LP solves to optimality in less than 15 s, which confirms earlier results. We propose an iterative procedure for QP that allows us to prescribe the target dose as an interval, while retaining independence between the solution time and the number of dose calculation points. This iterative procedure is comparable in speed to the LP model and produces better plans than the non-iterative QP. We formulate a new dose-volume-based model that maximizes V(100%) while satisfying pre-set DVH criteria. This model optimizes both catheter positions and dwell times within a few minutes depending on prostate volume and number of catheters, optimizes dwell times within 35 s and gives better DVH statistics than dose-based models. The solutions suggest that the correlation between the objective value and the clinical plan quality is weak in the existing dose-based models. PMID:23363622

  17. Conceptual Plans for Qualitatively and Quantitatively Improving Artificial Propagation of Anadromous Salmonids in the Columbia River Basin.

    SciTech Connect

    Bouck, Gerald R.

    1986-10-01

    In 1984, the Northwest Power Planning Council (Council) amended its Fish and Wildlife Program (Program) to include an Action Plan (Section 1500), to give focus and priority directions to various aspects of the Program. Regarding improved hatchery effectiveness, Bonneville Power Administration (BPA) was requested to evaluate ongoing work under 704(h) and submit a workplan to cover future efforts. This report provides concepts for increasing hatchery effectiveness. Additionally, it proposes numerical goals for increased fish production, identifies ways to accomplish them and lists supportive objectives, project schedules, and preliminary budgeting information. Preliminary data from subbasin planning indicates a large additional need for artificially reared salmon and steelhead in the Columbia River Basin. The total need depends upon many factors and this information will be developed and refined as subbasin plans are completed. Recently constructed fish hatcheries are coming on line, and other hatcheries are expected to be prescribed. This workplan is directed at increasing fish propagation at existing facilities, as described in program Section 700. In doing this, four approaches were considered and evaluated: (1) purchasing smolts from commercial resources; (2) building additional but typical hatcheries; (3) modifying existing hatcheries to increase their production with supplemental oxygen; and (4) increasing smolt quality to increase survival, via various supportive actions.

  18. Recent improvements in SPE3D: a VR-based surgery planning environment

    NASA Astrophysics Data System (ADS)

    Witkowski, Marcin; Sitnik, Robert; Verdonschot, Nico

    2014-02-01

    SPE3D is a surgery planning environment developed within TLEMsafe project [1] (funded by the European Commission FP7). It enables the operator to plan a surgical procedure on the customized musculoskeletal (MS) model of the patient's lower limbs, send the modified model to the biomechanical analysis module, and export the scenario's parameters to the surgical navigation system. The personalized patient-specific three-dimensional (3-D) MS model is registered with 3-D MRI dataset of lower limbs and the two modalities may be visualized simultaneously. Apart from main planes, any arbitrary MRI cross-section can be rendered on the 3-D MS model in real time. The interface provides tools for: bone cutting, manipulating and removal, repositioning muscle insertion points, modifying muscle force, removing muscles and placing implants stored in the implant library. SPE3D supports stereoscopic viewing as well as natural inspection/manipulation with use of haptic devices. Alternatively, it may be controlled with use of a standard computer keyboard, mouse and 2D display or a touch screen (e.g. in an operating room). The interface may be utilized in two main fields. Experienced surgeons may use it to simulate their operative plans and prepare input data for a surgical navigation system while student or novice surgeons can use it for training.

  19. Block models for improved earthwork allocation planning in linear infrastructure construction

    NASA Astrophysics Data System (ADS)

    Burdett, R.; Kozan, E.; Kenley, R.

    2015-03-01

    Earthwork planning is considered in this article and a generic block partitioning and modelling approach is devised to provide strategic plans of various levels of detail. Conceptually, this new approach is more accurate and comprehensive than others, for instance those that are section based. In response to recent environmental concerns, the metric for decision making was fuel consumption or emissions. Haulage distance and gradient, however, are important components of these metrics and are also included. Advantageously, the fuel consumption metric is generic and captures the physical difficulties of travelling over inclines of different gradients, which is consistent across all hauling vehicles. For validation, the proposed models and techniques are applied to a real-world road project. The numerical investigations demonstrate that the models can be solved with relatively little CPU time. The proposed block models also result in solutions of superior quality, i.e. they have reduced fuel consumption and cost. Furthermore, the plans differ considerably from those based solely on a distance-based metric, thus demonstrating a need for the industry to reflect on its current practices.

  20. Improved Test Planning and Analysis Through the Use of Advanced Statistical Methods

    NASA Technical Reports Server (NTRS)

    Green, Lawrence L.; Maxwell, Katherine A.; Glass, David E.; Vaughn, Wallace L.; Barger, Weston; Cook, Mylan

    2016-01-01

    The goal of this work is, through computational simulations, to provide statistically-based evidence to convince the testing community that a distributed testing approach is superior to a clustered testing approach for most situations. For clustered testing, numerous, repeated test points are acquired at a limited number of test conditions. For distributed testing, only one or a few test points are requested at many different conditions. The statistical techniques of Analysis of Variance (ANOVA), Design of Experiments (DOE) and Response Surface Methods (RSM) are applied to enable distributed test planning, data analysis and test augmentation. The D-Optimal class of DOE is used to plan an optimally efficient single- and multi-factor test. The resulting simulated test data are analyzed via ANOVA and a parametric model is constructed using RSM. Finally, ANOVA can be used to plan a second round of testing to augment the existing data set with new data points. The use of these techniques is demonstrated through several illustrative examples. To date, many thousands of comparisons have been performed and the results strongly support the conclusion that the distributed testing approach outperforms the clustered testing approach.

  1. Diabetes Health Information Technology Innovation to Improve Quality of Life for Health Plan Members in Urban Safety Net

    PubMed Central

    Ratanawongsa, Neda; Handley, Margaret A.; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

    2014-01-01

    Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support (ATSM) / health coaching intervention for English, Spanish-, and Cantonese-speaking members from four publicly-funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] 0.29, p<0.01) and SF-12 physical scores (ES 0.25, p=0.03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. ATSM is a strategy for improving patient-reported self-management and may also improve some outcomes. PMID:24594561

  2. A Knowledge-Based Approach to Improving and Homogenizing Intensity Modulated Radiation Therapy Planning Quality Among Treatment Centers: An Example Application to Prostate Cancer Planning

    SciTech Connect

    Good, David; Lo, Joseph; Lee, W. Robert; Wu, Q. Jackie; Yin, Fang-Fang; Das, Shiva K.

    2013-09-01

    Purpose: Intensity modulated radiation therapy (IMRT) treatment planning can have wide variation among different treatment centers. We propose a system to leverage the IMRT planning experience of larger institutions to automatically create high-quality plans for outside clinics. We explore feasibility by generating plans for patient datasets from an outside institution by adapting plans from our institution. Methods and Materials: A knowledge database was created from 132 IMRT treatment plans for prostate cancer at our institution. The outside institution, a community hospital, provided the datasets for 55 prostate cancer cases, including their original treatment plans. For each “query” case from the outside institution, a similar “match” case was identified in the knowledge database, and the match case’s plan parameters were then adapted and optimized to the query case by use of a semiautomated approach that required no expert planning knowledge. The plans generated with this knowledge-based approach were compared with the original treatment plans at several dose cutpoints. Results: Compared with the original plan, the knowledge-based plan had a significantly more homogeneous dose to the planning target volume and a significantly lower maximum dose. The volumes of the rectum, bladder, and femoral heads above all cutpoints were nominally lower for the knowledge-based plan; the reductions were significantly lower for the rectum. In 40% of cases, the knowledge-based plan had overall superior (lower) dose–volume histograms for rectum and bladder; in 54% of cases, the comparison was equivocal; in 6% of cases, the knowledge-based plan was inferior for both bladder and rectum. Conclusions: Knowledge-based planning was superior or equivalent to the original plan in 95% of cases. The knowledge-based approach shows promise for homogenizing plan quality by transferring planning expertise from more experienced to less experienced institutions.

  3. A performance improvement plan to increase nurse adherence to use of medication safety software.

    PubMed

    Gavriloff, Carrie

    2012-08-01

    Nurses can protect patients receiving intravenous (IV) medication by using medication safety software to program "smart" pumps to administer IV medications. After a patient safety event identified inconsistent use of medication safety software by nurses, a performance improvement team implemented the Deming Cycle performance improvement methodology. The combined use of improved direct care nurse communication, programming strategies, staff education, medication safety champions, adherence monitoring, and technology acquisition resulted in a statistically significant (p < .001) increase in nurse adherence to using medication safety software from 28% to above 85%, exceeding national benchmark adherence rates (Cohen, Cooke, Husch & Woodley, 2007; Carefusion, 2011). PMID:22703685

  4. An Improved Artificial Bee Colony Algorithm Based on Balance-Evolution Strategy for Unmanned Combat Aerial Vehicle Path Planning

    PubMed Central

    Gong, Li-gang; Yang, Wen-lun

    2014-01-01

    Unmanned combat aerial vehicles (UCAVs) have been of great interest to military organizations throughout the world due to their outstanding capabilities to operate in dangerous or hazardous environments. UCAV path planning aims to obtain an optimal flight route with the threats and constraints in the combat field well considered. In this work, a novel artificial bee colony (ABC) algorithm improved by a balance-evolution strategy (BES) is applied in this optimization scheme. In this new algorithm, convergence information during the iteration is fully utilized to manipulate the exploration/exploitation accuracy and to pursue a balance between local exploitation and global exploration capabilities. Simulation results confirm that BE-ABC algorithm is more competent for the UCAV path planning scheme than the conventional ABC algorithm and two other state-of-the-art modified ABC algorithms. PMID:24790555

  5. Setting objectives for community and systems change: an application of concept mapping for planning a statewide health improvement initiative.

    PubMed

    Trochim, William M K; Milstein, Bobby; Wood, Betty J; Jackson, Susan; Pressler, Virginia

    2004-01-01

    The Hawaii Department of Health (HDOH) used concept mapping techniques to engage local stakeholders and national subject area experts in defining the community and system factors that affect individuals' behaviors related to tobacco, nutrition, and physical activity. Over eight working days, project participants brainstormed 496 statements (edited to a final set of 90), which were then sorted and rated for their importance and feasibility. A sequence of multivariate statistical analyses, including multidimensional scaling and hierarchical cluster analysis, generated maps and figures that were then interpreted by project stakeholders. The results were immediately incorporated into an official plan, approved by the governor and state legislature, recommending how Hawaii's tobacco settlement resources could be used to create sustainable changes in population health. The results also provide empirical support for the premise that both community and systems factors ought to be considered when planning comprehensive health improvement initiatives. PMID:14965431

  6. An improved artificial bee colony algorithm based on balance-evolution strategy for unmanned combat aerial vehicle path planning.

    PubMed

    Li, Bai; Gong, Li-gang; Yang, Wen-lun

    2014-01-01

    Unmanned combat aerial vehicles (UCAVs) have been of great interest to military organizations throughout the world due to their outstanding capabilities to operate in dangerous or hazardous environments. UCAV path planning aims to obtain an optimal flight route with the threats and constraints in the combat field well considered. In this work, a novel artificial bee colony (ABC) algorithm improved by a balance-evolution strategy (BES) is applied in this optimization scheme. In this new algorithm, convergence information during the iteration is fully utilized to manipulate the exploration/exploitation accuracy and to pursue a balance between local exploitation and global exploration capabilities. Simulation results confirm that BE-ABC algorithm is more competent for the UCAV path planning scheme than the conventional ABC algorithm and two other state-of-the-art modified ABC algorithms. PMID:24790555

  7. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132...

  8. 42 CFR 460.132 - Quality assessment and performance improvement plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.132...

  9. Using Young Mothers' Clubs to Improve Knowledge of Postpartum Hemorrhage and Family Planning in Informal Settlements in Nairobi, Kenya.

    PubMed

    Ndirangu, Gathari; Gichangi, Anthony; Kanyuuru, Lynn; Otai, Jane; Mulindi, Rose; Lynam, Pamela; Koskei, Nancy; Tappis, Hannah; Archer, Linda

    2015-08-01

    Women living in Nairobi's informal settlements face a higher risk of maternal death than those living elsewhere in the country, and have limited knowledge of actions they can take to improve their chances of survival during pregnancy and childbirth. As one strategy to reach this high risk group, Jhpiego has implemented young mothers' clubs (YMCs). These clubs comprise mothers aged 18-30 who come together on a weekly basis to share experiences and solutions to their challenges while receiving health education from health facility staff and community health workers (CHWs). The aim of this study was to assess whether the YMC strategy could be used to improve participants' knowledge of postpartum hemorrhage (PPH), positive behavior around childbirth, and family planning. Participants in nine YMCs (n = 193) across four informal settlements were interviewed to assess their knowledge of safe motherhood topics before and after a series of eight health education sessions. Data were analyzed with the McNemar test to determine significance of change in knowledge pre- and post-intervention. The largest improvements were observed in knowledge about what to include in a birth plan, with correct responses increasing from 32 to 73% (p < 0.001), 58-93% (p < 0.001), 36-66% (p < 0.001), 58-85% (p < 0.001), and 64-88% (p < 0.001) for identifying a birth companion, budget, skilled birth attendant, emergency supplies, and place of birth, respectively. Less substantial improvements were observed in knowledge of danger signs of PPH (up 10% from 77%, p = 0.003). Although knowledge of actions to take in the event of bleeding after delivery did significantly improve, final knowledge scores remained low--knowledge to urinate increased from 14 to 28% (p < 0.001) and to breastfeed from 12 to 24% (p = 0.005). Even though the vast majority of respondents (84%) knew before the intervention that a woman should space pregnancy by at least 2 years after delivery, there was an increase to 94% after

  10. A plan to improve end-of-life care for trauma victims and their families.

    PubMed

    Jacobs, Lenworth M; Jacobs, Barbara Bennett; Burns, Karyl J

    2005-01-01

    End-of-life care for trauma patients is unique in that clinicians rarely have the advantage of knowing victims prior to the event. In this setting, the unfamiliarity with patients' wishes and values, the critical nature of the injury, the overwhelming feelings of guilt that families often experience, the suddenness and acuity of the crisis, and the need to make life-and-death decisions, can result in end-of-life care scenarios that are challenging to manage and often difficult to experience. This article describes a plan to develop, implement, and test a best practice model of end-of-life care for trauma victims and their families. PMID:16382585

  11. Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh

    PubMed Central

    Ahmed, Salahuddin; Norton, Maureen; Williams, Emma; Ahmed, Saifuddin; Shah, Rasheduzzaman; Begum, Nazma; Mungia, Jaime; Lefevre, Amnesty; Al-Kabir, Ahmed; Winch, Peter J; McKaig, Catharine; Baqui, Abdullah H

    2013-01-01

    ABSTRACT Background: Short birth intervals are associated with increased risk of adverse maternal and neonatal health (MNH) outcomes. Improving postpartum contraceptive use is an important programmatic strategy to improve the health and well-being of women, newborns, and children. This article documents the intervention package and evaluation design of a study conducted in a rural district of Bangladesh to evaluate the effects of an integrated, community-based MNH and postpartum family planning program on contraceptive use and birth-interval lengths. Intervention: The study integrated family planning counseling within 5 community health worker (CHW)-household visits to pregnant and postpartum women, while a community mobilizer (CM) led community meetings on the importance of postpartum family planning and pregnancy spacing for maternal and child health. The CM and the CHWs emphasized 3 messages: (1) Use of the Lactational Amenorrhea Method (LAM) during the first 6 months postpartum and transition to another modern contraceptive method; (2) Exclusive, rather than fully or nearly fully, breastfeeding to support LAM effectiveness and good infant breastfeeding practices; (3) Use of a modern contraceptive method after a live birth for at least 24 months before attempting another pregnancy (a birth-to-birth interval of about 3 years) to support improved infant health and nutrition. CHWs provided only family planning counseling in the original study design, but we later added community-based distribution of methods, and referrals for clinical methods, to meet women's demand. Methods: Using a quasi-experimental design, and relying primarily on pre/post-household surveys, we selected pregnant women from 4 unions to receive the intervention (n = 2,280) and pregnant women from 4 other unions (n = 2,290) to serve as the comparison group. Enrollment occurred between 2007 and 2009, and data collection ended in January 2013. Preliminary Results: Formative research showed

  12. Evolution of strategic risks under future scenarios for improved utility master plans.

    PubMed

    Luís, Ana; Lickorish, Fiona; Pollard, Simon

    2016-01-01

    Integrated, long-term risk management in the water sector is poorly developed. Whilst scenario planning has been applied to singular issues (e.g. climate change), it often misses a link to risk management because the likelihood of impacts in the long-term are frequently unaccounted for in these analyses. Here we apply the morphological approach to scenario development for a case study utility, Empresa Portuguesa das Águas Livres (EPAL). A baseline portfolio of strategic risks threatening the achievement of EPAL's corporate objectives was evolved through the lens of three future scenarios, 'water scarcity', 'financial resource scarcity' and 'strong economic growth', built on drivers such as climate, demographic, economic, regulatory and technological changes and validated through a set of expert workshops. The results represent how the baseline set of risks might develop over a 30 year period, allowing threats and opportunities to be identified and enabling strategies for master plans to be devised. We believe this to be the first combined use of risk and futures methods applied to a portfolio of strategic risks in the water utility sector. PMID:26584343

  13. Improvement to Airport Throughput Using Intelligent Arrival Scheduling and an Expanded Planning Horizon

    NASA Technical Reports Server (NTRS)

    Glaab, Patricia C.

    2012-01-01

    The first phase of this study investigated the amount of time a flight can be delayed or expedited within the Terminal Airspace using only speed changes. The Arrival Capacity Calculator analysis tool was used to predict the time adjustment envelope for standard descent arrivals and then for CDA arrivals. Results ranged from 0.77 to 5.38 minutes. STAR routes were configured for the ACES simulation, and a validation of the ACC results was conducted comparing the maximum predicted time adjustments to those seen in ACES. The final phase investigated full runway-to-runway trajectories using ACES. The radial distance used by the arrival scheduler was incrementally increased from 50 to 150 nautical miles (nmi). The increased Planning Horizon radii allowed the arrival scheduler to arrange, path stretch, and speed-adjust flights to more fully load the arrival stream. The average throughput for the high volume portion of the day increased from 30 aircraft per runway for the 50 nmi radius to 40 aircraft per runway for the 150 nmi radius for a traffic set representative of high volume 2018. The recommended radius for the arrival scheduler s Planning Horizon was found to be 130 nmi, which allowed more than 95% loading of the arrival stream.

  14. Shifting the open enrollment period for ACA Marketplaces could increase enrollment and improve plan choices.

    PubMed

    Swartz, Katherine; Graves, John A

    2014-07-01

    The next open enrollment period for plans offered in the Affordable Care Act's (ACA's) insurance Marketplaces is set to occur between November 15, 2014, and February 15, 2015--just when many lower-income people are financially stressed by demands of the holiday season. Recent research by experimental psychologists and behavioral economists strongly suggests that when people's decision-making capacity (bandwidth) is stretched thin, either they cannot make decisions or they make poor choices. Using data from nearly a decade of US-based Internet search queries to measure population behavior, we found considerable seasonality in measures of financial stress and in when people seek out information on health insurance plans. A more opportune time for scheduling open enrollment for the ACA Marketplaces may be between February 15 and April 15--weeks when low-income people typically receive income tax refunds and Earned Income Tax Credit payments. Such lump-sum payments could be applied to pay individuals' share of premiums. PMID:24966287

  15. Fair Student Funding and Other Reforms: Baltimore's Plan for Equity, Empowerment, Accountability and Improvement

    ERIC Educational Resources Information Center

    Frank, Stephen

    2012-01-01

    Superintendent Andres A. Alonso arrived in Baltimore in 2007 with a vision for improving the city's struggling schools. His vision included empowering school leaders and creating accountability for student learning through a series of reforms that center around a new system for giving resources to schools, called Fair Student Funding (FSF). FSF…

  16. Behavioral and Managerial Models That Can Help Improve AIDS Campaign Planning.

    ERIC Educational Resources Information Center

    Simmons, Robert E.; And Others

    This paper focuses on the challenge raised by the acquired immunodeficiency syndrome (AIDS) epidemic regarding the need to improve the effectiveness of health communication or education campaigns. The paper discusses the behaviors underlying health information processing and particularly what is called the "knowledge but not behavior-change…

  17. GPE 2020: Improving Learning and Equity through Stronger Education Systems. Strategic Plan 2016-2020

    ERIC Educational Resources Information Center

    Global Partnership for Education, 2016

    2016-01-01

    The Global Partnership for Education (GPE) addresses the most significant education challenges faced by developing countries through supporting governments to improve equity and learning by strengthening their education systems. GPE is a global fund and a partnership focused entirely on education in developing countries. The partnership has a…

  18. Utilizing the Multidisciplinary Team for Planning and Monitoring Care and Quality Improvement

    PubMed Central

    Patel, A.; Franko, Edward R.; Fleshman, James W.

    2015-01-01

    Multidisciplinary team management of patients with rectal cancer requires a dedicated group of surgeons, medical and radiation oncologists, pathologists, radiologists, and mid-level providers who meet to discuss every patient with rectal cancer. The data from that meeting is collected prospectively, recommendations made for case, follow-up obtained, and quality issues monitored. Improved case is the result. PMID:25733969

  19. Study and program plan for improved heavy duty gas turbine engine ceramic component development

    NASA Technical Reports Server (NTRS)

    Helms, H. E.

    1977-01-01

    Fuel economy in a commercially viable gas turbine engine was demonstrated through use of ceramic materials. Study results show that increased turbine inlet and generator inlet temperatures, through the use of ceramic materials, contribute the greatest amount to achieving fuel economy goals. Improved component efficiencies show significant additional gains in fuel economy.

  20. Project Plan: The MEDARP Documentation Unit to the School Improvement and Local School Development Projects.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Educational Evaluation.

    The Metropolitan Educational Development and Research Project (MEDARP) Documentation Unit, located in the Office of Educational Evaluation (OEE) at the New York City Board of Education, is funded by the Ford Foundation to document, evaluate and provide technical assistance to the School Improvement and Local School Development Projects; these are…

  1. Factors associated with frequency of abortions recorded through Dairy Herd Improvement test plans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Frequency of abortions recorded through Dairy Herd Improvement (DHI) testing was summarized for cows with lactations completed from 2001 through 2009. Reported abortions were 1.3% for 8.5 million DHI lactations of cows with recorded breeding dates and that were >151 d pregnant at lactation terminati...

  2. Focus First on Outcomes: When Planning Change, Improved Student Learning Is the Ultimate Goal

    ERIC Educational Resources Information Center

    Bradley, Janice; Munger, Linda; Hord, Shirley

    2015-01-01

    Educators working to achieve changes in classroom teaching practices that lead to improvement in student learning need to gain clarity in where they are going--what they want to accomplish. Teachers in a professional learning community need a road map as they begin learning and applying a new practice to ensure they reach their intended goal…

  3. Tracking Perceived and Observed Growth of Inquiry Practice: A Formative Plan to Improve Professional Development Experiences

    ERIC Educational Resources Information Center

    Marshall, Jeff C.; Smart, Julie; Horton, Robert M.

    2011-01-01

    The authors worked with 22 middle school math and science teachers for one year with the goal of improving the quantity and quality of inquiry-based instruction implemented in the classroom. The professional development experience was framed by the 4E x 2 Instruction Model, which combines key components of inquiry instruction (Engage, Explore,…

  4. Improving Children's Life Chances through Better Family Planning. CCF Brief #55

    ERIC Educational Resources Information Center

    Sawhill, Isabel; Venator, Joanna

    2015-01-01

    Non-marital childbearing is associated with many adverse outcomes for both the mother and the child. Most of these births are unintended. If these unintended births could be reduced it might improve children's prospects by enabling their mothers to get more education, earn more, and wait to have children within marriage. In this brief, the authors…

  5. A United Commitment to Change: Districts and Unions Collaborate to Implement School Improvement Plans

    ERIC Educational Resources Information Center

    Holmes, Ellen; Maiers, Staci

    2012-01-01

    Following the Department of Education's announcement of the $3.5 billion in Title I funding, 831 of the nation's "persistently lowest-achieving schools" received federal funding during the 2010-11 school year to embark on significant change in the form of a School Improvement Grant (U.S. Department of Education, 2010). The Department of Education…

  6. 78 FR 21414 - Central Valley Project Improvement Act, Water Management Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... available for review: Carpinteria Valley Water District Gravelly Ford Water District Hills Valley Irrigation District San Juan Water District San Luis Water District Shafter-Wasco Irrigation District Tea Pot Dome Irrigation District To meet the requirements of the Central Valley Project Improvement Act of 1992 and...

