Herbicide practices in hardwood plantings

Treesearch

Brian D. Beheler; Charles H. Michler

2013-01-01

Control of competing vegetation is an important early cultural practice that can improve survival and vigor in hardwood tree plantings. The type of program used depends on landowner objectives, species of weeds present, equipment available, and types of herbicides available. Pre-planting planning can greatly increase effectiveness of an herbicide program for the first...

Trends in financing and availability of capital

Treesearch

Donald G. Schink

1980-01-01

The past, present and future of recreation enterprise financing is developed in this paper. Developers need to utilize all available methods of financing sound projects. The long-term solution to the problems depend on better information, improved educational programs, and a loan program tailored to the needs of this industry.

Administrative Restructuring of a Residency Training Program for Improved Efficiency and Output

ERIC Educational Resources Information Center

van Zyl, Louis T.; Finch, Susan J.; Davidson, Paul R.; Arboleda-Florez, Julio

2005-01-01

Objectives: Canadian residency training programs (RTP) have a program director (PD) and a residency program committee (RPC) overseeing program administration. Limited guidance is available about the ideal administrative structure of an RTP. This article describes administrative load in Canadian RTPs, presents a novel approach to delegating core…

Rocket exhaust plume computer program improvement. Volume 1: Summary: Method of characteristics nozzle and plume programs

NASA Technical Reports Server (NTRS)

Ratliff, A. W.; Smith, S. D.; Penny, N. M.

1972-01-01

A summary is presented of the various documents that discuss and describe the computer programs and analysis techniques which are available for rocket nozzle and exhaust plume calculations. The basic method of characteristics program is discussed, along with such auxiliary programs as the plume impingement program, the plot program and the thermochemical properties program.

School Improvement Grants: Early Implementation under Way, but Reforms Affected by Short Time Frames. Report to Congressional Requesters. GAO-11-741

ERIC Educational Resources Information Center

Scott, George A.

2011-01-01

The School Improvement Grants (SIG) program, which was created in 2002, funds reforms in the country's lowest-performing schools with the goal of improving student outcomes, such as standardized test scores and graduation rates. Congress greatly increased SIG program funding from $125 million available in fiscal year 2007--the first year the…

78 FR 24714 - Notice of Funds Availability Inviting Applications for the Federal-State Marketing Improvement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... channels. Assist in the development of more efficient marketing methods, practices, and facilities to bring... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. No. AMS-TM-12-0053; TM-12-03] Notice of Funds Availability Inviting Applications for the Federal-State Marketing Improvement Program...

Industrial Energy Training and Certification

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

Glatt, Sandy; Cox, Daryl; Nimbalkar, Sachin U.

Compressed air systems, ammonia refrigeration systems, chilled water systems, steam systems, process heating systems, combined heat and power systems, pump systems and fan systems are major industrial energy systems commonly found in manufacturing facilities. Efficiency of these systems contributes significantly to whole facilities' energy performance. On the national, even international level, well-structured training and highly recognized certification programs help develop a highly-skilled and qualified workforce to maintain and improve facilities' energy performance, particularly as technologies within these systems become more advanced. The purpose of this paper is to review currently available training and certification programs focusing on these systems andmore » to identify the gap between market's needs and currently available programs. Three major conclusions are: first, most training programs focus on operations, maintenance, safety and design although some briefly touch the energy performance aspect; second, except CRES by RETA and PSA Certificate and PSAP Master Certification by HI, no other certifications had been found emphasizing on knowledge and skills for improving and maintaining these systems' energy performance; third, developing energy efficiency focused training and ANSI accredited certification programs on these energy systems will fill the gap between market's needs and currently available programs.« less

Industrial Energy Training and Certification

DOE PAGES

Glatt, Sandy; Cox, Daryl; Nimbalkar, Sachin U.; ...

2017-11-01

Compressed air systems, ammonia refrigeration systems, chilled water systems, steam systems, process heating systems, combined heat and power systems, pump systems and fan systems are major industrial energy systems commonly found in manufacturing facilities. Efficiency of these systems contributes significantly to whole facilities' energy performance. On the national, even international level, well-structured training and highly recognized certification programs help develop a highly-skilled and qualified workforce to maintain and improve facilities' energy performance, particularly as technologies within these systems become more advanced. The purpose of this paper is to review currently available training and certification programs focusing on these systems andmore » to identify the gap between market's needs and currently available programs. Three major conclusions are: first, most training programs focus on operations, maintenance, safety and design although some briefly touch the energy performance aspect; second, except CRES by RETA and PSA Certificate and PSAP Master Certification by HI, no other certifications had been found emphasizing on knowledge and skills for improving and maintaining these systems' energy performance; third, developing energy efficiency focused training and ANSI accredited certification programs on these energy systems will fill the gap between market's needs and currently available programs.« less

Data Availability in Appliance Standards and Labeling Program Development and Evaluation

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

Romankiewicz, John; Khanna, Nina; Vine, Edward

2013-05-01

In this report, we describe the necessary data inputs for both standards development and program evaluation and perform an initial assessment of the availability and uncertainty of those data inputs in China. For standards development, we find that China and its standards and labeling program administrators currently has access to the basic market and technical data needed for conducting market and technology assessment and technological and economic analyses. Some data, such as shipments data, is readily available from the China Energy Label product registration database while the availability of other data, including average unit energy consumption, prices and design options,more » needs improvement. Unlike some other countries such as the United States, most of the necessary data for conducting standards development analyses are not publicly available or compiled in a consolidated data source. In addition, improved data on design and efficiency options as well as cost data (e.g., manufacturing costs, mark-ups, production and product use-phase costs) – key inputs to several technoeconomic analyses – are particularly in need given China’s unconsolidated manufacturing industry. For program evaluation, we find that while China can conduct simple savings evaluations on its incentive programs with the data it currently has available from the Ministry of Finance – the program administrator, the savings estimates produced by such an evaluation will carry high uncertainty. As such, China could benefit from an increase in surveying and metering in the next one to three years to decrease the uncertainty surrounding key data points such as unit energy savings and free ridership.« less

Do Farmers' Markets Improve Diet of Participants Using Federal Nutrition Assistance Programs? A Literature Review

ERIC Educational Resources Information Center

Byker, Carmen J.; Misyak, Sarah; Shanks, Justin; Serrano, Elena L.

2013-01-01

Farmers' markets have emerged as one health strategy to improve the access and availability of fresh foods for limited-resource audiences using federal nutrition assistance programs, although their effectiveness on dietary intake is not well understood. The review reported here evaluates the strengths and weaknesses of existing research about…

Translation of Two Evidence-Based Programs for Training Families to Improve Care of Persons with Dementia

ERIC Educational Resources Information Center

Teri, Linda; McKenzie, Glenise; Logsdon, Rebecca G.; McCurry, Susan M.; Bollin, Salli; Mead, Jennifer; Menne, Heather

2012-01-01

The need for evidence-based non-pharmacological community programs to improve care of older adults with dementia is self-evident, considering the sheer numbers of affected individuals; the emotional, physical, and financial toll on affected individuals and their caregivers; the impact on our health care system; and the growing availability of…

Improving Behavior through Differential Reinforcement: A Praise Note System for Elementary School Students

ERIC Educational Resources Information Center

Wheatley, Rikki K.; West, Richard P.; Charlton, Cade T.; Sanders, Richard B.; Smith, Tim G.; Taylor, Matthew J.

2009-01-01

Schools are often in need of low-cost, high-impact strategies to improve student behavior in school common areas. While many behavior management programs exist, there are few resources available to guide the implementation of these programs and ensure they are grounded in evidence-based strategies. Therefore, the current study had two primary…

45 CFR 2524.10 - For what purposes will technical assistance and training funds be made available?

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Promote leadership development in such programs; (3) Improve the instructional and programmatic quality of such programs to build an ethic of civic responsibility; (4) Develop the management and budgetary... programs; (6) Encourage AmeriCorps programs to adhere to risk management procedures, including the training...

Successful integration of ergonomics into continuous improvement initiatives.

PubMed

Monroe, Kimberly; Fick, Faye; Joshi, Madina

2012-01-01

Process improvement initiatives are receiving renewed attention by large corporations as they attempt to reduce manufacturing costs and stay competitive in the global marketplace. These initiatives include 5S, Six Sigma, and Lean. These programs often take up a large amount of available time and budget resources. More often than not, existing ergonomics processes are considered separate initiatives by upper management and struggle to gain a seat at the table. To effectively maintain their programs, ergonomics program managers need to overcome those obstacles and demonstrate how ergonomics initiatives are a natural fit with continuous improvement philosophies.

Lessons Learned from FIPSE Projects II.

ERIC Educational Resources Information Center

Marcus, Dora; And Others

This monograph describes 30 college and university programs funded by the Fund for the Improvement of Postsecondary Education from 1989 to 1991. Each description includes information on program purpose, project activities, major insights and lessons, project continuation, and available information. The first group of 10 are programs focused on…

Six year improvement program : fiscal years 1996-97 thru 2001-2002 (Vol. 2)

DOT National Transportation Integrated Search

1997-01-01

This program is the Commonwealth Transportation Board's plan for the use of funds anticipated to be available for ports, airports, public transit, and highway construction in the 1996-97 fiscal year. The Board also uses this Six-Year Program to distr...

Six Year Improvement Program: Fiscal Years 1996-97 thru 2001-2002 (Vol. 1)

DOT National Transportation Integrated Search

1997-01-01

This program is the Commonwealth Transportation Board's plan for the use of funds anticipated to be available for ports, airports, public transit, and highway construction in the 1996-97 fiscal year. The Board also uses this Six-Year Program to distr...

PEP Up Your PE Program: Writing and Implementing a PEP Grant

ERIC Educational Resources Information Center

McCollum, Starla; Elliott, Steven M.; Burke, Michelle M.; Civalier, Aimee; Pruitt, Wayne; Palmer, Scott

2005-01-01

Physical Education for Progress grants, otherwise known as PEP grants, are part of the Carol M. White Physical Education Program administered by the federal government. PEP grants are available to local educational agencies and community-based organizations to initiate, expand, or improve physical education programs, including after-school…

Sequence and Uniformity in the High School Literature Program.

ERIC Educational Resources Information Center

Sauer, Edwin H.

A good, sequential literature program for secondary school students should deal simultaneously with literary forms, with the chronological development of literature, and with broad themes of human experience. By employing the abundance of teaching aids, texts, and improved foreign translations available today, an imaginatively planned program can…

Curriculum Development and Implementation of a National Interprofessional Fellowship in Patient Safety.

PubMed

Watts, Bradley V; Williams, Linda; Mills, Peter D; Paull, Douglas E; Cully, Jeffrey A; Gilman, Stuart C; Hemphill, Robin R

2018-06-15

Developing a workforce skilled in improving the safety of medical care has often been cited as an important means to achieve safer care. Although some educational programs geared toward patient safety have been developed, few advanced training programs have been described in the literature. We describe the development of a patient safety fellowship program. We describe the development and curriculum of an Interprofessional Fellowship in Patient Safety. The 1-year in residence fellowship focuses on domains such as leadership, spreading innovations, medical improvement, patient safety culture, reliability science, and understanding errors. Specific training in patient safety is available and has been delivered to 48 fellows from a wide range of backgrounds. Fellows have accomplished much in terms of improvement projects, educational innovations, and publications. After completing the fellowship program, fellows are obtaining positions within health-care quality and safety and are likely to make long-term contributions. We offer a curriculum and fellowship design for the topic of patient safety. Available evidence suggests that the fellowship results in the development of patient safety professionals.

Patient, Program, and System Barriers and Facilitators to Detoxification Services in the U.S. Veterans Health Administration: A Qualitative Study of Provider Perspectives.

PubMed

Schultz, Nicole R; Martinez, Rociel; Cucciare, Michael A; Timko, Christine

2016-08-23

Because substance use disorder (SUD) treatment is expanding, and detoxification (detox) is often the entry point to SUD treatment, it is critical to provide ready access to detox services. The purpose of the current study was to examine patient, program, and system barriers or facilitators to detox access within an integrated health care system with variable rates of detox utilization across facilities. Inpatient and outpatient providers from 31 different U.S. Veterans Health Administration detox programs were interviewed. Qualitative analyses identified six facilitators and 11 barriers to detox access. Facilitators included program staff and program characteristics such as encouragement and immediate access, as well as systemic cooperation and patient circumstances. Barriers to detox included programmatic and systemic problems, including lack of available detox services, program rules or admission requirements, funding shortages, stigma related to a SUD diagnosis or receiving detox services, and a deficiency of education and training. Other major barriers pertained to patients' lack of motivation and competing responsibilities. To improve detox access, health care settings should consider enhancing supportive relationships by emphasizing outreach, engagement, and rapport-building with patients, improving systemic communication and teamwork, educating patients on available detox services and the detox process, and addressing patient centered barriers such as resistance to detox or competing responsibilities. In addition, programs should consider open-door and immediate-admission policies. These approaches may improve detox access, which is important for increasing the likelihood of transitioning patients to SUD treatment, thus improving outcomes and reducing utilization of high-cost services.

Nursing Education and Training: Alternative Federal Approaches. Budget Issue Paper for Fiscal Year 1979.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Congressional Budget Office.

Key issues pertinent to federal support of nursing education and training are considered. Policy options for nurse training include: support for programs to increase aggregate supply, support for programs to improve geographic distribution of nurses, support for programs to increase the availability of nurses with advanced training, and support…

Improving Teaching through a Peer Support "Teacher Consultation Process."

ERIC Educational Resources Information Center

Kerwin, Mike; Rhoads, Judith

The Teaching Consultation Program (TCP) is one of the most popular faculty development programs offered in the University of Kentucky Community Colleges (UKCC's), having trained over 500 faculty since its implementation in 1977. The TCP is a confidential, peer consulting program available to faculty who wish to analyze their teaching behaviors and…

The National School Lunch Program--Is It Working? Report to the Congress.

ERIC Educational Resources Information Center

Comptroller General of the U.S., Washington, DC.

The National School Lunch Program is designed to safeguard schoolchild health by improving and/or maintaining levels of nutrition, and strengthen the agricultural economy by stimulating food demand. The General Accounting Office (GAO) examined whether the program is meeting its legislative objectives and analyzed available information on what is…

78 FR 2449 - Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... availability. The OSCUI Grant Program serves as a source of financial support, in the form of technical... provides financial support in the form of technical assistance grants to LICUs. These funds help improve...

Equasions for Curriculum Improvement.

ERIC Educational Resources Information Center

Eckenrod, James S.

1986-01-01

Describes the Technology in Curriculum (TIC) program resource guides which will be distributed to California schools in the fall of 1986. These guides match available instructional television programs and computer software to existing California curriculum guides in order to facilitate teachers' classroom use. (JDH)

Framework for development of TxDOT construction inspector training program.

DOT National Transportation Integrated Search

2017-02-01

To meet the need for a larger number of inspectors and to improve the experience and knowledge level on inspectors, the Texas Department of Transportation (TxDOT) is reviewing construction inspector training needs and training programs that are avail...

Application of visualization and simulation program to improve work zone safety and mobility.

DOT National Transportation Integrated Search

2010-01-01

A previous study sponsored by the Smart Work Zone Deployment Initiative, Feasibility of Visualization and Simulation Applications to Improve Work Zone Safety and Mobility, demonstrated the feasibility of combining readily available, inexpensive...

Application of visualization and simulation program to improve work zone safety and mobility.

DOT National Transportation Integrated Search

2010-01-01

"A previous study sponsored by the Smart Work Zone Deployment Initiative, Feasibility of Visualization and Simulation Applications to Improve Work Zone Safety and Mobility, demonstrated the feasibility of combining readily available, inexpensiv...

Adapting the Army’s Training and Leader Development Programs for Future Challenges

DTIC Science & Technology

2013-01-01

development information from the insti- tutional domain. • Collective training support products are proposed improvements in the primary prod- ucts...not to argue for a totally centralized approach. Decentralized initiatives are ben- eficial , and training program managers and executors should continue...institution that helps improve policy and decisionmaking through research and analysis. This electronic document was made available from www.rand.org as a

SYSTID - A flexible tool for the analysis of communication systems.

NASA Technical Reports Server (NTRS)

Dawson, C. T.; Tranter, W. H.

1972-01-01

Description of the System Time Domain Simulation (SYSTID) computer-aided analysis program which is specifically structured for communication systems analysis. The SYSTID program is user oriented so that very little knowledge of computer techniques and very little programming ability are required for proper application. The program is designed so that the user can go from a system block diagram to an accurate simulation by simply programming a single English language statement for each block in the system. The mathematical and functional models available in the SYSTID library are presented. An example problem is given which illustrates the ease of modeling communication systems. Examples of the outputs available are presented, and proposed improvements are summarized.

PSORTb 3.0: improved protein subcellular localization prediction with refined localization subcategories and predictive capabilities for all prokaryotes.

PubMed

Yu, Nancy Y; Wagner, James R; Laird, Matthew R; Melli, Gabor; Rey, Sébastien; Lo, Raymond; Dao, Phuong; Sahinalp, S Cenk; Ester, Martin; Foster, Leonard J; Brinkman, Fiona S L

2010-07-01

PSORTb has remained the most precise bacterial protein subcellular localization (SCL) predictor since it was first made available in 2003. However, the recall needs to be improved and no accurate SCL predictors yet make predictions for archaea, nor differentiate important localization subcategories, such as proteins targeted to a host cell or bacterial hyperstructures/organelles. Such improvements should preferably be encompassed in a freely available web-based predictor that can also be used as a standalone program. We developed PSORTb version 3.0 with improved recall, higher proteome-scale prediction coverage, and new refined localization subcategories. It is the first SCL predictor specifically geared for all prokaryotes, including archaea and bacteria with atypical membrane/cell wall topologies. It features an improved standalone program, with a new batch results delivery system complementing its web interface. We evaluated the most accurate SCL predictors using 5-fold cross validation plus we performed an independent proteomics analysis, showing that PSORTb 3.0 is the most accurate but can benefit from being complemented by Proteome Analyst predictions. http://www.psort.org/psortb (download open source software or use the web interface). psort-mail@sfu.ca Supplementary data are available at Bioinformatics online.

Improving Basal Reading Programs: A Report of the Adoption Guidelines Project at the Center for the Study of Reading. Reading Education Report No. 68.

ERIC Educational Resources Information Center

Dole, Janice A.; And Others

Commercially developed basal reading programs are used in most elementary school classrooms in the United States. Yet often neither the publishers developing these programs nor the members of textbook adoption committees selecting programs are able to take advantage of the best available knowledge about the reading process and reading instruction.…

78 FR 47480 - Notice of Funding Availability for the Tribal Transportation Program Safety Funds

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... engineering improvement projects include, but are not limited to: Intersection safety improvements; Pavement..., replacement, and other improvement of highway signage and pavement markings, or a project to maintain minimum... Administration entitled `Highway Design Handbook for Older Drivers and Pedestrians'; Truck parking facilities...

Economic analysis of tree improvement: A status report

Treesearch

George F. Dutrow

1974-01-01

Review of current literature establishes that most authors believe that tree improvement expands production, although some point out drawbacks and alternatives. Both softwood and hardwood improvement programs have been analyzed. The authors used various models, economic assumptions, and standards of measurement, but available data were limited. Future models shouId...

Technology applications for traffic safety programs : a primer

DOT National Transportation Integrated Search

2008-09-01

This document explores how emerging digital and communications technology can advance safety on the Nations highways. The range of technology described in this report is available or will be available in the near future to improve traffic safety. ...

Education: Firms Offer Academics Polymer Science Training.

ERIC Educational Resources Information Center

Chemical and Engineering News, 1983

1983-01-01

Provides information on industry-sponsored programs for college faculty and advanced undergraduate students designed to improve polymer science training: these include residency programs for professors available at industrial laboratories, establishment of a Polymer Education Award, newsletter on course materials/sources in polymer science,…

Partners In Motion And Customer Satisfaction In The Washington Dc Metropolitan Area

DOT National Transportation Integrated Search

1999-06-01

PARTNERS IN MOTION IS A PROGRAM AIMED AT IMPROVING THE QUALITY, QUANTITY, AND AVAILABILITY OF TRAVEL INFORMATION TO TRANSPORTATION AGENCIES, THE MEDIA, AND, ULTIMATELY, TO THE TRAVELER IN THE WASHINGTON, D.C. METROPOLITAN AREA. THE PROGRAM WAS INITIA...

The School Food Environment and Obesity Prevention: Progress Over the Last Decade.

PubMed

Welker, Emily; Lott, Megan; Story, Mary

2016-06-01

The school food environment-including when and where children obtain food and the types of options available during the school day-plays an important role in children's consumption patterns. Thus, childhood obesity prevention efforts often focus on altering the school food environment as a mechanism for improving student dietary intake. This review examines the role school food programs and policies play in improving children's diet, weight, and health. Overall, research suggests that significant improvements have been made in school nutrition policies and programs. Due to the recent program changes made as a result of the 2010 Healthy, Hunger-Free Kids Act, an emphasis was placed on research conducted over the past decade and especially on the evaluation of foods and beverages served and sold since implementation of this national law. This review also examines remaining gaps in the literature and opportunities for further improvements in school food programs and policies.

78 FR 24236 - Notice of Availability of Funds and Solicitation for Grant Applications for Trade Adjustment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-24

... benefit from the TAACCCT program once education and training programs are developed and implemented. The... grant program provides eligible institutions of higher education, as defined in section 102 of the Higher Education Act of 1965 (20 U.S.C. 1002), with funds to expand and improve their ability to deliver...

Exploring Children's Perceptions of Two School-Based Social Inclusion Programs: A Pilot Study

ERIC Educational Resources Information Center

Lindsay, Sally; McPherson, Amy C.; Aslam, Henna; McKeever, Patricia; Wright, Virginia

2013-01-01

Background: Although social exclusion among typically developing school-aged children has been well explored, it is under-researched for children with disabilities even though they are at a higher risk for being excluded. While there are a number of different programs available to improve social inclusion at school, the appeal of these programs to…

Predictors of Program Use and Child and Parent Outcomes of A Brief Online Parenting Intervention.

PubMed

Baker, Sabine; Sanders, Matthew R

2017-10-01

Web-based parenting interventions have the potential to increase the currently low reach of parenting programs, but few evidence-based online programs are available, and little is known about who benefits from this delivery format. This study investigated if improvements in child behavior and parenting, following participation in a brief online parenting program (Triple P Online Brief), can be predicted by family and program-related factors. Participants were 100 parents of 2-9-year-old children displaying disruptive behavior problems. Regression analyses showed that higher baseline levels of child behavior problems, older parental age and more intense conflict over parenting pre-intervention predicted greater improvement in child behavior at 9-month follow-up. Improvement in parenting was predicted by higher pre-intervention levels of ineffective parenting. Family demographics, parental adjustment and program related factors did not predict treatment outcomes. Younger child age and lower disagreement over parenting pre-intervention predicted completion of the recommended minimum dose of the program.

Defense Contracting Integrity. Opportunities Exist to Improve DOD’s Oversight of Contractor Ethics Programs

DTIC Science & Technology

2009-09-01

NUMBER(S) 12 . DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15...Implementing FAR Ethics Rules 10 Table 4: Contractor Responses on Practices Now Required by the FAR for Code of Business Ethics and Conduct 12 Table 5...Fiscal Year 2006 35 Table 12 : Required FAR Components for Contractor Ethics Program Practices 43 Figure Figure 1: DOD Hotline Posters Available

Delivery of Health Coaching by Medical Assistants in Primary Care

PubMed Central

Djuric, Zora; Segar, Michelle; Orizondo, Carissa; Mann, Jeffrey; Faison, Maya; Peddireddy, Nithin; Paletta, Matthew; Locke, Amy

2017-01-01

Background Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Methods Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. Results A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Conclusions Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control. PMID:28484068

25 CFR 170.150 - What Federal funds are available for a tribe's transit program?

Code of Federal Regulations, 2010 CFR

2010-04-01

...) DOT: Welfare-to-Work, Indian Reservation Roads Program, transportation and community and systems preservation, Federal transit capital improvement grants, public transportation for non-urbanized areas... industrial loans; rural enterprise grants; commerce, public works and economic development grants; and...

Early lessons from schistosomiasis mass drug administration programs

PubMed Central

Secor, W. Evan

2015-01-01

Mass drug administration using praziquantel is the backbone of the current strategy for the control of schistosomiasis. As the theoretical plans have moved into practical application, certain challenges with this approach have surfaced, and it is likely that annual mass drug administration alone may not be sufficient to achieve program goals. However, mass drug administration is still the only available intervention that can be readily used in the wide variety of settings where schistosomiasis is endemic. The task then becomes how to improve this approach and identify what adjuncts to mass drug administration are effective, as programs move from morbidity control to elimination goals. Other aspects worthy of consideration include how best to employ new diagnostic tools to more easily identify where treatment is needed, and new formulations of praziquantel to extend the availability of treatment to all age groups. The aim of this review is to highlight both areas of challenge and of opportunity to improve the public health impact of schistosomiasis control programs. PMID:26937275

7 CFR 4280.109 - Qualification for simplified applications.

Code of Federal Regulations, 2010 CFR

2010-01-01

...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Renewable Energy Systems and Energy Efficiency Improvements Program Section A. Grants § 4280.109 Qualification for... must use commercially available renewable energy systems or energy efficiency improvements. (5...

7 CFR 4280.109 - Qualification for simplified applications.

Code of Federal Regulations, 2011 CFR

2011-01-01

...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Renewable Energy Systems and Energy Efficiency Improvements Program Section A. Grants § 4280.109 Qualification for... must use commercially available renewable energy systems or energy efficiency improvements. (5...

Evaluation of a Postdischarge Call System Using the Logic Model.

PubMed

Frye, Timothy C; Poe, Terri L; Wilson, Marisa L; Milligan, Gary

2018-02-01

This mixed-method study was conducted to evaluate a postdischarge call program for congestive heart failure patients at a major teaching hospital in the southeastern United States. The program was implemented based on the premise that it would improve patient outcomes and overall quality of life, but it had never been evaluated for effectiveness. The Logic Model was used to evaluate the input of key staff members to determine whether the outputs and results of the program matched the expectations of the organization. Interviews, online surveys, reviews of existing patient outcome data, and reviews of publicly available program marketing materials were used to ascertain current program output. After analyzing both qualitative and quantitative data from the evaluation, recommendations were made to the organization to improve the effectiveness of the program.

Prevalence of School Policies, Programs, and Facilities That Promote a Healthy Physical School Environment

PubMed Central

Everett Jones, Sherry; Brener, Nancy D.; McManus, Tim

2003-01-01

Objectives. We examined the extent to which schools in the United States have health-promoting policies, programs, and facilities. Methods. We analyzed data from the School Health Policies and Programs Study 2000. Results. We found that public schools (vs private and Catholic schools), urban schools (vs rural and suburban schools), and schools with larger enrollments (vs smaller schools) had more health-promoting policies, programs, and facilities in place. On average, middle schools had 11.0 and middle/junior and high schools had 10.4 out of a possible 18 policies, programs, and facilities. Conclusions. Although some schools had many healthy physical environment features, room for improvement exists. Resources are available to help schools improve their health-promoting policies, programs, and facilities. PMID:12948982

Need for hyperlipidemia management policy reform in China: learning from the global experience.

PubMed

Yu, Wei; Shi, Ruizhi; Li, Jim; Lan, Yong; Li, Qian; Hu, Shanlian

2018-02-01

To evaluate the hyperlipidemia prevention programs and policies in different countries and highlight the need of reforming the hyperlipidemia prevention policies in China to lower the growing cardiovascular disease (CVD) risk. PubMed, Google Scholar and Cochrane were searched for global hyperlipidemia prevention policies. Government-funded policies pertaining to lipid management were considered for this review. Only those studies that evaluated the success of prevention policies on the basis of: (i) achievement of hyperlipidemia targets; (ii) improvement in Cardiovascular (CV) risk reduction; and (iii) outcomes with reduction in hyperlipidemia after implementation of the policy, were included. Several global policies and programs aimed to improve CV health by highlighting lipid profile management. Implementation of the global and national policies led to improvement in cholesterol related outcomes such as availability of diagnostic measures, awareness of the risk factors, decrease in cholesterol levels, achieving healthy lifestyle to prevent CVD and improvement in availability of hypolipidemic medications, etc. Statins have been covered under reimbursement policies in many countries to improve usage and thereby preventing incidence of stroke and CVD. We observed a need for introducing new programs in China as the ongoing hyperlipidemia management policies are inadequate. The World Bank Report 2016 recommended that prevention policies in China be modeled on the US Million Hearts program. New hyperlipidemia prevention policies must set a time-bound target, and need to be patient and clinician centric in terms of applications, and revised periodically for long-term benefits.

78 FR 46598 - Notice of Availability of the Draft Rob Jaggers Camping Area Business Plan and Expanded Amenity...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

..., improvements, and incidental expenses associated with the volunteer program, such as meals and transportation... publicly available at any time. While you may ask us in your comment to withhold your personal identifying...

Evaluating the Impact of School Nutrition Programs. Final Report. E-FAN-04-008

ERIC Educational Resources Information Center

Bhattacharya, Jayanta; Currie, Janet; Haider, Steven J.

2004-01-01

This study develops estimates of the efficacy of school nutrition programs in improving a broad range of dietary outcomes by comparing the nutritional status of students and their families during the school year with the status when school is out. The study finds evidence that children who have a School Breakfast Program (SBP) available consume a…

Simple Interactions: Piloting a Strengths-Based and Interaction-Based Professional Development Intervention for Out-of-School Time Programs

ERIC Educational Resources Information Center

Akiva, Thomas; Li, Junlei; Martin, Kelly M.; Horner, Christy Galletta; McNamara, Anne R.

2017-01-01

Background: Adult-child relational interactions constitute an essential component of out-of-school-time programs, and training staff to effectively interact with children is key to improving program quality. Efficient staff training, that meets the limited time availability of out-of-school time staff, is particularly needed. Objective: This pilot…

A Review of Information on Institutionalized Youths and the ECIA Chapter I Neglected or Delinquent Program.

ERIC Educational Resources Information Center

Marks, Ellen L.

This paper reviews and summarizes available information on the neglected or delinquent youth population, on education programs for delinquent youth, and on the Neglected or Delinquent (N or D) program funded under Chapter 1 of the Education Consolidation and Improvement Act that serves a portion of that population residing in state-operated or…

Educating Library Users at the Copperbelt University.

ERIC Educational Resources Information Center

Lungu, Charles B. M.

1990-01-01

Describes a library user education program for first-year students at Zambia's Copperbelt University that is designed to increase student awareness of available resources; improve their skills in independent learning; and enhance the presentation of their coursework. Planning user education programs in conjunction with faculty and other…

Diversifying the STEM Pipeline: The Model Replication Institutions Program

ERIC Educational Resources Information Center

Cullinane, Jenna

2009-01-01

In 2006, the National Science Foundation (NSF) began funding the Model Replication Institutions (MRI) program, which sought to improve the quality, availability, and diversity of science, technology, engineering, and mathematics (STEM) education. Faced with pressing national priorities in the STEM fields and chronic gaps in postsecondary…

7 CFR 4280.114 - Qualification for simplified applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... proposed project must use commercially available renewable energy systems or energy efficiency improvements...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Renewable Energy System and Energy Efficiency Improvement Grants § 4280.114...

7 CFR 4280.114 - Qualification for simplified applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... proposed project must use commercially available renewable energy systems or energy efficiency improvements...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Renewable Energy System and Energy Efficiency Improvement Grants § 4280.114...

7 CFR 4280.114 - Qualification for simplified applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... proposed project must use commercially available renewable energy systems or energy efficiency improvements...-COOPERATIVE SERVICE AND RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Renewable Energy System and Energy Efficiency Improvement Grants § 4280.114...

Seat Belts: Are They the Best Solution to the Real Problem?

ERIC Educational Resources Information Center

Comeau, Lee F.

1985-01-01

More children are killed outside their school buses than inside. To solve this problem, we should improve bus design, provide driver training programs for all school bus drivers, utilize the latest safety devices available, and improve ridership safety curriculum. (MLF)

Elbow ulnar collateral ligament injuries in athletes: Can we improve our outcomes?

PubMed Central

Redler, Lauren H; Degen, Ryan M; McDonald, Lucas S; Altchek, David W; Dines, Joshua S

2016-01-01

Injury to the ulnar collateral ligament (UCL) most commonly occurs in the overhead throwing athlete. Knowledge surrounding UCL injury pathomechanics continues to improve, leading to better preventative treatment strategies and rehabilitation programs. Conservative treatment strategies for partial injuries, improved operative techniques for reconstruction in complete tears, adjunctive treatments, as well as structured sport specific rehabilitation programs including resistive exercises for the entire upper extremity kinetic chain are all important factors in allowing for a return to throwing in competitive environments. In this review, we explore each of these factors and provide recommendations based on the available literature to improve outcomes in UCL injuries in athletes. PMID:27114930

Program of operation for the National Water Data Ex. (NAWDEX)

USGS Publications Warehouse

Edwards, M.D.

1985-01-01

The National Water Data Exchange (NAWDEX) has been established as a nationwide program directed at improving access to water and water-related data and disseminating information about the availability of these data throughout the entire water-resources community. NAWDEX is composed of a confederation of water-oriented organizations working together to facilitate the exchange of data and to improve the technology of data handling and transfer. This program of operation is directed at providing guidelines to assure that all member organizations participate equally and that a climate of cooperation and open communication be established among participating members.

The American College of Surgeons Children's Surgery Verification and Quality Improvement Program: implications for anesthesiologists.

PubMed

Houck, Constance S; Deshpande, Jayant K; Flick, Randall P

2017-06-01

The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV). The voluntary ACS CSV was officially launched in January 2017 and more than 125 pediatric surgical programs have expressed interest in verification. ACS CSV-verified programs have specific requirements for pediatric anesthesia leadership, resources, and the availability of pediatric anesthesiologists or anesthesiologists with pediatric expertise to care for infants and young children. The present review outlines the history of the ACS CSV, key elements of the program, and the standards specific to pediatric anesthesiology. As with the pediatric trauma programs initiated more than 40 years ago, this program has the potential to significantly improve surgical care for infants and children in the United States and Canada.

Getting Back to Living: Further Evidence for the Efficacy of an Interdisciplinary Pediatric Pain Treatment Program.

PubMed

Bruce, Barbara K; Ale, Chelsea M; Harrison, Tracy E; Bee, Susan; Luedtke, Connie; Geske, Jennifer; Weiss, Karen E

2017-06-01

This study examined key functional outcomes following a 3-week interdisciplinary pediatric pain rehabilitation program for adolescents with chronic pain. Maintenance of gains was evaluated at 3-month follow-up. Participants included 171 adolescents (12 to 18 y of age) with chronic pain who completed a hospital-based outpatient pediatric pain rehabilitation program. Participants completed measures of functional disability, depressive symptoms, pain catastrophizing, opioid use, school attendance, and pain severity at admission, discharge, and at 3-month follow-up. Similar to other interdisciplinary pediatric pain rehabilitation program outcome studies, significant improvements were observed at the end of the program. These improvements appeared to be maintained or further improved at 3-month follow-up. Nearly 14% of the patients were taking daily opioid medication at admission to the program. All adolescents were completely tapered off of these medications at the end of the 3-week program and remained abstinent at 3-month follow-up. This study adds to the available data supporting interdisciplinary pediatric pain rehabilitation as effective in improving functioning and psychological distress even when discontinuing opioids. Implications for future research and limitations of the study are discussed.

The NASA Firefighter's Breathing System Program: A Status Report

NASA Technical Reports Server (NTRS)

McLaughlan, Pat B.

1973-01-01

The National Aeronautics and Space Administration (NASA), through its Technology Utilization Program, has been making its advanced technology developments available to the public. This has coincided in recent years with a growing demand within the fire service for improved protective equipment. A better breathing system for firefighters was one of the more immediate needs identified by the firefighting organizations. The Johnson Space Center (JSC), based upon their experience in providing life support systems for space flight, was subsequently requested to determine the feasibility of providing an improved breathing system for firefighters. Such a system was determined to be well within the current state of the art, and the Center is well into a development program to provide design verification of this improved protective' equipment. This report - outlines the overall objectives of this program, progress to date, and future planned activities.

Evaluation of Laparoscopic Curricula in American Urology Residency Training: A 5-Year Update.

PubMed

Clements, Matthew B; Morrison, Kasey Y; Schenkman, Noah S

2016-03-01

Medical simulation offers the advantage of improving resident skill and comfort without impacting patient care. Five years ago, we identified trends in the use of robotic and laparoscopic simulation in 2008 and 2009 at American urology residency training programs. We seek to identify the changes in the use of simulators and the presence of formal curricula in the wake of technological advances and changes in graduate medical education. Attendees of the American Urological Association (AUA) Basic Sciences Course, mostly in their second or third year of residency, were surveyed on the availability and use of laparoscopic/robotic simulators at their program, the presence of a formal curriculum, and a Likert scale questionnaire regarding face and content validity. Over a 5-year period, the availability of virtual reality robotic simulators substantially increased from 14% to nearly 60% availability in 2013. Despite this increase, the frequency of simulator use remained unchanged (p = 0.40) and the reported presence of formal curricula decreased from 41% to 34.8%. There was no significant difference in simulator use between residents in programs with or without laparoscopic/robotic curricula (p = 0.95). There was also a decrease in the percentage of residents who felt official laparoscopic curricula (93%-81%) and simulators (82%-74%) should be involved in resident education. In the past 5 years, despite evidence supporting benefits from simulator use and increasing availability, self-reported resident use has remained unchanged and the reporting of presence of laparoscopic/robotic curricula has decreased. With more dedicated investment in formal curricula, residency training programs may receive greater returns on their simulator investments, improve resident skills and comfort, and ultimately improve the quality of patient care.

An Assessment of Cost Improvements in the NASA COTS - CRS Program and Implications for Future NASA Missions

NASA Technical Reports Server (NTRS)

Zapata, Edgar

2017-01-01

This review brings rigorous life cycle cost (LCC) analysis into discussions about COTS program costs. We gather publicly available cost data, review the data for credibility, check for consistency among sources, and rigorously define and analyze specific cost metrics.

Diversifying the STEM Pipeline: Recommendations from the Model Replication Institutions Program

ERIC Educational Resources Information Center

Institute for Higher Education Policy, 2010

2010-01-01

Launched in 2006 to address issues of national competitiveness and equity in science, technology, engineering, and mathematics (STEM) fields, the National Science Foundation-funded Model Replication Institutions (MRI) program sought to improve the quality, availability, and diversity of STEM education. The project offered technical assistance to…

West Virginia Interpretive Guide Training: A Collaborative Effort

ERIC Educational Resources Information Center

Balcarczyk, Kelly; McKenney, Kathryn; Smaldone, Dave; Arborgast, Doug

2013-01-01

West Virginia University's Extension Service partnered with the Recreation, Parks, and Tourism Resources Program to improve guide performance in West Virginia's tourism industry. The result of this partnership is a West Virginia Interpretive Guide Training program aimed at providing low-cost, widely available training to guides throughout the…

Sharing Resources in the Small School.

ERIC Educational Resources Information Center

Uxer, John E.

Improved strategies for sharing resources are absolutely essential to the survival of small schools. Although not all, or even a major portion, of school programs should be provided by a cooperative delivery system, a discerning superintendent and board will mobilize every resource available to them in conducting their educational programs.…

Student Selection for Selective Educational Programs Using Multiple Criteria.

ERIC Educational Resources Information Center

Jenkins, Jerry A.

This paper shows that multiple sources of data reflecting educational progress may be used with relative ease to systematically, objectively, and accurately place students in selective educational programs, such as those funded under Chapter 1 of the Education Consolidation and Improvement Act, using readily available commercial microcomputer…

Increased use of young bulls in dairy cattle breeding programs

USDA-ARS?s Scientific Manuscript database

Availability of genomic evaluations since 2008 has provided many benefits with regard to improving the rate of genetic gain in dairy cattle breeding programs, one of which is a greater accuracy for young animals. As a result, AI organizations have been aggressively promoting young bulls and producer...

75 FR 33323 - Notice of Availability: Notice of HUD's Fiscal Year (FY) 2010 Notice of Funding Availability...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-11

... Fair Housing; (4) Capacity Building and Knowledge Sharing; (5) Using Housing as a Platform for Improving Other Outcomes; and (6) Expanding Cross-Cutting Policy Knowledge. Detailed information on HUD's Strategic Plan for FY2010-2015 is available at: http://portal.hud.gov/portal/page/portal/HUD/program_offices...

40 CFR 51.369 - Improving repair effectiveness.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Requirements § 51.369 Improving repair effectiveness. Effective repairs are the key to achieving program goals... the community either through private or public facilities. This may involve working with local... might involve attracting private training providers to offer classes in the area. The training available...

40 CFR 51.369 - Improving repair effectiveness.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Requirements § 51.369 Improving repair effectiveness. Effective repairs are the key to achieving program goals... the community either through private or public facilities. This may involve working with local... might involve attracting private training providers to offer classes in the area. The training available...

40 CFR 51.369 - Improving repair effectiveness.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Requirements § 51.369 Improving repair effectiveness. Effective repairs are the key to achieving program goals... the community either through private or public facilities. This may involve working with local... might involve attracting private training providers to offer classes in the area. The training available...

40 CFR 51.369 - Improving repair effectiveness.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Requirements § 51.369 Improving repair effectiveness. Effective repairs are the key to achieving program goals... the community either through private or public facilities. This may involve working with local... might involve attracting private training providers to offer classes in the area. The training available...

Development and Implementation of Worksite Health and Wellness Programs: A Focus on Non-Communicable Disease.

PubMed

Cahalin, Lawrence P; Kaminsky, Leonard; Lavie, Carl J; Briggs, Paige; Cahalin, Brendan L; Myers, Jonathan; Forman, Daniel E; Patel, Mahesh J; Pinkstaff, Sherry O; Arena, Ross

2015-01-01

The development and implementation of worksite health and wellness programs (WHWPs) in the United States (US) hold promise as a means to improve population health and reverse current trends in non-communicable disease incidence and prevalence. However, WHWPs face organizational, economic, systematic, legal, and logistical challenges which have combined to impact program availability and expansion. Even so, there is a burgeoning body of evidence indicating WHWPs can significantly improve the health profile of participating employees in a cost effective manner. This foundation of scientific knowledge justifies further research inquiry to elucidate optimal WHWP models. It is clear that the development, implementation and operation of WHWPs require a strong commitment from organizational leadership, a pervasive culture of health and availability of necessary resources and infrastructure. Since organizations vary significantly, there is a need to have flexibility in creating a customized, effective health and wellness program. Furthermore, several key legal issues must be addressed to facilitate employer and employee needs and responsibilities; the US Affordable Care Act will play a major role moving forward. The purposes of this review are to: 1) examine currently available health and wellness program models and considerations for the future; 2) highlight key legal issues associated with WHWP development and implementation; and 3) identify challenges and solutions for the development and implementation of as well as adherence to WHWPs. Copyright © 2015 Elsevier Inc. All rights reserved.

Perceptions of the Impact of a PEP Grant on Elementary Physical Education Programs in One School District

ERIC Educational Resources Information Center

Elliott, Steven; McCollum, Starla; Colquitt, Gavin; Pritchard, Tony

2013-01-01

A school district received a Physical Education for Progress grant (PEP). PEP grants are part of the Carol M. White Program and are administered by the U.S. Department of Education. These grants are available to local educational agencies to initiate, expand, or improve physical education (PE) programs. The purpose of this study was to determine…

The Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program: an overview for medical directors and primary care clinicians in long term care.

PubMed

Ouslander, Joseph G; Bonner, Alice; Herndon, Laurie; Shutes, Jill

2014-03-01

Interventions to Reduce Acute Care Transfers (INTERACT) is a publicly available quality improvement program that focuses on improving the identification, evaluation, and management of acute changes in condition of nursing home residents. Effective implementation has been associated with substantial reductions in hospitalization of nursing home residents. Familiarity with and support of program implementation by medical directors and primary care clinicians in the nursing home setting are essential to effectiveness and sustainability of the program over time. In addition to helping nursing homes prevent unnecessary hospitalizations and their related complications and costs, and thereby continuing to be or becoming attractive partners for hospitals, health care systems, managed care plans, and accountable care organizations, effective INTERACT implementation will assist nursing homes in meeting the new requirement for a robust quality assurance performance improvement program, which is being rolled out by the federal government over the next year. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Has Chiranjeevi Yojana changed the geographic availability of free comprehensive emergency obstetric care services in Gujarat, India?

PubMed Central

Vora, Kranti Suresh; Yasobant, Sandul; Patel, Amit; Upadhyay, Ashish; Mavalankar, Dileep V.

2015-01-01

Background The high rate of maternal mortality in India is of grave concern. Poor rural Indian women are most vulnerable to preventable maternal deaths primarily because they have limited availability of affordable emergency obstetric care (EmOC) within reasonable geographic proximity. Scarcity of obstetricians in the public sector combined with financial barriers to accessing private sector obstetrician services preclude this underserved population from availing lifesaving functions of comprehensive EmOC such as C-section. In order to overcome this limitation, Government of Gujarat initiated a unique public–private partnership program called Chiranjeevi Yojana (CY) in 2005. The program envisaged leveraging private sector providers to increase availability and thereby accessibility of EmOC care for vulnerable sections of society. Under CY, private sector providers render obstetric care services to poor women at no cost to patients. This paper examines the CY's effectiveness in improving availability of CEmOC services between 2006 and 2012 in three districts of Gujarat, India. Methods Primary data on facility locations, EmOC functionality, and obstetric bed availability were collected in the years 2012 and 2013 in three study districts. Secondary data from Census 2001 and 2011 were used along with required geographic information from Topo sheets and Google Earth maps. ArcGIS version 10 was used to analyze the availability of services using two-step floating catchment area (2SFCA) method. Results Our analysis suggests that the availability of CEmOC services within reasonable travel distance has greatly improved in all three study districts as a result of CY. We also show that the declining participation of the private sector did not result in an increase in distance to the nearest facility, but the extent of availability of providers for several villages was reduced. Spatial and temporal analyses in this paper provide a comprehensive understanding of trends in the availability of EmOC services within reasonable travel distance. Conclusions This paper demonstrates how GIS could be useful for evaluating programs especially those focusing on improving availability and geographic accessibility. The study also shows usefulness of GIS for programmatic planning, particularly for optimizing resource allocation. PMID:26446287

Has Chiranjeevi Yojana changed the geographic availability of free comprehensive emergency obstetric care services in Gujarat, India?

PubMed

Vora, Kranti Suresh; Yasobant, Sandul; Patel, Amit; Upadhyay, Ashish; Mavalankar, Dileep V

2015-01-01

The high rate of maternal mortality in India is of grave concern. Poor rural Indian women are most vulnerable to preventable maternal deaths primarily because they have limited availability of affordable emergency obstetric care (EmOC) within reasonable geographic proximity. Scarcity of obstetricians in the public sector combined with financial barriers to accessing private sector obstetrician services preclude this underserved population from availing lifesaving functions of comprehensive EmOC such as C-section. In order to overcome this limitation, Government of Gujarat initiated a unique public-private partnership program called Chiranjeevi Yojana (CY) in 2005. The program envisaged leveraging private sector providers to increase availability and thereby accessibility of EmOC care for vulnerable sections of society. Under CY, private sector providers render obstetric care services to poor women at no cost to patients. This paper examines the CY's effectiveness in improving availability of CEmOC services between 2006 and 2012 in three districts of Gujarat, India. Primary data on facility locations, EmOC functionality, and obstetric bed availability were collected in the years 2012 and 2013 in three study districts. Secondary data from Census 2001 and 2011 were used along with required geographic information from Topo sheets and Google Earth maps. ArcGIS version 10 was used to analyze the availability of services using two-step floating catchment area (2SFCA) method. Our analysis suggests that the availability of CEmOC services within reasonable travel distance has greatly improved in all three study districts as a result of CY. We also show that the declining participation of the private sector did not result in an increase in distance to the nearest facility, but the extent of availability of providers for several villages was reduced. Spatial and temporal analyses in this paper provide a comprehensive understanding of trends in the availability of EmOC services within reasonable travel distance. This paper demonstrates how GIS could be useful for evaluating programs especially those focusing on improving availability and geographic accessibility. The study also shows usefulness of GIS for programmatic planning, particularly for optimizing resource allocation.

Developing a Valid Data Base for Continuing Education in the Health Sciences.

ERIC Educational Resources Information Center

Griffith, William S.

1981-01-01

Successful programs of continuing professional education must involve both the improvement of the learner's competence and the restructuring of the work environment to stimulate, encourage, recognize, and reward improved performance. (Journal availability: Subscription Manager, MOBIUS, University of California Press, Berkeley CA 94720.) (SK)

Delivery of Health Coaching by Medical Assistants in Primary Care.

PubMed

Djuric, Zora; Segar, Michelle; Orizondo, Carissa; Mann, Jeffrey; Faison, Maya; Peddireddy, Nithin; Paletta, Matthew; Locke, Amy

2017-01-01

Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form. A total of 82 subjects enrolled in the program, 72% completed 8 weeks and 49% completed 12 weeks. Subjects who completed assessments at 12 weeks had significant weight loss despite the fact that weight loss was not a study goal. There also were improvements in diet and physical activity. Subject who completed the study were highly satisfied with the program and felt that health coaching should be available in all family medicine clinics. The main barrier providers voiced was remembering to refer patients. The medical providers indicated high satisfaction with the study and valued having coaching available for their patients. Medical assistants can be trained to assist patients with lifestyle changes that are associated with improved health and weight control. © Copyright 2017 by the American Board of Family Medicine.

Computer program documentation: Raw-to-processed SINDA program (RTOPHS) user's guide

NASA Technical Reports Server (NTRS)

Damico, S. J.

1980-01-01

Use of the Raw to Processed SINDA(System Improved Numerical Differencing Analyzer) Program, RTOPHS, which provides a means of making the temperature prediction data on binary HSTFLO and HISTRY units generated by SINDA available to engineers in an easy to use format, is discussed. The program accomplishes this by reading the HISTRY unit and according to user input instructions, the desired times and temperature prediction data are extracted and written to a word addressable drum file.

Relationship Between the Number of Clinical Sites in Radiography Programs and Job Placement Rates of Graduates.

PubMed

Harrell, Angela; Matthews, Eric

2016-07-01

To determine whether a relationship exists between the number of clinical sites available in radiography programs accredited by the Joint Review Committee on Education in Radiologic Technology and the job placement rates of graduates. We performed a secondary analysis of data on job placement rates and the number of clinical sites available in 438 degree-granting radiography programs from January 2015 to March 2015. A weak, negative, nonsignificant correlation existed between the number of clinical sites and the job placement rate (Spearman's rho = -.113, n = 438, P = .018). The coefficient of determination was 1.28%.Discussion Research evaluating factors contributing to graduate employability is limited but indicates no need for radiography program administrators to adjust clinical site numbers solely on the basis of improving graduate employability. The number of clinical sites available in a radiography program is not related to the job placement rate of its graduates. ©2016 American Society of Radiologic Technologists.

A study of female students enrollment in engineering technology stem programs

NASA Astrophysics Data System (ADS)

Habib, Ihab S.

