Industrial Medicine in the Nuclear Energy Study Center at Mol.; LA MEDECINE INDUSTRIELLE DANS LE CENTRE D'ETUDE DE L'ENERGIE NUCLEAIRE DE MOL.

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

Faes, M.H.

1959-10-31

The aim of an industrial medical service is to maintain the health of the personnel in normal conditions and to treat personnel in the case of accidents or illnesses caused by the work. The first objective of a medical service is one of conirol, in which a thorough clinical, radiological, and laboratory examination is given to all prospective employees. This examination is described in detail. The discovery of professional illnesses is as fully described. The legal safeguards for a person accidentally exposed to radiation are discussed. (J.S.R.)

'Virtual' central business office: how UMMS improved revenue cycle performance.

PubMed

Henciak, Bill; Fontaine, Christine; Fields, Keith; Parks, Stacy

2010-06-01

Based on its experience with implementing a virtual central business office, UMMS recommends the following steps to ensure the success of such an initiative: Define the process flow for the organization's day-today revenue cycle operations prior to implementation. Then select best practices and milestones for managing accounts. Identify any possible technology issues that could arise during implementation prior to go live. Hold a midproject debriefing with staff. Develop an organizational chart that details who is responsible for handling issues that arise during implementation and afterward.

Phase III (final) evaluation report : national evaluation of the FY01 earmark, area transportation authority of North Central Pennsylvania--regional GIS/ITS initiative.

DOT National Transportation Integrated Search

2009-08-31

This report presents the results of the United States Department of Transportation evaluation of a federally funded earmark project implemented by the Area Transportation Authority of North Central Pennsylvania (ATA). The project implemented a suite ...

Timing and Trajectory in Rhythm Production

ERIC Educational Resources Information Center

Doumas, Michail; Wing, Alan M.

2007-01-01

The Wing-Kristofferson movement timing model (A. M. Wing & A. B. Kristofferson, 1973a, 1973b) distinguishes central timer and motor implementation processes. Previous studies have shown that increases in interresponse interval (IRI) variability with mean IRI are due to central timer processes, not motor implementation. The authors examine whether…

77 FR 8221 - Determination Under the Textile and Apparel Commercial Availability Provision of the Dominican...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... Commercial Availability Provision of the Dominican Republic-Central America-United States Free Trade...-Central America-United States Free Trade Agreement Implementation Act (``CAFTA-DR Implementation Act... FURTHER INFORMATION CONTACT: Maria Dybczak, Office of Textiles and Apparel, U.S. Department of Commerce...

Central station market development strategies for photovoltaics

NASA Technical Reports Server (NTRS)

1980-01-01

Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

Central station market development strategies for photovoltaics

NASA Astrophysics Data System (ADS)

1980-11-01

Federal market development strategies designed to accelerate the market penetration of central station applications of photovoltaic energy system are analyzed. Since no specific goals were set for the commercialization of central station applications, strategic principles are explored which, when coupled with specific objectives for central stations, can produce a market development implementation plan. The study includes (1) background information on the National Photovoltaic Program, photovoltaic technology, and central stations; (2) a brief market assessment; (3) a discussion of the viewpoints of the electric utility industry with respect to solar energy; (4) a discussion of commercialization issues; and (5) strategy principles. It is recommended that a set of specific goals and objectives be defined for the photovoltaic central station program, and that these goals and objectives evolve into an implementation plan that identifies the appropriate federal role.

Marketing to Develop the Premier Medical Brand in the Huaihai Economic Zone.

PubMed

Zhang, Peiying; Meng, Qingchao

2015-06-01

Based on the practices at Xuzhou Central Hospital, the authors analyzed the improvements in the healthcare quality and economic efficiency after implementing a brand marketing strategy. Using methods including questionnaires and business controlling means, we summarized that the improvements to the healthcare quality and economic efficiency after strategies were implemented in the areas of network, reputation, academic research, and public welfare. After the implementation of a brand marketing campaign, the medical service quality and brand reputation have been greatly improved. Meanwhile, a central hospital group was formed and gradually became the central healthcare provider in the Huaihai Economic Zone. The new marketing facilitated the drastic increase of medical service and brand reputation.

Partitioning of centralized integrated flight/propulsion control design for decentralized implementation

NASA Technical Reports Server (NTRS)

Garg, Sanjay

1993-01-01

The notion of partitioning a centralized controller into a decentralized, hierarchical structure suitable for integrated flight/propulsion control (IFPC) implementation is discussed. A systematic procedure is developed for determining partitioned airframe and engine subsystem controllers (subcontrollers), with the desired interconnection structure, that approximate the closed-loop performance and robustness characteristics of a given centralized controller. The procedure is demonstrated by application to IFPC design for a short take-off and vertical landing (STOVL) aircraft in the landing-approach-to-hover-transition flight phase.

Centralization and Experimentation in the Implementation of a National Monitoring and Evaluation System: The Experience of Malawi.

ERIC Educational Resources Information Center

Useem, Michael; Chipande, Graham

1991-01-01

To identify general principles of implementing a system of evaluation, the experience of Malawi in building a national system for agriculture is described. Applying principles of both centralization and decentralization and principles of trial and error has helped translate theories of evaluation into practice in Malawi. (SLD)

Lessons from the Field: Developing and Implementing the Qatar Student Assessment System, 2002-2006. Technical Report

ERIC Educational Resources Information Center

Gonzalez, Gabriella; Le, Vi-Nhuan; Broer, Markus; Mariano, Louis T.; Froemel, J. Enrique; Goldman, Charles A.; DaVanzo, Julie

2009-01-01

Qatar has recently positioned itself to be a leader in education. Central to the country's efforts is the implementation of reforms to its K-12 education system. Central to the reform initiatives was the development of internationally benchmarked curriculum standards in four subjects: Arabic, English as a foreign language, mathematics, and…

Protecting breastfeeding in West and Central Africa: over 25 years of implementation of the International Code of Marketing of Breastmilk Substitutes.

PubMed

Sokol, Ellen; Clark, David; Aguayo, Victor M

2008-09-01

In 1981 the World Health Assembly (WHA) adopted the International Code of Marketing of Breastmilk Substitutes out of concern that inappropriate marketing of breastmilk substitutes was contributing to the alarming decline in breastfeeding worldwide and the increase in child malnutrition and mortality, particularly in developing countries. To document progress, challenges, and lessons learned in the implementation of the International Code in West and Central Africa. Data were obtained by literature review and interviews with key informants. Twelve of the 24 countries have laws, decrees, or regulations that implement all or most of the provisions of the Code, 6 countries have a draft law or decree that is awaiting government approval or have a government committee that is studying how best to implement the Code, 3 countries have a legal instrument that enacts a few provisions of the Code, and 3 countries have not taken any action to implement the Code. International declarations and initiatives for child nutrition and survival have provided impetus for national implementation of the Code. National action to regulate the marketing of breastmilk substitutes needs to be linked to national priorities for nutrition and child survival. A clearly defined scope is essential for effective implementation of national legislation. Leadership and support by health professionals is essential to endorse and enforce national legislation. Training on Code implementation is instrumental for national action; national implementation of the Code requires provisions and capacity to monitor and enforce the legislative framework and needs to be part of a multipronged strategy to advance national child nutrition and survival goals. Nations in West and Central Africa have made important progress in implementing the International Code. More than 25 years after its adoption by the WHA, the Code remains as important as ever for child survival and development in West and Central Africa.

Implementation of evidence-informed practice through central network actors; a case study of three public health units in Canada.

PubMed

Yousefi Nooraie, Reza; Marin, Alexandra; Hanneman, Robert; Lohfeld, Lynne; Dobbins, Maureen

2017-03-15

Workforce development is an important aspect of evidence-informed decision making (EIDM) interventions. The social position of individuals in formal and informal social networks, and the relevance of formal roles in relation to EIDM are important factors identifying key EIDM players in public health organizations. We assessed the role of central actors in information sharing networks in promoting the adoption of EIDM by the staff of three public health units in Canada, over a two-year period during which an organization-wide intervention was implemented. A multi-faceted and tailored intervention to train select staff applying research evidence in practice was implemented in three public health units in Canada from 2011 to 2013. Staff (n = 572) were asked to identify those in the health unit whom they turned to get help using research in practice, whom they considered as experts in EIDM, and friends. We developed multi-level linear regression models to predict the change in EIDM behavior scores predicted by being connected to peers who were central in networks and were engaged in the intervention. Only the group of highly engaged central actors who were connected to each other, and the staff who were not engaged in the intervention but were connected to highly engaged central actors significantly improved their EIDM behavior scores. Among the latter group, the staff who were also friends with their information sources showed a larger improvement in EIDM behavior. If engaged, central network actors use their formal and informal connections to promote EIDM. Central actors themselves are more likely to adopt EIDM if they communicate with each other. These social communications should be reinforced and supported through the implementation of training interventions as a means to promoting EIDM.

A Faster Parallel Algorithm and Efficient Multithreaded Implementations for Evaluating Betweenness Centrality on Massive Datasets

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

Madduri, Kamesh; Ediger, David; Jiang, Karl

2009-05-29

We present a new lock-free parallel algorithm for computing betweenness centrality of massive small-world networks. With minor changes to the data structures, our algorithm also achieves better spatial cache locality compared to previous approaches. Betweenness centrality is a key algorithm kernel in the HPCS SSCA#2 Graph Analysis benchmark, which has been extensively used to evaluate the performance of emerging high-performance computing architectures for graph-theoretic computations. We design optimized implementations of betweenness centrality and the SSCA#2 benchmark for two hardware multithreaded systems: a Cray XMT system with the ThreadStorm processor, and a single-socket Sun multicore server with the UltraSparc T2 processor.more » For a small-world network of 134 million vertices and 1.073 billion edges, the 16-processor XMT system and the 8-core Sun Fire T5120 server achieve TEPS scores (an algorithmic performance count for the SSCA#2 benchmark) of 160 million and 90 million respectively, which corresponds to more than a 2X performance improvement over the previous parallel implementations. To better characterize the performance of these multithreaded systems, we correlate the SSCA#2 performance results with data from the memory-intensive STREAM and RandomAccess benchmarks. Finally, we demonstrate the applicability of our implementation to analyze massive real-world datasets by computing approximate betweenness centrality for a large-scale IMDb movie-actor network.« less

Implementation of a central line maintenance care bundle in hospitalized pediatric oncology patients.

PubMed

Rinke, Michael L; Chen, Allen R; Bundy, David G; Colantuoni, Elizabeth; Fratino, Lisa; Drucis, Kim M; Panton, Stephanie Y; Kokoszka, Michelle; Budd, Alicia P; Milstone, Aaron M; Miller, Marlene R

2012-10-01

To investigate whether a multidisciplinary, best-practice central line maintenance care bundle reduces central line-associated blood stream infection (CLABSI) rates in hospitalized pediatric oncology patients and to further delineate the epidemiology of CLABSIs in this population. We performed a prospective, interrupted time series study of a best-practice bundle addressing all areas of central line care: reduction of entries, aseptic entries, and aseptic procedures when changing components. Based on a continuous quality improvement model, targeted interventions were instituted to improve compliance with each of the bundle elements. CLABSI rates and epidemiological data were collected for 10 months before and 24 months after implementation of the bundle and compared in a Poisson regression model. CLABSI rates decreased from 2.25 CLABSIs per 1000 central line days at baseline to 1.79 CLABSIs per 1000 central line days during the intervention period (incidence rate ratio [IRR]: 0.80, P = .58). Secondary analyses indicated CLABSI rates were reduced to 0.81 CLABSIs per 1000 central line days in the second 12 months of the intervention (IRR: 0.36, P = .091). Fifty-nine percent of infections resulted from Gram-positive pathogens, 37% of patients with a CLABSI required central line removal, and patients with Hickman catheters were more likely to have a CLABSI than patients with Infusaports (IRR: 4.62, P = .02). A best-practice central line maintenance care bundle can be implemented in hospitalized pediatric oncology patients, although long ramp-up times may be necessary to reap maximal benefits. Further research is needed to determine if this CLABSI rate reduction can be sustained and spread.

Central-provincial relations for anti-schistosomiasis policy in china.

PubMed

Fan, Ka-Wai

2012-01-01

This paper discusses central-local relations for healthcare policy in China from a principal-agent perspective, based on schistosomiasis control. In order to control the disease, the central government produced the Outline of the Mid-Long-Term National Plan for Schistosomiasis Prevention and Control (2004-2015) in 2004. By discussing the implementation of the National Outline at the provincial level, the author uses principal-agent theory to examine conflict and coordination between the central and provincial governments. The documents were collected from the Internet. Although the central and provincial governments all want to eliminate schistosomiasis, allocating funding among them creates conflict and forms an obstacle to achieving the goal. This paper extensively discusses the topics related to central-provincial relation and schistosomiasis control program. Further case study on a single province may be needed to intensify the discussion from a micro perspective. The conflict between central and provincial relations needs to be resolved in order to implement the national policy.

Central-Provincial Relations for Anti-Schistosomiasis Policy in China

PubMed Central

FAN, Ka-wai

2012-01-01

This paper discusses central-local relations for healthcare policy in China from a principal-agent perspective, based on schistosomiasis control. In order to control the disease, the central government produced the Outline of the Mid-Long-Term National Plan for Schistosomiasis Prevention and Control (2004–2015) in 2004. By discussing the implementation of the National Outline at the provincial level, the author uses principal-agent theory to examine conflict and coordination between the central and provincial governments. The documents were collected from the Internet. Although the central and provincial governments all want to eliminate schistosomiasis, allocating funding among them creates conflict and forms an obstacle to achieving the goal. This paper extensively discusses the topics related to central-provincial relation and schistosomiasis control program. Further case study on a single province may be needed to intensify the discussion from a micro perspective. The conflict between central and provincial relations needs to be resolved in order to implement the national policy. PMID:23113188

Dynamic modeling of the cesium, strontium, and ruthenium transfer to grass and vegetables

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

Renaud, P.; Real, J.; Maubert, H.

1999-05-01

From 1988 to 1993, the Nuclear Safety and Protection Institute (Institut de Protection et de Surete Nucleaire -- IPSN) conducted experimental programs focused on transfers to vegetation following accidental localized deposits of radioactive aerosols. In relation to vegetable crops (fruit, leaves, and root vegetables) and meadow grass these experiments have enabled a determination of the factors involved in the transfer of cesium, strontium, and ruthenium at successive harvests, or cuttings, in respect of various time lags after contamination. The dynamic modeling given by these results allows an evaluation of changes in the mass activity of vegetables and grass during themore » months following deposit. It constitutes part of the ASTRAL post-accident radioecology model.« less

12 CFR 725.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ADMINISTRATION CENTRAL LIQUIDITY FACILITY § 725.1 Scope. This part contains the regulations implementing the National Credit Union Central Liquidity Facility Act, subchapter III of the Federal Credit Union Act. The National Credit Union Administration Central Liquidity Facility is a mixed-ownership Government corporation...

Good Ideas and Engagement Aren't Enough: School District Central Offices and the Micro-Politics of Implementing Comprehensive Human Resource Reform

ERIC Educational Resources Information Center

DeArmond, Michael

2013-01-01

This dissertation is about how organizational politics--or what some scholars call micro-politics--shapes the implementation of comprehensive human resource (HR) reform in school district central offices. Over the last decade, education reformers and advocates have promoted comprehensive HR reform as a way to improve teaching and learning in K-12…

An economic assessment of implementing streamside management zones in central Appalachian hardwood forests

Treesearch

Yaoxiang Li; Chris B. LeDoux; Jingxin Wang

2006-01-01

The effects of variable width of streamside management zones (25, 50, 75, and 100 ft) (SMZs) and removal level of trees (10%, 30%, and 50% of basal area) on production and cost of implementing SMZs in central Appalachian hardwood forests were simulated by using a computer model. Harvesting operations were performed on an 80-year-old generated natural hardwood stand...

Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

PubMed

Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

2018-05-15

The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Facility design, construction, and operation

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

NONE

France has been disposing of low-level radioactive waste (LLW) at the Centre de Stockage de la Manche (CSM) since 1969 and now at the Centre de Stockage de l`Aube (CSA) since 1992. In France, several agencies and companies are involved in the development and implementation of LLW technology. The Commissariat a l`Energie Atomic (CEA), is responsible for research and development of new technologies. The Agence National pour la Gestion des Dechets Radioactifs is the agency responsible for the construction and operation of disposal facilities and for wastes acceptance for these facilities. Compagnie Generale des Matieres Nucleaires provides fuel services, includingmore » uranium enrichment, fuel fabrication, and fuel reprocessing, and is thus one generator of LLW. Societe pour les Techniques Nouvelles is an engineering company responsible for commercializing CEA waste management technology and for engineering and design support for the facilities. Numatec, Inc. is a US company representing these French companies and agencies in the US. In Task 1.1 of Numatec`s contract with Martin Marietta Energy Systems, Numatec provides details on the design, construction and operation of the LLW disposal facilities at CSM and CSA. Lessons learned from operation of CSM and incorporated into the design, construction and operating procedures at CSA are identified and discussed. The process used by the French for identification, selection, and evaluation of disposal technologies is provided. Specifically, the decisionmaking process resulting in the change in disposal facility design for the CSA versus the CSM is discussed. This report provides` all of the basic information in these areas and reflects actual experience to date.« less

Central implementation strategies outperform local ones in improving HIV testing in Veterans Healthcare Administration facilities.

PubMed

Goetz, Matthew Bidwell; Hoang, Tuyen; Knapp, Herschel; Burgess, Jane; Fletcher, Michael D; Gifford, Allen L; Asch, Steven M

2013-10-01

Pilot data suggest that a multifaceted approach may increase HIV testing rates, but the scalability of this approach and the level of support needed for successful implementation remain unknown. To evaluate the effectiveness of a scaled-up multi-component intervention in increasing the rate of risk-based and routine HIV diagnostic testing in primary care clinics and the impact of differing levels of program support. Three arm, quasi-experimental implementation research study. Veterans Health Administration (VHA) facilities. Persons receiving primary care between June 2009 and September 2011 INTERVENTION: A multimodal program, including a real-time electronic clinical reminder to facilitate HIV testing, provider feedback reports and provider education, was implemented in Central and Local Arm Sites; sites in the Central Arm also received ongoing programmatic support. Control Arm sites had no intervention Frequency of performing HIV testing during the 6 months before and after implementation of a risk-based clinical reminder (phase I) or routine clinical reminder (phase II). The adjusted rate of risk-based testing increased by 0.4 %, 5.6 % and 10.1 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). During phase II, the adjusted rate of routine testing increased by 1.1 %, 6.3 % and 9.2 % in the Control, Local and Central Arms, respectively (all comparisons, p < 0.01). At study end, 70-80 % of patients had been offered an HIV test. Use of clinical reminders, provider feedback, education and social marketing significantly increased the frequency at which HIV testing is offered and performed in VHA facilities. These findings support a multimodal approach toward achieving the goal of having every American know their HIV status as a matter of routine clinical practice.

The Woodlands, Texas.

ERIC Educational Resources Information Center

McHaney, Larry J.; Bernhardt, Jerry

1988-01-01

The authors describe the "central project" concept for implementing technology education while addressing education reform. The central project is a topic around which students, teachers, administrators, and the community focus their energies as a team. At McCullough High School (Texas), the central project involved design and…

Centralized and distributed control architectures under Foundation Fieldbus network.

PubMed

Persechini, Maria Auxiliadora Muanis; Jota, Fábio Gonçalves

2013-01-01

This paper aims at discussing possible automation and control system architectures based on fieldbus networks in which the controllers can be implemented either in a centralized or in a distributed form. An experimental setup is used to demonstrate some of the addressed issues. The control and automation architecture is composed of a supervisory system, a programmable logic controller and various other devices connected to a Foundation Fieldbus H1 network. The procedures used in the network configuration, in the process modelling and in the design and implementation of controllers are described. The specificities of each one of the considered logical organizations are also discussed. Finally, experimental results are analysed using an algorithm for the assessment of control loops to compare the performances between the centralized and the distributed implementations. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.

Decentralizing Education in Transition Societies: Case Studies from Central and Eastern Europe. WBI Learning Resources Series.

ERIC Educational Resources Information Center

Fiszbein, Ariel, Ed.

This book is about education system reform in Central and Eastern Europe, with emphasis on decentralization and management. In the past, local authorities served as implementation arms of the central ministry, while finance and decision-making were controlled by the central government, leaving local communities with little influence. New education…

Cost-effectiveness of a quality improvement programme to reduce central line-associated bloodstream infections in intensive care units in the USA

PubMed Central

Herzer, Kurt R; Niessen, Louis; Constenla, Dagna O; Ward, William J; Pronovost, Peter J

2014-01-01

Objective To assess the cost-effectiveness of a multifaceted quality improvement programme focused on reducing central line-associated bloodstream infections in intensive care units. Design Cost-effectiveness analysis using a decision tree model to compare programme to non-programme intensive care units. Setting USA. Population Adult patients in the intensive care unit. Costs Economic costs of the programme and of central line-associated bloodstream infections were estimated from the perspective of the hospital and presented in 2013 US dollars. Main outcome measures Central line-associated bloodstream infections prevented, deaths averted due to central line-associated bloodstream infections prevented, and incremental cost-effectiveness ratios. Probabilistic sensitivity analysis was performed. Results Compared with current practice, the programme is strongly dominant and reduces bloodstream infections and deaths at no additional cost. The probabilistic sensitivity analysis showed that there was an almost 80% probability that the programme reduces bloodstream infections and the infections’ economic costs to hospitals. The opportunity cost of a bloodstream infection to a hospital was the most important model parameter in these analyses. Conclusions This multifaceted quality improvement programme, as it is currently implemented by hospitals on an increasingly large scale in the USA, likely reduces the economic costs of central line-associated bloodstream infections for US hospitals. Awareness among hospitals about the programme's benefits should enhance implementation. The programme's implementation has the potential to substantially reduce morbidity, mortality and economic costs associated with central line-associated bloodstream infections. PMID:25256190

ISO 50001 and SEP Faster and Cheaper - Exploring the Enterprise-Wide Approach

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

Liu, Jingjing; Rao, Prakash; Therkelsen, Peter

ISO 50001 and other management systems (e.g., ISO 9001 and ISO 14001) allow for implementation and certification at the enterprise level. The "Central Office" concept, which allows a small group of employees to manage and facilitate the organization’s energy management system (EnMS) at the enterprise level, was introduced within the ISO 50003 standard to provide guidance to ISO 50001 certification bodies. Four industrial companies have partnered with the United States Department of Energy to pilot the enterprise-wide ISO 50001/SEP concept under the Better Buildings Superior Energy Performance (SEP) Enterprise-wide Accelerator. Each organization developed a Central Office to host their EnMSmore » while implementing ISO 50001/SEP at multiple physically separated sites. The four corporate partners tailored their Central Office implementation model to meet their own specific circumstances and needs. This paper reviews the commonalities, differences, and benefits of each of these enterprise-wide implementation models, including organizational structures, Central Office staff responsibilities, and key strategies. The cost savings and benefits of using the enterprise-wide approach were assessed, including the cost per site compared with that of a conventional, single-site ISO 50001/SEP implementation approach. This paper also discusses the drivers for the cost reductions realized through these enterprise-wide approaches. The four partner companies worked with 30 total sites. On average, these 30 sites improved energy performance by 5% annually over their SEP achievement periods, saved more than $600,000 annually in energy costs and reduced implementation cost for ISO 50001 and SEP by $19,000 and 0.8 Full Time Equivalent × years (FTE-yr) of staff time per site. The results can inform other organizations seeking to implement enterprise-wide ISO 50001/SEP, as well as energy efficiency organizations seeking to promote wider adoption of ISO 50001 implementation.« less

77 FR 71501 - International Fisheries; Western and Central Pacific Fisheries for Highly Migratory Species...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-03

...NMFS issues regulations under the authority of the Western and Central Pacific Fisheries Convention Implementation Act (WCPFC Implementation Act) to implement requirements for U.S. fishing vessels used for commercial fishing that offload or receive transshipments of highly migratory species (HMS), U.S. fishing vessels used for commercial fishing that provide bunkering or other support services to fishing vessels, and U.S. fishing vessels used for commercial fishing that receive bunkering or engage in other support services, in the area of application of the Convention on the Conservation and Management of Highly Migratory Fish Stocks in the Western and Central Pacific Ocean (Convention). Some of the requirements also apply to transshipments of fish caught in the area of application of the Convention (Convention Area) and transshipped elsewhere. NMFS also issues requirements regarding notification of entry into and exit from the ``Eastern High Seas Special Management Area'' (Eastern SMA) and requirements relating to discards from purse seine fishing vessels. This action is necessary for the United States to implement decisions of the Commission for the Conservation and Management of Highly Migratory Fish Stocks in the Western and Central Pacific Ocean (Commission or WCPFC) and to satisfy its obligations under the Convention, to which it is a Contracting Party.

76 FR 62062 - Proposed Approval of the Central Characterization Project's Remote-Handled Transuranic Waste...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... Central Characterization Project's Remote-Handled Transuranic Waste Characterization Program at Sandia..., remote-handled (RH), transuranic (TRU) waste characterization program implemented by the Central Characterization Project (CCP) at Sandia National Laboratory (SNL) in Albuquerque, New Mexico. This waste is...

76 FR 33277 - Proposed Approval of the Central Characterization Project's Remote-Handled Transuranic Waste...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

... Central Characterization Project's Remote-Handled Transuranic Waste Characterization Program at Bettis... radioactive remote-handled (RH) transuranic (TRU) waste characterization program implemented by the Central Characterization Project (CCP) at Bettis Atomic Power Laboratory (BAPL) in West Mifflin, Pennsylvania. This waste...

19 CFR 10.581 - Scope.

Code of Federal Regulations, 2013 CFR

2013-04-01

... CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. Dominican Republic-Central America-United States Free Trade... provisions applicable to imported and exported goods under the Dominican Republic—Central America—United...—Central America—United States Free Trade Agreement Implementation Act (the Act; Pub. L. 109-53, 119 Stat...

19 CFR 10.581 - Scope.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. Dominican Republic-Central America-United States Free Trade... provisions applicable to imported and exported goods under the Dominican Republic—Central America—United...—Central America—United States Free Trade Agreement Implementation Act (the Act; Pub. L. 109-53, 119 Stat...

19 CFR 10.581 - Scope.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. Dominican Republic-Central America-United States Free Trade... provisions applicable to imported and exported goods under the Dominican Republic—Central America—United...—Central America—United States Free Trade Agreement Implementation Act (the Act; Pub. L. 109-53, 119 Stat...

19 CFR 10.581 - Scope.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. Dominican Republic-Central America-United States Free Trade... provisions applicable to imported and exported goods under the Dominican Republic—Central America—United...—Central America—United States Free Trade Agreement Implementation Act (the Act; Pub. L. 109-53, 119 Stat...

Chernobyl post-accident management: the ETHOS project.

PubMed

Dubreuil, G H; Lochard, J; Girard, P; Guyonnet, J F; Le Cardinal, G; Lepicard, S; Livolsi, P; Monroy, M; Ollagnon, H; Pena-Vega, A; Pupin, V; Rigby, J; Rolevitch, I; Schneider, T

1999-10-01

ETHOS is a pilot research project supported by the radiation protection research program of the European Commission (DG XII). The project provides an alternative approach to the rehabilitation of living conditions in the contaminated territories of the CIS in the post-accident context of Chernobyl. Initiated at the beginning of 1996, this 3-y project is currently being implemented in the Republic of Belarus. The ETHOS project involves an interdisciplinary team of European researchers from the following institutions: the Centre d'etude sur l'Evaluation de la Protection dans le domaine Nucleaire CEPN (radiological protection, economics), the Institute National d'Agronomie de Paris-Grignon INAPG (agronomy, nature & life management), the Compiegne University of Technology (technological and industrial safety, social trust), and the Mutadis Research Group (sociology, social risk management), which is in charge of the scientific co-ordination of the project. The Belarussian partners in the ETHOS project include the Ministry of Emergencies of Belarus as well as the various local authorities involved with the implementation site. The ETHOS project relies on a strong involvement of the local population in the rehabilitation process. Its main goal is to create conditions for the inhabitants of the contaminated territories to reconstruct their overall quality of life. This reconstruction deals with all the day-to-day aspects that have been affected or threatened by the contamination. The project aims at creating a dynamic process whereby acceptable living conditions can be rebuilt. Radiological security is developed in the ETHOS project as part of a general improvement in the quality of life. The approach does not dissociate the social and the technical dimensions of post-accident management. This is so as to avoid radiological risk assessment and management being reduced purely to a problem for scientific experts, from which local people are excluded, and to take into consideration the problems of acceptability of decisions and the distrust of the population towards experts. These cannot be solved merely by a better communication strategy. This paper presents the main features of the methodological approach of the ETHOS project. It also explains how it is being implemented in the village of Olmany in the district of Stolyn (Brest region) in Belarus since March 1996, as well as its initial achievements.