  7. Charting the Effects of Improving Instruction: College Seniors Learning to Write Lesson Plans

    ERIC Educational Resources Information Center

    Pass, Susan

    2006-01-01

    The purpose of this article is to chart improvement in student achievement by use of a new teaching strategy. An additional goal is to discover if an increase in student achievement might also increase students' interest, motivation, and sense of value in learning the subject (in this case, secondary social studies education). A third goal is to…

  8. Program Activity/Training Plans. STIP II (Skill Training Improvement Programs Round II).

    ERIC Educational Resources Information Center

    Los Angeles Community Coll. District, CA.

    Detailed operational guidelines, training objectives, and learning activities are provided for the Los Angeles Community College District's Skill Training Improvement Programs (STIP II), which are designed to train students for immediate employment. The first of four reports covers Los Angeles Southwest College's computer programming trainee…

  9. 11 Foot Unitary Plan Tunnel Facility Optical Improvement Large Window Analysis

    NASA Technical Reports Server (NTRS)

    Hawke, Veronica M.

    2015-01-01

    The test section of the 11 by 11-foot Unitary Plan Transonic Wind Tunnel (11-foot UPWT) may receive an upgrade of larger optical windows on both the North and South sides. These new larger windows will provide better access for optical imaging of test article flow phenomena including surface and off body flow characteristics. The installation of these new larger windows will likely produce a change to the aerodynamic characteristics of the flow in the Test Section. In an effort understand the effect of this change, a computational model was employed to predict the flows through the slotted walls, in the test section and around the model before and after the tunnel modification. This report documents the solid CAD model that was created and the inviscid computational analysis that was completed as a preliminary estimate of the effect of the changes.

  10. Linking HIV & family planning services to improve dual methods of contraception among women infected with HIV in Mumbai, Maharashtra, India

    PubMed Central

    Joshi, Beena; Velhal, Gajanan; Chauhan, Sanjay; Kulkarni, Ragini; Begum, Shahina

    2016-01-01

    Background & objectives: Preventing unintended pregnancies among people living with HIV (PLHIV) is one of the strategies of WHO for preventing parent-to-child transmission (PPTCT). Given the limitation of only condom use, the objective of this study was to improve use of dual contraceptive methods among HIV infected women. Methods: An experimental study among HIV positive women was conducted at two tertiary care level hospitals in Mumbai. Linking HIV with family planning services was the focus of intervention at one site and standard level of care was maintained at the control site. At each site, 150 HIV+ve women attending counselling and testing centres, who did not intend to get pregnant in the next one year and were eligible to use dual methods, were enrolled and followed up to one year. Results: At the end of one year, 60 per cent women in the intervention group reached Family Planning Centres compared to eight per cent in the control group. There was three times more acceptance and continuation of use of dual methods along with increase in consistent use of condoms and less number of unplanned pregnancies in the intervention group than the control group. Interpretation & conclusions: The study findings demonstrate that linking HIV and family planning services may facilitate the uptake of dual methods of contraception without reducing consistent condom use among HIV infected women. The PPTCT programmes need to focus on the component of Prong 2 of PPTCT which aims to prevent unintended pregnancies among HIV positive women. PMID:27377503

  11. Professional motivation and career plan differences between African-American and Caucasian dental students: implications for improving workforce diversity.

    PubMed Central

    Butters, Janice M.; Winter, Paul A.

    2002-01-01

    Vast disparities in oral health status coupled with projected decreases in African Americans enrolling in and graduating from dental school have heightened concern about the underrepresentation of African Americans in the dental profession. The purpose of this study was to explore differences between African-American and white American students regarding demographics, professional motivations, and career plans. African-American (n = 104) and white American (n = 226) dental students completed a biographical data survey instrument, which included information about family background and professional motivations and plans, and rated descriptions of three practice arrangements. African-American students were more motivated to become a dentist to serve the public, plan to specialize, work in an urban area, and work part-time. White American students were more motivated to become a dentist based on factors related to family commitments. Race was a significant predictor for student ratings for both solo and employee practice. Study results have implications for health professions educators, administrators, and policy makers in their efforts to improve the recruitment and retention of African-American students, shape dental curricula to meet diverse student needs, and implement loan forgiveness programs to enhance minority student recruitment. PMID:12078931

  12. Interventions to Improve Postpartum Family Planning in Low- and Middle-Income Countries: Program Implications and Research Priorities.

    PubMed

    Cleland, John; Shah, Iqbal H; Daniele, Marina

    2015-12-01

    This article provides programmatic guidance and identifies future research priorities through a review of interventions to improve postpartum contraception. Thirty-five interventions in low- and middle-income countries were identified and classified according to timing and nature of administration: antenatal, postnatal, both ante- and postnatal, and integration with other services. With the exception of single, short antenatal interventions, the evidence of impact is positive but incomplete. A major gap in knowledge concerns demand for, and means of promoting, immediate postpartum family planning services in Asia and Africa. Counseling before discharge is likely to have an impact on subsequent contraceptive uptake. Integration of family planning into immunization and pediatric services is justified, but policy and program obstacles remain. A case for relaxing the strict conditions of the lactational amenorrhea method (LAM) is strong, but qualitative evidence on the perspectives of women on pregnancy risks is required. Despite the gaps in knowledge, the evidence provides useful guidance for strategies to promote postpartum family planning, in ways that take different contexts into account. PMID:26643491

  13. Strengthening Postabortion Family Planning Services in Ethiopia: Expanding Contraceptive Choice and Improving Access to Long-Acting Reversible Contraception

    PubMed Central

    Samuel, Melaku; Fetters, Tamara; Desta, Demeke

    2016-01-01

    ABSTRACT Where unmet need for the safest, most effective, and long-acting reversible contraceptives (LARCs) is very high, the health system and partners need to implement problem-solving, locally feasible, and comprehensive family planning delivery strategies. Because young and unmarried women are most at risk for unintended pregnancy and repeat abortion due to poor access to contraceptive services, postabortion family planning (PAFP) is a key component in such strategies. In Southern Nations, Nationalities, and People’s Region, Ethiopia, Ipas implemented health system strengthening efforts from fiscal year (FY) 2010 (July 2009 to June 2010) to FY 2014 (July 2013 to June 2014) to improve the quality of PAFP services and expand method choice in 101 public facilities. The intervention significantly improved PAFP uptake at the project sites. Specifically, the proportion of abortion clients receiving LARCs progressively improved during the intervention period. The proportion of abortion clients who left the facilities with a contraceptive method increased from 58% in FY 2010 to 83% in FY 2014. The share of method mix for LARCs rose from 2% in FY 2010 to 55% in FY 2014, while the share for condoms, injectables, and oral contraceptives declined from 98% to 45%. Implant use rose from 2% in FY 2010 to 43% in FY 2014, while the use of intrauterine devices increased from 0.1% in FY 2010 to 12% in FY 2014. A larger proportion of PAFP users received LARCs at health centers, where midwives and nurses are the primary providers, than at hospitals (59% versus 37%, respectively). A broader method mix can satisfy clients with a variety of needs, a key factor for higher uptake of more effective methods and program success. Further evidence-based interventions need to be implemented to improve the quality of PAFP in a feasible and replicable strategy that addresses unmet need for modern contraceptive methods. PMID:27540126

  14. Strengthening Postabortion Family Planning Services in Ethiopia: Expanding Contraceptive Choice and Improving Access to Long-Acting Reversible Contraception.

    PubMed

    Samuel, Melaku; Fetters, Tamara; Desta, Demeke

    2016-08-11

    Where unmet need for the safest, most effective, and long-acting reversible contraceptives (LARCs) is very high, the health system and partners need to implement problem-solving, locally feasible, and comprehensive family planning delivery strategies. Because young and unmarried women are most at risk for unintended pregnancy and repeat abortion due to poor access to contraceptive services, postabortion family planning (PAFP) is a key component in such strategies. In Southern Nations, Nationalities, and People's Region, Ethiopia, Ipas implemented health system strengthening efforts from fiscal year (FY) 2010 (July 2009 to June 2010) to FY 2014 (July 2013 to June 2014) to improve the quality of PAFP services and expand method choice in 101 public facilities. The intervention significantly improved PAFP uptake at the project sites. Specifically, the proportion of abortion clients receiving LARCs progressively improved during the intervention period. The proportion of abortion clients who left the facilities with a contraceptive method increased from 58% in FY 2010 to 83% in FY 2014. The share of method mix for LARCs rose from 2% in FY 2010 to 55% in FY 2014, while the share for condoms, injectables, and oral contraceptives declined from 98% to 45%. Implant use rose from 2% in FY 2010 to 43% in FY 2014, while the use of intrauterine devices increased from 0.1% in FY 2010 to 12% in FY 2014. A larger proportion of PAFP users received LARCs at health centers, where midwives and nurses are the primary providers, than at hospitals (59% versus 37%, respectively). A broader method mix can satisfy clients with a variety of needs, a key factor for higher uptake of more effective methods and program success. Further evidence-based interventions need to be implemented to improve the quality of PAFP in a feasible and replicable strategy that addresses unmet need for modern contraceptive methods. PMID:27540126

  15. Priorities for Improving Iowa's Child-Care System: A Five-Year Plan for Early Care and Education. January 2014 Update

    ERIC Educational Resources Information Center

    Child and Family Policy Center, 2014

    2014-01-01

    The Child and Family Policy Center convened key stakeholders during 2011 and again in 2013 to identify needed improvements to the state's child-care system. This plan reflects the input of focus groups of parents and providers held around Iowa and a planning committee of representatives from public and nonprofit organizations involved with child…

  16. Using Massive Vehicle Positioning Data to Improve Control and Planning of Public Road Transport

    PubMed Central

    Padrón, Gabino; García, Carmelo R.; Quesada-Arencibia, A.; Alayón, Francisco; Pérez, Ricardo

    2014-01-01

    This study describes a system for the automatic recording of positioning data for public transport vehicles used on roads. With the data provided by this system, transportation-regulatory authorities can control, verify and improve the routes that vehicles use, while also providing new data to improve the representation of the transportation network and providing new services in the context of intelligent metropolitan areas. The system is executed autonomously in the vehicles, by recording their massive positioning data and transferring them to remote data banks for subsequent processing. To illustrate the utility of the system, we present a case of application that consists of identifying the points at which vehicles stop systematically, which may be points of scheduled stops or points at which traffic signals or road topology force the vehicle to stop. This identification is performed using pattern recognition techniques. The system has been applied under real operating conditions, providing the results discussed in the present study. PMID:24763212

  17. A plan for the economic assessment of the benefits of improved meteorological forecasts

    NASA Technical Reports Server (NTRS)

    Bhattacharyya, R.; Greenberg, J.

    1975-01-01

    Benefit-cost relationships for the development of meteorological satellites are outlined. The weather forecast capabilities of the various weather satellites (Tiros, SEOS, Nimbus) are discussed, and the development of additional satellite systems is examined. A rational approach is development that leads to the establishment of the economic benefits which may result from the utilization of meteorological satellite data. The economic and social impacts of improved weather forecasting for industries and resources management are discussed, and significant weather sensitive industries are listed.

  18. MicroRNA-16 is putatively involved in the NF-κB pathway regulation in ulcerative colitis through adenosine A2a receptor (A2aAR) mRNA targeting

    PubMed Central

    Tian, Ting; Zhou, Yu; Feng, Xiao; Ye, Shicai; Wang, Hao; Wu, Weiyun; Tan, Wenkai; Yu, Caiyuan; Hu, Juxiang; Zheng, Rong; Chen, Zonghao; Pei, Xinyu; Luo, Hesheng

    2016-01-01

    MicroRNAs (miRNAs) act as important post-transcriptional regulators of gene expression by targeting the 3′-untranslated region of their target genes. Altered expression of miR-16 is reported in human ulcerative colitis (UC), but its role in the development of the disease remains unclear. Adenosine through adenosine A2a receptor (A2aAR) could inhibit nuclear factor-kappaB (NF-κB) signaling pathway in inflammation. Here we identified overexpression of miR-16 and down-regulation of A2aAR in the colonic mucosa of active UC patients. We demonstrated that miR-16 negatively regulated the expression of the A2aAR at the post-transcriptional level. Furthermore, transfection of miR-16 mimics promoted nuclear translocation of NF-κB p65 protein and expression of pro-inflammatory cytokines, IFN-γ and IL-8 in colonic epithelial cells. Treatment with miR-16 inhibitor could reverse these effects in cells. The A2aAR-mediated effects of miR-16 on the activation of the NF-κB signaling pathway were confirmed by the A2aAR knockdown assay. Our results suggest that miR-16 regulated the immune and inflammatory responses, at least in part, by suppressing the expression of the A2aAR to control the activation of the NF-κB signaling pathway. PMID:27476546

  19. Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes

    PubMed Central

    Fromer, Len

    2011-01-01

    Current primary care patterns for chronic obstructive pulmonary disease (COPD) focus on reactive care for acute exacerbations, often neglecting ongoing COPD management to the detriment of patient experience and outcomes. Proactive diagnosis and ongoing multifactorial COPD management, comprising smoking cessation, influenza and pneumonia vaccinations, pulmonary rehabilitation, and symptomatic and maintenance pharmacotherapy according to severity, can significantly improve a patient’s health-related quality of life, reduce exacerbations and their consequences, and alleviate the functional, utilization, and financial burden of COPD. Redesign of primary care according to principles of the chronic care model, which is implemented in the patient-centered medical home, can shift COPD management from acute rescue to proactive maintenance. The chronic care model and patient-centered medical home combine delivery system redesign, clinical information systems, decision support, and self-management support within a practice, linked with health care organization and community resources beyond the practice. COPD care programs implementing two or more chronic care model components effectively reduce emergency room and inpatient utilization. This review guides primary care practices in improving COPD care workflows, highlighting the contributions of multidisciplinary collaborative team care, care coordination, and patient engagement. Each primary care practice can devise a COPD care workflow addressing risk awareness, spirometric diagnosis, guideline-based treatment and rehabilitation, and self-management support, to improve patient outcomes in COPD. PMID:22162647

  20. Improving the Use of Species Distribution Models in Conservation Planning and Management under Climate Change

    PubMed Central

    Porfirio, Luciana L.; Harris, Rebecca M. B.; Lefroy, Edward C.; Hugh, Sonia; Gould, Susan F.; Lee, Greg; Bindoff, Nathaniel L.; Mackey, Brendan

    2014-01-01

    Choice of variables, climate models and emissions scenarios all influence the results of species distribution models under future climatic conditions. However, an overview of applied studies suggests that the uncertainty associated with these factors is not always appropriately incorporated or even considered. We examine the effects of choice of variables, climate models and emissions scenarios can have on future species distribution models using two endangered species: one a short-lived invertebrate species (Ptunarra Brown Butterfly), and the other a long-lived paleo-endemic tree species (King Billy Pine). We show the range in projected distributions that result from different variable selection, climate models and emissions scenarios. The extent to which results are affected by these choices depends on the characteristics of the species modelled, but they all have the potential to substantially alter conclusions about the impacts of climate change. We discuss implications for conservation planning and management, and provide recommendations to conservation practitioners on variable selection and accommodating uncertainty when using future climate projections in species distribution models. PMID:25420020

  1. Codex Committee on Pesticide Residues--a plan for improved participation by governments.

    PubMed

    Wessel, J R

    1992-10-01

    The Codex Committee on Pesticide Residues (CCPR), which is responsible for establishing maximum residue limits (MRLs) for pesticides on food, has a vital role in protecting the public health and facilitating international trade. Codex MRLs are based on scientific evaluations by expert panels that constitute the Joint FAO/WHO Meeting on Pesticide Residues (JMPR). These panelists estimate an acceptable daily intake for a pesticide and expected level of residue remaining in food when the pesticide is used according to good agricultural practice. The goals of the CCPR are not being fully achieved. Governments are generally not accepting Codex MRLs; instead, technical and procedural aspects of the JMPR and CCPR process are being criticized. The CCPR is responding to valid criticisms of the process; however, governments may still lack the will to seek harmonization of pesticide limits for food in international trade. Overcoming this problem will be difficult, but not impossible. A plan of action is proposed that allows countries to selectively accept Codex MRLs, increase the number of chemicals in the JMPR/CCPR system for evaluation, and be responsive to both their consumers and their food producers without compromising national health and safety standards and competitive trade advantages. PMID:1438994

  2. A Plan for Academic Biobank Solvency-Leveraging Resources and Applying Business Processes to Improve Sustainability.

    PubMed

    Uzarski, Diane; Burke, James; Turner, Barbara; Vroom, James; Short, Nancy

    2015-10-01

    Researcher-initiated biobanks based at academic institutions contribute valuable biomarker and translational research advances to medicine. With many legacy banks once supported by federal funding, reductions in fiscal support threaten the future of existing and new biobanks. When the Brain Bank at Duke University's Bryan Alzheimer's Disease Center (ADRC) faced a funding crisis, a collaborative, multidisciplinary team embarked on a 2-year biobank sustainability project utilizing a comprehensive business strategy, dedicated project management, and a systems approach involving many Duke University entities. By synthesizing and applying existing knowledge, Duke Translational Medicine Institute created and launched a business model that can be adjusted and applied to legacy and start-up academic biobanks. This model provides a path to identify new funding mechanisms, while also emphasizing improved communication, business development, and a focus on collaborating with industry to improve access to biospecimens. Benchmarks for short-term Brain Bank stabilization have been successfully attained, and the evaluation of long-term sustainability metrics is ongoing. PMID:25996355

  3. Combining scales in habitat models to improve conservation planning in an endangered vulture

    NASA Astrophysics Data System (ADS)

    Mateo-Tomás, Patricia; Olea, Pedro P.

    2009-07-01

    Predictive modelling of species' distributions has been successfully applied in conservation ecology, but effective conservation requires predictive and accurate models. The combination of different scales to build habitat models might improve their predictive ability and hence their usefulness for conservation, but this approach has rarely been evaluated. We developed habitat-occupancy models combining scales from nest-site to landscape for a key population at the northwestern edge of the distribution of the globally endangered Egyptian vulture ( Neophron percnopterus). We used generalised linear models (GLM) and an information-theoretic approach to identify the best combination of scales and resolutions for explaining occurrence. Those models that combined nest-site and landscape scales improved the predictive ability compared with the scale-specific ones. The best combined model had a very high predictive ability when used against an independent dataset (92% correct classifications). Egyptian vultures preferred to nest in caves with vegetation at the entrance that were situated at the base of long cliffs, provided that these cliffs are embedded within low-lying, heterogeneous areas with little topographic irregularity and with little human disturbance. The density of sheep around the nest positively influenced Egyptian vulture presence. Conservation of the studied population should focus on minimising human disturbance and on promoting sustainable development through conservation of traditional pastoralism. Our findings highlight the importance of developing region-specific multiscale models in order to design effective conservation strategies. The approach described here may be applied similarly in other populations and species.

  4. Recent Updates to NRC Fuel Performance Codes and Plans for Future Improvements

    SciTech Connect

    Geelhood, Kenneth J.

    2011-12-31

    FRAPCON-3.4a and FRAPTRAN 1.4 are the most recent versions of the U.S. Nuclear Regulatory Commission (NRC) steady-state and transient fuel performance codes, respectively. These codes have been assessed against separate effects data and integral assessment data and have been determined to provide a best estimate calculation of fuel performance. Recent updates included in FRAPCON-3.4a include updated material properties models, models for new fuel and cladding types, cladding finite element analysis capability, and capability to perform uncertainty analyses and calculate upper tolerance limits for important outputs. Recent updates included in FRAPTRAN 1.4 include: material properties models that are consistent with FRAPCON-3.4a, cladding failure models that are applicable for loss-of coolant-accident and reactivity initiated accident modeling, and updated heat transfer models. This paper briefly describes these code updates and data assessments, highlighting the particularly important improvements and data assessments. This paper also discusses areas of improvements that will be addressed in upcoming code versions.

  5. Improving Planning and Post-Operative Assessment for Total Hip Arthroplasty

    PubMed Central

    Pétursson, Þröstur; Edmunds, Kyle; Magnúsdóttir, Gígja; Halldórsson, Grétar; jr., Halldór Jónsson; Gargiulo, Paolo

    2015-01-01

    Total Hip Arthroplasty (THA) remains the gold standard of treatment for patients who suffer with a variety of hip-related pathological degeneration or trauma. These patients often exhibit significantly less post-operative pain and an increase in the range of motion of the joint, but there are still relatively common instances of debilitating periprosthetic complications that call into question the method for pre-surgical implant choice. Currently, there are two principal options for THA prostheses: cemented or non cemented. Utilizing the cemented procedure ensures a faster acquisition of adequate implant stability than with the non cemented procedure, but can eventually lead to an increased periprosthetic fracture risk. Non cemented prosthetic stems are more frequently revised within the first few years following THA due to periprosthetic fracture, but non cemented revision surgeries generally result in fewer complications than those of cemented implants. Surgeons typically rely on experience or simple patient metrics such as age and sex to prescribe which implant procedure is optimal, and while this may work for most patients, there is a clear need to analyze more rigoriously patient conditions that correlate to optimal post-THA outcomes. The results from the investigation reported herein indicate that an understanding of how the percent composition and quality of a patient's quadriceps muscle in both healthy and operated legs may be a better indicator for prosthetic choice. Additionally, these data emphasize that the traditional metrics of age and sex inadequately predict changes in quadriceps composition and quality and thereby have comparatively minor utility in determining the patient-appropriate prosthetic type. Key Words: Total Hip Arthroplasty, Prosthetic selection, Muscle size and quality, Anatomical modeling, Surgical planning. PMID:26913152

  6. Diagnostic Accuracy of APRI, AAR, FIB-4, FI, and King Scores for Diagnosis of Esophageal Varices in Liver Cirrhosis: A Retrospective Study.

    PubMed

    Deng, Han; Qi, Xingshun; Peng, Ying; Li, Jing; Li, Hongyu; Zhang, Yongguo; Liu, Xu; Sun, Xiaolin; Guo, Xiaozhong

    2015-01-01

    BACKGROUND Aspartate aminotransferase-to-platelet ratio index (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), FIB-4, fibrosis index (FI), and King scores might be alternatives to the use of upper gastrointestinal endoscopy for the diagnosis of esophageal varices (EVs) in liver cirrhosis. This study aimed to evaluate their diagnostic accuracy in predicting the presence and severity of EVs in liver cirrhosis. MATERIAL AND METHODS All patients who were consecutively admitted to our hospital and underwent upper gastrointestinal endoscopy between January 2012 and June 2014 were eligible for this retrospective study. Areas under curve (AUCs) were calculated. Subgroup analyses were performed according to the history of upper gastrointestinal bleeding (UGIB) and splenectomy. RESULTS A total of 650 patients with liver cirrhosis were included, and 81.4% of them had moderate-severe EVs. In the overall analysis, the AUCs of these non-invasive scores for predicting moderate-severe EVs and presence of any EVs were 0.506-0.6 and 0.539-0.612, respectively. In the subgroup analysis of patients without UGIB, their AUCs for predicting moderate-severe varices and presence of any EVs were 0.601-0.664 and 0.596-0.662, respectively. In the subgroup analysis of patients without UGIB or splenectomy, their AUCs for predicting moderate-severe varices and presence of any EVs were 0.627-0.69 and 0.607-0.692, respectively. CONCLUSIONS APRI, AAR, FIB-4, FI, and King scores had modest diagnostic accuracy of EVs in liver cirrhosis. They might not be able to replace the utility of upper gastrointestinal endoscopy for the diagnosis of EVs in liver cirrhosis. PMID:26687574

  7. SU-E-T-247: Multi-Leaf Collimator Model Adjustments Improve Small Field Dosimetry in VMAT Plans

    SciTech Connect

    Young, L; Yang, F

    2014-06-01

    Purpose: The Elekta beam modulator linac employs a 4-mm micro multileaf collimator (MLC) backed by a fixed jaw. Out-of-field dose discrepancies between treatment planning system (TPS) calculations and output water phantom measurements are caused by the 1-mm leaf gap required for all moving MLCs in a VMAT arc. In this study, MLC parameters are optimized to improve TPS out-of-field dose approximations. Methods: Static 2.4 cm square fields were created with a 1-mm leaf gap for MLCs that would normally park behind the jaw. Doses in the open field and leaf gap were measured with an A16 micro ion chamber and EDR2 film for comparison with corresponding point doses in the Pinnacle TPS. The MLC offset table and tip radius were adjusted until TPS point doses agreed with photon measurements. Improvements to the beam models were tested using static arcs consisting of square fields ranging from 1.6 to 14.0 cm, with 45° collimator rotation, and 1-mm leaf gap to replicate VMAT conditions. Gamma values for the 3-mm distance, 3% dose difference criteria were evaluated using standard QA procedures with a cylindrical detector array. Results: The best agreement in point doses within the leaf gap and open field was achieved by offsetting the default rounded leaf end table by 0.1 cm and adjusting the leaf tip radius to 13 cm. Improvements in TPS models for 6 and 10 MV photon beams were more significant for smaller field sizes 3.6 cm or less where the initial gamma factors progressively increased as field size decreased, i.e. for a 1.6cm field size, the Gamma increased from 56.1% to 98.8%. Conclusion: The MLC optimization techniques developed will achieve greater dosimetric accuracy in small field VMAT treatment plans for fixed jaw linear accelerators. Accurate predictions of dose to organs at risk may reduce adverse effects of radiotherapy.