The problem studied in this research project was the enrollment of female STEM Engineering Technology students and the impact of professional mentoring and financial incentives on their enrollment, retention, and completion of engineering curriculum. Several tasks were presented in researchers' professional position; to recruit more students to the program, especially female as a minority in the Engineering Technology Department, make appropriate changes to the curriculum, and make improvements in mentoring students to improve rates of enrollment, retention, and completion of the program. A survey was created to study the effects of Science Engineering Technology and Mathematics for Engineering Technology (STEM ENGT) students' perceptions, mentorship, and scholarships availability, enrollment, retention, and program completion by enrolled student gender. Other studies have discovered that more scholarship and faculty mentorship support provided for female students resulted in improved diversity within engineering curricula student bodies (Sorcinelli, 2007).

Examining the Benefits and Barriers of Instructional Gardening Programs to Increase Fruit and Vegetable Intake among Preschool-Age Children

PubMed Central

Davis, Kristen L.

2017-01-01

Research exists on using instructional gardening programs with school age children as a means of improving dietary quality and for obesity prevention. This article examines the potential use of instructional gardens in childcare settings to improving fruit and vegetable intake in young children. A qualitative study was conducted with childcare providers. Participants (n = 20) were recruited via e-mails, letters, and follow-up phone calls. Interviews were recorded, transcribed, and coded to identify themes within two areas (1) childcare providers perceptions of children's fruit and vegetable consumption and (2) components necessary to initiate or improve instructional gardening programs. Themes associated with provider's perceptions of child fruit and vegetable consumption included benefits of consumption, willingness to try fruits and vegetables, meeting recommendations, and influence of the home and childcare environments on child eating. Benefits, barriers, and resources needed were identified as themes related to starting or improving instructional gardening programs. Benefits to gardening with preschoolers are consistent with those found in school-age populations. While several barriers exist, resources are available to childcare providers to address these barriers. Increased knowledge and awareness of resources are necessary to improve the success of gardening programs in the childcare setting with the goal of improving child diet quality. PMID:28607563

Examining the Benefits and Barriers of Instructional Gardening Programs to Increase Fruit and Vegetable Intake among Preschool-Age Children.

PubMed

Davis, Kristen L; Brann, Lynn S

2017-01-01

Research exists on using instructional gardening programs with school age children as a means of improving dietary quality and for obesity prevention. This article examines the potential use of instructional gardens in childcare settings to improving fruit and vegetable intake in young children. A qualitative study was conducted with childcare providers. Participants ( n = 20) were recruited via e-mails, letters, and follow-up phone calls. Interviews were recorded, transcribed, and coded to identify themes within two areas (1) childcare providers perceptions of children's fruit and vegetable consumption and (2) components necessary to initiate or improve instructional gardening programs. Themes associated with provider's perceptions of child fruit and vegetable consumption included benefits of consumption, willingness to try fruits and vegetables, meeting recommendations, and influence of the home and childcare environments on child eating. Benefits, barriers, and resources needed were identified as themes related to starting or improving instructional gardening programs. Benefits to gardening with preschoolers are consistent with those found in school-age populations. While several barriers exist, resources are available to childcare providers to address these barriers. Increased knowledge and awareness of resources are necessary to improve the success of gardening programs in the childcare setting with the goal of improving child diet quality.

A study of the effectiveness of the primary education improvement program (science) in selected schools of Northern Nigeria

NASA Astrophysics Data System (ADS)

Brown, Desmond P.; Reed, Jack A.

The Primary Education Improvement Program (Science) developed in Nigeria from 1970-1980 adopted a process approach to the teaching of science for children in Classes One and Two of primary school. In that insufficient formative data were available a study was organized to evaluate the attainment of the program's major objectives in terms of the children's ability to practice process skills. The study also attempted to measure children's interest, active participation and understanding of the lessons, as well as the availability of materials and ease of preparing and teaching the lessons for the teachers. Data were collected by means of teacher opinionnaires and a children's test to measure the attainment of process skills. The teachers who completed the opinionnaires rated the program as successful in terms of all the measured criteria. Children in the experimental and control groups were tested and their performances were compared. The results indicated that there were some significant differences in total test scores in favor of the experimental group after one year of primary school but none after two years. The program, though highly rated by teachers, did not produce the intended changes in children's behavior.

76 FR 45223 - Notice of Funding Availability: Inviting Applications for McGovern-Dole International Food for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

... Applications for McGovern-Dole International Food for Education and Child Nutrition Program Announcement Type... Service (FAS) announces it is inviting applications for the McGovern-Dole International Food for Education... program resources toward achieving two objectives: (1) Improve the literacy of school age children and (2...

A Needs Assessment: The Parenting Needs of Parents of Typical Children, Ages 6-10

ERIC Educational Resources Information Center

Cho, Charles Joon

2012-01-01

Programs and resources are available to parents to inform and improve their parenting skills. Despite these resources, the need for parent education continues to increase as parents find existing networks unsatisfactory or inaccessible. Parenting programs have produced inconsistent results in meeting the needs of parents. This study identifies the…

Improving Project Management of Complex or Major Systems

DTIC Science & Technology

2016-05-05

funding available through vehicle Mod-lines --- shared across various motor transport programs PB-17 $M (including OCO) Program ACAT FYDP (FY17...Requirements Description (CARD) ▪ ▪ ▪ ▪ ▪ ▪ DOT&E REPORT ON INITIAL OPERATIONAL TEST AND EVALUATION ( IOT &E) ▪ Development RFP Release Cost Assessment

75 FR 28789 - Office of Innovation and Improvement; Overview Information; Charter Schools Program (CSP) Grants...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-24

... Schools Program (CSP) Grants for Replication and Expansion of High-Quality Charter Schools; Notice... purpose of the CSP is to increase national understanding of the charter school model and to expand the number of high-quality charter schools available to students across the Nation by providing financial...

Remote monitoring and Tennessee Valley Authority programs

NASA Technical Reports Server (NTRS)

Stevens, A. R.; Voss, A. W.

1977-01-01

The Tennessee Valley Authority was created in 1933 as a resource development agency and was charged with the basic mission of improving the economy of a depressed region through power production, flood control, and navigation. Those programs which availed themselves of remotely monitored data, either directly or indirectly supporting this mission, were examined.

The NASA/industry Design Analysis Methods for Vibrations (DAMVIBS) program: Sikorsky Aircraft: Advances toward interacting with the airframe design process

NASA Technical Reports Server (NTRS)

Twomey, William J.

1993-01-01

A short history is traced of the work done at Sikorsky Aircraft under the NASA/industry DAMVIBS program. This includes both work directly funded by the program as well as work which was internally funded but which received its initial impetus from DAMVIBS. The development of a finite element model of the UH-60A airframe having a marked improvement in vibration-predicting ability is described. A new program, PAREDYM, developed at Sikorsky, which automatically adjusts an FEM so that its modal characteristics match test values, is described, as well as the part this program played in the improvement of the UH-60A model. Effects of the bungee suspension system on the shake test data used for model verification are described. The impetus given by the modeling improvement, as well as the recent availability of PAREDYM, has brought for the first time the introduction of low-vibration design into the design cycle at Sikorsky.

Capital Improvements Business Line

DTIC Science & Technology

2012-08-08

NAVFAC Southwest Dan Waid Program & Business Mgmt NAVFAC SW Capital Improvements Business Line NAVFAC SW 8 August 2012 1 Report...REPORT TYPE 3. DATES COVERED 00-00-2012 to 00-00-2012 4. TITLE AND SUBTITLE Capital Improvements Business Line 5a. CONTRACT NUMBER 5b. GRANT...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES Presented at the 2012 Navy Gold Coast Small Business

The Cummins advanced turbocompound diesel engine evaluation

NASA Technical Reports Server (NTRS)

Hoehne, J. L.; Werner, J. R.

1982-01-01

An advanced turbocompound diesel engine program was initiated to improve the tank mileage of the turbocompound engine by 5% over the vehicle test engines. Engine improvements could be realized by increasing the available energy of the exhaust gas at the turbine inlet, incorporating gas turbine techniques into improving the turbomachinery efficiencies, and through refined engine system optimization. The individual and cumulative performance gains achieved with the advanced turbocompound engine improvements are presented.

Energy Systems Training Programs and Certifications Survey White Paper

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

Cox, Daryl; Nimbalkar, Sachin U.; Wenning, Thomas J.

2017-02-01

Compressed air system, industrial refrigeration system, chilled water system, pump system, fan system, steam system, process heating system, and combined heat and power system are the major industrial energy systems. By helping enhance knowledge and skills of workforce, training and certification programs on these systems are essential to improve energy efficiency of manufacturing facilities. A literature survey of currently available training and certification programs on these systems was conducted.

Impact of a Multi-Strategy Community Intervention to Reduce Maternal and Child Health Inequalities in India: A Qualitative Study in Haryana

PubMed Central

Gupta, Madhu; Bosma, Hans; Angeli, Federica; Kaur, Manmeet; Chakrapani, Venkatesan; Rana, Monica; van Schayck, Onno C. P.

2017-01-01

A multi-strategy community intervention, known as National Rural Health Mission (NRHM), was implemented in India from 2005 to 2012. By improving the availability of and access to better-quality healthcare, the aim was to reduce maternal and child health (MCH) inequalities. This study was planned to explore the perceptions and beliefs of stakeholders about extent of implementation and effectiveness of NRHM’s health sector plans in improving MCH status and reducing inequalities. A total of 33 in-depth interviews (n = 33) with program managers, community representatives, mothers and 8 focus group discussions (n = 42) with health service providers were conducted from September to December 2013, in Haryana, post NRHM. Using NVivo software (version 9), an inductive applied thematic analysis was done based upon grounded theory, program theory of change and a framework approach. Almost all the participants reported that there was an improvement in overall health infrastructure through an increased availability of accredited social health activists, free ambulance services, and free treatment facilities in rural areas. This had increased the demand and utilization of MCH services, especially for those related to institutional delivery, even by the poor families. Service providers felt that acute shortage of human resources was a major health system level barrier. District-specific individual, community, and socio-political level barriers were also observed. Overall program managers, service providers and community representatives believed that NRHM had a role in improving MCH outcomes and in reduction of geographical and socioeconomic inequalities, through improvement in accessibility, availability and affordability of the MCH services in the rural areas and for the poor. Any reduction in gender-based inequalities, however, was linked to the adoption of small family sizes and an increase in educational levels. PMID:28099465

Evaluating the Influence of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Allocation Package on Healthy Food Availability, Accessibility, and Affordability in Texas.

PubMed

Lu, Wenhua; McKyer, E Lisako J; Dowdy, Diane; Evans, Alexandra; Ory, Marcia; Hoelscher, Deanna M; Wang, Suojin; Miao, Jingang

2016-02-01

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was implemented to improve the health of pregnant women and children of low socioeconomic status. In 2009, the program was revised to provide a wider variety of healthy food choices (eg, fresh fruits, vegetables, and whole-grain items). The purpose of this study was to evaluate (1) the impact of the revised WIC Nutrition Program's food allocation package on the availability, accessibility, and affordability of healthy foods in WIC-authorized grocery stores in Texas; and (2) how the impact of the policy change differed by store types and between rural and urban regions. WIC-approved stores (n=105) across Texas were assessed using a validated instrument (88 items). Pre- (June-September 2009) and post-new WIC package implementation (June-September 2012) audits were conducted. Paired-sample t tests were conducted to compare the differences between pre- and post-implementation audits on shelf width and number of varieties (ie, availability), visibility (ie, accessibility), and inflation-adjusted price (ie, affordability). Across the 105 stores, post-implementation audits showed increased availability in terms of shelf space for most key healthy food options, including fruit (P<0.001), vegetables (P<0.01), cereal (P<0.001), and varieties of vegetables (P<0.001). Food visibility increased for fresh juices (P<0.001). Visibility of WIC labeling improved for foods such as fruits (P<0.05), WIC cereal (P<0.05), and whole-grain or whole-wheat bread (P<0.01). Inflation-adjusted prices decreased only for bread (P<0.001) and dry grain beans (P<0.001). The positive effects of the policy change on food availability and visibility were observed in stores of different types and in different locations, although smaller or fewer effects were noted in small stores and stores in rural regions. Implementation of the revised WIC food package has generally improved availability and accessibility, but not affordability, of healthy foods in WIC-authorized stores in Texas. Future studies are needed to explore the impact of the revised program on healthy food option purchases and consumption patterns among Texas WIC participants. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

76 FR 65769 - Airport Improvement Program: Modifications to Benefit Cost Analysis (BCA) Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-24

...This document announces the publication of the final policy changes to the Federal Aviation Administration's policy requiring a benefit cost analysis (BCA) for capacity projects funded by Airport Improvement Program (AIP) discretionary funds. On December 16, 2010, the FAA issued a Notice of Availability of Draft Guidance and Request for Comments with regard to the modification of its policy requiring benefit cost analyses (BCA) for capacity projects, which was published in the Federal Register. (78 FR 78798-02, December 16, 2010). The FAA now is (1) Issuing the final policy modifying the threshold at which BCAs are required from $5 million to $10 million in Airport Improvement Program (AIP) Discretionary funds, and (2) responding to comments requested in the Notice on December 16, 2010.

A cost effectiveness study of integrated care in health services delivery: a diabetes program in Australia

PubMed Central

McRae, Ian S; Butler, James RG; Sibthorpe, Beverly M; Ruscoe, Warwick; Snow, Jill; Rubiano, Dhigna; Gardner, Karen L

2008-01-01

Background Type 2 diabetes is rapidly growing as a proportion of the disease burden in Australia as elsewhere. This study addresses the cost effectiveness of an integrated approach to assisting general practitioners (GPs) with diabetes management. This approach uses a centralized database of clinical data of an Australian Division of General Practice (a network of GPs) to co-ordinate care according to national guidelines. Methods Long term outcomes for patients in the program were derived using clinical parameters after 5 years of program participation, and the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model, to project outcomes for 40 years from the time of diagnosis and from 5 years post-diagnosis. Cost information was obtained from a range of sources. While program costs are directly available, and costs of complications can be estimated from the UKPDS model, other costs are estimated by comparing costs in the Division with average costs across the state or the nation. The outcome and cost measures are used derive incremental cost-effectiveness ratios. Results The clinical data show that the program is effective in the short term, with improvement or no statistical difference in most clinical measures over 5 years. Average HbA1c levels increased by less than expected over the 5 year period. While the program is estimated to generate treatment cost savings, overall net costs are positive. However, the program led to projected improvements in expected life years and Quality Adjusted Life Expectancy (QALE), with incremental cost effectiveness ratios of $A8,106 per life-year saved and $A9,730 per year of QALE gained. Conclusions The combination of an established model of diabetes progression and generally available data has provided an opportunity to establish robust methods of testing the cost effectiveness of a program for which a formal control group was not available. Based on this methodology, integrated health care delivery provided by a network of GPs improved health outcomes of type 2 diabetics with acceptable cost effectiveness, which suggests that similar outcomes may be obtained elsewhere. PMID:18834551

Resolution of singularities for multi-loop integrals

NASA Astrophysics Data System (ADS)

Bogner, Christian; Weinzierl, Stefan

2008-04-01

We report on a program for the numerical evaluation of divergent multi-loop integrals. The program is based on iterated sector decomposition. We improve the original algorithm of Binoth and Heinrich such that the program is guaranteed to terminate. The program can be used to compute numerically the Laurent expansion of divergent multi-loop integrals regulated by dimensional regularisation. The symbolic and the numerical steps of the algorithm are combined into one program. Program summaryProgram title: sector_decomposition Catalogue identifier: AEAG_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEAG_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 47 506 No. of bytes in distributed program, including test data, etc.: 328 485 Distribution format: tar.gz Programming language: C++ Computer: all Operating system: Unix RAM: Depending on the complexity of the problem Classification: 4.4 External routines: GiNaC, available from http://www.ginac.de, GNU scientific library, available from http://www.gnu.org/software/gsl Nature of problem: Computation of divergent multi-loop integrals. Solution method: Sector decomposition. Restrictions: Only limited by the available memory and CPU time. Running time: Depending on the complexity of the problem.

[Pay for performance (P4P). Long-term effects and perspectives].

PubMed

Schrappe, M; Gültekin, N

2011-02-01

After 10 years of experience and research, a wide array of results on evaluation and long-term effects of pay for performance (P4P) programs have been published. These data do not only give insight into most of the problems of implementation, but also into aspects which, in part, may attenuate the high expectations at the beginning of the discussion. P4P programs exhibit a ceiling effect, some improvements are reversed after incentives are cancelled, and improvements show opportunity costs as absent improvements for indicators, which are not object to financial incentives (in some cases for the same disease). These observations can be explained by the hypothesis that P4P programs have characteristics of fee-for-service reimbursement, if symmetric information is available for insurance and provider. P4P programs are local instruments. While integration of healthcare is considered as an important issue, they should be combined with programs and incentives which foster further vertical and horizontal integration. For Germany, further research in the implementation and effects of P4P programs is necessary.

Sensory education program development, application and its therapeutic effect in children

PubMed Central

Chung, Hae-Kyung

2014-01-01

There has recently been Increased interest in the emotional intelligence (EQ) of elementary school students, which is recognized as a more important value than IQ (intelligence quotient) for predict of their success in school or later life. However, there are few sensory education programs, available to improve the EQ of elementary school student's in Korea. This study was conducted to develop an educational program that reflects the characteristics and contents of traditional rice culture and verify the effects of those programs on the EQ of children. The program was developed based on the ADDIE (Analysis, Design, Development, Implementation and Evaluation) model and participants were elementary school students in 3rd and 4th grade (n = 120) in Cheonan, Korea. Descriptive statistics and paired t-tests were used. EQ scores pertaining to the basic sense group, culture group, and food group were significantly improved after the sensory educational program(P < 0.05), but no change was observed in the control group. These findings indicate that sensory education contributed to improving elementary school children's Emotional Intelligence (EI) and their actual understanding about Korean traditional rice culture. PMID:24611113

44 CFR 61.8 - Applicability of risk premium rates.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE... flood insurance made available for: (a) Any structure, the construction or substantial improvement of...

44 CFR 61.8 - Applicability of risk premium rates.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE... flood insurance made available for: (a) Any structure, the construction or substantial improvement of...

44 CFR 61.8 - Applicability of risk premium rates.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program INSURANCE... flood insurance made available for: (a) Any structure, the construction or substantial improvement of...

[Which rehabilitation for which low back pain?].

PubMed

Poiraudeau, S; Lefèvre-Colau, M M; Mayoux-Benhamou, M A; Revel, M

2000-10-15

Many rehabilitation technics for low back pain are available. Their aims are short time pain decrease, muscular strengthening in flexion or extension, increased hip and lumbar spine mobility, improved lumbar and pelvic proprioceptive sensibility, improved general fitness. During the past ten years, studies meeting widely accepted validity and applicability for therapeutic trials have addressed the clinical efficacy of rehabilitation in low back pain patients. Most studies assessing the back school approach have found no benefit. Spinal extension and flexion programs have yielded short-time improvements, without difference between the two methods. There is now strong evidence that functional restoration programs provide long-term benefits including better social and occupational outcomes.

IRQN award paper: Operational rounds: a practical administrative process to improve safety and clinical services in radiology.

PubMed

Donnelly, Lane F; Dickerson, Julie M; Lehkamp, Todd W; Gessner, Kevin E; Moskovitz, Jay; Hutchinson, Sally

2008-11-01

As part of a patient safety program in the authors' department of radiology, operational rounds have been instituted. This process consists of radiology leaders' visiting imaging divisions at the site of imaging and discussing frontline employees' concerns about patient safety, the quality of care, and patient and family satisfaction. Operational rounds are executed at a time to optimize the number of attendees. Minutes that describe the issues identified, persons responsible for improvement, and updated improvement plan status are available to employees online. Via this process, multiple patient safety and other issues have been identified and remedied. The authors believe that the process has improved patient safety, the quality of care, and the efficiency of operations. Since the inception of the safety program, the mean number of days between serious safety events involving radiology has doubled. The authors review the background around such walk rounds, describe their particular program, and give multiple illustrative examples of issues identified and improvement plans put in place.

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

PubMed

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

2017-06-01

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

Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs

PubMed Central

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

2017-01-01

Abstract Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes. PMID:27575977

Got junk? The federal role in regulating "competitive" foods.

PubMed

Salinsky, Eileen

2009-12-11

A wide variety of food and beverage items are available in schools in addition to the school meals provided through the National School Lunch Program and School Breakfast Program. A long-standing source of controversy, the need for stronger federal restrictions on foods that compete with school meals is again under debate. This issue brief examines the availability and consumption of competitive foods, explores the regulation of these foods at the federal level, considers trends in state and local restrictions, and summarizes perceived barriers to improving the nutritional quality of competitive food options.

Resource Optimization and World Peace. Occasional Paper 30.

ERIC Educational Resources Information Center

Purcell, Arthur H.

A comprehensive, international program is proposed to help nations optimize and conserve natural resources. The aim of the program is to increase the overall supply of natural resources available to improve the chances for world peace. The energy and material resources of the world are finite. We must live with and adapt to the concept of finite…

New Funding Opportunity: Tissue Purchase Order Acquisitions | Office of Cancer Clinical Proteomics Research

Cancer.gov

The National Cancer Institute (NCI) is expanding its basic and translational research programs that rely heavily on sufficient availability of high quality, well annotated biospecimens suitable for use in genomic and proteomic studies.  The NCI’s overarching goal with such programs is to improve the ability to diagnose, treat, and prevent cancer.

78 FR 77721 - Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-24

... any success or failure to meet objectives for use of proceeds, outcome, or impact. NCUA, in its sole... availability. The OSCUI Grant Program serves as a source of financial support, in the form of technical... provides financial support in the form of technical assistance grants to LICUs. These funds help improve...

(Almost) Word for Word: As Voice Recognition Programs Improve, Students Reap the Benefits

ERIC Educational Resources Information Center

Smith, Mark

2006-01-01

Voice recognition software is hardly new--attempts at capturing spoken words and turning them into written text have been available to consumers for about two decades. But what was once an expensive and highly unreliable tool has made great strides in recent years, perhaps most recognized in programs such as Nuance's Dragon NaturallySpeaking…

Risk Analysis of Loblolly Pine Controlled Mass Pollination Program

Treesearch

T.D. Byram; F.E. Bridgwater

1999-01-01

The economic success of controlled mass pollination (CMP) depends both upon the value of the genetic gain obtained and the cost per seed. Crossing the best six loblolly pine (Pinus taeda) parents currently available in each deployment region of the Western Gulf Forest Tree Improvement Program will produce seed with an average additional gain in mean...

Improvements in Routing for Packet-Switched Networks

DTIC Science & Technology

1975-02-18

PROGRAM FOR COMPUTER SIMULATION . . 90 B.l Flow Diagram of Adaptive Routine 90 B.2 Progiam ARPSIM 93 B.3 Explanation of Variables...equa. 90 APPENDIX B ADAPTIVE ROUTING PROGRAM FOR COMPUTER SIMULA HON The computer simulation for adaptive routing was initially run on a DDP-24 small...TRANSMIT OVER AVAILABLE LINKS MESSAGES IN QUEUE COMPUTE Ni NUMBER OF ARRIVALS AT EACH NODE i AT TIME T Fig. Bla - Flow Diagram of Program Routine 92

Equipment upgrades for the Pu-238 program

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

Congdon, J.W.; Stephens, W.D.; Marra, J.E.

1990-02-14

Much of the equipment and instrumentation in the Pu-238 production facilities is more than 15 years old. Significant improvements have been made in the available instrumentation, in particular, due to the application of microprocessors and lasers. The Actinide Technology Section of SRL has selected and is in the process of evaluating several state-of-the-art instruments which have potential applications in the Pu-238 program. The ease of operation and the accuracy of the instruments have been improved and, in most cases, the cost of the instruments have decreased. 5 refs.

Accessibility, availability, and quality of online information for US radiation oncology residencies.

PubMed

Wakefield, Daniel V; Manole, Bogdan A; Jethanandani, Amit; May, Michael E; Marcrom, Samuel R; Farmer, Michael R; Ballo, Matthew T; VanderWalde, Noam A

2016-01-01

Radiation oncology (RO) residency applicants commonly use Internet resources for information on residency programs. The purpose of this study is to assess the accessibility, availability, and quality of online information for RO graduate medical education. Accessibility of online information was determined by surveying databases for RO residency programs within the Fellowship Residency Electronic Interactive Data Access System (FREIDA) of the American Medical Association, the Accreditation Council for Graduate Medical Education (ACGME), and Google search. As of June 30, 2015, websites were assessed for presence, accessibility, and overall content availability based on a 55-item list of desired features based on 13 program features important to previously surveyed applicants. Quality scoring of available content was performed based on previously published Likert scale variables deemed desirable to RO applicants. Quality score labels were given based on percentage of desired information presented. FREIDA and ACGME databases listed 89% and 98% of program websites, respectively, but only 56% and 52% of links routed to a RO department-specific website, respectively. Google search obtained websites for 98% of programs and 95% of links routed to RO department-specific websites. The majority of websites had program descriptions (98%) and information on staff. However, resident information was more limited (total number [42%], education [47%], previous residents [28%], positions available [35%], contact information [13%]). Based on quality scoring, program websites contained only 47% of desired information on average. Only 13% of programs had superior websites containing 80% or more of desired information. Compared with Google, the FREIDA and ACGME program databases provide limited access to RO residency websites. The overall information availability and quality of information within RO residency websites varies widely. Applicants and programs may benefit from improved content accessibility and quality from US RO program websites in the residency application process. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

78 FR 20928 - Center for Devices and Radiological Health: Health of Women Program; Public Workshop; Request for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-08

... clinical Study recruitment and retention strategies; (2) improve analysis and communication of sex-specific... by: Improving the availability, consistency, and communication of sex-specific information for the... communication of sex-specific findings to providers and patients; and 3. Priority research road map for the HoW...

Who Moved My Curriculum? Leadership Preparation Programs and the Core Technology of Schools

ERIC Educational Resources Information Center

Doolittle, Gini; Browne, Evelyn Gallagher

2011-01-01

This cross-case study utilizes the publically available data of three urban low-performing, low-socioeconomic-status districts designated as "districts in need of improvement" under No Child Left Behind legislation. Despite multiple interventions aimed at improving student learning, these and other districts remain in corrective action.…

An All-Out Effort to Improve the Quality of Undergraduate Life.

ERIC Educational Resources Information Center

Monaghan, Peter

1993-01-01

In response to declining enrollments, Regis University (Colorado) is looking to increase retention and graduation rates by improving campus life. Efforts include creation and renewal of academic clubs and athletic teams, a program to ensure availability of student employment on campus, and a first-year seminar combining teaching, advising, and…

75 FR 7459 - Office of Elementary and Secondary Education; Overview Information; Improving Literacy Through...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-19

... DEPARTMENT OF EDUCATION Office of Elementary and Secondary Education; Overview Information; Improving Literacy Through School Libraries Program Notice Inviting Applications for New Awards for Fiscal Year (FY) 2010 Catalog of Federal Domestic Assistance (CFDA) Number: 84.364A. DATES: Applications Available: February 19, 2010. Deadline for...

The New, Improved 2016 SmartWay Truck Carrier Tool

EPA Pesticide Factsheets

This EPA presentation provides information on the SmartWay Transport Partnership Program, including key information about EPA, Partners' roles, benefits, tools, partner recognition, awards, and brand value. Transcript available

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.

Economic interventions to improve population health: a scoping study of systematic reviews.

PubMed

Khan, Mishal S; Guan, Bernie Y; Audimulam, Jananie; Cervero Liceras, Francisco; Coker, Richard J; Yoong, Joanne

2016-07-07

Recognizing the close relationship between poverty and health, national program managers, policy-makers and donors are increasingly including economic interventions as part of their core strategies to improve population health. However, there is often confusion among stakeholders about the definitions and operational differences between distinct types of economic interventions and financial instruments, which can lead to important differences in interpretation and expectations. We conducted a scoping study to define and clarify concepts underlying key economic interventions - price interventions (taxes and subsidies), income transfer programs, incentive programs, livelihood support programs and health-related financial services - and map the evidence currently available from systematic reviews. We identified 195 systematic reviews on economic interventions published between 2005 and July 2015. Overall, there was an increase in the number of reviews published after 2010. The majority of reviews focused on price interventions, income transfer programs and incentive programs, with much less evidence available from systematic reviews on livelihood support programs and health-related financial services. We also identified a lack of evidence on: health outcomes in low income countries; unintended or perverse outcomes; implementation challenges; scalability and cost-effectiveness of economic interventions. We conclude that while more research is clearly needed to assess suitability and effectiveness of economic interventions in different contexts, before interventions are tested and further systematic reviews conducted, a consistent and accurate understanding of the fundamental differences in terminology and approaches is essential among researchers, public health policy makers and program planners.

A Telerehabilitation Program Improves Postural Control in Multiple Sclerosis Patients: A Spanish Preliminary Study

PubMed Central

Ortiz-Gutiérrez, Rosa; Cano-de-la-Cuerda, Roberto; Galán-del-Río, Fernando; Alguacil-Diego, Isabel María; Palacios-Ceña, Domingo; Miangolarra-Page, Juan Carlos

2013-01-01

Postural control disorders are among the most frequent motor disorder symptoms associated with multiple sclerosis. This study aims to demonstrate the potential improvements in postural control among patients with multiple sclerosis who complete a telerehabilitation program that represents a feasible alternative to physical therapy for situations in which conventional treatment is not available. Fifty patients were recruited. Control group (n = 25) received physiotherapy treatment twice a week (40 min per session). Experimental group (n = 25) received monitored telerehabilitation treatment via videoconference using the Xbox 360® and Kinect console. Experimental group attended 40 sessions, four sessions per week (20 min per session).The treatment schedule lasted 10 weeks for both groups. A computerized dynamic posturography (Sensory Organization Test) was used to evaluate all patients at baseline and at the end of the treatment protocol. Results showed an improvement over general balance in both groups. Visual preference and the contribution of vestibular information yielded significant differences in the experimental group. Our results demonstrated that a telerehabilitation program based on a virtual reality system allows one to optimize the sensory information processing and integration systems necessary to maintain the balance and postural control of people with multiple sclerosis. We suggest that our virtual reality program enables anticipatory PC and response mechanisms and might serve as a successful therapeutic alternative in situations in which conventional therapy is not readily available. PMID:24185843

Engaging academia to advance the science and practice of environmental public health tracking.

PubMed

Strosnider, Heather; Zhou, Ying; Balluz, Lina; Qualters, Judith

2014-10-01

Public health agencies at the federal, state, and local level are responsible for implementing actions and policies that address health problems related to environmental hazards. These actions and policies can be informed by integrating or linking data on health, exposure, hazards, and population. The mission of the Centers for Disease Control and Prevention׳s National Environmental Public Health Tracking Program (Tracking Program) is to provide information from a nationwide network of integrated health, environmental hazard, and exposure data that drives actions to improve the health of communities. The Tracking Program and federal, state, and local partners collect, integrate, analyze, and disseminate data and information to inform environmental public health actions. However, many challenges exist regarding the availability and quality of data, the application of appropriate methods and tools to link data, and the state of the science needed to link and analyze health and environmental data. The Tracking Program has collaborated with academia to address key challenges in these areas. The collaboration has improved our understanding of the uses and limitations of available data and methods, expanded the use of existing data and methods, and increased our knowledge about the connections between health and environment. Valuable working relationships have been forged in this process, and together we have identified opportunities and improvements for future collaborations to further advance the science and practice of environmental public health tracking. Published by Elsevier Inc.

Introducing an accountability framework for polio eradication in Ethiopia: results from the first year of implementation 2014-2015

PubMed Central

Kassahun, Aron; Braka, Fiona; Gallagher, Kathleen; Gebriel, Aregai Wolde; Nsubuga, Peter; M’pele-Kilebou, Pierre

2017-01-01

Introduction the World Health Organization (WHO), Ethiopia country office, introduced an accountability framework into its Polio Eradication Program in 2014 with the aim of improving the program's performance. Our study aims to evaluate staff performance and key program indicators following the introduction of the accountability framework. Methods the impact of the WHO accountability framework was reviewed after its first year of implementation from June 2014 to June 2015. We analyzed selected program and staff performance indicators associated with acute flaccid paralysis (AFP) surveillance from a database available at WHO. Data on managerial actions taken were also reviewed. Performance of a total of 38 staff was evaluated during our review. Results our review of results for the first four quarters of implementation of the polio eradication accountability framework showed improvement both at the program and individual level when compared with the previous year. Managerial actions taken during the study period based on the results from the monitoring tool included eleven written acknowledgments, six discussions regarding performance improvement, six rotations of staff, four written first-warning letters and nine non-renewal of contracts. Conclusion the introduction of the accountability framework resulted in improvement in staff performance and overall program indicators for AFP surveillance. PMID:28890753

Using Facility Condition Assessments to Identify Actions Related to Infrastructure

NASA Technical Reports Server (NTRS)

Rubert, Kennedy F.

2010-01-01

To support cost effective, quality research it is essential that laboratory and testing facilities are maintained in a continuous and reliable state of availability at all times. NASA Langley Research Center (LaRC) and its maintenance contractor, Jacobs Technology, Inc. Research Operations, Maintenance, and Engineering (ROME) group, are in the process of implementing a combined Facility Condition Assessment (FCA) and Reliability Centered Maintenance (RCM) program to improve asset management and overall reliability of testing equipment in facilities such as wind tunnels. Specific areas are being identified for improvement, the deferred maintenance cost is being estimated, and priority is being assigned against facilities where conditions have been allowed to deteriorate. This assessment serves to assist in determining where to commit available funds on the Center. RCM methodologies are being reviewed and enhanced to assure that appropriate preventive, predictive, and facilities/equipment acceptance techniques are incorporated to prolong lifecycle availability and assure reliability at minimum cost. The results from the program have been favorable, better enabling LaRC to manage assets prudently.

Availability of herbal medicines and medicinal plants in the primary health facilities of the state of São Paulo, Southeast Brazil: results from the National Program for Access and Quality Improvement in Primary Care.

PubMed

Caccia-Bava, Maria do Carmo Gullaci Guimarães; Bertoni, Bianca Waléria; Pereira, Ana Maria Soares; Martinez, Edson Zangiacomi

2017-05-01

This study aims to describe the availability of herbal medicines and medicinal plants in the primary care facilities in the state of São Paulo, Southeast Brazil, from the results of the first cycle of the National Program for Access and Quality Improvement in Primary Care (PMAQ). The PMAQ uses a national cross-sectional multicenter design, with data from 4,249 health facilities distributed among 645 municipalities of the state of São Paulo. Of these facilities, 467 (11%) had herbal medicines and/or medicinal plants. Among the 645 municipalities, 104 (16.1%) had at least one health facility that provided these drugs. We observed that the availability of herbal medicines is greater in larger cities with better social and economic conditions. Furthermore, we found that use of industrialized herbal medicines prevailed over that of vegetal drugs or compounded herbal medicines.

Clean Air Markets - Compliance Query Wizard

EPA Pesticide Factsheets

The Compliance Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://ampd.epa.gov/ampd/. The Compliance module provides final compliance results. Using the Compliance Query Wizard, the user can find compliance information associated with specific programs, facilities, states or time frames. Quick Reports and Prepackaged Datasets are also available for data that are commonly requested. Final compliance results are available for all years since 1995 for the Acid Rain Program and for the various NOx trading programs EPA has operated since 1999.EPA's Clean Air Markets Division (CAMD) includes several market-based regulatory programs designed to improve air quality and ecosystems. The most well-known of these programs are EPA's Acid Rain Program and the NOx Programs, which reduce emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx)-compounds that adversely affect air quality, the environment, and public health. CAMD also plays an integral role in the development and implementation of the Clean Air Interstate Rule (CAIR).

Improving The Discipline of Cost Estimation and Analysis

NASA Technical Reports Server (NTRS)

Piland, William M.; Pine, David J.; Wilson, Delano M.

2000-01-01

The need to improve the quality and accuracy of cost estimates of proposed new aerospace systems has been widely recognized. The industry has done the best job of maintaining related capability with improvements in estimation methods and giving appropriate priority to the hiring and training of qualified analysts. Some parts of Government, and National Aeronautics and Space Administration (NASA) in particular, continue to need major improvements in this area. Recently, NASA recognized that its cost estimation and analysis capabilities had eroded to the point that the ability to provide timely, reliable estimates was impacting the confidence in planning many program activities. As a result, this year the Agency established a lead role for cost estimation and analysis. The Independent Program Assessment Office located at the Langley Research Center was given this responsibility. This paper presents the plans for the newly established role. Described is how the Independent Program Assessment Office, working with all NASA Centers, NASA Headquarters, other Government agencies, and industry, is focused on creating cost estimation and analysis as a professional discipline that will be recognized equally with the technical disciplines needed to design new space and aeronautics activities. Investments in selected, new analysis tools, creating advanced training opportunities for analysts, and developing career paths for future analysts engaged in the discipline are all elements of the plan. Plans also include increasing the human resources available to conduct independent cost analysis of Agency programs during their formulation, to improve near-term capability to conduct economic cost-benefit assessments, to support NASA management's decision process, and to provide cost analysis results emphasizing "full-cost" and "full-life cycle" considerations. The Agency cost analysis improvement plan has been approved for implementation starting this calendar year. Adequate financial and human resources are being made available to accomplish the goals of this important effort, and all indications are that NASA's cost estimation and analysis core competencies will be substantially improved within the foreseeable future.

Intensive strength and balance training with the Kinect console (Xbox 360) in a patient with CMT1A.

PubMed

Pagliano, Emanuela; Foscan, Maria; Marchi, Alessia; Corlatti, Alice; Aprile, Giorgia; Riva, Daria

2017-08-01

Effective drugs for type 1A Charcot-Marie-Tooth (CMT1A) disease are not available. Various forms of moderate exercise are beneficial, but few data are available on the effectiveness of exercise in CMT1A children. To investigate the feasibility and effectiveness of exercises to improve ankle strength and limb function in a child with CMT1A. Outpatient clinic. Nine-year-old boy with CMT1A. The rehabilitation program consisted of ankle exercises and Kinect videogame-directed physical activities (using an Xbox 360 console/movement sensor) that aimed to improve balance and limb strength. The program was given 3 times a week for 5 weeks. The child was assessed at baseline, after 5 weeks, and 3 and 6 months after. By the end of follow-up, child balance and endurance had improved, but ankle strength did not. The encouraging results for balance and endurance justify further studies on videogame-directed activities in CMT1A children/adolescents.

Improvements to the adaptive maneuvering logic program

NASA Technical Reports Server (NTRS)

Burgin, George H.

1986-01-01

The Adaptive Maneuvering Logic (AML) computer program simulates close-in, one-on-one air-to-air combat between two fighter aircraft. Three important improvements are described. First, the previously available versions of AML were examined for their suitability as a baseline program. The selected program was then revised to eliminate some programming bugs which were uncovered over the years. A listing of this baseline program is included. Second, the equations governing the motion of the aircraft were completely revised. This resulted in a model with substantially higher fidelity than the original equations of motion provided. It also completely eliminated the over-the-top problem, which occurred in the older versions when the AML-driven aircraft attempted a vertical or near vertical loop. Third, the requirements for a versatile generic, yet realistic, aircraft model were studied and implemented in the program. The report contains detailed tables which make the generic aircraft to be either a modern, high performance aircraft, an older high performance aircraft, or a previous generation jet fighter.

Assessment of the Housing Improvement Program for Chagas Disease Control in the Northwestern municipalities of Rio Grande do Sul, Brazil.

PubMed

Santos, Cibele Velleda Dos; Bedin, Clenonara; Wilhelms, Tania Stasiak; Villela, Marcos Marreiro

2016-01-01

The Housing Improvement Program for Chagas Disease Control (HIPCDC) was established in 2001 in Northwestern Rio Grande do Sul State, aiming to improve the conditions of the domiciliary and peridomiciliary environments to make them resistant to triatomine colonization. This study aimed to assess the impact of the HIPCDC on triatomine control by developing local population and authority awareness on the issue. The study was conducted by means of questionnaires applied to local authorities and the program beneficiaries. Three municipalities - Ajuricaba, Coronel Barros, and Crissiumal - were visited. A program coordinator from each municipality and 62 individuals from selected households were interviewed. The authorities reported difficulties in the implementation of the program due to differences between the project development period and financial resource availability, in addition to a lack of understanding by the community not included in the program. As for the houses, most improvements were made in the peridomiciliary environments; moreover, construction of 4 new residences, as well as the renovation of others, was also reported. Regarding suggestions to the program, requests for better planning (44.9%) and renovation quality (36.7%) were highlighted. With reference to the presence of triatomine bugs, prior to the HIPCDC adaptations, 12.9% of the respondents reported coming across at least one specimen at home, as compared to 22.6% who found these insects in peridomiciliary areas. Despite reports of difficulties in carrying out the HIPCDC, there was an improvement in the housing conditions, with no triatomine occurrence reports after the program implementation.

Evaluation of Q-band instrumentation requirements for Strategic Satellite System (SSS) program

NASA Astrophysics Data System (ADS)

Raponi, D. J.

1981-12-01

Q-band instrumentation appropriate for testing the Strategic Satellite System (SSS) satellite terminal is evaluated in terms of current and projected availability; desired and practical measurement capabilities; required development; and schedule/cost impacts to the program. The Air Force is considering several approaches to increasing the strategic communications capability now provided by the recently deployed ultra high frequency (UHF) Air Force Satellite Communications (AFSATCOM) system. The Strategic Satellite System (SSS) was proposed to improve antijam (AJ) characteristics through the use of advanced modulation techniques and higher frequencies (8 and 44 GHz) on links between ground and airborne terminals and the satellites. This report is an assessment of Q-band (44 GHz) test instrumentation requirements, availability, and accuracy as these factors affect cost and schedule for the SSS satellite terminal development program. Though the SSS program has been cancelled, information presented in the report has applicability to the EHF MILSTAR program.

Tribal Set-Aside Program of the Drinking Water Infrastructure Grant

EPA Pesticide Factsheets

The Safe Drinking Water Act (SWDA), as amended in 1996, established the Drinking Water State Revolving Fund (DWSRF) to make funds available to drinking water systems to finance infrastructure improvements.

Control research in the NASA high-alpha technology program

NASA Technical Reports Server (NTRS)

Gilbert, William P.; Nguyen, Luat T.; Gera, Joseph

1990-01-01

NASA is conducting a focused technology program, known as the High-Angle-of-Attack Technology Program, to accelerate the development of flight-validated technology applicable to the design of fighters with superior stall and post-stall characteristics and agility. A carefully integrated effort is underway combining wind tunnel testing, analytical predictions, piloted simulation, and full-scale flight research. A modified F-18 aircraft has been extensively instrumented for use as the NASA High-Angle-of-Attack Research Vehicle used for flight verification of new methods and concepts. This program stresses the importance of providing improved aircraft control capabilities both by powered control (such as thrust-vectoring) and by innovative aerodynamic control concepts. The program is accomplishing extensive coordinated ground and flight testing to assess and improve available experimental and analytical methods and to develop new concepts for enhanced aerodynamics and for effective control, guidance, and cockpit displays essential for effective pilot utilization of the increased agility provided.

Networking to support suicide survivors.

PubMed

De Fauw, Nico; Andriessen, Karl

2003-01-01

This paper is the first report on a national program for increasing bereavement support for suicide survivors in the Flemish region in Belgium. A Working Group consisting of representatives of a wide variety of mental health institutions, social programs, and suicide survivor groups in the area determined that a program developing networks between the services seems to hold the greatest promise for both an increase in the number of services available and an improvement in the quality of services offered.

Federal Educational Assistance Programs Available to Service Members: Program Features and Recommendations for Improved Delivery

DTIC Science & Technology

2015-01-01

psychology, this would be referred to as an untreated control group design with pretest and posttest (those who did not use the program with those who...3 Using primarily a qualitative approach, Steele, Salcedo, and Coley, 2011, conducted surveys and on -campus focus groups with Post-9/11 GI Bill...historical information on participants’ and a control group of nonparticipants’ sociodemo- graphic characteristics and service-related characteristics (e.g

Cyber-Based Turbulent Combustion Simulation

DTIC Science & Technology

2012-02-28

flame thickness by comparing with benchmark of AFRL/RZ ( UNICORN ) suppressing the oscillatory numerical behavior. These improvements in numerical...fraction with the benchmark results of AFRL/RZ. This validating base is generated by the UNICORN program on the finest mesh available and the local...shared kinematic and thermodynamic data from the UNICORN program. The most important and meaningful conclusion can be drawn from this comparison is

Native plant development and restoration program for the Great Basin, USA

Treesearch

N. L. Shaw; M. Pellant; P. Olweli; S. L. Jensen; E. D. McArthur

2008-01-01

The Great Basin Native Plant Selection and Increase Project, organized by the USDA Bureau of Land Management, Great Basin Restoration Initiative and the USDA Forest Service, Rocky Mountain Research Station in 2000 as a multi-agency collaborative program (http://www.fs.fed.us/rm/boise/research/shrub/greatbasin.shtml), has the objective of improving the availability of...

Effects of a Dialogue-Based Program to Improve Emotion Knowledge in Spanish Roma Preschoolers

ERIC Educational Resources Information Center

Giménez-Dasí, Marta; Quintanilla, Laura; Ojeda, Vanesa; Lucas-Molina, Beatriz

2017-01-01

Romas are one of the largest minority groups in Spain and Europe, but no specific data on children's socioemotional learning are available. Our goal was to determine the level of socioemotional knowledge of a group of 4- and 5-year-old Roma children and to implement an intervention program at school. Forty-three Roma children participated…

A National Assessment of the Impact of the Institutes for Higher Education Academy on School Health Faculty

ERIC Educational Resources Information Center

Huelskamp, Amelia C.; Dake, Joseph A.; Telljohann, Susan K.; Tappe, Marlene K.; Jordan, Timothy

2016-01-01

Background: Many school health teacher preparation programs do not train teacher candidates in the use of online resources available through the Centers for Disease Control and Prevention (CDC). Some CDC resources, such as the School Health Index, could significantly improve the quality of school health programs. To address this, the CDC and the…

The Impact of a Professional Development Program on Teachers' Mathematical Knowledge for Teaching, Instruction, and Student Achievement

ERIC Educational Resources Information Center

Jacob, Robin; Hill, Heather; Corey, Doug

2017-01-01

In this paper, we describe findings from a three-year evaluation of a well-developed mathematics professional development program that is commercially available on a wide scale. The professional development is designed to improve teachers' mathematical knowledge for teaching and to enable them to elicit more student thinking and reasoning during…

A Switching-Mode Power Supply Design Tool to Improve Learning in a Power Electronics Course

ERIC Educational Resources Information Center

Miaja, P. F.; Lamar, D. G.; de Azpeitia, M.; Rodriguez, A.; Rodriguez, M.; Hernando, M. M.

2011-01-01

The static design of ac/dc and dc/dc switching-mode power supplies (SMPS) relies on a simple but repetitive process. Although specific spreadsheets, available in various computer-aided design (CAD) programs, are widely used, they are difficult to use in educational applications. In this paper, a graphic tool programmed in MATLAB is presented,…

Improvement of Nickel-Stanogermanide Contact Properties by Platinum Interlayer

NASA Astrophysics Data System (ADS)

Wan, Wei-Jun; Ren, Wei; Meng, Xiao-Ran; Ping, Yun-Xia; Wei, Xing; Xue, Zhong-Ying; Yu, Wen-Jie; Zhang, Miao; Di, Zeng-Feng; Zhang, Bo

2018-05-01

Not Available Supported by the National Natural Science Foundation of China under Grant Nos 51672171 and 61604094, the Natural Science Foundation of Shanghai under Grant No 14ZR1418300, the National Key Basic Research Program of China under Grant No 2015CB921600, the Eastern Scholar Program from the Shanghai Municipal Education Commission, and the Fok Ying Tung Education Foundation.

Districts Say Convenience for Parents, Not Competition, Is Result of Open Enrollment. Research Brief. Volume 90, Number 7

ERIC Educational Resources Information Center

Public Policy Forum, 2002

2002-01-01

Wisconsin's Open Enrollment program, which policymakers hope will improve educational performance by introducing competition to public schools, allows students to enroll in any district in the state, provided space is available. First implemented in the 1998-1999 school year, the program now includes 1% of all Wisconsin K-12 students. In its first…

Back to BaySICS: a user-friendly program for Bayesian Statistical Inference from Coalescent Simulations.

PubMed

Sandoval-Castellanos, Edson; Palkopoulou, Eleftheria; Dalén, Love

2014-01-01

Inference of population demographic history has vastly improved in recent years due to a number of technological and theoretical advances including the use of ancient DNA. Approximate Bayesian computation (ABC) stands among the most promising methods due to its simple theoretical fundament and exceptional flexibility. However, limited availability of user-friendly programs that perform ABC analysis renders it difficult to implement, and hence programming skills are frequently required. In addition, there is limited availability of programs able to deal with heterochronous data. Here we present the software BaySICS: Bayesian Statistical Inference of Coalescent Simulations. BaySICS provides an integrated and user-friendly platform that performs ABC analyses by means of coalescent simulations from DNA sequence data. It estimates historical demographic population parameters and performs hypothesis testing by means of Bayes factors obtained from model comparisons. Although providing specific features that improve inference from datasets with heterochronous data, BaySICS also has several capabilities making it a suitable tool for analysing contemporary genetic datasets. Those capabilities include joint analysis of independent tables, a graphical interface and the implementation of Markov-chain Monte Carlo without likelihoods.

A National Evaluation of the Impact of State Policies on Competitive Foods in Schools

ERIC Educational Resources Information Center

Fernandes, Meenakshi M.

2013-01-01

Background: Since 2003, many states have introduced policies to improve the nutritional content and restrict the availability of competitive foods, which are foods offered outside of the National School Lunch and Breakfast Programs. This article evaluates the impact of 2 types of state-level policies on the availability of competitive foods in a…

Computer program to perform cost and weight analysis of transport aircraft. Volume 2: Technical volume

NASA Technical Reports Server (NTRS)

1973-01-01

An improved method for estimating aircraft weight and cost using a unique and fundamental approach was developed. The results of this study were integrated into a comprehensive digital computer program, which is intended for use at the preliminary design stage of aircraft development. The program provides a means of computing absolute values for weight and cost, and enables the user to perform trade studies with a sensitivity to detail design and overall structural arrangement. Both batch and interactive graphics modes of program operation are available.

A Multidisciplinary Quality Improvement Approach Increases Breastmilk Availability at Discharge from the Neonatal Intensive Care Unit for the Very-Low-Birth-Weight Infant.