77 FR 11112 - Proposed Approval of the Central Characterization Project's Remote-Handled Transuranic Waste...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-24

... Central Characterization Project's Remote-Handled Transuranic Waste Characterization Program at the...-handled (RH), transuranic (TRU) waste characterization program implemented by the Central Characterization... Criteria, EPA evaluated the characterization of RH TRU debris waste from SRS-CCP during an inspection on...

75 FR 41087 - Conforming Changes to Applicant Submission Requirements; Implementing Federal Financial Report...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-15

... Report and Central Contractor Registration Requirements AGENCY: Office of the Secretary, HUD. ACTION... codifies the requirement that applicants for HUD assistance possess an active Central Contractor... conform the reporting requirements to those provided for by the FFR. B. Requirement for Central Contractor...

Operation management system evaluation in the central Finland health care district - end users' view of system implementation.

PubMed

Lemmetty, Kaisa; Häyrinen, Eija

2005-01-01

In this paper we evaluate the implementation of the operation management system in the Central Finland Health Care District. The implementation of the operation management system changed the practice of operation management for the surgical clinic and concerned 500 personnel in total. A survey was carried out to investigate the end users' views on the system's usefulness, usability and the training and user support provided. The users' possibilities to accomplish their tasks and the kind of obstacles they face in operation management were explored. The assessment revealed that more end support is needed after the system implementation, even though a generally positive attitude towards the system was manifested among the staff.

Early goal-directed therapy (EGDT) for severe sepsis/septic shock: which components of treatment are more difficult to implement in a community-based emergency department?

PubMed

O'Neill, Rory; Morales, Javier; Jule, Michael

2012-05-01

Early goal-directed therapy (EGDT) has been shown to reduce mortality in patients with severe sepsis/septic shock, however, implementation of this protocol in the emergency department (ED) is sometimes difficult. We evaluated our sepsis protocol to determine which EGDT elements were more difficult to implement in our community-based ED. This was a non-concurrent cohort study of adult patients entered into a sepsis protocol at a single community hospital from July 2008 to March 2009. Charts were reviewed for the following process measures: a predefined crystalloid bolus, antibiotic administration, central venous catheter insertion, central venous pressure measurement, arterial line insertion, vasopressor utilization, central venous oxygen saturation measurement, and use of a standardized order set. We also compared the individual component adherence with survival to hospital discharge. A total of 98 patients presented over a 9-month period. Measures with the highest adherence were vasopressor administration (79%; 95% confidence interval [CI] 69-89%) and antibiotic use (78%; 95% CI 68-85%). Measures with the lowest adherence included arterial line placement (42%; 95% CI 32-52%), central venous pressure measurement (27%; 95% CI 18-36%), and central venous oxygen saturation measurement (15%; 95% CI 7-23%). Fifty-seven patients survived to hospital discharge (Mortality: 33%). The only element of EDGT to demonstrate a statistical significance in patients surviving to hospital discharge was the crystalloid bolus (79% vs. 46%) (respiratory rate [RR] = 1.76, 95% CI 1.11-2.58). In our community hospital, arterial line placement, central venous pressure measurement, and central venous oxygen saturation measurement were the most difficult elements of EGDT to implement. Patients who survived to hospital discharge were more likely to receive the crystalloid bolus. Copyright © 2012 Elsevier Inc. All rights reserved.

Application of controller partitioning optimization procedure to integrated flight/propulsion control design for a STOVL aircraft

NASA Technical Reports Server (NTRS)

Garg, Sanjay; Schmidt, Phillip H.

1993-01-01

A parameter optimization framework has earlier been developed to solve the problem of partitioning a centralized controller into a decentralized, hierarchical structure suitable for integrated flight/propulsion control implementation. This paper presents results from the application of the controller partitioning optimization procedure to IFPC design for a Short Take-Off and Vertical Landing (STOVL) aircraft in transition flight. The controller partitioning problem and the parameter optimization algorithm are briefly described. Insight is provided into choosing various 'user' selected parameters in the optimization cost function such that the resulting optimized subcontrollers will meet the characteristics of the centralized controller that are crucial to achieving the desired closed-loop performance and robustness, while maintaining the desired subcontroller structure constraints that are crucial for IFPC implementation. The optimization procedure is shown to improve upon the initial partitioned subcontrollers and lead to performance comparable to that achieved with the centralized controller. This application also provides insight into the issues that should be addressed at the centralized control design level in order to obtain implementable partitioned subcontrollers.

A comparative analysis of centralized waiting lists for patients without a primary care provider implemented in six Canadian provinces: study protocol.

PubMed

Breton, Mylaine; Green, Michael; Kreindler, Sara; Sutherland, Jason; Jbilou, Jalila; Wong, Sabrina T; Shaw, Jay; Crooks, Valorie A; Contandriopoulos, Damien; Smithman, Mélanie Ann; Brousselle, Astrid

2017-01-21

Having a regular primary care provider (i.e., family physician or nurse practitioner) is widely considered to be a prerequisite for obtaining healthcare that is timely, accessible, continuous, comprehensive, and well-coordinated with other parts of the healthcare system. Yet, 4.6 million Canadians, approximately 15% of Canada's population, are unattached; that is, they do not have a regular primary care provider. To address the critical need for attachment, especially for more vulnerable patients, six Canadian provinces have implemented centralized waiting lists for unattached patients. These waiting lists centralize unattached patients' requests for a primary care provider in a given territory and match patients with providers. From the little information we have on each province's centralized waiting list, we know the way they work varies significantly from province to province. The main objective of this study is to compare the different models of centralized waiting lists for unattached patients implemented in six provinces of Canada to each other and to available scientific knowledge to make recommendations on ways to improve their design in an effort to increase attachment of patients to a primary care provider. A logic analysis approach developed in three steps will be used. Step 1: build logic models that describe each province's centralized waiting list through interviews with key stakeholders in each province; step 2: develop a conceptual framework, separate from the provincially informed logic models, that identifies key characteristics of centralized waiting lists for unattached patients and factors influencing their implementation through a literature review and interviews with experts; step 3: compare the logic models to the conceptual framework to make recommendations to improve centralized waiting lists in different provinces during a pan Canadian face-to-face exchange with decision-makers, clinicians and researchers. This study is based on an inter-provincial learning exchange approach where we propose to compare centralized waiting lists and analyze variations in strategies used to increase attachment to a regular primary care provider. Fostering inter-provincial healthcare systems connectivity to improve centralized waiting lists' practices across Canada can lever attachment to a regular provider for timely access to continuous, comprehensive and coordinated healthcare for all Canadians and particular for those who are vulnerable.

Implementation challenges and successes of a population-based colorectal cancer screening program: a qualitative study of stakeholder perspectives.

PubMed

Liles, Elizabeth G; Schneider, Jennifer L; Feldstein, Adrianne C; Mosen, David M; Perrin, Nancy; Rosales, Ana Gabriela; Smith, David H

2015-03-29

Few studies describe system-level challenges or facilitators to implementing population-based colorectal cancer (CRC) screening outreach programs. Our qualitative study explored viewpoints of multilevel stakeholders before, during, and after implementation of a centralized outreach program. Program implementation was part of a broader quality-improvement initiative. During 2008-2010, we conducted semi-structured, open-ended individual interviews and focus groups at Kaiser Permanente Northwest (KPNW), a not-for-profit group model health maintenance organization using the practical robust implementation and sustainability model to explore external and internal barriers to CRC screening. We interviewed 55 stakeholders: 8 health plan leaders, 20 primary care providers, 4 program managers, and 23 endoscopy specialists (15 gastroenterologists, 8 general surgeons), and analyzed interview transcripts to identify common as well as divergent opinions expressed by stakeholders. The majority of stakeholders at various levels consistently reported that an automated telephone-reminder system to contact patients and coordinate mailing fecal tests alleviated organizational constraints on staff's time and resources. Changing to a single-sample fecal immunochemical test (FIT) lessened patient and provider concerns about feasibility and accuracy of fecal testing. The centralized telephonic outreach program did, however, result in some screening duplication and overuse. Higher rates of FIT completion and a higher proportion of positive results with FIT required more colonoscopies. Addressing barriers at multiple levels of a health system by changing the delivery system design to add a centralized outreach program, switching to a more accurate and easier-to-use fecal test, and providing educational and electronic support had both benefits and problematic consequences. Other health care organizations can use our results to understand the complexities of implementing centralized screening programs.

76 FR 20713 - Bureau of International Labor Affairs; Office of Trade and Labor Affairs; Request for Comments on...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

...This notice is a request for comments from the public to assist the Secretary of Labor and the United States Trade Representative in preparing a report on labor capacity-building efforts under Chapter 16 (``the Labor Chapter'') and Annex 16.5 of the Dominican Republic--Central America--United States Free Trade Agreement (``the CAFTA-DR''), as well as efforts made by the CAFTA-DR countries to implement the recommendations contained in the report entitled ``The Labor Dimension in Central America and the Dominican Republic--Building on Progress: Strengthening Compliance and Enhancing Capacity'' (``the White Paper''). This report is required under the Dominican Republic-- Central America--United States Free Trade Agreement Implementation Act (``the CAFTA-DR Implementation Act''). The reporting function and the responsibility for soliciting public comments required under this Act were assigned to the Secretary of Labor, in consultation with the United States Trade Representative.

Experimental animal studies of radon and cigarette smoke

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

Cross, F.T.; Dagle, G.E.; Gies, R.A.

Cigarette-smoking is a dominant cause of lung cancer and confounds risk assessment of exposure to radon decay products. Evidence in humans on the interaction between cigarette-smoking and exposure to radon decay products, although limited, indicates a possible synergy. Experimental animal data, in addition to showing synergy, also show a decrease or no change in risk with added cigarette-smoke exposures. This article reviews previous animal data developed at Compagnie Generale des Matieres Nucleaires and Pacific Northwest Laboratory (PNL) on mixed exposures to radon and cigarette smoke, and highlights new initiation-promotion-initiation (IPI) studies at PNL that were designed within the framework ofmore » a two-mutation carcinogenesis model. Also presented are the PNL exposure system, experimental protocols, dosimetry, and biological data observed to date in IPI animals.« less

75 FR 54631 - Proposed Approval of the Central Characterization Project's Transuranic Waste Characterization...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-08

... Central Characterization Project's Transuranic Waste Characterization Program at the Hanford Site AGENCY...) waste characterization program implemented by the Central Characterization Project (CCP) at the Hanford... characterization of TRU debris waste from Hanford-CCP during an inspection conducted on April 27-29, 2010. Using...

Utilisation de l'essai comete et du biomarqueur gamma-H2AX pour detecter les dommages induits a l'ADN cellulaire par le 5-bromodeoxyuridine post-irradiation

NASA Astrophysics Data System (ADS)

La Madeleine, Carole

Ce memoire est presente a la Faculte de medecine et des sciences de la sante de l'Universite de Sherbrooke en vue de l'obtention du grade de maitre es sciences (M.Sc.) en radiobiologie (2009). Un jury a revise les informations contenues dans ce memoire. Il etait compose de professeurs de la Faculte de medecine et des sciences de la sante soit : Darel Hunting PhD, directeur de recherche (departement de medecine nucleaire et radiobiologie), Leon Sanche PhD, directeur de recherche (departement de medecine nucleaire et radiobiologie), Richard Wagner PhD, membre du programme (departement de medecine nucleaire et radiobiologie) et Guylain Boissonneault PhD, membre exterieur au programme (departement de biochimie). Le 5-bromodeoxyuridine (BrdU), un analogue halogene de la thymidine reconnu depuis les annees 60 comme etant un excellent radiosensibilisateur. L'hypothese la plus repandue au sujet de l'effet radio sensibilisant du BrdU est qu'il augmente le nombre de cassures simple et double brin lorsqu'il est incorpore dans l'ADN de la cellule et expose aux radiations ionisantes. Toutefois, de nouvelles recherches semblent remettre en question les observations precedentes. Ces dernieres etudes ont confirme que le BrdU est un bon radiosensibilisateur, car il augmente les dommages radio-induits dans l'ADN. Mais, c'est en etant incorpore dans une region simple brin que le BrdU radiosensibilise l'ADN. Ces recherches ont egalement revele pour la premiere fois un nouveau type de dommages produits lors de l'irradiation de l'ADN contenant du BrdU : les dimeres interbrins. Le but de ces travaux de recherche est de determiner si la presence de bromodeoxyuridine dans l'ADN augmente l'induction de bris simple et / ou double brin chez les cellules irradiees en utilisant de nouvelles techniques plus sensibles et specifiques que celles utilisees auparavant. Pour ce faire, les essais cometes et la detection des foci H2AX phosphorylee pourraient permettre d'etablir les effets engendres par le BrdU au niveau cellulaire. Notre hypothese (basee sur des resultats preliminaires effectues dans notre laboratoire) est que l'irradiation de l'ADN cellulaire en presence de BrdU augmentera le nombre de bris simple brin sans toutefois augmenter le nombre de bris double brin. Les resultats presentes dans ce memoire semblent corroborer cette hypothese. Les nouvelles methodes d'analyse, soient l'essai comete et la detection des foci gamma-H2AX remettent en question ce qui a ete dit sur le BrdU au sujet de l'induction des cassures double brin depuis plusieurs annees. L'ensemble de ces nouveaux resultats effectue a l'aide de cellules ayant incorporees du BrdU sont en correlation avec de precedents resultats obtenus dans notre laboratoire sur des oligonucleotides bromes. Ils reaffirment que l'irradiation combinee au BrdU augmente l'induction de bris simple brin mais pas de bris double brin. L'investigation approfondie des mecanismes d'action non elucides du BrdU au niveau cellulaire et son utilisation a des moments strategiques pendant le traitement de radiotherapie pourraient accroitre son efficacite a des fins d'utilisation clinique. Mots cles : 5-bromodeoxyuridine, dimeres interbrins, dommage a l'ADN, essai comete, H2AX, radiosensibilisateur, radiotherapie

Social value and individual choice: The value of a choice-based decision-making process in a collectively funded health system.

PubMed

Espinoza, Manuel Antonio; Manca, Andrea; Claxton, Karl; Sculpher, Mark

2018-02-01

Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system. Copyright © 2017 John Wiley & Sons, Ltd.

Implementing a Daily Maintenance Care Bundle to Prevent Central Line-Associated Bloodstream Infections in Pediatric Oncology Patients.

PubMed

Duffy, Elizabeth A; Rodgers, Cheryl C; Shever, Leah L; Hockenberry, Marilyn J

2015-01-01

Eliminating central line-associated bloodstream infection (CLABSI) is a national priority. Central venous catheter (CVC) care bundles are composed of a series of interventions that, when used together, are effective in preventing CLABSI. A CVC daily maintenance care bundle includes procedural guidelines for hygiene, dressing changes, and access as well as specific timeframes. Failure to complete one of the components of the care bundle predisposes the patient to a bloodstream infection. A nurse-led multidisciplinary team implemented and, for six months, sustained a daily maintenance care bundle for pediatric oncology patients. This quality improvement project focused on nursing staffs' implementation of the daily maintenance care bundle and the sustainment of the intervention. The project used a pre-post program design to evaluate outcomes of CVC daily maintenance care bundle compliancy and CLABSI. A statistically significant increase between the pre- and post-assessments of the compliance was noted with the CVC daily maintenance care bundle. CLABSI infection rates decreased during the intervention. Strategies to implement practice change and promote sustainability are discussed. © 2015 by Association of Pediatric Hematology/Oncology Nurses.

Cost-effectiveness of a quality improvement programme to reduce central line-associated bloodstream infections in intensive care units in the USA.

PubMed

Herzer, Kurt R; Niessen, Louis; Constenla, Dagna O; Ward, William J; Pronovost, Peter J

2014-09-25

To assess the cost-effectiveness of a multifaceted quality improvement programme focused on reducing central line-associated bloodstream infections in intensive care units. Cost-effectiveness analysis using a decision tree model to compare programme to non-programme intensive care units. USA. Adult patients in the intensive care unit. Economic costs of the programme and of central line-associated bloodstream infections were estimated from the perspective of the hospital and presented in 2013 US dollars. Central line-associated bloodstream infections prevented, deaths averted due to central line-associated bloodstream infections prevented, and incremental cost-effectiveness ratios. Probabilistic sensitivity analysis was performed. Compared with current practice, the programme is strongly dominant and reduces bloodstream infections and deaths at no additional cost. The probabilistic sensitivity analysis showed that there was an almost 80% probability that the programme reduces bloodstream infections and the infections' economic costs to hospitals. The opportunity cost of a bloodstream infection to a hospital was the most important model parameter in these analyses. This multifaceted quality improvement programme, as it is currently implemented by hospitals on an increasingly large scale in the USA, likely reduces the economic costs of central line-associated bloodstream infections for US hospitals. Awareness among hospitals about the programme's benefits should enhance implementation. The programme's implementation has the potential to substantially reduce morbidity, mortality and economic costs associated with central line-associated bloodstream infections. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Evaluation of Central Services Professional Learning Teams as of Spring 2010. Eye on Evaluation. E&R Report No. 10.06

ERIC Educational Resources Information Center

Baenen, Nancy; Jackl, Andrew

2010-01-01

The Wake County Public School System (WCPSS) board policy states that central services staff are to support school implementation of Professional Learning Teams (PLTs) and to participate in PLTs at the central level. Central staff support school efforts in a variety of ways, and over 85% of principals at each level reported this support was…

A Faster Parallel Algorithm and Efficient Multithreaded Implementations for Evaluating Betweenness Centrality on Massive Datasets

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

Madduri, Kamesh; Ediger, David; Jiang, Karl

2009-02-15

We present a new lock-free parallel algorithm for computing betweenness centralityof massive small-world networks. With minor changes to the data structures, ouralgorithm also achieves better spatial cache locality compared to previous approaches. Betweenness centrality is a key algorithm kernel in HPCS SSCA#2, a benchmark extensively used to evaluate the performance of emerging high-performance computing architectures for graph-theoretic computations. We design optimized implementations of betweenness centrality and the SSCA#2 benchmark for two hardware multithreaded systems: a Cray XMT system with the Threadstorm processor, and a single-socket Sun multicore server with the UltraSPARC T2 processor. For a small-world network of 134 millionmore » vertices and 1.073 billion edges, the 16-processor XMT system and the 8-core Sun Fire T5120 server achieve TEPS scores (an algorithmic performance count for the SSCA#2 benchmark) of 160 million and 90 million respectively, which corresponds to more than a 2X performance improvement over the previous parallel implementations. To better characterize the performance of these multithreaded systems, we correlate the SSCA#2 performance results with data from the memory-intensive STREAM and RandomAccess benchmarks. Finally, we demonstrate the applicability of our implementation to analyze massive real-world datasets by computing approximate betweenness centrality for a large-scale IMDb movie-actor network.« less

75 FR 76260 - Conforming Changes to Applicant Submission Requirements; Implementing Federal Financial Report...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... Report and Central Contractor Registration Requirements AGENCY: Office of the Secretary, HUD. ACTION... that applicants for HUD assistance possess an active Central Contractor Registration (CCR). HUD is...

Online shopping interface components: relative importance as peripheral and central cues.

PubMed

Warden, Clyde A; Wu, Wann-Yih; Tsai, Dungchun

2006-06-01

The Elaboration Likelihood Model (ELM) uses central (more thoughtful) and peripheral (less thoughtful) routes of persuasion to maximize communication effectiveness. This research implements ELM to investigate the relative importance of different aspects of the user experience in online shopping. Of all the issues surrounding online shopping, convenience, access to information, and trust were found to be the most important. These were implemented in an online conjoint shopping task. Respondents were found to use the central route of the ELM on marketing messages that involved issues of minimizing travel, information access, and assurances of system security. Users employed the peripheral ELM route when considering usability, price comparison, and personal information protection. A descriptive model of Web-based marketing components, their roles in the central and peripheral routes, and their relative importance to online consumer segments was developed.

Analyzing implementation dynamics using theory-driven evaluation principles: lessons learnt from a South African centralized chronic dispensing model.

PubMed

Magadzire, Bvudzai Priscilla; Marchal, Bruno; Mathys, Tania; Laing, Richard O; Ward, Kim

2017-12-04

Centralized dispensing of essential medicines is one of South Africa's strategies to address the shortage of pharmacists, reduce patients' waiting times and reduce over-crowding at public sector healthcare facilities. This article reports findings of an evaluation of the Chronic Dispensing Unit (CDU) in one province. The objectives of this process evaluation were to: (1) compare what was planned versus the actual implementation and (2) establish the causal elements and contextual factors influencing implementation. This qualitative study employed key informant interviews with the intervention's implementers (clinicians, managers and the service provider) [N = 40], and a review of policy and program documents. Data were thematically analyzed by identifying the main influences shaping the implementation process. Theory-driven evaluation principles were applied as a theoretical framework to explain implementation dynamics. The overall participants' response about the CDU was positive and the majority of informants concurred that the establishment of the CDU to dispense large volumes of medicines is a beneficial strategy to address healthcare barriers because mechanical functions are automated and distribution of medicines much quicker. However, implementation was influenced by the context and discrepancies between planned activities and actual implementation were noted. Procurement inefficiencies at central level caused medicine stock-outs and affected CDU activities. At the frontline, actors were aware of the CDU's implementation guidelines regarding patient selection, prescription validity and management of non-collected medicines but these were adapted to accommodate practical realities and to meet performance targets attached to the intervention. Implementation success was a result of a combination of 'hardware' (e.g. training, policies, implementation support and appropriate infrastructure) and 'software' (e.g. ownership, cooperation between healthcare practitioners and trust) factors. This study shows that health system interventions have unpredictable paths of implementation. Discrepancies between planned and actual implementation reinforce findings in existing literature suggesting that while tools and defined operating procedures are necessary for any intervention, their successful application depends crucially on the context and environment in which implementation occurs. We anticipate that this evaluation will stimulate wider thinking about the implementation of similar models in low- and middle-income countries.

Help Central: Creating a Help Desk and Knowledge Portal in SharePoint

ERIC Educational Resources Information Center

Ennis, Lisa A.; Tims, Randy S.

2012-01-01

This article discusses the authors' implementation of Help Central, a site within the Lister Hill Library Collection on the University of Alabama-Birmingham's SharePoint server. Initially, Help Central was designed to address the inadequacies in the library's old, static HTML web-based support system, including haphazard issue reporting by staff…

CENTRAL PLATEAU REMEDIATION

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

ROMINE, L.D.

2006-02-01

A systematic approach to closure planning is being implemented at the Hanford Site's Central Plateau to help achieve the goal of closure by the year 2035. The overall objective of Central Plateau remediation is to protect human health and the environment from the significant quantity of contaminated material that resulted from decades of plutonium production in support of the nation's defense. This goal will be achieved either by removing contaminants or placing the residual contaminated materials in a secure configuration that minimizes further migration to the groundwater and reduces the potential for inadvertent intrusion into contaminated sites. The approach tomore » Central Plateau cleanup used three key concepts--closure zones, closure elements, and closure process steps--to create an organized picture of actions required to complete remediation. These actions were merged with logic ties, constraints, and required resources to produce an integrated time-phased schedule and cost profile for Central Plateau closure. Programmatic risks associated with implementation of Central Plateau closure were identified and analyzed. Actions to mitigate the most significant risks are underway while high priority remediation projects continue to make progress.« less

Implementation of collaborative governance in cross-sector innovation and education networks: evidence from the National Health Service in England.

PubMed

Ovseiko, Pavel V; O'Sullivan, Catherine; Powell, Susan C; Davies, Stephen M; Buchan, Alastair M

2014-11-08

Increasingly, health policy-makers and managers all over the world look for alternative forms of organisation and governance in order to add more value and quality to their health systems. In recent years, the central government in England mandated several cross-sector health initiatives based on collaborative governance arrangements. However, there is little empirical evidence that examines local implementation responses to such centrally-mandated collaborations. Data from the national study of Health Innovation and Education Clusters (HIECs) are used to provide comprehensive empirical evidence about the implementation of collaborative governance arrangements in cross-sector health networks in England. The study employed a mixed-methods approach, integrating both quantitative and qualitative data from a national survey of the entire population of HIEC directors (N = 17; response rate = 100%), a group discussion with 7 HIEC directors, and 15 in-depth interviews with HIEC directors and chairs. The study provides a description and analysis of local implementation responses to the central government mandate to establish HIECs. The latter represent cross-sector health networks characterised by a vague mandate with the provision of a small amount of new resources. Our findings indicate that in the case of HIECs such a mandate resulted in the creation of rather fluid and informal partnerships, which over the period of three years made partial-to-full progress on governance activities and, in most cases, did not become self-sustaining without government funding. This study has produced valuable insights into the implementation responses in HIECs and possibly other cross-sector collaborations characterised by a vague mandate with the provision of a small amount of new resources. There is little evidence that local dominant coalitions appropriated the central HIEC mandate to their own ends. On the other hand, there is evidence of interpretation and implementation of the central mandate by HIEC leaders to serve their local needs. These findings augur well for Academic Health Science Networks, which pick up the mantle of large-scale, cross-sector collaborations for health and innovation. This study also highlights that a supportive policy environment and sufficient time would be crucial to the successful implementation of new cross-sector health collaborations.

The South Central Superpave Center Summary Report

DOT National Transportation Integrated Search

1999-11-01

This is the summary report for Research Project 0-1250, The South Central Superpave Center." Initiated and sponsored by the Texas Department of Transportation and the Federal Highway Administration, the Superpave Center fostered the implementation of...

Controller partitioning for integrated flight/propulsion control implementation

NASA Technical Reports Server (NTRS)

Garg, Sanjay

1993-01-01

The notion of partitioning a centralized controller into a decentralized, hierarchical structure suitable for integrated flight/propulsion control (IFPC) implementation is discussed. A systematic procedure is developed for determining partitioned airframe and engine subsystem controllers (subcontrollers), with the desired interconnection structure, that approximate the closed-loop performance and robustness characteristics of a given centralized controller. The procedure is demonstrated by application to IFPC design for a Short Take-Off and Vertical Landing (STOVL) aircraft in the landing approach to hover transition flight phase.

45 CFR 170.205 - Content exchange standards and implementation specifications for exchanging electronic health...

Code of Federal Regulations, 2013 CFR

2013-10-01

.... The Healthcare Information Technology Standards Panel (HITSP) Summary Documents Using HL7 CCD... specifications. Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries...

Turning around Schools: A View from the Superintendent/Central Office as Policy Implementers

ERIC Educational Resources Information Center

Grandson, Charles A., IV

2014-01-01

This single case study examines how stakeholders of a local education agency (LEA) understand and implement state turnaround policy for its chronically underperforming schools. While there is ample research on how to improve chronically underperforming schools, a research gap exists specifically around addressing implementation of mandated…

Implementing a Systematic Planning Process in Two Very Small Rural Public Libraries.

ERIC Educational Resources Information Center

Senkevitch, Judith J.

1985-01-01

Describes a pilot project by a regional library system in central New York State to implement systematic planning activities in rural public libraries serving populations under 5,000. Motivations for the adoption of innovation and key elements in the decision making process during implementation are examined. (CLB)

Time-series analysis to observe the impact of a centrally organized educational intervention on the prevention of central-line-associated bloodstream infections in 32 German intensive care units.