  8. Objective 1: Extend Life, Improve Performance, and Maintain Safety of the Current Fleet Implementation Plan

    SciTech Connect

    Robert Youngblood

    2011-02-01

    Nuclear power has reliably and economically contributed almost 20% of electrical generation in the United States over the past two decades. It remains the single largest contributor (more than 70%) of non-greenhouse-gas-emitting electric power generation in the United States. By the year 2030, domestic demand for electrical energy is expected to grow to levels of 16 to 36% higher than 2007 levels. At the same time, most currently operating nuclear power plants will begin reaching the end of their 60 year operating licenses. Figure E 1 shows projected nuclear energy contribution to the domestic generating capacity. If current operating nuclear power plants do not operate beyond 60 years, the total fraction of generated electrical energy from nuclear power will begin to decline—even with the expected addition of new nuclear generating capacity. The oldest commercial plants in the United States reached their 40th anniversary in 2009. The U.S. Department of Energy Office of Nuclear Energy’s Research and Development (R&D) Roadmap has organized its activities in accordance with four objectives that ensure nuclear energy remains a compelling and viable energy option for the United States. The objectives are as follows: (1) develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the life of the current reactors; (2) develop improvements in the affordability of new reactors to enable nuclear energy to help meet the Administration’s energy security and climate change goals; (3) develop sustainable nuclear fuel cycles; and (4) understand and minimize risks of nuclear proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document describes how Objective 1 and the LWRS Program will be implemented. The existing U.S. nuclear fleet has a remarkable safety and performance record and today accounts for 70% of the low greenhouse

  9. Objective 1: Extend Life, Improve Performance, and Maintain Safety of the Current Fleet Implementation Plan

    SciTech Connect

    Robert Youngblood

    2011-01-01

    Nuclear power has reliably and economically contributed almost 20% of electrical generation in the United States over the past two decades. It remains the single largest contributor (more than 70%) of non-greenhouse-gas-emitting electric power generation in the United States. By the year 2030, domestic demand for electrical energy is expected to grow to levels of 16 to 36% higher than 2007 levels. At the same time, most currently operating nuclear power plants will begin reaching the end of their 60 year operating licenses. Figure E 1 shows projected nuclear energy contribution to the domestic generating capacity. If current operating nuclear power plants do not operate beyond 60 years, the total fraction of generated electrical energy from nuclear power will begin to decline—even with the expected addition of new nuclear generating capacity. The oldest commercial plants in the United States reached their 40th anniversary in 2009. The U.S. Department of Energy Office of Nuclear Energy’s Research and Development (R&D) Roadmap has organized its activities in accordance with four objectives that ensure nuclear energy remains a compelling and viable energy option for the United States. The objectives are as follows: (1) develop technologies and other solutions that can improve the reliability, sustain the safety, and extend the life of the current reactors; (2) develop improvements in the affordability of new reactors to enable nuclear energy to help meet the Administration’s energy security and climate change goals; (3) develop sustainable nuclear fuel cycles; and (4) understand and minimize risks of nuclear proliferation and terrorism. The Light Water Reactor Sustainability (LWRS) Program is the primary programmatic activity that addresses Objective 1. This document describes how Objective 1 and the LWRS Program will be implemented. The existing U.S. nuclear fleet has a remarkable safety and performance record and today accounts for 70% of the low greenhouse

  10. Improvement plans for the RHIC/AGS on-line model environments

    SciTech Connect

    Brown,K.A.; Ahrens, L.; Beebe-Wang, J.; Morris, J.; Nemesure, S.; Robert-Demolaize, G.; Satogata, T.; Schoefer, V.; Tepikian, S.

    2009-08-31

    The on-line models for Relativistic Ion Collider (RHIC) and the RHIC pre-injectors (the AGS and the AGS Booster) can be thought of as containing our best collective knowledge of these accelerators. As we improve these on-line models we are building the framework to have a sophisticated model-based controls system. Currently the RHIC on-line model is an integral part of the controls system, providing the interface for tune control, chromaticity control, and non-linear chromaticity control. What we discuss in this paper is our vision of the future of the on-line model environment for RHIC and the RHIC preinjectors. Although these on-line models are primarily used as Courant-Snyder parameter calculators using live machine settings, we envision expanding these environments to encompass many other problem domains.

  11. The urban harvest approach as framework and planning tool for improved water and resource cycles.

    PubMed

    Leusbrock, I; Nanninga, T A; Lieberg, K; Agudelo-Vera, C M; Keesman, K J; Zeeman, G; Rijnaarts, H H M

    2015-01-01

    Water and resource availability in sufficient quantity and quality for anthropogenic needs represents one of the main challenges in the coming decades. To prepare for upcoming challenges such as increased urbanization and climate change related consequences, innovative and improved resource management concepts are indispensable. In recent years we have developed and applied the urban harvest approach (UHA). The UHA aims to model and quantify the urban water cycle on different temporal and spatial scales. This approach allowed us to quantify the impact of the implementation of water saving measures and new water treatment concepts in cities. In this paper we will introduce the UHA and its application for urban water cycles. Furthermore, we will show first results for an extension to energy cycles and highlight future research items (e.g. nutrients, water-energy-nexus). PMID:26360761

  12. Instituting organizational learning for quality improvement through strategic planning nominal group processes.

    PubMed

    White, D B

    2000-01-01

    Healthcare managers are faced with unprecedented challenges as characterized by managed care constraints, downsizing, increased client needs, and a society demanding more responsive services. Managers must initiate change for quality, efficiency, and survival. This article provides information and strategies for (a) assessing the change readiness of an organization, (b) conducting an organizational diagnosis, (c) instituting a team culture, (d) developing a change strategy, (e) integrating the strategy with a quality improvement process, and (f) identifying the leadership skills to implement organization renewal. Nominal group processes, namely, SWOT and the Search Conference, are described, and case examples are provided. The implementation strategies have been used successfully in a variety of milieus; practical advice for success is described in detail. PMID:11184022

  13. USQA Health Profile Database as a tool for health plan quality improvement.

    PubMed

    Hanchak, N A; Murray, J F; Hirsch, A; McDermott, P D; Schlackman, N

    1996-01-01

    Managed care organizations are in a unique position to evaluate and improve the quality of care delivered to their defined memberships. Traditionally, health services delivery has been claims-focused. We describe a potentially richer, patient-centered approach, whereby patients with certain chronic diseases are first identified and then used as the unit of analysis. U.S. Quality Algorithms (USQA), a subsidiary of U.S. Healthcare (USHC) based in Blue Bell, Pennsylvania, has developed selection criteria for 36 different chronic diseases and a new database, the USQA Health Profile Database (HPD), to identify and archive patients with those diseases. Examples of how this approach and database can be used as a quality tool are demonstrated. PMID:10157263

  14. Improving health aid for a better planet: The planning, monitoring and evaluation tool (PLANET)

    PubMed Central

    Sridhar, Devi; Car, Josip; Chopra, Mickey; Campbell, Harry; Woods, Ngaire; Rudan, Igor

    2015-01-01

    Background International development assistance for health (DAH) quadrupled between 1990 and 2012, from US$ 5.6 billion to US$ 28.1 billion. This generates an increasing need for transparent and replicable tools that could be used to set investment priorities, monitor the distribution of funding in real time, and evaluate the impact of those investments. Methods In this paper we present a methodology that addresses these three challenges. We call this approach PLANET, which stands for planning, monitoring and evaluation tool. Fundamentally, PLANET is based on crowdsourcing approach to obtaining information relevant to deployment of large–scale programs. Information is contributed in real time by a diverse group of participants involved in the program delivery. Findings PLANET relies on real–time information from three levels of participants in large–scale programs: funders, managers and recipients. At each level, information is solicited to assess five key risks that are most relevant to each level of operations. The risks at the level of funders involve systematic neglect of certain areas, focus on donor’s interests over that of program recipients, ineffective co–ordination between donors, questionable mechanisms of delivery and excessive loss of funding to “middle men”. At the level of managers, the risks are corruption, lack of capacity and/or competence, lack of information and /or communication, undue avoidance of governmental structures / preference to non–governmental organizations and exclusion of local expertise. At the level of primary recipients, the risks are corruption, parallel operations / “verticalization”, misalignment with local priorities and lack of community involvement, issues with ethics, equity and/or acceptability, and low likelihood of sustainability beyond the end of the program’s implementation. Interpretation PLANET is intended as an additional tool available to policy–makers to prioritize, monitor and evaluate

  15. ‘Only systems thinking can improve family planning program in Pakistan’: A descriptive qualitative study

    PubMed Central

    Zafar, Saira; Shaikh, Babar Tasneem

    2014-01-01

    Background: Family Planning (FP) program in Pakistan has been struggling to achieve the desired indicators. Despite a well-timed initiation of the program in late 50s, fertility decline has been sparingly slow. As a result, rapid population growth is impeding economic development in the country. A high population growth rate, the current fertility rate, a stagnant contraceptive prevalence rate and high unmet need remain challenging targets for population policies and FP programs. To accelerate the pace of FP programs and targets concerned, it is imperative to develop and adopt a holistic approach and strategy for plugging the gaps in various components of the health system: service delivery, information systems, drugs-supplies, technology and logistics, Human Resources (HRs), financing, and governance. Hence, World Health Organization (WHO) health systems building blocks present a practical framework for overall health system strengthening. Methods: This descriptive qualitative study, through 23 in-depth interviews, explored the factors related to the health system, and those responsible for a disappointing FP program in Pakistan. Provincial representatives from Population Welfare and Health departments, donor agencies and non-governmental organizations involved with FP programs were included in the study to document the perspective of all stakeholders. Content analysis was done manually to generate nodes, sub-nodes and themes. Results: Performance of FP programs is not satisfactory as shown by the indicators, and these programs have not been able to deliver the desired outcomes. Interviewees agreed that inadequate prioritization given to the FP program by successive governments has led to this situation. There are issues with all health system areas, including governance, strategies, funding, financial management, service delivery systems, HRs, technology and logistic systems, and Management Information System (MIS); these have encumbered the pace of success of

  16. Healthcare improvement as planned system change or complex responsive processes? a longitudinal case study in general practice

    PubMed Central

    2013-01-01

    Background Interest in how to implement evidence-based practices into routine health care has never been greater. Primary care faces challenges in managing the increasing burden of chronic disease in an ageing population. Reliable prescriptions for translating knowledge into practice, however, remain elusive, despite intense research and publication activity. This study seeks to explore this dilemma in general practice by challenging the current way of thinking about healthcare improvement and asking what can be learned by looking at change through a complexity lens. Methods This paper reports the local level of an embedded case study of organisational change for better chronic illness care over more than a decade. We used interviews, document review and direct observation to explore how improved chronic illness care developed in one practice. This formed a critical case to compare, using pattern matching logic, to the common prescription for local implementation of best evidence and a rival explanation drawn from complexity sciences interpreted through modern sociology and psychology. Results The practice changed continuously over more than a decade to deliver better chronic illness care in line with research findings and policy initiatives – re-designing care processes, developing community linkages, supporting patient self-management, using guidelines and clinical information systems, and integrating nurses into the practice team. None of these improvements was designed and implemented according to an explicit plan in response to a documented gap in chronic disease care. The process that led to high quality chronic illness care exhibited clear complexity elements of co-evolution, non-linearity, self-organisation, emergence and edge of chaos dynamics in a network of agents and relationships where a stable yet evolving way of organizing emerged from local level communicative interaction, power relating and values based choices. Conclusions The current discourse

  17. Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management

    PubMed Central

    Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza

    2013-01-01

    training of emergency issues, increasing the teamwork, facing a variety of patients, practicing the role of general practitioners, role-playing on a real patient's bedside, having a multilateral approach to the patient, reducing the wasting time on minor wards, balancing the work and rest schedules of the interns, and better learning and satisfaction of the interns. Over 60% of the participants believed the program has the following benefits: More attention on the training plan, improving the learning of patient management, being more responsive for the training of interns, increasing operational approach to emergency patients, being more aware of the performed actions, and increasing the quality and speed of services provided to patients. The mean score assigned to the whole questionnaire of investigating the viewpoints was 37.5 out of 50. The mean score of the interns’ questionnaire was significantly more than the mean score of the assistants. Discussion: The results obtained indicated that the greatest existing consensus about this plan was the positive impact on the learning of interns in the emergency setting. Thus, it will not only increase the number of patients who the interns are managing during the internship course, but also increases the balance of their workload and they can learn and manage the emergency patients with more leisure. PMID:24520557

  18. Process improvement to the inspection readiness plan in chemical weapons convention challenge inspections. Master`s thesis

    SciTech Connect

    Triplett, W.M.

    1997-09-01

    This thesis identified current Information Technology initiatives to help improve the Navy`s Inspection Readiness Plan for Chemical Warfare Convention (CWC) Challenge Inspection. The CWC is an intensive inspection. The Challenge Inspection allows for a team of international inspectors to inspect a naval facility suspected of violating the CWC on very short notice. This thesis begins with a review of the CWC Challenge Inspection timeline. It then describes the Navy`s Inspection Readiness Plan for CWC Challenge Inspections as well as the Navy Tiger Team that is sent to naval facilities to assist the Commanding Officer and base personnel during inspections. One of the initiatives evaluated by this analysis is the use of videoconferencing. To ascertain the feasibility of using videoconferencing in the CWC Challenge Inspection process, this thesis reviews the current videoconferencing systems and standards, and the results of a questionnaire that was sent to various naval commands. This thesis concludes with recommendations for inclusion of videoconferencing and various other Information Technology initiatives in the CWC Challenge Inspection process.

  19. Improved treatment planning for boron neutron capture therapy for glioblastoma multiforme using fluorine-18 labeled boronophenylalanine and positron emission tomography.

    PubMed

    Nichols, Trent L; Kabalka, George W; Miller, Laurence F; Khan, Mohammad K; Smith, Gary T

    2002-10-01

    Boron neutron capture therapy (BNCT) is a cancer brachytherapy based upon the thermal neutron reaction: 10B(n,alpha)7Li. The efficacy of the treatment depends primarily upon two conditions being met: (a) the preferential concentration of a boronated compound in the neoplasm and (b) an adequate fluence of thermal neutrons delivered to the neoplasm. The boronated amino acid, para-boronophenylalanine (BPA), is the agent widely used in clinical trials to deliver 10B to the malignancy. Positron emission tomography (PET) can be used to generate in vivo boron distribution maps by labeling BPA with the positron emitting nuclide fluorine-18. The incorporation of the PET-derived boron distribution maps into current treatment planning protocols is shown to provide improved treatment plans. Using previously established protocols, six patients with glioblastoma had 18BPA PET scans. The PET distribution maps obtained were used in the conventional BNCT treatment codes. The isodose curves derived from the PET data are shown to differ both qualitatively and quantitatively from the conventional isodose curves that were derived from calculations based upon the assumption of uniform uptake of the pharmaceutical in tumor and normal brain regions. The clinical course of each of the patients who eventually received BNCT (five of the six patients) was compared using both sets of isodose calculations. The isodose contours based upon PET derived distribution data appear to be more consistent with the patients' clinical course. PMID:12408309

  20. Engineering work plan and design basis for 241-SY ventilation improvements

    SciTech Connect

    Andersen, J.A.

    1997-05-19

    There are three tanks in the 241-SY tank farm. Tank 241-SY101 and 241-SY-103 are flammable gas watch list tanks. Tank 241-SY-102 is included in the ventilation improvement process in an effort to further control air flow in the tank farm. This tank farm has only one outlet ventilation port for all three tanks. Flammable gas is released (may be steady and/or periodic) from the waste in the primary tank vapor space. The gas is removed from the tank by an active ventilation system. However, maintaining consistent measurable flow through the tank can be problematic due to the poor control capabilities of existing equipment. Low flow through the tank could allow flammable gas to build up in the tank and possibly exceed the lower flammability limit (LFL), prevent the most rapid removal of flammable gas from the tank after a sudden gas release, and/or cause high vacuum alarms to sound. Using the inlet and outlet down stream butterfly valves performs the current method of controlling flow in tank farm 241-SY. A filter station is installed on the inlet of each tank, but controlling air flow with its 12 inch butterfly valve is difficult. There is also in-leakage through pump and valve pits. Butterfly valves on the downstream side of each tank could also be used to control air flow. However, their large size and the relatively low air velocity make this control method also ineffective. The proposed method of optimizing tank air flow and pressure control capability is to install an air flow controller on the inlet of each existing filter station in SY farm, and seal as best as practical all other air leakage paths. Such air flow controllers have been installed on 241-AN and 241-AW tanks (see drawing H-2-85647).

  1. Improving nitrogen management via a regional management plan for Chinese rice production

    NASA Astrophysics Data System (ADS)

    Wu, Liang; Chen, Xinping; Cui, Zhenling; Wang, Guiliang; Zhang, Weifeng

    2015-09-01

    A lack of basic information on optimal nitrogen (N) management often results in over- or under-application of N fertilizer in small-scale intensive rice farming. Here, we present a new database of N input from a survey of 6611 small-scale rice farmers and rice yield in response to added N in 1177 experimental on-farm tests across eight agroecological subregions of China. This database enables us to evaluate N management by farmers and develop an optimal approach to regional N management. We also investigated grain yield, N application rate, and estimated greenhouse gas (GHG) emissions in comparison to N application and farming practices. Across all farmers, the average N application rate, weighted by the area of rice production in each subregion, was 210 kg ha-1 and ranged from 30 to 744 kg ha-1 across fields and from 131 to 316 kg ha-1 across regions. The regionally optimal N rate (RONR) determined from the experiments averaged 167 kg ha-1 and varied from 114 to 224 kg N ha-1 for the different regions. If these RONR were widely adopted in China, approximately 56% of farms would reduce their use of N fertilizer, and approximately 33% would increase their use of N fertilizer. As a result, grain yield would increase by 7.4% from 7.14 to 7.67 Mg ha-1, and the estimated GHG emissions would be reduced by 11.1% from 1390 to 1236 kg carbon dioxide (CO2) eq Mg-1 grain. These results suggest that to achieve the goals of improvement in regional yield and sustainable environmental development, regional N use should be optimized among N-poor and N-rich farms and regions in China.

  2. Improving D&D Planning and Waste Management with Cutting and Packaging Simulation

    SciTech Connect

    Richard H. Meservey; Jean-Louis Bouchet

    2005-08-01

    The increased amount of decontamination and decommissioning (D&D) being performed throughout the world not only strains nuclear cleanup budgets, but places severe demands on the capacities of nuclear waste disposal sites. Although budgets and waste disposal sites have been able to accommodate the demand thus far, the increasing number of large facilities being decommissioned will cause major impacts to the waste disposal process. It is thus imperative that new and innovative technologies are applied within the D&D industry to reduce costs and waste disposal requirements for the decommissioning of our inventory of large and aging nuclear facilities. One of the most significant problems reactor owner’s deal with is the accurate determination of the types and volumes of wastes that will be generated during decommissioning of their facilities. Waste disposal costs, restrictions, and transportation issues can account for as much as 30% of the total costs to decommission a facility and thus it is very important to have accurate waste volume estimates. The use of simulation technologies to estimate and reduce decommissioning waste volumes provides a new way to manage risks associated with this work. Simulation improves the process by allowing facility owners to obtain accurate estimates of the types and amounts of waste prior to starting the actual D&D work. This reduces risk by permitting earlier and better negotiations with the disposal sites, and more time to resolve transportation issues. While simulation is a tool to be used by the D&D contractors, its real value is in reducing risks and costs to the reactor owners.

  3. Combining supine MRI and 3D optical scanning for improved surgical planning of breast conserving surgeries

    NASA Astrophysics Data System (ADS)

    Pallone, Matthew J.; Poplack, Steven P.; Barth, Richard J., Jr.; Paulsen, Keith D.

    2012-02-01

    Image-guided wire localization is the current standard of care for the excision of non-palpable carcinomas during breast conserving surgeries (BCS). The efficacy of this technique depends upon the accuracy of wire placement, maintenance of the fixed wire position (despite patient movement), and the surgeon's understanding of the spatial relationship between the wire and tumor. Notably, breast shape can vary significantly between the imaging and surgical positions. Despite this method of localization, re-excision is needed in approximately 30% of patients due to the proximity of cancer to the specimen margins. These limitations make wire localization an inefficient and imprecise procedure. Alternatively, we investigate a method of image registration and finite element (FE) deformation which correlates preoperative supine MRIs with 3D optical scans of the breast surface. MRI of the breast can accurately define the extents of very small cancers. Furthermore, supine breast MR reduces the amount of tissue deformation between the imaging and surgical positions. At the time of surgery, the surface contour of the breast may be imaged using a handheld 3D laser scanner. With the MR images segmented by tissue type, the two scans are approximately registered using fiducial markers present in both acquisitions. The segmented MRI breast volume is then deformed to match the optical surface using a FE mechanical model of breast tissue. The resulting images provide the surgeon with 3D views and measurements of the tumor shape, volume, and position within the breast as it appears during surgery which may improve surgical guidance and obviate the need for wire localization.

  4. Using multibiomarker approach as a tool to improve the management plan for a Private Reserve of Natural Heritage (RPPN).

    PubMed

    da Silva, Manuela Dreyer; Rossi, Stéfani Cibele; Ghisi, Nédia de Castilhos; de Oliveira Ribeiro, Ciro Alberto; Cestari, Marta Margarete; Silva de Assis, Helena Cristina

    2014-05-01

    This study aimed to monitor an aquatic ecosystem during two different periods (dry and rainy season) on a protected area located inside a sugarcane farm, using the fish Astyanax sp. as bioindicator. An integrated approach was adopted by combining the responses of well-known biomarkers: acetylcholinesterase, lipid peroxidation (LPO), catalase (CAT), glutathione S-transferase (GST), micronucleus test, and liver histopathology. The activity of enzymes CAT and GST was increased after the rainy season. This can be explained mainly by the intensification of rain density, which drags substances into the streams, especially pesticides applied on agriculture. LPO and micronucleus test also suggested some effects of contamination in the surrounding area during this season. The results have supported a discussion about the effectiveness of protected areas in agricultural regions, emphasizing the biomonitoring as a tool for improving management plans in protected areas. PMID:24531322

  5. Does Integrating Family Planning into HIV Services Improve Gender Equitable Attitudes? Results from a Cluster Randomized Trial in Nyanza, Kenya.