PubMed

Bixby, Christine; Baker-Fox, Cindy; Deming, Crystal; Dhar, Vijay; Steele, Caroline

2016-03-01

Mothers of very-low-birth-weight (VLBW) infants often struggle to establish and maintain a milk supply. Children's Hospital of Orange County (CHOC Children's) data from 2005 to 2011 showed that while the total percentage of all neonatal intensive care unit (NICU) babies being discharged on breastmilk had remained stable, the percentage of VLBW babies with breastmilk at discharge had declined. This information resulted in a quality improvement initiative to remove barriers and implement programs shown to have the greatest impact on initiating and sustaining lactation in this patient subset. The objective of this initiative was to increase breastmilk availability at discharge for the VLBW population. A multidisciplinary program was initiated, which included NICU parent and staff education, clarification of roles, and improved access to pumping supplies. Physicians and nurses completed online education. An algorithm defining roles in lactation support was developed, and a resource team of trained bedside nurses was formed. Lactation consultant time was then refocused on the VLBW population. In addition, "Lactation Support" was added to the physician daily documentation to bring the topic to daily bedside rounds. Twice weekly lactation rounds between the lactation consultant and neonatologist addressed lactation concerns for each dyad. To address pumping issues, the loaner pump program was enhanced. To assess the effectiveness of the initiative, breastmilk availability at discharge for the VLBW population at CHOC Children's was compared from baseline (2011) to the end of June 2015. VLBW breastmilk availability at discharge upon project initiation was 58.7% and increased by 36% to a final rate of 80% by 2013--a rate sustained through the first 6 months of 2015. The results of this initiative suggest that a multidisciplinary approach, including education, changes in workflow, and redefinition of roles, is effective in improving breastmilk rates at discharge in the VLBW patient population.

The Use of Technology to Improve Staff Performance

ERIC Educational Resources Information Center

Nepo, Kaori G.

2010-01-01

The on-going staff training is one of critical components for the effective programming for adolescents and adults with autism, although it is often overlooked. The available technology can be useful to improve not only productivity and organization of our daily life, but also the work performance. The purpose of this study was to examine the…

Participatory Training to Improve Safety and Health in Small Construction Sites in Some Countries in Asia: Development and Application of the WISCON Training Program.

PubMed

Kawakami, Tsuyoshi

2016-08-01

A participatory training program, Work Improvement in Small Construction Sites, was developed to provide practical support measures to the small construction sector. Managers and workers from selected small sites were interviewed about their occupational safety and health risks. The Work Improvement in Small Construction Sites training program comprised a 45-item action checklist, photos, and illustrations showing local examples and group work methods. Pilot training workshops were carried out with workers and employers in Cambodia, Laos, Mongolia, Thailand, and Vietnam. Participants subsequently planned, and using locally available low-cost materials, implemented their own improvements such as hand-made hand trucks to carry heavy materials, removal of projecting nails from timber materials, and fences to protect roof workers from falling. Local Work Improvement in Small Construction Sites trainers consisting of government officials, workers, employers, and nongovernment organization representatives were then trained to implement the Work Improvement in Small Construction Sites training widely. Keys to success were easy-to-apply training tools aiming at immediate, low-cost improvements, and collaboration with various local people's networks. © The Author(s) 2016.

The Technology Boom

PubMed Central

Gilmore, L. Anne; Duhé, Abby F.; Frost, Elizabeth A.

2014-01-01

As technology continues to develop rapidly, the incidence of obesity also continues to climb at an alarming rate. The increase in available technology is thought to be a contributor in the obesogenic environment, yet at the same time technology can also be used to intervene and improve health and health behaviors. This article reviews the components of effective weight management programs and the novel role that technology, such as SMS, websites, and smartphone apps, is playing to improve the success of such programs. Use of these modern technologies can now allow for individualized treatment recommendations to be delivered to individuals remotely, increased self-monitoring/tracking of health-related data, broader and more rapid dissemination of health information/recommendations, and increased patient–dietician/physician contact. The use of technology in weight management programs results in improved long-term weight management, and in most cases improved cost-effectiveness. Rather than blaming increased food intake and sedentary lifestyle on technology, rapidly developing and innovative technologies should be used to our advantage and deployed to combat the obesity epidemic. PMID:24876625

A video approach to interactive patient education.

PubMed

Maller, C E; Twitty, V J; Sauve, A

1997-04-01

A quality improvement model presents the stages of designing and producing a preoperative videotape for improved patient satisfaction outcomes. PACU nurses formed an interdisciplinary team of providers and patients to update an existing preoperative sound/slide program into video. Improved patient outcomes were reflected in greater availability, accessibility, and consistency of preoperative instruction. A videotape program for home viewing was instituted to reach out to the surgical patient population served by the Albuquerque Veterans Affairs Medical Center in New Mexico. A quality improvement storyboard approach to videotape production met Joint Commission on Accreditation of Health Care Organization (JCAHO) standards for interactive patient education at a recent JCAHO survey. Preliminary evaluative data from patients supports a growing appeal of videos to patients and family members as an additional preoperative teaching strategy for adult surgical patients.

Management of exercise-induced bronchospasm in NCAA athletic programs

PubMed Central

Parsons, Jonathan P.; Pestritto, Vincent; Phillips, Gary; Kaeding, Christopher; Best, Thomas M.; Wadley, Gail; Mastronarde, John G.

2009-01-01

Purpose The prevalence of exercise-induced bronchospasm (EIB) is significantly higher in athletes than the general population, and can result in significant morbidity in young, competitive athletes. Guidelines emphasize that education and written treatment protocols improve clinical outcomes for asthmatics. Evidence also supports objective testing when exercise-induced bronchospasm is suspected, immediate availability of rescue inhalers, and involvement of asthma specialists in the care of asthmatic athletes. We sought to determine how EIB is managed at National Collegiate Athletic Association (NCAA) sports medicine programs. Methods A survey consisting of multiple-choice questions related to exercise-induced bronchospasm in athletes was sent electronically to 3200 athletic trainers affiliated with NCAA sports medicine programs. Results 541 athletic trainers responded. A minority of athletic trainers surveyed (21%) indicated an asthma management protocol exists at their institution. 22% indicated that pulmonologists are on staff in or consultants to the sports medicine department. Many indicated a short-acting beta-agonist is not required to be available at all practices (39%) and games (41%) and few athletic trainers indicated their programs utilize objective testing to diagnose EIB (17%). Regression modeling demonstrated education about EIB and involvement of pulmonologists significantly improved adherence to current consensus guidelines. Conclusions Based on our data, many NCAA sports medicine programs do not manage athletes with EIB according to current consensus guidelines. This may result in inaccurate diagnoses and may be detrimental to clinical outcomes and the overall health of student athletes. Providing education about EIB and involvement of pulmonologists significantly increase adherence to guidelines which likely improves clinical care of athletes and potentially athletic performance. PMID:19276862

Assessment of two e-learning methods teaching undergraduate students cephalometry in orthodontics.

PubMed

Ludwig, B; Bister, D; Schott, T C; Lisson, J A; Hourfar, J

2016-02-01

Cephalometry is important for orthodontic diagnosis and treatment planning and is part of the core curriculum for training dentists. Training involves identifying anatomical landmarks. The aim of this investigation was to assess whether e-learning improves learning efficiency; a programme specifically designed for this purpose was compared to commercially available software. Thirty undergraduate students underwent traditional training of cephalometry consisting of lectures and tutorials. Tracing skills were tested immediately afterwards (T0). The students were then randomly allocated to three groups: 10 students served as control (CF); they were asked to improve their skills using the material provided so far. Ten students were given a program specifically designed for this study that was based on a power point presentation (PPT). The last group was given a commercially available program that included teaching elements (SW). The groups were tested at the end the six week training (T1). The test consisted of tracing 30 points on two radiographs and a point score improvement was calculated. The students were interviewed after the second test. Both e-learning groups improved more than the traditional group. Improvement scores were four for CF; 8.6 for PPT and 2.8 for SW. For PPT all participants improved and the student feedback was the best compared to the other groups. For the other groups some candidates worsened. Blended learning produced better learning outcomes compared to using a traditional teaching method alone. The easy to use Power Point based custom software produced better results than the commercially available software. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Identifying state resources and support programs on e-government websites for persons with intellectual and developmental disabilities.

PubMed

Fisher, Kathleen M; Peterson, Justin D; Albert, Jon D

2015-01-01

This descriptive cross-sectional study identified resources and programs that are available nationwide on the Internet to support individuals and families with intellectual and developmental disabilities (I/DD), with a focus on intellectual disability. This evaluation included easily identifiable information on specific resources and highlighted unique programs found in individual states that were linked from e-government websites. Researchers documented the ease of access and available information for all 50 states and the District of Columbia. A number of disparities and areas for improvement were recorded for states and I/DD websites. The researchers conclude that a number of additional health and support services will be needed to address the growing needs of this vulnerable population.

The Stress Check Program: a new national policy for monitoring and screening psychosocial stress in the workplace in Japan.

PubMed

Kawakami, Norito; Tsutsumi, Akizumi

2016-01-01

The Japanese government launched a new occupational health policy called the Stress Check Program. This program mandates that all workplaces with 50 or more employees conduct the Stress Check Program for workers at least once a year. This article gives a brief overview and critical review of the program. We reviewed relevant laws, guidelines, and manuals, as well as the policy development process. The policy and the components of the program were compared using available scientific evidence and trends in the management of psychosocial factors at work according to the policies and guidelines of international bodies and European countries. The process of program policy development was based on a discussion among employer and employee representatives, occupational health professionals, and mental health experts. Scientific evidence shows that mandated components of the program (i.e., feedback of stress survey results and physician's interview) may be ineffective. However, additional components recommended to employers, such as stress management skill provision and work environment improvement, in conjunction with the program may be effective in improving psychosocial stress at work. The Stress Check Program is unique compared with the global trend for psychosocial risk management because it focuses on the assessment of stress among individual workers. The new program may be effective in improving worker mental health by facilitating the psychosocial risk management approach in Japan. Concerns regarding the program include mass leakage of collected information, and possible disadvantages for workers labeled as having high stress.

An intelligent position-specific training system for mission operations

NASA Technical Reports Server (NTRS)

Schneider, M. P.

1992-01-01

Marshall Space Flight Center's (MSFC's) payload ground controller training program provides very good generic training; however, ground controller position-specific training can be improved by including position-specific training systems in the training program. This report explains why MSFC needs to improve payload ground controller position-specific training. The report describes a generic syllabus for position-specific training systems, a range of system designs for position-specific training systems, and a generic development process for developing position-specific training systems. The report also describes a position-specific training system prototype that was developed for the crew interface coordinator payload operations control center ground controller position. The report concludes that MSFC can improve the payload ground controller training program by incorporating position-specific training systems for each ground controller position; however, MSFC should not develop position-specific training systems unless payload ground controller position experts will be available to participate in the development process.

Taking a unified approach to teaching and implementing quality improvements across multiple residency programs: the Atlantic Health experience.

PubMed

Daniel, Donna M; Casey, Donald E; Levine, Jeffrey L; Kaye, Susan T; Dardik, Raquel B; Varkey, Prathibha; Pierce-Boggs, Kimberly

2009-12-01

The Accreditation Council for Graduate Medical Education recently emphasized the importance of systems-based practice and systems-based learning; however, successful models of collaborative quality improvement (QI) initiatives in residency training curricula are not widely available. Atlantic Health successfully conceptualized and implemented a QI collaborative focused on medication safety across eight residency training programs representing 219 residents. During a six-month period, key faculty and resident leaders from 8 (of 10) Atlantic Health residency training programs participated in three half-day collaborative learning sessions focused on improving medication reconciliation. Each session included didactic presentations from a multidisciplinary team of clinical experts as well as the application of principles that identified challenges, barriers, and solutions to QI initiatives. The learning sessions emphasized the fundamental principles of medication reconciliation, its critical importance as a vital part of patient handoff in all health care settings, and the challenges of achieving successful medication reconciliation improvement in light of work hours restrictions and patient loads. Each residency program developed a detailed implementation and measurement plan for individual "action learning" projects, using the Plan-Do-Study-Act method of improvement. Each program then implemented its QI project, and expert faculty (e.g., physicians, nurses, pharmacists, QI staff) provided mentoring between learning sessions. Several projects resulted in permanent changes in medication reconciliation processes, which were then adopted by other programs. The structure, process, and outcomes of this effort are described in detail.

Program of operation for the National Water Data Exchange (NAWDEX)

USGS Publications Warehouse

Edwards, Melvin D.

1977-01-01

The National Water Data Exchange (NAWDEX) has been established as a nationwide program directed at improving access to water and water-related data and disseminating information about the availability of these data throughout the entire water-resources community. NAWDEX is composed of a confederation of water-oriented organizations working together to facilitate the exchange of data and to improve the technology of data handling and transfer. This report is intended to provide guidelines to assure that all member organizations participate equally and that a climate of cooperation and open communication is established among participating members. (Woodard-USGS)

Health Risk Reduction Programs in Employer-Sponsored Health Plans: Part I—Efficacy

PubMed Central

Rothstein, Mark A.; Harrell, Heather L.

2011-01-01

Objective We sought to determine whether workplace health risk reduction programs (HRRPs) using health risk assessments (HRAs), individually focused risk reduction, and financial incentives succeeded in improving employee health and reducing employer health benefit costs. Methods We reviewed the proprietary HRA available to us and conducted a literature review to determine the efficacy of HRRPs using HRAs, individualized employee interventions, and financial incentives for employee participation. Results There is some evidence that HRRPs in employer-sponsored programs improve measures of employee health, but the results of these studies are somewhat equivocal. Conclusion Employer-sponsored HRRPs may have some benefits, but problems in plan design and in the studies assessing their efficacy complicate drawing conclusions. PMID:19625972

A diabetes self-management program designed for urban American Indians.

PubMed

Castro, Sarah; O'Toole, Mary; Brownson, Carol; Plessel, Kimberly; Schauben, Laura

2009-10-01

Although the American Indian population has a disproportionately high rate of type 2 diabetes, little has been written about culturally sensitive self-management programs in this population. Community and clinic partners worked together to identify barriers to diabetes self-management and to provide activities and services as part of a holistic approach to diabetes self-management, called the Full Circle Diabetes Program. The program activities and services addressed 4 components of holistic health: body, spirit, mind, and emotion. Seven types of activities or services were available to help participants improve diabetes self-management; these included exercise classes, educational classes, and talking circles. Ninety-eight percent of program enrollees participated in at least 1 activity, and two-thirds participated in 2 or more activities. Program participation resulted in a significant improvement in knowledge of resources for managing diabetes. The Full Circle Diabetes Program developed and implemented culturally relevant resources and supports for diabetes self-management in an American Indian population. Lessons learned included that a holistic approach to diabetes self-management, community participation, and stakeholder partnerships are needed for a successful program.

Supervised toothbrushing programs in primary schools and early childhood settings: A scoping review.

PubMed

Dickson-Swift, V; Kenny, A; Gussy, M; de Silva, A M; Farmer, J; Bracksley-O'Grady, S

2017-12-01

In this article we report the findings of a scoping review that aimed to identify and summarise the range of programs and guidelines available for toothbrushing programs in schools and early childhood settings. Dental caries is one of the most common preventable diseases affecting children worldwide. Untreated caries can impact on child health and wellbeing, development, socialisation and school attendance. Supervised toothbrushing programs in schools and other early childhood settings can be effective in improving the oral health of young children. There is limited understanding of the salient issues to consider when developing such programs or how they are best implemented in real world settings. A scoping review methodology was utilised to provide a summary of the guidelines and programs available. Key search terms were developed, mapped and utilised to identify guidelines and programs across 6 databases and key search engines. We located 26 programs and guidelines that met the inclusion and exclusion criteria for the review. These were collated and summarised across key countries and critical aspects of program development and implementation were identified. Toothbrush type and storage, toothpaste strength and method of dispensing, toothbrush storage, staff training and parental consent are key considerations that varied widely. Guidelines for supervised toothbrushing programs vary within and across countries due to differences in water fluoridation and availability of low fluoride toothpastes. The results of this review provide critical information to be considered when establishing and implementing toothbrushing programs in these settings. Copyright© 2017 Dennis Barber Ltd.

Youth Opportunity Grants: Lessons Can Be Learned from Program, but Labor Needs to Make Data Available. Report to Congressional Requester. GAO-06-53

ERIC Educational Resources Information Center

Bellis, David D.

2005-01-01

The Youth Opportunity Grant program (YO) represented an innovative approach to improving education and employment opportunities for at-risk youth by targeting resources in high poverty areas and incorporating strategies that experts have identified as effective for serving this population. The Department of Labor (the Department) awarded 36 grants…

Qualitative assessment of Diabetes-STAR: a patient portal with disease management functions.

PubMed

Ross, Stephen E; Nowels, Carolyn T; Haverhals, Leah M; Bull, Sheana S; Lin, Chen-Tan; Main, Deborah S

2007-10-11

Diabetes-STAR is a disease management program integrated with an online patient portal. Of 331 patients enrolled in a randomized trial, we interviewed 37 users about benefits, barriers and recommendations for program improvements. User preferences included 1) addressing differences in types of users, 2) sending out alerts when new information is available, and 3) providing more oversight of user diary data.

More Time for Learning: Student Participation in Extended Day Programming at the UCCS Donoghue Campus during the 2009-10 School Year

ERIC Educational Resources Information Center

Lesnick, Joy; Hart, Bonnie; Spielberger, Julie

2011-01-01

The purpose of this study was to examine the participation of students in extended day programming at Donoghue Elementary School, a University of Chicago Charter School, during the 2009-2010 school year and explore whether participation was related to academic performance and improvement. Using the available written records, the authors found that…

Constellation Commodities Studies Summary

NASA Technical Reports Server (NTRS)

Dirschka, Eric

2011-01-01

Constellation program was NASA's long-term program for space exploration. The goal of the commodities studies was to solicit industry expertise in production, storage, and transportation required for future use and to improve efficiency and life cycle cost over legacy methods. Objectives were to consolidate KSC, CCAFS and other requirements; extract available industry expertise; identify commercial opportunities; and establish synergy with State of Florida partnerships. Study results are reviewed.

STX--Fortran-4 program for estimates of tree populations from 3P sample-tree-measurements

Treesearch

L. R. Grosenbaugh

1967-01-01

Describes how to use an improved and greatly expanded version of an earlier computer program (1964) that converts dendrometer measurements of 3P-sample trees to population values in terms of whatever units user desires. Many new options are available, including that of obtaining a product-yield and appraisal report based on regression coefficients supplied by user....

Medical students' perceptions of international accreditation.

PubMed

Ibrahim, Halah; Abdel-Razig, Sawsan; Nair, Satish C

2015-10-11

This study aimed to explore the perceptions of medical students in a developing medical education system towards international accreditation. Applicants to an Internal Medicine residency program in an academic medical center in the United Arab Emirates (UAE) accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I) were surveyed between May and June 2014. The authors analysed responses using inductive qualitative thematic analysis to identify emergent themes. Seventy-eight of 96 applicants (81%) completed the survey. The vast majority of respondents 74 (95%) reported that ACGME-I accreditation was an important factor in selecting a residency program. Five major themes were identified, namely improving the quality of education, increasing opportunities, meeting high international standards, improving program structure, and improving patient care. Seven (10%) of respondents felt they would be in a position to pursue fellowship training or future employment in the United States upon graduation from an ACGME-I program. UAE trainees have an overwhelmingly positive perception of international accreditation, with an emphasis on improving the quality of training provided. Misperceptions, however, exist about potential opportunities available to graduates of ACGME-I programs. As more countries adopt the standards of the ACGME-I or other international accrediting bodies, it is important to recognize and foster trainee "buy-in" of educational reform initiatives.

Predictors of improvement in hemoglobin concentration among toddlers enrolled in the Massachusetts WIC Program.

PubMed

Altucher, Kristine; Rasmussen, Kathleen M; Barden, Elizabeth M; Habicht, Jean-Pierre

2005-05-01

Nutrition supplementation programs are generally targeted to those members of the population who are thought to be at risk of an undesirable outcome, but not all who participate in such programs respond to them. We sought to identify determinants of improvement in hemoglobin concentration among young children in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). We conducted an observational study using data from 9,930 children who were enrolled in the Massachusetts WIC program and had data available on their hemoglobin values at both 1 and 2 years of age. Predictors of change in hemoglobin concentration between these ages were studied using multivariate statistical modeling. Overall, hemoglobin concentrations increased from age 1 to 2 years in those who had been breastfed 25 or more weeks (P < .0001) and were female (P < .01), and decreased with increasing weight at 1 year of age (P < .001). The determinants of change in hemoglobin concentration differed from the determinants of hemoglobin concentration at age 1 year. The analytical approach used here could be extended to identify subgroups of WIC participants likely to improve in other outcomes. If current efforts to increase the duration of breastfeeding among WIC participants are successful, the importance of WIC in improving hemoglobin concentration among young children also will increase.

Medical students’ perceptions of international accreditation

PubMed Central

Abdel-Razig, Sawsan; Nair, Satish C

2015-01-01

Objectives This study aimed to explore the perceptions of medical students in a developing medical education system towards international accreditation. Methods Applicants to an Internal Medicine residency program in an academic medical center in the United Arab Emirates (UAE) accredited by the Accreditation Council for Graduate Medical Education-International (ACGME-I) were surveyed between May and June 2014. The authors analysed responses using inductive qualitative thematic analysis to identify emergent themes. Results Seventy-eight of 96 applicants (81%) completed the survey. The vast majority of respondents 74 (95%) reported that ACGME-I accreditation was an important factor in selecting a residency program. Five major themes were identified, namely improving the quality of education, increasing opportunities, meeting high international standards, improving program structure, and improving patient care. Seven (10%) of respondents felt they would be in a position to pursue fellowship training or future employment in the United States upon graduation from an ACGME-I program. Conclusions UAE trainees have an overwhelmingly positive perception of international accreditation, with an emphasis on improving the quality of training provided. Misperceptions, however, exist about potential opportunities available to graduates of ACGME-I programs. As more countries adopt the standards of the ACGME-I or other international accrediting bodies, it is important to recognize and foster trainee “buy-in” of educational reform initiatives. PMID:26454402

Which Fecal Immunochemical Test Should I Choose?

PubMed Central

Daly, Jeanette M.; Xu, Yinghui; Levy, Barcey T.

2017-01-01

Objectives: To summarize the fecal immunochemical tests (FITs) available in the United States, the 2014 pathology proficiency testing (PT) program FIT results, and the literature related to the test characteristics of FITs available in the United States to detect advanced adenomatous polyps (AAP) and/or colorectal cancer (CRC). Methods: Detailed review of the Food and Drug Administration’s Clinical Laboratory Improvement Amendments (CLIA) database of fecal occult blood tests, the 2014 FIT PT program results, and the literature related to FIT accuracy. Results: A search of the CLIA database identified 65 FITs, with 26 FITs available for purchase in the United States. Thirteen of these FITs were evaluated on a regular basis by PT programs, with an overall sensitivity of 99.1% and specificity of 99.2% for samples spiked with hemoglobin. Automated FITs had better sensitivity and specificity than CLIA-waived FITs for detection of AAP and CRC in human studies using colonoscopy as the gold standard. Conclusion: Although many FITs are available in the United States, few have been tested in proficiency testing programs. Even fewer have data in humans on sensitivity and specificity for AAP or CRC. Our review indicates that automated FITs have the best test characteristics for AAP and CRC. PMID:28447866

Availability of Diagnostic and Treatment Services for Acute Stroke in Frontier Counties in Montana and Northern Wyoming

ERIC Educational Resources Information Center

Okon, Nicholas J.; Rodriguez, Daniel V.; Dietrich, Dennis W.; Oser, Carrie S.; Blades, Lynda L.; Burnett, Anne M.; Russell, Joseph A.; Allen, Martha J.; Chasson, Linda; Helgerson, Steven D.; Gohdes, Dorothy; Harwell, Todd S.

2006-01-01

Context: Rapid diagnosis and treatment of ischemic stroke can lead to improved patient outcomes. Hospitals in rural and frontier counties, however, face unique challenges in providing diagnostic and treatment services for acute stroke. Purpose: The aim of this study was to assess the availability of key diagnostic technology and programs for acute…

Water and climate

NASA Technical Reports Server (NTRS)

Randall, David A.

1994-01-01

The vertical profiles and temperature and moisture in convective regimes were investigated, using moist available energy as a guide. The generalized convective available potential energy observed during the Global Atmosphere Research Program's Atlantic Tropical Experiment (GATE) phase 3 was analyzed. Ice effects were included. The results have been used to develop an improved cumulus parameterization. Several reprints from the Journal of Atmospheric Sciences are appended.

The availability of community health center services and access to medical care.

PubMed

Kirby, James B; Sharma, Ravi

2017-12-01

Community Health Centers (CHCs) funded by Section 330 of the Public Health Service Act are an essential part of the health care safety net in the US. The Patient Protection and Affordable Care Act expanded the program significantly, but the extent to which the availability of CHCs improve access to care in general is not clear. In this paper, we examine the associations between the availability of CHC services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period. We pooled six years of data from the Medical Expenditure Panel Survey (2008-2013) and linked it to geographic data on CHCs from Health Resources and Services Administration's Health Center Program Uniform Data System. We also link other community characteristics from the Area Health Resource File and the Dartmouth Institute's data files. The associations between CHC availability and our access measures are estimated with logistic regression models stratified by insurance status. The availability of CHC services was positively associated with both measures of access among those with no insurance coverage. Additionally, it was positively associated with having a usual source of care among those with Medicaid and private insurance. These findings persist after controlling for key individual- and community-level characteristics. Our findings suggest that an enhanced CHC program could be an important resource for supporting the efficacy of expanded Medicaid coverage under the Affordable Care Act and, ultimately, improving access to quality primary care for underserved Americans. Published by Elsevier Inc.

Influenza in the Asia-Pacific region: Findings and recommendations from the Global Influenza Initiative.

PubMed

Cowling, Benjamin J; Caini, Saverio; Chotpitayasunondh, Tawee; Djauzi, Samsuridjal; Gatchalian, Salvacion R; Huang, Q Sue; Koul, Parvaiz A; Lee, Ping-Ing; Muttalif, Abdul Razak; Plotkin, Stanley

2017-02-07

The fourth roundtable meeting of the Global Influenza Initiative (GII) was held in Hong Kong, China, in July 2015. An objective of this meeting was to gain a broader understanding of the epidemiology, surveillance, vaccination policies and programs, and obstacles to vaccination of influenza in the Asia-Pacific region through presentations of data from Australia, Hong Kong, India, Indonesia, Malaysia, New Zealand, the Philippines, Taiwan, Thailand, and Vietnam. As well as a need for improved levels of surveillance in some areas, a range of factors were identified that act as barriers to vaccination in some countries, including differences in climate and geography, logistical challenges, funding, lack of vaccine awareness and education, safety concerns, perceived lack of vaccine effectiveness, and lack of inclusion in national guidelines. From the presentations at the meeting, the GII discussed a number of recommendations for easing the burden of influenza and overcoming the current challenges in the Asia-Pacific region. These recommendations encompass the need to improve surveillance and availability of epidemiological data; the development and publication of national guidelines, where not currently available and/or that are in line with those proposed by the World Health Organization; the requirement for optimal timing of vaccination programs according to local or country-specific epidemiology; and calls for advocacy and government support of vaccination programs in order to improve availability and uptake and coverage. In conclusion, in addition to the varied epidemiology of seasonal influenza across this diverse region, there are a number of logistical and resourcing issues that present a challenge to the development of optimally effective vaccination strategies and that need to be overcome to improve access to and uptake of seasonal influenza vaccines. The GII has developed a number of recommendations to address these challenges and improve the control of influenza. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of the three-dimensional parabolic flow computer program SHIP

NASA Technical Reports Server (NTRS)

Pan, Y. S.

1978-01-01

The three-dimensional parabolic flow program SHIP designed for predicting supersonic combustor flow fields is evaluated to determine its capabilities. The mathematical foundation and numerical procedure are reviewed; simplifications are pointed out and commented upon. The program is then evaluated numerically by applying it to several subsonic and supersonic, turbulent, reacting and nonreacting flow problems. Computational results are compared with available experimental or other analytical data. Good agreements are obtained when the simplifications on which the program is based are justified. Limitations of the program and the needs for improvement and extension are pointed out. The present three dimensional parabolic flow program appears to be potentially useful for the development of supersonic combustors.

Patient Protection and Affordable Care Act; HHS notice of benefit and payment parameters for 2016. Final rule.

PubMed

2015-02-27

This final rule sets forth payment parameters and provisions related to the risk adjustment, reinsurance, and risk corridors programs; cost sharing parameters and cost-sharing reductions; and user fees for Federally-facilitated Exchanges. It also finalizes additional standards for the individual market annual open enrollment period for the 2016 benefit year, essential health benefits, qualified health plans, network adequacy, quality improvement strategies, the Small Business Health Options Program, guaranteed availability, guaranteed renewability, minimum essential coverage, the rate review program, the medical loss ratio program, and other related topics.

Implementing a successful senior/geriatric health care program for veterinarians, veterinary technicians, and office managers.

PubMed

Fortney, William D

2012-07-01

Geriatrics and gerontology have emerged as one of the fastest growing portions of a progressive small animal practice. A critical component of geriatric medicine is a senior/geriatric health care program with senior profiling. Fifty percent of small animal practices have some form of senior/geriatric health care program and the percentage is growing. Armed with the knowledge gleaned from a successful health care program, the progressive veterinarian is better positioned to prevent and/or manage problems in the earliest stages, increasing the options available plus improving the overall outcome.

Professional pilots' views of alcohol use in aviation and the effectiveness of employee-assistance programs.

PubMed

Ross, S M; Ross, L E

1995-01-01

Pilots holding the Airline Transport Pilot certificate were surveyed about the seriousness of the alcohol problem in various areas of aviation and about the importance of a number of possible reasons why a pilot might drink and fly. They also rated a number of actions in terms of their potential effectiveness for reducing inappropriate alcohol use, and they evaluated a number of characteristics of employee-assistance programs. Respondents judged employee-assistance programs to be the best way to reduce problem drinking. They also identified areas in which currently available employee-assistance programs could be improved.

Improving environmental and social targeting through adaptive management in Mexico's payments for hydrological services program.

PubMed

Sims, Katharine R E; Alix-Garcia, Jennifer M; Shapiro-Garza, Elizabeth; Fine, Leah R; Radeloff, Volker C; Aronson, Glen; Castillo, Selene; Ramirez-Reyes, Carlos; Yañez-Pagans, Patricia

2014-10-01

Natural resource managers are often expected to achieve both environmental protection and economic development even when there are fundamental trade-offs between these goals. Adaptive management provides a theoretical structure for program administrators to balance social priorities in the presence of trade-offs and to improve conservation targeting. We used the case of Mexico's federal Payments for Hydrological Services program (PSAH) to illustrate the importance of adaptive management for improving program targeting. We documented adaptive elements of PSAH and corresponding changes in program eligibility and selection criteria. To evaluate whether these changes resulted in enrollment of lands of high environmental and social priority, we compared the environmental and social characteristics of the areas enrolled in the program with the characteristics of all forested areas in Mexico, all areas eligible for the program, and all areas submitted for application to the program. The program successfully enrolled areas of both high ecological and social priority, and over time, adaptive changes in the program's criteria for eligibility and selection led to increased enrollment of land scoring high on both dimensions. Three factors facilitated adaptive management in Mexico and are likely to be generally important for conservation managers: a supportive political environment, including financial backing and encouragement to experiment from the federal government; availability of relatively good social and environmental data; and active participation in the review process by stakeholders and outside evaluators. © 2014 Society for Conservation Biology.

Pesticide Program Dialogue Committee: Public Health Working Group

EPA Pesticide Factsheets

EPA formed this workgroup to assist in meeting its long-term goal of creating a publically-available framework that improves the reporting, quality and efficient use of pesticide incident data to ensure high-quality, science-based pesticide decisions.

Cape Cod National Seashore parking management system pilot synthesis

DOT National Transportation Integrated Search

2013-12-27

The Cape Cod National Seashore (CACO) has undertaken a program to improve parking management at its beach parking lots, and to provide information about parking availability to CACO visitors. This project will build upon work already accomplished, to...

Broadcast control of air traffic

NASA Technical Reports Server (NTRS)

Litchford, G. B.

1972-01-01

Applications of wide range broadcast procedures to improve air traffic control and make more airspace available are discussed. A combination of the Omega navigation system and the very high frequency omnirange (VOR) is recommended as a means for accomplishing improved air traffic control. The benefits to be derived by commercial and general aviation are described. The air/ground communications aspects of the improved air traffic control system are explained. Research and development programs for implementing the broadcast concept are recommended.

Peer review, program officers and science funding.

PubMed

Roebber, Paul J; Schultz, David M

2011-04-12

Increased competition for research funding has led to growth in proposal submissions and lower funding-success rates. An agent-based model of the funding cycle, accounting for variations in program officer and reviewer behaviors, for a range of funding rates, is used to assess the efficiency of different proposal-submission strategies. Program officers who use more reviewers and require consensus can improve the chances of scientists submitting fewer proposals. Selfish or negligent reviewers reduce the effectiveness of submitting more proposals, but have less influence as available funding declines. Policies designed to decrease proposal submissions reduce reviewer workload, but can lower the quality of funded proposals. When available funding falls below 10-15% in this model, the most effective strategy for scientists to maintain funding is to submit many proposals.

Institutional shared resources and translational cancer research.

PubMed

De Paoli, Paolo

2009-06-29

The development and maintenance of adequate shared infrastructures is considered a major goal for academic centers promoting translational research programs. Among infrastructures favoring translational research, centralized facilities characterized by shared, multidisciplinary use of expensive laboratory instrumentation, or by complex computer hardware and software and/or by high professional skills are necessary to maintain or improve institutional scientific competitiveness. The success or failure of a shared resource program also depends on the choice of appropriate institutional policies and requires an effective institutional governance regarding decisions on staffing, existence and composition of advisory committees, policies and of defined mechanisms of reporting, budgeting and financial support of each resource. Shared Resources represent a widely diffused model to sustain cancer research; in fact, web sites from an impressive number of research Institutes and Universities in the U.S. contain pages dedicated to the SR that have been established in each Center, making a complete view of the situation impossible. However, a nation-wide overview of how Cancer Centers develop SR programs is available on the web site for NCI-designated Cancer Centers in the U.S., while in Europe, information is available for individual Cancer centers. This article will briefly summarize the institutional policies, the organizational needs, the characteristics, scientific aims, and future developments of SRs necessary to develop effective translational research programs in oncology.In fact, the physical build-up of SRs per se is not sufficient for the successful translation of biomedical research. Appropriate policies to improve the academic culture in collaboration, the availability of educational programs for translational investigators, the existence of administrative facilitations for translational research and an efficient organization supporting clinical trial recruitment and management represent essential tools, providing solutions to overcome existing barriers in the development of translational research in biomedical research centers.

Fresh Fruit and Vegetable Program participation in elementary schools in the United States and availability of fruits and vegetables in school lunch meals.

PubMed

Ohri-Vachaspati, Punam; Turner, Lindsey; Chaloupka, Frank J

2012-06-01

Dietary intake among children in the United States falls short of national recommendations. Schools can play an important role in improving children's preferences and food consumption patterns. The US Department of Agriculture's Fresh Fruit and Vegetable Program (FFVP) aims to improve children's nutrient intake patterns by offering fresh fruits and vegetables as snacks outside the reimbursable meals programs in elementary schools that serve large numbers of low-income children. Using a nationally representative sample of public elementary schools, this cross-sectional study investigated FFVP participation patterns among schools by demographic and school characteristics. Further, the study investigated the association between FFVP participation and availability of fresh fruits, salads, and vegetables at lunch as reported by school administrators and foodservice staff. Data collected via a mail-back survey from 620 public elementary schools participating in the National School Lunch Program during 2009-2010 were analyzed. Almost 70% of the FFVP-participating schools had a majority of students (>50%) eligible for free and reduced-cost meals. Participating in US Department of Agriculture Team Nutrition Program and having a registered dietitian or a nutritionist on staff were significantly associated with FFVP participation. Based on the results from logistic regression analyses schools participating in the FFVP were significantly more likely (odds ratio 2.07; 95% CI 1.12 to 3.53) to serve fresh fruit during lunch meals. Slightly >25% of public elementary schools across the United States participated in the FFVP, and participation was associated with healthier food availability in school lunches. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Institutional shared resources and translational cancer research

PubMed Central

De Paoli, Paolo

2009-01-01

The development and maintenance of adequate shared infrastructures is considered a major goal for academic centers promoting translational research programs. Among infrastructures favoring translational research, centralized facilities characterized by shared, multidisciplinary use of expensive laboratory instrumentation, or by complex computer hardware and software and/or by high professional skills are necessary to maintain or improve institutional scientific competitiveness. The success or failure of a shared resource program also depends on the choice of appropriate institutional policies and requires an effective institutional governance regarding decisions on staffing, existence and composition of advisory committees, policies and of defined mechanisms of reporting, budgeting and financial support of each resource. Shared Resources represent a widely diffused model to sustain cancer research; in fact, web sites from an impressive number of research Institutes and Universities in the U.S. contain pages dedicated to the SR that have been established in each Center, making a complete view of the situation impossible. However, a nation-wide overview of how Cancer Centers develop SR programs is available on the web site for NCI-designated Cancer Centers in the U.S., while in Europe, information is available for individual Cancer centers. This article will briefly summarize the institutional policies, the organizational needs, the characteristics, scientific aims, and future developments of SRs necessary to develop effective translational research programs in oncology. In fact, the physical build-up of SRs per se is not sufficient for the successful translation of biomedical research. Appropriate policies to improve the academic culture in collaboration, the availability of educational programs for translational investigators, the existence of administrative facilitations for translational research and an efficient organization supporting clinical trial recruitment and management represent essential tools, providing solutions to overcome existing barriers in the development of translational research in biomedical research centers. PMID:19563639

The Impact of a Civic Service Program on Biopsychosocial Outcomes of Post 9/11 U.S. Military Veterans

PubMed Central

Matthieu, Monica M.; Lawrence, Karen A.; Robertson-Blackmore, Emma

2017-01-01

Volunteering as a health promotion intervention, improves physical health, mental health, and social outcomes particularly in older adults, yet limited research exists for veterans. We conducted a preliminary study to explore whether volunteering impacts a variety of biopsychosocial outcomes, including symptoms of post-traumatic stress disorder (PTSD) and depression, among returning military veterans from Iraq and Afghanistan. A survey enrolling a prospective cohort of United States (U.S.) veterans who served in the military after 11 September 2001 and who participated in a national civic service program was conducted. A total of 346 veterans completed standardized health, mental health, and psychosocial self-report measures before and after the program. Statistically significant differences were detected in overall health rating, level of emotional difficulty, PTSD and depression symptoms, purpose in life, self-efficacy, social isolation, and the perceived availability of social support at program completion. Screening positive for probable PTSD predicted improved perceived self-efficacy while probable depression predicted a decrease in loneliness, an increase in purpose in life, and an increase in perceived social support, at program completion. Volunteering was associated with significant improvements in health, mental health and social outcomes in returning veterans. PMID:28039802

NASA high performance computing and communications program

NASA Technical Reports Server (NTRS)

Holcomb, Lee; Smith, Paul; Hunter, Paul

1993-01-01

The National Aeronautics and Space Administration's HPCC program is part of a new Presidential initiative aimed at producing a 1000-fold increase in supercomputing speed and a 100-fold improvement in available communications capability by 1997. As more advanced technologies are developed under the HPCC program, they will be used to solve NASA's 'Grand Challenge' problems, which include improving the design and simulation of advanced aerospace vehicles, allowing people at remote locations to communicate more effectively and share information, increasing scientist's abilities to model the Earth's climate and forecast global environmental trends, and improving the development of advanced spacecraft. NASA's HPCC program is organized into three projects which are unique to the agency's mission: the Computational Aerosciences (CAS) project, the Earth and Space Sciences (ESS) project, and the Remote Exploration and Experimentation (REE) project. An additional project, the Basic Research and Human Resources (BRHR) project exists to promote long term research in computer science and engineering and to increase the pool of trained personnel in a variety of scientific disciplines. This document presents an overview of the objectives and organization of these projects as well as summaries of individual research and development programs within each project.

The AAHA Computer Program. American Animal Hospital Association.

PubMed

Albers, J W

1986-07-01

The American Animal Hospital Association Computer Program should benefit all small animal practitioners. Through the availability of well-researched and well-developed certified software, veterinarians will have increased confidence in their purchase decisions. With the expansion of computer applications to improve practice management efficiency, veterinary computer systems will further justify their initial expense. The development of the Association's veterinary computer network will provide a variety of important services to the profession.

Defense Acquisitions: Assessments of Selected Weapon Programs

DTIC Science & Technology

2010-03-01

improved availability for small terminals. It is to replace the Ultra High Frequency (UHF) Follow-On ( UFO ) satellite system currently in operation...of MUOS capabilities is time-critical due to the operational failures of two UFO satellites. The MUOS program has taken several steps to address...failures of two UFO satellites. Based on the current health of on-orbit satellites, UHF communication capabilities are predicted to fall below the

Pulmonary Rehabilitation: Improvement with Movement.

PubMed

Rajagopal, Anita; Casaburi, Richard

2016-01-15

This article serves as a CME- available, enduring material summary of the following COPD9 USA presentations: - "Lessons Learned from Pulmonary Education Program and On Track with COPD Ongoing Health Management." Presenter : Scott Cerreta, BS, RRT - "Cultivating Memorial Funds for Pulmonary Rehabilitation" Presenter : Valerie McLeod, RRT - "Strategies for Success: Maintenance Program Best Practices" Presenter : David Vines, MHS, RRT - "Strategies for Success-Maximizing Participation and Completion Rates," Presenter : Trina M. Limberg, BS, RRT.

Evaluation of a program to increase evidence-based practice change.

PubMed

Larrabee, June H; Sions, Jacqueline; Fanning, Mary; Withrow, Mary Lynne; Ferretti, Andrea

2007-06-01

The study evaluated a nursing research program designed to achieve systematic evidence-based practice change. Specifically, change in nurse attitudes about use of research and research conduct, practice change projects, and nurse participation in research-related activities were evaluated. Evidence indicates that successful evidence-based practice change in an organization requires senior leadership support and a systematic program for practice change. Evaluation of program effectiveness provides evidence about opportunities for further improvement. Quantitative evaluation used a pretest-posttest design. The site was an academic medical center in rural West Virginia. Participants were registered nurses from all inpatients units, perioperative services, and emergency departments. Surveys used Alcock et al's Staff Nurses and Research Activities scale. Descriptive evaluation included the number of nurses who attended the workshop, practice change projects, scholarly products disseminated, and outcome of a Magnet review. First, knowledge about the availability of support services increased between 1999 and 2002 and was associated with higher attitude scores about research and research utilization. Second, registered nurses who reported participating in research-related activities had more positive scores on all attitudes than registered nurses who reported not participating. Nurse leaders may improve participation and attitudes about research and research utilization by internally marketing the support available for research-related activities.

High-reliability gas-turbine combined-cycle development program: Phase II. Final report

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

Hecht, K.G.; Sanderson, R.A.; Smith, M.J.

This three-volume report presents the results of Phase II of the multiphase EPRI-sponsored High-Reliability Gas Turbine Combined-Cycle Development Program whose goal is to achieve a highly reliable gas turbine combined-cycle power plant, available by the mid-1980s, which would be an economically attractive baseload generation alternative for the electric utility industry. The Phase II program objective was to prepare the preliminary design of this power plant. This volume presents information of the reliability, availability, and maintainability (RAM) analysis of a representative plant and the preliminary design of the gas turbine, the gas turbine ancillaries, and the balance of plant including themore » steam turbine generator. To achieve the program goals, a gas turbine was incorporated which combined proven reliability characteristics with improved performance features. This gas turbine, designated the V84.3, is the result of a cooperative effort between Kraftwerk Union AG and United Technologies Corporation. Gas turbines of similar design operating in Europe under baseload conditions have demonstrated mean time between failures in excess of 40,000 hours. The reliability characteristics of the gas turbine ancillaries and balance-of-plant equipment were improved through system simplification and component redundancy and by selection of component with inherent high reliability. A digital control system was included with logic, communications, sensor redundancy, and mandual backup. An independent condition monitoring and diagnostic system was also included. Program results provide the preliminary design of a gas turbine combined-cycle baseload power plant. This power plant has a predicted mean time between failure of nearly twice the 3000-hour EPRI goal. The cost of added reliability features is offset by improved performance, which results in a comparable specific cost and an 8% lower cost of electricity compared to present market offerings.« less

Needs assessment and implementation of an employee assistance program: promoting a healthier work force.

PubMed

Monfils, M K

1995-05-01

1. The functions of a continuous quality improvement tool used by Deming--the Plan, Do, Check, Act Cycle--can be applied to the assessment, implementation, and ongoing evaluation of an Employee Assistance Program (EAP). 2. Various methods are available to assess the need for an EAP. As much data as possible should be collected to qualify and quantify the need so that management can make an informed decision and develop measures to determine program effectiveness. 3. Once an EAP is implemented, it should be monitored continually against the effectiveness measures initially developed. Using a continuous quality improvement process, the occupational health nurse and the EAP provider can establish a dynamic relationship that allows for growth beyond the original design and increased effectiveness of service to employees.

Pediatric emergency care capacity in a low-resource setting: An assessment of district hospitals in Rwanda.

PubMed

Hategeka, Celestin; Shoveller, Jean; Tuyisenge, Lisine; Kenyon, Cynthia; Cechetto, David F; Lynd, Larry D

2017-01-01

Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+)-a locally adapted pediatric advanced life support management program-in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management. The results of the study will shed light on the resources and support that are currently available to implement ETAT+, which aims to improve care for severely ill infants and children. A cross-sectional survey was undertaken in eight district hospitals across Rwanda focusing on the availability of physical and human resources, as well as hospital services organizations to provide emergency triage, assessment and treatment plus admission care for severely ill infants and children. Many of essential resources deemed necessary for the provision of emergency care for severely ill infants and children were readily available (e.g. drugs and laboratory services). However, only 4/8 hospitals had BVM for newborns; while nebulizer and MDI were not available in 2/8 hospitals. Only 3/8 hospitals had F-75 and ReSoMal. Moreover, there was no adequate triage system across any of the hospitals evaluated. Further, guidelines for neonatal resuscitation and management of malaria were available in 5/8 and in 7/8 hospitals, respectively; while those for child resuscitation and management of sepsis, pneumonia, dehydration and severe malnutrition were available in less than half of the hospitals evaluated. Our assessment provides evidence to inform new strategies to enhance the capacity of Rwandan district hospitals to provide pediatric advanced life support management. Identifying key gaps in the health care system is required in order to facilitate the implementation and scale up of ETAT+ in Rwanda. These findings also highlight a need to establish an outreach/mentoring program, embedded within the ongoing ETAT+ program, to promote cross-hospital learning exchanges.

Alberta: evaluation of nursing retention and recruitment programs.

PubMed

Weidner, Arlene; Graham, Carol; Smith, Jennifer; Aitken, Julia; Odell, Jill

2012-03-01

Retention and recruitment strategies are essential to address nursing workforce supply and ensure the viability of healthcare delivery in Canada. Knowledge transfer between experienced nurses and those new to the profession is also a focus for concern. The Multi-Employer/United Nurses of Alberta Joint Committee attempted to address these issues by introducing a number of retention and recruitment (R&R) initiatives for nurses in Alberta: in total, seven different programs that were introduced to some 24,000 nurses and employers across the province of Alberta in 2001 (the Transitional Graduate Nurse Recruitment Program) and 2007 (the remaining six R&R programs). Approximately 1,600 nurses participated in the seven programs between 2001 and 2009. Of the seven strategies, one supported entry into the workplace, two were pre-retirement strategies and four involved flexible work options. This project entailed a retrospective evaluation of the seven programs and differed from the other Research to Action (RTA) projects because it was solely concerned with evaluation of pre-existing initiatives. All seven programs were launched without a formal evaluation component, and the tracking of local uptake varied throughout the province. The union and various employers faced challenges in implementing these strategies in a timely fashion, as most were designed at the bargaining table during negotiations. As a result, systems, policy and procedural changes had to be developed to support their implementation after they became available.Participants in the programs indicated improvements over time in several areas, including higher levels of satisfaction with work–life balance, hours worked and their current practice and profession. The evaluation found that participation led to perceived improvements in nurses' confidence, greater control over their work environment, decreased stress levels, increased energy and morale and perceived improved ability to provide high-quality care. However, no formal implementation plan had been developed or made available to assist employers with implementation of the programs. The findings highlight the need for more discipline in communicating, implementing and evaluating initiatives such as those evaluated retrospectively in this project. In particular, key performance indicators, baseline data, monitoring mechanisms and an evaluation plan need to be developed prior to implementation.

What are the determinants of food security among regional and remote Western Australian children?

PubMed

Godrich, Stephanie L; Davies, Christina R; Darby, Jill; Devine, Amanda

2017-01-22

To explore how determinants of food security affect children in regional and remote Western Australia (WA), across food availability, access and utilisation dimensions. The Determinants of Food Security framework guided the thematic analysis (using NVivo 10) of semi-structured interviews with 20 key informants. Food availability factors included availability, price, promotion, quality, location of outlets and variety. Food access factors included social support, financial resources, transport to food outlets, distance to food outlets and mobility. Food utilisation factors included nutrition knowledge and skills, children's food preferences, storage facilities, preparation and cooking facilities and time to purchase food. Key food availability recommendations include increasing local food supply options. Food access recommendations include ensuring equitable formal social support and empowering informal support options. Food utilisation recommendations include prioritising food literacy programs focusing on quick, healthy food preparation and budgeting skills. Implications for public health: Policymakers should invest in local food supply options, equitable social support services and experiential food literacy programs. Practitioners should focus child/parent programs on improving attitude, knowledge and skills. © 2017 Public Health Association of Australia.

Education of the modern surgical resident: novel approaches to learning in the era of the 80-hour workweek.

PubMed

Nguyen, Liz; Brunicardi, F Charles; Dibardino, Daniel J; Scott, Bradford G; Awad, Samir S; Bush, Ruth L; Brandt, Mary L

2006-06-01

Implementation of the 80-hour work week has resulted in limitations on the hours available for resident education, creating a need for innovative approaches to teach surgical residents successfully. Herein we report the methods and results of an innovative didactic learning program at a large academic surgical residency program. Between 2004 and 2005, based on known principles of adult education and innovative learning techniques, a didactic learning program was instituted in a major academic surgery program. The course work consisted of a structured reading program using Schwartz's Textbook of Surgery, with weekly testing and problem-based learning (PBL) groups led by surgical faculty. The residents' progress was assessed by American Board of Surgery In-Training Examination (ABSITE) training scores before and after program implementation. A resident survey was also conducted to assess residents' attitudes toward the new program. Results were reported as a mean, and categoric variables were compared using a paired Student's t-test. During the academic year of the structured reading program, the mean ABSITE score improved by 10% (P=0.02) from the previous year. The postgraduate year 4 class had the largest change, with a score increase of 17% over the previous year's performance (P=0.02). Survey results demonstrated that 64% of the responders agreed that the small-group PBL was preferable for achieving educational goals. Furthermore, 89% of residents responded that the PBL groups improved interaction between residents and faculty members. An innovative formal learning program based on a major surgical textbook with weekly testing and small group sessions can significantly improve surgical training in the modern era of work-hour restrictions. Furthermore, surgical trainees find this format to be innovative and useful for improving didactic teaching.