PubMed

Hansen, S; Schwab, F; Schneider, S; Sohr, D; Gastmeier, P; Geffers, C

2014-08-01

Prevention measures reduce central-line-associated bloodstream infections (CLABSIs) but are not always implemented. To investigate the effect of a central educational programme in German intensive care units (ICUs) on CLABSI rates. Thirty-two German ICUs with CLABSI rates greater than or equal to the national average were compared with two control groups containing 277 and 67 ICUs. Processes and CLABSI rates were surveyed before, during and two years after the implementation of a year-long intervention programme. Segmented regression analysis of interrupted time series using generalized linear models was performed to estimate the association between the number of CLABSIs per month and time, intervention and other confounders, with the clustering effect within an ICU taken into account. In total, 508 cases of CLABSI were observed over 266,471 central line (CL)-days. At baseline, the pooled mean CLABSI rate was 2.29 per 1000 CL-days, and this decreased significantly to 1.64 per 1000 CL-days in the follow-up period. Compared with baseline, the relative risk for CLABSI was 0.88 [95% confidence interval (CI) 0.70-1.11] for the intervention period and 0.72 (95% CI 0.58-0.88) for the follow-up period. No changes were observed in either control group. Following successful implementation of the programme, ICUs showed a significant decrease in CLABSI rates. Although rates were already decreasing prior to implementation of the intervention, the invitation to participate in the study, and increased general awareness of CLABSI prevention through use of the comprehensive multi-modal training materials may have had a beneficial effect on practice. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

77 FR 59241 - Notice of Effective Date of Modifications to Certain Textile and Apparel Rules of Origin of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-26

... Rules of Origin of the Dominican Republic-Central America- United States Free Trade Agreement AGENCY... Certain Textile and Apparel Rules of Origin of the Dominican Republic-Central America- United States Free...- Central America-United States Free Trade Agreement Implementation Act (the ``CAFTA-DR Act'') approved the...

45 CFR 170.205 - Content exchange standards and implementation specifications for exchanging electronic health...

Code of Federal Regulations, 2014 CFR

2014-10-01

...) (incorporated by reference in § 170.299). Implementation specifications. The Healthcare Information Technology... Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries, HL7 Clinical Document...

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

Pluquet, Alain

Cette théetudie les techniques d'identication de l'electron dans l'experience D0 au laboratoire Fermi pres de Chicago Le premier chapitre rappelle quelques unes des motivations physiques de l'experience physique des jets physique electrofaible physique du quark top Le detecteur D0 est decrit en details dans le second chapitre Le troisieme cha pitre etudie les algorithmes didentication de lelectron trigger reconstruction ltres et leurs performances Le quatrieme chapitre est consacre au detecteur a radiation de transition TRD construit par le Departement dAstrophysique Physique des Particules Physique Nucleaire et dInstrumentation Associee de Saclay il presente son principe sa calibration et ses performances Ennmore » le dernier chapitre decrit la methode mise au point pour lanalyse des donnees avec le TRD et illustre son emploi sur quelques exemples jets simulant des electrons recherche du quark top« less

Lights, Camera, Action ... and Cooling - The case for centralized low carbon energy at Fox Studios

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

Robinson, Alastair; Regnier, Cindy

Fox Studios partnered with the U.S. Department of Energy (DOE) to develop and implement solutions to retrofit two production stages and one of its central cooling plants, to reduce energy consumption by at least 30% as part of DOE’s Commercial Building Partnerships (CBP) Program. Although this case study reports expected savings arising from proposed design recommendations for a unique building type and the unusual load characteristics associated with its use, the EEMs implemented for the central plant are applicable to any large campus, office and higher education facility. The intent is that by making the energy-efficiency measures (EEMs) set thatmore » were assessed as cost-effective from this project applicable to a larger number of buildings on the campus Fox Studios will be able to implement an integrated campus-wide energy strategy for the long term. The significant challenges for this project in the design phase included identifying how to assess and analyze multiple system types, develop a coherent strategy for assessment and analysis, implement the measurement and verification activities to collect the appropriate data (in terms of capturing ‘normal’ operating characteristics and granularity) and determine the best approach to providing cooling to the site buildings based on the nature of existing systems and the expected improvement in energy performance of the central cooling plant. The analytical framework adopted provides a blueprint for similar projects at other large commercial building campuses.« less

Changing Drug Markets Under New Intellectual Property Regimes: The View From Central America

PubMed Central

Cerón, Alejandro

2011-01-01

The intellectual property rules inscribed in the Central American Free Trade Agreement have generated concern about access to medicines. We examined the implementation of the new intellectual property regime by tracking the policies and practices in place across 4 Central American countries. Although all 4 were responding to the same requirements under the agreement, their implementation of intellectual property rules differed. Not only were institutional practices different, but the lists of drugs to which intellectual property protection was applied varied in both volume and content. We also found that even without the influence of intellectual property, drug pricing in the region was often unpredictable and that lower cost was not the only motivation driving governments' purchasing decisions. PMID:21566033

Changing drug markets under new intellectual property regimes: the view from Central America.

PubMed

Godoy, Angelina Snodgrass; Cerón, Alejandro

2011-07-01

The intellectual property rules inscribed in the Central American Free Trade Agreement have generated concern about access to medicines. We examined the implementation of the new intellectual property regime by tracking the policies and practices in place across 4 Central American countries. Although all 4 were responding to the same requirements under the agreement, their implementation of intellectual property rules differed. Not only were institutional practices different, but the lists of drugs to which intellectual property protection was applied varied in both volume and content. We also found that even without the influence of intellectual property, drug pricing in the region was often unpredictable and that lower cost was not the only motivation driving governments' purchasing decisions.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group

PubMed Central

Berendonk, Christoph; Schirlo, Christian; Balestra, Gianmarco; Bonvin, Raphael; Feller, Sabine; Huber, Philippe; Jünger, Ernst; Monti, Matteo; Schnabel, Kai; Beyeler, Christine; Guttormsen, Sissel; Huwendiek, Sören

2015-01-01

Objective: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. Methods: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. Results: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. Conclusion: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking. PMID:26483853

Service Learning for At-Risk Student Populations: The Contextual Dynamism of Implementation

ERIC Educational Resources Information Center

Akin, Jacob T.; Vesely, Randall S.

2016-01-01

The central purpose of this article is to explore research, issues, and perspectives on the implementation of service learning programs to improve student achievement in at-risk student populations. The implementation of service learning programs takes place within multiple contexts and across several terrains. The complexities of implementing…

Attitudinal Perspectives: A Factor to Implementation of a Dual Language Program

ERIC Educational Resources Information Center

Whitacre, Michael

2015-01-01

The central focus of this study was to determine the overall perceptions of school administrators, and the district bilingual coordinator on transferring theory to classroom practice, implementation, as viewed by those involved in the implementation process of the Gómez and Gómez Model of Dual Language Education. Responses were solicited from…

CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY

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

BERGMAN, T. B.; STEFANSKI, L. D.; SEELEY, P. N.

2012-09-19

THE CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY WAS CONDUCTED TO DEVELOP AN OPTIMAL SEQUENCE OF REMEDIATION ACTIVITIES IMPLEMENTING THE CERCLA DECISION ON THE CENTRAL PLATEAU. THE STUDY DEFINES A SEQUENCE OF ACTIVITIES THAT RESULT IN AN EFFECTIVE USE OF RESOURCES FROM A STRATEGIC PERSPECTIVE WHEN CONSIDERING EQUIPMENT PROCUREMENT AND STAGING, WORKFORCE MOBILIZATION/DEMOBILIZATION, WORKFORCE LEVELING, WORKFORCE SKILL-MIX, AND OTHER REMEDIATION/DISPOSITION PROJECT EXECUTION PARAMETERS.

[Acceptance of the Implementation of Standardised Patient Education Programmes by the Multidisciplinary Rehabilitation Team Using the Example of a Back School - A Qualitative Study].

PubMed

Peters, S; Schultze, A; Pfeifer, K; Faller, H; Meng, K

2016-03-01

The transfer of standardised patient education programmes into practice is a complex process with a multitude of influencing factors. Determinants relate among others to the organisation and individuals (e. g., practitioner, patient). Knowledge about individual factors regarding the trainers of patient education programmes in the German rehabilitation system is scarce. The aim of this study is to explore the acceptance of trainers concerning the implementation of a standardised back school and to derive facilitators and barriers to the implementation of patient education programmes. Semi-structured guideline-based interviews were conducted in 10 rehabilitation clinics. The sample consisted of 46 trainers (25 women): 11 physicians, 11 psychologists, 21 physio-/exercise therapists and 3 occupational therapists with a mean age of 41. The opinions of the trainers regarding the central components of back schools in general, their opinions about the new curriculum, their expectations on its implementation, anticipated difficulties with implementation and requests to the project team were explored as indicators for acceptance. The data were analysed with a multi-step qualitative content analysis. 6 main categories comprising 136 subcategories were created and 729 quotations coded. Regarding the central components that should be covered by back schools, back-friendly behaviour was addressed most often. Opinions regarding the new curriculum were mostly positive. Trainers' approval of content and methods was highlighted and the similarity with existing offers in the clinics as well as the structure of the programme were rated positively. The trainers expected an increased patient orientation and personal development as well as a common, coherent language and interdisciplinarity. Difficulties were anticipated regarding time and personnel as well as therapy and appointment planning and also regarding the motivation/acceptance of patients. A wish for communication, education of trainers and feedback was directed at the project team. The study demonstrates high acceptance of programme implementation and central components of modern patient education programmes among trainers. The basis of individual facilitators and barriers has been investigated and might contribute to further development of implementation interventions. Communication and education considering those factors play a central role. © Georg Thieme Verlag KG Stuttgart · New York.

Methods and implementation of a central biosample and data management in a three-centre clinical study.

PubMed

Angelow, Aniela; Schmidt, Matthias; Weitmann, Kerstin; Schwedler, Susanne; Vogt, Hannes; Havemann, Christoph; Hoffmann, Wolfgang

2008-07-01

In our report we describe concept, strategies and implementation of a central biosample and data management (CSDM) system in the three-centre clinical study of the Transregional Collaborative Research Centre "Inflammatory Cardiomyopathy - Molecular Pathogenesis and Therapy" SFB/TR 19, Germany. Following the requirements of high system resource availability, data security, privacy protection and quality assurance, a web-based CSDM was developed based on Java 2 Enterprise Edition using an Oracle database. An efficient and reliable sample documentation system using bar code labelling, a partitioning storage algorithm and an online documentation software was implemented. An online electronic case report form is used to acquire patient-related data. Strict rules for access to the online applications and secure connections are used to account for privacy protection and data security. Challenges for the implementation of the CSDM resided at project, technical and organisational level as well as at staff level.

Finding idle machines in a workstation-based distributed system

NASA Technical Reports Server (NTRS)

Theimer, Marvin M.; Lantz, Keith A.

1989-01-01

The authors describe the design and performance of scheduling facilities for finding idle hosts in a workstation-based distributed system. They focus on the tradeoffs between centralized and decentralized architectures with respect to scalability, fault tolerance, and simplicity of design, as well as several implementation issues of interest when multicast communication is used. They conclude that the principal tradeoff between the two approaches is that a centralized architecture can be scaled to a significantly greater degree and can more easily monitor global system statistics, whereas a decentralized architecture is simpler to implement.

Implementing a centralized institutional peer tutoring program.

PubMed

Gaughf, Natalie White; Foster, Penni Smith

2016-01-01

Peer tutoring has been found to be beneficial to both students and peer tutors in health sciences education programs. This article describes the implementation of a centralized, institutional peer tutoring program at the University of Mississippi Medical Center, an academic health science center in the U.S. The Program: This multispecialty peer tutoring program paired students experiencing academic difficulties with peer tutors who showed prior academic success, professionalism and effective communication skills. The program allowed students and peer tutors to coordinate their own tutoring services. Evaluations by both students and peer tutors showed satisfaction with the program. Recommendations for developing and implementing an effective peer tutoring program are presented, including utilization of an online system, consistent program policy with high professionalism expectations, funding, program evaluation and data tracking.

Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients of all ages: a systematic review and meta-analysis.

PubMed

Ista, Erwin; van der Hoven, Ben; Kornelisse, René F; van der Starre, Cynthia; Vos, Margreet C; Boersma, Eric; Helder, Onno K

2016-06-01

Central-line-associated bloodstream infections (CLABSIs) are a major problem in intensive care units (ICUs) worldwide. We aimed to quantify the effectiveness of central-line bundles (insertion or maintenance or both) to prevent these infections. We searched Embase, MEDLINE OvidSP, Web-of-Science, and Cochrane Library to identify studies reporting the implementation of central-line bundles in adult ICU, paediatric ICU (PICU), or neonatal ICU (NICU) patients. We searched for studies published between Jan 1, 1990, and June 30, 2015. For the meta-analysis, crude estimates of infections were pooled by use of a DerSimonian and Laird random effect model. The primary outcome was the number of CLABSIs per 1000 catheter-days before and after implementation. Incidence risk ratios (IRRs) were obtained by use of random-effects models. We initially identified 4337 records, and after excluding duplicates and those ineligible, 96 studies met the eligibility criteria, 79 of which contained sufficient information for a meta-analysis. Median CLABSIs incidence were 5·7 per 1000 catheter-days (range 1·2-46·3; IQR 3·1-9·5) on adult ICUs; 5·9 per 1000 catheter-days (range 2·6-31·1; 4·8-9·4) on PICUs; and 8·4 per 1000 catheter-days (range 2·6-24·1; 3·7-16·0) on NICUs. After implementation of central-line bundles the CLABSI incidence ranged from 0 to 19·5 per 1000 catheter-days (median 2·6, IQR 1·2-4·4) in all types of ICUs. In our meta-analysis the incidence of infections decreased significantly from median 6·4 per 1000 catheter-days (IQR 3·8-10·9) to 2·5 per 1000 catheter-days (1·4-4·8) after implementation of bundles (IRR 0·44, 95% CI 0·39-0·50, p<0·0001; I(2)=89%). Implementation of central-line bundles has the potential to reduce the incidence of CLABSIs. None. Copyright © 2016 Elsevier Ltd. All rights reserved.

Distributed cooperative control of AC microgrids

NASA Astrophysics Data System (ADS)

Bidram, Ali

In this dissertation, the comprehensive secondary control of electric power microgrids is of concern. Microgrid technical challenges are mainly realized through the hierarchical control structure, including primary, secondary, and tertiary control levels. Primary control level is locally implemented at each distributed generator (DG), while the secondary and tertiary control levels are conventionally implemented through a centralized control structure. The centralized structure requires a central controller which increases the reliability concerns by posing the single point of failure. In this dissertation, the distributed control structure using the distributed cooperative control of multi-agent systems is exploited to increase the secondary control reliability. The secondary control objectives are microgrid voltage and frequency, and distributed generators (DGs) active and reactive powers. Fully distributed control protocols are implemented through distributed communication networks. In the distributed control structure, each DG only requires its own information and the information of its neighbors on the communication network. The distributed structure obviates the requirements for a central controller and complex communication network which, in turn, improves the system reliability. Since the DG dynamics are nonlinear and non-identical, input-output feedback linearization is used to transform the nonlinear dynamics of DGs to linear dynamics. Proposed control frameworks cover the control of microgrids containing inverter-based DGs. Typical microgrid test systems are used to verify the effectiveness of the proposed control protocols.

Helping small babies survive: an evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda

PubMed Central

Aliganyira, Patrick; Kerber, Kate; Davy, Karen; Gamache, Nathalie; Sengendo, Namaala Hanifah; Bergh, Anne-Marie

2014-01-01

Introduction Prematurity is the leading cause of newborn death in Uganda, accounting for 38% of the nation's 39,000 annual newborn deaths. Kangaroo mother care is a high-impact; cost-effective intervention that has been prioritized in policy in Uganda but implementation has been limited. Methods A standardised, cross-sectional, mixed-method evaluation design was used, employing semi-structured key-informant interviews and observations in 11 health care facilities implementing kangaroo mother care in Uganda. Results The facilities visited scored between 8.28 and 21.72 out of the possible 30 points with a median score of 14.71. Two of the 3 highest scoring hospitals were private, not-for-profit hospitals whereas the second highest scoring hospital was a central teaching hospital. Facilities with KMC services are not equally distributed throughout the country. Only 4 regions (Central 1, Central 2, East-Central and Southwest) plus the City of Kampala were identified as having facilities providing KMC services. Conclusion KMC services are not instituted with consistent levels of quality and are often dependent on private partner support. With increasing attention globally and in country, Uganda is in a unique position to accelerate access to and quality of health services for small babies across the country. PMID:25667699

Helping small babies survive: an evaluation of facility-based Kangaroo Mother Care implementation progress in Uganda.

PubMed

Aliganyira, Patrick; Kerber, Kate; Davy, Karen; Gamache, Nathalie; Sengendo, Namaala Hanifah; Bergh, Anne-Marie

2014-01-01

Prematurity is the leading cause of newborn death in Uganda, accounting for 38% of the nation's 39,000 annual newborn deaths. Kangaroo mother care is a high-impact; cost-effective intervention that has been prioritized in policy in Uganda but implementation has been limited. A standardised, cross-sectional, mixed-method evaluation design was used, employing semi-structured key-informant interviews and observations in 11 health care facilities implementing kangaroo mother care in Uganda. The facilities visited scored between 8.28 and 21.72 out of the possible 30 points with a median score of 14.71. Two of the 3 highest scoring hospitals were private, not-for-profit hospitals whereas the second highest scoring hospital was a central teaching hospital. Facilities with KMC services are not equally distributed throughout the country. Only 4 regions (Central 1, Central 2, East-Central and Southwest) plus the City of Kampala were identified as having facilities providing KMC services. KMC services are not instituted with consistent levels of quality and are often dependent on private partner support. With increasing attention globally and in country, Uganda is in a unique position to accelerate access to and quality of health services for small babies across the country.

19 CFR 10.625 - Refunds of excess customs duties.

Code of Federal Regulations, 2010 CFR

2010-04-01

...-Central America-United States Free Trade Agreement Retroactive Preferential Tariff Treatment for Textile... Dominican Republic—Central America—United States Free Trade Agreement Implementation Act, as amended by... 10.625 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT...

Characteristics and Differences of Lifelong Learning Policy Implementation for the Elderly in Thailand

ERIC Educational Resources Information Center

Dhirathiti, Nopraenue S.; Pichitpatja, Pojjana

2018-01-01

The study examined the process of policy implementation of lifelong learning for the elderly in Thailand, covering four main regions within the country. The study empirically compared inputs, processes, outputs, and outcomes of policy implementation in the north, south, northeast, and central regions of Thailand and captured the rigor of policy…

Measuring Fidelity of Implementation--Methodological and Conceptual Issues and Challenges. CRESST Report 811

ERIC Educational Resources Information Center

Osmundson, Ellen; Herman, Joan; Ringstaff, Cathy; Dai, Yunyun; Timms, Mike

2012-01-01

A central challenge in efficacy studies centers on the issue of "fidelity of implementation," that is, the extent to which participants use the curriculum specified by curriculum developers. In this study, we describe and discuss a "fidelity of implementation" model using multiple methods and instruments to compare two versions of a science…

Developing and Implementing Effective Communications Systems: Improving SEA Communication with LEAs, Partners/Vendors, and the Public. Benchmark. No. 2

ERIC Educational Resources Information Center

Brasiel, S.; Nafziger, D.

2013-01-01

State education agencies (SEAs) are central players in initiating and leading new reform efforts and in supporting and implementing Federal initiatives. Traditional approaches to providing public information are not adequate for producing public awareness and support and in supporting program implementation at the local level. With limited…

System-Level Instructional Leadership--A District-Level Leadership Case: Implementing PLCs in Schools

ERIC Educational Resources Information Center

Archbald, Doug

2016-01-01

Objective of the Case--There is a large volume of theoretical and "how to" literature on professional learning communities (PLCs), but little documenting the challenges of implementation and even less on the challenges of system-wide implementation of PLCs. This case is about the role of the central office in initiating and supporting…

Local Hero.

ERIC Educational Resources Information Center

Rist, Marilee C.

1992-01-01

Shows how a former high school principal (with no doctorate, central office experience, or big-city political savvy) pulled the Cincinnati (Ohio) schools out of a $76 million debt and implemented reforms recommended by the Buenger Commission. The new superintendent slashed central office positions, reorganized 86 schools into 9 minidistricts, and…

Strategic planning for the activation and operation of the North Central Superpave Center (NCSC)

DOT National Transportation Integrated Search

1997-01-01

The North Central Superpave Center (NCSC) was established to serve the needs of the states and industry in ten states and two Canadian provinces as they implement the Superpave system. Accomplishing this goal requires the cooperation and active suppo...

Experimental and evaluated photoneutron cross sections for 197Au

NASA Astrophysics Data System (ADS)

Varlamov, V.; Ishkhanov, B.; Orlin, V.

2017-10-01

There is a serious well-known problem of noticeable disagreements between the partial photoneutron cross sections obtained in various experiments. Such data were mainly determined using quasimonoenergetic annihilation photon beams and the method of neutron multiplicity sorting at Lawrence Livermore National Laboratory (USA) and Centre d'Etudes Nucleaires of Saclay (France). The analysis of experimental cross sections employing new objective physical data reliability criteria has shown that many of those are not reliable. The IAEA Coordinated Research Project (CRP) on photonuclear data evaluation was approved. The experimental and previously evaluated cross sections of the partial photoneutron reactions (γ ,1 n ) and (γ ,2 n ) on 197Au were analyzed using the new data reliability criteria. The data evaluated using the new experimental-theoretical method noticeably differ from both experimental data and data previously evaluated using nuclear modeling codes gnash, gunf, alice-f, and others. These discrepancies needed to be resolved.

Heat, Mass and Aerosol Transfers in Spray Conditions for Containment Application

NASA Astrophysics Data System (ADS)

Porcheron, Emmanuel; Lemaitre, Pascal; Nuboer, Amandine; Vendel, Jacques

TOSQAN is an experimental program undertaken by the Institut de Radioprotection et de Surété Nucleaire (IRSN) in order to perform thermal hydraulic containment studies. The TOSQAN facility is a large enclosure devoted to simulating typical accidental thermal hydraulic flow conditions in nuclear Pressurized Water Reactor (PWR) containment. The TOSQAN facility, which is highly instrumented with non-intrusive optical diagnostics, is particularly adapted to nuclear safety CFD code validation. The present work is devoted to studying the interaction of a water spray injection used as a mitigation means in order to reduce the gas pressure and temperature in the containment, to produce gases mixing and washout of fission products. In order to have a better understanding of heat and mass transfers between spray droplets and the gas mixture, and to analyze mixing effects due to spray activation, we performed detailed characterization of the two-phase flow.

Nuclear recoil measurements with the ARIS experiment

NASA Astrophysics Data System (ADS)

Fan, Alden; ARIS Collaboration

2017-01-01

As direct dark matter searches become increasingly sensitive, it is important to fully characterize the target of the search. The goal of the Argon Recoil Ionization and Scintillation (ARIS) experiment is to quantify information related to the scintillation and ionization energy scale, quenching factor, ion recombination probability, and scintillation time response of nuclear recoils, as expected from WIMPs, in liquid argon. A time projection chamber with an active mass of 0.5 kg of liquid argon and capable of full 3D position reconstruction was exposed to an inverse kinematic neutron beam at the Institut de Physique Nucleaire d'Orsay in France. A scan of nuclear recoil energies was performed through coincidence with a set of neutron detectors to quantify properties of nuclear recoils in liquid argon at various electric fields. The difference in ionization and scintillation response with differing recoil track angle to the electric field was also studied. The preliminary results of the experiment will be presented.

[Multidimensional Strategy Regarding the Reduction of Central-Line Associated Infection in Pediatric Intensive Care].

PubMed

Rodrigues, Jorge; Dias, Andrea; Oliveira, Guiomar; Farela Neves, José

2016-06-01

To determine the central-line associated bloodstream infection rate after implementation of central venous catheter-care practice bundles and guidelines and to compare it with the previous central-line associated bloodstream infection rate. A prospective, longitudinal, observational descriptive study with an exploratory component was performed in a Pediatric Intensive Care Unit during five months. The universe was composed of every child admitted to Pediatric Intensive Care Unit who inserted a central venous catheter. A comparative study with historical controls was performed to evaluate the result of the intervention (group 1 versus group 2). Seventy five children were included, with a median age of 23 months: 22 (29.3%) newborns; 28 (37.3%) with recent surgery and 32 (43.8%) with underlying illness. A total of 105 central venous catheter were inserted, the majority a single central venous catheter (69.3%), with a mean duration of 6.8 ± 6.7 days. The most common type of central venous catheter was the short-term, non-tunneled central venous catheter (45.7%), while the subclavian and brachial flexure veins were the most frequent insertion sites (both 25.7%). There were no cases of central-line associated bloodstream infection reported during this study. Comparing with historical controls (group 1), both groups were similar regarding age, gender, department of origin and place of central venous catheter insertion. In the current study (group 2), the median length of stay was higher, while the mean duration of central venous catheter (excluding peripherally inserted central line) was similar in both groups. There were no statistical differences regarding central venous catheter caliber and number of lumens. Fewer children admitted to Pediatric Intensive Care Unit had central venous catheter inserted in group 2, with no significant difference between single or multiple central venous catheter. After multidimensional strategy implementation there was no reported central-line associated bloodstream infection Conclusions: Efforts must be made to preserve the same degree of multidimensional prevention, in order to confirm the effective reduction of the central-line associated bloodstream infection rate and to allow its maintenance.

The dynamic of tuberculosis case finding in the era of the public–private mix strategy for tuberculosis control in Central Java, Indonesia

PubMed Central

Reviono, Reviono; Setianingsih, Wahyu; Damayanti, Kusmadewi Eka; Ekasari, Ratna

2017-01-01

ABSTRACT Background: The public–private mix (PPM) strategy has strengthened tuberculosis care and control in many countries. Indonesia, a country with a high tuberculosis burden, has a low tuberculosis case detection rate (CDR), despite PPM implementation in 2003. The PPM in Indonesia involves primary healthcare centers, hospitals, and specialized chest clinics. The long-term impact of the strategy is unknown. Objective: We aimed to explore the case detection achievements of the tuberculosis program since PPM implementation in Central Java in 2003. Methods: This retrospective cohort study covered the period 1 January 2000 to 31 December 2014. The data from tuberculosis patients treated in all health facilities in Central Java implementing directly observed treatment short-course, recorded via a standardized form, were analyzed after being validated by the Office of Health of Central Java Province. We evaluated the CDR, case notification rate, and total number of cases, using linear regression to analyze the temporal trends of those indicators in the phases of PPM implementation. Results: The CDR increased during the initial phase (2000–2005), decreased during the mid-phase (2006–2009), and increased slightly during the late phase (2010–2014), ranging from 13 to 61.72. These trends were observed despite a steady increase in the number of participating healthcare facilities. The regression analysis showed that the CDR of referral institutions contributed the most to the total CDR of Central Java Province. Many of the smear-negative tuberculosis cases recorded at primary healthcare centers may have been smear positive; this probable misclassification could have been partially avoided if more specific and sensitive diagnostic tools were available. Conclusions: The CDR remains below the national target (70%). Early awareness of a negative trend in certain program indicators is important to ensure program sustainability. Careful observation of the indicator pattern will secure the long-term success of the program. PMID:28766465

The dynamic of tuberculosis case finding in the era of the public-private mix strategy for tuberculosis control in Central Java, Indonesia.

PubMed

Reviono, Reviono; Setianingsih, Wahyu; Damayanti, Kusmadewi Eka; Ekasari, Ratna

2017-01-01

The public-private mix (PPM) strategy has strengthened tuberculosis care and control in many countries. Indonesia, a country with a high tuberculosis burden, has a low tuberculosis case detection rate (CDR), despite PPM implementation in 2003. The PPM in Indonesia involves primary healthcare centers, hospitals, and specialized chest clinics. The long-term impact of the strategy is unknown.  We aimed to explore the case detection achievements of the tuberculosis program since PPM implementation in Central Java in 2003. This retrospective cohort study covered the period 1 January 2000 to 31 December 2014. The data from tuberculosis patients treated in all health facilities in Central Java implementing directly observed treatment short-course, recorded via a standardized form, were analyzed after being validated by the Office of Health of Central Java Province. We evaluated the CDR, case notification rate, and total number of cases, using linear regression to analyze the temporal trends of those indicators in the phases of PPM implementation. The CDR increased during the initial phase (2000-2005), decreased during the mid-phase (2006-2009), and increased slightly during the late phase (2010-2014), ranging from 13 to 61.72. These trends were observed despite a steady increase in the number of participating healthcare facilities. The regression analysis showed that the CDR of referral institutions contributed the most to the total CDR of Central Java Province. Many of the smear-negative tuberculosis cases recorded at primary healthcare centers may have been smear positive; this probable misclassification could have been partially avoided if more specific and sensitive diagnostic tools were available. The CDR remains below the national target (70%). Early awareness of a negative trend in certain program indicators is important to ensure program sustainability. Careful observation of the indicator pattern will secure the long-term success of the program.