    PubMed

    Newmann, Sara J; Rocca, Corinne H; Zakaras, Jennifer M; Onono, Maricianah; Bukusi, Elizabeth A; Grossman, Daniel; Cohen, Craig R

    2016-09-01

    This study investigated whether integrating family planning (FP) services into HIV care was associated with gender equitable attitudes among HIV-positive adults in western Kenya. Surveys were conducted with 480 women and 480 men obtaining HIV services from 18 clinics 1 year after the sites were randomized to integrated FP/HIV services (N = 12) or standard referral for FP (N = 6). We used multivariable regression, with generalized estimating equations to account for clustering, to assess whether gender attitudes (range 0-12) were associated with integrated care and with contraceptive use. Men at intervention sites had stronger gender equitable attitudes than those at control sites (adjusted mean difference in scores = 0.89, 95 % CI 0.03-1.74). Among women, attitudes did not differ by study arm. Gender equitable attitudes were not associated with contraceptive use among men (AOR = 1.06, 95 % CI 0.93-1.21) or women (AOR = 1.03, 95 % CI 0.94-1.13). Further work is needed to understand how integrating FP into HIV care affects gender relations, and how improved gender equity among men might be leveraged to improve contraceptive use and other reproductive health outcomes. PMID:26837632

  6. Improving district level health planning and priority setting in Tanzania through implementing accountability for reasonableness framework: Perceptions of stakeholders

    PubMed Central

    2010-01-01

    Background In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania. The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees. Methods Individual interviews were carried out with different categories of actors and stakeholders in the district. The interview guide consisted of a series of questions, asking respondents to describe their perceptions regarding each condition of the Accountability for Reasonableness framework in terms of priority setting. Interviews were analysed using thematic framework analysis. Documentary data were used to support, verify and highlight the key issues that emerged. Results Almost all stakeholders viewed Accountability for Reasonableness as an important and feasible approach for improving priority-setting and health service delivery in their context. However, a few aspects of Accountability for Reasonableness were seen as too difficult to implement given the socio-political conditions and traditions in Tanzania. Respondents mentioned: budget ceilings and guidelines, low level of public awareness, unreliable and untimely funding, as well as the limited capacity of the district to generate local resources as the major contextual factors that hampered the full implementation of the framework in their context. Conclusion This study was one of the first assessments of the applicability of Accountability for Reasonableness in health care priority-setting in Tanzania. The analysis, overall, suggests that the Accountability for Reasonableness framework could be an important tool for improving priority-setting processes in the

  7. Alpine re-activation of pre-Alpine structures: details from a large-scale shear zone in the Aar massif (Central Alps)

    NASA Astrophysics Data System (ADS)

    Wehrens, Philip; Baumberger, Roland; Herwegh, Marco

    2013-04-01

    The Aar massif belongs to the external massifs of the Alps and is mainly composed of granitoids and gneisses. Post-Variscan granitoid rocks have intruded old gneisses belonging to the pre-Variscan basement. Despite numerous detailed studies in the past decades, the overall exhumation history and the associated massif internal deformation (internal strain distribution and its evolution in time, kinematics etc.) are largely unknown at present. In this project, we aim to investigate the role of shear zones in the deformation history at a variety of scales. In this context it is important to understand their microstructural evolution, the involved deformation processes, kinematics and relative ages as well as the associated changes in rheology. A detailed study was conducted along a major shear zone located at the southern margin of the Aar massif (running from Furka to Grimsel Pass and Oberaar Glacier), where the Grimsel Granodiorite (GrGr) is juxtapositioned to strongly foliated gneisses. Preliminary results show that a crenulation of these gneisses predates the age of the granitoid intrusion, meaning they must be older than 298 Ma. The crenulation and a related axial plane foliation (145/80°) define mechanical anisotropies within these Pre-Variscan rocks. The intruding granite has exploited these anisotropies a first time during its emplacement in post-Variscan times. The lithological boundary between the intruded GrGr and Pre-Variscan rocks causes strain again to localize during Alpine deformation and results in a 40 m wide large-scale shear zone. The older part of the shear zone shows cm-scale shear zones with vertical lineations shearing off the aforementioned pre-Alpine axial plane foliation. Hence the contact is reactivated, now as Alpine normal/ reverse fault, a second time. Towards the youngest parts of the shear zone the stretching lineation on the shear surfaces turns from vertical towards a subhorizontal position, indicating a change from initial vertical

  8. Characterization of spatial distribution of Tetranychus urticae in peppermint in California and implication for improving sampling plan.

    PubMed

    Rijal, Jhalendra P; Wilson, Rob; Godfrey, Larry D

    2016-02-01

    Twospotted spider mite, Tetranychus urticae Koch, is an important pest of peppermint in California, USA. Spider mite feeding on peppermint leaves causes physiological changes in the plant, which coupling with the favorable environmental condition can lead to increased mite infestations. Significant yield loss can occur in absence of pest monitoring and timely management. Understating the within-field spatial distribution of T. urticae is critical for the development of reliable sampling plan. The study reported here aims to characterize the spatial distribution of mite infestation in four commercial peppermint fields in northern California using spatial techniques, variogram and Spatial Analysis by Distance IndicEs (SADIE). Variogram analysis revealed that there was a strong evidence for spatially dependent (aggregated) mite population in 13 of 17 sampling dates and the physical distance of the aggregation reached maximum to 7 m in peppermint fields. Using SADIE, 11 of 17 sampling dates showed aggregated distribution pattern of mite infestation. Combining results from variogram and SADIE analysis, the spatial aggregation of T. urticae was evident in all four fields for all 17 sampling dates evaluated. Comparing spatial association using SADIE, ca. 62% of the total sampling pairs showed a positive association of mite spatial distribution patterns between two consecutive sampling dates, which indicates a strong spatial and temporal stability of mite infestation in peppermint fields. These results are discussed in relation to behavior of spider mite distribution within field, and its implications for improving sampling guidelines that are essential for effective pest monitoring and management. PMID:26692381

  9. Improving Micro-Planning in Education through a Geographical Information System: Studies on Ethiopia and Palestine. School Mapping and Local-Level Planning.

    ERIC Educational Resources Information Center

    Attfield, Ian; Tamiru, Mathewos; Parolin, Bruno; De Grauwe, Anton

    This book contains reports of two projects--one in Ethiopia, one in Palestine--that integrated a Geographical Information System (GIS) into the educational planning process. (A GIS is a computer program that combines two databases: numerical data such as traditional data on schools, teachers, and students; and geographic data such as the location…

  10. Practical methods for improving dose distributions in Monte Carlo-based IMRT planning of lung wall-seated tumors treated with SBRT.

    PubMed

    Altman, Michael B; Jin, Jian-Yue; Kim, Sangroh; Wen, Ning; Liu, Dezhi; Siddiqui, M Salim; Ajlouni, Munther I; Movsas, Benjamin; Chetty, Indrin J

    2012-01-01

    Current commercially available planning systems with Monte Carlo (MC)-based final dose calculation in IMRT planning employ pencil-beam (PB) algorithms in the optimization process. Consequently, dose coverage for SBRT lung plans can feature cold-spots at the interface between lung and tumor tissue. For lung wall (LW)-seated tumors, there can also be hot spots within nearby normal organs (example: ribs). This study evaluated two different practical approaches to limiting cold spots within the target and reducing high doses to surrounding normal organs in MC-based IMRT planning of LW-seated tumors. First, "iterative reoptimization", where the MC calculation (with PB-based optimization) is initially performed. The resultant cold spot is then contoured and used as a simultaneous boost volume. The MC-based dose is then recomputed. The second technique uses noncoplanar beam angles with limited path through lung tissue. Both techniques were evaluated against a conventional coplanar beam approach with a single MC calculation. In all techniques the prescription dose was normalized to cover 95% of the PTV. Fifteen SBRT lung cases with LW-seated tumors were planned. The results from iterative reoptimization showed that conformity index (CI) and/or PTV dose uniformity (UPTV) improved in 12/15 plans. Average improvement was 13%, and 24%, respectively. Nonimproved plans had PTVs near the skin, trachea, and/or very small lung involvement. The maximum dose to 1cc volume (D1cc) of surrounding OARs decreased in 14/15 plans (average 10%). Using noncoplanar beams showed an average improvement of 7% in 10/15 cases and 11% in 5/15 cases for CI and UPTV, respectively. The D1cc was reduced by an average of 6% in 10/15 cases to surrounding OARs. Choice of treatment planning technique did not statistically significantly change lung V5. The results showed that the proposed practical approaches enhance dose conformity in MC-based IMRT planning of lung tumors treated with SBRT, improving target

  11. Growth of exfoliation joints and near-surface stress orientations inferred from fractographic markings observed in the upper Aar valley (Swiss Alps)

    NASA Astrophysics Data System (ADS)

    Ziegler, Martin; Loew, Simon; Bahat, Dov

    2014-06-01

    Granitic rock mass of the upper Aar valley (Grimsel area, Switzerland) contains distinct generations of exfoliation joints, which formed during different stages of the Pleistocene, subparallel to distinct glacial valley palaeotopography. The bulk of exfoliation joints shows prominent, common fractographic features: (1) radial plumose structures with distinct plume axes; (2) arrest marks superimposed by plumose striations; and (3) gradually-developing en échelon fringe cracks. Multiple arrest marks reveal that exfoliation joints formed incrementally and, together with the absence of hackle fringes, suggest stable, i.e., subcritical fracturing conditions. Smooth transitions from plumose structures on the parent plane to en échelon fringe cracks, combined with non-systematic stepping senses of fringe cracks, suggest local (vs. temporal) stress field variations. Assuming that plume axes formed parallel to the maximum principal compressive stress (σ1) enables us to infer near-surface palaeostress orientations and compare them with classical borehole-based in-situ stress data. The majority of plume axes suggest (1) persistently subhorizontal to slightly inclined σ1 orientations at trough valley slopes and (2) near-surface variability of σ1 orientations originating from topographic perturbation caused by glacial valley erosion superimposed on the regional stress field. Our investigations of fracture surface morphologies yield unique insights into exfoliation fracture formation, such as directional trends of fracture propagation and associated palaeostress orientations within Alpine valley slopes.

  12. The Possible Relationship of the California Master Plan for Special Education to the State Department of Education Bureau of Pupil Personnel Services Plan for Improvement of Guidance Services in California Relative to Delivery of Services to Handicapped Pupils: Who's On First?

    ERIC Educational Resources Information Center

    Mendocino County Office of Education, Ukiah, CA.

    Service delivery to handicapped pupils is discussed in regard to the relationship between the California Master Plan for Special Education (see EC 062 915) and the Bureau of Pupil Personnel's Plan for Improvement of Guidance Services. The goals, benefits and limitations of both plans are described; and each plan is examined and compared in terms…

  13. The New I.S.A.M. (Institutional Self-Assessment Measure): A Planning and Program Improvement Tool for Competency-Based Programs.

    ERIC Educational Resources Information Center

    Wise, John

    The Institutional Self-Assessment Measure (ISAM) is presented, which was designed to aid local agency program managers and staff members in planning and improving implementation of competency-based education (CBE) programs. It is a structured tool to be used with the support of a trained ISAM facilitator to enhance communication among staff…

  14. Applying the model of Goal-Directed Behavior, including descriptive norms, to physical activity intentions: A contribution to improving the Theory of Planned Behavior

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contributed to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) ap...

  15. Assessment in Online Programs: Use in Strategic Planning for Faculty/Adjunct Development and Course Instruction to Improve Faculty and Student Engagement

    ERIC Educational Resources Information Center

    Sutton, Melanie; White, Laura; Mbizo, Justice; Stewart, George

    2010-01-01

    This article describes the use of assessment in the design and implementation stages of launching online courses and programs. While use of assessment for improving student engagement in both face-to-face and online courses has been commonly used, the authors augmented the strategic planning of programs to include assessment as a tool for…

  16. Parent Involvement and Extended Learning Activities in School Improvement Plans in the Midwest Region. Summary. Issues & Answers. REL 2011-No. 115

    ERIC Educational Resources Information Center

    Kochanek, Julie Reed; Wraight, Sara; Wan, Yinmei; Nylen, Leslie; Rodriguez, Sheila

    2011-01-01

    According to the reauthorized Elementary and Secondary Education Act of 2001 (Public Law 107-110), commonly referred to as the No Child Left Behind (NCLB) Act, Title I schools that fail to make adequate yearly progress for two consecutive years are required to develop or revise school improvement plans aimed at boosting student achievement.…

  17. Mobilizing male opinion leaders’ support for family planning to improve maternal health: a theory-based qualitative study from Pakistan

    PubMed Central

    Azmat, Syed Khurram

    2011-01-01

    Purpose Pakistan is a patriarchal society in which male opinion leaders play an important role in determining health-seeking behaviors pertaining to family planning (FP) among their respective communities. This research focuses on cataloguing the perceptions of opinion leaders (clergymen, health professionals, and social workers) about the barriers for using services and practical solutions for promoting FP in the slums of Karachi, Pakistan. Materials and methods A qualitative study using an open-ended, semistructured interview schedule with hypothetical scenarios and in-depth interviews with a purposive sample of 45 opinion leaders (25 mosque imams/clergymen, 12 nonallopathic health professionals, and eight social workers/activists) was conducted in 2006–2007 in Karachi, Pakistan. Transcripts were coded thematically utilizing NVivo by using an adapted constant comparison analysis process as described by Strauss and Corbin. Results Seven key themes were derived from the in-depth interviews. Five themes provide insight into the opinion leaders’ perceptions of barriers to FP and modern contraception methods. Among the barriers religious taboos and cultural pressures were particularly note-worthy. Two themes offered opportunities for more effective development and implementation of FP programs. Conclusion It is evident from the study that opinion leaders in the community and the clergy lack the understanding of the importance of birth spacing. However, because they have a great deal of influence on the community at large, it is imperative to interact with them to build their capacity in order to propagate the messages of FP and improve maternal health and reproductive health in general. PMID:22247617

  18. Training for Leadership in Local Educational Improvement Programs. Unit 2. Theory and Strategies of Planned Change in Education.

    ERIC Educational Resources Information Center

    Heathers, Glen

    This unit reviews educational theory and its relationships to educational practice. Its purpose is not to survey various theories of planned educational change since there is an extensive body of literature dealing with this topic. Theory, as presented in this unit, is tied closely to strategies that can guide leaders in planning and conducting…

  19. 75 FR 35315 - Improving Public Safety Communications in the 800 MHz Band; New 800 MHz Band Plan for Puerto Rico...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... public safety and other land mobile communication systems operating in the band, 69 FR 67823, November 22... Puerto Rico market compared to other markets, 72 FR 39756, July 20, 2007. Rather than specify a band plan... 800 MHz band reconfiguration in Puerto Rico as well as alternative band plans, 73 FR 40274, July...

  20. General chemistry courses that can affect achievement: An action research study in developing a plan to improve undergraduate chemistry courses

    NASA Astrophysics Data System (ADS)

    Shweikeh, Eman

    Over the past 50 years, considerable research has been dedicated to chemistry education. In evaluating principal chemistry courses in higher education, educators have noted the learning process for first-year general chemistry courses may be challenging. The current study investigated perceptions of faculty, students and administrators on chemistry education at three institutions in Southern California. Via action research, the study sought to develop a plan to improve student engagement in general chemistry courses. A mixed method was utilized to analyze different perceptions on key factors determining the level of commitment and engagement in general chemistry education. The approach to chemistry learning from both a faculty and student perspective was examined including good practices, experiences and extent of active participation. The research study considered well-known measures of effective education with an emphasis on two key components: educational practices and student behavior. Institutional culture was inclusively assessed where cognitive expectations of chemistry teaching and learning were communicated. First, the extent in which faculty members are utilizing the "Seven Principles for Good Practice in Undergraduate Education" in their instruction was explored. Second, student attitudes and approaches toward chemistry learning were examined. The focus was on investigating student understanding of the learning process and the structure of chemistry knowledge. The seven categories used to measure students' expectations for learning chemistry were: effort, concepts, math link, reality link, outcome, laboratory, and visualization. This analysis represents the views of 16 faculty and 140 students. The results validated the assertion that students need some competencies and skills to tackle the challenges of the chemistry learning process to deeply engage in learning. A mismatch exists between the expectations of students and those of the faculty

  1. Comparison of IMRT planning with two-step and one-step optimization: a strategy for improving therapeutic gain and reducing the integral dose

    NASA Astrophysics Data System (ADS)

    Abate, A.; Pressello, M. C.; Benassi, M.; Strigari, L.

    2009-12-01

    The aim of this study was to evaluate the effectiveness and efficiency in inverse IMRT planning of one-step optimization with the step-and-shoot (SS) technique as compared to traditional two-step optimization using the sliding windows (SW) technique. The Pinnacle IMRT TPS allows both one-step and two-step approaches. The same beam setup for five head-and-neck tumor patients and dose-volume constraints were applied for all optimization methods. Two-step plans were produced converting the ideal fluence with or without a smoothing filter into the SW sequence. One-step plans, based on direct machine parameter optimization (DMPO), had the maximum number of segments per beam set at 8, 10, 12, producing a directly deliverable sequence. Moreover, the plans were generated whether a split-beam was used or not. Total monitor units (MUs), overall treatment time, cost function and dose-volume histograms (DVHs) were estimated for each plan. PTV conformality and homogeneity indexes and normal tissue complication probability (NTCP) that are the basis for improving therapeutic gain, as well as non-tumor integral dose (NTID), were evaluated. A two-sided t-test was used to compare quantitative variables. All plans showed similar target coverage. Compared to two-step SW optimization, the DMPO-SS plans resulted in lower MUs (20%), NTID (4%) as well as NTCP values. Differences of about 15-20% in the treatment delivery time were registered. DMPO generates less complex plans with identical PTV coverage, providing lower NTCP and NTID, which is expected to reduce the risk of secondary cancer. It is an effective and efficient method and, if available, it should be favored over the two-step IMRT planning.

  2. A randomized controlled trial with a Canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia

    PubMed Central

    Stip, Emmanuel; Vincent, Philippe D.; Sablier, Juliette; Guevremont, Catherine; Zhornitsky, Simon; Tranulis, Constantin

    2013-01-01

    Objective: Medication adherence is extremely important in preventing relapse and lowering symptoms in schizophrenic patients. However, estimates show that nearly half of these patients have poor adherence. The Brief Adherence Rating Scale (BARS) seems to be the most reliable tool assessing adherence in schizophrenia and shows that the antipsychotic adherence ratio (AAR) is about 49.5% in schizophrenia. The aim of the study was to test if an electronic pill dispenser named DoPill® improved AAR of schizophrenic patients. Furthermore, we compared AAR obtained by the DoPill® and the BARS, in order to verify whether the DoPill® provides reliable assessment of medication adherence. Methods: The DoPill® is a smart pill dispenser that beeps and flashes at the appropriate time of the day. Each of its 28 compartments is covered by a plastic lamina that, when taken off, sends a signal to the pharmacist. Patients were randomized to the DoPill® or treatment as usual groups for 6 weeks. The BARS was used as a reference measure. Results: Forty-six percent of patients were deemed to be non-adherent with antipsychotic medication. The mean AAR was 67% after 6 weeks. DoPill® recorded better AAR than some of those found in the literature and were lower than the BARS estimate we found. Conclusion: These results suggest that DoPill® is a valid tool that provides more reliable and objective data for the clinician about their patient’s adherence, than existing assessment tools like the BARS. Furthermore, the device may help patients successfully manage their medication regimen. PMID:23950746

  3. Field-in-field plan does not improve the dosimetric outcome compared with the wedged beams plan for breast cancer radiotherapy

    SciTech Connect

    Sun, Li-Min; Meng, Fan-Yun; Yang, Tsung-Han; Tsao, Min-Jen

    2014-04-01

    To evaluate and compare the dosimetry of field-in-field (FIF) and wedged beams (WB) techniques for patients with breast cancer receiving adjuvant radiotherapy after conservative surgery. A total of 89 patients with breast cancer participated in this study. Each patient received a computed tomography–based treatment plan with opposed tangential fields. Two planning techniques (FIF and WB) were generated for each patient by using the Pinnacle treatment-planning system. Three indices, the homogeneity index (HI), conformity index (CI), and uniformity index (UI), as well as maximum dose (D{sub max}), median dose (D{sub 50}), number of portals, monitor unit (MU), and lung volume at 20 Gy (lung{sub 20}) were used for comparison. The mean values tested using a t-test indicated that the WB technique had a significantly lower HI (p < 0.0001), a significantly higher CI (p < 0.0001), and a significantly higher D{sub 50} (p = 0.0002) than did the FIF technique. The FIF technique had a significantly higher D{sub max} compared with the WB technique, but lung{sub 20} did not exhibit a significant difference. By contrast, the FIF technique had a significantly higher UI and a significantly lower MU compared with the WB technique, but a significantly higher number of portals were found in the FIF technique. The FIF technique did not demonstrate superior dosimetric results. The WB technique had a significantly lower HI, higher CI, lower D{sub max}, and lower number of portals; but the FIF technique had a significantly higher UI and lower MU.

  4. Planning law and public health at an impasse in Australia: the need for targeted law reforms to improve local food environments to reduce overweight and obesity.

    PubMed

    Mills, Caroline

    2014-09-01

    Australia's high rates of overweight and obesity, and the associated increased population risk of non-communicable diseases, pose a challenge to policymakers across sectors beyond the health portfolio. In the last decade, strategies to promote healthy lifestyles and address non-communicable diseases have increasingly interested urban planners in Australia and internationally. However, Australian planning laws continue to operate largely without regard to public health goals, thus limiting the ability of communities to shape healthy built environments. In recent years, local governments have increasingly taken on responsibility for improving public health through community-based initiatives; however, their efforts are hindered by their limited capacity to influence planning priorities under current State-legislated planning schemes. This article considers the emerging body of research exploring the impact of urban planning on health and non-communicable diseases in Australia. It is contended that planning law in Australia is out of step with the evidence of planning's potential impact on health, and reforms are required to ensure consistency with public health priorities. PMID:25341327

  5. How urban system vulnerabilities to flooding could be assessed to improve resilience and adaptation in spatial planning

    NASA Astrophysics Data System (ADS)

    Pasi, Riccardo; Viavattene, Christophe; La Loggia, Goffredo

    2016-04-01

    Natural hazards damage assets and infrastructure inducing disruptions to urban functions and key daily services. These disruptions may be short or long with a variable spatial scale of impact. From an urban planning perspective, measuring these disruptions and their consequences at an urban scale is fundamental in order to develop more resilient cities. Whereas the assessment of physical vulnerabilities and direct damages is commonly addressed, new methodologies for assessing the systemic vulnerability at the urban scale are required to reveal these disruptions and their consequences. Physical and systemic vulnerability should be measured in order to reflect the multifaceted fragility of cities in the face of external stress, both in terms of the natural/built environment and socio-economic sphere. Additionally, a systemic approach allows the consideration of vulnerability across different spatial scales, as impacts may vary and be transmitted across local, regional or national levels. Urban systems are spatially distributed and the nature of this can have significant effects on flood impacts. The proposed approach identifies the vulnerabilities of flooding within urban contexts, including both in terms of single elementary units (buildings, infrastructures, people, etc.) and systemic functioning (urban functions and daily life networks). Direct losses are appraised initially using conventional methodologies (e.g. depth-damage functions). This aims to both understand the spatial distribution of physical vulnerability and associated losses and, secondly, to identify the most vulnerable building types and ways to improve the physical adaptation of our cities, proposing changes to building codes, design principles and other municipal regulation tools. The subsequent systemic approach recognises the city as a collection of sub-systems or functional units (such as neighbourhoods and suburbs) providing key daily services for inhabitants (e.g. healthcare facilities

  6. Stable isotope and Ar/Ar evidence of prolonged multiscale fluid flow during exhumation of orogenic crust: Example from the Mont Blanc and Aar Massifs (NW Alps)

    NASA Astrophysics Data System (ADS)

    Rossi, M.; Rolland, Y.

    2014-09-01

    The spatial and temporal scales and the geometry of fluid pathways in a collisional orogen are investigated using stable isotope analysis (O, C, and H) and 40Ar/39Ar dating of vein minerals formed at circa 11-16 Ma in the Mont Blanc and the Aar External Crystalline Massifs. In both massifs 40Ar/39Ar dating of veins adularia provides evidence for progressive crystallization from 16 to 9 Ma, and mainly at 11-12 Ma following veins opening during shear zone activity. The fluid flow duration thus ranges from 4 to 5 Ma in the two massifs. The δ18O values of vein quartz and calcite are similar to those of undeformed crystalline and sedimentary host rocks, suggesting rock buffering, while carbon isotope ratios of vein calcites fall into three compositional groups. A-type veins have δ13C values that are buffered by the Helvetic metasediments, which suggests that these veins formed in a closed system from a locally derived CO2-rich fluid. The fluid in equilibrium with C-type veins has depleted δ13C values similar to mantle-CO2, while the intermediate δ13C values of B-type veins suggest mixing between the A-type and C-type fluids. These results are in agreement with crustal- to lithosphere-scale upward vertical fluid flow along vertical shear zones related to the strike-slip system bounding the Adriatic block since 16-20 Ma, connecting a deep-seated fluid to some downward flow in the sedimentary cover of External Crystalline Massifs.