Building capacity for water, sanitation, and hygiene programming: Training evaluation theory applied to CLTS management training in Kenya.

PubMed

Crocker, Jonny; Shields, Katherine F; Venkataramanan, Vidya; Saywell, Darren; Bartram, Jamie

2016-10-01

Training and capacity building are long established critical components of global water, sanitation, and hygiene (WaSH) policies, strategies, and programs. Expanding capacity building support for WaSH in developing countries is one of the targets of the Sustainable Development Goals. There are many training evaluation methods and tools available. However, training evaluations in WaSH have been infrequent, have often not utilized these methods and tools, and have lacked rigor. We developed a conceptual framework for evaluating training in WaSH by reviewing and adapting concepts from literature. Our framework includes three target outcomes: learning, individual performance, and improved programming; and two sets of influences: trainee and context factors. We applied the framework to evaluate a seven-month community-led total sanitation (CLTS) management training program delivered to 42 government officials in Kenya from September 2013 to May 2014. Trainees were given a pre-training questionnaire and were interviewed at two weeks and seven months after initial training. We qualitatively analyzed the data using our conceptual framework. The training program resulted in trainees learning the CLTS process and new skills, and improving their individual performance through application of advocacy, partnership, and supervision soft skills. The link from trainees' performance to improved programming was constrained by resource limitations and pre-existing rigidity of trainees' organizations. Training-over-time enhanced outcomes and enabled trainees to overcome constraints in their work. Training in soft skills is relevant to managing public health programs beyond WaSH. We make recommendations on how training programs can be targeted and adapted to improve outcomes. Our conceptual framework can be used as a tool both for planning and evaluating training programs in WaSH. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Improving the Performance of AI Algorithms.

DTIC Science & Technology

1987-09-01

favorably -6 influenced by s uch progranmning practices as the intellige +nt selt,(-rion .%V ’%. ot’ data formats; to) minimize th~e n,,-ed for...GROUP SUB-GROUP Artifcial Intelgence (Al) Algorithms, Improving Software .’ u- 12 05 Performance, Program Behavior, Predicting Performance, % 12 07...tions in communications, threat assessment, res(orce availability, and so forth. This need for intelligent and adaptable behavior indicates that the

DOD Service Acquisition: Improved Use of Available Data Needed to Better Manage and Forecast Service Contract Requirements

DTIC Science & Technology

2016-02-01

Requirements Report to Congressional Committees February 2016 GAO-16-119 United States Government Accountability Office United States...Government Accountability Office Highlights of GAO-16-119, a report to congressional committees February 2016 DOD SERVICE ACQUISITION Improved... Definitions 12 Figures Figure 1: DOD’s Planning, Programming, Budgeting, and Execution (PPBE) Process for Determining Requirements and Allocating

How can Multi-Professional Education Support Better Stewardship?

PubMed Central

Pereira, Nuno Rocha; Castro-Sanchez, Enrique; Nathwani, Dilip

2017-01-01

Antimicrobial stewardship is widely accepted as an efficient strategy to combat the growing threat of antimicrobial resistance. Education is one of the cornerstones of successful antimicrobial stewardship programs. There is also general agreement that antimicrobial stewardship is a team effort that must involve the whole continuum of healthcare workers. Providing adequate education for all different professionals although challenging is deemed crucial to achieve good results. This paper reviews the different strategies available to educate the multiple healthcare workers, discusses how education can improve antimicrobial stewardship programs and outlines some of the challenges faced and research gaps that need to be addressed in order to improve education in this field. PMID:28458801

Improved NASA-ANOPP Noise Prediction Computer Code for Advanced Subsonic Propulsion Systems. Volume 2; Fan Suppression Model Development

NASA Technical Reports Server (NTRS)

Kontos, Karen B.; Kraft, Robert E.; Gliebe, Philip R.

1996-01-01

The Aircraft Noise Predication Program (ANOPP) is an industry-wide tool used to predict turbofan engine flyover noise in system noise optimization studies. Its goal is to provide the best currently available methods for source noise prediction. As part of a program to improve the Heidmann fan noise model, models for fan inlet and fan exhaust noise suppression estimation that are based on simple engine and acoustic geometry inputs have been developed. The models can be used to predict sound power level suppression and sound pressure level suppression at a position specified relative to the engine inlet.

The long-term impacts of group treatment for partner abuse.

PubMed

Mcgregor, Marla; Tutty, Leslie M; Babins-Wagner, Robbie; Gill, Marlyn

2002-01-01

This paper evaluates Responsible Choices for Men, a 14-week therapy group for abusive men based on feminist perspectives using narrative methods. Pre-test and post-test information was available for 76 program completers measuring physical and non-physical abuse, self-esteem, perceived stress, family relations, depression, assertiveness, and sex-role beliefs. The men significantly improved on all variables. A further focus was following up with 22 group members, contacted 5 to 28 months post treatment and asked to complete the same measures. The results indicated not only maintenance of the post-group changes, but continued improvement. Clinical implications and recommendations for group programming with abusive men are presented.

Active video gaming to improve balance in the elderly.

PubMed

Lamoth, Claudine J C; Caljouw, Simone R; Postema, Klaas

2011-01-01

The combination of active video gaming and exercise (exergaming) is suggested to improve elderly people's balance, thereby decreasing fall risk. Exergaming has been shown to increase motivation during exercise therapy, due to the enjoyable and challenging nature, which could support long-term adherence for exercising balance. However, scarce evidence is available of the direct effects of exergaming on postural control. Therefore, the aim of the study was to assess the effect of a six-week videogame-based exercise program aimed at improving balance in elderly people. Task performance and postural control were examined using an interrupted time series design. Results of multilevel analyses showed that performance on the dot task improved within the first two weeks of training. Postural control improved during the intervention. After the intervention period task performance and balance were better than before the intervention. Results of this study show that healthy elderly can benefit from a videogame-based exercise program to improve balance and that all subjects were highly motivated to exercise balance because they found gaming challenging and enjoyable.

A case study of quality improvement methods for complex adaptive systems applied to an academic hepatology program.

PubMed

Fontanesi, John; Martinez, Anthony; Boyo, Toritsesan O; Gish, Robert

2015-01-01

Although demands for greater access to hepatology services that are less costly and achieve better outcomes have led to numerous quality improvement initiatives, traditional quality management methods may be inappropriate for hepatology. We empirically tested a model for conducting quality improvement in an academic hepatology program using methods developed to analyze and improve complex adaptive systems. We achieved a 25% increase in volume using 15% more clinical sessions with no change in staff or faculty FTEs, generating a positive margin of 50%. Wait times for next available appointments were reduced from five months to two weeks; unscheduled appointment slots dropped from 7% to less than 1%; "no-show" rates dropped to less than 10%; Press-Ganey scores increased to the 100th percentile. We conclude that framing hepatology as a complex adaptive system may improve our understanding of the complex, interdependent actions required to improve quality of care, patient satisfaction, and cost-effectiveness.

Report: Improved Management of the Brownfields Revolving Loan Fund Program Is Required to Maximize Cleanups

EPA Pesticide Factsheets

Report #17-P-0368, August 23, 2017. For 10 of the 20 closed Brownfields RLF cooperative agreements reviewed, approximately $10.9 million available to clean up brownfields is not being used as intended.

IMPROVING AIR QUALITY THROUGH ENVIRONMENTAL TECHNOLOGY VERIFICATIONS

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) began the Environmental Technology Verification (ETV) Program in 1995 as a means of working with the private sector to establish a market-based verification process available to all environmental technologies. Under EPA's Office of R...

Evidence-Based Medicine and State Health Care Coverage: The Washington Health Technology Assessment Program.

PubMed

Rothman, David J; Blackwood, Kristy L; Adair, Whitney; Rothman, Sheila M

2018-04-01

To evaluate the Washington State Health Technology Assessment Program (WHTAP). Washington State Health Technology Assessment Program proceedings in Seattle, Washington. We assessed the program through observation of its proceedings over a 5-year period, 2009-2014. We conducted detailed analyses of the documents it produced and reviewed relevant literature. Washington State Health Technology Assessment Program is unique compared to other state and federal programs. It has successfully applied evidence-based medicine to health care decision making, limited by the strength of available data. It claims cost savings, but they are not substantiated. Washington State Health Technology Assessment Program is a useful model for other states considering implementation of technology assessment programs. We provide key lessons for improving WHTAP's process. © Health Research and Educational Trust.

DeepSig: deep learning improves signal peptide detection in proteins.

PubMed

Savojardo, Castrense; Martelli, Pier Luigi; Fariselli, Piero; Casadio, Rita

2018-05-15

The identification of signal peptides in protein sequences is an important step toward protein localization and function characterization. Here, we present DeepSig, an improved approach for signal peptide detection and cleavage-site prediction based on deep learning methods. Comparative benchmarks performed on an updated independent dataset of proteins show that DeepSig is the current best performing method, scoring better than other available state-of-the-art approaches on both signal peptide detection and precise cleavage-site identification. DeepSig is available as both standalone program and web server at https://deepsig.biocomp.unibo.it. All datasets used in this study can be obtained from the same website. pierluigi.martelli@unibo.it. Supplementary data are available at Bioinformatics online.

Dissemination and implementation science in program evaluation: A telemental health clinical consultation case example.

PubMed

Arora, Prerna G; Connors, Elizabeth H; Blizzard, Angela; Coble, Kelly; Gloff, Nicole; Pruitt, David

2017-02-01

Increased attention has been placed on evaluating the extent to which clinical programs that support the behavioral health needs of youth have effective processes and result in improved patient outcomes. Several theoretical frameworks from dissemination and implementation (D&I) science have been put forth to guide the evaluation of behavioral health program implemented in the context of real-world settings. Although a strong rationale for the integration of D&I science in program evaluation exists, few examples exist available to guide the evaluator in integrating D&I science in the planning and execution of evaluation activities. This paper seeks to inform program evaluation efforts by outlining two D&I frameworks and describing their integration in program evaluation design. Specifically, this paper seeks to support evaluation efforts by illustrating the use of these frameworks via a case example of a telemental health consultation program in pediatric primary care designed to improve access to behavioral health care for children and adolescents in rural settings. Lessons learned from this effort, as well as recommendations regarding the future evaluation of programs using D&I science to support behavioral health care in community-based settings are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Applications Integration Strategy in the Mission Development Process

NASA Astrophysics Data System (ADS)

Cox, E. L., Jr.

2016-12-01

NASA's Earth Science Applied Science Program has worked for the past four to five years with the Earth Science Division's Flight Program to cultivate an understanding of the importance of satellite remote sensing impacts on decision-making policy and decision support tools utilized by academia, state and local governments, other government agencies, private sector companies, and non-profit organizations. It has long been recognized that applications projects and studies in areas such as Health and Air Quality, Water Resources, Disasters, and Ecological Forecasting, have benefited and been enhanced through the use of satellite remote sensing. Applications researchers often use remote sensing data once it becomes available after the post-launch evaluation phase in the format and level of fidelity that is available. The results from the many applications projects, over the years, have been significant and there are countless examples of improvements and enhancements to operational systems and decision-making policies in the Applied Sciences community. However, feedback received from the applications community regarding the need for improved data availability and latency; processing and formatting, to name a few, prompted the idea of applied science involvement early in the life cycle of mission development. Over time, the Applied Science Program personnel have learned a great deal from the flight mission development life cycle process and recognized key areas of alignment. This presentation will discuss specific aspects of applied science that investigators should consider when proposing to future announcements involving an applications dimension. The Program's experience with user community needs, decision-making requirements, and stakeholder operations requirements will be highlighted.

The Stop Transmission of Polio Data Management (STOP DM) assignment and its role in polio eradication and immunization data improvement in Africa

PubMed Central

Benke, Amalia; Williams, Alford Joseph; MacNeil, Adam

2017-01-01

The availability and use of high quality immunization and surveillance data are crucial for monitoring all components of the Global Polio Eradication Program (GPEI). The Stop Transmission of Polio (STOP) program was initiated in 1999 to train and mobilize human resources to provide technical support to polio endemic and at-risk countries and in 2002 the STOP data management (STOP DM) deployment was created to provide capacity development in the area of data management for immunization and surveillance data for these countries. Since 2002, Africa has received the majority of support from the STOP DM program, with almost 80% of assignments being placed in African countries. The STOP DM program has played a valuable role in improving the quality and use of data for the GPEI and has increasingly supported other immunization program data needs. In this report we provide an overview of the history, current status, and future of the STOP DM program, with a specific focus on the African continent. PMID:29296155

The Stop Transmission of Polio Data Management (STOP DM) assignment and its role in polio eradication and immunization data improvement in Africa.

PubMed

Benke, Amalia; Williams, Alford Joseph; MacNeil, Adam

2017-01-01

The availability and use of high quality immunization and surveillance data are crucial for monitoring all components of the Global Polio Eradication Program (GPEI). The Stop Transmission of Polio (STOP) program was initiated in 1999 to train and mobilize human resources to provide technical support to polio endemic and at-risk countries and in 2002 the STOP data management (STOP DM) deployment was created to provide capacity development in the area of data management for immunization and surveillance data for these countries. Since 2002, Africa has received the majority of support from the STOP DM program, with almost 80% of assignments being placed in African countries. The STOP DM program has played a valuable role in improving the quality and use of data for the GPEI and has increasingly supported other immunization program data needs. In this report we provide an overview of the history, current status, and future of the STOP DM program, with a specific focus on the African continent.

Application of the docking program SOL for CSAR benchmark.

PubMed

Sulimov, Alexey V; Kutov, Danil C; Oferkin, Igor V; Katkova, Ekaterina V; Sulimov, Vladimir B

2013-08-26

This paper is devoted to results obtained by the docking program SOL and the post-processing program DISCORE at the CSAR benchmark. SOL and DISCORE programs are described. SOL is the original docking program developed on the basis of the genetic algorithm, MMFF94 force field, rigid protein, precalculated energy grid including desolvation in the frame of simplified GB model, vdW, and electrostatic interactions and taking into account the ligand internal strain energy. An important SOL feature is the single- or multi-processor performance for up to hundreds of CPUs. DISCORE improves the binding energy scoring by the local energy optimization of the ligand docked pose and a simple linear regression on the base of available experimental data. The docking program SOL has demonstrated a good ability for correct ligand positioning in the active sites of the tested proteins in most cases of CSAR exercises. SOL and DISCORE have not demonstrated very exciting results on the protein-ligand binding free energy estimation. Nevertheless, for some target proteins, SOL and DISCORE were among the first in prediction of inhibition activity. Ways to improve SOL and DISCORE are discussed.

Development of a hospital reiki training program: training volunteers to provide reiki to patients, families, and staff in the acute care setting.

PubMed

Hahn, Julie; Reilly, Patricia M; Buchanan, Teresa M

2014-01-01

Creating a healing and healthy environment for patients, families, and staff is an ongoing challenge. As part of our hospital's Integrative Care Program, a Reiki Volunteer Program has helped to foster a caring and healing environment, providing a means for patients, family, and staff to reduce pain and anxiety and improve their ability to relax and be present. Because direct care providers manage multiple and competing needs at any given time, they may not be available to provide Reiki when it is needed. This program demonstrates that a volunteer-based program can successfully support nurses in meeting patient, family, and staff demand for Reiki services.

Lowering the driving voltage and improving the luminance of blue fluorescent organic light-emitting devices by thermal annealing a hole injection layer of pentacene

NASA Astrophysics Data System (ADS)

Gao, Jian; Yu, Qian-Qian; Zhang, Juan; Liu, Yang; Jia, Ruo-Fei; Han, Jun; Wu, Xiao-Ming; Hua, Yu-Lin; Yin, Shou-Gen

2017-08-01

Not Available Project supported by the National Natural Science Foundation of China (Grant No. 60906022), the Natural Science Foundation of Tianjin, China (Grant No. 10JCYBJC01100), the Key Science and Technology Support Program of Tianjin, China (Grant No. 14ZCZDGX00006), and the National High Technology Research and Development Program of China (Grant No. 2013AA014201).

Toward the Assessment of Scientific and Public Health Impacts of the National Institute of Environmental Health Sciences Extramural Asthma Research Program Using Available Data

PubMed Central

Liebow, Edward; Phelps, Jerry; Van Houten, Bennett; Rose, Shyanika; Orians, Carlyn; Cohen, Jennifer; Monroe, Philip; Drew, Christina H.

2009-01-01

Background In the past 15 years, asthma prevalence has increased and is disproportionately distributed among children, minorities, and low-income persons. The National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research and Training developed a framework to measure the scientific and health impacts of its extramural asthma research to improve the scientific basis for reducing the health effects of asthma. Objectives Here we apply the framework to characterize the NIEHS asthma portfolio’s impact in terms of publications, clinical applications of findings, community interventions, and technology developments. Methods A logic model was tailored to inputs, outputs, and outcomes of the NIEHS asthma portfolio. Data from existing National Institutes of Health (NIH) databases are used, along with publicly available bibliometric data and structured elicitation of expert judgment. Results NIEHS is the third largest source of asthma-related research grant funding within the NIH between 1975 and 2005, after the National Heart, Lung, and Blood Institute and the National Institute of Allergy and Infectious Diseases. Much of NIEHS-funded asthma research focuses on basic research, but results are often published in journals focused on clinical investigation, increasing the likelihood that the work is moved into practice along the “bench to bedside” continuum. NIEHS support has led to key breakthroughs in scientific research concerning susceptibility to asthma, environmental conditions that heighten asthma symptoms, and cellular mechanisms that may be involved in treating asthma. Conclusions If gaps and limitations in publicly available data receive adequate attention, further linkages can be demonstrated between research activities and public health improvements. This logic model approach to research impact assessment demonstrates that it is possible to conceptualize program components, mine existing databases, and begin to show longer-term impacts of program results. The next challenges will be to modify current data structures, improve the linkages among relevant databases, incorporate as much electronically available data as possible, and determine how to improve the quality and health impact of the science that we support. PMID:19654926

A Comprehensive Review of the Effectiveness of Different Exercise Programs for Patients with Osteoarthritis

PubMed Central

Golightly, Yvonne M.; Allen, Kelli D.; Caine, Dennis J.

2014-01-01

Exercise is recommended as a first-line conservative intervention approach for osteoarthritis (OA). A wide range of exercise programs are available, and scientific evidence is necessary for advising patients with OA on the optimal treatment strategy. The purpose of this review is to discuss the effectiveness of different types of exercise programs for OA based on trials, systematic reviews, and meta-analyses in the literature. Publications from January 1997 to July 2012 were searched in 4 electronic databases using the terms osteoarthritis, exercise, exercise program, effectiveness, and treatment outcome. Strong evidence supports that aerobic and strengthening exercise programs, both land- and water-based, are beneficial for improving pain and physical function in adults with mild to moderate knee and hip OA. Areas that require further research include examination of the long-term effects of exercise programs for OA, balance training for OA, exercise programs for severe OA, the effect of exercise programs on progression of OA, the effectiveness of exercise for joint sites other than the knee or hip, and the effectiveness of exercise for OA by such factors as age, gender and obesity. Efforts to improve adherence to evidence-based exercise programs for OA and to promote the dissemination and implementation of these programs are crucial. PMID:23306415

Partners in motion and traffic congestion in the Washington, D.C. metropolitan area

DOT National Transportation Integrated Search

2001-01-01

Partners in Motion is a program aimed at improving the quality, quantity, and availability of travel information to transportation agencies, the media, and the public in the Washington, D.C. metropolitan area. This report evaluates Partners in Motion...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... female enrollees with direct access to a women's health specialist within the network for covered care... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access... health care needs of specific Medicaid populations represented in the particular MCO, PIHP, and PAHP...

The NSF IUSE-EHR Program: What's New (and Old) About It, and Resources for Geoscience Proposers

NASA Astrophysics Data System (ADS)

Singer, J.; Ryan, J. G.

2015-12-01

The NSF Division of Undergraduate Education recently released a new solicitation for the IUSE program -- the latest iteration in a succession of funding programs dating back over 30 years (including the Instrumentation and Laboratory Improvement Program (ILI), the Course and Curriculum Development Program (CCD), the Course Curriculum and Laboratory Improvement Program (CCLI), and the Transforming Undergraduate STEM Education Program (TUES). All of these programs sought/seek to support high quality STEM education for majors and non-majors in lower- and upper-division undergraduate courses. The current IUSE-EHR program is described in a 2-year solicitation that includes two tracks: Engaged Student Learning, and Institutional & Community Transformation. Each track has several options for funding level and project duration. A wide range of activities can be proposed for funding, and the program recognizes the varying needs across STEM disciplines. Geoscientists and other potential IUSE proposers are strongly encouraged to form collaborations with colleagues that conduct educational research and to propose projects that build upon the educational knowledge base in the discipline as well as contribute to it. Achieving this may not be immediately obvious to many geoscientists who have interests in improving student learning in their courses, but are not fluent in the scholarship of education in their field. To lower the barriers that have historically prevented larger numbers of geoscientists from developing their ideas into competitive education-related proposals, we have explored strategies for building and leveraging partnerships, sought to identify available resources for proposers, and explored a range of strategies for engaging and supporting larger numbers of potential geoscience proposers.

Calculating Trajectories And Orbits

NASA Technical Reports Server (NTRS)

Alderson, Daniel J.; Brady, Franklyn H.; Breckheimer, Peter J.; Campbell, James K.; Christensen, Carl S.; Collier, James B.; Ekelund, John E.; Ellis, Jordan; Goltz, Gene L.; Hintz, Gerarld R.;

Iterative refinement of structure-based sequence alignments by Seed Extension

PubMed Central

Kim, Changhoon; Tai, Chin-Hsien; Lee, Byungkook

2009-01-01

Background Accurate sequence alignment is required in many bioinformatics applications but, when sequence similarity is low, it is difficult to obtain accurate alignments based on sequence similarity alone. The accuracy improves when the structures are available, but current structure-based sequence alignment procedures still mis-align substantial numbers of residues. In order to correct such errors, we previously explored the possibility of replacing the residue-based dynamic programming algorithm in structure alignment procedures with the Seed Extension algorithm, which does not use a gap penalty. Here, we describe a new procedure called RSE (Refinement with Seed Extension) that iteratively refines a structure-based sequence alignment. Results RSE uses SE (Seed Extension) in its core, which is an algorithm that we reported recently for obtaining a sequence alignment from two superimposed structures. The RSE procedure was evaluated by comparing the correctly aligned fractions of residues before and after the refinement of the structure-based sequence alignments produced by popular programs. CE, DaliLite, FAST, LOCK2, MATRAS, MATT, TM-align, SHEBA and VAST were included in this analysis and the NCBI's CDD root node set was used as the reference alignments. RSE improved the average accuracy of sequence alignments for all programs tested when no shift error was allowed. The amount of improvement varied depending on the program. The average improvements were small for DaliLite and MATRAS but about 5% for CE and VAST. More substantial improvements have been seen in many individual cases. The additional computation times required for the refinements were negligible compared to the times taken by the structure alignment programs. Conclusion RSE is a computationally inexpensive way of improving the accuracy of a structure-based sequence alignment. It can be used as a standalone procedure following a regular structure-based sequence alignment or to replace the traditional iterative refinement procedures based on residue-level dynamic programming algorithm in many structure alignment programs. PMID:19589133

Science and society: some "made-in-Canada" options for improving integration.

PubMed

Kosseim, Patricia; Chapman, Sheila

2011-05-01

In this article, the authors describe relatively recent efforts by scientific research agencies to promote, through various funding programs, the integration of social sciences and humanities with the natural sciences. This "integrated" approach seeks to study science through a broader interdisciplinary lens in order to better anticipate, understand, and address its ethical, legal, and social implications. The authors review the origins and evolution of this trend, as well the arguments which have been formulated by both proponents and critics of integration. By using Genome Canada's "GE(3)LS" Research Program as a case study, the authors discuss the successes and continuing challenges of this model based on evaluation results available to date. The authors then go on to examine and compare three possible models for improving the future success of the GE(3)LS research program, including: 1) enhancing the current integrated research approach through incremental refinements based on concrete evidence and lessons learned; 2) promoting greater interaction and synergy across GE(3)LS research projects through a deliberate, systematic and coordinated "hub and spoke" approach; and 3) taking a broad programmatic approach to GE(3)LS research by creating a central resource of available expertise and advisory capacity.

Improved cognitive functioning in obese adolescents after a 30-week inpatient weight loss program.

PubMed

Vantieghem, Stijn; Bautmans, Ivan; Guchtenaere, Ann De; Tanghe, Ann; Provyn, Steven

2018-06-15

Studies linked obesity with a large number of medical conditions including decreased cognitive functioning. The relation between BMI and cognition was proven in adults, but in adolescents the results are conflicting. Further, limited data are available on the impact of weight loss on cognition. This study analyzed the impact of a 30-week lasting weight loss program on cognition and determined the impact of changes in body composition and self-perceived fatigue on changes in cognition. Sixty-two obese adolescents were evaluated at baseline and after 30 weeks. Stroop test (ST; selective attention), Continuous Performance Test (CPT; sustained attention) and Ray Auditory verbal learning test (RAVLT; short-term memory) were assessed. Additionally, body composition parameters and fatigue (MFI-20) were evaluated. Improved reaction times were found for ST and CPT after the intervention, but were independent for reductions in BMI, fat mass, fat%, and fatigue. Short memory also improved with decreased fatigue as an influencing parameter. Accuracy of ST and CPT showed no significant changes. A 30-week lasting inpatient weight loss program improved selective attention, sustained attention, and short-term memory. Changes in body composition did not explain the improvements in cognitive functioning. Decreased fatigue resulted in improved aspects of cognition.

Operationally Responsive Space: Creating Responsive Space for America

DTIC Science & Technology

2008-06-20

programs. Items identified for improvement include: 1 ) Fractured management and accounting , 2 ) Satellite availability, 3) Facilities (Processing...enveloped by our three output tiers. The three tiers: • Tier 1 is an immediate response taking minutes to days. • Tier 2 is a mid term response taking...needs to improve. 2 . Develop a philosophy. 3. Set a direction with specific goals (Fuchs 1 -7). The Department of Space should follow these

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach

PubMed Central

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007–08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women’s residing in more urbanized districts increased the utilization. “Inter-district” variation was 14 percent whereas “between-villages” variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation. PMID:26689199

Do Physical Proximity and Availability of Adequate Infrastructure at Public Health Facility Increase Institutional Delivery? A Three Level Hierarchical Model Approach.

PubMed

Patel, Rachana; Ladusingh, Laishram

2015-01-01

This study aims to examine the inter-district and inter-village variation of utilization of health services for institutional births in EAG states in presence of rural health program and availability of infrastructures. District Level Household Survey-III (2007-08) data on delivery care and facility information was used for the purpose. Bivariate results examined the utilization pattern by states in presence of correlates of women related while a three-level hierarchical multilevel model illustrates the effect of accessibility, availability of health facility and community health program variables on the utilization of health services for institutional births. The study found a satisfactory improvement in state Rajasthan, Madhya Pradesh and Orissa, importantly, in Bihar and Uttaranchal. The study showed that increasing distance from health facility discouraged institutional births and there was a rapid decline of more than 50% for institutional delivery as the distance to public health facility exceeded 10 km. Additionally, skilled female health worker (ANM) and observed improved public health facility led to significantly increase the probability of utilization as compared to non-skilled ANM and not-improved health centers. Adequacy of essential equipment/laboratory services required for maternal care significantly encouraged deliveries at public health facility. District/village variables neighborhood poverty was negatively related to institutional delivery while higher education levels in the village and women's residing in more urbanized districts increased the utilization. "Inter-district" variation was 14 percent whereas "between-villages" variation for the utilization was 11 percent variation once controlled for all the three-level variables in the model. This study suggests that the mere availability of health facilities is necessary but not sufficient condition to promote utilization until the quality of service is inadequate and inaccessible considering the inter-districts variation for the program implementation.

Medicare Advantage: options for standardizing benefits and information to improve consumer choice.

PubMed

O'Brien, Ellen; Hoadley, Jack

2008-04-01

The Medicare Advantage (MA) program offers beneficiaries a choice of private health plans as alternatives to the traditional fee-for-service Medicare program. MA plans potentially provide additional value, but as plan choices have proliferated, consumers contemplating their options have had difficulty understanding how they differ. Through "standardization" more consistent types of information and a limited number of dimensions along which plans vary--MA plans could reduce complexity and improve beneficiaries' ability to make informed choices. Such standardization steps would offer more meaningful variation in the health coverage options available to beneficiaries, Medicare officials and their community partners would find it far easier to educate beneficiaries about their health plan choices, and beneficiaries would better understand what they were buying. Standardization might also strengthen the ability of the market-based Medicare Advantage program to incorporate beneficiary preferences.

Assessing strategies for increasing urban routine immunization coverage of childhood vaccines in low and middle-income countries: A systematic review of peer-reviewed literature.

PubMed

Nelson, Kristin N; Wallace, Aaron S; Sodha, Samir V; Daniels, Danni; Dietz, Vance

2016-11-04

Immunization programs in developing countries increasingly face challenges to ensure equitable delivery of services within cities where rapid urban growth can result in informal settlements, poor living conditions, and heterogeneous populations. A number of strategies have been utilized in developing countries to ensure high community demand and equitable availability of urban immunization services; however, a synthesis of the literature on these strategies has not previously been undertaken. We reviewed articles published in English in peer-reviewed journals between 1990 and 2013 that assessed interventions for improving routine immunization coverage in urban areas in low- and middle-income countries. We categorized the intervention in each study into one of three groups: (1) interventions aiming to increase utilization of immunization services; (2) interventions aiming to improve availability of immunization services by healthcare providers, or (3) combined availability and utilization interventions. We summarized the main quantitative outcomes from each study and effective practices from each intervention category. Fifteen studies were identified; 87% from the African, Eastern Mediterranean and Southeast Asian regions of the World Health Organization (WHO). Six studies were randomized controlled trials, eight were pre- and post-intervention evaluations, and one was a cross-sectional study. Four described interventions designed to improve availability of routine immunization services, six studies described interventions that aimed to increase utilization, and five studies aiming to improve both availability and utilization of services. All studies reported positive change in their primary outcome indicator, although seven different primary outcomes indicators were used across studies. Studies varied considerably with respect to the type of intervention assessed, study design, and length of intervention assessment. Few studies have assessed interventions designed explicitly for the unique challenges facing immunization programs in urban areas. Further research on sustainability, scalability, and cost-effectiveness of interventions is needed to fill this gap. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing strategies for increasing urban routine immunization coverage of childhood vaccines in low and middle-income countries: A systematic review of peer-reviewed literature

PubMed Central

Nelson, Kristin N.; Wallace, Aaron S.; Sodha, Samir V.; Daniels, Danni; Dietz, Vance

2016-01-01

Introduction Immunization programs in developing countries increasingly face challenges to ensure equitable delivery of services within cities where rapid urban growth can result in informal settlements, poor living conditions, and heterogeneous populations. A number of strategies have been utilized in developing countries to ensure high community demand and equitable availability of urban immunization services; however, a synthesis of the literature on these strategies has not previously been undertaken. Methods We reviewed articles published in English in peer-reviewed journals between 1990 and 2013 that assessed interventions for improving routine immunization coverage in urban areas in low- and middle-income countries. We categorized the intervention in each study into one of three groups: (1) interventions aiming to increase utilization of immunization services; (2) interventions aiming to improve availability of immunization services by healthcare providers, or (3) combined availability and utilization interventions. We summarized the main quantitative outcomes from each study and effective practices from each intervention category. Results Fifteen studies were identified; 87% from the African, Eastern Mediterranean and Southeast Asian regions of the World Health Organization (WHO). Six studies were randomized controlled trials, eight were pre- and post-intervention evaluations, and one was a cross-sectional study. Four described interventions designed to improve availability of routine immunization services, six studies described interventions that aimed to increase utilization, and five studies aiming to improve both availability and utilization of services. All studies reported positive change in their primary outcome indicator, although seven different primary outcomes indicators were used across studies. Studies varied considerably with respect to the type of intervention assessed, study design, and length of intervention assessment. Conclusion Few studies have assessed interventions designed explicitly for the unique challenges facing immunization programs in urban areas. Further research on sustainability, scalability, and cost-effectiveness of interventions is needed to fill this gap. PMID:27692772

Clackamas/Hood River Habitat Enhancement Program, 1987 Annual Report.

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

MacDonald, Ken; Cain, Thomas C.; Heller, David A.

1988-03-01

Fisheries habitat improvement work is being done on priority drainages in the Clackamas and Rood River sub-basins under program measure 704(c), Action Item 4.2 of the Northwest Power Planning Council's Columbia River Basin Fish and Wildlife Program. This report describes the work completed in 1987 for Bonneville Power Administration (BPA) project number 84-11, the Clackamas/Hood River Habitat Enhancement Program. The program is composed of six projects: Collawash River Habitat Improvement Project; Collawash River Falls Passage Improvement Project, Oak Grove Fork Habitat Improvement Project; Lake Branch/West Fork Hood River Habitat Improvement Project; Fifteenmile Creek Habitat Improvement Project; and Abundance, Behavior, andmore » Habitat Utilization by Coho Salmon and Steelhead Trout in Fish Creek, Oregon, As Influenced by Habitat Enhancement. This ongoing program was initiated in 1984, although some of the projects were begun with BPA funding support as early as 1983. The projects are complemented by a variety of habitat improvement and management activities funded from a variety of Forest Service sources. This report describes the activities implemented for five of the six projects. A separate annual report on the 1987 habitat improvement and monitoring/evaluation efforts in the Fish Creek drainage has been prepared. Species for management emphasis include spring chinook and coho salmon, and summer and winter steelhead trout. Project work in 1987 primarily focused on increasing the quantity and quality of available rearing habitat, and improving access at passage barriers. The underlying theme of the improvement work has been to increase habitat diversity through the introduction of ''structure''. Structure provided by logs and boulders serves to deflect, pond, or otherwise disrupt flow patterns within a stream channel. This alteration of flow patterns results in formation of an increased number of habitat niches (i.e. pools, glides, alcoves, etc. ) in which a variety of species and age group: of salmon and trout can rear. It also results in the sorting of gravel, rubble, and boulders being transported downstream, creating high quality spawning and rearing habitats, and food producing areas. In 1987, a total of 11.0 miles of stream were treated; 334 log structures (Including: ''deflector'', ''digger'', ''sill'', and ''cover'' logs) and 141 boulder structures (including: single boulder placement, ''berms'', ''alcoves'', and ''clusters'') were completed to meet habitat improvement objectives. In addition to these direct habitat improvement activities, BPA and the Forest Service financed a number of project and program assessment activities that have improved the efficiency and effectiveness of the Forest's fisheries management program. Notable findings relate to the durability of habitat improvement structures, the associated changes in physical habitat, and biological response to the improvement activities. A discussion of the 1987 habitat monitoring and evaluation program results can be found in the supplemental document, Appendix: Monitoring and Evaluation of Mt. Hood National Forest Stream Habitat Improvement and Rehabilitation Projects: 1987 Annual Report (Forsgren, Heller, and Ober, 1988).« less

Does Group, Individual or Home Exercise Best Improve Mobility for People With Parkinson's Disease?

PubMed Central

King, LA; Wilhelm, J; Chen, Y; Blehm, R; Nutt, J; Chen, Z; Serdar, A; Horak, FB

2016-01-01

Background and Purpose Comparative studies of exercise interventions for people with Parkinson Disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by 1) home exercise program, 2) individualized physical therapy, or 3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. Methods Fifty-eight people (age 63.9 ± 8) with PD participated. People were randomized into: 1) home exercise program 2) individual physical therapy or 3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test (PPT). Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS motor and ADL scores were included. Results Only the individual group significantly improved in PPT. The individual exercise showed the most improvements in functional and balance measures, while the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. Discussion and Conclusions An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist. Video Abstract available for additional insights from the authors (See Supplemental Digital Content 1, http://links.lww.com/JNPT/A112). PMID:26308937

Establishing a Program for Individuals at High Risk for Breast Cancer

PubMed Central

Cadiz, Fernando; Kuerer, Henry M.; Puga, Julio; Camacho, Jamile; Cunill, Eduardo; Arun, Banu

2013-01-01

Our need to create a program for individuals at high risk for breast cancer development led us to research the available data on such programs. In this paper, we summarize our findings and our thinking process as we developed our own program. Breast cancer incidence is increasing worldwide. Even though there are known risk factors for breast cancer development, approximately 60% of patients with breast cancer have no known risk factor, although this situation will probably change with further research, especially in genetics. For patients with risk factors based on personal or family history, different models are available for assessing and quantifying risk. Assignment of risk levels permits tailored screening and risk reduction strategies. Potential benefits of specialized programs for women with high breast cancer risk include more cost -effective interventions as a result of patient stratification on the basis of risk; generation of valuable data to advance science; and differentiation of breast programs from other breast cancer units, which can result in increased revenue that can be directed to further improvements in patient care. Guidelines for care of patients at high risk for breast cancer are available from various groups. However, running a high-risk breast program involves much more than applying a guideline. Each high-risk program needs to be designed by its institution with consideration of local resources and country legislation, especially related to genetic issues. Development of a successful high-risk program includes identifying strengths, weaknesses, opportunities, and threats; developing a promotion plan; choosing a risk assessment tool; defining “high risk”; and planning screening and risk reduction strategies for the specific population served by the program. The information in this article may be useful for other institutions considering creation of programs for patients with high breast cancer risk. PMID:23833688

Avoiding 100 new power plants by increasing efficiency of room air conditioners in India: opportunities and challenges

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

Phadke, Amol; Abhyankar, Nikit; Shah, Nihar

Electricity demand for room ACs is growing very rapidly in emerging economies such as India. We estimate the electricity demand from room ACs in 2030 in India considering factors such as weather and income growth using market data on penetration of ACs in different income classes and climatic regions. We discuss the status of the current standards, labels, and incentive programs to improve the efficiency of room ACs in these markets and assess the potential for further large improvements in efficiency and find that efficiency can be improved by over 40% cost effectively. The total potential energy savings from Roommore » AC efficiency improvement in India using the best available technology will reach over 118 TWh in 2030; potential peak demand saving is found to be 60 GW by 2030. This is equivalent to avoiding 120 new coal fired power plants of 500 MW each. We discuss policy options to complement, expand and improve the ongoing programs to capture this large potential.« less

Portfolio theory and cost-effectiveness analysis: a further discussion.

PubMed

Sendi, Pedram; Al, Maiwenn J; Rutten, Frans F H

2004-01-01

Portfolio theory has been suggested as a means to improve the risk-return characteristics of investments in health-care programs through diversification when costs and effects are uncertain. This approach is based on the assumption that the investment proportions are not subject to uncertainty and that the budget can be invested in toto in health-care programs. In the present paper we develop an algorithm that accounts for the fact that investment proportions in health-care programs may be uncertain (due to the uncertainty associated with costs) and limited (due to the size of the programs). The initial budget allocation across programs may therefore be revised at the end of the investment period to cover the extra costs of some programs with the leftover budget of other programs in the portfolio. Once the total budget is equivalent to or exceeds the expected costs of the programs in the portfolio, the initial budget allocation policy does not impact the risk-return characteristics of the combined portfolio, i.e., there is no benefit from diversification anymore. The applicability of portfolio methods to improve the risk-return characteristics of investments in health care is limited to situations where the available budget is much smaller than the expected costs of the programs to be funded.

A Novel Approach for Evaluation of Water Quality Trends in Gulf Coast Estuaries

EPA Science Inventory

Water quality data form the backbone of management programs aimed at protecting environmental resources. The increasing availability of long-term monitoring data for estuaries can improve detection of temporal and spatial changes in water quality. However, the relatively simple...

78 FR 31554 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... Brief Description Cardiovascular disease (CVD), which includes heart disease, myocardial infarction, and... assess the effectiveness of the WISEWOMAN program in reducing the burden of cardiovascular disease risk... incidence, cardiovascular disease risk-factors, health promotion, to improve the availability of screening...

Area computer model for transportation noise prediction : phase II--improved noise prediction methods.

DOT National Transportation Integrated Search

1975-01-01

This report recommended that NOISE 3 initially use the same basic logic as the MICNOISE program for highway noise prediction except that additional options be made available, such as flexibility in specifying vehicle noise sources. A choice of six no...

Special Projects: An Historical Analysis.

ERIC Educational Resources Information Center

Thomas, M. Angele; Bunsen, Teresa D.

The Special Projects Competition is a separate federal government priority authorized to support an increased quantity and improved quality of personnel available to educate infants, toddlers, children, and youth with disabilities. Special project grants provide a means for the conceptualization of new approaches to preparation programs, the…

78 FR 38915 - Notice of Available Funding and Grant Application Deadlines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-28

... Learning and Telemedicine (DLT) Grant Program for the Fiscal Year (FY) 2013 competition. DATES: You may... Federal Agency: Rural Utilities Service (RUS). Funding Opportunity Title: Distance Learning and... financial assistance to encourage and improve telemedicine services and distance learning services in rural...

Is exercise training safe and beneficial in patients receiving left ventricular assist device therapy?

PubMed

Alsara, Osama; Perez-Terzic, Carmen; Squires, Ray W; Dandamudi, Sanjay; Miranda, William R; Park, Soon J; Thomas, Randal J

2014-01-01

Because a limited number of patients receive heart transplantation, alternative therapies, such as left ventricular assist device (LVAD) therapy, have emerged. Published studies have shown that LVAD implantation, by itself, improves exercise tolerance to the point where it is comparable to those with mild heart failure. The improvement in exercise capacity is maximally achieved 12 weeks after LVAD therapy and can continue even after explantation of the device. This effect varies, depending on the type of LVAD and exercise training. The available data in the literature on safety and benefits of exercise training in patients after LVAD implantation are limited, but the data that are available suggest that training trends to be safe and have an impact on exercise capacity in LVAD patients. Although no studies were identified on the role of cardiac rehabilitation programs in the management of LVAD patients, it appears that cardiac rehabilitation programs offer an ideal setting for the provision of supervised exercise training in this patient group.

Family planning in Tunisia and Morocco: a summary and evaluation of the recent record.

PubMed

Lapham, R

1971-05-01

Family planning activity during 1969-1970 in Morocco and Tunisia is discussed in terms of 12 criteria (such as leadership, educational services, availability) used to evaluate the programs in the 2 countries. Significant differences between family planning activity in the 2 countries can be seen in the nature of involvement of their governments through the open and public endorsement of family planning by Tunisia's president compared to the reserve of Morocco's king. Although family planning programs in both countries are organized within the Ministries of Health, the Tunisian program is conducted by a separate division, the Department of Family Planning and Maternal and Child Health, while Morocco's program is completely integrated within existing health services, a fusion which seems to create financial problems for the Moroccan family planning efforts. The Tunisian program, when compared to that of Morocco, is also characterized by a greater availability of contraceptives, more postpartum education and information activity, available induced-abortion and sterilization services, more widespread use of mass media and communication techniques and greater success in program evaluation. On a population basis, Tunisia (population of 5.2 million in 1970) has about 3 times the number of acceptors as Morocco (population of 15.4 million). Both programs have record-keeping systems which improved considerably during 1969 and 1970, but neither program has an effective field worker network. While Tunisia's program has demonstrated more success in meeting the criteria than Morocco's program and a slight decline has occurred in the crude birth rate in Tunisia in recent years, much of this decline can be attributed to a rising age at marriage resulting from the government's policies of social development. Evaluation indicated that both countries will have to increase availability of contraceptives and encourage effective use if substantial decreases in the crude birth rate are to be achieved.

A full-scale fire program to evaluate new furnishings and textile materials developed by the National Aeronautics and Space Administration

NASA Technical Reports Server (NTRS)

Hillenbrand, L. J.; Wray, J. A.

1974-01-01

A program of experimental fires was carried out to establish the advantages offered by new materials for improved fire safety. Four full-scale bedrooms, differing only in the materials used to furnish them, were built and burned to provide comparative data on the fire hazards produced. Cost and availability differences were not considered. The visual evidence provided by TV and photographic coverage of the four experimental room fires showed clearly that the rooms responded very differently to a common ignition condition. Resistance to the ignition and spread of fire was substantially improved in the rooms furnished completely or partially with the new materials.

Operation Program for the Spatially Phase-Shifted Digital Speckle Pattern Interferometer - SPS-DSPI

NASA Technical Reports Server (NTRS)

Blake, Peter N.; Jones, Joycelyn T.; Hostetter, Carl F.; Greenfield, Perry; Miller, Todd

2010-01-01

SPS-DSPI software has been revised so that Goddard optical engineers can operate the instrument, instead of data programmers. The user interface has been improved to view the data collected by the SPS-DSPI, with a real-time mode and a play-back mode. The SPS-DSPI has been developed by NASA/GSFC to measure the temperature distortions of the primary-mirror backplane structure for the James Webb Space Telescope. It requires a team of computer specialists to run successfully, because, at the time of this reporting, it just finished the prototype stage. This software improvement will transition the instrument to become available for use by many programs that measure distortion

NASA High Performance Computing and Communications program

NASA Technical Reports Server (NTRS)

Holcomb, Lee; Smith, Paul; Hunter, Paul

1994-01-01

The National Aeronautics and Space Administration's HPCC program is part of a new Presidential initiative aimed at producing a 1000-fold increase in supercomputing speed and a 1(X)-fold improvement in available communications capability by 1997. As more advanced technologies are developed under the HPCC program, they will be used to solve NASA's 'Grand Challenge' problems, which include improving the design and simulation of advanced aerospace vehicles, allowing people at remote locations to communicate more effectively and share information, increasing scientists' abilities to model the Earth's climate and forecast global environmental trends, and improving the development of advanced spacecraft. NASA's HPCC program is organized into three projects which are unique to the agency's mission: the Computational Aerosciences (CAS) project, the Earth and Space Sciences (ESS) project, and the Remote Exploration and Experimentation (REE) project. An additional project, the Basic Research and Human Resources (BRHR) project, exists to promote long term research in computer science and engineering and to increase the pool of trained personnel in a variety of scientific disciplines. This document presents an overview of the objectives and organization of these projects, as well as summaries of early accomplishments and the significance, status, and plans for individual research and development programs within each project. Areas of emphasis include benchmarking, testbeds, software and simulation methods.

Patient and Nurse Experiences in a Rural Chronic Disease Management Program: A Qualitative Evaluation.

PubMed

Davisson, Erica A; Swanson, Elizabeth A

Rural status confounds chronic disease self-management. The purpose of this qualitative, descriptive study was to evaluate the nurse-led "Living Well" chronic disease management program reporting patient recruitment and retention issues since program initiation in 2013. The Chronic Care Model (CCM) was the guiding framework used to reinforce that interdisciplinary teams must have productive patient interactions for their program(s) to be sustainable. A rural, Midwest county clinic's chronic disease management program. Observations, interviews, and within- and across-case coding were used. Patients' responses were analyzed to identify (1) reasons for recruitment and retention problems and (2) program elements that were viewed as successful or needing improvement. A convenience sample of 6 rural, English-speaking adults (65 years or older, with no severe cognitive impairment) with at least one chronic condition was recruited and interviewed. Themes emerged related to nurse knowledge, availability, and value; peer support; overcoming barriers; adherence enhancement; and family/friends' involvement. Patients reported engagement in self-management activities because of program elements such as support groups and productive nurse-patient interactions. Interdisciplinary communication, commitment, and patient referral processes were identified as reasons for recruitment and retention issues. Findings substantiated that certain elements must be present and improved upon for future rural programs to be successful. Interdisciplinary communication may need to be improved to address recruitment and retention problems. It was clear from patient interviews that the nurse coordinators played a major role in patients' self-management adherence and overall satisfaction with the program. This is important to case management because results revealed the need for programs of this nature that incorporate the vital role of nurse coordinators and align with the CCM value of providing a supportive community health care resource for patients with chronic disease.

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

PubMed

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

2017-04-04

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

Results of the 2017 National Resident Matching Program® and the American Osteopathic Association Intern/Resident Registration Program.

PubMed

Kozakowski, Stanley M; Travis, Alexandra; Marcinek, Julie P; Bentley, Ashley; Fetter, Gerald T

2017-10-01

The purpose of medicine as a profession is to meet the health needs of people and communities. Despite empirical evidence worldwide that an appropriate foundation of primary care in a health care system leads to improved health outcomes, improved experience of health care, a reduction in health disparities, and lower overall cost of care, publicly available data from National Resident Matching Program® (NRMP) and the American Osteopathic Association (AOA) Intern/Resident Registration Program show that PGY-1 family medicine and primary care positions offered in the NRMP Match continue to grow, but are losing ground in comparison to the growth of non-primary care specialties. In ACGME-accredited family medicine programs, DO students have been displacing non-US citizen IMGs while the proportion of US seniors has remained stable over the past decade. The impact of the displacement of non-US citizen IMGs by DO students in ACGME programs is unknown and deserves future research. Continuing trends in the growth of non-primary care specialties should raise great concern that the current primary shortage will be exacerbated, not serving the needs of the population. A major overhaul of the graduate medical education (GME) system is required to align the medical education system with the transformation of the health care system needed to improve quality, population health, and cost control.

A pilot Internet-based behavioral weight loss intervention with or without commercially available portion-controlled foods.

PubMed

Webber, Kelly H; Rose, Stephanie A

2013-09-01

To evaluate the short-term impact of portion-controlled food provision in combination with an Internet behavioral weight loss program on weight, blood cholesterol, and blood glucose levels. Fifty participants, mean age 46 ± 10.7 years and mean body mass index 35.1 ± 3.8 kg/m2 , were randomized to one of two study groups, an Internet behavioral weight loss program (Internet-alone; n = 25) or an Internet behavioral weight loss program plus a commercially available portion-controlled diet (Internet + PCD; n = 25) for 12 weeks. An intent-to-treat analysis found that the mean weight change in the Internet + PCD group was -5.7 ± 5.6 kg and in the Internet-alone group (n = 25) was -4.1 ± 4.0 kg (P = 0.26). Participants in the Internet + PCD group achieved significantly greater improvements in blood glucose (-2.6 ± 5.7 vs. 1.4 ± 11.0 mg/dl; P = 0.05) and LDL cholesterol (-8.2 ± 18.0 vs. -0.6 ± 21.0 mg/dl; P = 0.04), compared with Internet-alone group. These data suggest that there may be short-term clinical benefit in using a PCD in conjunction with a behavioral Internet-based weight loss program to enhance weight loss and improve health indicators. Copyright © 2013 The Obesity Society.

Assessment of commercially available energy-efficient room air conditioners including models with low global warming potential (GWP) refrigerants

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

Shah, N. K.; Park, W. Y.; Gerke, B.