Database System Design and Implementation for Marine Air-Traffic-Controller Training

DTIC Science & Technology

2017-06-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release. Distribution is unlimited. DATABASE SYSTEM DESIGN AND...thesis 4. TITLE AND SUBTITLE DATABASE SYSTEM DESIGN AND IMPLEMENTATION FOR MARINE AIR-TRAFFIC-CONTROLLER TRAINING 5. FUNDING NUMBERS 6. AUTHOR(S...12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) This project focused on the design , development, and implementation of a centralized

The Virtual Desktop: Options and Challenges in Selecting a Secure Desktop Infrastructure Based on Virtualization

DTIC Science & Technology

2011-10-01

Fortunately, some products offer centralized management and deployment tools for local desktop implementation . Figure 5 illustrates the... implementation of a secure desktop infrastructure based on virtualization. It includes an overview of desktop virtualization, including an in-depth...environment in the data centre, whereas LHVD places it on the endpoint itself. Desktop virtualization implementation considerations and potential

SOIL RADON POTENTIAL MAPPLING OF TWELVE COUNTIES IN NORTH-CENTRAL FLORIDA

EPA Science Inventory

The report describes the approach, methods, and detailed data used to prepare soil radon potential maps of 12 counties in North-Central Florida. he maps were developed under the Florida Radon Research Program to provide a scientific basis for implementing radon-protective buildin...

ConnectX2 In niBand Management Queues: New support for Network Of oaded

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

Graham, Richard L; Poole, Stephen W; Shamis, Pavel

2010-01-01

This paper introduces the newly developed InfiniBand (IB) Management Queue capability, used by the Host Channel Adapter (HCA) to manage network task data flow dependancies, and progress the communications associated with such flows. These tasks include sends, receives, and the newly supported wait task, and are scheduled by the HCA based on a data dependency description provided by the user. This functionality is supported by the ConnectX-2 HCA, and provides the means for delegating collective communication management and progress to the HCA, also known as collective communication offload. This provides a means for overlapping collective communications managed by the HCAmore » and computation on the Central Processing Unit (CPU), thus making it possible to reduce the impact of system noise on parallel applications using collective operations. This paper further describes how this new capability can be used to implement scalable Message Passing Interface (MPI) collective operations, describing the high level details of how this new capability is used to implement the MPI Barrier collective operation, focusing on the latency sensitive performance aspects of this new capability. This paper concludes with small scale benchmark experiments comparing implementations of the barrier collective operation, using the new network offload capabilities, with established point-to-point based implementations of these same algorithms, which manage the data flow using the central processing unit. These early results demonstrate the promise this new capability provides to improve the scalability of high-performance applications using collective communications. The latency of the HCA based implementation of the barrier is similar to that of the best performing point-to-point based implementation managed by the central processing unit, starting to outperform these as the number of processes involved in the collective operation increases.« less

ConnectX-2 InfiniBand Management Queues: First Investigation of the New Support for Network Offloaded Collective Operations

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

Graham, Richard L; Poole, Stephen W; Shamis, Pavel

2010-01-01

This paper introduces the newly developed Infini-Band (IB) Management Queue capability, used by the Host Channel Adapter (HCA) to manage network task data flow dependancies, and progress the communications associated with such flows. These tasks include sends, receives, and the newly supported wait task, and are scheduled by the HCA based on a data dependency description provided by the user. This functionality is supported by the ConnectX-2 HCA, and provides the means for delegating collective communication management and progress to the HCA, also known as collective communication offload. This provides a means for overlapping collective communications managed by the HCAmore » and computation on the Central Processing Unit (CPU), thus making it possible to reduce the impact of system noise on parallel applications using collective operations. This paper further describes how this new capability can be used to implement scalable Message Passing Interface (MPI) collective operations, describing the high level details of how this new capability is used to implement the MPI Barrier collective operation, focusing on the latency sensitive performance aspects of this new capability. This paper concludes with small scale benchmark experiments comparing implementations of the barrier collective operation, using the new network offload capabilities, with established point-to-point based implementations of these same algorithms, which manage the data flow using the central processing unit. These early results demonstrate the promise this new capability provides to improve the scalability of high performance applications using collective communications. The latency of the HCA based implementation of the barrier is similar to that of the best performing point-to-point based implementation managed by the central processing unit, starting to outperform these as the number of processes involved in the collective operation increases.« less

Structural and process factors affecting the implementation of antimicrobial resistance prevention and control strategies in U.S. hospitals.

PubMed

Chou, Ann F; Yano, Elizabeth M; McCoy, Kimberly D; Willis, Deanna R; Doebbeling, Bradley N

2008-01-01

To address increases in the incidence of infection with antimicrobial-resistant pathogens, the National Foundation for Infectious Diseases and Centers for Disease Control and Prevention proposed two sets of strategies to (a) optimize antibiotic use and (b) prevent the spread of antimicrobial resistance and control transmission. However, little is known about the implementation of these strategies. Our objective is to explore organizational structural and process factors that facilitate the implementation of National Foundation for Infectious Diseases/Centers for Disease Control and Prevention strategies in U.S. hospitals. We surveyed 448 infection control professionals from a national sample of hospitals. Clinically anchored in the Donabedian model that defines quality in terms of structural and process factors, with the structural domain further informed by a contingency approach, we modeled the degree to which National Foundation for Infectious Diseases and Centers for Disease Control and Prevention strategies were implemented as a function of formalization and standardization of protocols, centralization of decision-making hierarchy, information technology capabilities, culture, communication mechanisms, and interdepartmental coordination, controlling for hospital characteristics. Formalization, standardization, centralization, institutional culture, provider-management communication, and information technology use were associated with optimal antibiotic use and enhanced implementation of strategies that prevent and control antimicrobial resistance spread (all p < .001). However, interdepartmental coordination for patient care was inversely related with antibiotic use in contrast to antimicrobial resistance spread prevention and control (p < .0001). Formalization and standardization may eliminate staff role conflict, whereas centralized authority may minimize ambiguity. Culture and communication likely promote internal trust, whereas information technology use helps integrate and support these organizational processes. These findings suggest concrete strategies for evaluating current capabilities to implement effective practices and foster and sustain a culture of patient safety.

[Study on the overall implementation status of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

PubMed

Li, J J; Li, J L; Zhang, J; Jin, R R; Ma, S; Deng, G J; Su, X W; Bian, F; Qu, Y M; Hu, L L; Jiang, Y

2018-04-10

Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.

Using real-time problem solving to eliminate central line infections.

PubMed

Shannon, Richard P; Frndak, Diane; Grunden, Naida; Lloyd, Jon C; Herbert, Cheryl; Patel, Bhavin; Cummins, Daniel; Shannon, Alexander H; O'Neill, Paul H; Spear, Steven J

2006-09-01

An estimated 200,000 Americans suffer central line-associated bloodstream infections (CLABs) each year, with 15%-20% mortality. Two intensive care units (ICUs) redefined the processes of care through system redesign to deliver reliable outcomes free of the variations that created the breeding ground for infection. The ICUs, comprising 28 beds at Allegheny General Hospital, employed the principles of the Toyota Production System adapted to health care--Perfecting Patient Care--and applied them to central line placement and maintenance. Intensive observations, which revealed multiple variances from established practices, and root cause analyses of all CLABs empowered the workers to implement countermeasures designed to eliminate the defects in the processes of central line placement and maintenance. New processes were implemented within 90 days. Within a year CLABs decreased from 49 to 6 (10.5 to 1.2 infections/1,000 line-days), and mortalities from 19 to 1 (51% to 16%), despite an increase in the use of central lines and number of line-days. These results were sustained during a 34-month period. CLABs are not an inevitable product of complex ICU care but the result of highly variable and therefore unreliable care delivery that predisposes to infection.

SPH Simulations of Spherical Bondi Accretion: First Step of Implementing AGN Feedback in Galaxy Formation

NASA Astrophysics Data System (ADS)

Barai, Paramita; Proga, D.; Nagamine, K.

2011-01-01

Our motivation is to numerically test the assumption of Black Hole (BH) accretion (that the central massive BH of a galaxy accretes mass at the Bondi-Hoyle accretion rate, with ad-hoc choice of parameters), made in many previous galaxy formation studies including AGN feedback. We perform simulations of a spherical distribution of gas, within the radius range 0.1 - 200 pc, accreting onto a central supermassive black hole (the Bondi problem), using the 3D Smoothed Particle Hydrodynamics code Gadget. In our simulations we study the radial distribution of various gas properties (density, velocity, temperature, Mach number). We compute the central mass inflow rate at the inner boundary (0.1 pc), and investigate how different gas properties (initial density and velocity profiles) and computational parameters (simulation outer boundary, particle number) affect the central inflow. Radiative processes (namely heating by a central X-ray corona and gas cooling) have been included in our simulations. We study the thermal history of accreting gas, and identify the contribution of radiative and adiabatic terms in shaping the gas properties. We find that the current implementation of artificial viscosity in the Gadget code causes unwanted extra heating near the inner radius.

Analytics that Inform the University: Using Data You Already Have

ERIC Educational Resources Information Center

Dziuban, Charles; Moskal, Patsy; Cavanagh, Thomas; Watts, Andre

2012-01-01

The authors describe the University of Central Florida's top-down/bottom-up action analytics approach to using data to inform decision-making at the University of Central Florida. The top-down approach utilizes information about programs, modalities, and college implementation of Web initiatives. The bottom-up approach continuously monitors…

Assessing Child Welfare Outcomes in Central and Eastern Europe.

ERIC Educational Resources Information Center

Herczog, Maria

1998-01-01

Discusses the need to examine effectiveness of services to children and families in central and eastern Europe, focusing on programs in Hungary. Notes that financial considerations and differences in objectives have increased the importance of outcomes measurement. Reports that the pilot implementation of "Looking After Children"…

76 FR 15970 - Central Ferry to Lower Monumental 500-kilovolt Transmission Line Project

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

...-kilovolt Transmission Line Project AGENCY: Bonneville Power Administration (BPA), Department of Energy (DOE... Project in Garfield, Columbia, and Walla Walla counties, Washington. BPA has decided to implement the... consists of constructing a new 500-kV single- circuit transmission line from BPA's new Central Ferry...

CIVITAS: An International Civic Education Exchange Program. Evaluation Report.

ERIC Educational Resources Information Center

Cabello, Beverly

This evaluation report documents the CIVITAS program's progress toward its five stated goals: (1) acquaint educators from Eastern and Central Europe with exemplary curricular and teacher training programs in civic education developed in the United States; (2) assist educators from Eastern and Central Europe in adapting and implementing effective…

Distributed Computing with Centralized Support Works at Brigham Young.

ERIC Educational Resources Information Center

McDonald, Kelly; Stone, Brad

1992-01-01

Brigham Young University (Utah) has addressed the need for maintenance and support of distributed computing systems on campus by implementing a program patterned after a national business franchise, providing the support and training of a centralized administration but allowing each unit to operate much as an independent small business.…

Creative Faculty Development in Times of Diminishing Resources.

ERIC Educational Resources Information Center

Meyer, Don

North Central Bible College (Minnesota) has implemented a faculty development program over several years despite restricted financial resources. North Central Bible College (NCBC) is an independent, primarily residential college that is owned and operated by a group of 11 Assemblies of God districts. It offers bachelors degrees in 22 majors and…

78 FR 41901 - Determination of Attainment for the West Central Pinal Nonattainment Area for the 2006 Fine...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... reasonably available control measures (RACM), a reasonable further progress (RFP) plan, and contingency... for implementation of reasonably available control measures (RACM), reasonable further progress (RFP..., Arizona Department of Environmental Quality, requested that EPA determine whether the West Central Pinal...

Impacts of climate and land use change on reservoir sedimentation

USDA-ARS?s Scientific Manuscript database

Impacts of evolving climate and implementation of upstream soil conservation measures on sedimentation of the Fort Cobb Reservoir in West-Central Oklahoma are investigated. Conservation practices before the 1950s were few. Between 1950 and 2008, extensive soil conservation measures were implemented...

Information system equality for food security--implementation of the food safety control system in Taiwan.

PubMed

Chen, Shaun C; Hsu, Guoo-Shyng Wang; Chiu, Chihwei P

2009-01-01

Food security plays a central role in governing agricultural policies in Taiwan. In addition to overuse or the illegal use of pesticide, meat leanness promoters, animal drugs and melamine in the food supply; as well as foodborne illness draws the greatest public concern due to incidents that occur every year in Taiwan. The present report demonstrates the implementation of a food safety control system in Taiwan. In order to control foodborne outbreaks effectively, the central government of the Department of Health of Taiwan launched the food safety control system which includes both the good hygienic practice (GHP) and the HACCP plan, in the last decade. From 1998 to the present, 302 food affiliations that implemented the system have been validated and accredited by a well-established audit system. The implementation of a food safety control system in compliance with international standards is of crucial importance to ensure complete safety and the high quality of foods, not only for domestic markets, but also for international trade.

Central intake to improve access to physiotherapy for children with complex needs: a mixed methods case report.

PubMed

Wittmeier, Kristy D M; Restall, Gayle; Mulder, Kathy; Dufault, Brenden; Paterson, Marie; Thiessen, Matthew; Lix, Lisa M

2016-08-31

Children with complex needs can face barriers to system access and navigation related to their need for multiple services and healthcare providers. Central intake for pediatric rehabilitation was developed and implemented in 2008 in Winnipeg Manitoba Canada as a means to enhance service coordination and access for children and their families. This study evaluates the process and impact of implementing a central intake system, using pediatric physiotherapy as a case example. A mixed methods instrumental case study design was used. Interviews were completed with 9 individuals. Data was transcribed and analyzed for themes. Quantitative data (wait times, referral volume and caregiver satisfaction) was collected for children referred to physiotherapy with complex needs (n = 1399), and a comparison group of children referred for orthopedic concerns (n = 3901). Wait times were analyzed using the Kruskal-Wallis test, caregiver satisfaction was analyzed using Fisher exact test and change point modeling was applied to examine referral volume over the study period. Interview participants described central intake implementation as creating more streamlined processes. Factors that facilitated successful implementation included 1) agreement among stakeholders, 2) hiring of a central intake coordinator, 3) a financial commitment from the government and 4) leadership at the individual and organization level. Mean (sd) wait times improved for children with complex needs (12.3(13.1) to 8.0(6.9) days from referral to contact with family, p < 0.0001; 29.8(17.9) to 24.3(17.0) days from referral to appointment, p < 0.0001) while referral volumes remained consistent. A small but significant increase in wait times was observed for the comparison group (9.6(8.6) to 10.1(6.6) days from referral to contact with family, p < 0.001; 20.4(14.3) to 22.1(13.1) days from referral to appointment, p < 0.0001), accompanied by an increasing referral volume for this group. Caregiver satisfaction remained high throughout the process (p = 0.48). Central intake implementation achieved the intended outcomes of streamlining processes and improving transparency and access to pediatric physiotherapy (i.e., decreasing wait times) for families of children with complex needs. Future research is needed to build on this single discipline case study approach to examine changes in wait times, therapy coordination and stakeholder satisfaction within the context of continuing improvements for pediatric therapy services within the province.

Combating Gangs: Federal Agencies Have Implemented a Central American Gang Strategy, but Could Strengthen Oversight and Measurement of Efforts. Report to Congressional Requesters. GAO-10-395

ERIC Educational Resources Information Center

Larence, Eileen R.

2010-01-01

Thousands of gang members in the United States belong to gangs such as MS-13 and 18th Street that are also active in Central American countries. Federal entities with responsibilities for addressing Central American gangs include the National Security Council (NSC); the Departments of Homeland Security (DHS), Justice (DOJ), and State; and the U.S.…

Did States Use Implementation Discretion to Reduce the Stringency of NCLB? Evidence from a Database of State Regulations

ERIC Educational Resources Information Center

Wong, Vivian C.; Wing, Coady; Martin, David; Krishnamachari, Anandita

2018-01-01

When No Child Left Behind (NCLB) became law in 2002, it was viewed as an effort to create uniform standards for students and schools across the country. More than a decade later, we know surprisingly little about how states actually implemented NCLB and the extent to which state implementation decisions managed to undo the centralizing objectives…

[Perception over smoke-free policies amongst bar and restaurant representatives in central Mexico].

PubMed

Barrientos-Gutiérrez, Tonatiuh; Gimeno, David; Thrasher, James F; Reynales-Shigematsu, Luz Myriam; Amick, Benjamin C; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

2010-01-01

To analyze the perceptions and appreciations over smoke-free environments of restaurant and bar managers from four cities in central Mexico. Managers from 219 restaurants and bars from Mexico City, Colima, Cuernavaca and Toluca were surveyed about smoke-free environments opinions and implementation. Simultaneously, environmental nicotine was monitored. The majority of surveyed managers considered public places should be smoke-free, although more than half were concerned with potential economic loses. Implementation of smoke-free environments was more frequent in Mexico City (85.4%) than in the other cities (15.3% overall), with consequently lower environmental nicotine concentrations. Managers acknowledge the need to create smoke-free environments. Concerns over economic negative effects derived from the prohibition could explain, at least partially, the rejection of this sector towards the implementation of this type of policy.

The political economy of noncompliance in China: The case of industrial energy policy

DOE PAGES

Van Aken, Tucker; Lewis, Orion A.

2015-03-18

One of the greatest challenges facing China today is the central government's ability to ensure that policies are implemented effectively at the local level, particularly policies that seek to make China's economic growth model more sustainable. These policies face resistance from local authorities and enterprises that benefit from the status quo. This raises a key research question: why do some provinces more fully implement these central policies? We argue the extent of local implementation is best conceptualized as a rational balance between economic and political incentives: localities with regulatory autonomy, low regulatory capacity and alternative interests will not fully implementmore » policies that are at odds with local economic imperatives. By examining a critical case of central policy implementation—industrial energy intensity reduction in the eleventh five-year plan—this article demonstrates that, regardless of industrial makeup or economic development, provinces that have greater regulatory autonomy for noncompliance coupled with alternative economic interests do not, on average, perform as well. As a result, using a nested analysis approach this study illustrates this argument with both quantitative analysis and original case study evidence from fieldwork interviews.« less

Medications at school: disposing of pharmaceutical waste.

PubMed

Taras, Howard; Haste, Nina M; Berry, Angela T; Tran, Jennifer; Singh, Renu F

2014-03-01

This project quantified and categorized medications left unclaimed by students at the end of the school year. It determined the feasibility of a model medication disposal program and assessed school nurses' perceptions of environmentally responsible medication disposal. At a large urban school district all unclaimed medications were collected at the end of a school year to determine the extent and nature of this problem. Nurses documented unclaimed medications and transported them to a central district location. An environmentally responsible medication disposal program, consisting of sealed containers bound for a local hospital's disposal system, was implemented. In a school district of approximately 133,000 students, there were 926 different medications abandoned at the end of a school year brought to a central disposal area. Nurses complied with the newly implemented protocol. Information collected from nurses indicates acceptance of the program. Disposal of unclaimed medications at a central location, use of secured containers, and transportation to a hospital for environmentally responsible disposal proved to be feasible and acceptable to the staff. Unclaimed medications at school each year pose a potentially huge environmental risk when disposed of improperly. It is feasible to implement an environmentally responsible medication disposal protocol at schools. © 2014, American School Health Association.

Identification of multi-locus genetic heterogeneity in anaplasma marginale ss. centrale and its restriction following tick-borne transmission.

USDA-ARS?s Scientific Manuscript database

Anaplasma marginale ss. centrale was the first vaccine used to protect against a rickettsial disease and continues in widespread use a century after initial implementation. As its use preceded development of either cryopreservation or cell culture, the vaccine strain was maintained for decades by se...

Improving the Procurement of Information Technology Commodities

DTIC Science & Technology

1994-04-12

and 0 the federal government. Apply Electronic Data Interchange (EDI) to order processing at AVC. Implementing EDI at AVC and throughout the Air Force...ordering process by approximately 2 weeks. 4. Centralize the Central Order Processing Offices. By consolidating AVC and SSCs order processing responsibilities...Im plem entation ..................................................................................... 21 5. ORDER PROCESSING WITH EDI

Amalgamation, Expansion, Quality Assurance and Innovations: A Case Study on a Key University in China

ERIC Educational Resources Information Center

Zhang, Jingning

2010-01-01

The Chinese higher education reform policies since 1993 have been pursued in a centralized, top-down manner, which some theorists characterize as "centralized decentralization" or governmental "steering at distance." This case-study dissertation has two purposes. First, is to evaluate the implementation or the "situated…

19 CFR 10.581 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... CONDITIONALLY FREE, SUBJECT TO A REDUCED RATE, ETC. Dominican Republic-Central America-United States Free Trade...—Central America—United States Free Trade Agreement Implementation Act (the Act; Pub. L. 109-53, 119 Stat... 19 Customs Duties 1 2010-04-01 2010-04-01 false Scope. 10.581 Section 10.581 Customs Duties U.S...

Implementation Issues in Federal Reform Efforts in Education: The United States and Australia.

ERIC Educational Resources Information Center

Porter, Paige

Multiple data sources are used in this study of educational change in the United States and Australia. The author considers political issues that may affect the implementation of educational reform efforts at the federal level, such as homogeneity versus heterogeneity, centralization versus decentralization, constitutional responsibility for…

Compulsory Schooling Policy in Nunavut: Challenges and Suggestions

ERIC Educational Resources Information Center

Fredua-Kwarteng, Eric

2008-01-01

This paper uses Nunavut's compulsory schooling policy as a case study to discuss the role that cultural difference plays in policy development and implementation. The central argument of the paper is that the implementation and sustainability of the compulsory schooling policy would be fraught with enormous problems, given its colonialist,…

The Politics of Public Accountability: Implications for Centralized Music Education Policy Development and Implementation

ERIC Educational Resources Information Center

Horsley, Stephanie

2009-01-01

This article addresses accountability issues that affect music education policy and implementation in the neoliberal education system. Using examples from education reform in Ontario, Canada, the author argues that two forms of accountability imbalances fostered by the neoliberal state--hierarchical answerability over communicative reason and…

Implementing Site-based Budgeting.

ERIC Educational Resources Information Center

Sielke, Catherine C.

2001-01-01

Discusses five questions that must be answered before implementing site-based budgeting: Why are we doing this? What budgeting decisions will be devolved to the school site? How do dollars flow from the central office to the site? Who will be involved at the site? How will accountability be achieved? (Author/PKP)

77 FR 40302 - Department of the Treasury Acquisition Regulation; Internet Payment Platform

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-09

... Treasury Acquisition Regulation; Internet Payment Platform AGENCY: Office of the Procurement Executive... Treasury Acquisition Regulation (DTAR) to implement use of the Internet Payment Platform, a centralized... implement the Internet Payment Platform (IPP) no later than the end of fiscal year 2012; with all new...

76 FR 16734 - Determination Under the Textile and Apparel Commercial Availability Provision of the Dominican...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

... Commercial Availability Provision of the Dominican Republic-Central America-United States Free Trade... FURTHER INFORMATION CONTACT: Maria Dybczak, Office of Textiles and Apparel, U.S. Department of Commerce...-United States Free Trade Agreement Implementation Act (``CAFTA-DR Implementation Act''), Public Law 109...

Assistive Technology Instruction within a Continuously Evolving Technology Environment

ERIC Educational Resources Information Center

Peterson-Karlan, George R.

2015-01-01

The movement toward greater availability of online education in the university setting creates challenges for design, development, and implementation of online courses, particularly those focused on the educational use of technology as content. This article is structured around a central theme of designing and implementing hybrid online courses…

[Lessons learned from the implementation of Dutch national healthcare guidelines on childhood obesity].

PubMed

Schalkwijk, A A H; Nijpels, G; Bot, S D M; Chin A Paw, M J M; Renders, C M; Elders, P J M

2016-01-01

To describe the implementation and feasibility of the national healthcare guidelines on childhood obesity in a region with a high prevalence of overweight and obesity in children. Descriptive, implementation study. The implementation of the guidelines took place in the borough Amsterdam West. In total, 17 general practitioners (GP) from the Academic General Practice Network (ANH) of the VU University Medical Center, Amsterdam, participated in the study, along with 19 child healthcare practitioners and 3 paediatricians. A number of measures were taken to promote implementation. Feasibility was evaluated using both qualitative and quantitative methods. The participating healthcare providers found the training in application of the guidelines and case study discussions useful. GPs found that their role as central caregiver was not feasible. All participants expressed a preference for child healthcare practitioners as the central caregiver. A total of 327 obese children were invited to attend the GP's surgery; only 65 of them participated in the study and only 28 children were monitored for a whole year. Collaboration agreements between involved healthcare providers were rarely fulfilled. Implementation of the national healthcare guidelines on childhood obesity in the current form appears not to be feasible in Amsterdam West, despite the many implementation-enhancing measures that were applied. It is questionable whether the national healthcare guidelines on childhood obesity in its current form can contribute to addressing the societal problem of overweight and obesity in children.

Implementing interorganizational cooperation in labour market reintegration: a case study.

PubMed

Ståhl, Christian

2012-06-01

To bring people with complex medical, social and vocational needs back to the labour market, interorganizational cooperation is often needed. Yet, studies of processes and strategies for achieving sustainable interorganizational cooperation are sparse. The aim of this study was to analyse the implementation processes of Swedish legislation on financial coordination, with specific focus on different strategies for and perspectives on implementing interorganizational cooperation. A multiple-case study was used, where two local associations for financial coordination were studied in order to elucidate and compare the development of cooperative work in two settings. The material, collected during a 3-year period, consisted of documents, individual interviews with managers, and focus groups with officials. Two different implementation strategies were identified. In case 1, a linear strategy was used to implement cooperative projects, which led to difficulties in maintaining cooperative work forms due to a fragmented and time-limited implementation process. In case 2, an interactive strategy was used, where managers and politicians were continuously involved in developing a central cooperation team that became a central part of a developing structure for interorganizational cooperation. An interactive cooperation strategy with long-term joint financing was here shown to be successful in overcoming organizational barriers to cooperation. It is suggested that a strategy based on adaptation to local conditions, flexibility and constant evaluation is preferred for developing sustainable interorganizational cooperation when implementing policies or legislation affecting interorganizational relationships.

Forest pricing and concession policies: Managing the high forest of west and central Africa. World Bank technical paper; Politique de redevances et de concessions forestieres: gestion des futaies en afrique occidentale et centrale

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

Grut, M.; Gray, J.A.; Egli, N.

1993-12-01

This French edition describes forest revenue systems and concession policies in the tropical moist hardwood forests of West and Central Africa. The paper reviews current issues in silviculture, tenure, concession management, and biological and financial sustainable development. Until the fledgling forestry departments of governments in West and Central Africa are strengthened, the report concludes that a simple system of forest fees should be implemented. The report recommends that such a system emphasize bidding and concession fees.

Implementation of partnership management model of SMK (Vocational High School) with existing industries in mechanical engineering expertise in Central Java

NASA Astrophysics Data System (ADS)

Sumbodo, Wirawan; Pardjono, Samsudi, Rahadjo, Winarno Dwi

2018-03-01

This study aims to determine the existing conditions of implementation of partnership management model of SMK with the industry on the mechanical engineering expertise in Central Java. The method used is descriptive analysis. The research result shows that the implementation of partnership management model of SMK based on new existing industry produces ready graduates of 62.5% which belongs to low category, although the partnership program of SMK with the industry is done well with the average score of 3.17. As many as 37.5% of SMK graduates of Mechanical Engineering Expertise Program choose to continue their studies or to be an entrepreneur. It is expected that the partnership model of SMK with the industry can be developed into a reference for government policy in developing SMK that is able to produce graduates who are ready to work according to the needs of partner industry.

The dependency on central government funding of decentralised health systems: experiences of the challenges and coping strategies in the Kongwa District, Tanzania.

PubMed

Frumence, Gasto; Nyamhanga, Tumaini; Mwangu, Mughwira; Hurtig, Anna-Karin

2014-01-25

Decentralised health systems in Tanzania depend largely on funding from the central government to run health services. Experience has shown that central funding in a decentralised system is not an appropriate approach to ensure the effective and efficient performance of local authorities due to several limitations. One of the limitations is that funds from the central government are not disbursed on a timely basis, which in turn, leads to the serious problem of shortage of financial resources for Council Health Management Teams (CHMT). This paper examines how dependency on central government funding in Tanzania affects health activities in Kongwa district council and the strategies used by the CHMT cope with the situation. The study adopted a qualitative approach and data were collected using semi-structured interviews and focus group discussions. One district in the central region of Tanzania was strategically selected. Ten key informants involved in the management of health service delivery at the district level were interviewed and one focus group discussion was held, which consisted of members of the council health management team. The data generated were analysed for themes and patterns. The results showed that late disbursement of funds interrupts the implementation of health activities in the district health system. This situation delays the implementation of some activities, while a few activities may not be implemented at all. However, based on their prior knowledge of the anticipated delays in financial disbursements, the council health management team has adopted three main strategies to cope with this situation. These include obtaining supplies and other services on credit, borrowing money from other projects in the council, and using money generated from cost sharing. Local government authorities (LGAs) face delays in the disbursement of funds from the central government. This has necessitated introduction of informal coping strategies to deal with the situation. National-level policy and decision makers should minimise the bureaucracy involved in allocating funds to the district health systems to reduce delays.