  7. Multi-objective optimization in spatial planning: Improving the effectiveness of multi-objective evolutionary algorithms (non-dominated sorting genetic algorithm II)

    NASA Astrophysics Data System (ADS)

    Karakostas, Spiros

    2015-05-01

    The multi-objective nature of most spatial planning initiatives and the numerous constraints that are introduced in the planning process by decision makers, stakeholders, etc., synthesize a complex spatial planning context in which the concept of solid and meaningful optimization is a unique challenge. This article investigates new approaches to enhance the effectiveness of multi-objective evolutionary algorithms (MOEAs) via the adoption of a well-known metaheuristic: the non-dominated sorting genetic algorithm II (NSGA-II). In particular, the contribution of a sophisticated crossover operator coupled with an enhanced initialization heuristic is evaluated against a series of metrics measuring the effectiveness of MOEAs. Encouraging results emerge for both the convergence rate of the evolutionary optimization process and the occupation of valuable regions of the objective space by non-dominated solutions, facilitating the work of spatial planners and decision makers. Based on the promising behaviour of both heuristics, topics for further research are proposed to improve their effectiveness.

  8. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop.

    PubMed

    Balogh, Erin P; Ganz, Patricia A; Murphy, Sharon B; Nass, Sharyl J; Ferrell, Betty R; Stovall, Ellen

    2011-01-01

    The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment. There are numerous obstacles to achieving patient-centered cancer treatment planning in practice. Some of these challenges stem from the patient and include patients' lack of assertiveness, health literacy, and numeracy, and their emotional state and concurrent illnesses. Others are a result of physician limitations, such as a lack of time to explain complex information and a lack of tools to facilitate treatment planning, as well as insensitivity to patients' informational, cultural, and emotional needs. Potential solutions to address these obstacles include better training of health care providers and patients in optimal communication and shared decision making, and greater use of support services and tools such as patient navigation and electronic health records. Other options include greater use of quality metrics and reimbursement for the time it takes to develop, discuss, and document a treatment plan. PMID:22128118

  9. Development, Implementation, and Evaluation of a Strategic Plan for Improving Physical Plant Management at Southwest Texas Junior College.

    ERIC Educational Resources Information Center

    Box, Wilford Winston

    A study was conducted at Southwest Texas Junior College (STJC) to assess current management practices used by the physical plant maintenance department (PPMD) and to develop a strategic plan for physical plant management. Procedures included an analysis of current management practices and systems that affect physical resources, and periodic and…

  10. Thinking Ahead: Improving Support for People with Learning Disabilities and Their Families to Plan for the Future

    ERIC Educational Resources Information Center

    Towers, Christine

    2013-01-01

    The increasing life expectancy of people with learning disabilities makes it imperative that families plan for the future. The number of people with learning disabilities over the age of 65 is predicted to double over the next two decades. The greatest increase in life expectancy will be amongst people with mild learning disabilities who will have…

  11. 75 FR 35363 - Improving Public Safety Communications in the 800 MHz Band; New 800 MHz Band Plan for Puerto Rico...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... markets, 72 FR 39756, July 20, 2007. Rather than specify a band plan for Puerto Rico, the Commission... Filing of Documents in Rulemaking Proceedings, 63 FR 24121 (1998). Electronic Filers: Comments may be..., 69 FR 67823, November 22, 2004. In a Second Memorandum Opinion and Order, adopted in May 2007,...

  12. Forward Intensity-Modulated Radiotherapy Planning in Breast Cancer to Improve Dose Homogeneity: Feasibility of Class Solutions

    SciTech Connect

    Peulen, Heike; Hanbeukers, Bianca; Boersma, Liesbeth; Baardwijk, Angela van; Ende, Piet van den; Houben, Ruud; Jager, Jos; Murrer, Lars; Borger, Jacques

    2012-01-01

    Purpose: To explore forward planning methods for breast cancer treatment to obtain homogeneous dose distributions (using International Commission on Radiation Units and Measurements criteria) within normal tissue constraints and to determine the feasibility of class solutions. Methods and Materials: Treatment plans were optimized in a stepwise procedure for 60 patients referred for postlumpectomy irradiation using strict dose constraints: planning target volume (PTV){sub 95%} of >99%; V{sub 107%} of <1.8 cc; heart V{sub 5Gy} of <10% and V{sub 10Gy} of <5%; and mean lung dose of <7 Gy. Treatment planning started with classic tangential beams. Optimization was done by adding a maximum of four segments before adding beams, in a second step. A breath-hold technique was used for heart sparing if necessary. Results: Dose constraints were met for all 60 patients. The classic tangential beam setup was not sufficient for any of the patients; in one-third of patients, additional segments were required (<3), and in two-thirds of patients, additional beams (<2) were required. Logistic regression analyses revealed central breast diameter (CD) and central lung distance as independent predictors for transition from additional segments to additional beams, with a CD cut-off point at 23.6 cm. Conclusions: Treatment plans fulfilling strict dose homogeneity criteria and normal tissue constraints could be obtained for all patients by stepwise dose intensity modification using limited numbers of segments and additional beams. In patients with a CD of >23.6 cm, additional beams were always required.

  13. Improving Global Modeling and Data Analysis Using Remotely-Sensed Rainfall Data: Lessons From TRMM and Plans for GPM

    NASA Technical Reports Server (NTRS)

    Hou, Arthur Y.; Einaudi, Franco (Technical Monitor)

    2001-01-01

    I will discuss the need for accurate rainfall observations to improve our ability to model the earth's climate and improve short-range weather forecasts. I will give an overview of the recent progress in using of rainfall data provided by TRMM and other microwave instruments in data assimilation to improve global analyses and diagnose state-dependent systematic errors in physical parameterizations. I will outline the current and future research strategies in preparation for the Global Precipitation Mission.

  14. Using Quality Improvement Methods to Implement an Electronic Medical Record (EMR) Supported Individualized Home Pain Management Plan for Children with Sickle Cell Disease

    PubMed Central

    Crosby, Lori E.; Simmons, Kenya; Kaiser, Peggy; Davis, Blair; Boyd, Patricia; Eichhorn, Tiffany; Mahaney, Tracy; Joffe, Naomi; Morgan, Darice; Schibler, Kathy; Anderson, Viia; Quinn, Charles T.; Kalinyak, Karen A.

    2014-01-01

    Objective Using quality improvement methodology, our goal was to develop and implement individualized home pain management plans (HPMP) that included pharmacologic as well as non-pharmacologic strategies for children with sickle cell disease (SCD). We hypothesized that successfully implemented HPMPs would have an impact on Emergency Department (ED) use, decreasing ED visits for uncomplicated SCD pain episodes. Methods A multidisciplinary quality improvement team developed a questionnaire to assess the frequency, location and severity of a patient’s pain during a routine, comprehensive visit in order to help the patient and family develop an effective pain management strategy using both pharmacologic and non-pharmacologic actions. Using plan do study act cycles (PDSAs), this team was able to build this process into the daily workflow for all SCD patients age 5 years to 21 years of age. Patients with comprehensive visits scheduled from January 2012 to May 2013 were included (N=188) in the intervention. Results By May of 2013, 88% of eligible patients had an individualized HPMP in place. There was a concomitant reduction in the percentage of SCD patients seen in the ED for uncomplicated SCD pain (6.9% vs. 1.1%). Conclusions Using quality improvement methods, an individualized HPMP intervention was incorporated successfully into the daily workflow of a busy outpatient SCD clinic. This intervention has the potential to improve patient outcomes by decreasing avoidable ED visits as well as reducing overall healthcare costs. PMID:25258504

  15. Evaluation of the 1989 and 1990 Reading Improvement Program. Illinois Initiatives for Educational Reform. Research, Evaluation, & Planning Report.

    ERIC Educational Resources Information Center

    Bakall, Liz; And Others

    This document evaluates the 1989 and 1990 Reading Improvement Program, which aimed to enhance and support 330 local schools in the implementation of Chicago (Illinois) Public Schools' goals for reading and language arts in kindergarten through grade 6. The program focused on improving instruction and reading achievement. Program features included…

  16. Data Mining Nursing Care Plans of End of Life Patients: A Study to Improve Healthcare Decision Making

    PubMed Central

    Almasalha, F.; Xu, D.; Keenan, G. M.; Khokhar, A.; Yao, Y.; Chen, Yu-C.; Johnson, A.; Ansari, R.; Wilkie, D. J.

    2012-01-01

    Pain management of end of life patients (EOL) (n=596 episodes) is examined using statistical and data mining processes of the HANDS database of care plans coded with NANDA-I, NOC, and NIC (NNN) terminologies. HANDS episode data (episode =care plans updated at every handoff on a patient while staying on a hospital unit) were gathered in 8 units located in 4 different health care facilities (total episodes = 40,747; EOL episodes = 1,425) over two years. Results show the multiple discoveries such as EOL patients with hospital stays (< 72 hrs.) are less likely (p<0.005) to meet the pain relief goals compared to EOL patients with longer hospital stays. The study demonstrates a major benefit of systematically integrating NNN into electronic health records. PMID:23413930

  17. A Low-Dose Ipsilateral Lung Restriction Improves 3-D Conformal Planning for Partial Breast Radiation Therapy

    SciTech Connect

    Mitchell, Tracy; Truong, Pauline T.; Salter, Lee; Graham, Cathy; Gaffney, Helene; Beckham, Wayne; Olivotto, Ivo A.

    2011-04-01

    In trials of 3D conformal external beam partial breast radiotherapy (PBRT), the dosimetrist must balance the priorities of achieving high conformity to the target versus minimizing low-dose exposure to the normal structures. This study highlights the caveat that in the absence of a low-dose lung restriction, the use of relatively en-face fields may meet trial-defined requirements but expose the ipsilateral lung to unnecessary low-dose radiation. Adding a low-dose restriction that {<=}20% of the ipsilateral lung should receive 10% of the prescribed dose resulted in successful plans in 88% of cases. This low-dose lung limit should be used in PBRT planning.

  18. Improved monitoring framework for local planning in the water, sanitation and hygiene sector: From data to decision-making.

    PubMed

    Garriga, Ricard Giné; de Palencia, Alejandro Jiménez Fdez; Foguet, Agustí Pérez

    2015-09-01

    Today, a vast proportion of people still lack a simple pit latrine and a source of safe drinking water. To help end this appalling state of affairs, there is a pressing need to provide policymakers with evidences which may be the basis of effective planning, targeting and prioritization. Two major challenges often hinder this process: i) lack of reliable data to identify which areas are most in need; and ii) inadequate instruments for decision-making support. In tackling previous shortcomings, this paper proposes a monitoring framework to compile, analyze, interpret and disseminate water, sanitation and hygiene information. In an era of decentralization, where decision-making moves to local governments, we apply such framework at the local level. The ultimate goal is to develop appropriate tools for decentralized planning support. To this end, the study first implements a methodology for primary data collection, which combines the household and the waterpoint as information sources. In doing so, we provide a complete picture of the context in which domestic WASH services are delivered. Second, the collected data are analyzed to underline the emerging development challenges. The use of simple planning indicators serves as the basis to i) reveal which areas require policy attention, and to ii) identify the neediest. Third, a classification process is proposed to prioritize among various populations. Three different case studies from East and Southern African countries are presented. Results indicate that accurate and comprehensive data, if adequately exploited through simple instruments, may be the basis of effective targeting and prioritization, which are central to sector planning. The application of the proposed framework in the real world, however, is to a certain extent elusive; and we point out to conclude two specific challenges that remain unaddressed, namely the upgrade of existing decision-making processes to enhance transparency and inclusiveness, and the

  19. Early Discharge Planning and Improved Care Transitions: Pre-Admission Assessment for Readmission Risk in an Elective Orthopedic and Cardiovascular Surgical Population

    PubMed Central

    Mola, Ana; Rosenfeld, Peri; Ford, Shauna

    2016-01-01

    Background/Methods: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan. An 8-item questionnaire, which includes patient self-reported health, was integrated into care managers’ telephonic pre-admission assessments during a 12-month period. Results: Regression models found the questionnaire to be predictive of readmission (p ≤ .005; R2 = .334) and length-of-stay (p ≤ .001; R2 = .314). Independent variables of “lives-alone” and “self-rated health” were statistically significant for increased readmission odds, as was “self-rated health” for increased length-of-stay. Quality measures, patient experience and increased rates of discharges-to-home further supported the benefit of embedding these questions into the pro-active planning process. Conclusion: The pilot discharge risk assessment was predictive of readmission risk and length-of-stay for elective orthopedic/cardiovascular patients. Given the usability of the questionnaire in advance of elective admissions, it can facilitate pro-active discharge planning essential for producing quality outcomes and addressing new reimbursement methodologies for continuum-based episodes of care.

  20. Distribution and inferred age of exfoliation joints in the Aar Granite of the central Swiss Alps and relationship to Quaternary landscape evolution

    NASA Astrophysics Data System (ADS)

    Ziegler, Martin; Loew, Simon; Moore, Jeffrey R.

    2013-11-01

    deepest exfoliation joint generation is associated with erosion of the inner glacial troughs of the upper Aar valley, which likely occurred during the mid-Pleistocene Revolution. Our study shows how exfoliation joint episodes can be dated, and, conversely, that better knowledge of the distribution of exfoliation joint sets can reveal unique information about the morphological evolution of an Alpine valley.

  1. A Plan to Improve Melanoma Tumor Depth Data Quality in the Surveillance, Epidemiology, and End Results Program.

    PubMed

    Lam, Clara; Dickie, Lois; Adamo, Peggy; Penberthy, Lynne

    2016-01-01

    In light of the recent assessment done for ProstateSpecific Antigen values in the Surveillance, Epidemiology, and End Results (SEER) Program, it is possible that coding procedures for melanoma tumor depth may have similar quality issues. Potential errors that have been initially identified are implied decimal errors, transcription errors, and incomplete information. Because of the SEER Program's commitment to high data quality standards, various studies are being planned to review and adjudicate incorrect lab values for several different data items in the SEER data collection. PMID:27556846

  2. Improving compliance to meal-replacement food regimens. Forming implementation intentions (conscious IF-THEN plans) increases compliance.

    PubMed

    Zandstra, E H; den Hoed, W; van der Meer, N; van der Maas, A

    2010-12-01

    Creating and changing habits around dieting behaviour can be a way to help consumers to consume more healthy products and to control their weight. Previous studies suggested that implementation intentions - deliberate plans on when, where and how - increase the likelihood that consumers perform the intended behaviour (Armitage, 2004; Gollwitzer & Sheeran, 2006; Jackson et al., 2005). This study investigated the effect of forming implementation intentions on compliance to a regimen based on a range of meal-replacement food products and snacks. Participants (n = 57) were allocated to one of two groups, either: (1) an implementation-intention group, who formed deliberate plans (implementation intentions) to consume the products - these implementation intentions were formed only once at the beginning of the study -, or (2) a control group who formed no implementation intentions. Participants were then instructed to follow a daily regimen, which included the consumption of foods from a range of meal-replacement products and snacks provided gratis for four weeks. Results showed that the implementation-intention group consumed significantly more meal-replacement food products per week (p < 0.05) and decreased their BMI score more than did the control group (p < 0.05). The effect of forming the implementation intentions was apparent for 18 days. These findings indicate that forming implementation intentions may assist individuals in their compliance to a meal-replacement product regimen. PMID:20883734

  3. Research Plans for Improving Understanding of Effects of Very Low-Frequency Noise of Heavy Lift Rotorcraft

    NASA Technical Reports Server (NTRS)

    Fidell, Sanford; Horonieff, Richard D.; Schmitz, Fredric H.

    2010-01-01

    This report reviews the English-language technical literature on infrasonic and low-frequency noise effects; identifies the most salient effects of noise produced by a future large civil tiltrotor aircraft on crew, passengers, and communities near landing areas; and recommends research needed to improve understanding of the effects of such noise on passengers, crew, and residents of areas near landing pads.

  4. The Impact of School Improvement Grants on Achievement: Plans for a National Evaluation Using a Regression Discontinuity Design

    ERIC Educational Resources Information Center

    Deke, John; Dragoset, Lisa

    2015-01-01

    Does receipt of School Improvement Grants (SIG) funding to implement a school intervention model have an impact on outcomes for low-performing schools? This study answers this question using a regression discontinuity design (RDD) that exploits cutoff values on the continuous variables used to define SIG eligibility tiers, comparing outcomes in…

  5. FY 2014 Educational Facilities Master Plan and Amendments to the FY 2013-2018 Capital Improvements Program

    ERIC Educational Resources Information Center

    Montgomery County Public Schools, 2013

    2013-01-01

    In November 1996, the voters of Montgomery County (Maryland) approved by referendum an amendment to the County Charter that changed the County Council's review and approval cycle of the six-year Capital Improvements Program (CIP) from an annual to biennial cycle. The referendum specified that in odd-numbered fiscal years (on-years) the County…

  6. Creating and Sustaining a Culture of Evidence and Improvement: How Can Integrating Institutional Research, Assessment and Planning Help?

    ERIC Educational Resources Information Center

    Leimer, Christina

    2009-01-01

    Regional accrediting agencies today require higher education institutions to develop and demonstrate a culture of evidence-based decision-making and improvement as part of its emphasis on effectiveness. However, scant literature or examples exist to guide colleges and universities in developing such a culture. Cultural change is usually prompted…

  7. Improving the Design of Science Intervention Studies: An Empirical Investigation of Design Parameters for Planning Group Randomized Trials

    ERIC Educational Resources Information Center

    Westine, Carl; Spybrook, Jessaca

    2013-01-01

    The capacity of the field to conduct power analyses for group randomized trials (GRTs) of educational interventions has improved over the past decade (Authors, 2009). However, a power analysis depends on estimates of design parameters. Hence it is critical to build the empirical base of design parameters for GRTs across a variety of outcomes and…

  8. Differentiated Accountability Policy and School Improvement Plans: A Look at Professional Development and Inclusive Practices for Exceptional Students

    ERIC Educational Resources Information Center

    Simon, Marsha; Black, William R.

    2011-01-01

    The Individuals with Disabilities Education Improvement Act (IDEA) of 2004 and the No Child Left Behind Act of 2002 (NCLB) require that students with disabilities have equal access to general education curricula and contexts. Florida's Differentiated Accountability Program (DAP) is designed to support educators in meeting IDEA and NCLB…

  9. School Improvement Grants. Guidance and Tools for the 2015 Amended Regulations: Maximizing the Optional Planning/Pre-Implementation Year

    ERIC Educational Resources Information Center

    Redding, Sam; Dunn, Lenay; McCauley, Carlas

    2015-01-01

    School Improvement Grants (SIGs) are authorized under section 1003(g) of Title I of the Elementary and Secondary Education Act (ESEA). The grants are made to state education agencies (SEAs), and the SEAs award competitive subgrants to local education agencies (LEAs) that demonstrate: (1) the greatest need for the funds; and (2) the strongest…

  10. School Improvement Grants: Guidance and Tools for the 2015 Amended Regulations--Maximizing the Optional Planning/Pre-Implementation Year

    ERIC Educational Resources Information Center

    Redding, Sam; Dunn, Lenay; McCauley, Carlas

    2015-01-01

    The purpose of this guide is to provide states, districts, and schools with information and support to prepare applications for 2015-2016 School Improvement Grants (SIGs). The guide includes tools, checklists, and questions for SEAs and LEAs aligned with the revised SIG requirements, primarily focused on how to leverage the "planning…

  11. Washington State Guide to Planning, Implementing and Improving Work-based Learning. A Guide for Educators at All Levels.

    ERIC Educational Resources Information Center

    Highline Community Coll., Des Moines, WA.

    This guide, which is intended primarily for school and college personnel interested in initiating or improving work-based learning, examines the development and implementation of work-based education programs in Washington. The following topics are discussed: the rationale for work-based learning (legislative and educational change information,…

  12. Planning and development of the Better Bites program: a pricing manipulation strategy to improve healthy eating in a hospital cafeteria.

    PubMed

    Liebert, Mina L; Patsch, Amy J; Smith, Jennifer Howard; Behrens, Timothy K; Charles, Tami; Bailey, Taryn R

    2013-07-01

    The Better Bites program, a hospital cafeteria nutrition intervention strategy, was developed by combining evidence-based practices with hospital-specific formative research, including key informant interviews, the Nutrition Environment Measures Study in Restaurants, hospital employee surveys, and nutrition services staff surveys. The primary program components are pricing manipulation and marketing to promote delicious, affordable, and healthy foods to hospital employees and other cafeteria patrons. The pricing manipulation component includes decreasing the price of the healthy items and increasing the price of the unhealthy items using a 35% price differential. Point-of-purchase marketing highlights taste, cost, and health benefits of the healthy items. The program aims to increase purchases of healthy foods and decrease purchases of unhealthy foods, while maintaining revenue neutrality. This article addresses the formative research, planning, and development that informed the Better Bites program. PMID:23182861

  13. Saltwater intrusion in the surficial aquifer system of the Big Cypress Basin, southwest Florida, and a proposed plan for improved salinity monitoring

    USGS Publications Warehouse

    Prinos, Scott T.

    2013-01-01

    The installation of drainage canals, poorly cased wells, and water-supply withdrawals have led to saltwater intrusion in the primary water-use aquifers in southwest Florida. Increasing population and water use have exacerbated this problem. Installation of water-control structures, well-plugging projects, and regulation of water use have slowed saltwater intrusion, but the chloride concentration of samples from some of the monitoring wells in this area indicates that saltwater intrusion continues to occur. In addition, rising sea level could increase the rate and extent of saltwater intrusion. The existing saltwater intrusion monitoring network was examined and found to lack the necessary organization, spatial distribution, and design to properly evaluate saltwater intrusion. The most recent hydrogeologic framework of southwest Florida indicates that some wells may be open to multiple aquifers or have an incorrect aquifer designation. Some of the sampling methods being used could result in poor-quality data. Some older wells are badly corroded, obstructed, or damaged and may not yield useable samples. Saltwater in some of the canals is in close proximity to coastal well fields. In some instances, saltwater occasionally occurs upstream from coastal salinity control structures. These factors lead to an incomplete understanding of the extent and threat of saltwater intrusion in southwest Florida. A proposed plan to improve the saltwater intrusion monitoring network in the South Florida Water Management District’s Big Cypress Basin describes improvements in (1) network management, (2) quality assurance, (3) documentation, (4) training, and (5) data accessibility. The plan describes improvements to hydrostratigraphic and geospatial network coverage that can be accomplished using additional monitoring, surface geophysical surveys, and borehole geophysical logging. Sampling methods and improvements to monitoring well design are described in detail. Geochemical analyses

  14. A Plan for the Evaluation and Continuous Improvement of Texas' Community and Technical Colleges: Report and Recommendations of the Task Force on Institutional Effectiveness to the Texas Higher Education Coordinating Board.

    ERIC Educational Resources Information Center

    Texas Higher Education Coordinating Board, Austin. Div. of Community and Technical Colleges.

    In May 1993, the Texas Higher Education Coordinating Board formed the Task Force on Institutional Effectiveness (TFIE) to develop a state-level evaluation and continuous improvement plan for community and technical college (CTC) workforce education and academic programs. This report presents the plan for utilizing data collected on CTC's in three…

  15. Improving Image Quality of On-Board Cone-Beam CT in Radiation Therapy Using Image Information Provided by Planning Multi-Detector CT: A Phantom Study

    PubMed Central

    Yang, Ching-Ching; Chen, Fong-Lin; Lo, Yeh-Chi

    2016-01-01

    Purpose The aim of this study was to improve the image quality of cone-beam computed tomography (CBCT) mounted on the gantry of a linear accelerator used in radiation therapy based on the image information provided by planning multi-detector CT (MDCT). Methods MDCT-based shading correction for CBCT and virtual monochromatic CT (VMCT) synthesized using the dual-energy method were performed. In VMCT, the high-energy data were obtained from CBCT, while the low-energy data were obtained from MDCT. An electron density phantom was used to investigate the efficacy of shading correction and VMCT on improving the target detectability, Hounsfield unit (HU) accuracy and variation, which were quantified by calculating the contrast-to-noise ratio (CNR), the percent difference (%Diff) and the standard deviation of the CT numbers for tissue equivalent background material, respectively. Treatment plan studies for a chest phantom were conducted to investigate the effects of image quality improvement on dose planning. Results For the electron density phantom, the mean value of CNR was 17.84, 26.78 and 34.31 in CBCT, shading-corrected CBCT and VMCT, respectively. The mean value of %Diff was 152.67%, 11.93% and 7.66% in CBCT, shading-corrected CBCT and VMCT, respectively. The standard deviation within a uniform background of CBCT, shading-corrected CBCT and VMCT was 85, 23 and 15 HU, respectively. With regards to the chest phantom, the monitor unit (MU) difference between the treatment plan calculated using MDCT and those based on CBCT, shading corrected CBCT and VMCT was 6.32%, 1.05% and 0.94%, respectively. Conclusions Enhancement of image quality in on-board CBCT can contribute to daily patient setup and adaptive dose delivery, thus enabling higher confidence in patient treatment accuracy in radiation therapy. Based on our results, VMCT has the highest image quality, followed by the shading corrected CBCT and the original CBCT. The research results presented in this study should be

  16. Probabilistic Requirements (Partial) Verification Methods Best Practices Improvement. Variables Acceptance Sampling Calculators: Derivations and Verification of Plans. Volume 1

    NASA Technical Reports Server (NTRS)

    Johnson, Kenneth L.; White, K, Preston, Jr.