Improving the energy efficiency of room air conditioners (RACs) while transitioning to low global-warming-potential (GWP) refrigerants will be a critical step toward reducing the energy, peak load, and emissions impacts of RACs while keeping costs low. Previous research quantified the benefits of leapfrogging to high efficiency in tandem with the transition to low-GWP refrigerants for RACs (Shah et al., 2015) and identified opportunities for initial action to coordinate energy efficiency with refrigerant transition in economies constituting about 65% of the global RAC market (Shah et al., 2017). This report describes further research performed to identify the best-performing (i.e., most efficientmore » and low-GWP-refrigerant using) RACs on the market, to support an understanding of the best available technology (BAT). Understanding BAT can help support market-transformation programs for high-efficiency and low-GWP equipment such as minimum energy performance standards (MEPS), labeling, procurement, and incentive programs. We studied RACs available in six economies—China, Europe, India, Japan, South Korea, and the United States—that together account for about 70% of global RAC demand, as well as other emerging economies. The following are our key findings: • Highly efficient RACs using low-GWP refrigerants, e.g., HFC-32 (R-32) and HC-290 (R-290), are commercially available today at prices comparable to similar RACs using high-GWP HCFC-22 (R-22) or HFC-410A (R-410A). • High efficiency is typically a feature of high-end products. However, highly efficient, cost-competitive (less than 1,000 or 1,500 U.S. dollars in retail price, depending on size) RACs are available. • Where R-22 is being phased out, high GWP R-410A still dominates RAC sales in most mature markets except Japan, where R-32 dominates. • In all of the economies studied except Japan, only a few models are energy efficient and use low-GWP refrigerants. For example, in Europe, India, and Indonesia, the highest-efficiency RAC models employ the low-GWP refrigerants R-32 or R-290. • RACs are available in most regions and worldwide that surpass the highest efficiency levels recognized by labeling programs. • Fixed-speed RACs using high-GWP and ozone-depleting R-22 refrigerant still dominate the market in many emerging economies. There is significant scope to improve RAC efficiency and transition to low-GWP refrigerants using commercially available technology and to design market-transformation programs for high-efficiency, low-GWP equipment including standards, labeling, procurement, and incentive programs.« less

Physics and medicine: the Bevatron/Bevalac experience, 1979-1980

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

Lothrop, F.; Alonso, J.; Force, R.

1981-01-01

Heavy ion radiobiology has been integrated successfully into the research program at the Bevatron/Bevalac for the past several years. During the 1979 to 1980 year radiotherapy trials have been conducted side-by-side with the demanding program of heavy ion nuclear science research at this national facility. Careful attention is given to the scheduling of research on the SuperHILAC and Bevatron/Bevalac so that the nuclear science and biomedical programs at the Bevatron/Bevalac and the program at the SuperHILAC are served to maximum effect. Efforts to maximize the researchers' time have resulted in hardware, software, and operating improvements that offer a total machinemore » availability of about 90% and a user availability of about 80%. Fast beam switching and beam sharing permit virtually simultaneous use of the Bevatron/Bevalac by two or more users. Current beam delivery systems will be augmented in FY 1981 to provide two ion energies per Bevatron/Bevalac pulse.« less

A Multiple-star Combined Solution Program - Application to the Population II Binary μ Cas

NASA Astrophysics Data System (ADS)

Gudehus, D. H.

2001-05-01

A multiple-star combined-solution computer program which can simultaneously fit astrometric, speckle, and spectroscopic data, and solve for the orbital parameters, parallax, proper motion, and masses has been written and is now publicly available. Some features of the program are the ability to scale the weights at run time, hold selected parameters constant, handle up to five spectroscopic subcomponents for the primary and the secondary each, account for the light travel time across the system, account for apsidal motion, plot the results, and write the residuals in position to a standard file for further analysis. The spectroscopic subcomponent data can be represented by reflex velocities and/or by independent measurements. A companion editing program which can manage the data files is included in the package. The program has been applied to the Population II binary μ Cas to derive improved masses and an estimate of the primordial helium abundance. The source code, executables, sample data files, and documentation for OpenVMS and Unix, including Linux, are available at http://www.chara.gsu.edu/\\rlap\\ \\ gudehus/binary.html.

Update on PISCES

NASA Technical Reports Server (NTRS)

Pearson, Don; Hamm, Dustin; Kubena, Brian; Weaver, Jonathan K.

2010-01-01

An updated version of the Platform Independent Software Components for the Exploration of Space (PISCES) software library is available. A previous version was reported in Library for Developing Spacecraft-Mission-Planning Software (MSC-22983), NASA Tech Briefs, Vol. 25, No. 7 (July 2001), page 52. To recapitulate: This software provides for Web-based, collaborative development of computer programs for planning trajectories and trajectory- related aspects of spacecraft-mission design. The library was built using state-of-the-art object-oriented concepts and software-development methodologies. The components of PISCES include Java-language application programs arranged in a hierarchy of classes that facilitates the reuse of the components. As its full name suggests, the PISCES library affords platform-independence: The Java language makes it possible to use the classes and application programs with a Java virtual machine, which is available in most Web-browser programs. Another advantage is expandability: Object orientation facilitates expansion of the library through creation of a new class. Improvements in the library since the previous version include development of orbital-maneuver- planning and rendezvous-launch-window application programs, enhancement of capabilities for propagation of orbits, and development of a desktop user interface.

Public finance policy strategies to increase access to preconception care.

PubMed

Johnson, Kay A

2006-09-01

Policy and finance barriers reduce access to preconception care and, reportedly, limit professional practice changes that would improve the availability of needed services. Millions of women of childbearing age (15-44) lack adequate health coverage (i.e., uninsured or underinsured), and others live in medically underserved areas. Service delivery fragmentation and lack of professional guidelines are additional barriers. This paper reviews barriers and opportunities for financing preconception care, based on a review and analysis of state and federal policies. We describe states' experiences with and opportunities to improve health coverage, through public programs such as Medicaid, Medicaid waivers, and the State Children's Health Insurance Program (SCHIP). The potential role of Title V and of community health centers in providing primary and preventive care to women also is discussed. In these and other public health and health coverage programs, opportunities exist to finance preconception care for low-income women. Three major policy directions are discussed. To increase access to preconception care among women of childbearing age, the federal and state governments have opportunities to: (1) improve health care coverage, (2) increase the supply of publicly subsidized health clinics, and (3) direct delivery of preconception screening and interventions in the context of public health programs.

Microgravity science and applications projects and payloads

NASA Technical Reports Server (NTRS)

Crouch, R. K.

1987-01-01

An overview of work conducted by the Microgravity Science and Applications Division of NASA is presented. The goals of the program are the development and implementation of a reduced-gravity research, science and applications program, exploitation of space for human benefits, and the application of reduced gravity research for the development of advanced technologies. Space research of fluid dynamics and mass transport phenomena is discussed and the facilities available for reduced gravity experiments are presented. A program for improving communication with the science and applications communities and the potential use of the Space Station for microgravity research are also examined.

Assessing faculty integration of adult learning needs in second-degree nursing education.

PubMed

Robert, Tracey E; Pomarico, Carole A; Nolan, Mary

2011-01-01

The limited research data available on effective teaching strategies for accelerated baccalaureate nursing programs has generated interest in identifying and assessing successful teaching tools and strategies in current programs. Most data have been anecdotal and have not emphasized the effectiveness of accelerated programs. This study used a qualitative research design to determine the effectiveness of an integrative learning model in improving nursing student outcomes of second-degree students. Overall data from focus groups in the beginning and end of the study indicated that the use focus groups enhanced the learning process and outcomes.

HerzMobil Tirol network: rationale for and design of a collaborative heart failure disease management program in Austria.

PubMed

Von der Heidt, Andreas; Ammenwerth, Elske; Bauer, Karl; Fetz, Bettina; Fluckinger, Thomas; Gassner, Andrea; Grander, Willhelm; Gritsch, Walter; Haffner, Immaculata; Henle-Talirz, Gudrun; Hoschek, Stefan; Huter, Stephan; Kastner, Peter; Krestan, Susanne; Kufner, Peter; Modre-Osprian, Robert; Noebl, Josef; Radi, Momen; Raffeiner, Clemens; Welte, Stefan; Wiseman, Andreas; Poelzl, Gerhard

2014-11-01

Heart failure (HF) is approaching epidemic proportions worldwide and is the leading cause of hospitalization in the elderly population. High rates of readmission contribute substantially to excessive health care costs and highlight the fragmented nature of care available to HF patients. Disease management programs (DMPs) have been implemented to improve health outcomes, patient satisfaction, and quality of life, and to reduce health care costs. Telemonitoring systems appear to be effective in the vulnerable phase after discharge from hospital to prevent early readmissions. DMPs that emphasize comprehensive patient education and guideline-adjusted therapy have shown great promise to result in beneficial long-term effects. It can be speculated that combining core elements of the aforementioned programs may substantially improve long-term cost-effectiveness of patient management.We introduce a collaborative post-discharge HF disease management program (HerzMobil Tirol network) that incorporates physician-controlled telemonitoring and nurse-led care in a multidisciplinary network approach.

A shock wave capability for the improved Two-Dimensional Kinetics (TDK) computer program

NASA Technical Reports Server (NTRS)

Nickerson, G. R.; Dang, L. D.

1984-01-01

The Two Dimensional Kinetics (TDK) computer program is a primary tool in applying the JANNAF liquid rocket engine performance prediction procedures. The purpose of this contract has been to improve the TDK computer program so that it can be applied to rocket engine designs of advanced type. In particular, future orbit transfer vehicles (OTV) will require rocket engines that operate at high expansion ratio, i.e., in excess of 200:1. Because only a limited length is available in the space shuttle bay, it is possible that OTV nozzles will be designed with both relatively short length and high expansion ratio. In this case, a shock wave may be present in the flow. The TDK computer program was modified to include the simulation of shock waves in the supersonic nozzle flow field. The shocks induced by the wall contour can produce strong perturbations of the flow, affecting downstream conditions which need to be considered for thrust chamber performance calculations.

Bangladesh.

PubMed

Ahmed, K S

1979-01-01

In Bangladesh the Population Control and Family Planning Division of the Ministry of Health and Population Control has decided to delegate increased financial and administrative powers to the officers of the family planning program at the district level and below. Currently, about 20,000 family planning workers and officials are at work in rural areas. The government believes that the success of the entire family planning program depends on the performance of workers in rural areas, because that is where about 90% of the population lives. Awareness of the need to improve statistical data in Bangladesh has been increasing, particularly in regard to the development of rural areas. An accurate statistical profile of rural Bangladesh is crucial to the formation, implementation and evaluation of rural development programs. A Seminar on Statistics for Rural Development will be held from June 18-20, 1980. The primary objectives of the Seminar are to make an exhaustive analysis of the current availability of statistics required for rural development programs and to consider methodological and operational improvements toward building up an adequate data base.

COMPREHENSIVE STRENGTH TRAINING PROGRAM FOR A RECREATIONAL SENIOR GOLFER 11-MONTHS AFTER A ROTATOR CUFF REPAIR

PubMed Central

Meira, Erik P.; En Gilpin, Hui; Brunette, Meredith

2011-01-01

Background and Purpose: Golf is a popular sport played by hundreds of thousands of individuals of all ages and of varying skill levels. An orthopedic or sports-related injury and/or surgery may limit an individual's sport participation, require him/her to complete a course of rehabilitation, and initiate (or resume) a sport-specific training program. Unlike the availability of evidence to guide postsurgical rehabilitation and sport-specific training of athletes from sports other than golf, there have only been two reports describing outcomes after surgery and for golfers. The purpose of this case report is to present a post-rehabilitation return to sport-training program for a recreational golfer 11-months after a rotator cuff repair. Case Description: The subject, a 67-year old female, injured her right shoulder requiring a rotator cuff repair 11-months prior to her participation in a golf fitness training program. The subject participated in six training sessions over seven week period consisting of general strengthening exercises (including exercises for the rotator cuff), exercises for the core, plyometrics, and power exercises. Outcomes: The subject made improvements in power and muscular endurance of the core. She was able to resume golf at the completion of the training program. Discussion: The subject was able to make functional improvements and return to golf after participation in a comprehensive strength program. Additional studies are necessary to improve program design for golfers who wish to return to sport after shoulder surgery. PMID:22163096

Test/QA Plan For Verification Of Anaerobic Digester For Energy Production And Pollution Prevention

EPA Science Inventory

The ETV-ESTE Program conducts third-party verification testing of commercially available technologies that improve the environmental conditions in the U.S. A stakeholder committee of buyers and users of such technologies guided the development of this test on anaerobic digesters...

77 FR 20781 - Notice of Funding Availability (NOFA) for the Rural Energy for America Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... grants and guaranteed loans for the development and construction of renewable energy systems and for energy efficiency improvement projects; grants for conducting energy audits; grants for conducting renewable energy development assistance; and grants for conducting renewable energy system feasibility...

The Great Poetry Race

ERIC Educational Resources Information Center

Pitcher, Sharon M.

2009-01-01

Research suggests that parent involvement improves academic achievement, but in the busy world in which we live it is often difficult to promote. Many researchers suggest that successful programs value parents' limited time constraints, diversity of literacy skills, and availability of materials. The Great Poetry Race provides an easy vehicle to…

Establishing a Campus-Based Assessment Program.

ERIC Educational Resources Information Center

Ewell, Peter T.

1987-01-01

Assessment has at two purposes--to improve teaching and learning and to promote greater external accountability. Determining an appropriate assessment approach depends on clear knowledge of what is intended, solid research about available instruments and about the experiences of other institutions, and a diagnosis of the local organizational and…

Characteristic improvements of thin film AlGaInP red light emitting diodes on a metallic substrate

NASA Astrophysics Data System (ADS)

Zhao, Bin; Hu, Wei; Tang, Xian-Sheng; Huo, Wen-Xue; Han, Li-Li; Zhao, Ming-Long; Ma, Zi-Guang; Wang, Wen-Xin; Jia, Hai-Qiang; Chen, Hong

2018-04-01

Not Available Project supported by the National Key Research and Development Program of China (Grant Nos. 2016YFB0400600 and 2016YFB0400603) and the National Natural Science Foundation of China (Grant Nos. 11574362, 61210014, and 11374340).

Guide to Federal Resources for the Developmentally Disabled.

ERIC Educational Resources Information Center

Russem, Wendy, Ed.; And Others

The guide presents information on available federal resources to improve services for developmentally disabled persons. An introductory chapter provides an overview of the creation and evolution of the Developmental Disabilities Program. Chapter two focuses on federal funding and appropriations, including methods of awarding grants and contracts.…

Management intensity and genetics affect loblolly pine seedling performance

Treesearch

Scott D. Roberts; Randall J. Rousseau; B. Landis Herrin

2012-01-01

Capturing potential genetic gains from tree improvement programs requires selection of the appropriate genetic stock and application of appropriate silvicultural management techniques. Limited information is available on how specific loblolly pine varietal genotypes perform under differing growing environments and management approaches. This study was established in...

FY2016 Propulsion Materials Annual Progress Report

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

None, None

The Propulsion Materials Program actively supports the energy security and reduction of greenhouse emissions goals of VTO by investigating and identifying the materials properties that are most essential for continued development of cost-effective, highly efficient, and environmentally friendly next-generation heavy and light-duty powertrains. The technical approaches available to enhance propulsion systems focus on improvements in both vehicle efficiency and fuel substitution, both of which must overcome the performance limitations of the materials currently in use. Propulsion Materials Program activities work with national laboratories, industry experts, and VTO powertrain systems (e.g., Advanced Combustion Engines and Fuels) teams to develop strategies thatmore » overcome materials limitations in future powertrain performance. The technical maturity of the portfolio of funded projects ranges from basic science to subsystem prototype validation. Projects within a Propulsion Materials Program activity address materials concerns that directly impact critical technology barriers within each of the above programs, including barriers that impact fuel efficiency, thermal management, emissions reduction, improved reliability, and reduced manufacturing costs. The program engages only the barriers that result from material property limitations and represent fundamental, high-risk materials issues.« less

Lessons learned from evaluations of California's statewide school nutrition standards.

PubMed

Woodward-Lopez, Gail; Gosliner, Wendi; Samuels, Sarah E; Craypo, Lisa; Kao, Janice; Crawford, Patricia B

2010-11-01

We assessed the impact of legislation that established nutrition standards for foods and beverages that compete with reimbursable school meals in California. We used documentation of available foods and beverages, sales accounts, and surveys of and interviews with students and food service workers to conduct 3 studies measuring pre- and postlegislation food and beverage availability, sales, and student consumption at 99 schools. Availability of nutrition standard-compliant foods and beverages increased. Availability of noncompliant items decreased, with the biggest reductions in sodas and other sweetened beverages, regular chips, and candy. At-school consumption of some noncompliant foods dropped; at-home consumption of selected noncompliant foods did not increase. Food and beverage sales decreased at most venues, and food service à la carte revenue losses were usually offset by increased meal program participation. Increased food service expenditures outpaced revenue increases. Regulation of competitive foods improved school food environments and student nutritional intake. Improvements were modest, partly because many compliant items are fat- and sugar-modified products of low nutritional value. Additional policies and actions are needed to achieve more substantive improvements in school nutrition environments and student nutrition and health.

Trauma Collaborative Care Intervention: Effect on Surgeon Confidence in Managing Psychosocial Complications After Orthopaedic Trauma.

PubMed

Wegener, Stephen T; Carroll, Eben A; Gary, Joshua L; McKinley, Todd O; OʼToole, Robert V; Sietsema, Debra L; Castillo, Renan C; Frey, Katherine P; Scharfstein, Daniel O; Huang, Yanjie; Collins, Susan C J; MacKenzie, Ellen J

2017-08-01

The impact of the Trauma Collaborative Care (TCC) program on surgeon confidence in managing the psychosocial sequelae of orthopaedic trauma was evaluated as part of a larger prospective, multisite, cluster clinical trial. We compared confidence and perceived resource availability among surgeons practicing in trauma centers that implemented the TCC program with orthopaedic trauma surgeons in similar trauma centers that did not implement the TCC. Prospective cohort design. Level-I trauma centers. Attending surgeons and fellows (N = 95 Pre and N = 82 Post). Self-report 10-item measure of surgeon confidence in managing psychosocial issues associated with trauma and perceived availability of support resources. Analyses, performed on the entire sample and repeated on the subset of 52 surgeons who responded to the survey at both times points, found surgeons at intervention sites experienced a significantly greater positive improvement (P < 0.05) in their (1) belief that they have strategies to help orthopaedic trauma patients change their psychosocial situation; (2) confidence in making appropriate referrals for orthopaedic trauma patients with psychosocial problems; and (3) belief that they have access to information to guide the management of psychosocial issues related to recovery. Initial data suggest that the establishment of the TCC program can improve surgeons' perceived availability of resources and their confidence in managing the psychosocial sequelae after injury. Further studies will be required to determine if this translates into beneficial patient effects. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

National briefing summaries: Nuclear fuel cycle and waste management

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

Schneider, K.J.; Lakey, L.T.; Silviera, D.J.

The National Briefing Summaries is a compilation of publicly available information concerning the nuclear fuel cycle and radioactive waste management strategies and programs of 21 nations, including the United States and three international agencies that have publicized their activities in this field. It presents available highlight information with references that may be used by the reader for additional information. The information in this document is compiled primarily for use by the US Department of Energy and other US federal agencies and their contractors to provide summary information on radioactive waste management activities in other countries. This document provides an awarenessmore » to managers and technical staff of what is occurring in other countries with regard to strategies, activities, and facilities. The information may be useful in program planning to improve and benefit United States' programs through foreign information exchange. Benefits to foreign exchange may be derived through a number of exchange activities.« less

SAGES quality initiative: an introduction.

PubMed

Lidor, Anne; Telem, Dana; Bower, Curtis; Sinha, Prashant; Orlando, Rocco; Romanelli, John

2017-08-01

The Medicare program has transitioned to paying healthcare providers based on the quality of care delivered, not on the quantity. In May 2015, SAGES held its first ever Quality Summit. The goal of this meeting was to provide us with the information necessary to put together a strategic plan for our Society over the next 3-5 years, and to participate actively on a national level to help develop valid measures of quality of surgery. The transition to value-based medicine requires that providers are now measured and reimbursed based on the quality of services they provide rather than the quantity of patients in their care. As of 2014, quality measures must cover 3 of the 6 available National Quality domains. Physician quality reporting system measures are created via a vigorous process which is initiated by the proposal of the quality measure and subsequent validation. Commercial, non-profit, and governmental agencies have now been engaged in the measurement of hospital performance through structural measures, process measures, and increasingly with outcomes measures. This more recent focus on outcomes measures have been linked to hospital payments through the Value-Based Purchasing program. Outcomes measures of quality drive CMS' new program, MACRA, using two formats: Merit-based incentive programs and alternative payment models. But, the quality of information now available is highly variable and difficult for the average consumer to use. Quality metrics serve to guide efforts to improve performance and for consumer education. Professional organizations such as SAGES play a central role in defining the agenda for improving quality, outcomes, and safety. The mission of SAGES is to improve the quality of patient care through education, research, innovation, and leadership, principally in gastrointestinal and endoscopic surgery.

What can be Learned from Silage Breeding Programs?

NASA Astrophysics Data System (ADS)

Lorenz, Aaron J.; Coors, James G.

Improving the quality of cellulosic ethanol feedstocks through breeding and genetic manipulation could significantly impact the economics of this industry. Attaining this will require comprehensive and rapid characterization of large numbers of samples. There are many similarities between improving corn silage quality for dairy production and improving feedstock quality for cellulosic ethanol. It was our objective to provide insight into what is needed for genetic improvement of cellulosic feedstocks by reviewing the development and operation of a corn silage breeding program. We discuss the evolving definition of silage quality and relate what we have learned about silage quality to what is needed for measuring and improving feedstock quality. In addition, repeatability estimates of corn stover traits are reported for a set of hybrids. Repeatability of theoretical ethanol potential measured by near-infrared spectroscopy is high, suggesting that this trait may be easily improved through breeding. Just as cell wall digestibility has been factored into the latest measurements of silage quality, conversion efficiency should be standardized and included in indices of feedstock quality to maximize overall, economical energy availability.

Innovating for quality and value: Utilizing national quality improvement programs to identify opportunities for responsible surgical innovation.

PubMed

Woo, Russell K; Skarsgard, Erik D

2015-06-01

Innovation in surgical techniques, technology, and care processes are essential for improving the care and outcomes of surgical patients, including children. The time and cost associated with surgical innovation can be significant, and unless it leads to improvements in outcome at equivalent or lower costs, it adds little or no value from the perspective of the patients, and decreases the overall resources available to our already financially constrained healthcare system. The emergence of a safety and quality mandate in surgery, and the development of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) allow needs-based surgical care innovation which leads to value-based improvement in care. In addition to general and procedure-specific clinical outcomes, surgeons should consider the measurement of quality from the patients' perspective. To this end, the integration of validated Patient Reported Outcome Measures (PROMs) into actionable, benchmarked institutional outcomes reporting has the potential to facilitate quality improvement in process, treatment and technology that optimizes value for our patients and health system. Copyright © 2015 Elsevier Inc. All rights reserved.

Facing the PA team growth problem in space programs: The Hermes approach

NASA Astrophysics Data System (ADS)

Bernede, G.

1991-08-01

The increasing need for product assurance (PA) in space programs makes finding skilled and trained engineers willing to work in the PA field a top level difficulty. Few engineers are available and exchanging them from one project to another is not a solution. No reservoir of talent exists for the time being in Europe. Educational efforts have started in several countries to have product assurance techniques become part of basic engineering knowledge. These efforts will bring strong improvement compared to today's situation but not in time for programs such as Hermes. Peculiar solutions must be developed. Approaches used to solve this problem within the Hermes program are outlined.

The uncounted benefits: Federal efforts in domestic technology transfer

NASA Technical Reports Server (NTRS)

Chapman, R. L.; Hirst, K.

1986-01-01

Organized technology transfer activities conducted by the agencies of the U.S. government are described. The focus is upon agency or departmental level activity rather than the laboratory level. None of the programs on which information was collected has been assessed or evaluated individually. However, the aggregate programs of the government have been judged in terms of obvious gaps and opportunities for future improvement. An overview, descriptions of the various agency or department programs of technology transfer, a list of persons interviewed or consulted during the survey, and a bibliography of publications, reports and other material made available to the study staff are given. An extensive appendix of illustrative material collected from the various programs is also given.

Improvement in maternal health literacy among pregnant women who did not complete compulsory education: policy implications for community care services.

PubMed

Ohnishi, Mayumi; Nakamura, Keiko; Takano, Takehito

2005-05-01

This paper examined factors that influence the improvement in maternal health literacy among pregnant women in Paraguay, including those who did not complete compulsory education but participated in a community-based antenatal care program. Structured interviews were conducted to evaluate the pregnant women's maternal health literacy during their first, second, and third visits to the program in the Caazapa Region. The associations between individual maternal health knowledge scores and its gains, healthcare personnel capabilities, available health facility equipment, community social network, and living environment were analyzed by multiple regression analysis. The mean maternal health knowledge score from 124 women who completed three-consecutive assessments increased between the first and third interviews. Higher capabilities of healthcare personnel and better living environment were significantly related to gains in the maternal health knowledge score (p<0.01). Wider application of a community-based antenatal care program to meet the needs of those who are functionally illiterate in the standard language of the country, training for community healthcare personnel to improve capabilities, and resources for social network in the community would contribute to the improvement in maternal health literacy.

Pharmacist-led, primary care-based disease management improves hemoglobin A1c in high-risk patients with diabetes.

PubMed

Rothman, Russell; Malone, Robb; Bryant, Betsy; Horlen, Cheryl; Pignone, Michael

2003-01-01

We developed and evaluated a comprehensive pharmacist-led, primary care-based diabetes disease management program for patients with Type 2 diabetes and poor glucose control at our academic general internal medicine practice. The primary goal of this program was to improve glucose control, as measured by hemoglobin A1c (HbA1c). Clinic-based pharmacists offered support to patients with diabetes through direct teaching about diabetes, frequent phone follow-up, medication algorithms, and use of a database that tracked patient outcomes and actively identified opportunities to improve care. From September 1999, to May 2000, 159 subjects were enrolled, and complete follow-up data were available for 138 (87%) patients. Baseline HbA1c averaged 10.8%, and after an average of 6 months of intervention, the mean reduction in HbA1c was 1.9 percentage points (95% confidence interval, 1.5-2.3). In predictive regression modeling, baseline HbA1c and new onset diabetes were associated with significant improvements in HbA1c. Age, race, gender, educational level, and provider status were not significant predictors of improvement. In conclusion, a pharmacist-based diabetes care program integrated into primary care practice significantly reduced HbA1c among patients with diabetes and poor glucose control.

Space Shuttle Upgrades: Long Life Alkaline Fuel Cell

NASA Technical Reports Server (NTRS)

McCurdy, Kerri

2004-01-01

NASA has utilized the alkaline fuel cell technology to provide electrical power for manned launch vehicles such as Gemini, Apollo, and the Space Shuttle. The current Shuttle alkaline fuel cells are procured from UTC Fuel Cells, a United Technologies Company. The alkaline fuel cells are very reliable but the operating life is limited to 2600 hours due to voltage degradation of the individual cells. The main limiting factor in the life of the cells is corrosion of the cell's fiberglass/epoxy frame by the aqueous potassium hydroxide electrolyte. To reduce operating costs, the orbiter program office approved the Long Life Alkaline Fuel Cell (LLAFC) program as a shuttle upgrade in 1999 to increase the operating life of the fuel cell powerplant to 5000 hours. The LLAFC program incorporates improving the cell by extending the length of the corrosion path, which reduces the cell frame corrosion. UTCFC performed analysis to understand the fundamental mechanisms that drive the cell frame corrosion. The analysis indicated that the corrosion path started along the bond line between the cathode and the cell frame. Analysis also showed that the oxygen available at the cathode, the catalyst on the electrode, and the electrode substrate all supported or intensified the corrosion. The new cell design essentially doubled the corrosion path to mitigate the problem. A 10-cell stack was tested for 5000 hours during the development phase of this program to verify improved cell performance. A complete 96-cell stack was then tested for 5000 hours during the full manned-space qualification phase of this program. Additional upgrades to the powerplant under this program are: replacing the aluminum body in the pressure regulator with stainless steel to reduce corrosion, improving stack insulator plate with improved resistance to stress failure and improved temperature capability, and replacing separator plate elastomer seals with a more durable material and improved seal retention.

Creating a bridge between data collection and program planning: a technical assistance model to maximize the use of HIV/AIDS surveillance and service utilization data for planning purposes.

PubMed

Logan, Jennifer A; Beatty, Maile; Woliver, Renee; Rubinstein, Eric P; Averbach, Abigail R

2005-12-01

Over time, improvements in HIV/AIDS surveillance and service utilization data have increased their usefulness for planning programs, targeting resources, and otherwise informing HIV/AIDS policy. However, community planning groups, service providers, and health department staff often have difficulty in interpreting and applying the wide array of data now available. We describe the development of the Bridging Model, a technical assistance model for overcoming barriers to the use of data for program planning. Through the use of an iterative feedback loop in the model, HIV/AIDS data products constantly are evolving to better inform the decision-making tasks of their multiple users. Implementation of this model has led to improved data quality and data products and to a greater willingness and ability among stakeholders to use the data for planning purposes.

The geographic applications program of the U. S. Geological Survey

USGS Publications Warehouse

Gerlach, Arch C.

1969-01-01

The fundamental objective of modern Geography is to improve man's level of living through a better understanding of man-environment inter actions. Related goals of the USGS program for applications of remote sensor data to Geographical research are: (1) the analysis and improvement of land use, with special emphasis on urban problems; and (2) more effective use of the total available energy budget, including insolation, mineral fuels, atomic energy, human resources, and mental energy, all of which are integrated into man-environment interactions. The collection of data through remote sensors in air craft and spacecraft is financed largely by funds from NASA, and is part of the much broader EROS Program of the Department of the Interior. Results to date have achieved much toward the identification of remote sensor signatures for Earth features and human activities, and toward evaluation of instruments for collecting essential information.

Influence of Sequential vs. Simultaneous Dual-Task Exercise Training on Cognitive Function in Older Adults.

PubMed

Tait, Jamie L; Duckham, Rachel L; Milte, Catherine M; Main, Luana C; Daly, Robin M

2017-01-01

Emerging research indicates that exercise combined with cognitive training may improve cognitive function in older adults. Typically these programs have incorporated sequential training, where exercise and cognitive training are undertaken separately. However, simultaneous or dual-task training, where cognitive and/or motor training are performed simultaneously with exercise, may offer greater benefits. This review summary provides an overview of the effects of combined simultaneous vs. sequential training on cognitive function in older adults. Based on the available evidence, there are inconsistent findings with regard to the cognitive benefits of sequential training in comparison to cognitive or exercise training alone. In contrast, simultaneous training interventions, particularly multimodal exercise programs in combination with secondary tasks regulated by sensory cues, have significantly improved cognition in both healthy older and clinical populations. However, further research is needed to determine the optimal characteristics of a successful simultaneous training program for optimizing cognitive function in older people.

A comparison of computer-assisted detection (CAD) programs for the identification of colorectal polyps: performance and sensitivity analysis, current limitations and practical tips for radiologists.

PubMed

Bell, L T O; Gandhi, S

2018-06-01

To directly compare the accuracy and speed of analysis of two commercially available computer-assisted detection (CAD) programs in detecting colorectal polyps. In this retrospective single-centre study, patients who had colorectal polyps identified on computed tomography colonography (CTC) and subsequent lower gastrointestinal endoscopy, were analysed using two commercially available CAD programs (CAD1 and CAD2). Results were compared against endoscopy to ascertain sensitivity and positive predictive value (PPV) for colorectal polyps. Time taken for CAD analysis was also calculated. CAD1 demonstrated a sensitivity of 89.8%, PPV of 17.6% and mean analysis time of 125.8 seconds. CAD2 demonstrated a sensitivity of 75.5%, PPV of 44.0% and mean analysis time of 84.6 seconds. The sensitivity and PPV for colorectal polyps and CAD analysis times can vary widely between current commercially available CAD programs. There is still room for improvement. Generally, there is a trade-off between sensitivity and PPV, and so further developments should aim to optimise both. Information on these factors should be made routinely available, so that an informed choice on their use can be made. This information could also potentially influence the radiologist's use of CAD results. Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Lessons Learned from Sleep Education in Schools: A Review of Dos and Don'ts.

PubMed

Blunden, Sarah; Rigney, Gabrielle

2015-06-15

Sleep duration and quality are associated with negative neuropsychological and psychosocial outcomes in children and adolescents. However, community awareness of this is low and sleep education programs in schools are attempting to address this issue. Several studies now exist assessing the efficacy of these sleep education programs for improving sleep knowledge, sleep hygiene and sleep patterns. This paper presents these sleep education programs, most particularly, it presents the strengths and weaknesses of the current available studies in the hope that this can identify areas where future sleep education programs can improve. A systematic search of all school-based sleep education studies in adolescents was undertaken. Studies were scrutinized for author, teacher and participant comment regarding strengths and limitations of each study, which were then extracted and summarized. Two specific types of sleep education programs emerged from the review, those that sought to change sleep behavior and those that sought simply to disseminate information. Issues that dictated the strength or weakness of a particular study including who delivers the program, the theoretical basis, the tools utilized to measure sleep patterns, the content, and their capacity to engage students were assessed. Sleep education was considered important by teachers, students and parents alike. Future sleep education programs need to take into account lessons learned from previous sleep education efforts in order to maximize the potential for sleep education programs to improve the sleep health of our young people. A commentary on this article appears in this issue on page 595. © 2015 American Academy of Sleep Medicine.

Essential Elements for a Pharmacy Practice Mentoring Program

PubMed Central

Hardy, Yolanda M.; Jarvis, Courtney; Stoner, Steven C.; Pitlick, Matthew; Hilaire, Michelle L.; Hanes, Scott; Carey, Katherine; Burke, Jack; Lodise, Nicole M.

2013-01-01

Formal guidelines for mentoring faculty members in pharmacy practice divisions of colleges and schools of pharmacy do not exist in the literature. This paper addresses the background literature on mentoring programs, explores the current state of mentoring programs used in pharmacy practice departments, and provides guidelines for colleges and schools instituting formal mentoring programs. As the number of pharmacy colleges and schools has grown, the demand for quality pharmacy faculty members has dramatically increased. While some faculty members gain teaching experience during postgraduate residency training, new pharmacy practice faculty members often need professional development to meet the demands of their academic responsibilities. A mentoring program can be 1 means of improving faculty success and retention. Many US colleges and schools of pharmacy have developed formal mentoring programs, whereas several others have informal processes in place. This paper discusses those programs and the literature available, and makes recommendations on the structure of mentoring programs. PMID:23519448

Impact of a diabetes disease management program on diabetes control and patient quality of life.

PubMed

Rasekaba, Tshepo Mokuedi; Graco, Marnie; Risteski, Chrissie; Jasper, Andrea; Berlowitz, David J; Hawthorne, Graeme; Hutchinson, Anastasia

2012-02-01

The worldwide burden of diabetes is projected to be 5.4% of the adult population by the year 2025. Diabetes is associated with multiple medical complications that both decrease health-related quality of life (HR-QOL) and contribute to earlier mortality. There is growing evidence for the effectiveness of multidisciplinary disease management programs that incorporate self-management principles in improving patients' long-term outcomes. The aim of this project was to evaluate the effectiveness of this approach in improving: (1) glycemic control measured by HbA1c, and (2) HR-QOL measured by the Assessment of Quality of Life (AQOL), at enrollment and at 12-months follow-up. Between 2004 and 2008, a total of 967 patients were enrolled in the program; 545 (56%) of these patients had HbA1c data available at baseline and at 12 months. Mean HbA1c at enrollment was 8.6% (SD 1.9) versus 7.3% (SD 1.2) at 12 months (P<0.001). Overall, 68% of patients experienced improvements in HbA1c. At enrollment, patients reported "fair" HR-QOL, which was significantly lower than age-adjusted population norms who reported "good" HR-QOL. At 12 months, 251 (64%) patients had improved HR-QOL, 27 (7%) had no change, and 114 (29%) deteriorated. Mean utility scores improved by 0.11 (P<0.001), which is almost twice the minimum clinically important difference for the AQOL. This study confirms that a multidisciplinary disease management program for patients with poorly controlled type 2 diabetes can improve both glycemic control and HR-QOL.

BioBlend.objects: metacomputing with Galaxy.

PubMed

Leo, Simone; Pireddu, Luca; Cuccuru, Gianmauro; Lianas, Luca; Soranzo, Nicola; Afgan, Enis; Zanetti, Gianluigi

2014-10-01

BioBlend.objects is a new component of the BioBlend package, adding an object-oriented interface for the Galaxy REST-based application programming interface. It improves support for metacomputing on Galaxy entities by providing higher-level functionality and allowing users to more easily create programs to explore, query and create Galaxy datasets and workflows. BioBlend.objects is available online at https://github.com/afgane/bioblend. The new object-oriented API is implemented by the galaxy/objects subpackage. © The Author 2014. Published by Oxford University Press.

Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

PubMed

McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

2012-10-01

To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management of the program.

Patient’s self-evaluation of two education programs for age-related skin changes in the face: a prospective, randomized, controlled study

PubMed Central

Williams, Linda M; Alderman, Jane E; Cussell, Garry; Goldston, John; Hamilton, Neal; Lim, Adrian C; Goodman, Greg J; Halstead, Michael B; Rogers, John D

2011-01-01

Background: An interactive software program (HOYS) has been developed utilizing a database of digital images depicting various aspects and degrees of aging of exposed skin across seven geographic regions, representing a total of 35 facial and extrafacial subregions. A five-point photonumeric rating scale, which portrays age-related skin changes across five decades for each of these subregions, underpins this patient-based interactive self-assessment program. Based on the resulting outputs from this program, an individualized treatment prioritization list is generated for each region where significant differences between the patient’s chronological and esthetic ages exist. This provides guidance for the patient and the treating physician on treatment options. Methods: To evaluate the utility of HOYS in the clinic, relative to education programs currently used in Australian private esthetic clinics, a total of 95 esthetically-orientated patients were enrolled in a prospective, randomized, controlled, multicenter study. Results: Compared with a prospective cohort of patients completing a standard education program commonly utilized in Australian esthetic clinics, patients receiving the HOYS education program reported greater empowerment through improved knowledge of specific age-related skin changes. This was associated with a clearer understanding of treatment options available to them, and a perceived ability to participate in the selection of the treatments potentially administered to improve their appearance. These differences between the two education groups were highly significant. Conclusion: Patients completing the HOYS patient education program have an improved understanding of age-related changes to exposed skin of their face, neck, décolletage, and hands. Due to the patient-specific nature of the program, these patients perceive a greater role in the deciding which esthetic treatments should be subsequently administered to enhance their appearance, through an improved understanding of the rationale for these treatments and indeed how they should be prioritized to achieve the best outcome for them. PMID:22087069

78 FR 79659 - Chronic Wasting Disease Herd Certification Program and Interstate Movement of Farmed or Captive...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

...We are giving notice of changes to the Program Standards for the chronic wasting disease (CWD) herd certification program. The CWD herd certification program is a voluntary, cooperative program that establishes minimum requirements for the interstate movement of farmed or captive cervids, provisions for participating States to administer Approved State CWD Herd Certification Programs, and provisions for participating herds to become certified as having a low risk of being infected with CWD. The Program Standards provide optional guidance, explanation, and clarification on how to meet the requirements for interstate movement and for the Herd Certification Programs. Recently, we convened a group of State, laboratory, and industry representatives to discuss possible changes to the current Program Standards. The revised Program Standards reflect these discussions, and we believe the revised version will improve understanding of the program among State and industry cooperators. We are making the revised version of the Program Standards available for review and comment.

Details at 11. How the Media View Higher Education.

ERIC Educational Resources Information Center

Tanzer, Les

1980-01-01

Reasons are given for media myopia about higher education, and suggestions are made for improving news media perceptions: (1) using personalities to enhance the university's image; (2) establishing a program for making faculty expertise available to the media; (3) emphasizing solutions, not problems; and (4) taking risks. (MSE)

Design Features of Pedagogically-Sound Software in Mathematics.

ERIC Educational Resources Information Center

Haase, Howard; And Others

Weaknesses in educational software currently available in the domain of mathematics are discussed. A technique that was used for the design and production of mathematics software aimed at improving problem-solving skills which combines sound pedagogy and innovative programming is presented. To illustrate the design portion of this technique, a…

Make Kids Count: Giving Babies a Smart Beginning.

ERIC Educational Resources Information Center

Thompson, Anne, Ed.

The Smart Beginnings project in Arizona is designed to increase public awareness and parent education about early childhood development and family support resources. The program is intended to identify, link, establish, and expand a public/private family support system and improve the quality and increase availability of infant and toddler child…

Improving American Schools: A National Perspective.

ERIC Educational Resources Information Center

Jennings, John F.

Although the amount of federal aid available directly to secondary schools is small, cutbacks in federal aid can have a significant impact on secondary education because several direct aid programs receiving major funding from federal sources affect secondary education indirectly. All education is also affected by federal tax deductions for state…

Vignettes of Several Existing Resources for Improving Rural Science, Mathematics, and Technology Education.

ERIC Educational Resources Information Center

Crosby, Greg, Comp.

This directory lists 24 organizations providing educational resource materials on rural science and technology, conservation, and the environment. Each entry contains the address and phone number of the organization, name of a contact person, and brief description of programs, activities, publications, and services available. Resource materials…

49 CFR 260.15 - Credit risk premium.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Credit risk premium. 260.15 Section 260.15... REHABILITATION AND IMPROVEMENT FINANCING PROGRAM Overview § 260.15 Credit risk premium. (a) Where available... pay to the Administrator a Credit Risk Premium adequate to cover that portion of the subsidy cost not...

Cap check helps reconcile payments with eligibility lists to improve cash flow.

PubMed

2003-05-01

Some capitated provider groups are becoming more adept at using software solutions to effectively manage retroactive deletions, additions and changes in membership enrollment. While a variety of software programs are available, several sources recommend using Cap Check to help match up eligibility lists with capitation payment.

Partnerships in natural resource agencies: a conceptual framework

Treesearch

Catherine V. Darrow; Jerry J. Vaske

1995-01-01

To meet financial constraints while maintaining or improving programs, natural resource managers have increasingly turned to partnerships with other public agencies or private businesses. The process of developing a successful partnership, however, is rarely chronicled, much less empirically studied. By using the available natural resource and business management...

7 CFR 4280.114 - Laws that contain other compliance requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Renewable Energy Systems and Energy Efficiency Improvements Program Section A. Grants § 4280.114 Laws that... of this title. Initial reviews will be conducted after Form RD 400-4 is signed and all subsequent... practicable after they decide to pursue any form of financial assistance directly or indirectly available...

The Impact of School Choice and Public Policy on Segregation: Evidence from Chile

ERIC Educational Resources Information Center

Elacqua, Gregory

2012-01-01

Advocates argue that vouchers can make improved educational opportunity available to disadvantaged students. Critics contend that vouchers increase the risk of stratification. Researchers have found that Chile's voucher program has lead to increased socioeconomic school segregation. What has been overlooked, however, is segregation between schools…

Improving Instructions Using a Data Analysis Collaborative Model

ERIC Educational Resources Information Center

Good, Rebecca B.; Jackson, Sherion H.

2007-01-01

As student data analysis reports become more sophisticated, these reports reveal greater details on low performance skills. Availability of models and programs depicting detailed instructions or guidance for utilizing data to impact classroom instruction, in an effort to increase student achievement, has been lacking. This study examines the…

42 CFR 438.207 - Assurances of adequate capacity and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Access Standards § 438.207 Assurances of adequate capacity and services. (a) Basic rule. The State... with the State's requirements for availability of services, as set forth in § 438.206. (e) CMS' right...

Rationale and Resources for Teaching the Mathematical Modeling of Athletic Training and Performance

ERIC Educational Resources Information Center

Clarke, David C.; Skiba, Philip F.

2013-01-01

A number of professions rely on exercise prescription to improve health or athletic performance, including coaching, fitness/personal training, rehabilitation, and exercise physiology. It is therefore advisable that the professionals involved learn the various tools available for designing effective training programs. Mathematical modeling of…

Future Directions in Public Relations Education.

ERIC Educational Resources Information Center

Kalupa, Frank B.; Allen, T. Harrell

1982-01-01

Survey of public relations practitioners and educators shows strong agreement for (1) changes and improvements in public relations education; (2) more business courses and greater emphasis on social science research; and (3) separate degree programs, not public relations majors within a journalism degree. For journal availability, see CS 705 902.…

Geologic map of the Sauvie Island quadrangle, Multnomah and Columbia Counties, Oregon, and Clark County, Washington

USGS Publications Warehouse

Evarts, Russell C.; O'Connor, Jim; Cannon, Charles M.

2016-03-02

This map contributes to a U.S. Geological Survey program to improve the geologic database for the Portland region of the Pacific Northwest urban corridor. The map and ancillary data will support assessments of seismic risk, ground-failure hazards, and resource availability.

Using Community Assessments to Improve 4-H Youth Development Programming Efforts

ERIC Educational Resources Information Center

Teuteberg, Dan; Cummins, Melissa M.

2017-01-01

Understanding resources available in a community is essential before any 4-H youth development professional can begin addressing local needs. Conducting a community assessment generates valuable information about the unique components and resources of a specific community. This information then provides a foundation for identifying specific…

GAPS OF DECISION SUPPORT MODELS FOR PIPELINE RENEWAL AND RECOMMENDATIONS FOR IMPROVEMENT - Paper

EPA Science Inventory

As part of the U.S. Environmental Protection Agency (EPA)’s Aging Water Infrastructure Research Program, one key area of research pursued, in collaboration with wastewater and water utilities, was a study of the current approaches available for making rehabilitation versus replac...

Does Student Attrition Explain KIPP's Success?

ERIC Educational Resources Information Center

Nichols-Barrer, Ira; Gill, Brian P.; Gleason, Philip; Tuttle, Christina Clark

2014-01-01

The Knowledge Is Power Program (KIPP) is a network of charter schools designed to improve the educational opportunities available to low-income families. KIPP schools seek to boost their students' academic achievement and ultimately prepare them to enroll and succeed in college. To achieve these objectives, KIPP schools leverage strong…

Health insurance systems in five Sub-Saharan African countries: medicine benefits and data for decision making.

PubMed

Carapinha, João L; Ross-Degnan, Dennis; Desta, Abayneh Tamer; Wagner, Anita K

2011-03-01

Medicine benefits through health insurance programs have the potential to improve access to and promote more effective use of affordable, high quality medicines. Information is lacking about medicine benefits provided by health insurance programs in Sub-Saharan Africa. We describe the structure of medicine benefits and data routinely available for decision-making in 33 health insurance programs in Ghana, Kenya, Nigeria, Tanzania and Uganda. Most programs surveyed were private, for profit schemes covering voluntary enrollees, mostly in urban areas. Almost all provide both inpatient and outpatient medicine benefits, with members sharing the cost of medicines in all programs. Some programs use strategies that are common in high-income countries to manage the medicine benefits, such as formularies, generics policies, reimbursement limits, or price negotiation. Basic data to monitor performance in delivering medicine benefits are available in most programs, but key data elements and the resources needed to generate useful management information from the available data are typically missing. Many questions remain unanswered about the design, implementation, and effects of specific medicines policies in the emerging and expanding health insurance programs in Sub-Saharan Africa. These include questions about the most effective medicines policy choices, given different corporate and organizational structures and resources; impacts of specific benefit designs on quality and affordability of care and health outcomes; and ways to facilitate use of routine data for monitoring. Technical capacity building, strong government commitment, and international donor support will be needed to realize the benefits of medicines coverage in emerging and expanding health insurance programs in Sub-Saharan Africa. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A yoga program for cognitive enhancement.

PubMed

Brunner, Devon; Abramovitch, Amitai; Etherton, Joseph

2017-01-01

Recent studies suggest that yoga practice may improve cognitive functioning. Although preliminary data indicate that yoga improves working memory (WM), high-resolution information about the type of WM subconstructs, namely maintenance and manipulation, is not available. Furthermore, the association between cognitive enhancement and improved mindfulness as a result of yoga practice requires empirical examination. The aim of the present study is to assess the impact of a brief yoga program on WM maintenance, WM manipulation and attentive mindfulness. Measures of WM (Digit Span Forward, Backward, and Sequencing, and Letter-Number Sequencing) were administered prior to and following 6 sessions of yoga (N = 43). Additionally, the Mindfulness Attention Awareness Scale was administered to examine the potential impact of yoga practice on mindfulness, as well as the relationships among changes in WM and mindfulness. Analyses revealed significant improvement from pre- to post- training assessment on both maintenance WM (Digit Span Forward) and manipulation WM (Digit Span Backward and Letter-Number Sequencing). No change was found on Digit Span Sequencing. Improvement was also found on mindfulness scores. However, no correlation was observed between mindfulness and WM measures. A 6-session yoga program was associated with improvement on manipulation and maintenance WM measures as well as enhanced mindfulness scores. Additional research is needed to understand the extent of yoga-related cognitive enhancement and mechanisms by which yoga may enhance cognition, ideally by utilizing randomized controlled trials and more comprehensive neuropsychological batteries.

Standard Engineering Installation Package, Technical Control Facility, Technical Control Improvement Program (TCIP)

DTIC Science & Technology

1979-10-01

software. This document may not be cited for purpose of advertisement . AVAILABILITY This publication is available to non-Government agencies and may be...voltage interface requirements for repeaters. This supply occupies one slot in the 10306 mounting shelf. 1.4.2.8.5 Teletypewriter monitor. The AN/ UGC -61X...The AN/ UGC -61X keyboard send-receive (KSR) TTY set is an electromechanical apparatus that provides terminal facilities with two receive only, one KSR

Improving Warfarin Management Within the Medical Home: A Health-System Approach.

PubMed

Rose, Anne E; Robinson, Erin N; Premo, Joan A; Hauschild, Lori J; Trapskin, Philip J; McBride, Ann M

2017-03-01

Anticoagulation clinics have been considered the optimal strategy for warfarin management with demonstrated improved patient outcomes through increased time in therapeutic international normalized ratio (INR) range, decreased critical INR values, and decreased anticoagulation-related adverse events. However, not all health systems are able to support a specialized anticoagulation clinic or may see patient volume exceed available anticoagulation clinic resources. The purpose of this study was to utilize an anticoagulation clinic model to standardize warfarin management in a primary care clinic setting. A warfarin management program was developed that included standardized patient assessment, protocolized warfarin-dosing algorithm, and electronic documentation and reporting tools. Primary care clinics were targeted for training and implementation of this program. The warfarin management program was applied to over 2000 patients and implemented at 39 clinic sites. A total of 160 nurses and 15 pharmacists were trained on the program. Documentation of warfarin dose and date of the next INR increased from 70% to 90% (P <.0001), documentation occurring within 24 hours of the INR result increased from 75% to 87% (P <.0001), and monitoring the INR at least every 4 weeks increased from 71% to 83% (P <.0001) per patient encounter. Time in therapeutic INR range improved from 65% to 75%. Incorporating a standardized approach to warfarin management in the primary care setting significantly improves warfarin-related documentation and time in therapeutic INR range. Copyright © 2016 Elsevier Inc. All rights reserved.