The dependency on central government funding of decentralised health systems: experiences of the challenges and coping strategies in the Kongwa District, Tanzania

PubMed Central

2014-01-01

Background Decentralised health systems in Tanzania depend largely on funding from the central government to run health services. Experience has shown that central funding in a decentralised system is not an appropriate approach to ensure the effective and efficient performance of local authorities due to several limitations. One of the limitations is that funds from the central government are not disbursed on a timely basis, which in turn, leads to the serious problem of shortage of financial resources for Council Health Management Teams (CHMT). This paper examines how dependency on central government funding in Tanzania affects health activities in Kongwa district council and the strategies used by the CHMT cope with the situation. Methods The study adopted a qualitative approach and data were collected using semi-structured interviews and focus group discussions. One district in the central region of Tanzania was strategically selected. Ten key informants involved in the management of health service delivery at the district level were interviewed and one focus group discussion was held, which consisted of members of the council health management team. The data generated were analysed for themes and patterns. Results The results showed that late disbursement of funds interrupts the implementation of health activities in the district health system. This situation delays the implementation of some activities, while a few activities may not be implemented at all. However, based on their prior knowledge of the anticipated delays in financial disbursements, the council health management team has adopted three main strategies to cope with this situation. These include obtaining supplies and other services on credit, borrowing money from other projects in the council, and using money generated from cost sharing. Conclusion Local government authorities (LGAs) face delays in the disbursement of funds from the central government. This has necessitated introduction of informal coping strategies to deal with the situation. National-level policy and decision makers should minimise the bureaucracy involved in allocating funds to the district health systems to reduce delays. PMID:24460781

Emerging issues in Integrated Pest Management implementation and adoption in the North Central USA

USDA-ARS?s Scientific Manuscript database

There is a long tradition of integrated pest management (IPM) in the North Central region of the U.S. IPM is difficult to define, and it means different things to different people. But in general it is a philosophy based on multiple tactics to prevent a population from building up to unacceptable da...

A 3D stand generator for central Appalachian hardwood forests

Treesearch

Jingxin Wang; Yaoxiang Li; Gary W. Miller

2002-01-01

A 3-dimensional (3D) stand generator was developed for central Appalachian hardwood forests. It was designed for a harvesting simulator to examine the interactions of stand, harvest, and machine. The Component Object Model (COM) was used to design and implement the program. Input to the generator includes species composition, stand density, and spatial pattern. Output...

A Brief Study of Cafeteria Facilities and Operations, with Recommendations for Implementation.

ERIC Educational Resources Information Center

Okamura, James T.

The facilities and operations of the school lunch program in the public schools of Hawaii are reviewed. Several types of school lunch programs are described including--(1) traditional school lunch programs, (2) kitchen and classroom dining, (3) central and decentralized dining, (4) home school-feeder school system, (5) central kitchen, and (6) the…

TORCAPP: time-dependent cyclotron orbit calculation and plotting package

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

Malarkey, C.H.; McNeilly, G.S.; Merriman, L.D.

1982-11-01

This addendum describes the modifications and additions to TORCAPP which have been implemented since the original report was issued in November 1979 by L.B. Maddox and G.S. McNeilly. Major changes include input of electric field data for central region studies, provision for extractor elements to allow extraction studies, and three-dimensional tracking of central rays.

Collaborative Peer Review. The Role of Faculty in Improving College Teaching. ERIC Digest.

ERIC Educational Resources Information Center

Keig, Larry; Waggoner, Michael D.

This digest, based on a full report of the same title, provides an examination of the improvement of college teaching and argues for the central involvement of faculty themselves in collaborative peer review and looks at some central issues and challenges to implementation. Since summative evaluation involved in tenure and promotion decisions…

Leading for Instructional Improvement in the Context of Accountability: Central Office Leadership

ERIC Educational Resources Information Center

Rigby, Jessica Goodman; Corriell, Rebecca; Kuhl, Katie J.

2018-01-01

This case was written to help prepare central office leaders who are expected to design systems and lead toward instructional improvement in the context of both educational accountability and implementation of standards with increased rigor. The intent of this case study is to encourage educators to examine the complex and multiple challenges of…

Higher Education Governance in Central and Eastern Europe: A Perspective on Hungary and Poland

ERIC Educational Resources Information Center

Tarlea, Silvana

2017-01-01

This paper seeks to answer the question of what motivates governments to introduce and implement reforms in higher education (HE). The political and economic reasons why some governments in the countries of Central and Eastern Europe (CEE), for the period 1990 and 2015, have invested resources in order to facilitate cooperation between employers…

Three-dimensional cascaded lattice Boltzmann method: Improved implementation and consistent forcing scheme

NASA Astrophysics Data System (ADS)

Fei, Linlin; Luo, Kai H.; Li, Qing

2018-05-01

The cascaded or central-moment-based lattice Boltzmann method (CLBM) proposed in [Phys. Rev. E 73, 066705 (2006), 10.1103/PhysRevE.73.066705] possesses very good numerical stability. However, two constraints exist in three-dimensional (3D) CLBM simulations. First, the conventional implementation for 3D CLBM involves cumbersome operations and requires much higher computational cost compared to the single-relaxation-time (SRT) LBM. Second, it is a challenge to accurately incorporate a general force field into the 3D CLBM. In this paper, we present an improved method to implement CLBM in 3D. The main strategy is to adopt a simplified central moment set and carry out the central-moment-based collision operator based on a general multi-relaxation-time (GMRT) framework. Next, the recently proposed consistent forcing scheme for CLBM [Fei and Luo, Phys. Rev. E 96, 053307 (2017), 10.1103/PhysRevE.96.053307] is extended to incorporate a general force field into 3D CLBM. Compared with the recently developed nonorthogonal CLBM [Rosis, Phys. Rev. E 95, 013310 (2017), 10.1103/PhysRevE.95.013310], our implementation is proved to reduce the computational cost significantly. The inconsistency of adopting the discrete equilibrium distribution functions in the nonorthogonal CLBM is analyzed and validated. The 3D CLBM developed here in conjunction with the consistent forcing scheme is verified through numerical simulations of several canonical force-driven flows, highlighting very good properties in terms of accuracy, convergence, and consistency with the nonslip rule. Finally, the techniques developed here for 3D CLBM can be applied to make the implementation and execution of 3D MRT-LBM more efficient.

Priority setting and implementation in a centralized health system: a case study of Kerman province in Iran.

PubMed

Khayatzadeh-Mahani, Akram; Fotaki, Marianna; Harvey, Gillian

2013-08-01

The question of how priority setting processes work remains topical, contentious and political in every health system across the globe. It is particularly acute in the context of developing countries because of the mismatch between needs and resources, which is often compounded by an underdeveloped capacity for decision making and weak institutional infrastructures. Yet there is limited research into how the process of setting and implementing health priorities works in developing countries. This study aims to address this gap by examining how a national priority setting programme works in the centralized health system of Iran and what factors influence its implementation at the meso and micro levels. We used a qualitative case study approach, incorporating mixed methods: in-depth interviews at three levels and a textual analysis of policy documents. The data analysis showed that the process of priority setting is non-systematic, there is little transparency as to how specific priorities are decided, and the decisions made are separated from their implementation. This is due to the highly centralized system, whereby health priorities are set at the macro level without involving meso or micro local levels or any representative of the public. Furthermore, the two main benefit packages are decided by different bodies (Ministry of Health and Medical Education and Ministry of Welfare and Social Security) and there is no co-ordination between them. The process is also heavily influenced by political pressure exerted by various groups, mostly medical professionals who attempt to control priority setting in accordance with their interests. Finally, there are many weaknesses in the implementation of priorities, resulting in a growing gap between rural and urban areas in terms of access to health services.

Implementing the Regular Education Initiative in Secondary Schools: A Different Ball Game.

ERIC Educational Resources Information Center

Schumaker, Jean B.; Deshler, Donald D.

1988-01-01

The article reviews potential barriers to implementing the Regular Education Initiative (REI) in secondary schools and then discusses a set of factors central to developing a workable partnership, one that is compatible with the goals of the REI but that also responds to the unique parameters of secondary schools. (Author/DB)

Teachers' Reasons for Using Peer Assessment: Positive Experience Predicts Use

ERIC Educational Resources Information Center

Panadero, Ernesto; Brown, Gavin T. L.

2017-01-01

Peer assessment (PA) is one of the central principles of formative assessment and assessment for learning (AfL) fields. There is ample empirical evidence as to the benefits for students' learning when AfL principles are implemented. However, teachers play a critical role in mediating the implementation of intended policies. Hence, their…

A Socio-Cultural Analysis of Practitioner Perspectives on Implementation of Evidence-Based Practice in Special Education

ERIC Educational Resources Information Center

Hudson, Roxanne F.; Davis, Carol A.; Blum, Grace; Greenway, Rosanne; Hackett, Jacob; Kidwell, James; Liberty, Lisa; McCollow, Megan; Patish, Yelena; Pierce, Jennifer; Schulze, Maggie; Smith, Maya M.; Peck, Charles A.

2016-01-01

Despite the central role "evidence-based practice" (EBP) plays in special education agendas for both research and policy, it is widely recognized that achieving "implementation" of EBPs remains an elusive goal. In an effort to better understand this problem, we interviewed special education practitioners in four school…

Implementation of a Collaborative Series of Classroom-Based Undergraduate Research Experiences Spanning Chemical Biology, Biochemistry, and Neurobiology

ERIC Educational Resources Information Center

Kowalski, Jennifer R.; Hoops, Geoffrey C.; Johnson, R. Jeremy

2016-01-01

Classroom undergraduate research experiences (CUREs) provide students access to the measurable benefits of undergraduate research experiences (UREs). Herein, we describe the implementation and assessment of a novel model for cohesive CUREs focused on central research themes involving faculty research collaboration across departments. Specifically,…

An Investigation of the Implementation of Support Services in a Graduate Advising Center

ERIC Educational Resources Information Center

Maxey, Susan W.

2014-01-01

This capstone examined the differences in support services provided for undergraduate versus graduate students. From the research, a centralized advising system was designed and implemented for graduate students at a public state supported university in Kentucky to help students be more satisfied with their graduate school experience and increase…

The Saturday School: An Installation Manual.

ERIC Educational Resources Information Center

Parrish, Valinda E.; Wilson, Winston T.

This manual describes the mechanics and major features of a Saturday school project for 40 Negro preschool children implemented by the South Central Region Educational Laboratory in the 1968-69 school year in Caddo Parish, Louisiana. The manual has two goals: (1) to inform the reader about how the project was successfully implemented, and (2) to…

Fidelity of Problem Solving in Everyday Practice: Typical Training May Miss the Mark

ERIC Educational Resources Information Center

Ruby, Susan F.; Crosby-Cooper, Tricia; Vanderwood, Michael L.

2011-01-01

With national attention on scaling up the implementation of Response to Intervention, problem solving teams remain one of the central components for development, implementation, and monitoring of school-based interventions. Studies have shown that problem solving teams evidence a sound theoretical base and demonstrated efficacy; however, limited…

Free Teacher Education Policy Implementation in China

ERIC Educational Resources Information Center

Hagin, Dean A.

2012-01-01

In 2007 the Chinese central government implemented the Free Teacher Education Policy (FTEP), which offered qualifying students admission to prestigious national universities, four years of free tuition, room and board, and a stipend in exchange for a commitment to teach in their home province for ten years; the first two of those years in a rural…

DiffSLC: A graph centrality method to detect essential proteins of a protein-protein interaction network.

PubMed

Mistry, Divya; Wise, Roger P; Dickerson, Julie A

2017-01-01

Identification of central genes and proteins in biomolecular networks provides credible candidates for pathway analysis, functional analysis, and essentiality prediction. The DiffSLC centrality measure predicts central and essential genes and proteins using a protein-protein interaction network. Network centrality measures prioritize nodes and edges based on their importance to the network topology. These measures helped identify critical genes and proteins in biomolecular networks. The proposed centrality measure, DiffSLC, combines the number of interactions of a protein and the gene coexpression values of genes from which those proteins were translated, as a weighting factor to bias the identification of essential proteins in a protein interaction network. Potentially essential proteins with low node degree are promoted through eigenvector centrality. Thus, the gene coexpression values are used in conjunction with the eigenvector of the network's adjacency matrix and edge clustering coefficient to improve essentiality prediction. The outcome of this prediction is shown using three variations: (1) inclusion or exclusion of gene co-expression data, (2) impact of different coexpression measures, and (3) impact of different gene expression data sets. For a total of seven networks, DiffSLC is compared to other centrality measures using Saccharomyces cerevisiae protein interaction networks and gene expression data. Comparisons are also performed for the top ranked proteins against the known essential genes from the Saccharomyces Gene Deletion Project, which show that DiffSLC detects more essential proteins and has a higher area under the ROC curve than other compared methods. This makes DiffSLC a stronger alternative to other centrality methods for detecting essential genes using a protein-protein interaction network that obeys centrality-lethality principle. DiffSLC is implemented using the igraph package in R, and networkx package in Python. The python package can be obtained from git.io/diffslcpy. The R implementation and code to reproduce the analysis is available via git.io/diffslc.

Implementation of a written protocol for management of central venous access devices: a theoretical and practical education, including bedside examinations.

PubMed

Ahlin, Catharina; Klang-Söderkvist, Birgitta; Brundin, Seija; Hellström, Birgitta; Pettersson, Karin; Johansson, Eva

2006-01-01

The objectives of this study were to evaluate registered nurses' (RN) compliance with a local clinical central venous access device (CVAD) protocol after completing an educational program and to determine RNs' perception of the program. Seventy-five RNs working in hematology participated in the educational part of the program. Sixty-eight RNs were examined while changing CVAD dressings or placing a Huber needle into a port on actual patients. Sixty percent of the RNs passed the examination and reported that the program increased their knowledge. The results indicated that the educational program could be recommended for use when implementing a new clinical protocol.

Implementation of a post-cardiac arrest care bundle including therapeutic hypothermia and hemodynamic optimization in comatose patients with return of spontaneous circulation after out-of-hospital cardiac arrest: a feasibility study.

PubMed

Walters, Elizabeth Lea; Morawski, Kyle; Dorotta, Ihab; Ramsingh, Davinder; Lumen, Kelly; Bland, David; Clem, Kathleen; Nguyen, H Bryant

2011-04-01

Patients who present to the emergency department (ED) with return of spontaneous circulation after cardiac arrest generally have poor outcomes. Guidelines for treatment can be complicated and difficult to implement. This study examined the feasibility of implementing a care bundle including therapeutic hypothermia (TH) and early hemodynamic optimization for comatose patients with return of spontaneous circulation after out-of-hospital cardiac arrest. The study included patients over a 2-year period in the ED and intensive care unit of an academic tertiary-care medical center. The first year (prebundle) provided a historical control, followed by a prospective observational period of bundle implementation during the second year. The bundle elements included (a) TH initiated; (b) central venous pressure/central venous oxygen saturation monitoring in 2 h; (c) target temperature in 4 h; (d) central venous pressure greater than 12 mmHg in 6 h; (e) MAP greater than 65 mmHg in 6 h; (f) central venous oxygen saturation greater than 70% in 6 h; (g) TH maintained for 24 h; and (h) decreasing lactate in 24 h. Fifty-five patients were enrolled, 26 patients in the prebundle phase and 29 patients in the bundle phase. Seventy-seven percent of bundle elements were completed during the bundle phase. In-hospital mortality in bundle compared with prebundle patients was 55.2% vs. 69.2% (P = 0.29). In the bundle patients, those patients who received all elements of the care bundle had mortality 33.3% compared with 60.9% in those receiving some of the bundle elements (P = 0.22). Bundle patients tended to achieve good neurologic outcome compared with prebundle patients, Cerebral Performance Category 1 or 2 in 31 vs. 12% patients, respectively (P = 0.08). Our study demonstrated that a post-cardiac arrest care bundle that incorporates TH and early hemodynamic optimization can be implemented in the ED and intensive care unit collaboratively and can achieve similar clinical benefits compared with those observed in previous clinical trials.

A Qualitative Phenomenology of Christian Middle School Implementation of Inquiry-based Science Instruction

NASA Astrophysics Data System (ADS)

Ferrin, Patricia Ann

The purpose of this qualitative phenomenology study will be to explore curriculum coordinators, teachers, and principals' implementation of Inquiry-Based Instruction (IBI) in Christian middle school science classes in the central Virginia area. IBI will be referred to as "a teaching method that combines the curiosity of students and the scientific method to enhance the development of critical thinking skills while learning science" (Warner & Myers, 2008, p.3). A qualitative phenomenology study will be made to consider the requirements and implementation of IBI in the Christian middle schools as compared to the requirements and implementation of IBI in the National Science Education Standard (NSES). Curriculum coordinators, teachers, and principals, and participated in this study from five Christian middle schools in the central Virginia area. The guiding theories include John Dewey's (1948) Constructivism, Lev Vygotsky's (1998) Social Constructivism, and William Glasser's (2005) Choice Theory as they relate to the beliefs curriculum coordinators, teachers, and principals have regarding the implementation of IBI. A primary research question for this study is, "If research supports successful outcomes of IBI, then how and why do Christian CMSST, principals, and curriculum coordinators implement or not implement IBI?" Interviews, classroom observations, and document reviews were used for triangulation and data collection. The data analysis used in this study were completed by using Moustakas' (1994) seven step thematic coding derived from the observations, interview transcriptions, and school documents in the form of lesson plans and objectives (Merriam, 2009; Moustakas, 1994).

Removing the regional level from the Niger vaccine supply chain.

PubMed

Assi, Tina-Marie; Brown, Shawn T; Kone, Souleymane; Norman, Bryan A; Djibo, Ali; Connor, Diana L; Wateska, Angela R; Rajgopal, Jayant; Slayton, Rachel B; Lee, Bruce Y

2013-06-10

Since many of the world's vaccine supply chains contain multiple levels, the question remains of whether removing a level could bring efficiencies. We utilized HERMES to generate a detailed discrete-event simulation model of Niger's vaccine supply chain and compared the current four-tier (central, regional, district, and integrated health center levels) with a modified three-tier structure (removing the regional level). Different scenarios explored various accompanying shipping policies and frequencies. Removing the regional level and implementing a collection-based shipping policy from the district stores increases vaccine availability from a mean of 70-100% when districts could collect vaccines at least weekly. Alternatively, implementing a delivery-based shipping policy from the central store monthly in three-route and eight-route scenarios only increases vaccine availability to 87%. Restricting central-to district vaccine shipments to a quarterly schedule for three-route and eight-route scenarios reduces vaccine availability to 49%. The collection-based shipping policy from district stores reduces supply chain logistics cost per dose administered from US$0.14 at baseline to US$0.13 after removing the regional level. Removing the regional level from Niger's vaccine supply chain can substantially improve vaccine availability as long as certain concomitant adjustments to shipping policies and frequencies are implemented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Removing the Regional Level from the Niger Vaccine Supply Chain

PubMed Central

Assi, Tina-Marie; Brown, Shawn T.; Kone, Souleymane; Norman, Bryan A.; Djibo, Ali; Connor, Diana L.; Wateska, Angela R.; Rajgopal, Jayant; Slayton, Rachel B.; Lee, Bruce Y.

2013-01-01

Objective Since many of the world’s vaccine supply chains contain multiple levels, the question remains of whether removing a level could bring efficiencies. Methods We utilized HERMES to generate a detailed discrete-event simulation model of Niger’s vaccine supply chain and compare the current four-tier (central, regional, district and integrated health center levels) with a modified three-tier structure (removing the regional level). Different scenarios explored various accompanying shipping policies and frequencies. Findings Removing the regional level and implementing a collection-based shipping policy from the district stores increases vaccine availability from a mean of 70% to 100% when districts could collect vaccines at least weekly. Alternatively, implementing a delivery-based shipping policy from the central store monthly in three-route and eight-route scenarios only increases vaccine availability to 87%. Restricting central-to district vaccine shipments to a quarterly schedule for three-route and eight-route scenarios reduces vaccine availability to 49%. The collection-based shipping policy from district stores reduces supply chain logistics cost per dose administered from US$0.14 at baseline to US$0.13 after removing the regional level. Conclusion Removing the regional level from Niger’s vaccine supply chain can substantially improve vaccine availability as long as certain concomitant adjustments to shipping policies and frequencies are implemented. PMID:23602666

Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines.

PubMed

Dormuth, Colin R; Miller, Tarita A; Huang, Anjie; Mamdani, Muhammad M; Juurlink, David N

2012-11-06

Opioid analgesics and benzodiazepines are often misused in clinical practice. We determined whether implementation of a centralized prescription network offering real-time access to patient-level data on filled prescriptions (PharmaNet) reduced the number of potentially inappropriate prescriptions for opioids and benzodiazepines. We conducted a time series analysis using prescription records between Jan. 1, 1993, and Dec. 31, 1997, for residents of the province of British Columbia who were receiving social assistance or were 65 years or older. We calculated monthly percentages of filled prescriptions for an opioid or a benzodiazepine that were deemed inappropriate (those issued by a different physician and dispensed at a different pharmacy within 7 days after a filled prescription of at least 30 tablets of the same drug). Within 6 months after implementation of PharmaNet in July 1995, we observed a relative reduction in inappropriate filled prescriptions for opioids of 32.8% (95% confidence interval [CI] 31.0%-34.7%) among patients receiving social assistance; inappropriate filled prescriptions for benzodiazepines decreased by 48.6% (95% CI 43.2%-53.1%). Similar and statistically significant reductions were observed among residents 65 years or older. The implementation of a centralized prescription network was associated with a dramatic reduction in inappropriate filled prescriptions for opioids and benzodiazepines.

Neighborhood comparison operator

NASA Technical Reports Server (NTRS)

Gennery, D. B. (Inventor)

1985-01-01

Digital values in a moving window are compared by an operator having nine comparators connected to line buffers for receiving a succession of central pixels together with eight neighborhood pixels. A single bit of program control determines whether the neighborhood pixels are to be compared with the central pixel or a threshold value. The central pixel is always compared with the threshold. The omparator output plus 2 bits indicating odd-even pixel/line information about the central pixel addresses a lookup table to provide 14 bits of information, including 2 bits which control a selector to pass either the central pixel value, the other 12 bits of table information, or the bit-wise logical OR of all nine pixels through circuit that implements a very wide OR gate.

Community Participation on an Urban Sanitation Program: a Comparative Study

NASA Astrophysics Data System (ADS)

Rini Dwi Ari, Ismu; Nyoman Suluh Wijaya, I.; Dewanto, Aditya

2018-05-01

Sanitation development becomes one aspect, particularly the sixth pillar, of Sustainable Development Goals that aims at ensuring the access to water and sanitation for all. The success of the sanitation program will bring about significant changes in the human life. However, it is necessary to consider community involvement in the development program in all of the steps holistically – planning, implementation, operation and maintenance. This research scrutinizes the key factors of successful urban sanitation development programs in Talangagung sub-district as compared to Ardirejo sub-district in Kepanjen district in Malang regency, Indonesia. Through field observation in the two-research areas, and questionnaire survey distributed to to104 heads of households in Talangagung sub-district and 84 heads of households in Ardirejo sub-district, an evaluation on the suitability of the program as well as the social capital measurement was conducted. The result of estimation illustrates that Talangagung sub-district has higher score than Adirejo sub-district, which respectively 470 and 340 for the whole steps of the development. Then, the study continued with the social capital measurement using three indices of social network analysis – covering rate of participation, density and centrality. In general, the rate of participation and density of the residents involved in the urban sanitation program development in Talangagung sub-district was higher value than in Ardirejo sub-district. However, the residents’ participation in the development process tends to decrease from the planning – implementation – operation/maintenance. It is predicted that the low participation in the third step – operation/maintenance, is due to the lack of understanding of the whole participants, since the information is exclusively understood by the organizing committee. In other words, there is asymmetrical information occurring between the organizing committee and the residents. For the centrality, this research utilized three indices of the centrality covering degree – closeness – betweenness centrality. The estimation result at planning step draws that there are 21 central actors in Talangagung, wherein 8 of them are the committee members and 13 of them are regular residents. Meanwhile, in Ardirejo sub-disctrict, there are 5 central actors, but all of them are committee members. In the implementation step, there are 10 central actors, consisting of 7 committee members and 3 residents in Talangagung sub-district. Meanwhile, in Ardirejo sub-district, there are 7 central actors and all of them are the committee members. Finally, at the operation/maintenance step, there is no central actor for both sub-districts.

Central Control and Automation Systems: A Management and Procurement Handbook. Second Edition.

ERIC Educational Resources Information Center

Association of Physical Plant Administrators of Universities and Colleges, Washington, DC.

It is presumed that those reading this book presently own and operate a central control and monitoring system (CCMS) or plan to implement one in the near future. One objective of this workbook is to present useful knowledge from case histories of members of the Association of Physical Plant Administrators of Universities and Colleges as well as…

A three-dimensional bucking system for optimal bucking of Central Appalachian hardwoods

Treesearch

Jingxin Wang; Jingang Liu; Chris B. LeDoux

2009-01-01

An optimal tree stembucking systemwas developed for central Appalachian hardwood species using three-dimensional (3D) modeling techniques. ActiveX Data Objects were implemented via MS Visual C++/OpenGL to manipulate tree data which were supported by a backend relational data model with five data entity types for stems, grades and prices, logs, defects, and stem shapes...

Using Centrality of Concept Maps as a Measure of Problem Space States in Computer-Supported Collaborative Problem Solving

ERIC Educational Resources Information Center

Clariana, Roy B.; Engelmann, Tanja; Yu, Wu

2013-01-01

Problem solving likely involves at least two broad stages, problem space representation and then problem solution (Newell and Simon, Human problem solving, 1972). The metric centrality that Freeman ("Social Networks" 1:215-239, 1978) implemented in social network analysis is offered here as a potential measure of both. This development research…

The University Next Door: Developing a Centralized Unit That Strategically Cultivates Community Engagement at an Urban University

ERIC Educational Resources Information Center

Holton, Valerie L.; Early, Jennifer L.; Resler, Meghan; Trussell, Audrey; Howard, Catherine

2016-01-01

Using Kotter's model of change as a framework, this case study will describe the structure and efforts of a centralized unit within an urban, research university to deepen and extend the institutionalization of community engagement. The change model will be described along with details about the implemented strategies and practices that fall…

Using ethnography in implementation research to improve nutrition interventions in populations

PubMed Central

Neufeld, Lynnette M.; Pelto, Gretel H.

2015-01-01

Abstract ‘Implementation research in nutrition’ is an emerging area of study aimed at building evidence‐based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view – the insider's perspective – and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the ‘emic’ (insider's) perspective.Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography.Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the ‘black box’ in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. PMID:26778802

Using ethnography in implementation research to improve nutrition interventions in populations.

PubMed

Tumilowicz, Alison; Neufeld, Lynnette M; Pelto, Gretel H

2015-12-01

'Implementation research in nutrition' is an emerging area of study aimed at building evidence-based knowledge and sound theory to design and implement programs that will effectively deliver nutrition interventions. This paper describes some of the basic features of ethnography and illustrates its applications in components of the implementation process. We review the central purpose of ethnography, which is to obtain the emic view--the insider's perspective--and how ethnography has historically interfaced with nutrition. We present examples of ethnographic studies in relation to an analytic framework of the implementation process, situating them with respect to landscape analysis, formative research, process evaluation and impact evaluation. These examples, conducted in various parts of the world by different investigators, demonstrate how ethnography provided important, often essential, insights that influenced programming decisions or explained programme outcomes. Key messages Designing, implementing and evaluating interventions requires knowledge about the populations and communities in which interventions are situated, including knowledge from the 'emic' (insider's) perspective. Obtaining emic perspectives and analysing them in relation to cultural, economic and structural features of social organisation in societies is a central purpose of ethnography. Ethnography is an essential aspect of implementation research in nutrition, as it provides important insights for making decisions about appropriate interventions and delivery platforms; determining how best to fit aspects of programme design and implementation into different environmental and cultural contexts; opening the 'black box' in interventions to understand how delivery and utilisation processes affect programme outcomes or impacts; and understanding how programme impacts were achieved, or not. © 2015 John Wiley & Sons Ltd.