    2012-01-01

    The NASA Engineering and Safety Center was requested to improve on the Best Practices document produced for the NESC assessment, Verification of Probabilistic Requirements for the Constellation Program, by giving a recommended procedure for using acceptance sampling by variables techniques. This recommended procedure would be used as an alternative to the potentially resource-intensive acceptance sampling by attributes method given in the document. This document contains the outcome of the assessment.

  17. Design of Cycle 3 of the National Water-Quality Assessment Program, 2013-23: Part 2: Science plan for improved water-quality information and management

    USGS Publications Warehouse

    Rowe, Gary L.; Belitz, Kenneth; Demas, Charlie R.; Essaid, Hedeff I.; Gilliom, Robert J.; Hamilton, Pixie A.; Hoos, Anne B.; Lee, Casey J.; Munn, Mark D.; Wolock, David W.

    2013-01-01

    This report presents a science strategy for the third decade of the National Water-Quality Assessment (NAWQA) Program, which since 1991, has been responsible for providing nationally consistent information on the quality of the Nation's streams and groundwater; how water quality is changing over time; and the major natural and human factors that affect current water quality conditions and trends. The strategy is based on an extensive evaluation of the accomplishments of NAWQA over its first two decades, the current status of water-quality monitoring activities by USGS and its partners, and an updated analysis of stakeholder priorities. The plan is designed to address priority issues and national needs identified by NAWQA stakeholders and the National Research Council (2012) irrespective of budget constraints. This plan describes four major goals for the third decade (Cycle 3), the approaches for monitoring, modeling, and scientific studies, key partnerships required to achieve these goals, and products and outcomes that will result from planned assessment activities. The science plan for 2013–2023 is a comprehensive approach to meet stakeholder priorities for: (1) rebuilding NAWQA monitoring networks for streams, rivers, and groundwater, and (2) upgrading models used to extrapolate and forecast changes in water-quality and stream ecosystem condition in response to changing climate and land use. The Cycle 3 plan continues approaches that have been central to the Program’s long-term success, but adjusts monitoring intensities and study designs to address critical information needs and identified data gaps. Restoration of diminished monitoring networks and new directions in modeling and interpretative studies address growing and evolving public and stakeholder needs for water-quality information and improved management, particularly in the face of increasing challenges related to population growth, increasing demands for water, and changing land use and climate

  18. Applying value engineering and modern assessment tools in managing NEPA: Improving effectiveness of the NEPA scoping and planning process

    SciTech Connect

    ECCLESTON, C.H.

    1998-09-03

    While the National Environmental Policy Act (NEPA) implementing regulations focus on describing ''What'' must be done, they provide surprisingly little direction on ''how'' such requirements are to be implemented. Specific implementation of these requirements has largely been left to the discretion of individual agencies. More than a quarter of a century after NEPA's enactment, few rigorous tools, techniques, or methodologies have been developed or widely adopted for implementing the regulatory requirements. In preparing an Environmental Impact Statement, agencies are required to conduct a public scoping process to determine the range of actions, alternatives, and impacts that will be investigated. Determining the proper scope of analysis is an element essential in the successful planning and implementation of future agency actions. Lack of rigorous tools and methodologies can lead to project delays, cost escalation, and increased risk that the scoping process may not adequately capture the scope of decisions that eventually might need to be considered. Recently, selected Value Engineering (VE) techniques were successfully used in managing a prescoping effort. A new strategy is advanced for conducting a pre-scoping/scoping effort that combines NEPA with VE. Consisting of five distinct phases, this approach has potentially wide-spread implications in the way NEPA, and scoping in particular, is practiced.

  19. The 45 and Up Study: a tool for local population health and health service planning to improve integration of healthcare.

    PubMed

    Comino, Elizabeth J; Harris, Elizabeth; Page, Jude; McDonald, Julie; Harris, Mark F

    2016-01-01

    Data on patient access to, and use of, primary and secondary care services are a potential tool for population health and health service planning, and for researchers. The Sax Institute's 45 and Up Study was established to support research about healthy ageing. This paper considers how data from the 45 and Up Study could be useful to Local Health Districts and the Primary Health Networks in New South Wales to support their work, particularly in evaluating integration of primary and secondary health services. Preliminary exploration of these data identified more than 31 000 participants in the 45 and Up Study living in central and eastern Sydney who were included in some demonstration projects. The value of these data to the region included access to a population-based sample of residents, and capacity to link to health data held within different jurisdictions and local data sources. The resultant data collection can address questions of interest to planners working in primary and secondary care, such as integration and coordination of services, including transition of care. These are key performance goals for both sectors. PMID:27421341

  20. Improving the seismic torsional behavior of plan-asymmetric, single-storey, concrete moment resisting buildings with fluid viscous dampers

    NASA Astrophysics Data System (ADS)

    Rofooei, Fayaz Rahimzadeh; Mohammadzadeh, Sahar

    2016-03-01

    The optimal distribution of fluid viscous dampers (FVD) in controlling the seismic response of eccentric, single-storey, moment resisting concrete structures is investigated using the previously defined center of damping constant (CDC). For this purpose, a number of structural models with different one-way stiffness and strength eccentricities are considered. Extensive nonlinear time history analyses are carried out for various arrangements of FVDs. It is shown that the arrangement of FVDs for controlling the torsional behavior due to asymmetry in the concrete structures is very dependent on the intensity of the peak ground acceleration (PGA) and the extent of the structural stiffness and strength eccentricities. The results indicate that, in the linear range of structural behavior the stiffness eccentricity es which is the main parameter in determining the location of optimal CDC, is found to be less or smaller than the optimal damping constant eccentricity e*d, i.e., |e*d| > |es|. But, in the nonlinear range of structural behavior where the strength eccentricity er is the dominant factor in determining the location of optimal CDC, |e*d| > |er|. It is also concluded that for the majority of the plan-asymmetric, concrete structures considered in this study with er ≠ 0, the optimal CDC approaches the center of mass as er decreases.

  1. Improving equity in the provision of primary health care: lessons from decentralized planning and management in Namibia.

    PubMed Central

    Bell, Ruth; Ithindi, Taathi; Low, Anne

    2002-01-01

    This paper draws lessons from a review of primary health care services in Windhoek, the capital of Namibia, undertaken by a regional health management team. The review was carried out because of perceived increases in workload and inadequate staffing levels, arising from the rapid expansion of the city associated with inward migration. A survey of the utilization of government clinics was used to develop a more equitable allocation of primary health care services between localities. The survey revealed disparities between patterns of utilization of the services and the allocation of staff: the poorer localities were relatively underprovided. Decisions made centrally on resource allocation had reinforced the inequities. On the basis of the results of the review, the regional health management team redistributed nursing and medical staff and argued for a shift in the allocation of capital expenditure towards the poorer communities. The review demonstrates the potential for regional and provincial health management teams to make effective assessments of the needs of their populations and to promote the equitable delivery of primary health care services. In order to achieve this they need not only to become effective managers, but also to develop population-based planning skills and the confidence and authority to influence the allocation of resources between and within their regions and provinces. PMID:12219160

  2. Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes

    PubMed Central

    2011-01-01

    Background There is increasing attention, globally and in countries, to monitoring and addressing the health systems and human resources inputs, processes and outputs that impede or facilitate progress towards achieving the Millennium Development Goals for maternal and child health. We reviewed the situation of human resources for health (HRH) in 68 low- and middle-income countries that together account for over 95% of all maternal and child deaths. Methods We collected and analysed cross-nationally comparable data on HRH availability, distribution, roles and functions from new and existing sources, and information from country reviews of HRH interventions that are associated with positive impacts on health services delivery and population health outcomes. Results Findings from 68 countries demonstrate availability of doctors, nurses and midwives is positively correlated with coverage of skilled birth attendance. Most (78%) of the target countries face acute shortages of highly skilled health personnel, and large variations persist within and across countries in workforce distribution, skills mix and skills utilization. Too few countries appropriately plan for, authorize and support nurses, midwives and community health workers to deliver essential maternal, newborn and child health-care interventions that could save lives. Conclusions Despite certain limitations of the data and findings, we identify some key areas where governments, international partners and other stakeholders can target efforts to ensure a sufficient, equitably distributed and efficiently utilized health workforce to achieve MDGs 4 and 5. PMID:21702913

  3. THE RELATIVISTIC HEAVY ION COLLIDER (RHIC) CRYOGENIC SYSTEM AT BNL: REVIEW OF THE MODIFICATIONS AND UPGRADES SINCE 2002 AND PLANNED IMPROVEMENTS.

    SciTech Connect

    THAN,Y.R.; TUOZZOLO, J.; SIDI-YAKHLEF, A.; GANNI, V.; KNUDSEN, P.; ARENIUS, D.

    2007-07-16

    Brookhaven National Laboratory continues its multi-year program to improve the operational efficiency, reliability, and stability of the cryogenic system which also resulted in improved beam availability of the Relativistic Heavy Ion Collider (RHIC). This paper summarizes the work and changes made after each phase over the past four years to the present, as well as proposed future improvements. Power usage dropped from an initial 9.4 MW to the present 5.1 MW and is expected to drop below 5 MW after the completion of the remaining proposed improvements. The work proceeded in phases by balancing the Collider's schedule of operation, time required for the modifications and budget constraints. The main changes include process control, compressor oil removal and management, elimination of the use of cold compressors and two liquid helium storage tanks, insulation of the third liquid helium storage tank, compressor bypass flow reduction and the addition of a load turbine (Joule-Thompson expander) with associated heat exchangers at the cold end of the plant. Also, liquid helium pumps used for forced circulation of the sub-cooled helium through the magnet loops were eliminated by an accelerator supply flow reconfiguration. Planned future upgrades include the resizing of expanders 5 and 6 to increase their efficiencies.

  4. PROPOSAL FOR IMPROVEMENT OF BUINESS CONTINUITY PLAN (BCP) BASED ON THE LESSONS OF THE GREAT EAST JAPAN EARTHQUAKE

    NASA Astrophysics Data System (ADS)

    Maruya, Hiroaki

    For most Japanese companies and organizations, the enormous damage of the Great East Japan Earthquake was more than expected. In addition to great tsunami and earthquake motion, the lack of electricity and fuel disturbed to business activities seriously, and they should be considered important constraint factors in future earthquakes. Furthermore, disruption of supply chains also led considerable decline of production in many industries across Japan and foreign countries. Therefore it becomes urgent need for Japanese government and industries to utilize the lessons of the Great Earthquake and execute effective countermeasures, considering great earthquakes such as Tonankai & Nankai earthquakes and Tokyo Inland Earthquakes. Obviously most basic step is improving earthquake-resistant ability of buildings and facilities. In addition the spread of BCP and BCM to enterprises and organizations is indispensable. Based on the lessons, the BCM should include the point of view of the supply chain management more clearly, and emphasize "substitute strategy" more explicitly because a company should survive even if it completely loses its present production base. The central and local governments are requested, in addition to develop their own BCP, to improve related systematic conditions for BCM of the private sectors.

  5. Indirect assessment of stifle angle for improved accuracy of preoperative planning of tibial osteotomy procedures in dogs.

    PubMed

    Barnes, D C; Owen, M R

    2015-07-25

    To assess reliability of the mechanical axes stifle angle in dogs positioned for radiography with a neutral stifle (neutral stifle angle (nSA)). To investigate radiographic landmarks for assessment of nSA from a collimated radiographic view. One hundred radiographs were taken of normal stifles belonging to 55 skeletally mature medium and large breed dogs, positioned using a repeatable protocol. Radiographs were widely collimated to include the femoral head and the talus. The angle of Blumensaat's line through the intercondylar fossa relative to the Mechanical Axis of the femur (intercondylar fossa angle, IFA), the angle of inclination of a tibial crest tangent line relative to the Mechanical Axis of the tibia (tibial crest angle, TCA) and the tibial plateau angle (TPA) were recorded. Mean nSA was 133.5°. Mean IFA was 155.5°. TCA had a mean of 6.7°. Estimates for nSA were calculated using mean IFA combined with mean TCA (enSA1), mean TPA (enSA2) and the mechanical axis of the tibia (enSA3). Mean percentage error relative was 2.99 per cent for enSA1, 2.82 per cent for enSA2, 1.67 per cent for enSA3. Blumensaat's line provides a consistent radiological feature for assessment of nSA. Assessment of nSA and correction for values varying from 135° may allow more consistent and accurate measurement of patellar tendon angle for presurgical planning. PMID:26187631

  6. The determination of waste generation and composition as an essential tool to improve the waste management plan of a university.

    PubMed

    Gallardo, A; Edo-Alcón, N; Carlos, M; Renau, M

    2016-07-01

    When many people work in organized institutions or enterprises, those institutions or enterprises become big meeting places that also have energy, water and resources necessities. One of these necessities is the correct management of the waste that is daily produced by these communities. Universities are a good example of institution where every day a great amount of people go to work or to study. But independently of their task, they use the different services at the University such as cafeterias, canteens, and photocopy and as a result of their activity a cleaning service is also needed. All these activities generate an environmental impact. Nowadays, many Universities have accepted the challenge to minimize this impact applying several measures. One of the impacts to be reduced is the waste generation. The first step to implement measures to implement a waste management plan at a University is to know the composition, the amount and the distribution of the waste generated in its facilities. As the waste composition and generation depend among other things on the climate, these variables should be analysed over one year. This research work estimates the waste generation and composition of a Spanish University, the Universitat Jaume I, during a school year. To achieve this challenge, all the waste streams generated at the University have been identified and quantified emphasizing on those which are not controlled. Furthermore, several statistical analyses have been carried out to know if the season of the year or the day of the week affect waste generation and composition. All this information will allow the University authorities to propose a set of minimization measures to enhance the current management. PMID:27107706

  7. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction

    PubMed Central

    Gausvik, Christian; Lautar, Ashley; Miller, Lisa; Pallerla, Harini; Schlaudecker, Jeffrey

    2015-01-01

    Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR) on an acute care for the elderly (ACE) unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer patient care. These results point to the interconnectedness and dual benefit to both job satisfaction and patient quality of care that can come from enhancements to team communication. PMID:25609978

  8. An evaluation of an initiative to improve Veterans Health Administration mental health services: broad impacts of the VHA's Mental Health Strategic Plan.

    PubMed

    Greenberg, Greg A; Rosenheck, Robert A

    2009-12-01

    In federal fiscal year (FY) 2005 the Department of Veterans Affairs (VA) implemented the comprehensive Mental Health Strategic Plan (MHSP). This study used performance measures from six broad domains to examine changes in the overall delivery of mental health services in the VA since the implementation of the MHSP. Performance measures from fiscal year 2004, the year before implementation of the MHSP, were compared with measures from fiscal years 2005, 2006, and 2007, the first 3 years of MHSP implementation. We combined heterogeneous performance measures within domains through the use of standardized scores or "z-scores." An overall improvement of 0.32 standardized units was observed from FY 2004 to FY 2007, representing moderate to large changes by conventional standards. The domains with the greatest improvement (>1.0 standard deviation units) from FY 2004 to FY 2007 were population coverage/access, outpatient care quality, economic performance (primarily efficiency), and global functioning. There was a 0.3 standard deviation decline in inpatient satisfaction and a slight increase in reliance on inpatient care. Overall improvement in VA mental health care was thus substantial and continuing. PMID:20055066

  9. Improved accuracy with 3D planning and patient-specific instruments during simulated pelvic bone tumor surgery.

    PubMed

    Cartiaux, Olivier; Paul, Laurent; Francq, Bernard G; Banse, Xavier; Docquier, Pierre-Louis

    2014-01-01

    In orthopaedic surgery, resection of pelvic bone tumors can be inaccurate due to complex geometry, limited visibility and restricted working space of the pelvis. The present study investigated accuracy of patient-specific instrumentation (PSI) for bone-cutting during simulated tumor surgery within the pelvis. A synthetic pelvic bone model was imaged using a CT-scanner. The set of images was reconstructed in 3D and resection of a simulated periacetabular tumor was defined with four target planes (ischium, pubis, anterior ilium, and posterior ilium) with a 10-mm desired safe margin. Patient-specific instruments for bone-cutting were designed and manufactured using rapid-prototyping technology. Twenty-four surgeons (10 senior and 14 junior) were asked to perform tumor resection. After cutting, ISO1101 location and flatness parameters, achieved surgical margins and the time were measured. With PSI, the location accuracy of the cut planes with respect to the target planes averaged 1 and 1.2 mm in the anterior and posterior ilium, 2 mm in the pubis and 3.7 mm in the ischium (p < 0.0001). Results in terms of the location of the cut planes and the achieved surgical margins did not reveal any significant difference between senior and junior surgeons (p = 0.2214 and 0.8449, respectively). The maximum differences between the achieved margins and the 10-mm desired safe margin were found in the pubis (3.1 and 5.1 mm for senior and junior surgeons respectively). Of the 24 simulated resection, there was no intralesional tumor cutting. This study demonstrates that using PSI technology during simulated bone cuts of the pelvis can provide good cutting accuracy. Compared to a previous report on computer assistance for pelvic bone cutting, PSI technology clearly demonstrates an equivalent value-added for bone cutting accuracy than navigation technology. When in vivo validated, PSI technology may improve pelvic bone tumor surgery by providing clinically acceptable margins. PMID

  10. Radiotherapy treatment planning with contrast-enhanced computed tomography: feasibility of dual-energy virtual unenhanced imaging for improved dose calculations

    PubMed Central

    2014-01-01

    Background In radiotherapy treatment planning, intravenous administration of an iodine-based contrast agent during computed tomography (CT) improves the accuracy of delineating target volumes. However, increased tissue attenuation resulting from the high atomic number of iodine may result in erroneous dose calculations because the contrast agent is absent during the actual procedure. The purpose of this proof-of-concept study was to present a novel framework to improve the accuracy of dose calculations using dual-energy virtual unenhanced CT in the presence of an iodine-based contrast agent. Methods Simple phantom experiments were designed to assess the feasibility of the proposed concept. By utilizing a “second-generation” dual-source CT scanner equipped with a tin filter for improved spectral separation, four CT datasets were obtained using both a water phantom and an iodine phantom: “true unenhanced” images with attenuation values of 2 ± 11 Hounsfield Units (HU), “enhanced” images with attenuation values of 274 ± 23 HU, and two series of “virtual unenhanced” images synthesized from dual-energy scans of the iodine phantom, each with a different combination of tube voltages. Two series of virtual unenhanced images demonstrated attenuation values of 12 ± 29 HU (with 80 kVp/140 kVp) and 34 ± 10 HU (with 100 kVp/140 kVp) after removing the iodine component from the contrast-enhanced images. Dose distributions of the single photon beams calculated from the enhanced images and two series of virtual unenhanced images were compared to those from true unenhanced images as a reference. Results The dose distributions obtained from both series of virtual unenhanced images were almost equivalent to that from the true unenhanced images, whereas the dose distribution obtained from the enhanced images indicated increased beam attenuation caused by the high attenuation characteristics of iodine. Compared to the reference dose distribution from

  11. Scaling-Up Access to Family Planning May Improve Linear Growth and Child Development in Low and Middle Income Countries

    PubMed Central

    Fink, Günther; Sudfeld, Christopher R.; Danaei, Goodarz; Ezzati, Majid; Fawzi, Wafaie W.

    2014-01-01

    Background A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs) remains limited. Methods and Results Data from 153 cross-sectional Demographic and Health Surveys (DHS) across 61 LMICs conducted between 1990 and 2011 were combined to assess the association of birth timing with child stunting (height-for-age z-score <−2). A total of 623,789 children of birth order 1–5 contributed to the maternal age analysis, while the birth spacing dataset consisted of 584,226 children of birth order 2 and higher. Compared to 27–34 year old mothers, maternal age under 18 years was associated with a relative stunting risk of 1.35 (95% CI: 1.29–1.40) for firstborn children, whereas the relative risk was 1.24 (95% CI: 1.19–1.29) for mothers aged 18–19 years. The association of young maternal age with stunting was significantly greater for urban residents and those in the top 50% of household wealth. Birth intervals less than 12 months and 12–23 months had relative risks for stunting of 1.09 (95% CI: 1.06–1.12) and 1.06 (95% CI: 1.05–1.06) as compared to a 24–35 month inter-pregnancy interval, respectively. The strength of both teenage pregnancy and short birth interval associations showed substantial variation across WHO region. We estimate that 8.6% (6.9–10.3%) of stunted cases in the South Asian DHS sample would have been averted by jointly eliminating teen pregnancies and birth intervals less than 24 months, while only 3.6% (1.5–5.7%) of stunting cases would have prevented in the Middle East and North Africa sample. Conclusions Postponing the age of first birth and increasing inter-pregnancy intervals has the potential to significantly reduce the prevalence of stunting and improve child development in LMICs. PMID:25020132

  12. Participatory Planning for the improvement of water management in uncertain conditions: Case study of the Souss-Massa basin in Morocco

    NASA Astrophysics Data System (ADS)

    Imani, Yasmina; Lahlou, Ouiam; Slimani, Imane; Joyce, Brian

    2016-04-01

    Due to its geographical location and to the natural features of its climate, Morocco is known as a drought prone and water scarce country. However, the country now faces, in the current context of Climate Change, an increasing and alarming water scarcity due to the combined effects of a strong decline of precipitations and a growing pressure on water resources induced by the economic development and demographic growth. Aware of this pressing issue, Morocco implemented a national water strategy based on the decentralization of water management at the river basin level and the establishment of Integrated Water Resources Management master plans for each basin. Unfortunately, these plans often underestimate the impact of uncertainty and this may lead to inefficient and unsustainable water management strategies. In this context, the aim of this study is to develop an innovative approach for robust decision making in uncertain conditions by coupling the WEAP (Water Evaluation and Planning System) model and the "XLRM" robust decision making framework to support the evaluation of management options and promote long-term sustainable integrated water management strategies at the basin level. The Souss-Massa basin, located in the south-western part of the country was retained as a case study because of its strategic importance but also because it now faces, as a consequence of the irrational use of water resources during the last decades significant water resources management challenges mainly due to the overexploitation of ground water resources, the increased of water demand due to the irrigation development, the urban and industrial growth and the expansion of tourism. Thus, in this study, a three step methodology was developed. First, the WEAP model were developed and calibrated for the Souss-Massa basin. In a second step, a XLRM participatory workshop gathering the basin main stakeholders were organized in order to identify the EXogenous factors (key uncertainties

  13. Guidance for the design and management of a maintenance plan to assure safety and improve the predictability of a DOE nuclear irradiation facility. Final report

    SciTech Connect

    Booth, R.S.; Kryter, R.C.; Shepard, R.L.; Smith, O.L.; Upadhyaya, B.R.; Rowan, W.J.

    1994-10-01

    A program is recommended for planning the maintenance of DOE nuclear facilities that will help safety and enhance availability throughout a facility`s life cycle. While investigating the requirements for maintenance activities, a major difference was identified between the strategy suitable for a conventional power reactor and one for a research reactor facility: the latter should provide a high degree of predicted availability (referred to hereafter as ``predictability``) to its users, whereas the former should maximize total energy production. These differing operating goals necessitate different maintenance strategies. A strategy for scheduling research reactor facility operation and shutdown for maintenance must balance safety, reliability,and predicted availability. The approach developed here is based on three major elements: (1) a probabilistic risk analysis of the balance between assured reliability and predictability (presented in Appendix C), (2) an assessment of the safety and operational impact of maintenance activities applied to various components of the facility, and (3) a data base of historical and operational information on the performance and requirements for maintenance of various components. These factors are integrated into a set of guidelines for designing a new highly maintainable facility, for preparing flexible schedules for improved maintenance of existing facilities, and for anticipating the maintenance required to extend the life of an aging facility. Although tailored to research reactor facilities, the methodology has broader applicability and may therefore be used to improved the maintenance of power reactors, particularly in anticipation of peak load demands.