Review of Strategies to Enhance Outcomes for Patients with Type 2 Diabetes: Payers' Perspective

PubMed Central

Greenapple, Rhonda

2011-01-01

Background Diabetes and its clinical consequences exact a great toll on patients and on society in terms of its effects on morbidity and mortality and its staggering economic impact. Objective To review various programs and strategies that aim at enhancing adherence to antihyperglycemic therapy and suggest the best approach to improving patient outcomes and reducing healthcare costs. Discussion Treatment goals for patients with diabetes have been defined, and multiple safe and effective medications are available. Nevertheless, the majority of patients with diabetes fail to achieve treatment goals, because of difficulty with adherence to medication regimens and lifestyle modifications, and because of economic barriers. This article discusses various initiatives developed to improve patient outcomes, including consumer-driven health plans and wellness and prevention programs. Furthermore, economic incentives to patients, such as value-based insurance design, may increase adherence; nevertheless, evidence suggests that such programs alone provide only modest gains. Primary providers in disease management programs can include nurses, case managers, or pharmacists. Supportive interventions across several modalities have been shown to be effective. Conclusion An approach that uses a combination of strategies designed to impact patients' health-related behaviors across a variety of modalities may help to improve outcomes and reduce costs. Additional novel, innovative interdisciplinary initiatives are necessary to effect meaningful change that can facilitate improved health outcomes for patients with diabetes and maximize cost-effectiveness approaches for payers. PMID:25126364

ATR NSUF Instrumentation Enhancement Efforts

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

Joy L. Rempe; Mitchell K. Meyer; Darrell L. Knudson

A key component of the Advanced Test Reactor (ATR) National Scientific User Facility (NSUF) effort is to expand instrumentation available to users conducting irradiation tests in this unique facility. In particular, development of sensors capable of providing real-time measurements of key irradiation parameters is emphasized because of their potential to increase data fidelity and reduce posttest examination costs. This paper describes the strategy for identifying new instrumentation needed for ATR irradiations and the program underway to develop and evaluate new sensors to address these needs. Accomplishments from this program are illustrated by describing new sensors now available to users ofmore » the ATR NSUF. In addition, progress is reported on current research efforts to provide improved in-pile instrumentation to users.« less

Using a Non-Equivalent Groups Quasi Experimental Design to Reduce Internal Validity Threats to Claims Made by Math and Science K-12 Teacher Recruitment Programs

NASA Astrophysics Data System (ADS)

Moin, Laura

2009-10-01

The American Recovery and Reinvestment Act national policy established in 2009 calls for ``meaningful data'' that demonstrate educational improvements, including the recruitment of high-quality teachers. The scant data available and the low credibility of many K-12 math/science teacher recruitment program evaluations remain the major barriers for the identification of effective recruitment strategies. Our study presents a methodology to better evaluate the impact of recruitment programs on increasing participants' interest in teaching careers. The research capitalizes on the use of several control groups and presents a non-equivalent groups quasi-experimental evaluation design that produces program effect claims with higher internal validity than claims generated by current program evaluations. With this method that compares responses to a teaching career interest question from undergraduates all along a continuum from just attending an information session to participating (or not) in the recruitment program, we were able to compare the effect of the program in increasing participants' interest in teaching careers versus the evolution of the same interest but in the absence of the program. We were also able to make suggestions for program improvement and further research. While our findings may not apply to other K-12 math/science teacher recruitment programs, we believe that our evaluation methodology does and will contribute to conduct stronger program evaluations. In so doing, our evaluation procedure may inform recruitment program designers and policy makers.

A systematic review of school-based suicide prevention programs.

PubMed

Katz, Cara; Bolton, Shay-Lee; Katz, Laurence Y; Isaak, Corinne; Tilston-Jones, Toni; Sareen, Jitender

2013-10-01

Suicide is one of the leading causes of death among youth today. Schools are a cost-effective way to reach youth, yet there is no conclusive evidence regarding the most effective prevention strategy. We conducted a systematic review of the empirical literature on school-based suicide prevention programs. Studies were identified through MEDLINE and Scopus searches, using keywords such as "suicide, education, prevention and program evaluation." Additional studies were identified with a manual search of relevant reference lists. Individual studies were rated for level of evidence, and the programs were given a grade of recommendation. Five reviewers rated all studies independently and disagreements were resolved through discussion. Sixteen programs were identified. Few programs have been evaluated for their effectiveness in reducing suicide attempts. Most studies evaluated the programs' abilities to improve students' and school staffs' knowledge and attitudes toward suicide. Signs of Suicide and the Good Behavior Game were the only programs found to reduce suicide attempts. Several other programs were found to reduce suicidal ideation, improve general life skills, and change gatekeeper behaviors. There are few evidence-based, school-based suicide prevention programs, a combination of which may be effective. It would be useful to evaluate the effectiveness of general mental health promotion programs on the outcome of suicide. The grades assigned in this review are reflective of the available literature, demonstrating a lack of randomized controlled trials. Further evaluation of programs examining suicidal behavior outcomes in randomized controlled trials is warranted. © 2013 Wiley Periodicals, Inc.

Crosswords to computers: a critical review of popular approaches to cognitive enhancement.

PubMed

Jak, Amy J; Seelye, Adriana M; Jurick, Sarah M

2013-03-01

Cognitive enhancement strategies have gained recent popularity and have the potential to benefit clinical and non-clinical populations. As technology advances and the number of cognitively healthy adults seeking methods of improving or preserving cognitive functioning grows, the role of electronic (e.g., computer and video game based) cognitive training becomes more relevant and warrants greater scientific scrutiny. This paper serves as a critical review of empirical evaluations of publically available electronic cognitive training programs. Many studies have found that electronic training approaches result in significant improvements in trained cognitive tasks. Fewer studies have demonstrated improvements in untrained tasks within the trained cognitive domain, non-trained cognitive domains, or on measures of everyday function. Successful cognitive training programs will elicit effects that generalize to untrained, practical tasks for extended periods of time. Unfortunately, many studies of electronic cognitive training programs are hindered by methodological limitations such as lack of an adequate control group, long-term follow-up and ecologically valid outcome measures. Despite these limitations, evidence suggests that computerized cognitive training has the potential to positively impact one's sense of social connectivity and self-efficacy.

Development and evaluation of addiction treatment programs in Latin America.

PubMed

Marín-Navarrete, Rodrigo; Medina-Mora, María Elena; Pérez-López, Alejandro; Horigian, Viviana E

2018-07-01

The aim of this article is to present a state-of-the-art review of the scientific studies that have evaluated healthcare systems, services and programs for addiction treatment in Latin America. As a secondary aim, this article presents a brief description and analysis of the addiction prevention and treatment resources and programs available in Latin America, based on information from the ATLAS on Substance Use (ATLAS-SU) project led by the WHO. Substance use disorders (SUDs) are among the main causes associated with global burden of disease. Around the world, many initiatives have been proposed to promote policies to reduce substance use and reduce the impact of SUD, including integrating treatments into healthcare systems, increasing access to treatment programs and impacting outcome measures. In Latin America, multiple efforts have been implemented to improve addiction services and programs, although little is known about the impact they have generated. International studies report the availability of strategies and public inicitatives on prevention and treatment of addiction in Latin America. These studies also report established networks of public and private services that include prevention and detoxification programs, outpatient and residential treatment, and also social reintegration initiatives. However, despite these advances, information on the evaluation of the progress, results and impact of these programs is limited.

Evaluation of the content and accessibility of microsurgery fellowship program websites.

PubMed

Silvestre, Jason; Vargas, Christina R; Ho, Olivia; Lee, Bernard T

2015-10-01

Microsurgery fellowship applicants utilize Internet-based resources such as the San Francisco Match (SF Match) to manage their applications. In deciding where to apply, applicants rely on advice from mentors and online resources including microsurgery fellowship websites (MFWs). The purpose of this study was to evaluate the content and accessibility of MFWs. While microsurgery is practiced by many surgical specialties, this study focused on MFWs for programs available in the 2014 Microsurgery Fellowship Match. Program lists from the American Society for Reconstructive Microsurgery (ASRM) and the San Francisco Match (SF Match) were analyzed for the accessibility of MFW links. MFWs were evaluated for education and recruitment content, and MFW comprehensiveness was compared on the basis of program characteristics using chi square tests. Of the 25 fellowships available, only 18 had websites (72%). SF Match and ASRM listed similar programs (96% overlap) and provided website links (89%, 76%), but only a minority connected directly to the MFW (38%, 23%). A minority of programs were responsive via email inquiry (36%). MFWs maintained minimal education and recruitment content. MFW comprehensiveness was not associated with program characteristics. MFWs are often not readily accessible and contain limited information for fellowship applicants. Given the relative low-cost of website development, MFWs may be improved to facilitate fellow recruitment. © 2015 Wiley Periodicals, Inc.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

PubMed Central

Van der Wees, Philip J; Hendriks, Erik JM; Custers, Jan WH; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-01-01

Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program. PMID:18036215

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

PubMed

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

Criminal investigations of child abuse: the research behind "best practices".

PubMed

Jones, Lisa M; Cross, Theodore P; Walsh, Wendy A; Simone, Monique

2005-07-01

This article reviews the research relevant to seven practices considered by many to be among the most progressive approaches to criminal child abuse investigations: multidisciplinary team investigations, trained child forensic interviewers, videotaped interviews, specialized forensic medical examiners, victim advocacy programs, improved access to mental health treatment for victims, and Children's Advocacy Centers (CACs). The review finds that despite the popularity of these practices, little outcome research is currently available documenting their success. However, preliminary research supports many of these practices or has influenced their development. Knowledge of this research can assist investigators and policy makers who want to improve the response to victims, understand the effectiveness of particular programs, or identify where assumptions about effectiveness are not empirically supported.

Using data to make decisions and drive results: a LEAN implementation strategy.

PubMed

Panning, Rick

2005-03-28

During the process of facility planning, Fairview Laboratory Services utilized LEAN manufacturing to maximize efficiency, simplify processes, and improve laboratory support of patient care services. By incorporating the LEAN program's concepts in our pilot program, we were able to reduce turnaround time by 50%, improve productivity by greater than 40%, reduce costs by 31%, save more than 440 square feet of space, standardize work practices, reduce errors and error potential, continuously measure performance, eliminate excess unused inventory and visual noise, and cross-train 100% of staff in the core laboratory. In addition, we trained a core team of people that is available to coordinate future LEAN projects in the laboratory and other areas of the organization.

Sterilization, contraception and abortion: global issues for women.

PubMed

Potts, M; Masho, S W

1995-08-01

Research in contraceptive technology, investments in family planning programs, and the availability of safe abortion are essential not only to control population growth and improve the health of mothers and children, but also to improve the status of women. At present, however, it is estimated that 25% of married women in sub-Saharan Africa, 18% in Latin America and the Caribbean, and 13% in Asia, the Middle East, and North Africa have an unmet need for contraception. Without rapid advances in access to family planning, more women will die during this decade from pregnancy, childbirth, and abortion than in any other decade in history. Although the 1994 Cairo Conference achieved consensus on a range of reproductive health issues, strategies for implementing and funding these programs remain undefined.

Computer-Based Auditory Training Programs for Children with Hearing Impairment - A Scoping Review.

PubMed

Nanjundaswamy, Manohar; Prabhu, Prashanth; Rajanna, Revathi Kittur; Ningegowda, Raghavendra Gulaganji; Sharma, Madhuri

2018-01-01

Introduction  Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective  To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis  Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was well-structured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions  There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices.

Computer-Based Auditory Training Programs for Children with Hearing Impairment – A Scoping Review

PubMed Central

Nanjundaswamy, Manohar; Prabhu, Prashanth; Rajanna, Revathi Kittur; Ningegowda, Raghavendra Gulaganji; Sharma, Madhuri

2018-01-01

Introduction  Communication breakdown, a consequence of hearing impairment (HI), is being fought by fitting amplification devices and providing auditory training since the inception of audiology. The advances in both audiology and rehabilitation programs have led to the advent of computer-based auditory training programs (CBATPs). Objective  To review the existing literature documenting the evidence-based CBATPs for children with HIs. Since there was only one such article, we also chose to review the commercially available CBATPs for children with HI. The strengths and weaknesses of the existing literature were reviewed in order to improve further researches. Data Synthesis  Google Scholar and PubMed databases were searched using various combinations of keywords. The participant, intervention, control, outcome and study design (PICOS) criteria were used for the inclusion of articles. Out of 124 article abstracts reviewed, 5 studies were shortlisted for detailed reading. One among them satisfied all the criteria, and was taken for review. The commercially available programs were chosen based on an extensive search in Google. The reviewed article was well-structured, with appropriate outcomes. The commercially available programs cover many aspects of the auditory training through a wide range of stimuli and activities. Conclusions  There is a dire need for extensive research to be performed in the field of CBATPs to establish their efficacy, also to establish them as evidence-based practices. PMID:29371904

ACCOMPLISHMENTS OF THE AMERICAN-POLISH PROGRAM FOR ELIMINATION OF LOW EMISSIONS IN KRAKOW

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

BUTCHER,T.A.; PIERCE,B.

1998-11-05

In 1991, US and Polish officials signed a Memorandum of Understanding formally initiating and directing the Cracow Clean Fossil Fuels and Energy Efficiency Program. Developing a program approach for the most effective use of the available funds required considerable effort on the part of all project participants. The team recognized early that the cost of solving the low emissions problem even in only one city far exceeded the amount of available US funds. Economic conditions in Poland limited availability of local capital funds for environmental projects. Imposing environmental costs on struggling companies or city residents under difficult conditions of themore » early 1990's required careful consideration of the economic and political impacts. For all of these reasons the program sought to identify technologies for achieving air quality goals which, through improved efficiency and/or reduced fuel cost, could be so attractive economically as to lead to self-sustaining activities beyond the end of the formal project. The effort under this program has been focused into 5 main areas of interest as follows: (1) Energy Conservation and Extension of Central Station District Heating; (2) Replacement of Coal- and Coke-Fired Boilers with Natural Gas-Fired Boilers; (3) Replacement of Coal-Fired Home Stoves with Electric Heating Appliances; (4) Reduction of Emissions from Stoker-Fired Boiler Houses; and (5) Reduction of Emissions from Coal-Fired Home Heating Stoves.« less

Using Data to Improve Programs: Assessment of a Data Quality and Use Intervention Package for Integrated Community Case Management in Malawi.

PubMed

Hazel, Elizabeth; Chimbalanga, Emmanuel; Chimuna, Tiyese; Nsona, Humphreys; Mtimuni, Angella; Kaludzu, Ernest; Gilroy, Kate; Guenther, Tanya

2017-09-27

Health Surveillance Assistants (HSAs) have been providing integrated community case management (iCCM) for sick children in Malawi since 2008. HSAs report monthly iCCM program data but, at the time of this study, little of it was being used for service improvement. Additionally, HSAs and facility health workers did not have the tools to compile and visualize the data they collected to make evidence-based program decisions. From 2012 to 2013, we worked with Ministry of Health staff and partners to develop and pilot a program in Dowa and Kasungu districts to improve data quality and use at the health worker level. We developed and distributed wall chart templates to display and visualize data, provided training to 426 HSAs and supervisors on data analysis using the templates, and engaged health workers in program improvement plans as part of a data quality and use (DQU) package. We assessed the package through baseline and endline surveys of the HSAs and facility and district staff in the study areas, focusing specifically on availability of reporting forms, completeness of the forms, and consistency of the data between different levels of the health system as measured through results verification ratio (RVR). We found evidence of significant improvements in reporting consistency for suspected pneumonia illness (from overreporting cases at baseline [RVR=0.82] to no reporting inconsistency at endline [RVR=1.0]; P =.02). Other non-significant improvements were measured for fever illness and gender of the patient. Use of the data-display wall charts was high; almost all HSAs and three-fourths of the health facilities had completed all months since January 2013. Some participants reported the wall charts helped them use data for program improvement, such as to inform community health education activities and to better track stock-outs. Since this study, the DQU package has been scaled up in Malawi and expanded to 2 other countries. Unfortunately, without the sustained support and supervision provided in this project, use of the tools in the Malawi scale-up is lower than during the pilot period. Nevertheless, this pilot project shows community and facility health workers can use data to improve programs at the local level given the opportunity to access and visualize the data along with supervision support. © Hazel et al.

Impact of Participation in a Community-Based Intimate Partner Violence Prevention Program on Medical Students: A Multi-Center Study

PubMed Central

Guiton, Gretchen; Chirra, Annapoorna; Núñez, Ana E.; Bigby, JudyAnn; Stahl, Christiane; Robertson, Candace; Thul, Elizabeth C.; Miller, Elizabeth; Sims, Abigail; Sachs, Carolyn J.; Pregler, Janet P.

2008-01-01

Background Physicians are generally poorly trained to recognize, treat or refer adolescents at risk for intimate partner violence (IPV). Participation in community programs may improve medical students’ knowledge, skills, and attitudes about IPV prevention. Objective To determine whether the experience of serving as educators in a community-based adolescent IPV prevention program improves medical students’ knowledge, skills, and attitudes toward victims of IPV, beyond that of didactic training. Participants One hundred and seventeen students attending 4 medical schools. Design Students were randomly assigned to didactic training in adolescent IPV prevention with or without participation as educators in a community-based adolescent IPV prevention program. Students assigned to didactic training alone served as community educators after the study was completed. Measurement Knowledge, self-assessment of skills and attitudes about intimate partner violence and future plans to pursue outreach work. Results The baseline mean knowledge score of 10.25 improved to 21.64 after didactic training (p ≤ .001). Medical students in the “didactic plus outreach” group demonstrated higher levels of confidence in their ability to address issues of intimate partner violence, (mean = 41.91) than did students in the “didactic only” group (mean = 38.94) after controlling for initial levels of confidence (p ≤ .002). Conclusions Experience as educators in a community-based program to prevent adolescent IPV improved medical students’ confidence and attitudes in recognizing and taking action in situations of adolescent IPV, whereas participation in didactic training alone significantly improved students’ knowledge. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0624-y) contains supplementary material, which is available to authorized users. PMID:18612741

Improving cold chain systems: Challenges and solutions.

PubMed

Ashok, Ashvin; Brison, Michael; LeTallec, Yann

2017-04-19

While a number of new vaccines have been rolled out across the developing world (with more vaccines in the pipeline), cold chain systems are struggling to efficiently support national immunization programs in ensuring the availability of safe and potent vaccines. This article reflects on the Clinton Health Access Initiative, Inc. (CHAI) experience working since 2010 with national immunization programs and partners to improve vaccines cold chains in 10 countries-Ethiopia, Nigeria, Kenya, Malawi, Tanzania, Uganda, Cameroon, Mozambique, Lesotho and India - to identify the root causes and solutions for three common issues limiting cold chain performance. Key recommendations include: Collectively, the solutions detailed in this article chart a path to substantially improving the performance of the cold chain. Combined with an enabling global and in-country environment, it is possible to eliminate cold chain issues as a substantial barrier to effective and full immunization coverage over the next few years. Copyright © 2017. Published by Elsevier Ltd.

Measuring the implementation of early childhood development programs.

PubMed

Aboud, Frances E; Prado, Elizabeth L

2018-05-01

In this paper we describe ways to measure variables of interest when evaluating the implementation of a program to improve early childhood development (ECD). The variables apply to programs delivered to parents in group sessions and home or clinic visits, as well as in early group care for children. Measurements for four categories of variables are included: training and assessment of delivery agents and supervisors; program features such as quality of delivery, reach, and dosage; recipients' acceptance and enactment; and stakeholders' engagement. Quantitative and qualitative methods are described, along with when measures might be taken throughout the processes of planning, preparing, and implementing. A few standard measures are available, along with others that researchers can select and modify according to their goals. Descriptions of measures include who might collect the information, from whom, and when, along with how information might be analyzed and findings used. By converging on a set of common methods to measure implementation variables, investigators can work toward improving programs, identifying gaps that impede the scalability and sustainability of programs, and, over time, ascertain program features that lead to successful outcomes. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.

Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

PubMed

Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

2016-05-01

Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P < .003 for all). The findings indicate that an interdisciplinary rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Another Program For Generating Interactive Graphics

NASA Technical Reports Server (NTRS)

Costenbader, Jay; Moleski, Walt; Szczur, Martha; Howell, David; Engelberg, Norm; Li, Tin P.; Misra, Dharitri; Miller, Philip; Neve, Leif; Wolf, Karl;

Ground-Water Availability in the United States

USGS Publications Warehouse

Reilly, Thomas E.; Dennehy, Kevin F.; Alley, William M.; Cunningham, William L.

2008-01-01

Ground water is among the Nation's most important natural resources. It provides half our drinking water and is essential to the vitality of agriculture and industry, as well as to the health of rivers, wetlands, and estuaries throughout the country. Large-scale development of ground-water resources with accompanying declines in ground-water levels and other effects of pumping has led to concerns about the future availability of ground water to meet domestic, agricultural, industrial, and environmental needs. The challenges in determining ground-water availability are many. This report examines what is known about the Nation's ground-water availability and outlines a program of study by the U.S. Geological Survey Ground-Water Resources Program to improve our understanding of ground-water availability in major aquifers across the Nation. The approach is designed to provide useful regional information for State and local agencies who manage ground-water resources, while providing the building blocks for a national assessment. The report is written for a wide audience interested or involved in the management, protection, and sustainable use of the Nation's water resources.

Cloudgene: A graphical execution platform for MapReduce programs on private and public clouds

PubMed Central

2012-01-01

Background The MapReduce framework enables a scalable processing and analyzing of large datasets by distributing the computational load on connected computer nodes, referred to as a cluster. In Bioinformatics, MapReduce has already been adopted to various case scenarios such as mapping next generation sequencing data to a reference genome, finding SNPs from short read data or matching strings in genotype files. Nevertheless, tasks like installing and maintaining MapReduce on a cluster system, importing data into its distributed file system or executing MapReduce programs require advanced knowledge in computer science and could thus prevent scientists from usage of currently available and useful software solutions. Results Here we present Cloudgene, a freely available platform to improve the usability of MapReduce programs in Bioinformatics by providing a graphical user interface for the execution, the import and export of data and the reproducibility of workflows on in-house (private clouds) and rented clusters (public clouds). The aim of Cloudgene is to build a standardized graphical execution environment for currently available and future MapReduce programs, which can all be integrated by using its plug-in interface. Since Cloudgene can be executed on private clusters, sensitive datasets can be kept in house at all time and data transfer times are therefore minimized. Conclusions Our results show that MapReduce programs can be integrated into Cloudgene with little effort and without adding any computational overhead to existing programs. This platform gives developers the opportunity to focus on the actual implementation task and provides scientists a platform with the aim to hide the complexity of MapReduce. In addition to MapReduce programs, Cloudgene can also be used to launch predefined systems (e.g. Cloud BioLinux, RStudio) in public clouds. Currently, five different bioinformatic programs using MapReduce and two systems are integrated and have been successfully deployed. Cloudgene is freely available at http://cloudgene.uibk.ac.at. PMID:22888776

Case report: a work simulation program for a manual worker with a fracture injury.

PubMed

Chan, Chi-Chung; Chow, Jonathan H.W.

2000-01-01

Work rehabilitation programs targeting different client groups are available in nearly all major hospital occupational therapy departments in Hong Kong. Clients receiving work rehabilitation are referred from various out-patient clinics and other occupational therapists. Those clients experience limitation in work after their injuries or diseases and plan to return to work after rehabilitation. Program objectives are 1) to assist clients to reach maximum work capacity as rapidly as possible 2) to ensure clients return to work safely 3) to improve clients' work readiness. This case report describes an individualized work simulation program at a general hospital in Hong Kong provided for a typical client who is preparing to return to his worker role. Specific job analysis, goals and program rationale for the client are discussed.

Improving the interactivity and functionality of Web-based radiology teaching files with the Java programming language.

PubMed

Eng, J

1997-01-01

Java is a programming language that runs on a "virtual machine" built into World Wide Web (WWW)-browsing programs on multiple hardware platforms. Web pages were developed with Java to enable Web-browsing programs to overlay transparent graphics and text on displayed images so that the user could control the display of labels and annotations on the images, a key feature not available with standard Web pages. This feature was extended to include the presentation of normal radiologic anatomy. Java programming was also used to make Web browsers compatible with the Digital Imaging and Communications in Medicine (DICOM) file format. By enhancing the functionality of Web pages, Java technology should provide greater incentive for using a Web-based approach in the development of radiology teaching material.

Heliocentric interplanetary low thrust trajectory optimization program, supplement 1, part 2

NASA Technical Reports Server (NTRS)

Mann, F. I.; Horsewood, J. L.

1978-01-01

The improvements made to the HILTOP electric propulsion trajectory computer program are described. A more realistic propulsion system model was implemented in which various thrust subsystem efficiencies and specific impulse are modeled as variable functions of power available to the propulsion system. The number of operating thrusters are staged, and the beam voltage is selected from a set of five (or less) constant voltages, based upon the application of variational calculus. The constant beam voltages may be optimized individually or collectively. The propulsion system logic is activated by a single program input key in such a manner as to preserve the HILTOP logic. An analysis describing these features, a complete description of program input quantities, and sample cases of computer output illustrating the program capabilities are presented.

Educating nurses about research ethics and practices with a self-directed practice-based learning program.

PubMed

Cibulka, Nancy J

2011-11-01

Learner-driven and practice-based education programs are recommended for integration of learning. A continuing education program on research ethics was introduced to five nurses in an ambulatory care setting at a Magnet® hospital, using a commercially available web-based course followed by a research practicum. The seasoned nurses reported little previous education in this area. Working with a nurse researcher, three nurses participated in a research project for improving clinic care delivery. The success of the continuing education program was determined by knowledge acquisition, satisfaction with learning activities, and perceived confidence in research participation. This continuing education program was effective in providing for knowledge and skill development in research ethics. The integrative learning format was well received. Copyright 2011, SLACK Incorporated.

Improved NASTRAN plotting

NASA Technical Reports Server (NTRS)

Chan, Gordon C.

1991-01-01

The new 1991 COSMIC/NASTRAN version, compatible with the older versions, tries to remove some old constraints and make it easier to extract information from the plot file. It also includes some useful improvements and new enhancements. New features available in the 1991 version are described. They include a new PLT1 tape with simplified ASCII plot commands and short records, combined hidden and shrunk plot, an x-y-z coordinate system on all structural plots, element offset plot, improved character size control, improved FIND and NOFIND logic, a new NASPLOT post-prosessor to perform screen plotting or generate PostScript files, and a BASIC/NASTPLOT program for PC.

Advantages and Disadvantages of Health Care Accreditation Mod-els.

PubMed

Tabrizi, Jafar S; Gharibi, Farid; Wilson, Andrew J

2011-01-01

This systematic review seeks to define the general advantages and disadvan-tages of accreditation programs to assist in choosing the most appropriate approach. Systematic search of SID, Ovid Medline & PubMed databases was conducted by the keywords of accreditation, hospital, medical practice, clinic, accreditation models, health care and Persian meanings. From 2379 initial articles, 83 articles met the full inclusion criteria. From initial analysis, 23 attributes were identified which appeared to define advantages and disadvantages of different accreditation approaches and the available systems were compared on these. Six systems were identified in the international literature including the JCAHO from USA, the Canadian program of CCHSA, and the accreditation programs of UK, Australia, New Zealand and France. The main distinguishing attributes among them were: quality improve-ment, patient and staff safety, improving health services integration, public's confi-dence, effectiveness and efficiency of health services, innovation, influence global standards, information management, breadth of activity, history, effective relationship with stakeholders, agreement with AGIL attributes and independence from government. Based on 23 attributes of comprehensive accreditation systems we have defined from a systematic review, the JCAHO accreditation program of USA and then CCHSA of Can-ada offered the most comprehensive systems with the least disadvantages. Other programs such as the ACHS of Australia, ANAES of France, QHNZ of New Zealand and UK accredita-tion programs were fairly comparable according to these criteria. However the decision for any country or health system should be based on an assessment weighing up their specific objec-tives and needs.

Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial.

PubMed

King, Laurie A; Wilhelm, Jennifer; Chen, Yiyi; Blehm, Ron; Nutt, John; Chen, Zunqiu; Serdar, Andrea; Horak, Fay B

2015-10-01

Comparative studies of exercise interventions for people with Parkinson disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by (1) home exercise program, (2) individualized physical therapy, or (3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. Fifty-eight people (age = 63.9 ± 8 years) with PD participated. People were randomized into (1) home exercise program, (2) individual physical therapy, or (3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test. Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS-Motor, and activity of daily living scores were included. Only the individual group significantly improved in the Physical Performance Test. The individual exercise showed the most improvements in functional and balance measures, whereas the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD, and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A112).

Measurement of high altitude air quality using aircraft

NASA Technical Reports Server (NTRS)

Rudey, R. A.; Perkins, P. J.

1973-01-01

The minor atmospheric constituents associated with and affected by aircraft exhaust emissions at altitudes from 6 to 20 km will be monitored in flight programs presently being implemented. Preliminary in situ data are available from flight tests of dedicated instruments to be used in these programs. A Global Atmospheric Sampling Program using Boeing 747 airliners was determined to be feasible in studies conducted by airlines and airframe companies. Worldwide monitoring in the troposphere and the lower stratosphere is planned. Stratospheric air sampling on a more local basis will be done with a U2 aircraft. Measuring system evaluations and improvements have been required to detect the low background levels.

Measurement of high-altitude air quality using aircraft.

NASA Technical Reports Server (NTRS)

Rudey, R. A.; Perkins, P. J.

1973-01-01

The minor atmospheric constituents associated with and affected by aircraft exhaust emissions at altitudes from 6 to 20 km will be monitored in flight programs presently being implemented. Preliminary in situ data are available from flight tests of dedicated instruments to be used in these programs. A Global Atmospheric Sampling Program using Boeing 747 airliners was determined to be feasible in studies conducted by airlines and airframe companies. Worldwide monitoring in the troposphere and the lower stratosphere is planned. Stratospheric air sampling on a more local basis will be done with a U2 aircraft. Measuring system evaluations and improvements have been required to detect the low background levels.

Residents-as-teachers programs in psychiatry: a systematic review.

PubMed

Dewey, Charlene M; Coverdale, John H; Ismail, Nadia J; Culberson, John W; Thompson, Britta M; Patton, Cynthia S; Friedland, Joan A

2008-02-01

Because psychiatry residents have important roles as teachers and significant opportunities to contribute to medical student education, we set out to: identify all randomized control trials (RCT) for residents' teaching skills programs in psychiatry and to identify the efficacy of those interventions for improving teaching skills; identify the strengths and weaknesses of the available studies across medical disciplines; and identify currently available methods for enhancing residents' teaching skills for residents training in psychiatry. The published English-language literature was searched using PubMed, Social Sciences Index, and PsycINFO databases, with key search words including: residents, teaching skills, residents as teachers, psychiatry, and assessments. Both RCT and controlled, nonrandomized trials of residents' teaching programs directed to enhance residents' teaching skills were selected and critically appraised. Of 13 trials identified and reviewed, most included residents in internal medicine. Only one included psychiatry residents and assessed their ability to teach interviewing skills to medical students. Along with other studies, this study demonstrated improvement in residents' teaching skills. Overall, interventions and outcome measures were heterogeneous while the quality of methodologies varied. Five studies were of higher quality, representing examples of quality educational research. Several described group differences, blinding, good follow-up, and use of valid, reliable tools. Only one trial exists that incorporated psychiatry residents. Significant opportunity to advance educational research in this field exists. Psychiatry residency program directors should incorporate high-quality methodologies and can benefit from the findings of trials in other disciplines.

Building a Navigation System to Reduce Cancer Disparities in Urban Black Older Adults

PubMed Central

Bone, Lee; Edington, Kristen; Rosenberg, Jessica; Wenzel, Jennifer; Garza, Mary A.; Klein, Catherine; Schmitt, Lisa; Ford, Jean G.

2014-01-01

Background Although cancer outcomes have improved in recent decades, substantial disparities by race, ethnicity, income and education persist. Increasingly, patient navigation services are demonstrating success in improving cancer detection, treatment and care and in reducing cancer health disparities. To advance progress in developing patient navigation programs, extensive descriptions of each component of the program must be made available to researchers and health service providers. Objective To describe the components of a patient navigation program designed to improve cancer screening based on informed decision-making on cancer screening and cancer treatment services among predominantly Black older adults in Baltimore City. Methods A community-academic participatory approach was used to develop a patient navigation program in Baltimore, Maryland. The components of the patient navigation system included the development of a community academic (advisory) committee (CAC); recruitment and selection of community health workers (CHWs)/navigators and supervisory staff; initial training and continuing education of the CHWs/navigators; and evaluation of CHWs/navigators. The study was approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board. Conclusions The incorporation of community-based participatory research (CPBR) principles into each facet of this patient navigation program facilitated the attainment of the intervention’s objectives. This patient navigation program successfully delivered cancer navigation services to 1302 urban Black older adults. Appropriately recruited, selected and trained CHWs monitored by an experienced supervisor and investigators are the key elements in a patient navigation program. This model has the potential to be adapted by research and health service providers. PMID:23793252

The Business Value of Superior Energy Performance

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

McKane, Aimee; Scheihing, Paul; Evans, Tracy

Industrial facilities participating in the U.S. Department of Energy’s (US DOE) Superior Energy Performance (SEP) program are finding that it provides them with significant business value. This value starts with the implementation of ISO 50001-Energy management system standard, which provides an internationally-relevant framework for integration of energy management into an organization’s business processes. The resulting structure emphasizes effective use of available data and supports continual improvement of energy performance. International relevance is particularly important for companies with a global presence or trading interests, providing them with access to supporting ISO standards and a growing body of certified companies representing themore » collective knowledge of communities of practice. This paper examines the business value of SEP, a voluntary program that builds on ISO 50001, inviting industry to demonstrate an even greater commitment through third-party verification of energy performance improvement to a specified level of achievement. Information from 28 facilities that have already achieved SEP certification will illustrate key findings concerning both the value and the challenges from SEP/ISO 50001 implementation. These include the facilities’ experience with implementation, internal and external value of third-party verification of energy performance improvement; attractive payback periods and the importance of SEP tools and guidance. US DOE is working to bring the program to scale, including the Enterprise-Wide Accelerator (SEP for multiple facilities in a company), the Ratepayer-Funded Program Accelerator (supporting tools for utilities and program administrators to include SEP in their program offerings), and expansion of the program to other sectors and industry supply chains.« less

Avoiding 100 New Power Plants by Increasing Efficiency of Room Air Conditioners in India: Opportunities and Challenges

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

Phadke, Amol; Abhyankar, Nikit; Shah, Nihar

Electricity demand for room ACs is growing very rapidly in emerging economies such as India. We estimate the electricity demand from room ACs in 2030 in India considering factors such as weather and income growth using market data on penetration of ACs in different income classes and climatic regions. We discuss the status of the current standards, labels, and incentive programs to improve the efficiency of room ACs in these markets and assess the potential for further large improvements in efficiency and find that efficiency can be improved by over 40percent cost effectively. The total potential energy savings from Roommore » AC efficiency improvement in India using the best available technology will reach over 118 TWh in 2030; potential peak demand saving is found to be 60 GW by 2030. This is equivalent to avoiding 120 new coal fired power plants of 500 MW each. We discuss policy options to complement, expand and improve the ongoing programs to capture this large potential.« less

Air medical referring customer satisfaction: a valuable insight.

PubMed

Fultz, J H; Coyle, C B; Reynolds, P W

1998-01-01

To remain competitive and survive, air medical programs must have a mechanism for obtaining customer feedback, especially when alternate transport options are available. The goal of this survey was to examine the air medical service's performance as perceived by customers requesting the transport. Surveys were mailed to 400 referring customers who had contact with the flight crew during the transition of patient care. The survey consisted of 16 statements evaluating the service by using a 4-point Likert scale, three demographic questions, one statement evaluating overall satisfaction, and two open-ended questions for comments or suggestions. Two hundred forty-four surveys were returned for a 61% responses rate. Results indicated referring customers are satisfied with the service provided Written comments and suggestions were divided into two categories, positive comments and suggestions for improvement. Three common themes were identified within the suggestions for improvement: crew rapport, communications, and operations. Suggested improvements were evaluated, and selected strategies were incorporated into program operation. Customer feedback furnishes valuable insight into their needs and perception of a service. Comments and suggestions for improvement can promote critical inquiry into service operation and provide a catalyst for improvement.

A pilot videoconference group stress management program in cancer survivors: lessons learned.

PubMed

Zhou, Eric S; Partridge, Ann H; Blackmon, Jaime E; Morgan, Evan; Recklitis, Christopher J

2016-01-01

Cancer is a challenging experience and there is evidence that psychosocial interventions are effective at improving adjustment following treatment. At our cancer center, 14 cancer survivors (breast, prostate and blood cancers) completed a four-session cognitive-behavioral stress program. The first session was delivered at the survivor's local cancer center, where they were provided with a loaner tablet. The three subsequent sessions were delivered through group-based videoconference on the tablet. Session content was supplemented with a tailored ebook, designed specifically for this program. Participants provided feedback about the program as well as a standardized measure of perceived stress. Despite evidence that psychosocial programs are effective, there are significant barriers to dissemination, particularly for those residing in rural areas who do not live near academic medical centers where such programming is more readily available. Our experiences delivering a group-based videoconference program in cancer survivors are described, including positives and challenges associated with its design and implementation. Study participants enrolled from across four different US states, and the majority reported at least a 30-minute commute to their cancer center. This travel burden played a meaningful role in their desire to participate in our videoconference-based program. Although participants reported that session content was well suited to addressing stress management concerns, and session facilitators were able to effectively teach program techniques (eg progressive muscle relaxation, cognitive-reframing) and that the program was helpful overall, only modest improvements in perceived stress were seen. Participants noted challenges of the delivery including feeling disconnected from others, difficulty focusing, technical problems, and a desire for a longer program. Thus, although the novel delivery of a group-based, psychosocial program using tablet videoconference is feasible in a survivorship program, and desired by cancer survivors, key improvements must be made in future efforts. Our enthusiasm about the potential of telehealth must be tempered with the reality that such delivery can present challenges that interfere with the intervention implementation and efficacy. Facilitators must proactively address both the technological and interpersonal challenges associated with the use of group-based videoconference in order to improve its ability to positively impact cancer survivors. Many of these issues can be resolved prior to program launch, and require foresight and planning on the part of the program team.

Prevalence of health promotion programs in primary health care units in Brazil

PubMed Central

Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

2014-01-01

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

Evaluating Dermatology Residency Program Websites.

PubMed

Ashack, Kurt A; Burton, Kyle A; Soh, Jonathan M; Lanoue, Julien; Boyd, Anne H; Milford, Emily E; Dunnick, Cory; Dellavalle, Robert P

2016-03-16

Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms to improve their websites and provide adequate content to attract the top residents for their respective programs.

Surface water-quality assessment of the lower Kansas River basin, Kansas and Nebraska: analysis of available water-quality data through 1986

USGS Publications Warehouse

Jordan, P.R.; Stamer, J.K.

1991-01-01

Beginning in 1986, the U.S. Congress appropriated funds for the U.S. Geological Survey to test and refine concepts for a National Water-Quality Assessment (NAWQA) Program. The long-term goals of the full-scale program are to: (1) provide a nationally consistent description of current water-quality conditions for a large part of the Nation's surface- and ground-water resources; (2) define long-term trends (or lack of trends) in water quality; and (3) identify, describe, and explain, insofar as possible, the major factors that affect current conditions and trends in water quality. This information, obtained on a continuing basis, will be made available to water managers, policy makers, and the public to provide an improved scientific basis for evaluating the effectiveness of water-quality-management programs and for predicting the likely effects of contemplated changes in land-and water-management practices. At present (1990), the assessment program is in a pilot phase in seven areas that represent diverse hydrologic environments and water-quality conditions.This report completes one of the first activities undertaken as part of the lower Kansas River basin pilot study, which was to compile, screen, and interpret available water-quality data for the study unit through 1986. The report includes information on the sources and types of water-quality data available, the utility of available water-quality data for assessment purposes, and a description of current water-quality conditions and trends and their relation to natural and human factors.

Improving Water Management Decision Support Tools Using NASA Satellite and Modeling Data

NASA Astrophysics Data System (ADS)

Toll, D. L.; Arsenault, K.; Nigro, J.; Pinheiro, A.; Engman, E. T.; Triggs, J.; Cosgrove, B.; Alonge, C.; Boyle, D.; Allen, R.; Townsend, P.; Ni-Meister, W.

2006-05-01

One of twelve Applications of National priority within NASA's Applied Science Program, the Water Management Program Element addresses concerns and decision making related to water availability, water forecast and water quality. The goal of the Water Management Program Element is to encourage water management organizations to use NASA Earth science data, models products, technology and other capabilities in their decision support tools for problem solving. The Water Management Program Element partners with Federal agencies, academia, private firms, and may include international organizations. This paper further describes the Water Management Program with the objective of informing the applications community of the potential opportunities for using NASA science products for problem solving. We will illustrate some ongoing and application Water Management projects evaluating and benchmarking NASA data with partnering federal agencies and their decision support tools: 1) Environmental Protection Agency for water quality; 2) Bureau of Reclamation for water supply, demand and forecast; and 3) NOAA National Weather Service for improved weather prediction. Examples of the types of NASA contributions to the these agency decision support tools include: 1) satellite observations within models assist to estimate water storage, i.e., snow water equivalent, soil moisture, aquifer volumes, or reservoir storages; 2) model derived products, i.e., evapotranspiration, precipitation, runoff, ground water recharge, and other 4-dimensional data assimilation products; 3) improve water quality, assessments by using improved inputs from NASA models (precipitation, evaporation) and satellite observations (e.g., temperature, turbidity, land cover) to nonpoint source models; and 4) water (i.e., precipitation) and temperature predictions from days to decades over local, regional and global scales.

Telemedicine and Diabetic Retinopathy: Review of Published Screening Programs

PubMed Central

Tozer, Kevin; Woodward, Maria A.; Newman-Casey, Paula A.

2016-01-01

Background Diabetic Retinopathy (DR) is a leading cause of blindness worldwide even though successful treatments exist. Improving screening and treatment could avoid many cases of vision loss. However, due to an increasing prevalence of diabetes, traditional in-person screening for DR for every diabetic patient is not feasible. Telemedicine is one viable solution to provide high-quality and efficient screening to large number of diabetic patients. Purpose To provide a narrative review of large DR telemedicine screening programs. Methods Articles were identified through a comprehensive search of the English-language literature published between 2000 and 2014. Telemedicine screening programs were included for review if they had published data on at least 150 patients and had available validation studies supporting their model. Screening programs were then categorized according to their American Telemedicine Association Validation Level. Results Seven programs from the US and abroad were identified and included in the review. Three programs were Category 1 programs (Ophdiat, EyePacs, and Digiscope), two were Category 2 programs (Eye Check, NHS Diabetic Eye Screening Program), and two were Category 3 programs (Joslin Vision Network, Alberta Screening Program). No program was identified that claimed category 4 status. Programs ranged from community or city level programs to large nationwide programs including millions of individuals. The programs demonstrated a high level of clinical accuracy in screening for DR. There was no consensus amongst the programs regarding the need for dilation, need for stereoscopic images, or the level of training for approved image graders. Conclusion Telemedicine programs have been clinically validated and successfully implemented across the globe. They can provide a high-level of clinical accuracy for screening for DR while improving patient access in a cost-effective and scalable manner. PMID:27430019

Evaluation of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) Fellowship Program Website Content and Quality.

PubMed

Homer, Natalie; Yoon, Michael K

The qualities that applicants value in the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) fellowship programs have been studied, but the availability of this information on program websites has not yet been reviewed. The authors evaluated the availability of resident-valued ASOPRS fellowship program information on the Internet. The authors performed an Internet search of the 53 ASOPRS fellowship program websites and evaluated websites for 20 characteristics of interest to ASOPRS fellowship applicants such as teaching faculty, program description, rotation schedule, operative cases, and interview information. Of the 53 ASOPRS fellowship programs, 43 (81.1%) had a fellowship program-dedicated website. The fellowship websites contained a mean 7.6 characteristics (38.1%, range 0-15). Faculty listing, program description, and case diversity were the most commonly included data (74.4%, 72.1%, and 69.8%, respectively). Fellow selection process, interview information, and graduate job placement were least commonly included (7.0%, 2.3%, and 0.0%, respectively). There was no significant difference in website inclusiveness based on fellowship region or faculty number. Programs affiliated with an ophthalmology residency were more complete than those that were not (40.3% vs. 20.0%, p = 0.0098). This review found that most programs had websites and contained a reasonable number of characteristics. However, applicant-valued information regarding surgical volume, procedure variety, application information, and postgraduate employment history were often missing. American Society of Ophthalmic Plastic and Reconstructive Surgery fellowship programs may improve match outcomes by providing and enhancing program websites with details that their applicants seek.

China's women leaders promote quality and equity in family planning.

PubMed

He, S

1995-08-01

In China, key policy-makers at the highest levels of government recognize that the success of the family planning (FP) program depends upon improving the status of Chinese women. The highest ranking female government official, Peng Peiyun, a State Councilor and the Minister of the State Family Planning (FP) Commission, has initiated a new policy of improving the quality of service in the FP program. She recognizes that women who are gainfully employed and control their income are less likely to desire large families. One aspect of the effort to improve quality involves training FP personnel in interpersonal communication and counseling skills. The results of a pilot training program show that clients are pleased with the new approach and that use of FP services has increased. The FP Commission is also experimenting with programs which integrate all the needs of women and their families (FP, credit availability, old age support) in rural areas. Traditionally, sons provided for their elderly parents, so families with only one daughter are concerned about old age provision. Thus, national efforts are underway to develop social security systems. In the meantime, women at all levels, from grassroots FP acceptors to FP staff members and researchers are the major contributors to the innovations which will allow China to control its population growth.

Organizing graduate medical education programs into communities of practice.

PubMed

Bing-You, Robert G; Varaklis, Kalli

2016-01-01

Background A new organizational model of educational administrative support was instituted in the Department of Medical Education (DME) to better meet increasing national accreditation demands. Residency and fellowship programs were organized into four 'Communities of Practice' (CoOPs) based on discipline similarity, number of learners, and geographic location. Program coordinator reporting lines were shifted from individual departments to a centralized reporting structure within the DME. The goal of this project was to assess the impact on those most affected by the change. Methods This was a mixed methods study that utilized structured interviews and the Organizational Culture Assessment Instrument (OCAI). Eleven members of the newly formed CoOPs participated in the study. Results Three major themes emerged after review and coding of the interview transcripts: improved group identity, improved availability of resources, and increased opportunity for professional growth. OCAI results indicated that respondents are committed to the DME and perceived the culture to be empowering. The 'preferred culture' was very similar to the culture at the time of the study, with some indication that DME employees are ready for more creativity and innovation in the future. Conclusion Reorganization within the DME of residency programs into CoOPs was overwhelmingly perceived as a positive change. Improved resources and accountability may position our DME to better handle the increasing complexity of graduate medical education.

Organizing graduate medical education programs into communities of practice.

PubMed

Bing-You, Robert G; Varaklis, Kalli

2016-01-01

A new organizational model of educational administrative support was instituted in the Department of Medical Education (DME) to better meet increasing national accreditation demands. Residency and fellowship programs were organized into four 'Communities of Practice' (CoOPs) based on discipline similarity, number of learners, and geographic location. Program coordinator reporting lines were shifted from individual departments to a centralized reporting structure within the DME. The goal of this project was to assess the impact on those most affected by the change. This was a mixed methods study that utilized structured interviews and the Organizational Culture Assessment Instrument (OCAI). Eleven members of the newly formed CoOPs participated in the study. Three major themes emerged after review and coding of the interview transcripts: improved group identity, improved availability of resources, and increased opportunity for professional growth. OCAI results indicated that respondents are committed to the DME and perceived the culture to be empowering. The 'preferred culture' was very similar to the culture at the time of the study, with some indication that DME employees are ready for more creativity and innovation in the future. Reorganization within the DME of residency programs into CoOPs was overwhelmingly perceived as a positive change. Improved resources and accountability may position our DME to better handle the increasing complexity of graduate medical education.

Public Finance Policy Strategies to Increase Access to Preconception Care

PubMed Central

2006-01-01

Policy and finance barriers reduce access to preconception care and, reportedly, limit professional practice changes that would improve the availability of needed services. Millions of women of childbearing age (15–44) lack adequate health coverage (i.e., uninsured or underinsured), and others live in medically underserved areas. Service delivery fragmentation and lack of professional guidelines are additional barriers. This paper reviews barriers and opportunities for financing preconception care, based on a review and analysis of state and federal policies. We describe states’ experiences with and opportunities to improve health coverage, through public programs such as Medicaid, Medicaid waivers, and the State Children's Health Insurance Program (SCHIP). The potential role of Title V and of community health centers in providing primary and preventive care to women also is discussed. In these and other public health and health coverage programs, opportunities exist to finance preconception care for low-income women. Three major policy directions are discussed. To increase access to preconception care among women of childbearing age, the federal and state governments have opportunities to: (1) improve health care coverage, (2) increase the supply of publicly subsidized health clinics, and (3) direct delivery of preconception screening and interventions in the context of public health programs. PMID:16802188

77 FR 15263 - Approval and Promulgation of Implementation Plans; New Jersey; Motor Vehicle Enhanced Inspection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-15

... copyrighted material, is not placed on the Internet and will be publicly available only in hard copy form... to 5 years and an acknowledgement with supporting justification that New Jersey's decentralized I/M... improvements in effectiveness of the decentralized program and to determine a reasonable effectiveness fraction...

9 CFR 149.3 - Site audit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Site audit. 149.3 Section 149.3... LIVESTOCK IMPROVEMENT VOLUNTARY TRICHINAE CERTIFICATION PROGRAM § 149.3 Site audit. (a) General. (1) The producer must contact a QAV or QVMO to request a site audit. A list of available QAVs may be obtained by...

Center for Nondestructive Evaluation - Center for Nondestructive Evaluation

Science.gov Websites

available for the full range of inspection methods, housed in a 52,000 sq. ft. facility with over $5M in - 1990): Development of NDE methods for application to DOE energy and weapons programs, including multi for enhanced frequency bandwidth and improved flaw reconstruction, and novel methods for poling

78 FR 11700 - Notice of Availability: Beta Test of Electronic Product Fulfillment for Addressing and Delivery...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-19

... additional information to [email protected] to: Mr. Charles B. Hunt, Program Manager, Licensing Group... FURTHER INFORMATION CONTACT: Charles B. Hunt at (901) 681-4651, or Angela D. Lawson at (901) 681-4458..., and identify opportunities for service improvement. This functionality will give licensees more...

Changing Directions: Toward a Comprehensive System of Services for Early Childhood Care and Education.

ERIC Educational Resources Information Center

Miller, Susan R.

This paper discusses the nature and availability of early childhood care and education in Illinois and advances recommendations to improve the current system. It argues that current multiple federal, state, and local funding streams, with different eligibility requirements and administrations, divide families and programs into artificial and…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

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

78 FR 65523 - Farm Loan Programs; Clarification and Improvement

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... experiencing a lack of availability and therefore have problems with both timeliness and the cost of an... an appraisal and timeliness has not been a significant problem. Due to these differences in the..., pest and disease problems, etc. so the CFS filing would have to be amended every year resulting in...