A system to build distributed multivariate models and manage disparate data sharing policies: implementation in the scalable national network for effectiveness research.

PubMed

Meeker, Daniella; Jiang, Xiaoqian; Matheny, Michael E; Farcas, Claudiu; D'Arcy, Michel; Pearlman, Laura; Nookala, Lavanya; Day, Michele E; Kim, Katherine K; Kim, Hyeoneui; Boxwala, Aziz; El-Kareh, Robert; Kuo, Grace M; Resnic, Frederic S; Kesselman, Carl; Ohno-Machado, Lucila

2015-11-01

Centralized and federated models for sharing data in research networks currently exist. To build multivariate data analysis for centralized networks, transfer of patient-level data to a central computation resource is necessary. The authors implemented distributed multivariate models for federated networks in which patient-level data is kept at each site and data exchange policies are managed in a study-centric manner. The objective was to implement infrastructure that supports the functionality of some existing research networks (e.g., cohort discovery, workflow management, and estimation of multivariate analytic models on centralized data) while adding additional important new features, such as algorithms for distributed iterative multivariate models, a graphical interface for multivariate model specification, synchronous and asynchronous response to network queries, investigator-initiated studies, and study-based control of staff, protocols, and data sharing policies. Based on the requirements gathered from statisticians, administrators, and investigators from multiple institutions, the authors developed infrastructure and tools to support multisite comparative effectiveness studies using web services for multivariate statistical estimation in the SCANNER federated network. The authors implemented massively parallel (map-reduce) computation methods and a new policy management system to enable each study initiated by network participants to define the ways in which data may be processed, managed, queried, and shared. The authors illustrated the use of these systems among institutions with highly different policies and operating under different state laws. Federated research networks need not limit distributed query functionality to count queries, cohort discovery, or independently estimated analytic models. Multivariate analyses can be efficiently and securely conducted without patient-level data transport, allowing institutions with strict local data storage requirements to participate in sophisticated analyses based on federated research networks. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Institute of Medicine Early Infant Feeding Recommendations for Childhood Obesity Prevention: Implementation by Immigrant Mothers From Central America.

PubMed

Gaffney, Kathleen F; Brito, Albert V; Kitsantas, Panagiota; Kermer, Deborah A; Pereddo, Graciela; Ramos, Katya M

Describe implementation of Institute of Medicine (IOM) early infant feeding recommendations for child obesity prevention by immigrant mothers from Central America; examine potential relationships with food insecurity and postpartum depressive symptoms. Using a cross-sectional, descriptive design, face-to-face interviews were conducted with 318 mothers of 2month old infants at a large pediatric setting for low income families. Logistic regression models assessed feeding practices, food insecurity and postpartum depressive symptoms. Exclusive breastfeeding rates were low (9.4%); most mothers (62.7%) both breastfed and bottle fed their infants. Mothers who bottle fed at moderate and high intensity were twice as likely to affirm that if you give a baby a bottle, you should always make sure s/he finishes it (OR=2.30, 95% CI=1.13, 4.69; OR=2.29, 95% CI=1.26, 4.14). Food insecurity was experienced by 57% of mothers but postpartum depressive symptoms were low (Possible range=0-30; M=2.96, SD =3.6). However, for each increase in the postpartum depressive symptoms score, the likelihood of affirming a controlling feeding style increased by 11-13%. Immigrant mothers from Central America were more likely to both breastfeed and bottle feed (las dos cosas) than implement exclusive breastfeeding. Bottle feeding intensity was associated with a controlling feeding style. Infant well visits provide the ideal context for promoting IOM recommendations for the prevention of obesity among children of immigrant mothers from Central America. Copyright © 2018 Elsevier Inc. All rights reserved.

Professional Learning Communities Focusing on Results and Data-Use to Improve Student Learning: The Right Implementation Matters

ERIC Educational Resources Information Center

Muñoz, Marco A.; Branham, Karen E.

2016-01-01

Professional Learning Communities are an important means toward the goal of improving schools so that students can learn at high levels. Professional Learning Communities, when well-implemented, have a laser-focus on learning, work collaboratively, and hold themselves accountable for results. In this article, the central concept of…

A Pilot Study of the Challenges and Prospects of Continuous Assessment Implementation in Nigeria

ERIC Educational Resources Information Center

Owolabi, Henry O.; Onuka, Adams O. U.

2010-01-01

This study obtained basic information from teachers and students on the challenges and prospects of implementing continuous assessment (CA) in the Nigerian school system. Secondary Schools in Ilorin, the capital city of Kwara State, located in the central region of Nigeria were sampled for use in the study. It employed survey research design…

An Evaluative Review of School Accreditation Implementation Program in Indonesian Contexts

ERIC Educational Resources Information Center

Haryati, Sri

2014-01-01

This paper critically reviews and evaluates the implementation of School Accreditation Program for the period of 2013 with a particular reference to Central Java Schools, consisting of Kindergarten (TK) Elementary School (SD), Junior High School (SMP) and Senior High School (SMA) (Note 1). The aim of the review is to see to what extent they can…

Schools' Responses to Voucher Policy: Participation Decisions and Early Implementation Experiences in the Indiana Choice Scholarship Program

ERIC Educational Resources Information Center

Austin, Megan J.

2015-01-01

Little is known about the supply side of voucher programs, despite schools' central role in program effectiveness. Using survey and interview data on the Indiana Choice Scholarship Program (ICSP), I analyze schools' participation decisions and early implementation experiences to understand better how schools respond to program regulations. I find…

Development of Learning Resources to Promote Knowledge Sharing in Problem Based Learning

ERIC Educational Resources Information Center

Uden, Lorna; Page, Tom

2008-01-01

Problem Based Learning offers many benefits to students' learning, however, the design and implementation of effective problem based learning (PBL) is not trivial. Central to effective implementation of PBL are the problem design and group working of the students. Design of good problems requires that the learning outcomes of the subject are…

Implementing Educational Language Policy in Arizona: Legal, Historical and Current Practices in SEI

ERIC Educational Resources Information Center

Arias, M. Beatriz, Ed.; Faltis, Christian, Ed.

2012-01-01

This volume is a unique contribution to the study of language policy and education for English Learners because it focuses on the decade long implementation of "English Only" in Arizona. How this policy influences teacher preparation and classroom practice is the central topic of this volume. Scholars and researchers present their latest…

Design and Implementation of an Interactive System for Teaching the Islamic Prayer

ERIC Educational Resources Information Center

Farsi, Mohammed; Munro, Malcolm

2016-01-01

Background: The Islamic Prayer is central to the Islam religion and is a requirement for all Muslims to learn and perform properly. Teaching the Islamic Prayer had traditionally been through the use of textbooks. Aims: This paper describes the design and implementation of the iIP (interactive Islamic Prayer) system to teach the Islamic prayer…

Developing and Implementing a Mobile Conservation Education Unit for Rural Primary School Children in Lao PDR

ERIC Educational Resources Information Center

Hansel, Troy; Phimmavong, Somvang; Phengsopha, Kaisone; Phompila, Chitana; Homduangpachan, Khiaosaphan

2010-01-01

In this article, the authors examine the implementation and success of a mobile conservation education unit targeting primary schools in central Lao PDR (People's Democratic Republic). The mobile unit conducted 3-hour interactive programs for school children focused on the importance of wildlife and biodiversity around the primary schools in rural…

Universal Prevention Program Outcomes: Safe Schools Healthy Students in a Rural, Multicultural Setting

ERIC Educational Resources Information Center

Harris, Elizabeth; McFarland, Joyce; Siebold, Wendi; Aguilar, Rafael; Sarmiento, Ana

2007-01-01

The Idaho Consortium for Safe Schools Healthy Students consists of three school districts in rural North Central Idaho and the Nez Perce Tribe's Students for Success Program. Universal prevention programs implemented in the elementary schools include Second Step and the middle schools implemented the Life Skills program. Each of the three…

Leading Change in Tissue Viability Best Practice: An Action Learning Programme for Link Nurse Practitioners

ERIC Educational Resources Information Center

Kellie, Jean; Henderson, Eileen; Milsom, Brian; Crawley, Hayley

2010-01-01

This account of practice reports on an action learning initiative designed and implemented in partnership between a regional NHS Acute Trust and a UK Business School. The central initiative was the implementation of an action learning programme entitled "Leading change in tissue viability best practice: a development programme for Link Nurse…

Decentralization and Participatory Decision-Making: Implementing School-Based Management in the Abbott Districts.

ERIC Educational Resources Information Center

Walker, Elaine M.

2000-01-01

This study examined issues faced during implementation of school-based management (SBM) in New Jersey's special needs or Abbott districts, using a literature review, surveys of K-12 schools, and focus groups with central office administrators. The study examined forms of SBM, team operations, local autonomy versus state power, skills required to…

Impact of Change Management on Employee Behavior in a University Administrative Office

ERIC Educational Resources Information Center

Turner, Kendra

2017-01-01

This qualitative case study focused on the effect of a system implementation upgrade on employees' job performance within a central administration department of a major research university in the Southern United States. Review of literature revealed a lack of a specific model or process for system implementation upgrades and its impact on…

The Centrality of the "Mediation" Concept in the Participatory Management of Water Resources

ERIC Educational Resources Information Center

dos Santos, Irenilda Angela; Berlinck, Christian Niel; de Santana Araujo, Symone Christine; Steinke, Ercilia Torres; Steinke, Valdir Adilson; Pianta, Taissa Ferreira; Graebner, Ivete Teresinha; Saito, Carlos Hiroo

2005-01-01

This work presents questions related to the viability and the requirements for the implementation of a National Policy of Water Resources in Brazil, and identifies the means to bring about active participation by the population in the management of water resources. While social inequalities may be an impediment to the implementation of full…

Forging Consensus for Implementing Youth Socialization Policy in Northwest China

ERIC Educational Resources Information Center

Fairbrother, Gregory P.

2011-01-01

The goal of this article is to examine how the provincial education media in China play a role of forging consensus among local actors responsible for the implementation of new centrally-promulgated youth socialization policy. In doing so, it also explores the tension among three of the Chinese state's claims to legitimacy: economic development,…

"We Can't Change Much Unless the Exams Change": Teachers' Dilemmas in the Curriculum Reform in China

ERIC Educational Resources Information Center

Yan, Chunmei

2015-01-01

This article reports on a study of English secondary teachers' perceptions of and implementation of the New English Curriculum Reform in China. Triangulated data collection methods were employed to gather information about teachers' perceptions of the New Curriculum and their teaching behaviours in Central China. An implementation gap emerged…

The Implementation and Preliminary Results of an Action Research Project in the Mahopac Schools.

ERIC Educational Resources Information Center

Cicchelli, Jerry J.; Richards, Edgar L.

This 3-month investigation of changes in teaching and learning behaviors as microcomputers and computer literacy are integrated into the curriculum involved nine primary teachers (Mahopac Central School District, New York) in grades 1 to 3, who had received training in the use of microcomputers and in Logo. Each teacher implemented the same…

RESTful M2M Gateway for Remote Wireless Monitoring for District Central Heating Networks

PubMed Central

Cheng, Bo; Wei, Zesan

2014-01-01

In recent years, the increased interest in energy conservation and environmental protection, combined with the development of modern communication and computer technology, has resulted in the replacement of distributed heating by central heating in urban areas. This paper proposes a Representational State Transfer (REST) Machine-to-Machine (M2M) gateway for wireless remote monitoring for a district central heating network. In particular, we focus on the resource-oriented RESTful M2M gateway architecture, and present an uniform devices abstraction approach based on Open Service Gateway Initiative (OSGi) technology, and implement the resource mapping mechanism between resource address mapping mechanism between RESTful resources and the physical sensor devices, and present the buffer queue combined with polling method to implement the data scheduling and Quality of Service (QoS) guarantee, and also give the RESTful M2M gateway open service Application Programming Interface (API) set. The performance has been measured and analyzed. Finally, the conclusions and future work are presented. PMID:25436650

RESTful M2M gateway for remote wireless monitoring for district central heating networks.

PubMed

Cheng, Bo; Wei, Zesan

2014-11-27

In recent years, the increased interest in energy conservation and environmental protection, combined with the development of modern communication and computer technology, has resulted in the replacement of distributed heating by central heating in urban areas. This paper proposes a Representational State Transfer (REST) Machine-to-Machine (M2M) gateway for wireless remote monitoring for a district central heating network. In particular, we focus on the resource-oriented RESTful M2M gateway architecture, and present an uniform devices abstraction approach based on Open Service Gateway Initiative (OSGi) technology, and implement the resource mapping mechanism between resource address mapping mechanism between RESTful resources and the physical sensor devices, and present the buffer queue combined with polling method to implement the data scheduling and Quality of Service (QoS) guarantee, and also give the RESTful M2M gateway open service Application Programming Interface (API) set. The performance has been measured and analyzed. Finally, the conclusions and future work are presented.

Study of the Tributyl Phosphate--30 Percent Dodecane Solvent; ETUDE DU SOLVANT PHOSPHATE TRIBUTYLIQUE 30 PERCENT--DODECANE (in French)

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

Leroy, P.

1967-07-01

This study, originating mainly from a literature survey, gives the principal chemical and physical features of the tributyl-phosphate (TBP) agent diluted at 30 volumes per cent in dodecane. The mixture is a very commonly used extractant in nuclear fuel processing. In this paper, the main following points are reported: -) the components (TBP and diluents) -) the TBP-diluents systems (non-loaded), -) the TBP-diluents-water systems, -) TBP-diluents-water-nitric acid systems, and -) industrial solvents. (author) [French] Cette etude, d'origine bibliographique, regroupe les caracteristiques physico-chimiques essentielles du phosphate tributylique (TBP) dilue a 30% en volume dans du dodecane. Ce melange constitue un agentmore » d'extraction tres utilise dans le traitement des combustibles nucleaires. Les principaux points traites sont les suivants: -) les constituants (TBP et diluants), -) les systemes TBP-diluants non charges, -) les systemes TBP-diluants-eau, -) les systemes TBP-diluants-eau-acide nitrique, et -) les solvants industriels. (auteur)« less

Response functions of Fuji imaging plates to monoenergetic protons in the energy range 0.6-3.2 MeV

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

Bonnet, T.; Denis-Petit, D.; Gobet, F.

2013-01-15

We have measured the responses of Fuji MS, SR, and TR imaging plates (IPs) to protons with energies ranging from 0.6 to 3.2 MeV. Monoenergetic protons were produced with the 3.5 MV AIFIRA (Applications Interdisciplinaires de Faisceaux d'Ions en Region Aquitaine) accelerator at the Centre d'Etudes Nucleaires de Bordeaux Gradignan (CENBG). The IPs were irradiated with protons backscattered off a tantalum target. We present the photo-stimulated luminescence response of the IPs together with the fading measurements for these IPs. A method is applied to allow correction of fading effects for variable proton irradiation duration. Using the IP fading corrections, amore » model of the IP response function to protons was developed. The model enables extrapolation of the IP response to protons up to proton energies of 10 MeV. Our work is finally compared to previous works conducted on Fuji TR IP response to protons.« less

The Implementation of Managed Entry Agreements in Central and Eastern Europe: Findings and Implications.

PubMed

Ferrario, Alessandra; Arāja, Diāna; Bochenek, Tomasz; Čatić, Tarik; Dankó, Dávid; Dimitrova, Maria; Fürst, Jurij; Greičiūtė-Kuprijanov, Ieva; Hoxha, Iris; Jakupi, Arianit; Laidmäe, Erki; Löblová, Olga; Mardare, Ileana; Markovic-Pekovic, Vanda; Meshkov, Dmitry; Novakovic, Tanja; Petrova, Guenka; Pomorski, Maciej; Tomek, Dominik; Voncina, Luka; Haycox, Alan; Kanavos, Panos; Vella Bonanno, Patricia; Godman, Brian

2017-12-01

Managed entry agreements (MEAs) are a set of instruments to facilitate access to new medicines. This study surveyed the implementation of MEAs in Central and Eastern Europe (CEE) where limited comparative information is currently available. We conducted a survey on the implementation of MEAs in CEE between January and March 2017. Sixteen countries participated in this study. Across five countries with available data on the number of different MEA instruments implemented, the most common MEAs implemented were confidential discounts (n = 495, 73%), followed by paybacks (n = 92, 14%), price-volume agreements (n = 37, 5%), free doses (n = 25, 4%), bundle and other agreements (n = 19, 3%), and payment by result (n = 10, >1%). Across seven countries with data on MEAs by therapeutic group, the highest number of brand names associated with one or more MEA instruments belonged to the Anatomical Therapeutic Chemical (ATC)-L group, antineoplastic and immunomodulating agents (n = 201, 31%). The second most frequent therapeutic group for MEA implementation was ATC-A, alimentary tract and metabolism (n = 87, 13%), followed by medicines for neurological conditions (n = 83, 13%). Experience in implementing MEAs varied substantially across the region and there is considerable scope for greater transparency, sharing experiences and mutual learning. European citizens, authorities and industry should ask themselves whether, within publicly funded health systems, confidential discounts can still be tolerated, particularly when it is not clear which country and party they are really benefiting. Furthermore, if MEAs are to improve access, countries should establish clear objectives for their implementation and a monitoring framework to measure their performance, as well as the burden of implementation.

Accuracy and time requirements of a bar-code inventory system for medical supplies.

PubMed

Hanson, L B; Weinswig, M H; De Muth, J E

1988-02-01

The effects of implementing a bar-code system for issuing medical supplies to nursing units at a university teaching hospital were evaluated. Data on the time required to issue medical supplies to three nursing units at a 480-bed, tertiary-care teaching hospital were collected (1) before the bar-code system was implemented (i.e., when the manual system was in use), (2) one month after implementation, and (3) four months after implementation. At the same times, the accuracy of the central supply perpetual inventory was monitored using 15 selected items. One-way analysis of variance tests were done to determine any significant differences between the bar-code and manual systems. Using the bar-code system took longer than using the manual system because of a significant difference in the time required for order entry into the computer. Multiple-use requirements of the central supply computer system made entering bar-code data a much slower process. There was, however, a significant improvement in the accuracy of the perpetual inventory. Using the bar-code system for issuing medical supplies to the nursing units takes longer than using the manual system. However, the accuracy of the perpetual inventory was significantly improved with the implementation of the bar-code system.

Climate change challenges for central banks and financial regulators

NASA Astrophysics Data System (ADS)

Campiglio, Emanuele; Dafermos, Yannis; Monnin, Pierre; Ryan-Collins, Josh; Schotten, Guido; Tanaka, Misa

2018-06-01

The academic and policy debate regarding the role of central banks and financial regulators in addressing climate-related financial risks has rapidly expanded in recent years. This Perspective presents the key controversies and discusses potential research and policy avenues for the future. Developing a comprehensive analytical framework to assess the potential impact of climate change and the low-carbon transition on financial stability seems to be the first crucial challenge. These enhanced risk measures could then be incorporated in setting financial regulations and implementing the policies of central banks.

Addressing the medicinal chemistry bottleneck: a lean approach to centralized purification.

PubMed

Weller, Harold N; Nirschl, David S; Paulson, James L; Hoffman, Steven L; Bullock, William H

2012-09-10

The use of standardized lean manufacturing principles to improve drug discovery productivity is often thought to be at odds with fostering innovation. This manuscript describes how selective implementation of a lean optimized process, in this case centralized purification for medicinal chemistry, can improve operational productivity and increase scientist time available for innovation. A description of the centralized purification process is provided along with both operational and impact (productivity) metrics, which indicate lower cost, higher output, and presumably more free time for innovation as a result of the process changes described.

Effects of a Cross-Age Peer Tutoring Intervention on English Language Oral Reading Fluency in a Belizean Grade School

ERIC Educational Resources Information Center

Sytsma, Marcia Ruth

2014-01-01

A cross-age peer tutoring program was implemented in a small rural school in west central Belize, Central America. All students at the school were native Spanish speakers, and all general instruction was conducted in English. The program was devised to supplement existing reading and language arts instruction at all grade levels. Progress of both…

Providing for the Needs of New Teachers: A Study of New Teacher Induction in a Rural School District in Central North Carolina

ERIC Educational Resources Information Center

Powell, Lori T.

2016-01-01

This study evaluated the effectiveness of a new teacher induction program as implemented in a rural school district in central North Carolina. All beginning teachers with 3 or less years of experience, all school-based administrators, and all mentoring teachers were the target participants. The purpose of the study was to evaluate the…

Successfully Implementing Net-Zero Energy Policy through the Air Force Military Construction Program

DTIC Science & Technology

2013-03-01

Meets Does not meet Does not meet Meets Renewable Farms Meets Meets Meets Meets On-Site (Distributed Generation) Meets* Meets* Meets Meets...independence, nor does it allow for net-zero energy installations. Developing centralized renewable energy farms is another method for obtaining...combination of centralized renewable energy farms and distributed generation methods. The specific combination of methods an installation will utilize

Evaluating Implementations of Service Oriented Architecture for Sensor Network via Simulation

DTIC Science & Technology

2011-04-01

Subject: COMPUTER SCIENCE Approved: Boleslaw Szymanski , Thesis Adviser Rensselaer Polytechnic Institute Troy, New York April 2011 (For Graduation May 2011...simulation supports distributed and centralized composition with a type hierarchy and multiple -service statically-located nodes in a 2-dimensional space...distributed and centralized composition with a type hierarchy and multiple -service statically-located nodes in a 2-dimensional space. The second simulation

Development and implementation of a monitoring and information system to increase water use efficiency in arid and semi-arid areas in Limarí, Central Chile (WEIN)

NASA Astrophysics Data System (ADS)

Berger, Erich; Balmert, David; Richter, Jürgen

2016-10-01

The project WEIN was funded by the Federal Ministry of Education and Research (BMBF | Berlin, Germany) in the framework of the high-tech strategy of Germany's program "KMU-Innovativ". The project started in 2012 and was completed in 2014. In the scope of the project, an integrated system for analysis, monitoring and information at river basin level was developed, which provides relevant information for all stakeholders that are concerned with water resource issues. The main objective of the project was to improve water use efficiency and hence ensure the agricultural production in the region. The pilot region, in which this system was implemented, is the semi-arid Limarí basin in Northern Central Chile. One of the main parts of the project was the development and implementation of a web- and app-based irrigation water ordering and accounting system for local farmers.

Pharmacy-based distribution system for enteral nutrition products.

PubMed

Craig, S A; Paulson, M F

1985-12-01

A hospital pharmacy department's implementation of enteral nutrition product distribution and its proposal for an enteral nutrition product admixture service are described. Responsibility for the distribution of enteral nutrition formulations was transferred from the central distribution department to the pharmacy after problems with inventory control, billing procedures, and inappropriate administration of enteral nutrition products were recognized by personnel from the central-distribution area and nutrition services. After additional problems were identified using a multi-disciplinary approach, the pharmacy department implemented an enteral nutrition product distribution system and developed an enteral nutrition product formulary. A proposal was developed for a pharmacy-based enteral nutrition admixture service, but implementation of this service was deferred because data from a cost-effectiveness evaluation and random bacteriologic monitoring did not justify adding the service. Pharmacy-based distribution and formulary control of enteral nutrition products alleviated problems with inaccurate patient charges and accumulation of stock on the nursing units. Pharmacists at this hospital hope to develop an enteral nutrition product admixture program that will result in cost savings for the institution.

An Analysis of Costs and Health Co-Benefits for a U.S. Power Plant Carbon Standard

PubMed Central

Buonocore, Jonathan J.; Lambert, Kathleen F.; Burtraw, Dallas; Sekar, Samantha; Driscoll, Charles T.

2016-01-01

Reducing carbon dioxide (CO2) emissions from power plants can have important “co-benefits” for public health by reducing emissions of air pollutants. Here, we examine the costs and health co-benefits, in monetary terms, for a policy that resembles the U.S. Environmental Protection Agency’s Clean Power Plan. We then examine the spatial distribution of the co-benefits and costs, and the implications of a range of cost assumptions in the implementation year of 2020. Nationwide, the total health co-benefits were $29 billion 2010 USD (95% CI: $2.3 to $68 billion), and net co-benefits under our central cost case were $12 billion (95% CI: -$15 billion to $51 billion). Net co-benefits for this case in the implementation year were positive in 10 of the 14 regions studied. The results for our central case suggest that all but one region should experience positive net benefits within 5 years after implementation. PMID:27270222

An Analysis of Costs and Health Co-Benefits for a U.S. Power Plant Carbon Standard.

PubMed

Buonocore, Jonathan J; Lambert, Kathleen F; Burtraw, Dallas; Sekar, Samantha; Driscoll, Charles T

2016-01-01

Reducing carbon dioxide (CO2) emissions from power plants can have important "co-benefits" for public health by reducing emissions of air pollutants. Here, we examine the costs and health co-benefits, in monetary terms, for a policy that resembles the U.S. Environmental Protection Agency's Clean Power Plan. We then examine the spatial distribution of the co-benefits and costs, and the implications of a range of cost assumptions in the implementation year of 2020. Nationwide, the total health co-benefits were $29 billion 2010 USD (95% CI: $2.3 to $68 billion), and net co-benefits under our central cost case were $12 billion (95% CI: -$15 billion to $51 billion). Net co-benefits for this case in the implementation year were positive in 10 of the 14 regions studied. The results for our central case suggest that all but one region should experience positive net benefits within 5 years after implementation.

Evaluation of Rural Primary Health Care in Western China: A Cross-Sectional Study

PubMed Central

Wang, Manli; Fang, Haiqing; Bishwajit, Ghose; Xiang, Yuanxi; Fu, Hang; Feng, Zhanchun

2015-01-01

Purpose: China’s Ministry of Health has enacted Rural Primary Health Care Program (2001–2010) (HCP) guidelines to improve the quality of people’s health. However, the program’s success in Western China remains unevaluated. Thus, this study aims to begin to fill that gap by analyzing the provision and utilization of Rural Primary Health Care (RPHC) in Western China. Methods: A cross-sectional study was conducted to collect secondary data on the socio-economic characteristics, system construction, services use and implementation of RPHC, and the residents’ health status of the sampled areas. Four hundred counties from 31 provinces in China were selected via stratified random sampling, including 171 counties from 12 Western provinces. Twenty-seven analysis indicators, covering system construction, services use and implementation of RPHC were chosen to assess Western China’s primary health quality. Analysis of Variance (ANOVA) and Least Significant Difference (LSD) methods were used to measure the RPHC disparities between Western and Eastern and Central China. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank Western, Eastern and Central internal provinces regarding quality of their RPHC. Results: Of the 27 indicators, 13 (48.15%) were below the standard in Western China. These focused on rural health service system construction, Chinese medicine services, and public health. In the comparison between Western, Central and Eastern China, 12 indicators had statistical significance (p < 0.05), and using LSD to compare between Western and Eastern China, all indicators were statistically significant (p < 0.05), demonstrating regional disparities. Xinjiang Province’s RPHC ranked highest overall, and Yunnan Province ranked the lowest, indicating the internal differences within the 12 Western provinces; and Western provinces’ Ci value was lower than that of Eastern and Central China overall. Conclusion: Western China’s RPHC has proceeded well, but remains weaker than that of Eastern and Central China. Differences within Western internal provinces threaten the successful implementation of RPHC.  PMID:26528993

Evaluation of Rural Primary Health Care in Western China: A Cross-Sectional Study.

PubMed

Wang, Manli; Fang, Haiqing; Bishwajit, Ghose; Xiang, Yuanxi; Fu, Hang; Feng, Zhanchun

2015-10-29

China's Ministry of Health has enacted Rural Primary Health Care Program (2001-2010) (HCP) guidelines to improve the quality of people's health. However, the program's success in Western China remains unevaluated. Thus, this study aims to begin to fill that gap by analyzing the provision and utilization of Rural Primary Health Care (RPHC) in Western China. A cross-sectional study was conducted to collect secondary data on the socio-economic characteristics, system construction, services use and implementation of RPHC, and the residents' health status of the sampled areas. Four hundred counties from 31 provinces in China were selected via stratified random sampling, including 171 counties from 12 Western provinces. Twenty-seven analysis indicators, covering system construction, services use and implementation of RPHC were chosen to assess Western China's primary health quality. Analysis of Variance (ANOVA) and Least Significant Difference (LSD) methods were used to measure the RPHC disparities between Western and Eastern and Central China. Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used to rank Western, Eastern and Central internal provinces regarding quality of their RPHC. Of the 27 indicators, 13 (48.15%) were below the standard in Western China. These focused on rural health service system construction, Chinese medicine services, and public health. In the comparison between Western, Central and Eastern China, 12 indicators had statistical significance (p < 0.05), and using LSD to compare between Western and Eastern China, all indicators were statistically significant (p < 0.05), demonstrating regional disparities. Xinjiang Province's RPHC ranked highest overall, and Yunnan Province ranked the lowest, indicating the internal differences within the 12 Western provinces; and Western provinces' Ci value was lower than that of Eastern and Central China overall. Western China's RPHC has proceeded well, but remains weaker than that of Eastern and Central China. Differences within Western internal provinces threaten the successful implementation of RPHC.