  14. The Development of a Plan for the Assessment, Improvement and Deployment of a Radar Acoustic Sounding System (RASS) for Wake Vortex Detection

    NASA Technical Reports Server (NTRS)

    Morris, Philip J.; McLaughlin, Dennis K.; Gabrielson, Thomas B.; Boluriaan, Said

    2004-01-01

    This report describes the activities completed under a grant from the NASA Langley Research Center to develop a plan for the assessment, improvement, and deployment of a Radar Acoustic Sounding System (RASS) for the detection of wake vortices. A brief review is provided of existing alternative instruments for wake vortex detection. This is followed by a review of previous implementations and assessment of a RASS. As a result of this review, it is concluded that the basic features of a RASS have several advantages over other commonly used wake vortex detection and measurement systems. Most important of these features are the good fidelity of the measurements and the potential for all weather operation. To realize the full potential of this remote sensing instrument, a plan for the development of a RASS designed specifically for wake vortex detection and measurement has been prepared. To keep costs to a minimum, this program would start with the development an inexpensive laboratory-scale version of a RASS system. The new instrument would be developed in several stages, each allowing for a critical assessment of the instrument s potential and limitations. The instrument, in its initial stages of development, would be tested in a controlled laboratory environment. A jet vortex simulator, a prototype version of which has already been fabricated, would be interrogated by the RASS system. The details of the laboratory vortex would be measured using a Particle Image Velocimetry (PIV) system. In the early development stages, the scattered radar signal would be digitized and the signal post-processed to determine how extensively and accurately the RASS could measure properties of the wake vortex. If the initial tests prove to be successful, a real-time, digital signal processing system would be developed as a component of the RASS system. At each stage of the instrument development and testing, the implications of the scaling required for a full-scale instrument would be

  15. The influence of snow cover on alpine floods reconstructed from the analysis of satellite images. The case of the Hasli-Aare river basin, Berner Oberland (1987-2012)

    NASA Astrophysics Data System (ADS)

    Cabrera-Medina, Paula; Schulte, Lothar; Carvalho, Filipe; Peña, Juan Carlos; García, Carles

    2016-04-01

    Regarding the hydrological hazards in the Hasli-Aare river over the last century, instrumental and documentary data show that flood frequency and magnitude increased since 1977. One of the main water inputs contributing to peak discharges is given by the thaw of the stored snow. Therefore, the knowledge of the evolution of snow cover is considered essential for the assessment of alpine floods. Snow cover studies can be made by different approaches such as the analysis of data provided by field work or by nivometeorological stations. However, these methods are usually expensive and do not present adequate spatial or temporal coverage data. For this reason, satellite images with different spatial and temporal resolution are an interesting complementary source for the understanding of the snow cover dynamics. The aim of the paper is to study the influence of snow cover variations during years of severe floods that occurred in the upper Aare basin from 1987 to 2012. Three satellite images have been selected for each of the 9 studied events: 1) maximum snow cover during winter, 2) the last image before the event and 3) the first image after the flood. Each image has been processed with the ArcGIS software applying a statistical method of supervised classification. This image processing allows the spatial quantification of the variation of the snow cover in the Aare headwater catchment. Because the melting of snow cover is related to the changes of weather situations before and during the flood episode, it is important to analyse also the nivometeorological data of stations located in the catchment (snow depth, temperature and precipitation). From these data we determined 4 types of flood, which can be classified according to their nivometeorological variables and synoptic situation (500 hPa geopotential and Sea Level Pressure) into two patterns. The first group of events can be associated to an Atlantic pattern recording decreasing temperatures, moderate to high

  16. SU-C-204-02: Improved Patient-Specific Optimization of the Stopping Power Calibration for Proton Therapy Planning Using a Single Proton Radiography

    SciTech Connect

    Rinaldi, I; Parodi, K; Krah, N

    2015-06-15

    Purpose: We present an improved method to calculate patient-specific calibration curves to convert X-ray computed tomography (CT) Hounsfield Unit (HU) to relative stopping powers (RSP) for proton therapy treatment planning. Methods: By optimizing the HU-RSP calibration curve, the difference between a proton radiographic image and a digitally reconstructed X-ray radiography (DRR) is minimized. The feasibility of this approach has previously been demonstrated. This scenario assumes that all discrepancies between proton radiography and DRR originate from uncertainties in the HU-RSP curve. In reality, external factors cause imperfections in the proton radiography, such as misalignment compared to the DRR and unfaithful representation of geometric structures (“blurring”). We analyze these effects based on synthetic datasets of anthropomorphic phantoms and suggest an extended optimization scheme which explicitly accounts for these effects. Performance of the method is been tested for various simulated irradiation parameters. The ultimate purpose of the optimization is to minimize uncertainties in the HU-RSP calibration curve. We therefore suggest and perform a thorough statistical treatment to quantify the accuracy of the optimized HU-RSP curve. Results: We demonstrate that without extending the optimization scheme, spatial blurring (equivalent to FWHM=3mm convolution) in the proton radiographies can cause up to 10% deviation between the optimized and the ground truth HU-RSP calibration curve. Instead, results obtained with our extended method reach 1% or better correspondence. We have further calculated gamma index maps for different acceptance levels. With DTA=0.5mm and RD=0.5%, a passing ratio of 100% is obtained with the extended method, while an optimization neglecting effects of spatial blurring only reach ∼90%. Conclusion: Our contribution underlines the potential of a single proton radiography to generate a patient-specific calibration curve and to improve

  17. Applying the Model of Goal-Directed Behavior, Including Descriptive Norms, to Physical Activity Intentions: A Contribution to Improving the Theory of Planned Behavior.

    PubMed

    Esposito, Gabriele; van Bavel, René; Baranowski, Tom; Duch-Brown, Néstor

    2016-08-01

    The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contribute to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) applied to physical activity (PA) intention. We also test the inclusion of a descriptive norms construct as an addition to the subjective norms construct, also applied to PA, resulting in two additional models: TPB including descriptive norms (TPB + DN) and MGDB including descriptive norms (MGDB + DN). The study is based on an online survey of 400 young adult Internet users, previously enrolled in a subject pool. Confirmatory factor analysis (CFA) showed that TPB and TPB + DN were not fit for purpose, while MGDB and MGDB + DN were. Structural equation modelling (SEM) conducted on MGDB and MGDB + DN showed that the inclusion of descriptive norms took over the significance of injunctive norms, and increased the model's account of total variance in intention to be physically active. PMID:27229344

  18. Calibration of amino acid racemization (AAR) kinetics in United States mid-Atlantic Coastal Plain Quaternary mollusks using 87Sr/ 86Sr analyses: Evaluation of kinetic models and estimation of regional Late Pleistocene temperature history

    USGS Publications Warehouse

    Wehmiller, J. F.; Harris, W.B.; Boutin, B.S.; Farrell, K.M.

    2012-01-01

    The use of amino acid racemization (AAR) for estimating ages of Quaternary fossils usually requires a combination of kinetic and effective temperature modeling or independent age calibration of analyzed samples. Because of limited availability of calibration samples, age estimates are often based on model extrapolations from single calibration points over wide ranges of D/L values. Here we present paired AAR and 87Sr/ 86Sr results for Pleistocene mollusks from the North Carolina Coastal Plain, USA. 87Sr/ 86Sr age estimates, derived from the lookup table of McArthur et al. [McArthur, J.M., Howarth, R.J., Bailey, T.R., 2001. Strontium isotopic stratigraphy: LOWESS version 3: best fit to the marine Sr-isotopic curve for 0-509 Ma and accompanying Look-up table for deriving numerical age. Journal of Geology 109, 155-169], provide independent age calibration over the full range of amino acid D/L values, thereby allowing comparisons of alternative kinetic models for seven amino acids. The often-used parabolic kinetic model is found to be insufficient to explain the pattern of racemization, although the kinetic pathways for valine racemization and isoleucine epimerization can be closely approximated with this function. Logarithmic and power law regressions more accurately represent the racemization pathways for all amino acids. The reliability of a non-linear model for leucine racemization, developed and refined over the past 20 years, is confirmed by the 87Sr/ 86Sr age results. This age model indicates that the subsurface record (up to 80m thick) of the North Carolina Coastal Plain spans the entire Quaternary, back to ???2.5Ma. The calibrated kinetics derived from this age model yield an estimate of the effective temperature for the study region of 11??2??C., from which we estimate full glacial (Last Glacial Maximum - LGM) temperatures for the region on the order of 7-10??C cooler than present. These temperatures compare favorably with independent paleoclimate information

  19. PLANNING THE MUSIC SUITE.

    ERIC Educational Resources Information Center

    HICK, BASIL L.; SAETVEIT, JOSEPH G.

    A PUBLICATION DESIGNED TO IMPROVE THE PLANNING OF MUSIC SUITES IN SCHOOLS. THE INFORMATION CAN BE USED IN THE PREPARATION OF PLANS FOR NEW BUILDINGS AND IMPROVING FACILITIES FOR MUSIC EDUCATION IN EXISTING BUILDINGS. SECTIONS INCLUDED DEAL WITH--(1) THE MUSIC PROGRAM AND SPECIAL NEEDS OF THE MUSIC DEPARTMENT, (2) LOCATION OF MUSIC ROOMS, (3) TYPES…

  20. Site Development Planning Handbook

    SciTech Connect

    1981-01-01

    The Handbook provides facility managers and site planners at DOE organizations responsible for planning site developments and facilities utilization a step-by-step planning checklist to ensure that planners at each site are focusing on Department-wide goals and objectives. It begins with a brief discussion of a site development-by-objectives program design to promote, recognize, and implement opportunities for improvements in site utilization through planning. Additional information is included on: assembling existing data, plans, programs, and procedures; establishing realistic objectives; identifying site problems, opportunities; and development needs; determining priorities among development needs; developing short and long-range plans; choosing the right development solutions and meeting minimum legal site restrictions; presenting the plan; implementing elements of the plan; monitoring and reporting plan status; and modifying development program plans. (MCW)

  1. Focus on Customer Service. Service Management: How to Plan for it Rather Than Hope for It [and] Learning to Say "Yes": A Customer Service Program for Library Staff [and] Maintaining Momentum in a Quality Improvement Process.

    ERIC Educational Resources Information Center

    Brewer, Julie; And Others

    1995-01-01

    Presents three articles that discuss customer service in libraries, with a focus on planning for service management, a customer service program for library staff, and a quality improvement process. Highlights include developing and implementing service strategies, dealing with requests, redefining work relationships, coworkers as customers,…

  2. School Evaluation for Quality Improvement. Meeting of the Asian Network of Training and Research Institutions in Educational Planning (ANTRIEP) (Kuala Lumpur, Malaysia, July 2-4, 2002)

    ERIC Educational Resources Information Center

    De Grauwe, Anton, Ed.; Naidoo, Jordan P., Ed.

    2004-01-01

    The papers brought together in this volume are a selection from among those presented at the seminar organized in Kuala Lumpur, in July 2002 by the Asian Network of Training and Research Institutions in Educational Planning (ANTRIEP). The network consists of institutions whose main mandate includes training and research in educational planning and…

  3. Manpower and project planning

    NASA Technical Reports Server (NTRS)

    Johnson, David W.

    1991-01-01

    The purpose was to study how manpower and projects are planned at the Facilities Engineering Division (FENGD) within the Systems Engineering and Operations Directorate of the LaRC and to make recommendations for improving the effectiveness and productivity ot the tools that are used. The existing manpower and project planning processes (including the management plan for the FENGD, existing manpower planning reports, project reporting to LaRC and NASA Headquarters, employee time reporting, financial reporting, and coordination/tracking reports for procurement) were discussed with several people, and project planning software was evaluated.

  4. Peacekeeping and peacemaking: the conceptual foundations of a plan to reduce violence and improve the quality of life in a midsized community in Jamaica.

    PubMed

    Twemlow, S W; Sacco, F C

    1996-01-01

    Thomas Jefferson noted that social ills breed economic ills and vice versa. An endless regress can occur with violence and mayhem as a chorus: Every community in the world has its own thresholds and patterns of violence, and communities experience varied levels of deterioration of safety with a reciprocal increase in violence. The United States, having undergone 200 years of social evolution as an independent nation, has a spiraling problem with violence. Jamaica, with only recent independence from British sovereignty, is an ideal crucible for the study of evolution of violence in a very young democracy and, hopefully, to identify problems and provide some solutions. Having gained independence from British rule in 1962, Jamaica immediately demonstrated a facile experimentation with forms of government that differed dramatically from what had been previously experienced under the rather rigid, autocratic British administration. In its 33 years of independence, this country has gone through some extraordinary shifts. An initial courtship with Communist theory led to a destructive liaison with Fidel Castro's version of Marxism. During this brief interlude, the intellectual ideals of equality and peace came into direct contrast with facts of a failing Communist regime. During this period, there was a steady exodus of wealthy Jamaican families for whom heavy taxation threatened financial ruin. The prime minister, the Honorable Michael Manley, a highly sophisticated left-wing intellectual liberal, soon realized the political cost of the alliance with his Caribbean neighbor, Fidel Castro, who was then and is now dedicated to old-fashioned, state-controlled Communism. He attempted to return to a free-market democracy with financial foundations that were, by then, very shaky. To succeed in a project to reduce violence and improve the quality of life, the entire community needs to be involved. From our work in countries where community projects were primarily financed by

  5. Stable isotope and Ar/Ar evidence of prolonged multi-scale fluid flow during exhumation of orogenic crust: example from the Mont Blanc and Aar massifs (NW Alps)

    NASA Astrophysics Data System (ADS)

    Rolland, Yann; Rossi, Magali

    2015-04-01

    The spatial and temporal scales and the geometry of fluid pathways in a collisional orogen are investigated using stable isotope analysis (O, C, H) and 40Ar/39Ar dating of vein minerals formed at c. 11-16 Ma in the Mont Blanc and the Aar External Crystalline Massifs. In both massifs 40Ar/39Ar dating of veins adularia provides evidence for progressive crystallization from 16 to 9 Ma, and mainly at 11-12 Ma following veins opening during shear zone activity. The fluid flow duration thus ranges from 4 to 5 Ma in the two massifs. The δ18O values of vein quartz and calcite are similar to those of undeformed crystalline and sedimentary host-rocks, suggesting rock buffering, while carbon isotope ratios of vein calcites fall into three compositional groups. A-type veins have δ13C values that are buffered by the Helvetic metasediments, which suggests that these veins formed in a closed-system from a locally-derived CO2-rich fluid. The fluid in equilibrium with C-type veins has depleted δ13C values similar to mantle-CO2, while the intermediate δ13C values of B-type veins suggest mixing between the A-type and C-type fluids. These results are in agreement with crustal- to lithosphere-scale upward vertical fluid flow along vertical shear zones related to the strike-slip system bounding the Adriatic block since 16-20 Ma, connecting a deep-seated fluid to some downward flow in the sedimentary cover of External Crystalline Massifs.

  6. Using vessel monitoring system data to improve systematic conservation planning of a multiple-use marine protected area, the Kosterhavet National Park (Sweden).

    PubMed

    Gonzalez-Mirelis, Genoveva; Lindegarth, Mats; Sköld, Mattias

    2014-03-01

    When spatial fishing data is fed into systematic conservation planning processes the cost to a fishery could be ensured to be minimal in the zoning of marine protected areas. We used vessel monitoring system (VMS) data to map the distribution of prawn trawling and calculate fishing intensity for 1-ha grid cells, in the Kosterhavet National Park (Sweden). We then used the software Marxan to generate cost-efficient reserve networks that represented every biotope in the Park. We asked what were the potential gains and losses in terms of fishing effort and species conservation of different planning scenarios. Given a conservation target of 10 % representation of each biotope, the fishery need not lose more than 20 % of its fishing grounds to give way to cost-efficient conservation of benthic diversity. No additional reserved area was needed to achieve conservation targets while minimizing fishing costs. We discuss the benefits of using VMS data for conservation planning. PMID:23715796

  7. Kootenai River Wildlife Habitat Enhancement Project : Long-term Bighorn Sheep/Mule Deer Winter and Spring Habitat Improvement Project : Wildlife Mitigation Project, Libby Dam, Montana : Management Plan.

    SciTech Connect

    Yde, Chis

    1990-06-01

    The Libby hydroelectric project, located on the Kootenai River in northwestern Montana, resulted in several impacts to the wildlife communities which occupied the habitats inundated by Lake Koocanusa. Montana Department of Fish, Wildlife and Parks, in cooperation with the other management agencies, developed an impact assessment and a wildlife and wildlife habitat mitigation plan for the Libby hydroelectric facility. In response to the mitigation plan, Bonneville Power Administration funded a cooperative project between the Kootenai National Forest and Montana Department of Fish, Wildlife and Parks to develop a long-term habitat enhancement plan for the bighorn sheep and mule deer winter and spring ranges adjacent to Lake Koocanusa. The project goal is to rehabilitate 3372 acres of bighorn sheep and 16,321 acres of mule deer winter and spring ranges on Kootenai National Forest lands adjacent to Lake Koocanusa and to monitor and evaluate the effects of implementing this habitat enhancement work. 2 refs.

  8. SU-E-T-205: Improving Quality Assurance of HDR Brachytherapy: Verifying Agreement Between Planned and Delivered Dose Distributions Using DICOM RTDose and Advanced Film Dosimetry

    SciTech Connect

    Palmer, A L; Bradley, D A; Nisbet, A

    2014-06-01

    Purpose: HDR brachytherapy is undergoing significant development, and quality assurance (QA) checks must keep pace. Current recommendations do not adequately verify delivered against planned dose distributions: This is particularly relevant for new treatment planning system (TPS) calculation algorithms (non TG-43 based), and an era of significant patient-specific plan optimisation. Full system checks are desirable in modern QA recommendations, complementary to device-centric individual tests. We present a QA system incorporating TPS calculation, dose distribution export, HDR unit performance, and dose distribution measurement. Such an approach, more common in external beam radiotherapy, has not previously been reported in the literature for brachytherapy. Methods: Our QA method was tested at 24 UK brachytherapy centres. As a novel approach, we used the TPS DICOM RTDose file export to compare planned dose distribution with that measured using Gafchromic EBT3 films placed around clinical brachytherapy treatment applicators. Gamma analysis was used to compare the dose distributions. Dose difference and distance to agreement were determined at prescription Point A. Accurate film dosimetry was achieved using a glass compression plate at scanning to ensure physically-flat films, simultaneous scanning of known dose films with measurement films, and triple-channel dosimetric analysis. Results: The mean gamma pass rate of RTDose compared to film-measured dose distributions was 98.1% at 3%(local), 2 mm criteria. The mean dose difference, measured to planned, at Point A was -0.5% for plastic treatment applicators and -2.4% for metal applicators, due to shielding not accounted for in TPS. The mean distance to agreement was 0.6 mm. Conclusion: It is recommended to develop brachytherapy QA to include full-system verification of agreement between planned and delivered dose distributions. This is a novel approach for HDR brachytherapy QA. A methodology using advanced film

  9. Operating plan FY 1998

    SciTech Connect

    1997-10-01

    This document is the first edition of Argonne`s new Operating Plan. The Operating Plan complements the strategic planning in the Laboratory`s Institutional Plan by focusing on activities that are being pursued in the immediate fiscal year, FY 1998. It reflects planning that has been done to date, and it will serve in the future as a resource and a benchmark for understanding the Laboratory`s performance. The heart of the Institutional Plan is the set of major research initiatives that the Laboratory is proposing to implement in future years. In contrast, this Operating Plan focuses on Argonne`s ongoing R&D programs, along with cost-saving measures and other improvements being implemented in Laboratory support operations.

  10. Planning To Grow.

    ERIC Educational Resources Information Center

    Upchurch, Thomas Hayne

    2002-01-01

    Traces the master planning efforts for expanding the campus of Prairie View A & M University in Houston, Texas, through to the year 2015. The plan's framework for growth includes significantly enhancing student campus life by building privatized housing and providing improvements and enhancements for future off-campus extensions. (GR)

  11. External Strategic Planning Conference.

    ERIC Educational Resources Information Center

    Los Angeles Community Coll. District, CA. Office of Research and Planning.

    In response to a community reputation that has grown increasingly negative, the Los Angeles Community College District (LACCD) devised a strategic plan in 1998 to improve its programs and services and assure the educational success of its students. The planning process involved several steps: (1) revisiting the district mission statement; (2)…

  12. Planning for older workers.

    PubMed

    Randolph, Susan A

    2013-12-01

    Occupational and environmental health nurses can improve planning for an aging workforce by reviewing existing programs and services and adding aging and multi-generational workforce issues to ongoing training. PMID:24328920

  13. Planning for the future

    SciTech Connect

    Lesh, Pamela

    2009-06-15

    Four changes to integrated resource planning could significantly improve alignment between future utility spending and the forces and changes that are upending past preconceptions of how to predict future load. (author)

  14. The Ranking of the Regions with Regard to Their Sports Facilities to Improve Their Planning in Sport: The Case of Spain

    ERIC Educational Resources Information Center

    Gallardo, Leonor; Burillo, Pablo; Garcia-Tascon, Marta; Salinero, Juan J.

    2009-01-01

    Sports facility planning by the public authorities should be considered to be one of the main policies to have an indirect influence on the aim of ensuring a healthy population, as well as reducing its physical inactivity. Our research aims to study and compare the state of sports infrastructures in the regions of Spain, using a synthetic…

  15. Louisiana State Performance Plan--Part B. July 1, 2005-June 30, 2011. Under the Individuals with Disabilities Educational Improvement Act of 2004. Revised

    ERIC Educational Resources Information Center

    White, John

    2012-01-01

    Louisiana developed a time frame for compiling the State Performance Plan with as much opportunity for broad stakeholder input as possible before the required submission date. Bearing in mind the requirements of No Child Left Behind (NCLB) legislation, Louisiana's Steering Committee projected performance targets through the year 2014 for the…

  16. 78 FR 23855 - Improving Public Safety Communications in the 800 MHz Band; New 800 MHz Band Plan for U.S.-Mexico...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... communication systems operating in the band, 69 FR 67823, November 22, 2004. The Commission, however, deferred... once agreements are reached with Canada and Mexico, 72 FR 39756, July 20, 2007. 3. On June 8, 2012, the... for the National Public Safety Planning Advisory Committee (NPCPAC) Regions bordering Mexico, 77...

  17. Integrating an EMR-based Transition Planning Tool for CYSHCN at a Children's Hospital: A Quality Improvement Project to Increase Provider Use and Satisfaction

    PubMed Central

    Wiemann, Constance M.; Hergenroeder, Albert C.; Bartley, Krystle A.; Sanchez-Fournier, Blanca; Hilliard, Marisa E.; Warren, Laura J.; Graham, Sarah C.