Using Keystroke Analytics to Improve Pass-Fail Classifiers

ERIC Educational Resources Information Center

Casey, Kevin

2017-01-01

Learning analytics offers insights into student behaviour and the potential to detect poor performers before they fail exams. If the activity is primarily online (for example computer programming), a wealth of low-level data can be made available that allows unprecedented accuracy in predicting which students will pass or fail. In this paper, we…

Critical Reading: A Guide for Faculty and Students in Economics and History. Final Report, Second Year.

ERIC Educational Resources Information Center

Bean, Thomas W.

The first year of California State University's program to improve university students' critical reading of introductory texts had two objectives: to develop professors' available repertoire of strategies for guiding students' independent learning from texts and to develop students' facility in learning from texts with adjunct guide materials…

Climb Hard, Train Harder: Supplemental Training Techniques for Improved Rock Climbing Performance

ERIC Educational Resources Information Center

Larew, Bradley; Haibach-Beach, Pamela

2017-01-01

Climbing is an increasingly popular recreational activity that has attracted interest from a wide variety of populations, likely because of the increasing availability and challenge of climbing. Many children and adolescents are introduced to rock climbing in adventure programming units in their schools. Through physical education, children are…

75 FR 68312 - Notice of Availability of a Draft Environmental Impact Statement (DEIS) for New Medium- and Heavy...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... (DEIS) for New Medium- and Heavy-Duty Fuel Efficiency Improvement Program AGENCY: National Highway... commercial medium- and heavy-duty on-highway vehicles and work trucks (``HD vehicles''), which NHTSA recently... to Create First-Ever National Efficiency and Emissions Standards for Medium- and Heavy-Duty Trucks...

Improving Student Outcomes of Community-Based Programs through Peer-to-Peer Conversation

ERIC Educational Resources Information Center

Mitchell, Joshua J.; Gillon, Kathleen E.; Reason, Robert D.; Ryder, Andrew J.

2016-01-01

The authors used the Personal and Social Responsibility Inventory (PSRI), a nationally available campus climate assessment, for this study. The PSRI, which assesses individual students' behavior and perceptions of campus climate related to civic learning in higher education, was developed in 2006 as part of the Core Commitments Initiative of the…

Exploring the Experiences of Female Student Veterans with Disabilities Entering Higher Education during Reintegration: A Phenomenological Study

ERIC Educational Resources Information Center

Williams, Beverly Tillery

2016-01-01

The purpose of this qualitative transcendental phenomenological study was to explore and describe the lived experiences of female student veterans with disabilities entering higher education during reintegration in order to improve programs, services, and support available to female student veterans with disabilities. A screening questionnaire,…

Adopting NDN Projects. A Guide for Adult Education Programs.

ERIC Educational Resources Information Center

Office of Vocational and Adult Education (ED), Washington, DC.

This guide is designed to assist adult education leaders and practitioners to consider carefully the adoption of one or more of the available National Diffusion Network (NDN) projects. It is also intended to help them understand their opportunity and responsibility for improving adult education practice through the proper use of adoption…

Improvement of sensitivity of graphene photodetector by creating bandgap structure

NASA Astrophysics Data System (ADS)

Zhang, Ni-Zhen; He, Meng-Ke; Yu, Peng; Zhou, Da-Hua

2017-10-01

Not Available Project supported by the National Natural Science Foundation of China (Grant No. 51271210), the Chongqing Municipal Research Program of Basic Research and Frontier Technology, China (Grant No. cstc2015jcyjBX0039), and the Foundation for the Creative Research Groups of Higher Education of Chongqing Municipality, China (Grant No. CXTDX201601016).

Protocol for the evaluation of a quality-based pay for performance scheme in Liberia.

PubMed

Bawo, Luke; Leonard, Kenneth L; Mohammed, Rianna

2015-01-13

Improving the quality of care at hospitals is a key next step in rebuilding Liberia's health system. In order to improve the efficiency, effectiveness, and quality of care at the secondary hospital level, the country is developing a system to upgrade health worker skills and competencies, and shifting towards improved provider accountability for results, including a Graduate Medical Residency Program (GMRP) and provider accountability for improvements in quality through performance-based financing (PBF) at the hospital level. This document outlines the protocol for the impact evaluation of the hospital improvement program. The evaluation will provide an estimate of the impact of the project and investigate the mechanism for success in a way that can provide general lessons about the quality of health care in low-income countries. The evaluation aims 1) to provide the best possible estimate of program impact and 2) to quantitatively describe the changes that took place within facilities as a result of the program. In particular, the impact evaluation focuses on the changes in human resources within the hospitals. As such, we use a three-period intensive evaluation of treated and matched comparison hospitals to see how services change in treated hospitals as well as a continuous data collection effort to track the activities of individual health workers within treated hospitals. We are particularly interested in understanding how facilities met quality targets. Did they bring in new health workers with higher qualifications? Did they improve the knowledge or competence of their existing staff? Did they improve the availability of medicines and equipment so that the capacities of existing health workers were improved? Did they address the motivation of health workers so that individuals with the same competence and capacity were able to provide higher quality? And, if they did improve quality, did patients notice?

Research and development of improved geothermal well logging techniques, tools and components (current projects, goals and status). Final report

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

Lamers, M.D.

One of the key needs in the advancement of geothermal energy is availability of adequate subsurface measurements to aid the reservoir engineer in the development and operation of geothermal wells. Some current projects being sponsored by the U. S. Department of Energy's Division of Geothermal Energy pertaining to the development of improved well logging techniques, tools and components are described. An attempt is made to show how these projects contribute to improvement of geothermal logging technology in forming key elements of the overall program goals.

Improving designer productivity

NASA Technical Reports Server (NTRS)

Hill, Gary C.

1992-01-01

Designer and design team productivity improves with skill, experience, and the tools available. The design process involves numerous trials and errors, analyses, refinements, and addition of details. Computerized tools have greatly speeded the analysis, and now new theories and methods, emerging under the label Artificial Intelligence (AI), are being used to automate skill and experience. These tools improve designer productivity by capturing experience, emulating recognized skillful designers, and making the essence of complex programs easier to grasp. This paper outlines the aircraft design process in today's technology and business climate, presenting some of the challenges ahead and some of the promising AI methods for meeting those challenges.

Communicating quality improvement through a hospital newsletter.

PubMed

Tietz, A; Tabor, R

1995-01-01

Healthcare organizations across the United States are embracing the tenets of continuous quality improvement. The challenge is to disseminate information about this quality activity throughout the organization. A monthly newsletter serves two vital purposes: to share the improvements and to generate more enthusiasm and participation by staff members. This article gives practical suggestions for promoting a monthly newsletter. Preparation of an informative newsletter requires a significant investment of time and effort. However, the positive results of providing facilitywide communications can make it worth the effort. The current availability of relatively inexpensive desktop publishing computer software programs has made the process much easier.

Life after the ban: an assessment of US syringe exchange programs' attitudes about and early experiences with federal funding.

PubMed

Green, Traci C; Martin, Erika G; Bowman, Sarah E; Mann, Marita R; Beletsky, Leo

2012-05-01

We aimed to determine whether syringe exchange programs (SEPs) currently receive or anticipate pursuing federal funding and barriers to funding applications following the recent removal of the long-standing ban on using federal funds for SEPs. We conducted a telephone-administered cross-sectional survey of US SEPs. Descriptive statistics summarized responses; bivariate analyses examined differences in pursuing funding and experiencing barriers by program characteristics. Of the 187 SEPs (92.1%) that responded, 90.9% were legally authorized. Three received federal funds and 116 intended to pursue federal funding. Perceived federal funding barriers were common and included availability and accessibility of funds, legal requirements such as written police support, resource capacity to apply and comply with funding regulations, local political and structural organization, and concern around altering program culture. Programs without legal authorization, health department affiliation, large distribution, or comprehensive planning reported more federal funding barriers. Policy implementation gaps appear to render federal support primarily symbolic. In practice, funding opportunities may not be available to all SEPs. Increased technical assistance and legal reform could improve access to federal funds, especially for SEPs with smaller capacity and tenuous local support.

Lessons Learned from Sleep Education in Schools: A Review of Dos and Don'ts

PubMed Central

Blunden, Sarah; Rigney, Gabrielle

2015-01-01

Study Objectives: Sleep duration and quality are associated with negative neuropsychological and psychosocial outcomes in children and adolescents. However, community awareness of this is low and sleep education programs in schools are attempting to address this issue. Several studies now exist assessing the efficacy of these sleep education programs for improving sleep knowledge, sleep hygiene and sleep patterns. This paper presents these sleep education programs, most particularly, it presents the strengths and weaknesses of the current available studies in the hope that this can identify areas where future sleep education programs can improve. Methods: A systematic search of all school-based sleep education studies in adolescents was undertaken. Studies were scrutinized for author, teacher and participant comment regarding strengths and limitations of each study, which were then extracted and summarized. Results: Two specific types of sleep education programs emerged from the review, those that sought to change sleep behavior and those that sought simply to disseminate information. Issues that dictated the strength or weakness of a particular study including who delivers the program, the theoretical basis, the tools utilized to measure sleep patterns, the content, and their capacity to engage students were assessed. Sleep education was considered important by teachers, students and parents alike. Conclusions: Future sleep education programs need to take into account lessons learned from previous sleep education efforts in order to maximize the potential for sleep education programs to improve the sleep health of our young people. Commentary: A commentary on this article appears in this issue on page 595. Citation: Blunden S, Rigney G. Lessons learned from sleep education in schools: a review of dos and don'ts. J Clin Sleep Med 2015;11(6):671–680. PMID:25766709

Behavioral Change Strategies for Improving Complementary Feeding and Breastfeeding.

PubMed

Osendarp, Saskia J M; Roche, Marion L

2016-01-01

Improving infant and young child feeding (IYCF) practices, including breastfeeding and complementary feeding, has been identified as one of the most effective interventions to improve child survival, stunting and wasting. Evidence from randomized controlled trials suggests that effective promotion of breastfeeding and complementary feeding, with or without food provision, has the potential to improve IYCF practices and child nutrition. However, in many countries, breastfeeding practices and complementary feeding practices are still far from optimal. The lack of implementation of available, effective, affordable interventions in scale-up programs is in part attributed to a lack of innovative, creative and effective behavioral change strategies that enable and encourage caregivers. Successful behavioral change strategies should be based on a rigorous situational analysis and formative research, and the findings and insights of formative research should be used to further design interventions that address the identified barriers and enablers, to select delivery channels, and to formulate appropriate and effective messages. In addition, successful behavioral change interventions should a priori define and investigate the program impact pathway to target behavioral change and should assess intermediary behavioral changes and indicators to learn why the expected outcome was achieved or not achieved by testing the program theory. The design of behavioral change communication must be flexible and responsive to shifts in societies and contexts. Performance of adequate IYCF also requires investments to generate community demand through social mobilization, relevant media and existing support systems. Applying these principles has been shown to be effective in improving IYCF practices in Vietnam, Bangladesh and Ethiopia and is recommended to be adopted by other programs and countries in order to accelerate progress in improving child nutrition. © 2016 S. Karger AG, Basel.

Comprehensive review of the evidence regarding the effectiveness of community-based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects.

PubMed

Perry, Henry B; Sacks, Emma; Schleiff, Meike; Kumapley, Richard; Gupta, Sundeep; Rassekh, Bahie M; Freeman, Paul A

2017-06-01

As part of our review of the evidence of the effectiveness of community-based primary health care (CBPHC) in improving maternal, neonatal and child health (MNCH), we summarize here the common delivery strategies of projects, programs and field research studies (collectively referred to as projects) that have demonstrated effectiveness in improving child mortality. Other articles in this series address specifically the effects of CBPHC on improving MNCH, while this paper explores the specific strategies used. We screened 12 166 published reports in PubMed of community-based approaches to improving maternal, neonatal and child health in high-mortality, resource-constrained settings from 1950-2015. A total of 700 assessments, including 148 reports from other publicly available sources (mostly unpublished evaluation reports and books) met the criteria for inclusion and were reviewed using a data extraction form. Here we identify and categorize key strategies used in project implementation. Six categories of strategies for program implementation were identified, all of which required working in partnership with communities and health systems: (a) program design and evaluation, (b) community collaboration, (c) education for community-level staff, volunteers, beneficiaries and community members, (d) health systems strengthening, (e) use of community-level workers, and (f) intervention delivery. Four specific strategies for intervention delivery were identified: (a) recognition, referral, and (when possible) treatment of serious childhood illness by mothers and/or trained community agents, (b) routine systematic visitation of all homes, (c) facilitator-led participatory women's groups, and (d) health service provision at outreach sites by mobile health teams. The strategies identified here provide useful starting points for program design in strengthening the effectiveness of CBPHC for improving MNCH.

Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 6. strategies used by effective projects

PubMed Central

Perry, Henry B; Sacks, Emma; Schleiff, Meike; Kumapley, Richard; Gupta, Sundeep; Rassekh, Bahie M; Freeman, Paul A

2017-01-01

Background As part of our review of the evidence of the effectiveness of community–based primary health care (CBPHC) in improving maternal, neonatal and child health (MNCH), we summarize here the common delivery strategies of projects, programs and field research studies (collectively referred to as projects) that have demonstrated effectiveness in improving child mortality. Other articles in this series address specifically the effects of CBPHC on improving MNCH, while this paper explores the specific strategies used. Methods We screened 12 166 published reports in PubMed of community–based approaches to improving maternal, neonatal and child health in high–mortality, resource–constrained settings from 1950–2015. A total of 700 assessments, including 148 reports from other publicly available sources (mostly unpublished evaluation reports and books) met the criteria for inclusion and were reviewed using a data extraction form. Here we identify and categorize key strategies used in project implementation. Results Six categories of strategies for program implementation were identified, all of which required working in partnership with communities and health systems: (a) program design and evaluation, (b) community collaboration, (c) education for community–level staff, volunteers, beneficiaries and community members, (d) health systems strengthening, (e) use of community–level workers, and (f) intervention delivery. Four specific strategies for intervention delivery were identified: (a) recognition, referral, and (when possible) treatment of serious childhood illness by mothers and/or trained community agents, (b) routine systematic visitation of all homes, (c) facilitator–led participatory women’s groups, and (d) health service provision at outreach sites by mobile health teams. Conclusions The strategies identified here provide useful starting points for program design in strengthening the effectiveness of CBPHC for improving MNCH. PMID:28685044

FY2014 Propulsion Materials R&D Annual Progress Report

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

None

The Propulsion Materials Program actively supports the energy security and reduction of greenhouse emissions goals of VTO by investigating and identifying the materials properties that are most essential for continued development of cost-effective, highly efficient, and environmentally friendly next-generation heavy and light-duty powertrains. The technical approaches available to enhance propulsion systems focus on improvements in both vehicle efficiency and fuel substitution, both of which must overcome the performance limitations of the materials currently in use. Propulsion Materials Program activities work with national laboratories, industry experts, and VTO powertrain systems (e.g., Advanced Combustion Engines [ACE], Advanced Power Electronics and Electrical Machinesmore » [APEEM], and fuels) teams to develop strategies that overcome materials limitations in future powertrain performance. The technical maturity of the portfolio of funded projects ranges from basic science to subsystem prototype validation. Projects within a Propulsion Materials Program activity address materials concerns that directly impact critical technology barriers within each of the above programs, including barriers that impact fuel efficiency, thermal management, emissions reduction, improved reliability, and reduced manufacturing costs. The program engages only the barriers that result from material property limitations and represent fundamental, high-risk materials issues.« less

FY2015 Propulsion Materials Annual Report

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

None, None

The Propulsion Materials Program actively supports the energy security and reduction of greenhouse emissions goals of VTO by investigating and identifying the materials properties that are most essential for continued development of cost-effective, highly efficient, and environmentally friendly next-generation heavy and light-duty powertrains. The technical approaches available to enhance propulsion systems focus on improvements in both vehicle efficiency and fuel substitution, both of which must overcome the performance limitations of the materials currently in use. Propulsion Materials Program activities work with national laboratories, industry experts, and VTO powertrain systems (e.g., Advanced Combustion Engines [ACE], Advanced Power Electronics and Electrical Machinesmore » [APEEM], and fuels) teams to develop strategies that overcome materials limitations in future powertrain performance. The technical maturity of the portfolio of funded projects ranges from basic science to subsystem prototype validation. Projects within a Propulsion Materials Program activity address materials concerns that directly impact critical technology barriers within each of the above programs, including barriers that impact fuel efficiency, thermal management, emissions reduction, improved reliability, and reduced manufacturing costs. The program engages only the barriers that result from material property limitations and represent fundamental, high-risk materials issues.« less

Improving maternal care with a continuous quality improvement strategy: a report from the Interventions to Minimize Preterm and Low Birth Weight Infants through Continuous Improvement Techniques (IMPLICIT) Network.

PubMed

Bennett, Ian M; Coco, Andrew; Anderson, Janice; Horst, Michael; Gambler, Angela S; Barr, Wendy Brooks; Ratcliffe, Stephen

2009-01-01

Maternal medical care (prenatal and postpartum) involves a set of clinical interventions addressing risk factors associated with important maternal and infant outcomes. Programs to increase the rate of delivery of these interventions in clinical practice have not been widely implemented. A practice-based research network focused on developing continuous quality improvement (CQI) processes for maternal care among 10 family medicine residency training sites in the northeastern United States (the IMPLICIT Network) from January 2003 through September 2007. Documented delivery of 5 standard maternal care interventions was assessed before and after initiating a program to increase their frequency. Proportion chart analyses were conducted comparing the period before and after implementation of the CQI interventions. Data were available for 3936 pregnancies during the course of the study period. Results varied across the clinical interventions. Significant improvement in care processes was seen for 3 screening activities: (1) prenatal depression symptomatology (by 15 weeks' gestation); (2) screening for smoking at 30 weeks' gestation; (3) and postpartum contraception planning. Screening for smoking by 15 weeks' gestation and testing for asymptomatic bacteriuria were already conducted >90% of the time during the baseline period and did not increase significantly after initiating the CQI program. Screening for postpartum depression symptomatology was recorded in 50% to 60% of women before the CQI program and did not increase significantly. A practice-based research network of family medicine residency practices focused on CQI outcomes was successful in increasing the delivery of some maternal care interventions.

Results from a Community-Wide Pilot Program to Standardize COPD Education for Patients Across Healthcare Settings in Rhode Island.

PubMed

Pelland, Kimberly; Youssef, Rouba; Calandra, Kathleen; Cellar, Jennifer; Thiesen, Jennifer; Gardner, Rebekah

2017-07-05

Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity, decreased quality of life, and burdensome hospital admissions. Therefore, patients with COPD interact with clinicians in a number of healthcare settings. A coalition of healthcare practitioners in Rhode Island, in partnership with the local Quality Improvement Organization, designed and implemented a standardized, COPD education program for use across multiple healthcare settings. More than 60 organizations participated, producing 140 Master Trainers, who trained 634 staff members at their facilities from October 2015 through June 2016. Master Trainers were satisfied with the training, and we observed significant increases in knowledge scores post-training among all participants, which remained significant when stratified by setting. These results demonstrate that implementation of a community-based program to disseminate patient-centered, standardized COPD education in multiple healthcare settings is feasible. We hope this program will ultimately improve patient outcomes and serve as the foundation for expanding standardized education for other chronic conditions. [Full article available at http://rimed.org/rimedicaljournal-2017-07.asp].

Improving and integrating data on invasive species collected by citizen scientists

USGS Publications Warehouse

2010-01-01

Limited resources make it difficult to effectively document, monitor, and control invasive species across large areas, resulting in large gaps in our knowledge of current and future invasion patterns. We surveyed 128 citizen science program coordinators and interviewed 15 of them to evaluate their potential role in filling these gaps. Many programs collect data on invasive species and are willing to contribute these data to public databases. Although resources for education and monitoring are readily available, groups generally lack tools to manage and analyze data. Potential users of these data also retain concerns over data quality. We discuss how to address these concerns about citizen scientist data and programs while preserving the advantages they afford. A unified yet flexible national citizen science program aimed at tracking invasive species location, abundance, and control efforts could be designed using centralized data sharing and management tools. Such a system could meet the needs of multiple stakeholders while allowing efficiencies of scale, greater standardization of methods, and improved data quality testing and sharing. Finally, we present a prototype for such a system (see www.citsci.org).

Development of a North American paleoclimate pollen-based reconstruction database application

NASA Astrophysics Data System (ADS)

Ladd, Matthew; Mosher, Steven; Viau, Andre

2013-04-01

Recent efforts in synthesizing paleoclimate records across the globe has warranted an effort to standardize the different paleoclimate archives currently available in order to facilitate data-model comparisons and hence improve our estimates of future climate change. It is often the case that the methodology and programs make it challenging for other researchers to reproduce the results for a reconstruction, therefore there is a need for to standardize paleoclimate reconstruction databases in an application specific to proxy data. Here we present a methodology using the open source R language using North American pollen databases (e.g. NAPD, NEOTOMA) where this application can easily be used to perform new reconstructions and quickly analyze and output/plot the data. The application was developed to easily test methodological and spatial/temporal issues that might affect the reconstruction results. The application allows users to spend more time analyzing and interpreting results instead of on data management and processing. Some of the unique features of this R program are the two modules each with a menu making the user feel at ease with the program, the ability to use different pollen sums, select one of 70 climate variables available, substitute an appropriate modern climate dataset, a user-friendly regional target domain, temporal resolution criteria, linear interpolation and many other features for a thorough exploratory data analysis. The application program will be available for North American pollen-based reconstructions and eventually be made available as a package through the CRAN repository by late 2013.

Sustainable Materials Management (SMM) Food Recovery Challenge (FRC) Data

EPA Pesticide Factsheets

As part of EPA's Food Recovery Challenge (FRC), organizations pledge to improve their sustainable food management practices and report their results. The FRC is part of EPA's Sustainable Materials Management Program (SMM). SMM seeks to reduce the environmental impact of materials through their entire life cycle. This includes how they are extracted, manufactured, distributed, used, reused, recycled, and disposed. Organizations are encouraged to follow the Food Recovery Hierarchy (https://www.epa.gov/sustainable-management-food/food-recovery-hierarchy) to prioritize their actions to prevent and divert wasted food. Each tier of the Food Recovery Hierarchy focuses on different management strategies for your wasted food. The program started in 2011 and the first data were made available in 2012. The FRC is part of EPA's larger SMM program (https://www.epa.gov/smm). Sustainable Materials Management (SMM) is a systemic approach to using and reusing materials more productively over their entire lifecycles. It represents a change in how our society thinks about the use of natural resources and environmental protection. By looking at a product's entire lifecycle we can find new opportunities to reduce environmental impacts, conserve resources, and reduce costs. There are multiple challenge programs available as part of the SMM program, including the Food Recovery Challenge, the Electronics Challenge, the Federal Green Challenge, and the WasteWise program.

Lessons Learned From Evaluations of California's Statewide School Nutrition Standards

PubMed Central

Gosliner, Wendi; Samuels, Sarah E.; Craypo, Lisa; Kao, Janice; Crawford, Patricia B.

2010-01-01

Objectives. We assessed the impact of legislation that established nutrition standards for foods and beverages that compete with reimbursable school meals in California. Methods. We used documentation of available foods and beverages, sales accounts, and surveys of and interviews with students and food service workers to conduct 3 studies measuring pre- and postlegislation food and beverage availability, sales, and student consumption at 99 schools. Results. Availability of nutrition standard–compliant foods and beverages increased. Availability of noncompliant items decreased, with the biggest reductions in sodas and other sweetened beverages, regular chips, and candy. At-school consumption of some noncompliant foods dropped; at-home consumption of selected noncompliant foods did not increase. Food and beverage sales decreased at most venues, and food service à la carte revenue losses were usually offset by increased meal program participation. Increased food service expenditures outpaced revenue increases. Conclusions. Regulation of competitive foods improved school food environments and student nutritional intake. Improvements were modest, partly because many compliant items are fat- and sugar-modified products of low nutritional value. Additional policies and actions are needed to achieve more substantive improvements in school nutrition environments and student nutrition and health. PMID:20864696

CRISPRCasFinder, an update of CRISRFinder, includes a portable version, enhanced performance and integrates search for Cas proteins.

PubMed

Couvin, David; Bernheim, Aude; Toffano-Nioche, Claire; Touchon, Marie; Michalik, Juraj; Néron, Bertrand; C Rocha, Eduardo P; Vergnaud, Gilles; Gautheret, Daniel; Pourcel, Christine

2018-05-22

CRISPR (clustered regularly interspaced short palindromic repeats) arrays and their associated (Cas) proteins confer bacteria and archaea adaptive immunity against exogenous mobile genetic elements, such as phages or plasmids. CRISPRCasFinder allows the identification of both CRISPR arrays and Cas proteins. The program includes: (i) an improved CRISPR array detection tool facilitating expert validation based on a rating system, (ii) prediction of CRISPR orientation and (iii) a Cas protein detection and typing tool updated to match the latest classification scheme of these systems. CRISPRCasFinder can either be used online or as a standalone tool compatible with Linux operating system. All third-party software packages employed by the program are freely available. CRISPRCasFinder is available at https://crisprcas.i2bc.paris-saclay.fr.

Pteros 2.0: Evolution of the fast parallel molecular analysis library for C++ and python.

PubMed

Yesylevskyy, Semen O

2015-07-15

Pteros is the high-performance open-source library for molecular modeling and analysis of molecular dynamics trajectories. Starting from version 2.0 Pteros is available for C++ and Python programming languages with very similar interfaces. This makes it suitable for writing complex reusable programs in C++ and simple interactive scripts in Python alike. New version improves the facilities for asynchronous trajectory reading and parallel execution of analysis tasks by introducing analysis plugins which could be written in either C++ or Python in completely uniform way. The high level of abstraction provided by analysis plugins greatly simplifies prototyping and implementation of complex analysis algorithms. Pteros is available for free under Artistic License from http://sourceforge.net/projects/pteros/. © 2015 Wiley Periodicals, Inc.

Can the national surgical quality improvement program provide surgeon-specific outcomes?

PubMed

Kuhnen, Angela H; Marcello, Peter W; Roberts, Patricia L; Read, Thomas E; Schoetz, David J; Rusin, Lawrence C; Hall, Jason F; Ricciardi, Rocco

2015-02-01

Efforts to improve the quality of surgical care and reduce morbidity and mortality have resulted in outcomes reporting at the service and institutional level. Surgeon-specific outcomes are not readily available. The aim of this study is to compare surgeon-specific outcomes from the National Surgical Quality Improvement Program and 100% capture institutional quality data. We conducted a cohort study evaluating institutional and surgeon-specific outcomes following colorectal surgery procedures at 1 institution over 5 years. All patients who underwent an operation by a colorectal surgeon at Lahey Hospital & Medical Center from January 1, 2008 through December 31, 2012 were identified. Thirty-day mortality, reoperation, urinary tract infection, deep vein thrombosis, pneumonia, superficial surgical site infection, and organ space infection were the primary outcomes measured. We compared annual and 5-year institutional and surgeon-specific adverse event rates between the data sets. In addition, we categorized individual surgeons as low-outlier, average, or high-outlier in relation to aggregate averages and determined the concordance between the data sets in identifying outliers. Concordance was designated if the 2 databases classified outlier status similarly for the same adverse event category. In the 100% capture institutional data, 6459 operative encounters were identified in comparison with 1786 National Surgical Quality Improvement Program encounters (28% sampled). Annual aggregate adverse event rates were similar between the institutional data and the National Surgical Quality Improvement Program. For annual surgeon-specific comparisons, concordance in identifying outliers between the 2 data sets was 51.4%, and gross discordance between outlier status was in 8.2%. Five-year surgeon-specific comparisons demonstrated 59% concordance in identifying outlier status with 8.2% gross discordance for the group. The inclusion of data from only 1 academic referral center is a limitation of this study. Each surgeon was identified as a "high outlier" in at least 1 adverse event category. Comparisons at the annual and 5-year points demonstrated poor concordance between our 100% capture institutional data and the National Surgical Quality Improvement Program data.

Evaluation of Hospital-Based Palliative Care Programs.

PubMed

Hall, Karen Lynn; Rafalson, Lisa; Mariano, Kathleen; Michalek, Arthur

2016-02-01

This study evaluated current hospital-based palliative care programs using recommendations from the Center to Advance Palliative Care (CAPC) as a framework. Seven hospitals located in Buffalo, New York were included based on the existence of a hospital-based palliative care program. Data was collected from August through October of 2013 by means of key informant interviews with nine staff members from these hospitals using a guide comprised of questions based on CAPC's recommendations. A gap analysis was conducted to analyze the current state of each hospital's program based upon CAPC's definition of a quality palliative care program. The findings identify challenges facing both existing/evolving palliative care programs, and establish a foundation for strategies to attain best practices not yet implemented. This study affirms the growing availability of palliative care services among these selected hospitals along with opportunities to improve the scope of services in line with national recommendations. © The Author(s) 2014.

Teacher perspectives on implementing and sustaining a handwashing promotion intervention in Western Kenyan primary schools.

PubMed

Graves, Janessa M; Finsness, Erica D; Quick, Robert; Nyando Integrated Child Health And Education Project Niche Study Team; Harris, Julie R; Daniell, William E

School-based handwashing programs are challenging to establish and sustain, especially in low-resource settings. This qualitative study described teacher perspectives associated with implementing and sustaining a handwashing program in primary schools participating in the Nyando Integrated Child Health and Education (NICHE) project. Structured key informant interviews were conducted with teachers. Prevalent concepts and themes were grouped into themes and topic areas using an iterative, open coding approach. Forty-one teacher respondents reported favorable expectations and benefits of handwashing programs. The importance of available resources (e.g., reliable water) was cited as a primary concern. Other challenges included time and personal or institutional financial commitment necessary to ensure program sustainability. Handwashing programs in low-income, rural schools, where infrastructure is lacking and "student ambassadors" extend the intervention to the surrounding community, hold great promise to improve community health. Teachers must have adequate support and resources to implement and sustain the programs.

Project Prospector: Unmanned Exploration and Apollo Support Program

NASA Technical Reports Server (NTRS)

1969-01-01

Prior to the establishment of a manned lunar observatory or base, it is essential that a compendium of information be available on the environment, composition, structure, and topography of the moon. In an effort to satisfy this need for improved and detailed information, NASA has undertaken a lunar program which ranges from the utilization of circumlunar flight vehicles, equipped with automatic photographic and radiation measuring equipment which responds to commands from the earth, to actual determination of surface composition and features obtained from unmanned instrumented spacecraft which impact the moon.

Healthy start program participation: the consumers' perspective.

PubMed

Ley, Christine E; Copeland, Valire Carr; Flint, Cheryl Squire

2011-01-01

In 1991, the federal Maternal and Child Health Bureau developed the Healthy Start Initiative as a comprehensive community-based program to eliminate the high rates of poor pregnancy outcomes among women of color. To date, few studies of the programmatic outcomes of this Initiative have examined the views of Healthy Start consumers. To understand the benefits of Healthy Start from their consumers' perspective, the Pittsburgh Allegheny County Healthy Start project conducted a survey of 202 of their Healthy Start participants in 2003. The participants completing the survey reported benefits of participating in the program including stress reduction, receiving resources and referrals, and consistent social support of program staff. According to the project's annual statistics, Healthy Start has improved pregnancy outcomes among African American women participants in the Pittsburgh community. However, and according to these participants, the quality of staff and consumer connectedness, availability and consistency of material resources, and social support are as critical as more traditional health interventions to their satisfaction, motivation to participate, and willingness to refer others to the program. Women of color will often forego health services perceived as intimidating and/or culturally insensitive, but programs such as the Healthy Start Initiative offer a critical link that encourages participation and, as a result, improves maternal and child health status.

Improving the availability and accessibility of opioids for the treatment of pain: the International Pain Policy Fellowship.

PubMed

Bosnjak, Snezana; Maurer, Martha A; Ryan, Karen M; Leon, Marta X; Madiye, Gabriel

2011-08-01

Opioid analgesics are simultaneously indispensable medicines for the treatment of moderate to severe pain and are harmful when abused. The challenge for governments is to balance the obligation to prevent diversion, trafficking, and abuse of opioids with the equally important obligation to ensure their availability and accessibility for the relief of pain and suffering. Over the last 30 years, significant progress has been made toward improving access to opioids as measured by increasing global medical opioid consumption. However, this progress is marked by ongoing large disparities among countries, with most increases in medical opioid consumption attributed to high-income countries, not low- and middle-income countries (LMICs). The International Pain Policy Fellowship (IPPF) was developed by the Pain & Policy Studies Group, with the central goal of developing national leaders from LMICs and empowering them to improve availability and accessibility of opioids for the treatment of pain. To date, two classes of fellows have been selected, representing 17 fellows from 15 countries. Progress achieved by the leadership of three fellows from Sierra Leone, Colombia, and Serbia is highlighted in this paper. The fellows from each country were successful at initiating collaboration with relevant governmental bodies, national authorities, and professional societies, which resulted in a new supply of oral opioids in Sierra Leone and Serbia, and improvements in the distribution of already available opioids in Colombia. All fellows were instrumental in facilitating evaluation of national policy. The IPPF program empowers fellows with the necessary knowledge, skills, and guidance to improve the availability and accessibility of opioids for the treatment of pain.

Benefits of Sharing Information: Supermodel Ensemble and Applications in South America

NASA Astrophysics Data System (ADS)

Dias, P. L.

2006-05-01

A model intercomparison program involving a large number of academic and operational institutions has been implemented in South America since 2003, motivated by the SALLJEX Intercomparison Program in 2003 (a research program focused on the identification of the role of the Andes low level jet moisture transport from the Amazon to the Plata basin) and the WMO/THORPEX (www.wmo.int/thorpex) goals to improve predictability through the proper combination of numerical weather forecasts. This program also explores the potential predictability associated with the combination of a large number of possible scenarios in the time scale of a few days to up to 15 days. Five academic institutions and five operational forecasting centers in several countries in South America, 1 academic institution in the USA, and the main global forecasting centers (NCEP, UKMO, ECMWF) agreed to provide numerical products based on operational and experimental models. The metric for model validation is concentrated on the fit of the forecast to surface observations. Meteorological data from airports, synoptic stations operated by national weather services, automatic data platforms maintained by different institutions, the PIRATA buoys etc are all collected through LDM/NCAR or direct transmission. Approximately 40 models outputs are available on a daily basis, twice a day. A simple procedure based on data assimilation principles was quite successful in combining the available forecasts in order to produce temperature, dew point, wind, pressure and precipitation forecasts at station points in S. America. The procedure is based on removing each model bias at the observational point and a weighted average based on the mean square error of the forecasts. The base period for estimating the bias and mean square error is of the order of 15 to 30 days. Products of the intercomparison model program and the optimal statistical combination of the available forecasts are public and available in real time (www.master.iag.usp.br/). Monitoring of the use of the products reveal a growing trend in the last year (reaching about 10.000 accesses per day in recent months). The intercomparison program provides a rich data set for educational products (real time use in Synoptic Meteorology and Numerical Weather Forecasting lectures), operational weather forecasts in national or regional weather centers and for research purposes. During the first phase of the program it was difficult to convince potential participants to share the information in the public homepage. However, as the system evolved, more and more institutions became associated with the program. The general opinion of the participants is that the system provides an unified metric for evaluation, a forum for discussion of the physical origin of the model forecast differences and therefore improvement of the quality of the numerical guidance.

Quantifying and reducing statistical uncertainty in sample-based health program costing studies in low- and middle-income countries.

PubMed

Rivera-Rodriguez, Claudia L; Resch, Stephen; Haneuse, Sebastien

2018-01-01

In many low- and middle-income countries, the costs of delivering public health programs such as for HIV/AIDS, nutrition, and immunization are not routinely tracked. A number of recent studies have sought to estimate program costs on the basis of detailed information collected on a subsample of facilities. While unbiased estimates can be obtained via accurate measurement and appropriate analyses, they are subject to statistical uncertainty. Quantification of this uncertainty, for example, via standard errors and/or 95% confidence intervals, provides important contextual information for decision-makers and for the design of future costing studies. While other forms of uncertainty, such as that due to model misspecification, are considered and can be investigated through sensitivity analyses, statistical uncertainty is often not reported in studies estimating the total program costs. This may be due to a lack of awareness/understanding of (1) the technical details regarding uncertainty estimation and (2) the availability of software with which to calculate uncertainty for estimators resulting from complex surveys. We provide an overview of statistical uncertainty in the context of complex costing surveys, emphasizing the various potential specific sources that contribute to overall uncertainty. We describe how analysts can compute measures of uncertainty, either via appropriately derived formulae or through resampling techniques such as the bootstrap. We also provide an overview of calibration as a means of using additional auxiliary information that is readily available for the entire program, such as the total number of doses administered, to decrease uncertainty and thereby improve decision-making and the planning of future studies. A recent study of the national program for routine immunization in Honduras shows that uncertainty can be reduced by using information available prior to the study. This method can not only be used when estimating the total cost of delivering established health programs but also to decrease uncertainty when the interest lies in assessing the incremental effect of an intervention. Measures of statistical uncertainty associated with survey-based estimates of program costs, such as standard errors and 95% confidence intervals, provide important contextual information for health policy decision-making and key inputs for the design of future costing studies. Such measures are often not reported, possibly because of technical challenges associated with their calculation and a lack of awareness of appropriate software. Modern statistical analysis methods for survey data, such as calibration, provide a means to exploit additional information that is readily available but was not used in the design of the study to significantly improve the estimation of total cost through the reduction of statistical uncertainty.

Quantifying and reducing statistical uncertainty in sample-based health program costing studies in low- and middle-income countries

PubMed Central

Resch, Stephen

2018-01-01

Objectives: In many low- and middle-income countries, the costs of delivering public health programs such as for HIV/AIDS, nutrition, and immunization are not routinely tracked. A number of recent studies have sought to estimate program costs on the basis of detailed information collected on a subsample of facilities. While unbiased estimates can be obtained via accurate measurement and appropriate analyses, they are subject to statistical uncertainty. Quantification of this uncertainty, for example, via standard errors and/or 95% confidence intervals, provides important contextual information for decision-makers and for the design of future costing studies. While other forms of uncertainty, such as that due to model misspecification, are considered and can be investigated through sensitivity analyses, statistical uncertainty is often not reported in studies estimating the total program costs. This may be due to a lack of awareness/understanding of (1) the technical details regarding uncertainty estimation and (2) the availability of software with which to calculate uncertainty for estimators resulting from complex surveys. We provide an overview of statistical uncertainty in the context of complex costing surveys, emphasizing the various potential specific sources that contribute to overall uncertainty. Methods: We describe how analysts can compute measures of uncertainty, either via appropriately derived formulae or through resampling techniques such as the bootstrap. We also provide an overview of calibration as a means of using additional auxiliary information that is readily available for the entire program, such as the total number of doses administered, to decrease uncertainty and thereby improve decision-making and the planning of future studies. Results: A recent study of the national program for routine immunization in Honduras shows that uncertainty can be reduced by using information available prior to the study. This method can not only be used when estimating the total cost of delivering established health programs but also to decrease uncertainty when the interest lies in assessing the incremental effect of an intervention. Conclusion: Measures of statistical uncertainty associated with survey-based estimates of program costs, such as standard errors and 95% confidence intervals, provide important contextual information for health policy decision-making and key inputs for the design of future costing studies. Such measures are often not reported, possibly because of technical challenges associated with their calculation and a lack of awareness of appropriate software. Modern statistical analysis methods for survey data, such as calibration, provide a means to exploit additional information that is readily available but was not used in the design of the study to significantly improve the estimation of total cost through the reduction of statistical uncertainty. PMID:29636964

Improved Operating Room Efficiency via Constraint Management: Experience of a Tertiary-Care Academic Medical Center.

PubMed

Kimbrough, Charles W; McMasters, Kelly M; Canary, Jeff; Jackson, Lisa; Farah, Ian; Boswell, Mark V; Kim, Daniel; Scoggins, Charles R

2015-07-01

Suboptimal operating room (OR) efficiency is a universal complaint among surgeons. Nonetheless, maximizing efficiency is critical to institutional success. Here, we report improvement achieved from low-cost, low-technology measures instituted within a tertiary-care academic medical center/Level I trauma center. Improvements in preadmission testing and OR scheduling, including appointing a senior nurse anesthetist to help direct OR use, were instituted in March 2012. A retrospective review of prospectively maintained OR case data was performed to evaluate time periods before and after program implementation, as well as to assess trends over time. Operating room performance metrics were compared using Mann-Whitney and chi-squared tests. Changes over time were analyzed using linear regression. Data including all surgical cases were available for a 36-month period; 10 months (6,581 cases) before program implementation and 26 months afterward (17,574 cases). Dramatic improvement was seen in first-case on-time starts, which increased from 39.3% to 83.8% (p < 0.0001). Additionally, the percent utilization of available OR time demonstrated a steady increase (p < 0.001). After an initial lag, case volume also improved, evident by an increase observed in the 12-month rolling average of cases per month (p < 0.001). The increase in case volume occurred during peak OR time (7 am to 5 pm), and did not result from adding cases after hours (5 pm to 11 pm). After many years of what seemed an insoluble problem, simple changes fostering collaboration among services, including active management of the OR schedule and transparent data, have resulted in substantial improvement in OR efficiency and case volume. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Open source clustering software.

PubMed

de Hoon, M J L; Imoto, S; Nolan, J; Miyano, S

2004-06-12

We have implemented k-means clustering, hierarchical clustering and self-organizing maps in a single multipurpose open-source library of C routines, callable from other C and C++ programs. Using this library, we have created an improved version of Michael Eisen's well-known Cluster program for Windows, Mac OS X and Linux/Unix. In addition, we generated a Python and a Perl interface to the C Clustering Library, thereby combining the flexibility of a scripting language with the speed of C. The C Clustering Library and the corresponding Python C extension module Pycluster were released under the Python License, while the Perl module Algorithm::Cluster was released under the Artistic License. The GUI code Cluster 3.0 for Windows, Macintosh and Linux/Unix, as well as the corresponding command-line program, were released under the same license as the original Cluster code. The complete source code is available at http://bonsai.ims.u-tokyo.ac.jp/mdehoon/software/cluster. Alternatively, Algorithm::Cluster can be downloaded from CPAN, while Pycluster is also available as part of the Biopython distribution.

FADS: A demonstrator for MilComSat AOCS

NASA Astrophysics Data System (ADS)

Huddleston, Martin; Cope, Paul

1995-03-01

This project covers the attitude and orbit control systems (AOCS) research program being carried out as part of the MOD applied research program for AD CIS(OR)1. The project program is to evaluate the candidate sensor technologies and control algorithms, such as Kalman filters, which may be applied to future UK military ComSats. The specific needs of military satellites for robust and threat-resistant control are not offered by current civil technologies which normally use vulnerable earth sensors or RF pointing which is vulnerable to deception. The program is also to investigate ways of reducing control system complexity and improvements in attitude control precision by enabling structural modes to be controlled. The project examines the most promising attitude control system technologies required to support such future communications payloads. User requirements indicate a need for improved threat resistance and for narrower spot beams, and the program supports this perceived need by the use of improved sensors and control algorithms. Improved pointing on civil ComSats is normally by means of ground RF measurements to form a closed loop control system with the spacecraft. For threat reasons this method is unsuitable for military ComSats, and on-board sensors are therefore used. The use of Silicon array star or earth sensors are the most promising, and the sensor program is to concentrate on these. Limited development and available civil sensors will be considered. Experimental work is based on demonstrating and evaluating real hardware in-the-loop on an existing air bearing experimental rig. This offers the closest simulation of real flight performance that can be obtained. The program will develop the Filtered Attitude Determination System (FADS)rig to be fully representative of a MilSatCom satellite, threat-resistant AOCS solution, employing Silicon array star and earth sensors. Both the BAe Mosaic Earth Sensor (MES) nad Marconi Versatile Star Sensor (VSS) technologies show considerable potential as attitude sensors. The VSS and MES capabilities will be evalutated on the FADS rig.

Baltimore City Stores Increased The Availability Of Healthy Food After WIC Policy Change.

PubMed

Cobb, Laura K; Anderson, Cheryl A M; Appel, Lawrence; Jones-Smith, Jessica; Bilal, Usama; Gittelsohn, Joel; Franco, Manuel

2015-11-01

As part of a 2009 revision to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, the Department of Agriculture required WIC-authorized stores to stock additional varieties of healthy food. The long-term effects of this policy on access to healthy food are unknown. Using surveys conducted in 118 Baltimore City, Maryland, food stores in 2006 and 2012, we examined associations of the change in healthy food availability with store type, neighborhood demographics, and the 2009 WIC policy change. Overall, healthy food availability improved significantly between 2006 and 2012, with the greatest increases in corner stores and in census tracts with more than 60 percent black residents. On an 11-point scale measuring availability of fruit (3 points), vegetables (4 points), bread (2 points), and milk (2 points), the WIC policy change was associated with a 0.72-point increase in WIC-relevant healthy food availability, while joining WIC was associated with a 0.99-point increase. Stores that carry a limited variety of food items may be more receptive to stocking healthier food than previously thought, particularly within neighborhoods with a majority of black residents. Policies targeting healthy food availability have the potential to increase availability and decrease health disparities. Project HOPE—The People-to-People Health Foundation, Inc.

Evaluation of Healthy2Go: A country store transformation project to improve the food environment and consumer choices in Appalachian Kentucky.

PubMed

Rushakoff, Joshua A; Zoughbie, Daniel E; Bui, Nancy; DeVito, Katerina; Makarechi, Leila; Kubo, Hitomi

2017-09-01

Rates of obesity and type 2 diabetes in Kentucky's Cumberland Valley region are among the highest in the United States and limited access to healthy food contributes to these epidemics. The aim of Healthy2Go (H2G), a country store transformation project launched by Spread the Health Appalachia (STHA), was to improve awareness and availability of healthy options in small, rural stores. Ten country stores participated in H2G and received training and technical assistance to increase availability and awareness of healthy foods. Stores made inventory changes; installed point-of-purchase educational and in-store marketing materials directing shoppers to healthier options; provided nutrition education such as healthy recipes; and altered the display and location of healthy items. To measure changes within stores and the potential impact on resident eating and purchasing habits, STHA used four instruments: a modified version of the Nutrition Environs Measures Survey - Corner Stores at baseline and follow-up, a bimonthly store inventory assessment, a final store owner survey, and a Community Nutrition Survey at baseline (n = 287) and follow-up (n = 281). The stores in the H2G program (n = 10) had a 40% increase in stocking fresh produce, a 20% increase in produce variety, and trends towards increasing healthy inventory. During the same period, surveyed residents reported a statistically significant increase in the frequency of healthy food consumption. Small store transformation programs can improve availability of and access to healthy food in rural settings and influence local purchasing patterns.

Nuclear Engine System Simulation (NESS). Version 2.0: Program user's guide

NASA Technical Reports Server (NTRS)

Pelaccio, Dennis G.; Scheil, Christine M.; Petrosky, Lyman

1993-01-01

This Program User's Guide discusses the Nuclear Thermal Propulsion (NTP) engine system design features and capabilities modeled in the Nuclear Engine System Simulation (NESS): Version 2.0 program (referred to as NESS throughout the remainder of this document), as well as its operation. NESS was upgraded to include many new modeling capabilities not available in the original version delivered to NASA LeRC in Dec. 1991, NESS's new features include the following: (1) an improved input format; (2) an advanced solid-core NERVA-type reactor system model (ENABLER 2); (3) a bleed-cycle engine system option; (4) an axial-turbopump design option; (5) an automated pump-out turbopump assembly sizing option; (6) an off-design gas generator engine cycle design option; (7) updated hydrogen properties; (8) an improved output format; and (9) personal computer operation capability. Sample design cases are presented in the user's guide that demonstrate many of the new features associated with this upgraded version of NESS, as well as design modeling features associated with the original version of NESS.

Influence of Sequential vs. Simultaneous Dual-Task Exercise Training on Cognitive Function in Older Adults

PubMed Central

Tait, Jamie L.; Duckham, Rachel L.; Milte, Catherine M.; Main, Luana C.; Daly, Robin M.

2017-01-01

Emerging research indicates that exercise combined with cognitive training may improve cognitive function in older adults. Typically these programs have incorporated sequential training, where exercise and cognitive training are undertaken separately. However, simultaneous or dual-task training, where cognitive and/or motor training are performed simultaneously with exercise, may offer greater benefits. This review summary provides an overview of the effects of combined simultaneous vs. sequential training on cognitive function in older adults. Based on the available evidence, there are inconsistent findings with regard to the cognitive benefits of sequential training in comparison to cognitive or exercise training alone. In contrast, simultaneous training interventions, particularly multimodal exercise programs in combination with secondary tasks regulated by sensory cues, have significantly improved cognition in both healthy older and clinical populations. However, further research is needed to determine the optimal characteristics of a successful simultaneous training program for optimizing cognitive function in older people. PMID:29163146

Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

PubMed Central

Brown, Charlotte A.; Bogers, Johnannes; Sahebali, Shaira; Depuydt, Christophe E.; De Prins, Frans; Malinowski, Douglas P.

2012-01-01

Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67, p16INK4a, BD ProEx C, and Cytoactiv HPV L1. PMID:22481919

Evidence, Goals, and Outcomes in Stuttering Treatment: Applications With an Adolescent Who Stutters.

PubMed

Marcotte, Anne K

2018-01-09

The purpose of this clinical focus article is to summarize 1 possible process that a clinician might follow in designing and conducting a treatment program with John, a 14-year-old male individual who stutters. The available research evidence, practitioner experience, and consideration of individual preferences are combined to address goals, treatment procedures, and outcomes for John. The stuttering treatment research literature includes multiple well-designed reviews and individual studies that have shown the effectiveness of prolonged speech (and smooth speech and related variations) for improving stuttered speech and for improving social, emotional, cognitive, and related variables in adolescents who stutter. Based on that evidence, and incorporating the additional elements of practitioner experience and client preferences, this clinical focus article suggests that John would be likely to benefit from a treatment program based on prolonged speech. The basic structure of 1 possible such program is also described, with an emphasis on the goals and outcomes that John could be expected to achieve.

DupTree: a program for large-scale phylogenetic analyses using gene tree parsimony.

PubMed

Wehe, André; Bansal, Mukul S; Burleigh, J Gordon; Eulenstein, Oliver

2008-07-01

DupTree is a new software program for inferring rooted species trees from collections of gene trees using the gene tree parsimony approach. The program implements a novel algorithm that significantly improves upon the run time of standard search heuristics for gene tree parsimony, and enables the first truly genome-scale phylogenetic analyses. In addition, DupTree allows users to examine alternate rootings and to weight the reconciliation costs for gene trees. DupTree is an open source project written in C++. DupTree for Mac OS X, Windows, and Linux along with a sample dataset and an on-line manual are available at http://genome.cs.iastate.edu/CBL/DupTree

Medicaid Disproportionate Share and Other Special Financing Programs

PubMed Central

Ku, Leighton; Coughlin, Teresa A.