Dynamic Training Elements in a Circuit Theory Course to Implement a Self-Directed Learning Process

ERIC Educational Resources Information Center

Krouk, B. I.; Zhuravleva, O. B.

2009-01-01

This paper reports on the implementation of a self-directed learning process in a circuit theory course, incorporating dynamic training elements which were designed on the basis of a cybernetic model of cognitive process management. These elements are centrally linked in a dynamic learning frame, created on the monitor screen, which displays the…

Operationalizing Social Work Science through Research-Practice Partnerships: Lessons from Implementation Science

ERIC Educational Resources Information Center

Palinkas, Lawrence A.; He, Amy S.; Choy-Brown, Mimi; Hertel, Amy Locklear

2017-01-01

Recent efforts to identify and promote a distinct science for the discipline of social work have led to an ongoing debate regarding the nature and function of such a science. Central to this debate is a lack of consensus as to how to operationalize a social work science. Drawing from the field of implementation science and its application in…

The Implementation of Project Citizen in Bolivian Schools: Perspectives from Three Teacher Educators

ERIC Educational Resources Information Center

Medina-Jerez, William; Taylor, Carolyn; Bryant, Carol

2009-01-01

The central aim of the present paper is to examine, from the Social Studies, Modern Languages, and Science Education perspectives, the role of the Project Citizen initiative in school communities of Bolivia. To that end, Project Citizen in Bolivia, during its first three years of implementation will be discussed, followed by views from each field…

The Cure for Ailing Self-Service Business Intelligence

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

Burke, Marsha; Simpson, Wayne; Staples, Shad

There are many reasons that self-service models fail. Furthermore, these reasons are directly applicable in the management of self-service business inteligence modeling. Our article expands upon the reasons for failure and suggests how self-service models can be made successful through implementation of a centralized approach to development, testing, implementation and support for the delivery of decision making information.

The Cure for Ailing Self-Service Business Intelligence

DOE PAGES

Burke, Marsha; Simpson, Wayne; Staples, Shad

2016-09-14

There are many reasons that self-service models fail. Furthermore, these reasons are directly applicable in the management of self-service business inteligence modeling. Our article expands upon the reasons for failure and suggests how self-service models can be made successful through implementation of a centralized approach to development, testing, implementation and support for the delivery of decision making information.

Leading Change for the Implementation of Common Core State Standards in Rural School Districts

ERIC Educational Resources Information Center

Lopez, Paul; Wise, Donald

2015-01-01

Rural school districts across the nation, with their limited resources, face daunting challenges posed by the implementation of the Common Core State Standards. This article presents a recent study of 13 rural school districts in the Central Valley of California and how these districts are responding to those challenges. A total of 352 teachers…

Framework for Flexible Security in Group Communications

NASA Technical Reports Server (NTRS)

McDaniel, Patrick; Prakash, Atul

2006-01-01

The Antigone software system defines a framework for the flexible definition and implementation of security policies in group communication systems. Antigone does not dictate the available security policies, but provides high-level mechanisms for implementing them. A central element of the Antigone architecture is a suite of such mechanisms comprising micro-protocols that provide the basic services needed by secure groups.

HTA Implementation Roadmap in Central and Eastern European Countries

PubMed Central

Gheorghe, Adrian; Huic, Mirjana; Csanádi, Marcell; Kristensen, Finn Boerlum

2016-01-01

Abstract The opportunity cost of inappropriate health policy decisions is greater in Central and Eastern European (CEE) compared with Western European (WE) countries because of poorer population health and more limited healthcare resources. Application of health technology assessment (HTA) prior to healthcare financing decisions can improve the allocative efficiency of scarce resources. However, few CEE countries have a clear roadmap for HTA implementation. Examples from high‐income countries may not be directly relevant, as CEE countries cannot allocate so much financial and human resources for substantiating policy decisions with evidence. Our objective was to describe the main HTA implementation scenarios in CEE countries and summarize the most important questions related to capacity building, financing HTA research, process and organizational structure for HTA, standardization of HTA methodology, use of local data, scope of mandatory HTA, decision criteria, and international collaboration in HTA. Although HTA implementation strategies from the region can be relevant examples for other CEE countries with similar cultural environment and economic status, HTA roadmaps are not still fully transferable without taking into account country‐specific aspects, such as country size, gross domestic product per capita, major social values, public health priorities, and fragmentation of healthcare financing. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26763688

Are NHS foundation trusts able and willing to exercise autonomy? 'You can take a horse to water...'.

PubMed

Exworthy, Mark; Frosini, Francesca; Jones, Lorelei

2011-10-01

Foundation trusts (FTs) have been a central part of the government's National Health Service (NHS) reforms in England since 2004. They illustrate the government's claim to decentralization, by granting greater autonomy to high performing organizations. The number of FTs has grown steadily, reaching 131 in September 2010, over 50% of eligible trusts. Despite this growth, and notwithstanding the fact that organizations which initially became FTs were previously high performing, doubts remain about the implementation of the FT policy. This article examines the implementation of FTs in the NHS and focuses on the nature and exercise of autonomy by FTs. It argues that the ability of FTs to exercise autonomy is in place, but the (relatively limited) extent of implementation may be explained by trusts' lack of willingness to exercise such autonomy. Such unwillingness may be because of continued centralization, unclear policy and financial regimes, fear of negative impacts on relations with other local organizations, and awareness of greater risk to the FT, among others. Addressing the tension between FTs' ability and willingness to exercise autonomy will largely explain the extent to which the government's provider side reforms will be implemented.

Implementation of a Goal-Based Systems Engineering Process Using the Systems Modeling Language (SysML)

NASA Technical Reports Server (NTRS)

Patterson, Jonathan D.; Breckenridge, Jonathan T.; Johnson, Stephen B.

2013-01-01

Building upon the purpose, theoretical approach, and use of a Goal-Function Tree (GFT) being presented by Dr. Stephen B. Johnson, described in a related Infotech 2013 ISHM abstract titled "Goal-Function Tree Modeling for Systems Engineering and Fault Management", this paper will describe the core framework used to implement the GFTbased systems engineering process using the Systems Modeling Language (SysML). These two papers are ideally accepted and presented together in the same Infotech session. Statement of problem: SysML, as a tool, is currently not capable of implementing the theoretical approach described within the "Goal-Function Tree Modeling for Systems Engineering and Fault Management" paper cited above. More generally, SysML's current capabilities to model functional decompositions in the rigorous manner required in the GFT approach are limited. The GFT is a new Model-Based Systems Engineering (MBSE) approach to the development of goals and requirements, functions, and its linkage to design. As a growing standard for systems engineering, it is important to develop methods to implement GFT in SysML. Proposed Method of Solution: Many of the central concepts of the SysML language are needed to implement a GFT for large complex systems. In the implementation of those central concepts, the following will be described in detail: changes to the nominal SysML process, model view definitions and examples, diagram definitions and examples, and detailed SysML construct and stereotype definitions.

One Rural Hospital's Experience Implementing the Society for Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.

PubMed

Curlej, Maria H; Katrancha, Elizabeth

2016-01-01

In an effort to take advantage of the Highmark Quality Blue Initiative () requiring information from hospitals detailing their central line-associated blood stream infections (CLABSIs) surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Recognizing the baseline rate of 2.4 CLABSIs per 1,000 central line days and its effect on patient outcomes and medical costs, this hospital made a commitment to improve their CLABSI outcomes. As a result, the facility adopted the Society for Healthcare Epidemiology of America (SHEA) guidelines. The purpose of this article is to review the CLABSI rates and examine the prevention strategies following implementation of the SHEA guidelines. A quantitative, descriptive retrospective program evaluation examined the hospital's pre- and post-SHEA implementation methods of decreasing CLABSIs and the subsequent CLABSI rates over 3 time periods. Any patient with a CLABSI infection admitted to this hospital July 2007 to June 2010 (N = 78). CLABSI rates decreased from 1.9 to 1.3 over the study period. Compliance with specific SHEA guidelines was evaluated and measures were put into place to increase compliance where necessary. CLABSI rates at this facility remain below the baseline of 2.4 for calendar year 2013 (0.79), 2014 (0.07), and 2015 (0.33).

An evaluation of the Australian Football League Central Australian Responsible Alcohol Strategy 2005-07.

PubMed

Mentha, Ricky; Wakerman, Johne

2009-12-01

In 2004, the Australian Football League Central Australia (AFLCA) implemented the Responsible Alcohol Strategy (RAS), which aimed to decrease alcohol consumption at matches, and to promote healthy lifestyle messages to the youth of Central Australia participating in Australian Rules football. The evaluation adopted a pre- and post-implementation design to monitor a number of performance indicators. The evaluation analysed routinely collected data from AFLCA, its Security Company, Alice Springs Police Department and Alice Springs Hospital; we surveyed AFLCA staff, club officials and umpires; and undertook direct observation at AFLCA events. The volume of alcohol sold at matches decreased. Survey data indicate decreased alcohol related violence, improved spectator behaviour and decreased spectator attendances. Police data suggest declining alcohol-related and violent behaviours, but trends were not statistically significant. Alice Springs Hospital injury admission data indicate a non-significant interaction between year and season effect. In a community context of high alcohol consumption and high rates of interpersonal violence, the strategies implemented were successful in decreasing alcohol consumption and related undesirable behaviours at football games. However, these measures have resulted in unintended consequences: decreased numbers of spectators attending games, decreased canteen sales and falling sponsorship. The decreased revenue has raised serious issues about sustainability of the alcohol intervention, and stimulated discussions with government and others about strategies to maintain this important alcohol reduction policy.

Effect of a centralized prescription network on inappropriate prescriptions for opioid analgesics and benzodiazepines

PubMed Central

Dormuth, Colin R.; Miller, Tarita A.; Huang, Anjie; Mamdani, Muhammad M.; Juurlink, David N.

2012-01-01

Background: Opioid analgesics and benzodiazepines are often misused in clinical practice. We determined whether implementation of a centralized prescription network offering real-time access to patient-level data on filled prescriptions (PharmaNet) reduced the number of potentially inappropriate prescriptions for opioids and benzodiazepines. Methods: We conducted a time series analysis using prescription records between Jan. 1, 1993, and Dec. 31, 1997, for residents of the province of British Columbia who were receiving social assistance or were 65 years or older. We calculated monthly percentages of filled prescriptions for an opioid or a benzodiazepine that were deemed inappropriate (those issued by a different physician and dispensed at a different pharmacy within 7 days after a filled prescription of at least 30 tablets of the same drug). Results: Within 6 months after implementation of PharmaNet in July 1995, we observed a relative reduction in inappropriate filled prescriptions for opioids of 32.8% (95% confidence interval [CI] 31.0%–34.7%) among patients receiving social assistance; inappropriate filled prescriptions for benzodiazepines decreased by 48.6% (95% CI 43.2%–53.1%). Similar and statistically significant reductions were observed among residents 65 years or older. Interpretation: The implementation of a centralized prescription network was associated with a dramatic reduction in inappropriate filled prescriptions for opioids and benzodiazepines. PMID:22949563

Modeling the vestibulo-ocular reflex of the squirrel monkey during eccentric rotation and roll tilt

NASA Technical Reports Server (NTRS)

Merfeld, D. M.; Paloski, W. H. (Principal Investigator)

1995-01-01

Model simulations of the squirrel monkey vestibulo-ocular reflex (VOR) are presented for two motion paradigms: constant velocity eccentric rotation and roll tilt about a naso-occipital axis. The model represents the implementation of three hypotheses: the "internal model" hypothesis, the "gravito-inertial force (GIF) resolution" hypothesis, and the "compensatory VOR" hypothesis. The internal model hypothesis is based on the idea that the nervous system knows the dynamics of the sensory systems and implements this knowledge as an internal dynamic model. The GIF resolution hypothesis is based on the idea that the nervous system knows that gravity minus linear acceleration equals GIF and implements this knowledge by resolving the otolith measurement of GIF into central estimates of gravity and linear acceleration, such that the central estimate of gravity minus the central estimate of acceleration equals the otolith measurement of GIF. The compensatory VOR hypothesis is based on the idea that the VOR compensates for the central estimates of angular velocity and linear velocity, which sum in a near-linear manner. During constant velocity eccentric rotation, the model correctly predicts that: (1) the peak horizontal response is greater while "facing-motion" than with "back-to-motion"; (2) the axis of eye rotation shifts toward alignment with GIF; and (3) a continuous vertical response, slow phase downward, exists prior to deceleration. The model also correctly predicts that a torsional response during the roll rotation is the only velocity response observed during roll rotations about a naso-occipital axis. The success of this model in predicting the observed experimental responses suggests that the model captures the essence of the complex sensory interactions engendered by eccentric rotation and roll tilt.

The School of Public Safety at Valencia College: Visioning and Implementation of a College-Wide Distributive and Collaborative Program Model for the Central Florida Community

ERIC Educational Resources Information Center

Goltz, Jeffrey W.

2016-01-01

The central Florida region, faced with record tourism, a large service population, and significant population growth over the next few decades, must rely on a community-based institution of higher education with lifelong learning offerings, a local community college, to create world class public safety education and training for the region.…

Socio-political implications of the fight against alcoholism and tuberculosis in Colombia, 1910-1925.

PubMed

Jalil-Paier, Hanni; Donado, Guillermo

2010-06-01

The emergence of a modern state in Colombia and the centralization of political and administrative power in Bogotá began to take shape during the latter decades of the nineteenth century. The state had a central role within the overarching modernisation discourse that sought to create a common national identity. One of the tasks assigned to the state by the national project was that of implementing policy for regulating public health and strengthening social control institutions. Such objectives should be analyzed as part of larger political centralization processes and the desire to create "ideal" citizens. Public health and sanitary campaigns implemented by government officials during this period targeted vice, immorality, illness and ignorance under the umbrella of social reform programmes. Government officials, hygienists and medical doctors continually placed emphasis on eradicating or regulating alcoholism and tuberculosis from 1910 to 1925, with the hopes of avoiding a national crisis. This paper examines how alcoholism and tuberculosis became central themes in the fears expressed by Colombia's ruling class at the time regarding the broader social decay of the nation. As intellectuals and public officials sought solutions to these ills, their explanations alluded to the disintegration of morality and values and the degenerative effects of vice, addiction and unsanitary conditions.

Using Practice-Based Evidence to Improve Supportive Care Practices to Reduce Central Line-Associated Bloodstream Infections in a Pediatric Oncology Unit [Formula: see text].

PubMed

Linder, Lauri A; Gerdy, Cheryl; Abouzelof, Rouett; Wilson, Andrew

Children with cancer are a subset of patients with central lines with distinct risk factors for infection including periods of prolonged neutropenia and compromised mucous membrane integrity. This article relates the implementation of principles of practice-based evidence to identify interventions in addition to best practice maintenance care bundles to reduce central line-associated bloodstream infections involving viridans group streptococci and coagulase-negative staphylococci on an inpatient pediatric oncology unit. Review of individual events combined with review of current clinical practice guided the development of structured protocols emphasizing routine oral care and general supportive cares. Key principles of the protocols emphasized a 1-2-3 mnemonic and included daily bathing, twice daily oral care, and out-of-bed activity 3 times daily. Poisson regression identified a significant main effect for time period for central line-associated bloodstream infection rates involving both viridans group streptococci and coagulase-negative staphylococci. Significant differences were present between the preintervention baseline and implementation of the supportive care protocols. Project outcomes demonstrate the added value of using principles of practice-based evidence to guide the development of interventions to improve clinical care when evidence-based sources are limited.

Capillary toroid cavity detector for high pressure NMR

DOEpatents

Gerald, II, Rex E.; Chen, Michael J.; Klingler, Robert J.; Rathke, Jerome W.; ter Horst, Marc

2007-09-11

A Toroid Cavity Detector (TCD) is provided for implementing nuclear magnetic resonance (NMR) studies of chemical reactions under conditions of high pressures and temperatures. A toroid cavity contains an elongated central conductor extending within the toroid cavity. The toroid cavity and central conductor generate an RF magnetic field for NMR analysis. A flow-through capillary sample container is located within the toroid cavity adjacent to the central conductor to subject a sample material flowing through the capillary to a static magnetic field and to enable NMR spectra to be recorded of the material in the capillary under a temperature and high pressure environment.

Significant reduction of central line-associated bloodstream infection rates in a tertiary neonatal unit.

PubMed

Rallis, Dimitrios; Karagianni, Paraskevi; Papakotoula, Ifigeneia; Nikolaidis, Nikolaos; Tsakalidis, Christos

2016-04-01

To evaluate the effectiveness of a quality initiative in reducing central line-associated bloodstream infections (CLABSIs) in our neonatal intensive care unit, we designed a prospective study (January 2012-September 2013) estimating CLABSI incidence before and after our implementation. CLABSI rates were significantly decreased after our intervention, from 12 cases per 1,000 central vascular catheter (CVC) days during the preinterventional period to 3.4 cases per 1,000 CVC days during the postinterventional period (P = .004). Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Automated Power Systems Management (APSM)

NASA Technical Reports Server (NTRS)

Bridgeforth, A. O.

1981-01-01

A breadboard power system incorporating autonomous functions of monitoring, fault detection and recovery, command and control was developed, tested and evaluated to demonstrate technology feasibility. Autonomous functions including switching of redundant power processing elements, individual load fault removal, and battery charge/discharge control were implemented by means of a distributed microcomputer system within the power subsystem. Three local microcomputers provide the monitoring, control and command function interfaces between the central power subsystem microcomputer and the power sources, power processing and power distribution elements. The central microcomputer is the interface between the local microcomputers and the spacecraft central computer or ground test equipment.

An updated protocol for a systematic review of implementation-related measures.

PubMed

Lewis, Cara C; Mettert, Kayne D; Dorsey, Caitlin N; Martinez, Ruben G; Weiner, Bryan J; Nolen, Elspeth; Stanick, Cameo; Halko, Heather; Powell, Byron J

2018-04-25

Implementation science is the study of strategies used to integrate evidence-based practices into real-world settings (Eccles and Mittman, Implement Sci. 1(1):1, 2006). Central to the identification of replicable, feasible, and effective implementation strategies is the ability to assess the impact of contextual constructs and intervention characteristics that may influence implementation, but several measurement issues make this work quite difficult. For instance, it is unclear which constructs have no measures and which measures have any evidence of psychometric properties like reliability and validity. As part of a larger set of studies to advance implementation science measurement (Lewis et al., Implement Sci. 10:102, 2015), we will complete systematic reviews of measures that map onto the Consolidated Framework for Implementation Research (Damschroder et al., Implement Sci. 4:50, 2009) and the Implementation Outcomes Framework (Proctor et al., Adm Policy Ment Health. 38(2):65-76, 2011), the protocol for which is described in this manuscript. Our primary databases will be PubMed and Embase. Our search strings will be comprised of five levels: (1) the outcome or construct term; (2) terms for measure; (3) terms for evidence-based practice; (4) terms for implementation; and (5) terms for mental health. Two trained research specialists will independently review all titles and abstracts followed by full-text review for inclusion. The research specialists will then conduct measure-forward searches using the "cited by" function to identify all published empirical studies using each measure. The measure and associated publications will be compiled in a packet for data extraction. Data relevant to our Psychometric and Pragmatic Evidence Rating Scale (PAPERS) will be independently extracted and then rated using a worst score counts methodology reflecting "poor" to "excellent" evidence. We will build a centralized, accessible, searchable repository through which researchers, practitioners, and other stakeholders can identify psychometrically and pragmatically strong measures of implementation contexts, processes, and outcomes. By facilitating the employment of psychometrically and pragmatically strong measures identified through this systematic review, the repository would enhance the cumulativeness, reproducibility, and applicability of research findings in the rapidly growing field of implementation science.

A decentralized software bus based on IP multicas ting

NASA Technical Reports Server (NTRS)

Callahan, John R.; Montgomery, Todd

1995-01-01

We describe decentralized reconfigurable implementation of a conference management system based on the low-level Internet Protocol (IP) multicasting protocol. IP multicasting allows low-cost, world-wide, two-way transmission of data between large numbers of conferencing participants through the Multicasting Backbone (MBone). Each conference is structured as a software bus -- a messaging system that provides a run-time interconnection model that acts as a separate agent (i.e., the bus) for routing, queuing, and delivering messages between distributed programs. Unlike the client-server interconnection model, the software bus model provides a level of indirection that enhances the flexibility and reconfigurability of a distributed system. Current software bus implementations like POLYLITH, however, rely on a centralized bus process and point-to-point protocols (i.e., TCP/IP) to route, queue, and deliver messages. We implement a software bus called the MULTIBUS that relies on a separate process only for routing and uses a reliable IP multicasting protocol for delivery of messages. The use of multicasting means that interconnections are independent of IP machine addresses. This approach allows reconfiguration of bus participants during system execution without notifying other participants of new IP addresses. The use of IP multicasting also permits an economy of scale in the number of participants. We describe the MULITIBUS protocol elements and show how our implementation performs better than centralized bus implementations.

Implementation of Tuberculosis Intensive Case Finding, Isoniazid Preventive Therapy, and Infection Control ("Three I's") and HIV-Tuberculosis Service Integration in Lower Income Countries.

PubMed

Charles, M Katherine; Lindegren, Mary Lou; Wester, C William; Blevins, Meridith; Sterling, Timothy R; Dung, Nguyen Thi; Dusingize, Jean Claude; Avit-Edi, Divine; Durier, Nicolas; Castelnuovo, Barbara; Nakigozi, Gertrude; Cortes, Claudia P; Ballif, Marie; Fenner, Lukas

2016-01-01

World Health Organization advocates for integration of HIV-tuberculosis (TB) services and recommends intensive case finding (ICF), isoniazid preventive therapy (IPT), and infection control ("Three I's") for TB prevention and control among persons living with HIV. To assess the implementation of the "Three I's" of TB-control at HIV treatment sites in lower income countries. Survey conducted between March-July, 2012 at 47 sites in 26 countries: 6 (13%) Asia Pacific, 7 (15%), Caribbean, Central and South America, 5 (10%) Central Africa, 8 (17%) East Africa, 14 (30%) Southern Africa, and 7 (15%) West Africa. ICF using symptom-based screening was performed at 38% of sites; 45% of sites used symptom-screening plus additional diagnostics. IPT at enrollment or ART initiation was implemented in only 17% of sites, with 9% of sites providing IPT to tuberculin-skin-test positive patients. Infection control measures varied: 62% of sites separated smear-positive patients, and healthcare workers used masks at 57% of sites. Only 12 (26%) sites integrated HIV-TB services. Integration was not associated with implementation of TB prevention measures except for IPT provision at enrollment (42% integrated vs. 9% non-integrated; p = 0.03). Implementation of TB screening, IPT provision, and infection control measures was low and variable across regional HIV treatment sites, regardless of integration status.

Lessons for major system change: centralization of stroke services in two metropolitan areas of England

PubMed Central

Ramsay, Angus; Perry, Catherine; Boaden, Ruth; McKevitt, Christopher; Morris, Stephen; Pursani, Nanik; Rudd, Anthony; Tyrrell, Pippa; Wolfe, Charles; Fulop, Naomi

2016-01-01

Objectives Our aim was to identify the factors influencing the selection of a model of acute stroke service centralization to create fewer high-volume specialist units in two metropolitan areas of England (London and Greater Manchester). It considers the reasons why services were more fully centralized in London than in Greater Manchester. Methods In both areas, we analysed 316 documents and conducted 45 interviews with people leading transformation, service user organizations, providers and commissioners. Inductive and deductive analyses were used to compare the processes underpinning change in each area, with reference to propositions for achieving major system change taken from a realist review of the existing literature (the Best framework), which we critique and develop further. Results In London, system leadership was used to overcome resistance to centralization and align stakeholders to implement a centralized service model. In Greater Manchester, programme leaders relied on achieving change by consensus and, lacking decision-making authority over providers, accommodated rather than challenged resistance by implementing a less radical transformation of services. Conclusions A combination of system (top-down) and distributed (bottom-up) leadership is important in enabling change. System leadership provides the political authority required to coordinate stakeholders and to capitalize on clinical leadership by aligning it with transformation goals. Policy makers should examine how the structures of system authority, with performance management and financial levers, can be employed to coordinate transformation by aligning the disparate interests of providers and commissioners. PMID:26811375

Lessons for major system change: centralization of stroke services in two metropolitan areas of England.

PubMed

Turner, Simon; Ramsay, Angus; Perry, Catherine; Boaden, Ruth; McKevitt, Christopher; Morris, Stephen; Pursani, Nanik; Rudd, Anthony; Tyrrell, Pippa; Wolfe, Charles; Fulop, Naomi

2016-07-01

Our aim was to identify the factors influencing the selection of a model of acute stroke service centralization to create fewer high-volume specialist units in two metropolitan areas of England (London and Greater Manchester). It considers the reasons why services were more fully centralized in London than in Greater Manchester. In both areas, we analysed 316 documents and conducted 45 interviews with people leading transformation, service user organizations, providers and commissioners. Inductive and deductive analyses were used to compare the processes underpinning change in each area, with reference to propositions for achieving major system change taken from a realist review of the existing literature (the Best framework), which we critique and develop further. In London, system leadership was used to overcome resistance to centralization and align stakeholders to implement a centralized service model. In Greater Manchester, programme leaders relied on achieving change by consensus and, lacking decision-making authority over providers, accommodated rather than challenged resistance by implementing a less radical transformation of services. A combination of system (top-down) and distributed (bottom-up) leadership is important in enabling change. System leadership provides the political authority required to coordinate stakeholders and to capitalize on clinical leadership by aligning it with transformation goals. Policy makers should examine how the structures of system authority, with performance management and financial levers, can be employed to coordinate transformation by aligning the disparate interests of providers and commissioners. © The Author(s) 2016.

Learning to manage a complex ecosystem: adaptive management and the Northwest Forest Plan.

Treesearch

George H. Stankey; Roger N. Clark; Bernard T. Bormann

2006-01-01

The Northwest Forest Plan (the Plan) identifies adaptive management as a central strategy for effective implementation. Despite this, there has been a lack of any systematic evaluation of its performance. This study is based on an extensive literature review, 50 interviews with resource managers and scientists involved with the Plan’s implementation, and a survey of...

Quality Assurance of Teachers in the Implementation of the Curriculum of Technical and Vocational Education in Colleges of Education (Technical) in North Cental Nigeria

ERIC Educational Resources Information Center

Attaochu, Egbita Ugbalu

2013-01-01

This study was carried out to ascertain the quality assurance of teachers (lecturers) in the implementation of the curriculum of Technical and Vocational Education (TVE) in Colleges of Education (Technical) in North Central Nigeria. Two research questions were formulated and answered in this study. Survey research and evaluation designs were…

Implementing the System for Health in the US Army Reserves Through the Performance Triad

DTIC Science & Technology

2014-02-13

Training Brigade in San Antonio, Texas. iv Abstract Strategic parameters such as reducing the portion of the Department of Defense...ready and resilient Soldiers. RAND Corporation and the World Health Organization provide insight through the successful implementation of workplace ...centralized resources found on active duty military bases may reduce Triad effectiveness 3 in its current design. The USAR must mitigate these

Teachers' Implementation of the Coaching Role: Do Teachers' Ownership, Sensemaking, and Agency Make a Difference?

ERIC Educational Resources Information Center

Ketelaar, Evelien; Beijaard, Douwe; Brok, Perry J.; Boshuizen, Henny P.

2013-01-01

The aim of this study was to explore whether teachers' positioning towards an innovation is related to their implementation of it. Positioning was reflected in terms of teachers' ownership, sensemaking, and agency. The innovation that was of central focus in this study pertained to the changing role of teachers towards a more coaching…

Improving Prediction Accuracy of “Central Line-Associated Blood Stream Infections” Using Data Mining Models

PubMed Central

Noaman, Amin Y.; Jamjoom, Arwa; Al-Abdullah, Nabeela; Nasir, Mahreen; Ali, Anser G.