    2016-01-01

    An electronic medical record (EMR)-based transition planning tool (TPT) designed to facilitate transition from pediatric to adult-based health care for youth (16–25 years) with special health care needs was introduced at a large children's hospital. Activities to increase provider use were implemented in five plan–do–study–act cycles. Overall, 22 of 25 (88%) consenting providers in four pediatric subspecialty services used the TPT during 303 patient encounters, with nurses and case-managers the top users and physicians the least likely users. Use was highest with intensive technical assistance and following the introduction of an upgraded tool. Provider satisfaction with the TPT and self-reported transition planning activities notably increased across the PDSA cycles. PMID:26209173

  18. A Comparative Study on Improved Arrhenius-Type and Artificial Neural Network Models to Predict High-Temperature Flow Behaviors in 20MnNiMo Alloy

    PubMed Central

    Yu, Chun-tang; Liu, Ying-ying; Xia, Yu-feng

    2014-01-01

    The stress-strain data of 20MnNiMo alloy were collected from a series of hot compressions on Gleeble-1500 thermal-mechanical simulator in the temperature range of 1173∼1473 K and strain rate range of 0.01∼10 s−1. Based on the experimental data, the improved Arrhenius-type constitutive model and the artificial neural network (ANN) model were established to predict the high temperature flow stress of as-cast 20MnNiMo alloy. The accuracy and reliability of the improved Arrhenius-type model and the trained ANN model were further evaluated in terms of the correlation coefficient (R), the average absolute relative error (AARE), and the relative error (η). For the former, R and AARE were found to be 0.9954 and 5.26%, respectively, while, for the latter, 0.9997 and 1.02%, respectively. The relative errors (η) of the improved Arrhenius-type model and the ANN model were, respectively, in the range of −39.99%∼35.05% and −3.77%∼16.74%. As for the former, only 16.3% of the test data set possesses η-values within ±1%, while, as for the latter, more than 79% possesses. The results indicate that the ANN model presents a higher predictable ability than the improved Arrhenius-type constitutive model. PMID:24688358

  19. NASA Performance Plan

    NASA Technical Reports Server (NTRS)

    1999-01-01

    The Government Performance and Results Act (GPRA) passed by Congress and signed by the President in 1993 provides a new tool to improve the efficiency of all Federal agencies. The goals of GPRA are to: Improve citizen confidence in Government performance; Improve Federal program management, effectiveness, and public accountability; and Improve congressional decisionmaking on where to commit the Nation's financial and human resources. The Act directs Executive Branch agencies to develop a customer-focused strategic plan that aligns activities with concrete missions and goals. The first plans were submitted in September 1998 as part of the Fiscal Year 1999 (FY99) budget process. These budget submissions were expected to support the goals expressed in the agency strategic plans. The Act also directs agencies to manage and measure results to justify congressional appropriations and authorizations. Six months after the completion of the fiscal year, agencies will report on the degree of success in achieving the goals and evaluation measures defined in the strategic and performance plans. The plans required by GPRA have been submitted to the Office of Management and Budget (OMB) and to Congress. Copies of NASA plans are available from the Office of Policy and Plans at NASA Headquarters and can be accessed on the i nterinet web sites identified in the Appendix.

  20. Improving 4D plan quality for PBS-based liver tumour treatments by combining online image guided beam gating with rescanning.

    PubMed

    Zhang, Ye; Knopf, Antje-Christin; Weber, Damien Charles; Lomax, Antony John

    2015-10-21

    Pencil beam scanned (PBS) proton therapy has many advantages over conventional radiotherapy, but its effectiveness for treating mobile tumours remains questionable. Gating dose delivery to the breathing pattern is a well-developed method in conventional radiotherapy for mitigating tumour-motion, but its clinical efficiency for PBS proton therapy is not yet well documented. In this study, the dosimetric benefits and the treatment efficiency of beam gating for PBS proton therapy has been comprehensively evaluated. A series of dedicated 4D dose calculations (4DDC) have been performed on 9 different 4DCT(MRI) liver data sets, which give realistic 4DCT extracting motion information from 4DMRI. The value of 4DCT(MRI) is its capability of providing not only patient geometries and deformable breathing characteristics, but also includes variations in the breathing patterns between breathing cycles. In order to monitor target motion and derive a gating signal, we simulate time-resolved beams' eye view (BEV) x-ray images as an online motion surrogate. 4DDCs have been performed using three amplitude-based gating window sizes (10/5/3 mm) with motion surrogates derived from either pre-implanted fiducial markers or the diaphragm. In addition, gating has also been simulated in combination with up to 19 times rescanning using either volumetric or layered approaches. The quality of the resulting 4DDC plans has been quantified in terms of the plan homogeneity index (HI), total treatment time and duty cycle. Results show that neither beam gating nor rescanning alone can fully retrieve the plan homogeneity of the static reference plan. Especially for variable breathing patterns, reductions of the effective duty cycle to as low as 10% have been observed with the smallest gating rescanning window (3 mm), implying that gating on its own for such cases would result in much longer treatment times. In addition, when rescanning is applied on its own, large differences between volumetric

  1. Improving 4D plan quality for PBS-based liver tumour treatments by combining online image guided beam gating with rescanning

    NASA Astrophysics Data System (ADS)

    Zhang, Ye; Knopf, Antje-Christin; Weber, Damien Charles; Lomax, Antony John

    2015-10-01

    Pencil beam scanned (PBS) proton therapy has many advantages over conventional radiotherapy, but its effectiveness for treating mobile tumours remains questionable. Gating dose delivery to the breathing pattern is a well-developed method in conventional radiotherapy for mitigating tumour-motion, but its clinical efficiency for PBS proton therapy is not yet well documented. In this study, the dosimetric benefits and the treatment efficiency of beam gating for PBS proton therapy has been comprehensively evaluated. A series of dedicated 4D dose calculations (4DDC) have been performed on 9 different 4DCT(MRI) liver data sets, which give realistic 4DCT extracting motion information from 4DMRI. The value of 4DCT(MRI) is its capability of providing not only patient geometries and deformable breathing characteristics, but also includes variations in the breathing patterns between breathing cycles. In order to monitor target motion and derive a gating signal, we simulate time-resolved beams’ eye view (BEV) x-ray images as an online motion surrogate. 4DDCs have been performed using three amplitude-based gating window sizes (10/5/3 mm) with motion surrogates derived from either pre-implanted fiducial markers or the diaphragm. In addition, gating has also been simulated in combination with up to 19 times rescanning using either volumetric or layered approaches. The quality of the resulting 4DDC plans has been quantified in terms of the plan homogeneity index (HI), total treatment time and duty cycle. Results show that neither beam gating nor rescanning alone can fully retrieve the plan homogeneity of the static reference plan. Especially for variable breathing patterns, reductions of the effective duty cycle to as low as 10% have been observed with the smallest gating rescanning window (3 mm), implying that gating on its own for such cases would result in much longer treatment times. In addition, when rescanning is applied on its own, large differences between volumetric

  2. The Relativistic Heavy Ion Collider (RHIC) cryogenic system at Brookhaven National Laboratory: Review of the modifications and upgrades since 2002 and planned improvements.

    SciTech Connect

    Than, R.; Tuozzolo, Joseph; Sidi-Yekhlef, Ahmed; Ganni, Venkatarao; Knudsen, Peter; Arenius, Dana

    2008-03-01

    Brookhaven National Laboratory continues its multi-year program to improve the operational efficiency, reliability, and stability of the cryogenic system, which also resulted in an improved beam availability of the Relativistic Heavy Ion Collider (RHIC). This paper summarizes the work and changes made after each phase over the past four years to the present, as well as proposed future improvements. Power usage dropped from an initial 9.4 MW to the present 5.1 MW and is expected to drop below 5 MW after the completion of the remaining proposed improvements. The work proceeded in phases, balancing the Collider's schedule of operation, time required for the modifications and budget constraints. The main changes include process control, compressor oil removal and management, elimination of the use of cold compressors and two liquid-helium storage tanks, insulation of the third liquid-helium storage tank, compressor-bypass flow reduction and the addition of a load turbine (Joule-Thomson ex

  3. TU-C-17A-08: Improving IMRT Planning and Reducing Inter-Planner Variability Using the Stochastic Frontier Method: Validation Based On Clinical and Simulated Data

    SciTech Connect

    Gagne, MC; Archambault, L; Tremblay, D; Varfalvy, N

    2014-06-15

    Purpose: Intensity modulated radiation therapy always requires compromises between PTV coverage and organs at risk (OAR) sparing. We previously developed metrics that correlate doses to OAR to specific patients’ morphology using stochastic frontier analysis (SFA). Here, we aim to examine the validity of this approach using a large set of realistically simulated dosimetric and geometric data. Methods: SFA describes a set of treatment plans as an asymmetric distribution with respect to a frontier defining optimal plans. Eighty head and neck IMRT plans were used to establish a metric predicting the mean dose to parotids as a function of simple geometric parameters. A database of 140 parotids was used as a basis distribution to simulate physically plausible data of geometry and dose. Distributions comprising between 20 and 5000 were simulated and the SFA was applied to obtain new frontiers, which were compared to the original frontier. Results: It was possible to simulate distributions consistent with the original dataset. Below 160 organs, the SFA could not always describe distributions as asymmetric: a few cases showed a Gaussian or half-Gaussian distribution. In order to converge to a stable solution, the number of organs in a distribution must ideally be above 100, but in many cases stable parameters could be achieved with as low as 60 samples of organ data. Mean RMS value of the error of new frontiers was significantly reduced when additional organs are used. Conclusion: The number of organs in a distribution showed to have an impact on the effectiveness of the model. It is always possible to obtain a frontier, but if the number of organs in the distribution is small (< 160), it may not represent de lowest dose achievable. These results will be used to determine number of cases necessary to adapt the model to other organs.

  4. Managing wetlands for waterbirds: How managers can make a difference in improving habitat to support a North American Bird Conservation Plan

    USGS Publications Warehouse

    Erwin, R.M.; Laubhan, M.K.; Cornely, J.E.; Bradshaw, D.M.

    2000-01-01

    Wetlands are the most productive ecosystems in the world, yet they have suffered more loss and degradation than any other ecosystem. Not surprisingly, 50% (29 of 58) of all the bird species in the U. S. (excluding Hawaii and territories) that are listed either as federally threatened or endangered, or are on the U. S. Fish & Wildlife Service 1995 List of Migratory Nongame Birds of Management Concern, occupy wetland or aquatic habitats even though many remaining wetlands across the North American landscape already are managed primarily for waterbirds. Some of these wetlands are administered by federal and state entities (e.g., national wildlife refuges, national and state parks, state wetland management areas) or are maintained on private lands through federally supported restoration and enhancement programs (e.g., Conservation Reserve Program, Wetland Reserve Program, Waterfowl Production Areas, and Partners for Wildlife). Private organizations, such as the National Audubon Society, The Nature Conservancy, and private hunting clubs, also own wetland areas that are managed specifically to benefit wildlife. If management philosophies are altered to consider the entire complex of wetlands, many wetlands can provide benefits to a broad array of waterbirds, as opposed to just one or a few species. However, challenges for natural resource managers are in forming partnerships with owners-managers of wetlands where the objectives are not primarily wildlife oriented. These owners or managers need to be included in wetland training workshops in an attempt to educate them about wetland values and secondary wildlife benefits that may be derived in flooded agricultural lands, aquaculture ponds, altered coastal marshes (mosquito control), and salt evaporation ponds. In some cases, compensation for crop damages by wildlife may be a necessary part of any cooperative agreements. In the development of a North American Bird Conservation Plan we propose a four-step approach and

  5. Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

    PubMed Central

    2013-01-01

    Background Knowledge translation strategies are an approach to increase the use of evidence within policy and practice decision-making contexts. In clinical and health service contexts, knowledge translation strategies have focused on individual behavior change, however the multi-system context of public health requires a multi-level, multi-strategy approach. This paper describes the design of and implementation plan for a knowledge translation intervention for public health decision making in local government. Methods Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan. Results The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these

  6. Performance Improvement in Behavioral Health Care: Collateral Effects of Planned Treatment Integrity Observations as an Applied Example of Schedule-Induced Responding

    ERIC Educational Resources Information Center

    Reed, Derek D.; Fienup, Daniel M.; Luiselli, James K.; Pace, Gary M.

    2010-01-01

    With rising interest in the role of treatment integrity on student outcomes, research has primarily focused on isolating the techniques and procedures necessary to improve staff's acquisition and maintenance of adequate levels of integrity. Despite increasing numbers of publications on this topic, there has been little discussion of the variables…

  7. Using a Response to Intervention Framework to Improve Student Learning: A Pocket Guide for State and District Leaders. Implementing ESEA Flexibility Plans

    ERIC Educational Resources Information Center

    McInerney, Maurice; Elledge, Amy

    2013-01-01

    The 2002 reauthorization of the Elementary and Secondary Education Act (ESEA) contained provisions that expanded state and district accountability for improving all schools and increasing the learning and achievement of all students, including those who struggle to master basic skills in reading and mathematics. In 2011, the U.S. Department of…

  8. Participatory Planning.

    ERIC Educational Resources Information Center

    DeJong, William S.

    1980-01-01

    A synopsis of a Planning Assistance Kit designed by the Council of Educational Facility Planners (CEFP) and Educational Facilities Laboratories (EFL) to assist local communities in participatory planning. (MLF)

  9. Planning Diseases.

    ERIC Educational Resources Information Center

    Gabel, Medard

    1984-01-01

    To solve societal problems, both local and global, a global approach is needed. Serious diseases that are crippling present-day problem solving and planning are discussed, and the characteristics of a healthy, effective planning approach are described. (RM)

  10. Statistical analysis plan for the Stroke Oxygen Study (SO2S): a multi-center randomized controlled trial to assess whether routine oxygen supplementation in the first 72 hours after a stroke improves long-term outcome

    PubMed Central

    2014-01-01

    Background The Stroke Oxygen Study (SO2S) is a multi-center randomized controlled trial of oxygen supplementation in patients with acute stroke. The main hypothesis for the trial is that fixed-dose oxygen treatment during the first 3 days after an acute stroke improves outcome. The secondary hypothesis is that restricting oxygen supplementation to night time only is more effective than continuous supplementation. This paper describes the statistical analysis plan for the study. Methods and design Patients (n = 8000) are randomized to three groups: (1) continuous oxygen supplementation for 72 hours; (2) nocturnal oxygen supplementation for three nights; and (3) no routine oxygen supplementation. Outcomes are recorded at 7 days, 90 days, 6 months, and 12 months. The primary outcome measure is the modified Rankin scale at 90 days. Data will be analyzed according to the intention-to-treat principle. Methods of statistical analysis are described, including the handling of missing data, the covariates used in adjusted analyses, planned subgroups analyses, and planned sensitivity analyses. Trial registration This trial is registered with the ISRCTN register, number ISRCTN52416964 (30 September 2005). PMID:24939648

  11. Audio-Visual Biofeedback Does Not Improve the Reliability of Target Delineation Using Maximum Intensity Projection in 4-Dimensional Computed Tomography Radiation Therapy Planning

    SciTech Connect

    Lu, Wei; Neuner, Geoffrey A.; George, Rohini; Wang, Zhendong; Sasor, Sarah; Huang, Xuan; Regine, William F.; Feigenberg, Steven J.; D'Souza, Warren D.

    2014-01-01

    Purpose: To investigate whether coaching patients' breathing would improve the match between ITV{sub MIP} (internal target volume generated by contouring in the maximum intensity projection scan) and ITV{sub 10} (generated by combining the gross tumor volumes contoured in 10 phases of a 4-dimensional CT [4DCT] scan). Methods and Materials: Eight patients with a thoracic tumor and 5 patients with an abdominal tumor were included in an institutional review board-approved prospective study. Patients underwent 3 4DCT scans with: (1) free breathing (FB); (2) coaching using audio-visual (AV) biofeedback via the Real-Time Position Management system; and (3) coaching via a spirometer system (Active Breathing Coordinator or ABC). One physician contoured all scans to generate the ITV{sub 10} and ITV{sub MIP}. The match between ITV{sub MIP} and ITV{sub 10} was quantitatively assessed with volume ratio, centroid distance, root mean squared distance, and overlap/Dice coefficient. We investigated whether coaching (AV or ABC) or uniform expansions (1, 2, 3, or 5 mm) of ITV{sub MIP} improved the match. Results: Although both AV and ABC coaching techniques improved frequency reproducibility and ABC improved displacement regularity, neither improved the match between ITV{sub MIP} and ITV{sub 10} over FB. On average, ITV{sub MIP} underestimated ITV{sub 10} by 19%, 19%, and 21%, with centroid distance of 1.9, 2.3, and 1.7 mm and Dice coefficient of 0.87, 0.86, and 0.88 for FB, AV, and ABC, respectively. Separate analyses indicated a better match for lung cancers or tumors not adjacent to high-intensity tissues. Uniform expansions of ITV{sub MIP} did not correct for the mismatch between ITV{sub MIP} and ITV{sub 10}. Conclusions: In this pilot study, audio-visual biofeedback did not improve the match between ITV{sub MIP} and ITV{sub 10}. In general, ITV{sub MIP} should be limited to lung cancers, and modification of ITV{sub MIP} in each phase of the 4DCT data set is recommended.

  12. Comprehensive Planning.

    ERIC Educational Resources Information Center

    Pavlenko, Victor V.

    Comprehensive planning, defined as the work of those who engage in efforts, within a delimited geographic area, to identify and order the physical, social, and economic relationships of that area, is discussed in the four sections of this paper. Section I, Introduction, describes what "planning" and "comprehensive planning" are. In Section II, Why…

  13. Fire Plans

    ERIC Educational Resources Information Center

    Power, June

    2011-01-01

    Many libraries have disaster recovery plans, but not all have prevention and action plans to prepare for an emergency in advance. This article presents the author's review of the prevention and action plans of several libraries: (1) Evergreen State College; (2) Interlochen Public Library; (3) University of Maryland, Baltimore-Marshall Law Library;…

  14. Improving maternity care in the Dominican Republic: a pilot study of a community-based participatory research action plan by an international healthcare team.

    PubMed

    Foster, Jennifer; Gossett, Sarah; Burgos, Rosa; Cáceres, Ramona; Tejada, Carmen; Dominguez García, Luis; Ambrosio Rosario, Angel; Almonte, Asela; Perez, Lydia J

    2015-05-01

    This article is a report of the process and results of a feasibility pilot study to improve the quality of maternity care in a sample of 31 women and their newborns delivering in a public, tertiary hospital in the Dominican Republic. The pilot study was the first "action step" taken as a result of a formative, community-based participatory research (CBPR) study conducted between 2008 and 2010 by an interdisciplinary, international partnership of U.S. academic researchers, Dominican medical/nursing personnel, and Dominican community health workers. Health personnel and community health workers separately identified indicators most important to measure quality of antepartum maternity care: laboratory and diagnostic studies and respectful, interpersonal communication. At the midpoint and the completion of data collection, the CBPR team evaluated the change in quality indicators to assess improvement in care. The pilot study supports the idea that joint engagement of community health workers, health personnel, and academic researchers with data creation and patient monitoring is motivating for all to continue to improve services in the cultural context of the Dominican Republic. PMID:24793488

  15. Inventory of U.S. Greenhouse Gas Emissions and Sinks: an overview of planned improvements to the methodologies and activity data used to develop the carbon estimates in the Land Use, Land-use Change, and Forestry (LULUCF) sector

    NASA Astrophysics Data System (ADS)

    Wirth, T. C.; Shrestha, G.; Baranski, M.

    2015-12-01

    The Inventory of U.S. Greenhouse Gas Emissions and Sinks provides a complete assessment of GHG emissions and removals for submission to the United Nations Framework Convention on Climate Change (UNFCCC). The sectors covered in the inventory include Energy; Industrial Processes and Product Use; Agriculture; Land Use, Land-use Change and Forestry (LULUCF); and Waste. The LULUCF sector currently represents a net carbon sink of 885.5 MMT CO2 Equivalent for 2013, but this estimate is expected to be refined over time as a number of existing and planned improvements to the methodologies and activity data used to develop the LULUCF estimates are implemented in the U.S. GHG Inventory. This presentation provides an overview of these planned improvements including (1) a new approach for reconciling the land survey data sets used to represent the U.S. land base, (2) a modification of the forest carbon estimation methods, (3) incorporation of new NRCS data from the Conservation Effects Assessment Project (CEAP), and (4) inclusion of new guidance based on the recently released IPCC Wetlands Supplement.

  16. Mobile reminders to improve opportunistic screening of type 2 diabetes mellitus: Data documentation and data analysis plan of a randomized trial data.

    PubMed

    Shewade, Hemant Deepak; Kumar, Sathish

    2016-03-01

    This Data in Brief article contains individual level data of a randomized trial in a primary care setting. This trial offered mobile reminder to follow up for definitive tests during opportunistic screening of diabetes mellitus in Puducherry, India (2014). ("Effect of mobile reminders on screening yield during opportunistic screening for type 2 diabetes mellitus in a primary health care setting: a randomized trial" (Kumar et al., 2015) [1]) Variables collected included the baseline characteristics of study participants (n=390) and information on initial screening and eligibility for definitive test, study group (intervention/control), follow up for definitive test and definitive test results. The data was double entered with adequate checks and validated in EpiData. Final data after correcting the data entry errors has been shared here. In addition, we have shared data entry plan, EpiData triplet files for data entry and program file for data analysis. They may be used by other researchers who intend to replicate this research in their setting. PMID:26937453

  17. Environmental monitoring plan

    SciTech Connect

    Holland, R.C.

    1997-02-01

    This Environmental Monitoring Plan was written to fulfill the requirements of Department of Energy (DOE) Order 5400.1 and DOE Environmental Regulatory Guide DOE/EH 0173T. This Plan documents the background, organizational structure, and methods used for effluent monitoring and environmental surveillance at Sandia National Laboratories/California. The design, rationale, and historical results of the environmental monitoring system are discussed in detail. Throughout the Plan, recommendations for improvements to the monitoring system are made. 52 refs., 10 figs., 12 tabs.

  18. Implementing the National Institute of Clinical Excellence improving outcome guidelines for head and neck cancer: developing a business plan with reorganisation of head and neck cancer services.

    PubMed

    Jeannon, J-P; Abbs, I; Calman, F; Gleeson, M; Lyons, A; Hussain, K; McGurk, M; O'Connell, M; Probert, D; Ng, R; Simo, R

    2008-04-01

    The implementation of the National Institute of Clinical Excellence improving outcome guidelines (NICE-IOG) manual for head and neck cancer may have a huge potential cost implication. Head and neck cancer is a rare disease which utilises large quantities of resources which can only be provided in a tertiary centre. Head and neck cancer services should be centralised into a single site for each cancer network. A new higher tariff rate for complex head and neck cancer cases is needed which recognises the true cost of this work. Each network should set its own tariff to make head and neck cancer care financially viable. PMID:18429872

  19. Integrated Planning: Consolidating Annual Facility Planning - More Time for Execution

    SciTech Connect

    Nelson, J. G.; R., L. Morton; Ramirez, C.; Morris, P. S.; McSwain, J. T.

    2011-02-02

    Previously, annual planning for Readiness in Technical Base and Facilities (RTBF) at the Nevada National Security Site (NNSS) was fragmented, disconnected, circular, and occurred constantly throughout the fiscal year (FY) comprising 9 of the 12 months, reducing the focus on implementation and execution. This required constant “looking back” instead of “looking forward.” In FY 2009, annual planning was consolidated into one comprehensive integrated plan (IP) for each facility/project, which comprised annual task planning/outyear budgeting, AMPs, and investment planning (i.e., TYIP). In FY 2010, the Risk Management Plans were added to the IPs. The integrated planning process achieved the following: 1) Eliminated fragmented, circular, planning and moved the plan to be more forward-looking; 2) Achieved a 90% reduction in schedule planning timeframe from 40 weeks (9 months) to 6 weeks; 3) Achieved an 80% reduction in cost from just under $1.0M to just over $200K, for a cost savings of nearly $800K (reduced combined effort from over 200 person-weeks to less than 40); 4) Reduced the number of plans generated from 21 plans (1 per facility per plan) per year to 8 plans per year (1 per facility plus 1 program-level IP); 5) Eliminated redundancy in common content between plans and improved consistency and overall quality; 6) Reduced the preparation time and cost of the FY 2010 SEP by 50% due to information provided in the IP; 7) Met the requirements for annual task planning, annual maintenance planning, ten-year investment planning, and risk management plans.

  20. Initial assessment of strategic plans for improving the performance of veterinary services in developing countries: a review of OIE PVS gap analysis reports.

    PubMed

    Weaver, J; Leon, E; Edan, M; D'Alessio, F

    2012-08-01

    The World Organisation for Animal Health (OIE) carries out Gap Analysis missions (if a country so wishes) as part of its programme to assess and improve the Performance of Veterinary Services (the 'PVS Pathway') in Member Countries. These Gap Analysis missions have found that many national Veterinary Services comply to only a limited extent with the international standards established by the OIE and that their competence is compromised by poor governance. This failure threatens animal and public health not only nationally but also internationally. The OIE PVS Gap Analysis reports reviewed found that all the Veterinary Services have a strong vision and commitmentto improvement but are held back by a weak chain of command, inadequate and outdated legislation, insufficient funding, weak technical competencies, compromised technical independence, poor communications and limited joint programmes. There are weaknesses across all the core technical areas of trade, animal health, veterinary public health and veterinary laboratories and also in the overall management of the Veterinary Services. The OIE PVS Gap Analysis missions recommend significant increases in budget in all countries. PMID:23413738