1995-01-01

Medicaid disproportionate share hospital (DSH) and related programs, such as provider-specific taxes or intergovernmental transfers (IGTs), help support uncompensated care and effectively reduce State Medicaid expenditures by increasing Federal matching funds. We analyze the uses of these funds, based on a survey completed by 39 States and case studies of 6 States. We find that only a small share of these funds were available to cover the costs of uncompensated care. One method to ensure that funds are used for health care would be to reprogram funds into health insurance subsidies. An alternative to improve equity of funding across the Nation would be to create a substitute Federal grant program to directly support uncompensated care. PMID:10142580

Are We Pulling the Rug out from under Their Feet? What if Academic Interventions Are Removed?

ERIC Educational Resources Information Center

Lively Summers, Robin M.

2014-01-01

With the loss of revenue and education cut backs, school districts have faced the loss of supplemental academic supports such as after school tutoring and summer school programs. Up until recently research has focused on improving student outcomes by implementing supplemental instruction. There was little research available that examined the…

The Potential of the Traditional Birth Attendant. WHO Offset Publication No. 95.

ERIC Educational Resources Information Center

Maglacas, A. Mangay, Ed.; Simons, John, Ed.

In nine chapters, this book considers the extent to which training programs can be utilized to improve midwifery practice and reduce the risks surrounding childbirth in rural populations. The book opens with a chapter reviewing the question of whether the availability of trained birth attendants can be linked to a reduced incidence of neonatal…

Model-assisted survey regression estimation with the lasso

Treesearch

Kelly S. McConville; F. Jay Breidt; Thomas C. M. Lee; Gretchen G. Moisen

2017-01-01

In the U.S. Forest Service’s Forest Inventory and Analysis (FIA) program, as in other natural resource surveys, many auxiliary variables are available for use in model-assisted inference about finite population parameters. Some of this auxiliary information may be extraneous, and therefore model selection is appropriate to improve the efficiency of the survey...

Evaluation of New Texas Charter Schools: Interim Report (2007-10). Executive Summary

ERIC Educational Resources Information Center

Maloney, Catherine; Sheehan, Daniel; Rainey, Katie

2009-01-01

As interest in expanding the number of high quality charter schools available to parents and students has grown, policy makers have increased their focus on identifying and providing support to new charter programs that have the potential to improve student outcomes and satisfy parent and student needs. Since 1994, the U.S. Department of Education…

Evaluation of New Texas Charter Schools: Interim Report (2007-10)

ERIC Educational Resources Information Center

Maloney, Catherine; Sheehan, Daniel; Rainey, Katie

2009-01-01

As interest in expanding the number of high quality charter schools available to parents and students has grown, policy makers have increased their focus on identifying and providing support to new charter programs that have the potential to improve student outcomes and satisfy parent and student needs. Since 1994, the U.S. Department of Education…

Chapter 12. Seedbed preparation and seeding practices

Treesearch

Stephen B. Monsen; Richard Stevens

2004-01-01

Selection and use of seeds of different species must be carefully considered in range and wildland improvement projects. The selection of species to be planted in any restoration program usually takes place after the decision has been made to restore or rehabilitate an area, and the objectives of the project have been determined. However, availability of seed and...

Facilitating the Collection and Dissemination of Information to Parents of Children in a Child Care Program.

ERIC Educational Resources Information Center

de Armas, Maria P.

To improve conditions at a nonprofit day care center serving low-income, mainly non-English-speaking families, this practicum addressed the need of recently immigrated parents to increase their knowledge of child development and available community resources. A total of 52 Hispanic parents were given materials at an information distribution area…

Are Voucher Schools Putting the Squeeze on MPS? Research Brief. Volume 95, Number 1

ERIC Educational Resources Information Center

Public Policy Forum, 2007

2007-01-01

For seventeen years an underlying rationale for Milwaukee's private school voucher program has been that competition from private schools is needed to bring about improvements in Milwaukee Public Schools (MPS). However, despite an increased availability of vouchers for more eligible children than ever before, demand during the past school year did…

Improvement of Operation Characteristics for MONOS Charge Trapping Flash Memory with SiGe Buried Channel

NASA Astrophysics Data System (ADS)

Hou, Zhao-Zhao; Wang, Gui-Lei; Yao, Jia-Xin; Zhang, Qing-Zhu; Yin, Hua-Xiang

2018-05-01

Not Available Supported by the National Science and Technology Major Project of China under Grant No 2013ZX02303007, the National Key Research and Development Program of China under Grant No 2016YFA0301701, and the Youth Innovation Promotion Association of the Chinese Academy of Sciences under Grant No 2016112.

75 FR 20326 - Technology Innovation Program (TIP) Notice of Availability of Funds and Announcement of Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... efficiency gas turbines; composites make larger, more efficient wind turbine blades and provide improved... the virus to prepare a vaccine in record time, but encountered problems supplying the large volumes of... monitoring and analysis could address these problems and would help to not only respond rapidly to new virus...

77 FR 19408 - Deadline for Notification of Intent To Use the Airport Improvement Program (AIP) Primary, Cargo...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... fiscal year 2012. After Friday, August 10, 2012, the FAA will carry over all remaining entitlement funds... business Friday, August 10, 2012, to use their fiscal year 2012 entitlement funds available under Title 49... Entitlement Funds for Fiscal Year 2012 AGENCY: Federal Aviation Administration, DOT. ACTION: Notice. SUMMARY...

Using Electronic Journals to Facilitate Reflective Thinking Regarding Instructional Practices during Early Field Experiences

ERIC Educational Resources Information Center

Meyers, Eldon, Jr.

2006-01-01

Loras College recently became a laptop campus. Faculty members in the Division of Education viewed the transformation of the college learning environment as an opportunity to enhance the elementary education teacher preparation program. There was a desire to make productive use of the improved technology available and the early field experience…

75 FR 5608 - National Protection and Programs Directorate; Communications Unit Leader (COML) Prerequisite and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... assurance and improvement purposes, evaluation data will be collected in an evaluation form. OEC will use... electronic but can also be received in paper form to facilitate ease of registration and evaluation of OEC events. Evaluation forms will be available in hard copy at each training session, and time will be...

Food-intake patterns assessed by using front-of-pack labeling program criteria associated with better diet quality and lower cardiometabolic risk

USDA-ARS?s Scientific Manuscript database

Front-of-pack labeling systems may provide additional guidance to that already available to facilitate the identification of foods that improve diet quality. We examined the association between choosing foods that meet criteria of an established front-of-pack labeling system with food-group and nutr...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

Strategies for conserving forest genetic resources in the face of climate change

Treesearch

John Bradley St. Clair; Glenn Thomas Howe

2011-01-01

Conservation of genetic diversity is important for continued evolution of populations to new environments, as well as continued availability of traits of interest in genetic improvement programs. Rapidly changing climates present new threats to the conservation of forest genetic resources. We can no longer assume that in situ reserves will continue to preserve existing...

Log-odds sequence logos

PubMed Central

Yu, Yi-Kuo; Capra, John A.; Stojmirović, Aleksandar; Landsman, David; Altschul, Stephen F.

2015-01-01

Motivation: DNA and protein patterns are usefully represented by sequence logos. However, the methods for logo generation in common use lack a proper statistical basis, and are non-optimal for recognizing functionally relevant alignment columns. Results: We redefine the information at a logo position as a per-observation multiple alignment log-odds score. Such scores are positive or negative, depending on whether a column’s observations are better explained as arising from relatedness or chance. Within this framework, we propose distinct normalized maximum likelihood and Bayesian measures of column information. We illustrate these measures on High Mobility Group B (HMGB) box proteins and a dataset of enzyme alignments. Particularly in the context of protein alignments, our measures improve the discrimination of biologically relevant positions. Availability and implementation: Our new measures are implemented in an open-source Web-based logo generation program, which is available at http://www.ncbi.nlm.nih.gov/CBBresearch/Yu/logoddslogo/index.html. A stand-alone version of the program is also available from this site. Contact: altschul@ncbi.nlm.nih.gov Supplementary information: Supplementary data are available at Bioinformatics online. PMID:25294922

Molecular markers: a potential resource for ginger genetic diversity studies.

PubMed

Ismail, Nor Asiah; Rafii, M Y; Mahmud, T M M; Hanafi, M M; Miah, Gous

2016-12-01

Ginger is an economically important and valuable plant around the world. Ginger is used as a food, spice, condiment, medicine and ornament. There is available information on biochemical aspects of ginger, but few studies have been reported on its molecular aspects. The main objective of this review is to accumulate the available molecular marker information and its application in diverse ginger studies. This review article was prepared by combing material from published articles and our own research. Molecular markers allow the identification and characterization of plant genotypes through direct access to hereditary material. In crop species, molecular markers are applied in different aspects and are useful in breeding programs. In ginger, molecular markers are commonly used to identify genetic variation and classify the relatedness among varieties, accessions, and species. Consequently, it provides important input in determining resourceful management strategies for ginger improvement programs. Alternatively, a molecular marker could function as a harmonizing tool for documenting species. This review highlights the application of molecular markers (isozyme, RAPD, AFLP, SSR, ISSR and others such as RFLP, SCAR, NBS and SNP) in genetic diversity studies of ginger species. Some insights on the advantages of the markers are discussed. The detection of genetic variation among promising cultivars of ginger has significance for ginger improvement programs. This update of recent literature will help researchers and students select the appropriate molecular markers for ginger-related research.

An Electronic Asthma Self-Management Intervention for Young African American Adults.

PubMed

Speck, Aimee L; Hess, Michael; Baptist, Alan P

2016-01-01

Health disparities are seen in many chronic conditions including asthma. Young African American adults represent a population at high risk for poor asthma outcomes due to both their minority status and the difficult transition from adolescence to adulthood. Recruitment and retention has been challenging in this demographic stratum, and traditional asthma education is often not feasible. The objective of this study was to develop and assess the feasibility of an electronic asthma self-management program for young African American adults. A total of 44 African American adults (age 18-30 years) with uncontrolled persistent asthma were enrolled in an asthma self-management program. The 6-week Breathe Michigan program (predicated on the social cognitive theory) was tailored specifically to the concerns and preferences of young African American adults. The entire program was completed electronically, without any specialized human support. At 2 weeks and 3 months after program completion, participants were contacted for follow-up. A total of 89% of enrolled subjects completed the 6-week intervention, and 77% were available for evaluation at 3 months. All subjects completing the 2-week postprogram survey reported that the program was helpful, and 97% would recommend it to others. Asthma control as measured by the Asthma Control Test improved from 16.1 to 19.3 (P < .01), and asthma quality of life as measured by the Mini Asthma Quality of Life Questionnaire improved from 4.0 to 5.1 (P < .01). The Breathe Michigan program is feasible for recruitment and retention, and demonstrated an improvement in asthma control and quality of life for young African American adults. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Review of functional markers for improving cooking, eating, and the nutritional qualities of rice

PubMed Central

Lau, Wendy C. P.; Rafii, Mohd Y.; Ismail, Mohd R.; Puteh, Adam; Latif, Mohammad A.; Ramli, Asfaliza

2015-01-01

After yield, quality is one of the most important aspects of rice breeding. Preference for rice quality varies among cultures and regions; therefore, rice breeders have to tailor the quality according to the preferences of local consumers. Rice quality assessment requires routine chemical analysis procedures. The advancement of molecular marker technology has revolutionized the strategy in breeding programs. The availability of rice genome sequences and the use of forward and reverse genetics approaches facilitate gene discovery and the deciphering of gene functions. A well-characterized gene is the basis for the development of functional markers, which play an important role in plant genotyping and, in particular, marker-assisted breeding. In addition, functional markers offer advantages that counteract the limitations of random DNA markers. Some functional markers have been applied in marker-assisted breeding programs and have successfully improved rice quality to meet local consumers’ preferences. Although functional markers offer a plethora of advantages over random genetic markers, the development and application of functional markers should be conducted with care. The decreasing cost of sequencing will enable more functional markers for rice quality improvement to be developed, and application of these markers in rice quality breeding programs is highly anticipated. PMID:26528304

The development of the Nucleus Freedom Cochlear implant system.

PubMed

Patrick, James F; Busby, Peter A; Gibson, Peter J

2006-12-01

Cochlear Limited (Cochlear) released the fourth-generation cochlear implant system, Nucleus Freedom, in 2005. Freedom is based on 25 years of experience in cochlear implant research and development and incorporates advances in medicine, implantable materials, electronic technology, and sound coding. This article presents the development of Cochlear's implant systems, with an overview of the first 3 generations, and details of the Freedom system: the CI24RE receiver-stimulator, the Contour Advance electrode, the modular Freedom processor, the available speech coding strategies, the input processing options of Smart Sound to improve the signal before coding as electrical signals, and the programming software. Preliminary results from multicenter studies with the Freedom system are reported, demonstrating better levels of performance compared with the previous systems. The final section presents the most recent implant reliability data, with the early findings at 18 months showing improved reliability of the Freedom implant compared with the earlier Nucleus 3 System. Also reported are some of the findings of Cochlear's collaborative research programs to improve recipient outcomes. Included are studies showing the benefits from bilateral implants, electroacoustic stimulation using an ipsilateral and/or contralateral hearing aid, advanced speech coding, and streamlined speech processor programming.

A summary of public access defibrillation laws, United States, 2010.

PubMed

Gilchrist, Siobhan; Schieb, Linda; Mukhtar, Qaiser; Valderrama, Amy; Zhang, Guangyu; Yoon, Paula; Schooley, Michael

2012-01-01

On average, less than 8% of people who experience an out-of-hospital cardiac arrest survive. However, death from sudden cardiac arrest is preventable if a bystander quickly retrieves and applies an automated external defibrillator (AED). Public access defibrillation (PAD) policies have been enacted to create programs that increase the public availability of these devices. The objective of this study was to describe each state's legal requirements for recommended PAD program elements. We reviewed state laws and described the extent to which 13 PAD program elements are mandated in each state. No jurisdiction requires all 13 PAD program elements, 18% require at least 10 elements, and 31% require 3 or fewer elements. All jurisdictions provide some level of immunity to AED users, 60% require PAD maintenance, 59% require emergency medical service notification, 55% impose training requirements, and 41% require medical oversight. Few jurisdictions require a quality improvement process. PAD programs in many states are at risk of failure because critical elements such as maintenance, medical oversight, emergency medical service notification, and continuous quality improvement are not required. Policy makers should consider strengthening PAD policies by enacting laws that can reduce the time from collapse to shock, such as requiring the strategic placement of AEDs in high-risk locations or mandatory PAD registries that are coordinated with local EMS and dispatch centers. Further research is needed to identify the most effective PAD policies for increasing AED use by lay persons and improving survival rates.

Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome.

PubMed

Vigorito, Carlo; Giallauria, Francesco; Palomba, Stefano; Cascella, Teresa; Manguso, Francesco; Lucci, Rosa; De Lorenzo, Anna; Tafuri, Domenico; Lombardi, Gaetano; Colao, Annamaria; Orio, Francesco

2007-04-01

Polycystic ovary syndrome (PCOS) is an endocrine disease closely related to several risk factors for cardiovascular disease. An impaired cardiopulmonary functional capacity was previously demonstrated in PCOS women. No data regarding the effects of a structured exercise training (ET) program on cardiopulmonary functional capacity in PCOS women are available. Our objective was to evaluate the effects of a 3-month ET program on cardiopulmonary functional capacity in young PCOS women. A prospective baseline-randomized clinical study was conducted at the University "Federico II" of Naples, School of Medicine (Italy). Ninety young overweight PCOS women were enrolled. Ninety young PCOS women were randomly subdivided into two groups, each composed of 45 subjects. The PCOS-T (trained) group underwent a 3-month structured ET program, whereas the PCOS-UnT (untrained) group did not. Hormonal and metabolic profiles and cardiopulmonary and exercise parameters were evaluated. After 3-month ET, PCOS-T showed a significant improvement in peak oxygen consumption (+35.4%; P<0.001) and in maximal workload (+37.2%; P<0.001). In PCOS-T we also observed a significant reduction in body mass index (-4.5%; P<0.001) and in C-reactive protein (-10%; P<0.001), and a significant (P<0.001) improvement in insulin sensitivity indexes. After 3 months, no changes were observed in PCOS-UnT. A 3-month structured ET program improves cardiopulmonary functional capacity in young PCOS women.

Air Force electrochemical power research and technology program for space applications

NASA Technical Reports Server (NTRS)

Allen, Douglas

1987-01-01

An overview is presented of the existing Air Force electrochemical power, battery, and fuel cell programs for space application. Present thrusts are described along with anticipated technology availability dates. Critical problems to be solved before system applications occur are highlighted. Areas of needed performance improvement of batteries and fuel cells presently used are outlined including target dates for key demonstrations of advanced technology. Anticipated performance and current schedules for present technology programs are reviewed. Programs that support conventional military satellite power systems and special high power applications are reviewed. Battery types include bipolar lead-acid, nickel-cadmium, silver-zinc, nickel-hydrogen, sodium-sulfur, and some candidate advanced couples. Fuel cells for pulsed and transportation power applications are discussed as are some candidate advanced regenerative concepts.

Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial.

PubMed

Meyer, Björn; Berger, Thomas; Caspar, Franz; Beevers, Christopher G; Andersson, Gerhard; Weiss, Mario

2009-05-11

Depression is associated with immense suffering and costs, and many patients receive inadequate care, often because of the limited availability of treatment. Web-based treatments may play an increasingly important role in closing this gap between demand and supply. We developed the integrative, Web-based program Deprexis, which covers therapeutic approaches such as behavioral activation, cognitive restructuring, mindfulness/acceptance exercises, and social skills training. To evaluate the effectiveness of the Web-based intervention in a randomized controlled trial. There were 396 adults recruited via Internet depression forums in Germany, and they were randomly assigned in an 80:20 weighted randomization sequence to either 9 weeks of immediate-program-access as an add-on to treatment-as-usual (N = 320), or to a 9-week delayed-access plus treatment-as-usual condition (N = 76). At pre- and post-treatment and 6-month follow-up, we measured depression (Beck Depression Inventory) as the primary outcome measure and social functioning (Work and Social Adjustment Scale) as the secondary outcome measure. Complete analyses and intention-to-treat analyses were performed. Of 396 participants, 216 (55%) completed the post-measurement 9 weeks later. Available case analyses revealed a significant reduction in depression severity (BDI), Cohen's d = .64 (CI 95% = 0.33 - 0.94), and significant improvement in social functioning (WSA), Cohen's d = .64, 95% (CI 95% = 0.33 - 0.95). These improvements were maintained at 6-month follow-up. Intention-to-treat analyses confirmed significant effects on depression and social functioning improvements (BDI: Cohen's d = .30, CI 95% = 0.05 - 0.55; WSA: Cohen's d = .36, CI 95% = 0.10 - 0.61). Moreover, a much higher percentage of patients in the intervention group experienced a significant reduction of depression symptoms (BDI: odds ratio [OR] = 6.8, CI 95% = 2.90 - 18.19) and recovered more often (OR = 17.3, 95% CI 2.3 - 130). More than 80% of the users felt subjectively that the program had been helpful. This integrative, Web-based intervention was effective in reducing symptoms of depression and in improving social functioning. Findings suggest that the program could serve as an adjunctive or stand-alone treatment tool for patients suffering from symptoms of depression.

National Enhanced Elevation Assessment at a glance

USGS Publications Warehouse

Snyder, Gregory I.

2012-01-01

Elevation data are essential for hazards mitigation, conservation, infrastructure development, national security, and many other applications. Under the leadership of the U.S. Geological Survey and the member States of the National Digital Elevation Program (NDEP), Federal agencies, State agencies, and others work together to acquire high-quality elevation data for the United States and its territories. New elevation data are acquired using modern technology to replace elevation data that are, on average, more than 30 years old. Through the efforts of the NDEP, a project-by-project data acquisition approach resulted in improved, publicly available data for 28 percent of the conterminous United States and 15 percent of Alaska over the past 15 years. Although the program operates efficiently, the rate of data collection and the typical project specifications are currently insufficient to address the needs of government, the private sector, and other organizations. The National Enhanced Elevation Assessment was conducted to (1) document national-level requirements for improved elevation data, (2) estimate the benefits and costs of meeting those requirements, and (3) evaluate multiple national-level program-implementation scenarios. The assessment was sponsored by the NDEP's member agencies. The study participants came from 34 Federal agencies, agencies from all 50 States, selected local government and Tribal offices, and private and not-for-profit organizations. A total of 602 mission-critical activities were identified that need significantly more accurate data than are currently available. The results of the assessment indicate that a national-level enhanced-elevation-data program has the potential to generate from $1.2 billion to $13 billion in new benefits annually.

IVS Working Group 2 for Product Specification and Observing Programs

NASA Astrophysics Data System (ADS)

Schuh, H.; Charlot, P.; Hase, H.; Himwich, E.; Kingham, K.; Klatt, C.; Ma, C.; Malkin, Z.; Niell, A.; Nothnagel, A.; Schluter, W.; Takashima, K.; Vandenberg, N.

2002-03-01

After the scientific rationale is given in the introduction the Terms of Reference and the proceeding of IVS Working Group 2 are presented. Then the present status and future goals of all international activities within IVS are described. In particular the current products of IVS are described in terms of accuracy, reliability, frequency of observing sessions, temporal resolution of the parameters estimated by VLBI data analysis, time delay from observing to product, i.e. time which has passed after the end of the last session included in the VLBI solution till availability of the final products and frequency of solution (in the case of "global solutions";, when all existing or a high number of VLBI sessions are used to determine so-called global parameters). All IVS products and their potential users are covered in the report. This includes the Earth orientation parameters (EOP), the reference frames (TRF and CRF), geodynamical and geophysical parameters and physical parameters. Measures which should be taken within IVS to meet the goals defined in the first steps are presented. As most of the measures are related to the observing programs, these are the main focus for improving the current status of IVS products. The report shows that due to various requirements of the different users of IVS products the following aspects must be accomplished: - significant improvement of the accuracy of VLBI products, - shorter time delay from observation to availability of results, - almost continuous temporal coverage by VLBI sessions. A first scenario of the IVS observing program for 2002 and 2003 considers an increase of observing time by about 30%-40% and includes sessions carried out by S2 and K4 technology. The midterm observing program for the next 4-5 years seems to be rather ambitious. However, it appears feasible if all efforts are concentrated and the necessary resources are made available. From: Bidzina Kapanadze (Ilia State Iniversity) Address: bidzina_kapanadze@iliauni.edu.ge Database: ast

A new resource for developing and strengthening large-scale community health worker programs.

PubMed

Perry, Henry; Crigler, Lauren; Lewin, Simon; Glenton, Claire; LeBan, Karen; Hodgins, Steve

2017-01-12

Large-scale community health worker programs are now growing in importance around the world in response to the resurgence of interest and growing evidence of the importance of community-based primary health care for improving the health of populations in resource-constrained, high-mortality settings. These programs, because of their scale and operational challenges, merit special consideration by the global health community, national policy-makers, and program implementers. A new online resource is now available to assist in that effort: Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers ( http://www.mchip.net/CHWReferenceGuide ). This CHW Reference Guide is the product of 27 different collaborators who, collectively, have a formidable breadth and depth of experience and knowledge about CHW programming around the world. It provides a thoughtful discussion about the many operational issues that large-scale CHW programs need to address as they undergo the process of development, expansion or strengthening. Detailed case studies of 12 national CHW programs are included in the Appendix-the most current and complete cases studies as a group that are currently available. Future articles in this journal will highlight many of the themes in the CHW Reference Guide and provide an update of recent advances and experiences. These articles will serve, we hope, to (1) increase awareness about the CHW Reference Guide and its usefulness and (2) connect a broader audience to the critical importance of strengthening large-scale CHW programs for the health benefits that they can bring to underserved populations around the world.

Access to Archived Astronaut Data for Human Research Program Researchers: Update on Progress and Process Improvements

NASA Technical Reports Server (NTRS)

Lee, L. R.; Montague, K. A.; Charvat, J. M.; Wear, M. L.; Thomas, D. M.; Van Baalen, M.

2016-01-01

Since the 2010 NASA directive to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for astronaut medical data has increased greatly. LSAH and LSDA personnel are working with Human Research Program on many fronts to improve data access and decrease lead time for release of data. Some examples include the following: Feasibility reviews for NASA Research Announcement (NRA) data mining proposals; Improved communication, support for researchers, and process improvements for retrospective Institutional Review Board (IRB) protocols; Supplemental data sharing for flight investigators versus purely retrospective studies; Work with the Multilateral Human Research Panel for Exploration (MHRPE) to develop acceptable data sharing and crew consent processes and to organize inter-agency data coordinators to facilitate requests for international crewmember data. Current metrics on data requests crew consenting will be presented, along with limitations on contacting crew to obtain consent. Categories of medical monitoring data available for request will be presented as well as flow diagrams detailing data request processing and approval steps.

Scalable geocomputation: evolving an environmental model building platform from single-core to supercomputers

NASA Astrophysics Data System (ADS)

Schmitz, Oliver; de Jong, Kor; Karssenberg, Derek

2017-04-01

There is an increasing demand to run environmental models on a big scale: simulations over large areas at high resolution. The heterogeneity of available computing hardware such as multi-core CPUs, GPUs or supercomputer potentially provides significant computing power to fulfil this demand. However, this requires detailed knowledge of the underlying hardware, parallel algorithm design and the implementation thereof in an efficient system programming language. Domain scientists such as hydrologists or ecologists often lack this specific software engineering knowledge, their emphasis is (and should be) on exploratory building and analysis of simulation models. As a result, models constructed by domain specialists mostly do not take full advantage of the available hardware. A promising solution is to separate the model building activity from software engineering by offering domain specialists a model building framework with pre-programmed building blocks that they combine to construct a model. The model building framework, consequently, needs to have built-in capabilities to make full usage of the available hardware. Developing such a framework providing understandable code for domain scientists and being runtime efficient at the same time poses several challenges on developers of such a framework. For example, optimisations can be performed on individual operations or the whole model, or tasks need to be generated for a well-balanced execution without explicitly knowing the complexity of the domain problem provided by the modeller. Ideally, a modelling framework supports the optimal use of available hardware whichsoever combination of model building blocks scientists use. We demonstrate our ongoing work on developing parallel algorithms for spatio-temporal modelling and demonstrate 1) PCRaster, an environmental software framework (http://www.pcraster.eu) providing spatio-temporal model building blocks and 2) parallelisation of about 50 of these building blocks using the new Fern library (https://github.com/geoneric/fern/), an independent generic raster processing library. Fern is a highly generic software library and its algorithms can be configured according to the configuration of a modelling framework. With manageable programming effort (e.g. matching data types between programming and domain language) we created a binding between Fern and PCRaster. The resulting PCRaster Python multicore module can be used to execute existing PCRaster models without having to make any changes to the model code. We show initial results on synthetic and geoscientific models indicating significant runtime improvements provided by parallel local and focal operations. We further outline challenges in improving remaining algorithms such as flow operations over digital elevation maps and further potential improvements like enhancing disk I/O.

Providing primary health care through integrated microfinance and health services in Latin America.

PubMed

Geissler, Kimberley H; Leatherman, Sheila

2015-05-01

The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic health needs, but challenges remain to ensure that health care provided is of reliable quality to predictably improve health outcomes over time. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cost-effectiveness of breast cancer control strategies in Central America: the cases of Costa Rica and Mexico.

PubMed

Niëns, Laurens M; Zelle, Sten G; Gutiérrez-Delgado, Cristina; Rivera Peña, Gustavo; Hidalgo Balarezo, Blanca Rosa; Rodriguez Steller, Erick; Rutten, Frans F H

2014-01-01

This paper reports the most cost-effective policy options to support and improve breast cancer control in Costa Rica and Mexico. Total costs and effects of breast cancer interventions were estimated using the health care perspective and WHO-CHOICE methodology. Effects were measured in disability-adjusted life years (DALYs) averted. Costs were assessed in 2009 United States Dollars (US$). To the extent available, analyses were based on locally obtained data. In Costa Rica, the current strategy of treating breast cancer in stages I to IV at a 80% coverage level seems to be the most cost-effective with an incremental cost-effectiveness ratio (ICER) of US$4,739 per DALY averted. At a coverage level of 95%, biennial clinical breast examination (CBE) screening could improve Costa Rica's population health twofold, and can still be considered very cost-effective (ICER US$5,964/DALY). For Mexico, our results indicate that at 95% coverage a mass-media awareness raising program (MAR) could be the most cost-effective (ICER US$5,021/DALY). If more resources are available in Mexico, biennial mammography screening for women 50-70 yrs (ICER US$12,718/DALY), adding trastuzumab (ICER US$13,994/DALY) or screening women 40-70 yrs biennially plus trastuzumab (ICER US$17,115/DALY) are less cost-effective options. We recommend both Costa Rica and Mexico to engage in MAR, CBE or mammography screening programs, depending on their budget. The results of this study should be interpreted with caution however, as the evidence on the intervention effectiveness is uncertain. Also, these programs require several organizational, budgetary and human resources, and the accessibility of breast cancer diagnostic, referral, treatment and palliative care facilities should be improved simultaneously. A gradual implementation of early detection programs should give the respective Ministries of Health the time to negotiate the required budget, train the required human resources and understand possible socioeconomic barriers.

Cost-Effectiveness of Breast Cancer Control Strategies in Central America: The Cases of Costa Rica and Mexico

PubMed Central

Niëns, Laurens M.; Zelle, Sten G.; Gutiérrez-Delgado, Cristina; Rivera Peña, Gustavo; Hidalgo Balarezo, Blanca Rosa; Rodriguez Steller, Erick; Rutten, Frans F. H.

2014-01-01

This paper reports the most cost-effective policy options to support and improve breast cancer control in Costa Rica and Mexico. Total costs and effects of breast cancer interventions were estimated using the health care perspective and WHO-CHOICE methodology. Effects were measured in disability-adjusted life years (DALYs) averted. Costs were assessed in 2009 United States Dollars (US$). To the extent available, analyses were based on locally obtained data. In Costa Rica, the current strategy of treating breast cancer in stages I to IV at a 80% coverage level seems to be the most cost-effective with an incremental cost-effectiveness ratio (ICER) of US$4,739 per DALY averted. At a coverage level of 95%, biennial clinical breast examination (CBE) screening could improve Costa Rica's population health twofold, and can still be considered very cost-effective (ICER US$5,964/DALY). For Mexico, our results indicate that at 95% coverage a mass-media awareness raising program (MAR) could be the most cost-effective (ICER US$5,021/DALY). If more resources are available in Mexico, biennial mammography screening for women 50–70 yrs (ICER US$12,718/DALY), adding trastuzumab (ICER US$13,994/DALY) or screening women 40–70 yrs biennially plus trastuzumab (ICER US$17,115/DALY) are less cost-effective options. We recommend both Costa Rica and Mexico to engage in MAR, CBE or mammography screening programs, depending on their budget. The results of this study should be interpreted with caution however, as the evidence on the intervention effectiveness is uncertain. Also, these programs require several organizational, budgetary and human resources, and the accessibility of breast cancer diagnostic, referral, treatment and palliative care facilities should be improved simultaneously. A gradual implementation of early detection programs should give the respective Ministries of Health the time to negotiate the required budget, train the required human resources and understand possible socioeconomic barriers. PMID:24769920

Organization of population-based cancer control programs: Europe and the world.

PubMed

Otter, Renée; Qiao, You-Lin; Burton, Robert; Samiei, Massoud; Parkin, Max; Trapido, Edward; Weller, David; Magrath, Ian; Sutcliffe, Simon

2009-01-01

As cancer is to a large extent avoidable and treatable, a cancer control program should be able to reduce mortality and morbidity and improve the quality of life of cancer patients and their families. However, the extent to which the goals of a cancer control program can be achieved will depend on the resource constraints a country faces. Such population-based cancer control plans should prioritize effective interventions and programs that are beneficial to the largest part of the population, and should include activities devoted to prevention, screening and early detection, treatment, palliation and end-of-life care, and rehabilitation. In order to develop a successful cancer control program, leadership and the relevant stakeholders, including patient organizations, need to be identified early on in the process so that all partners can take ownership and responsibility for the program. Various tools have been developed to aid them in the planning and implementation process. However, countries developing a national cancer control program would benefit from a discussion of different models for planning and delivery of population-based cancer control in settings with differing levels of resource commitment, in order to determine how best to proceed given their current level of commitment, political engagement and resources. As the priority assigned to different components of cancer control will differ depending on available resources and the burden and pattern of cancer, it is important to consider the relative roles of prevention, early detection, diagnosis, treatment, rehabilitation and palliative care in a cancer control program, as well as how to align available resources to meet prioritized needs. Experiences from countries with differing levels of resources are presented and serve to illustrate the difficulties in developing and implementing cancer control programs, as well as the innovative strategies that are being used to maximize available resources and enhance the quality of care provided to cancer patients around the world.

Mapping educational opportunities for healthcare workers on antimicrobial resistance and stewardship around the world.

PubMed

Rogers Van Katwyk, Susan; Jones, Sara L; Hoffman, Steven J

2018-02-05

Antimicrobial resistance is an important global issue facing society. Healthcare workers need to be engaged in solving this problem, as advocates for rational antimicrobial use, stewards of sustainable effectiveness, and educators of their patients. To fulfill this role, healthcare workers need access to training and educational resources on antimicrobial resistance. To better understand the resources available to healthcare workers, we undertook a global environmental scan of educational programs and resources targeting healthcare workers on the topic of antimicrobial resistance and antimicrobial stewardship. Programs were identified through contact with key experts, web searching, and academic literature searching. We summarized programs in tabular form, including participating organizations, region, and intended audience. We developed a coding system to classify programs by program type and participating organization type, assigning multiple codes as necessary and creating summary charts for program types, organization types, and intended audience to illustrate the breadth of available resources. We identified 94 educational initiatives related to antimicrobial resistance and antimicrobial stewardship, which represent a diverse array of programs including courses, workshops, conferences, guidelines, public outreach materials, and online-resource websites. These resources were developed by a combination of government bodies, professional societies, universities, non-profit and community organizations, hospitals and healthcare centers, and insurance companies and industry. Most programs either targeted healthcare workers collectively or specifically targeted physicians. A smaller number of programs were aimed at other healthcare worker groups including pharmacists, nurses, midwives, and healthcare students. Our environmental scan shows that there are many organizations working to develop and share educational resources for healthcare workers on antimicrobial resistance and antimicrobial stewardship. Governments, hospitals, and professional societies appear to be driving action on this front, sometimes working with other types of organizations. A broad range of resources have been made freely available; however, we have noted several opportunities for action, including increased engagement with students, improvements to pre-service education, recognition of antimicrobial resistance courses as continuing medical education, and better platforms for resource-sharing online.

Improving designer productivity. [artificial intelligence

NASA Technical Reports Server (NTRS)

Hill, Gary C.

1992-01-01

Designer and design team productivity improves with skill, experience, and the tools available. The design process involves numerous trials and errors, analyses, refinements, and addition of details. Computerized tools have greatly speeded the analysis, and now new theories and methods, emerging under the label Artificial Intelligence (AI), are being used to automate skill and experience. These tools improve designer productivity by capturing experience, emulating recognized skillful designers, and making the essence of complex programs easier to grasp. This paper outlines the aircraft design process in today's technology and business climate, presenting some of the challenges ahead and some of the promising AI methods for meeting these challenges.

KMC 3: counting and manipulating k-mer statistics.

PubMed

Kokot, Marek; Dlugosz, Maciej; Deorowicz, Sebastian

2017-09-01

Counting all k -mers in a given dataset is a standard procedure in many bioinformatics applications. We introduce KMC3, a significant improvement of the former KMC2 algorithm together with KMC tools for manipulating k -mer databases. Usefulness of the tools is shown on a few real problems. Program is freely available at http://sun.aei.polsl.pl/REFRESH/kmc . sebastian.deorowicz@polsl.pl. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Employer and Employee Opinions About Workplace Health Promotion (Wellness) Programs: Results of the 2015 Harris Poll Nielsen Survey.

PubMed

McCleary, Katherine; Goetzel, Ron Z; Roemer, Enid Chung; Berko, Jeff; Kent, Karen; Torre, Hector De La

2017-03-01

The aim of this study was to provide a current picture of the state of workplace health promotion (wellness) programs in the U.S. from both employer and employee perspectives. We analyzed data from two independent surveys of employers (N = 1500) and the general population (N = 4611). Employers reported offering wellness programs at almost twice the rate of employees who reported having these programs available to them. Most (59.4%) employees felt employers should play a role in improving worker health and nearly three-fourths (72.1%) thought that lower insurance premiums should be offered for participation in wellness programs. However, fewer than half felt that their work environment allows them to maintain good health. Although wellness programs are offered at the majority of workplaces in the U.S., employees are unlikely to be aware of these efforts and would like employers to be forthcoming in providing programs promoting good health.

A Summer Math and Physics Program for High School Students: Student Performance and Lessons Learned in the Second Year

NASA Astrophysics Data System (ADS)

Timme, Nicholas; Baird, Michael; Bennett, Jake; Fry, Jason; Garrison, Lance; Maltese, Adam

2013-05-01

For the past two years, the Foundations in Physics and Mathematics (FPM) summer program has been held at Indiana University in order to fulfill two goals: provide additional physics and mathematics instruction at the high school level, and provide physics graduate students with experience and autonomy in designing curricula and teaching courses. In this paper we will detail changes made to the program for its second year and the motivation for these changes, as well as implications for future iterations of the program. We gauge the impact of the changes on student performance using pre-/post-test scores, student evaluations, and anecdotal evidence. These data show that the program has a positive impact on student knowledge and this impact was greater in magnitude in the second year of the program. We attribute this improvement primarily to the inclusion of more inquiry-driven activities. All activities, worksheets, and lesson plans used in the program are available online.

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

Moyer, Kevin

When the Toledo Lucas County Port Authority (TLCPA) filed for the Department of Energy EECBG grant in late 2009, it was part of a strategic and Board backed objective to expand the organization’s economic development and financing programs into alternative energy and energy efficiency. This plan was filed with the knowledge and support of the areas key economic development agencies. The City of Toledo was also a key partner with the Mayor designating a committee to develop a Strategic Energy Policy for the City. This would later give rise to a Community Sustainability Strategic Plan for Toledo, Lucas County andmore » the surrounding region with energy efficiency as a key pillar. When the TLCPA signed the grant documents with the DOE in June of 2010, the geographic area was severely distressed economically, in the early stages of a recovery from over a 30% drop in business activity and high unemployment. The TLCPA and its partners began identifying potential project areas well before the filing of the application, continuing to work diligently before the formal award and signing of the grant documents. Strong implementation and actions plans and business and financing models were developed and revised throughout the 3 year grant period with the long term goal of creating a sustainable program. The TLCPA and the City of Toledo demonstrated early leadership by forming the energy improvement district and evaluating buildings under their control including transportation infrastructure and logistics, government services buildings and buildings which housed several for profit and not for profit tenants while completing significant energy efficiency projects that created public awareness and confidence and solid examples of various technologies and energy savings. As was stated in the DOE Award Summary, the undertaking was focused as a commercial program delving into Alternative Energy Utility Districts; what are referred to in Ohio Statute as Energy Special Improvement Districts or ESIDs and what is nationally known as Property Assessed Clean Energy or PACE districts and PACE financing. The project methodology followed the identify, develop, implement, monitor and measure format. These districts began in Toledo and adjoining areas and are expanding to TLCPA’s 28 county financing agency geographic footprint. What began as the Toledo Ohio Advanced Energy Improvement Corporation is now doing business as the Northwest Ohio Advanced Energy Improvement District recognizing it expansion into creating and financing other districts in NW Ohio. The program has been sought out as an advisor by major communities and states in the process of developing similar legislation and programs and has become one of the largest most successful PACE energy improvement and financing districts in the US. The program and the energy district focused on transforming energy use, delivery, conservation and renewable energy as “options of first choice”. The significant energy savings paid for many of the improvements and created a financially viable program well beyond the grant period. The program has become a model within the State of Ohio and Nationally on how to implement and finance projects in broad energy districts including how to evolve and integrate several financing methodologies. It is a unique utilization of revolving loan funds and energy bond pooling with revenue backing primarily from energy improvement special assessments on commercial properties along with some power purchase agreement (PPA) and loan agreement revenue. The program has also incorporated Qualified Energy Conservation Bonds, State of Ohio Energy Loans (SEP), utility rebates, solar and renewable energy certificates, renewable tax incentives and grants, and owner funded equity as additional program leverage and funding. Other keys to this success have been a continual simplification and refinement of the application and documentation process to make funding available easily and quickly to building owners when they are prepared to commit to the project as well as act as a trusted facilitator and advisor to both building owners and other stakeholders. Taking a flexible and pragmatic approach to project evaluation and implementation that matches time and expense to the complexity of the project has been another key learning. To date the program has closed 3 energy bond issues through the TLCPA sponsored and managed NW Ohio Bond Fund totaling $16.54 million (of which $3.34 million were QECB qualified). The program has turned over its $3.0 million revolving loan fund twice as construction financing in advance of bond issuance and currently has issued $1.25 million in revolving term loans. The program has $1.66 million of remaining capacity for QECB qualified bonds. The program can issue an additional $13.46 million in energy bonds continuing to utilize its DOE EECBG loan loss reserves. In addition, the program has available $3.6 million of loan loss reserves from the State of Ohio, as an eligible Port Authority, that can back the issuance of an additional $7.2 to $14.4 million of energy bonds. This does not include additional bond capacity is available from the NW Ohio Bond Fund. The program is the master escrow agent for $18 million of loan loss reserves from the State of Ohio for eligible Port Authorities that can be utilized to assist the formation of energy districts and financing programs in major metropolitan areas and regions around the State of Ohio. Other leveraged funds now total $10 million; placing the total project value completed and financed at over $30 million. In addition that program has generated an active pipeline of projects in various stages that total $25 – $30 million.« less

Improvements in newborn care and newborn resuscitation following a quality improvement program at scale: results from a before and after study in Tanzania.

PubMed

Makene, Christina Lulu; Plotkin, Marya; Currie, Sheena; Bishanga, Dunstan; Ugwi, Patience; Louis, Henry; Winani, Kiholeth; Nelson, Brett D

2014-11-19

Every year, more than a million of the world's newborns die on their first day of life; as many as two-thirds of these deaths could be saved with essential care at birth and the early newborn period. Simple interventions to improve the quality of essential newborn care in health facilities - for example, improving steps to help newborns breathe at birth - have demonstrated up to 47% reduction in newborn mortality in health facilities in Tanzania. We conducted an evaluation of the effects of a large-scale maternal-newborn quality improvement intervention in Tanzania that assessed the quality of provision of essential newborn care and newborn resuscitation. Cross-sectional health facility surveys were conducted pre-intervention (2010) and post intervention (2012) in 52 health facilities in the program implementation area. Essential newborn care provided by health care providers immediately following birth was observed for 489 newborns in 2010 and 560 in 2012; actual management of newborns with trouble breathing were observed in 2010 (n = 18) and 2012 (n = 40). Assessments of health worker knowledge were conducted with case studies (2010, n = 206; 2012, n = 217) and a simulated resuscitation using a newborn mannequin (2010, n = 299; 2012, n = 213). Facility audits assessed facility readiness for essential newborn care. Index scores for quality of observed essential newborn care showed significant overall improvement following the quality-of-care intervention, from 39% to 73% (p <0.0001). Health worker knowledge using a case study significantly improved as well, from 23% to 41% (p <0.0001) but skills in resuscitation using a newborn mannequin were persistently low. Availability of essential newborn care supplies, which was high at baseline in the regional hospitals, improved at the lower-level health facilities. Within two years, the quality improvement program was successful in raising the quality of essential newborn care services in the program facilities. Some gaps in newborn care were persistent, notably practical skills in newborn resuscitation. Continued investment in life-saving improvements to newborn care through the health services is a priority for reduction of newborn mortality in Tanzania.

Tuning in to Kids: improving emotion socialization practices in parents of preschool children--findings from a community trial.

PubMed

Havighurst, Sophie S; Wilson, Katherine R; Harley, Ann E; Prior, Margot R; Kehoe, Christiane

2010-12-01

This study evaluated a new prevention and early intervention parenting program: Tuning in to Kids. The program aims to improve emotion socialization practices in parents of preschool children and is based on research evidence that parents' responses to, and coaching of, their children's emotions influence emotional and behavioral functioning in children. Two hundred and sixteen primary caregiver parents of children aged 4.0-5.11 years were randomized into an intervention or waitlist control group. Parents in the intervention condition attended a 6-session group parenting program plus two booster sessions. Assessment occurred pre-intervention, post-intervention and at six-month follow-up. Questionnaires assessed parent emotion awareness and regulation, parent beliefs and practices of emotion socialization (emotion dismissing, emotion coaching, empathy) and child behavior (parent and teacher report). Observation of emotion socialization practices and child emotional knowledge was conducted pre-intervention and at follow-up with 161 parent-child dyads. Parents in the intervention condition reported significant improvements in their own emotion awareness and regulation, increases in emotion coaching, and decreases in emotionally dismissive beliefs and behaviors. There were increases in parents' observed use of emotion labels and discussion of causes and consequences of emotions with their children. Child emotional knowledge improved, and reductions in child behavior problems were reported by parents and teachers. This study provides support for the efficacy of a parenting intervention targeting parent emotion socialization practices that lead to improved child emotional knowledge and behavior. This preventative intervention targeting parents' own emotion awareness and regulation, as well as emotional communication in parent-child relationships, is a promising addition to available parenting programs. © 2010 The Authors. Journal of Child Psychology and Psychiatry. © 2010 Association for Child and Adolescent Mental Health.

Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Total Knee Arthroplasty.

PubMed

Soffin, Ellen M; Gibbons, Melinda M; Ko, Clifford Y; Kates, Stephen L; Wick, Elizabeth; Cannesson, Maxime; Scott, Michael J; Wu, Christopher L

2018-06-08

Enhanced recovery after surgery (ERAS) has rapidly gained popularity in a variety of surgical subspecialities. A large body of literature suggests that ERAS leads to superior outcomes, improved patient satisfaction, reduced length of hospital stay, and cost benefits, without affecting rates of readmission after surgery. These patterns have been described for patients undergoing elective total knee arthroplasty (TKA); however, adoption of ERAS to orthopedic surgery has lagged behind other surgical disciplines. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute (AI) for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery. The program comprises a national effort to incorporate best practice in perioperative care and improve patient safety, for over 750 hospitals and multiple procedures over the next 5 years, including orthopedic surgery. We have conducted a full evidence review of anesthetic interventions to derive anesthesiology-related components of an evidence-based ERAS pathway for TKA. A PubMed search was performed for each protocol component, focusing on the highest levels of evidence in the literature. Search findings are summarized in narrative format. Anesthesiology components of care were identified and evaluated across the pre-, intra-, and postoperative phases. A summary of the best available evidence, together with recommendations for inclusion in ERAS protocols for TKA, is provided. There is extensive evidence in the literature, and from society guidelines to support the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery goals for TKA.

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

Hadley, I.; Sinclair, C.I.K.; Magne, E.

This paper describes the life extension of a semi-submersible drilling rig built in the early 1970`s. A nominal design life of 20 years was estimated at the time of building; however, in the interim period, numerous improvements have been made in fatigue life estimation ad life improvement techniques, raising the possibility that a further 20 years of operation could be considered. The life extension strategy made use of a number of aspects of offshore technology which were not available at the time of construction of the rig. Finite element studies and results from offshore research programs were used to gaugemore » the effect of fatigue life improvement techniques. The program demonstrated the feasibility of extending the operation of the rig for a further 20 years, with the interval between in-service inspection increased to every five years. It also provided a valuable database of fracture toughness data for the rig materials, which may be used in future work to address reliability issues.« less

Use of virtual reality intervention to improve reaction time in children with cerebral palsy: A randomized controlled trial.

PubMed

Pourazar, Morteza; Mirakhori, Fatemeh; Hemayattalab, Rasool; Bagherzadeh, Fazlolah

2017-09-21

The purpose of this study was to investigate the training effects of Virtual Reality (VR) intervention program on reaction time in children with cerebral palsy. Thirty boys ranging from 7 to 12 years (mean = 11.20; SD = .76) were selected by available sampling method and randomly divided into the experimental and control groups. Simple Reaction Time (SRT) and Discriminative Reaction Time (DRT) were measured at baseline and 1 day after completion of VR intervention. Multivariate analysis of variance (MANOVA) and paired sample t-test were performed to analyze the results. MANOVA test revealed significant effects for group in posttest phase, with lower reaction time in both measures for the experimental group. Based on paired sample t-test results, both RT measures significantly improved in experimental group following the VR intervention program. This paper proposes VR as a promising tool into the rehabilitation process for improving reaction time in children with cerebral palsy.

A karate program for improving self-concept and quality of life in childhood epilepsy: results of a pilot study.

PubMed

Conant, Kerry D; Morgan, Amy K; Muzykewicz, David; Clark, Derrick C; Thiele, Elizabeth A

2008-01-01

The potential cognitive and psychosocial effects of childhood epilepsy have significant implications for a child's self-image and academic achievement. This study focuses on a 10-week karate program for children and adolescents with epilepsy aimed at increasing social confidence, self-concept, and quality of life, as well as reducing parental anxiety. Eleven children (8-16 years old) and their parents participated in this questionnaire study, and complete data were available for nine of these families. Measures consisted of the Piers-Harris Children's Self-Concept Scale, the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire, and the Parental Stress Index. By parental report, significant improvement in memory function and largely positive trends in quality of life on multiple subscales were observed. By child report, intellectual self-esteem and social confidence also improved. Parental stress decreased, although not significantly, suggesting a potential benefit and indicating a role for future interventions targeting family anxiety.

A comparative approach to deep vein thrombosis risk assessment.

PubMed

Hums, Wendy; Blostein, Paul

2006-01-01

Trauma patients are at risk for developing DVT/PE. The Bronson Trauma Model incorporates a DVT scoring system into the daily routine for all injured patients admitted to the Trauma Care Unit. Dr Paul Blostein added the DVT Risk Assessment spreadsheet to his personal digital assistant and made it available to other members of the team to allow calculation of a patient's DVT risk percentage during daily multidisciplinary rounds in the Trauma Care Unit. The Trauma Program has found the incorporation of the scoring systems into the trauma registry to be a value-added component of our performance improvement process. Bronson's unique model of trauma care, where patients are admitted and discharged from the same room, combined with today's technology of wireless laptops and personal digital assistants, promotes a progressive approach to DVT/PE prophylaxis and performance improvement. Our trauma follow-up program has proven to be effective in reintegrating patients back into the trauma system to optimize their functional status and improve their outcome.

A "client perspective" helps improve services.

PubMed

1998-01-01

Egypt's Ministry of Health launched a campaign in 1992 to improve client satisfaction with family planning clinic services in the country. In the program, family planning clinic supervisors are being trained to use a checklist of 101 indicators to evaluate services, ranging from the availability of contraceptive commodities to the condition of facilities. Television messages and posters disseminated throughout communities instruct potential clients to look for gold stars on the doors of family planning clinics across the country, indicators of a clinic which meets quality service standards. This program is currently used by almost 4000 clinics nationwide. Family planning services worldwide have long focused upon increasing levels of contraceptive use. More recently, however, they are also focusing upon the quality of services provided. Frameworks for improving services tend to emphasize better ways to interact with clients, and often address how to approach specific management concerns, such as maintaining adequate contraceptive supplies. Client interaction, management concerns, and how quality makes a difference are discussed.