2017-01-01

Prediction of nosocomial infections among patients is an important part of clinical surveillance programs to enable the related personnel to take preventive actions in advance. Designing a clinical surveillance program with capability of predicting nosocomial infections is a challenging task due to several reasons, including high dimensionality of medical data, heterogenous data representation, and special knowledge required to extract patterns for prediction. In this paper, we present details of six data mining methods implemented using cross industry standard process for data mining to predict central line-associated blood stream infections. For our study, we selected datasets of healthcare-associated infections from US National Healthcare Safety Network and consumer survey data from Hospital Consumer Assessment of Healthcare Providers and Systems. Our experiments show that central line-associated blood stream infections (CLABSIs) can be successfully predicted using AdaBoost method with an accuracy up to 89.7%. This will help in implementing effective clinical surveillance programs for infection control, as well as improving the accuracy detection of CLABSIs. Also, this reduces patients' hospital stay cost and maintains patients' safety. PMID:29085836

The Ontario Cancer Research Ethics Board: a central REB that works

PubMed Central

Chaddah, M.R.

2008-01-01

The Ontario Cancer Research Ethics Board (ocreb) has made its mark within Ontario as a successful, centralized, oncology-specific research ethics board. As such, ocreb has proven invaluable to principal investigators, sponsors, and study participants given its ability to reduce duplication during the submission process, to provide the highest quality of review, to shorten study start-up time, and to implement more efficient methods of reporting serious adverse events. PMID:18317585

Public acceptance of disturbance-based forest management: a study of the Blue River Landscape Strategy in the Central Cascades Adaptive Management Area.

Treesearch

Bruce Shindler; Angela L. Mallon

2009-01-01

This report examines public perspectives on disturbance-based management conducted in the central Cascade Range in Oregon as part of the Blue River Landscape Strategy. A mail survey to local residents was used to describe the public’s understanding of this form of management, identify perceived associated risks and potential barriers to implementation, and the overall...

Summary statistics and graphical comparisons of historical hydrologic and water-quality data, Seco Creek Watershed, South-Central Texas

USGS Publications Warehouse

Brown, David W.; Slattery, Richard N.; Gilhousen, Jon R.

1998-01-01

The U.S. Geological Survey collected hydrologic (rainfall, streamflow, and reservoir content) and water-quality data in the Seco Creek watershed, south-central Texas. Most of the data from 15 sites were collected as part of a study in cooperation with the U.S. Department of Agriculture and the Texas State Soil and Water Conservation Board to evaluate the effects of agricultural best-management practices on surface- and ground-water quantity and quality in the 255-square-mile watershed. Nearly 400 best-management practices at 58 sites were implemented by landowners in the watershed during March 1990-September 1995. Most of the data are from the early 1990s, the period during and after implementation of best-management practices. Data from five sites include water quality and are summarized in tables and graphics in the text; and data from all 15 sites are summarized on a diskette. Maximum annual rainfall among the sites for which data are presented in the text (excluding one site) for the during-and-after-implementation period (March 1990-September 1995) was 53.27 inches in water year 1992. Maximum annual total streamflow among the sites for the period was 63,400 acre-feet, also in water year 1992. At the one site with water-quality data (under base-flow conditions) for both the before-implementation period and the during-and-after implementation period of best-management practices, percentiles (5, 25, 50, 75, 95) for specific conductance, nitrate concentration, and fecal coliform density were less for the during-and-after-implementation period than for the before-implementation period.

Air Force Global Weather Central System Architecture Study. Final System/Subsystem Summary Report. Volume 7. Implementation and Development Plans

DTIC Science & Technology

1976-03-01

special access; PS2 will be for the variable perimeter; and PS3, PS4 , and PS5 will make up the normal access area. This added computer power will be...implementation of PS1 and PS4 will continue as new com- munications consoles are actively established for possible side-by-side opera- tion of the

Detecting water yield variability due to the small proportional land use and land cover changes in a watershed on the Loess Plateau, China

Treesearch

S. Wang; Z. Zhang; G. Sun; S.G. McNulty; M. Zhang

2009-01-01

Soil conservation practices have been widely implemented on the Loess Plateau to reduce severe soil erosion in north-central China over the past three decades. However, the hydrologic impacts of these practices are not well documented and understood. The objective of this study was to examine how water yield has changed after implementing soil conservation practices...

Improvement of Human Resources Quality through Vocational Training in Tourism in Karimunjawa Islands (Central Java, Indonesia): A Pro-Economical Tourism Approach

ERIC Educational Resources Information Center

Putro, S. Eko; Sukirno; Budi, S.; Didik, W.

2016-01-01

The effort to improve human resource quality is not easy to be implemented. This effort becomes more complicated to do when implemented to the group of poor community, especially in this case marginal community of small island. This research analyzes the characteristic of poor household in small island as well as the strategy of poverty…

Making Choices, Taking Chances, Facing Challenges, Managing Change: The Implementation of a Voice/Video/Data Network at the Alliance Library System.

ERIC Educational Resources Information Center

Wilford, Valerie J.; Logan, Lee; Bell, Lori; Cloyes, Kay

The Alliance Library System (ALS) is one of 12 regional library systems in Illinois, providing a full spectrum of support services for 300 member libraries of all types (public, school, academic, and special) located in west central Illinois. This paper describes the process by which ALS implemented a voice/video/data network connecting their four…

Toward a More Efficient Military Exchange System

DTIC Science & Technology

1991-07-01

Corps exchanges to use AAFES facility design and construction services. 0 Require the Navy and Marine Corps to adopt the AAFES food service franchising ... Franchising Development The Navy (NAVRESSO) is about to centrally develop and implement some in- house food franchising concepts. AAFES already has such...chose to implement the AAFES concepts. From the results of initial surveys, AAFES believes that introducing all of its food franchising concepts on all

HTA Implementation Roadmap in Central and Eastern European Countries.

PubMed

Kaló, Zoltán; Gheorghe, Adrian; Huic, Mirjana; Csanádi, Marcell; Kristensen, Finn Boerlum

2016-02-01

The opportunity cost of inappropriate health policy decisions is greater in Central and Eastern European (CEE) compared with Western European (WE) countries because of poorer population health and more limited healthcare resources. Application of health technology assessment (HTA) prior to healthcare financing decisions can improve the allocative efficiency of scarce resources. However, few CEE countries have a clear roadmap for HTA implementation. Examples from high-income countries may not be directly relevant, as CEE countries cannot allocate so much financial and human resources for substantiating policy decisions with evidence. Our objective was to describe the main HTA implementation scenarios in CEE countries and summarize the most important questions related to capacity building, financing HTA research, process and organizational structure for HTA, standardization of HTA methodology, use of local data, scope of mandatory HTA, decision criteria, and international collaboration in HTA. Although HTA implementation strategies from the region can be relevant examples for other CEE countries with similar cultural environment and economic status, HTA roadmaps are not still fully transferable without taking into account country-specific aspects, such as country size, gross domestic product per capita, major social values, public health priorities, and fragmentation of healthcare financing. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Challenges in developing e-government for good governance in North Sumatra

NASA Astrophysics Data System (ADS)

Siahaan, AY

2017-01-01

E-government as one form of public administration reform in Indonesia is increasingly related to the pursuance of good governance. This paper examines the relationship between of e-government and good governance by utilizing the case study design on the implementation of e-procurement in North Sumatra. It reveals centrality of local politics and business culture in understanding resistances of both local government officials and local business which creates loopholes’ for the practice of ‘bad governance’ in all phases of e-procurement in North Sumatra province. Data transparency does not equate and guarantee the realization of good governance. Public knowledge and understanding on government decision making processes and accountability (process and policy transparency) are central to achieve good governance through e-procurement. E-procurement system does not automatically change organizational and working culture of the implementers and suppliers. This paper provides insight to the attitude and the perception of private sector engage in e-procurement towards government in implementing e-government. Resistance, digital divide and local politics interrelatedly obstruct the realization of pursuing good governance through e-procurement.

Assessment of environmental policy implementation in solid waste management in Kathmandu, Nepal.

PubMed

Dangi, Mohan B; Schoenberger, Erica; Boland, John J

2017-06-01

In Nepal, full-fledged environmental legislation was rare before the democratic constitution of 1990. The first law covering the environment and sustainability was the Environment Protection Act 1997. While the Solid Waste Act was introduced in 1987, the problem of solid waste management still surfaces in Kathmandu. In order to understand the bedrock of this unrelenting failure in solid waste management, the manuscript digs deeper into policy implementation by dissecting solid waste rules, environmental legislations, relevant local laws, and solid waste management practices in Kathmandu, Nepal. A very rich field study that included surveys, interviews, site visits, and literature review provided the basis for the article. The study shows that volumes of new Nepalese rules are crafted without effective enforcement of their predecessors and there is a frequent power struggle between local government bodies and central authority in implementing the codes and allocating resources in solid waste management. The study concludes that Kathmandu does not require any new instrument to address solid waste problems; instead, it needs creation of local resources, execution of local codes, and commitment from central government to allow free exercise of these policies.

Actualizing a provider alliance to expand health services access to a low-income urban community.

PubMed

Tataw, David; Bazargan-Hejazi, Shahrzad; James, Frederick W

2011-01-01

Social change to facilitate health care access for vulnerable populations sometimes involves model-driven innovative structures and innovative planning and implementation approaches. This paper described and analyzed the rationale, conceptual framework, program components, and implementation of the South Central Health Care Alliance (SCHCA) implemented in South Los Angeles from January 2002 to December 2004. The program development and implementation was guided by an integrated framework linking the Open Systems Theory, the Social Cognitive Theory, the Health Belief Model, and the Preventive Health Education and Medical Home Project. The performance of the SCHCA as a social system, partnership, and participatory implementation program is also presented. While the SCHCA was found to be a dynamic social system that responded well to contingencies, its performance as a partnership and participatory implementation program was wanting in many respects.

A comparison of decentralized, distributed, and centralized vibro-acoustic control.

PubMed

Frampton, Kenneth D; Baumann, Oliver N; Gardonio, Paolo

2010-11-01

Direct velocity feedback control of structures is well known to increase structural damping and thus reduce vibration. In multi-channel systems the way in which the velocity signals are used to inform the actuators ranges from decentralized control, through distributed or clustered control to fully centralized control. The objective of distributed controllers is to exploit the anticipated performance advantage of the centralized control while maintaining the scalability, ease of implementation, and robustness of decentralized control. However, and in seeming contradiction, some investigations have concluded that decentralized control performs as well as distributed and centralized control, while other results have indicated that distributed control has significant performance advantages over decentralized control. The purpose of this work is to explain this seeming contradiction in results, to explore the effectiveness of decentralized, distributed, and centralized vibro-acoustic control, and to expand the concept of distributed control to include the distribution of the optimization process and the cost function employed.

Use of Six Sigma strategies to pull the line on central line-associated bloodstream infections in a neurotrauma intensive care unit.

PubMed

Loftus, Kelli; Tilley, Terry; Hoffman, Jason; Bradburn, Eric; Harvey, Ellen

2015-01-01

The creation of a consistent culture of safety and quality in an intensive care unit is challenging. We applied the Six Sigma Define-Measure-Analyze-Improve-Control (DMAIC) model for quality improvement (QI) to develop a long-term solution to improve outcomes in a high-risk neurotrauma intensive care unit. We sought to reduce central line utilization as a cornerstone in preventing central line-associated bloodstream infections (CLABSIs). This study describes the successful application of the DMAIC model in the creation and implementation of evidence-based quality improvement designed to reduce CLABSIs to below national benchmarks.

45 CFR 170.205 - Content exchange standards and implementation specifications for exchanging electronic health...

Code of Federal Regulations, 2012 CFR

2012-10-01

.... The Healthcare Information Technology Standards Panel (HITSP) Summary Documents Using HL7 CCD... Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries, HL7 Clinical Document...

A Practical Approach to Identity on Digital Ecosystems Using Claim Verification and Trust

NASA Astrophysics Data System (ADS)

McLaughlin, Mark; Malone, Paul

Central to the ethos of digital ecosystems (DEs) is that DEs should be distributed and have no central points of failure or control. This essentially mandates a decentralised system, which poses significant challenges for identity. Identity in decentralised environments must be treated very differently to identity in traditional environments, where centralised naming, authentication and authorisation can be assumed, and where identifiers can be considered global and absolute. In the absence of such guarantees we have expanded on the OPAALS identity model to produce a general implementation for the OPAALS DE that uses a combination of identity claim verification protocols and trust to give assurances in place of centralised servers. We outline how the components of this implementation function and give an illustrated workflow of how identity issues are solved on the OPAALS DE in practice.

Implementation of the Clinical Encounters Tracking system at the Indiana University School of Medicine.

PubMed

Hatfield, Amy J; Bangert, Michael P

2005-01-01

The Indiana University School of Medicine (IUSM) Office of Medical Education &Student Services directed the IUSM Educational Technology Unit to develop a Clinical Encounters Tracking system in response to the Liaison Committee on Medical Education's (LCME) updated accreditation standards. A personal digital assistant (PDA) and centralized database server solution was implemented. Third-year medical students are required to carry a PDA on which they record clinical encounter experiences during all clerkship clinical rotations. Clinical encounters data collected on the PDAs are routinely uploaded to the central server via the PDA HotSyncing process. Real-time clinical encounter summary reports are accessed in the school's online curriculum management system: ANGEL. The resulting IUSM Clinical Encounters Tracking program addresses the LCME accreditation standard which mandates the tracking of medical students' required clinical curriculum experiences.

Central line-associated bloodstream infection in a trauma intensive care unit: impact of implementation of Society for Healthcare Epidemiology of America/Infectious Diseases Society of America practice guidelines.

PubMed

Mazi, Waleed; Begum, Zikra; Abdulla, Diaa; Hesham, Ahmed; Maghari, Sami; Assiri, Abdullah; Senok, Abiola

2014-08-01

This study aimed to assess the impact implementation of the basic Society for Healthcare Epidemiology of America/Infectious Diseases Society of America (SHEA/IDSA) practice recommendations in reducing central line-associated bloodstream infection (CLABSI) in intensive care units (ICUs). The prospective study was conducted from January 2011-December 2012 at the 23-bed trauma ICU in Saudi Arabia. The basic SHEA/IDSA practice recommendations were introduced and implemented during the year 2012. Laboratory-confirmed CLABSIs were identified, and the antimicrobial susceptibility of isolates was determined. Data were collected and analyzed for benchmarking with the National Healthcare Safety Network. There was a 58% decline in the CLABSI incidence rate from 3.87 to 1.5 per 1,000 central line days in 2011 and 2012, respectively (standardized infection ratio, 0.42; P = .043). Three institutional risk factors were identified and resolved: health care personnel education, removal of nonessential catheters, and use of a catheter cart. Three Klebsiella pneumoniae isolates susceptible only to imipenem, 1 pandrug resistant Acinetobacter baumannii, and 2 Enterococcus faecalis, with 1 isolate resistant to vancomycin, were identified in 2012. The basic SHEA/ISDA practice recommendation is an effective prevention model for the reduction of CLABSIs in the ICU. Additional measures are needed to control the spread of multidrug-resistant organisms. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Do Providers Know What They Do Not Know? A Correlational Study of Knowledge Acquisition and Person-Centered Care.

PubMed

Matthews, Elizabeth B; Stanhope, Victoria; Choy-Brown, Mimi; Doherty, Meredith

2018-07-01

Person-centered care (PCC) is a central feature of health care reform, yet the tools needed to deliver this practice have not been implemented consistently. Person-centered care planning (PCCP) is a treatment planning approach operationalizing the values of recovery. To better understand PCCP implementation, this study examined the relationship between recovery knowledge and self-reported PCCP behaviors among 224 community mental health center staff. Results indicated that increased knowledge decreased the likelihood of endorsing non-recovery implementation barriers and self-reporting a high level of PCCP implementation. Findings suggest that individuals have difficulty assessing their performance, and point to the importance of objective fidelity measures.

Low-Level Space Optimization of an AES Implementation for a Bit-Serial Fully Pipelined Architecture

NASA Astrophysics Data System (ADS)

Weber, Raphael; Rettberg, Achim

A previously developed AES (Advanced Encryption Standard) implementation is optimized and described in this paper. The special architecture for which this implementation is targeted comprises synchronous and systematic bit-serial processing without a central controlling instance. In order to shrink the design in terms of logic utilization we deeply analyzed the architecture and the AES implementation to identify the most costly logic elements. We propose to merge certain parts of the logic to achieve better area efficiency. The approach was integrated into an existing synthesis tool which we used to produce synthesizable VHDL code. For testing purposes, we simulated the generated VHDL code and ran tests on an FPGA board.

Social determinants of workers' health in Central America.

PubMed

Aragón, Aurora; Partanen, Timo; Felknor, Sarah; Corriols, Marianela

2011-01-01

This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region.

Evolution, opportunity and challenges of transboundary water and energy problems in Central Asia.

PubMed

Guo, Lidan; Zhou, Haiwei; Xia, Ziqiang; Huang, Feng

2016-01-01

Central Asia is one of the regions that suffer the most prominent transboundary water and energy problems in the world. Effective transboundary water-energy resource management and cooperation are closely related with socioeconomic development and stability in the entire Central Asia. Similar to Central Asia, Northwest China has an arid climate and is experiencing a water shortage. It is now facing imbalanced supply-demand relations of water and energy resources. These issues in Northwest China and Central Asia pose severe challenges in the implementation of the Silk Road Economic Belt strategy. Based on the analysis of water and energy distribution characteristics in Central Asia as well as demand characteristics of different countries, the complexity of local transboundary water problems was explored by reviewing corresponding historical problems of involved countries, correlated energy issues, and the evolution of inter-country water-energy cooperation. With references to experiences and lessons of five countries, contradictions, opportunities, challenges and strategies for transboundary water-energy cooperation between China and Central Asia were discussed under the promotion of the Silk Road Economic Belt construction based on current cooperation conditions.

Employing Content-Based Curricula in Nursing at Illinois Central College to Improve Equity and Outcomes for Students. Pathways to Results: Implementation Partnerships Strategy Brief

ERIC Educational Resources Information Center

Graham, Edmund

2016-01-01

Since the creation of Pathways to Results (PTR) in 2009, Illinois Central College (ICC) has participated in all but one year, working to improve outcomes across a number of different pathways. ICC has been innovative in its use of PTR over the years, and the 2014/2015 PTR project was no different. The ICC team worked to identify parallels between…

Fuel treatments, fire suppression, and their interaction with wildfire and its impacts: the Warm Lake experience during the Cascade Complex of wildfires in central Idaho, 2007

Treesearch

Russell T. Graham; Theresa B. Jain; Mark Loseke

2009-01-01

Wildfires during the summer of 2007 burned over 500,000 acres within central Idaho. These fires burned around and through over 8,000 acres of fuel treatments designed to offer protection from wildfire to over 70 summer homes and other buildings located near Warm Lake. This area east of Cascade, Idaho, exemplifies the difficulty of designing and implementing fuel...

Enhanced central venous catheter bundle for pediatric parenteral-dependent intestinal failure.

PubMed

Ormsby, Jennifer A; Bukoye, Bola; Lajoie, Debra; Shermont, Herminia; Martin, Lisa; Leger, Kierrah; Mahoney, Judy; Potter-Bynoe, Gail; Carpenter, Jane; Ozonoff, Al; Lee, Grace M

2018-05-16

Central line-associated bloodstream infections (CLABSIs) cause substantial morbidity and increase antimicrobial use and length of stay among hospitalized children in the United States. CLABSI occurs more frequently among high-risk pediatric patients, such as those with intestinal failure (IF) who are parenteral nutrition (PN) dependent. Following an increase in CLABSI rates, a quality improvement (QI) initiative was implemented. Using QI methodology, an enhanced central venous catheter (CVC) maintenance bundle was developed and implemented on 2 units for pediatric PN-dependent patients with IF. CLABSI rates were prospectively monitored pre- and postimplementation, and bundle element adherence was monitored. Enhanced bundle elements included chlorhexidine-impregnated patch, daily bathing, ethanol locks, 2 nurses for CVC care in a distraction-free zone, peripheral laboratory draws, bundling routine laboratory tests, and PN administration set changes every 24 hours. Adherence to enhanced bundle elements increased to >90% over 3 months. CLABSI rates averaged 1.41 per 1,000 central line days preimplementation compared with 0.40 per 1,000 device days postimplementation (P = .003), an 85% absolute reduction in CLABSI rates over 12 months. Patients with IF are at an increased risk for CLABSI. Enhanced CVC maintenance bundles that specifically target prevention practices in this population may be beneficial. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Turning Access into a web-enabled secure information system for clinical trials.

PubMed

Dongquan Chen; Chen, Wei-Bang; Soong, Mayhue; Soong, Seng-Jaw; Orthner, Helmuth F

2009-08-01

Organizations that have limited resources need to conduct clinical studies in a cost-effective, but secure way. Clinical data residing in various individual databases need to be easily accessed and secured. Although widely available, digital certification, encryption, and secure web server, have not been implemented as widely, partly due to a lack of understanding of needs and concerns over issues such as cost and difficulty in implementation. The objective of this study was to test the possibility of centralizing various databases and to demonstrate ways of offering an alternative to a large-scale comprehensive and costly commercial product, especially for simple phase I and II trials, with reasonable convenience and security. We report a working procedure to transform and develop a standalone Access database into a secure Web-based secure information system. For data collection and reporting purposes, we centralized several individual databases; developed, and tested a web-based secure server using self-issued digital certificates. The system lacks audit trails. The cost of development and maintenance may hinder its wide application. The clinical trial databases scattered in various departments of an institution could be centralized into a web-enabled secure information system. The limitations such as the lack of a calendar and audit trail can be partially addressed with additional programming. The centralized Web system may provide an alternative to a comprehensive clinical trial management system.

Pod nursing on a medical/surgical unit: implementation and outcomes evaluation.

PubMed

Friese, Christopher R; Grunawalt, Julie C; Bhullar, Sara; Bihlmeyer, Karen; Chang, Robert; Wood, Winnie

2014-04-01

A medical/surgical unit at the University of Michigan Health System implemented a pod nursing model of care to improve efficiency and patient and staff satisfaction. One centralized station was replaced with 4 satellites and supplies were relocated next to patient rooms. Patients were assigned to 2 nurses who worked as partners. Three patient (satisfaction, call lights, and falls) and nurse (satisfaction and overtime) outcomes improved after implementation. Efforts should be focused on addressing patient acuity imbalances across assignments and strengthening communication among the healthcare team. Studies are needed to test the model in larger and more diverse settings.

Convergence acceleration of the Proteus computer code with multigrid methods

NASA Technical Reports Server (NTRS)

Demuren, A. O.; Ibraheem, S. O.

1992-01-01

Presented here is the first part of a study to implement convergence acceleration techniques based on the multigrid concept in the Proteus computer code. A review is given of previous studies on the implementation of multigrid methods in computer codes for compressible flow analysis. Also presented is a detailed stability analysis of upwind and central-difference based numerical schemes for solving the Euler and Navier-Stokes equations. Results are given of a convergence study of the Proteus code on computational grids of different sizes. The results presented here form the foundation for the implementation of multigrid methods in the Proteus code.

Simulating Pressure Profiles for the Free-Electron Laser Photoemission Gun Using Molflow+

NASA Astrophysics Data System (ADS)

Song, Diego; Hernandez-Garcia, Carlos

2012-10-01

The Jefferson Lab Free Electron Laser (FEL) generates tunable laser light by passing a relativistic electron beam generated in a high-voltage DC electron gun with a semiconducting photocathode through a magnetic undulator. The electron gun is in stringent vacuum conditions in order to guarantee photocathode longevity. Considering an upgrade of the electron gun, this project consists of simulating pressure profiles to determine if the novel design meets the electron gun vacuum requirements. The method of simulation employs the software Molflow+, developed by R. Kersevan at the Organisation Europ'eene pour la Recherche Nucl'eaire (CERN), which uses the test-particle Monte Carlo method to simulate molecular flows in 3D structures. Pressure is obtained along specified chamber axes. Results are then compared to measured pressure values from the existing gun for validation. Outgassing rates, surface area, and pressure were found to be proportionally related. The simulations indicate that the upgrade gun vacuum chamber requires more pumping compared to its predecessor, while it holds similar vacuum conditions. The ability to simulate pressure profiles through tools like Molflow+, allows researchers to optimize vacuum systems during the engineering process.

Contribution to the Study of Nuclear Interactions at Several Tens of Bev by Means of Cosmic Radiations (thesis); CONTRIBUTION A L'ETUDE DES INTERACTIONS NUCLEAIRES DE PLUSIEURS DIZAINES DE Gev., AU MOYEN DES RAYONS COSMIQUES (THESES)

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

Pelletier, C.

1960-01-01

The secondaries produced by the interaction of highenergy cosmic radiation with aluminum were studied with Wilson chambers placed in a magnetic field. From 9600 photographs made, 117 interactions of charged particles with energy higher than 10 Bev in aluminum were selected. These photographs were obtained with the apparatus installed at the Observatory of the Pic du Midi de Bigorre. This apparatus is described. The quantities of motion and the emission direction of charged secondaries of each interaction were determined. The measurements and the methods of calculation are described. The results obtained on charged secondaries and unstable particles are reported. Themore » selection of the interactions which occurred with only one nucleon of the aluminum nucleus is discussed. These interactions were studied in the center-of-mass system of the interacting particles. The results obtained are compared with the predictions of the principal theoreticat models of nucleon-nucleon interactions. (trauth)« less

The Challenges of Adopting a Culture of Mission Command in the US Army

DTIC Science & Technology

2015-05-23

NUMBER 6. AUTHOR(S) LTC(P) James W. Wright 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND...the development and implementation of high- end information technology creates a paradox for mission command. 15. SUBJECT TERMS Mission command...centralized control and less risk. Likewise, the development and implementation of high- end information technology creates a paradox for mission

Turbo Pascal Implementation of a Distributed Processing Network of MS-DOS Microcomputers Connected in a Master-Slave Configuration

DTIC Science & Technology

1989-12-01

Interrupt Procedures ....... 29 13. Support for a Larger Memory Model ................ 29 C. IMPLEMENTATION ........................................ 29...describe the programmer’s model of the hardware utilized in the microcomputers and interrupt driven serial communication considerations. Chapter III...Central Processor Unit The programming model of Table 2.1 is common to the Intel 8088, 8086 and 80x86 series of microprocessors used in the IBM PC/AT

Perspectives of Central Office Staff, Principals, Teachers, and School Site Councils on Resource Allocation and SSFR Implementation in 2010-11. A Report Prepared for the Twin Rivers Unified School District

ERIC Educational Resources Information Center

Haxton, Clarisse L.; Chambers, Jay G.; Manship, Karen; Cruz, Lisa; O'Neil, Caitlin

2012-01-01

As part of the evaluation of the Strategic School Funding for Results (SSFR) project, American Institutes for Research (AIR) conducted surveys of principals, teachers, and members of School Site Councils (SSCs) to gather information on the attitudes and perspectives regarding the implementation of key components of the SSFR model in Twin Rivers…

Caltrans fog detection and warning system.

DOT National Transportation Integrated Search

2009-01-01

The California Department of Transportation (Caltrans) has implemented a fog detection and warning system on Highway 99 near Fresno. The entire central valley region is susceptible to Tule fog, which can reduce visibility tremendously, sometimes to n...

The Funding of Academic Collaborations

ERIC Educational Resources Information Center

Michelau, Demaree K.; Poulin, Russell

2008-01-01

To leverage expertise and efficiencies in implementing educational technologies, higher education leaders often create centralized service organizations or inter-institutional partnerships. Defined as "academic collaborations," these organizations foster inter-institutional partnerships that share resources to increase institutional…

Downtown Crossing: Auto Restricted Zone in Boston

DOT National Transportation Integrated Search

1982-07-01

The Downtown Crossing auto restricted zone, implemented in 1978, involved the : elimination of all auto traffic froma zone of twelve blocks encompassing six : different streets in Bostn's central business district. Some of the blocks were : pedestria...

EPA LABORATORIES IMPLEMENT EMS PROGRAM

EPA Science Inventory

This paper highlights the breadth and magnitude of carrying out an effective Environmental Management System (EMS) program at the U.S. EPA's research and development laboratories. Federal research laboratories have unique operating challenges compared to more centralized industr...

A Different Type of Test.

ERIC Educational Resources Information Center

Brady, Lisa

2003-01-01

Describes a successful random drug-testing program for athletes and students involved in school-sponsored activities at Hunterdon Central Regional High School in Flemington, New Jersey. Urges all high schools to implement a random drug-testing program. (PKP)

Identification of influential nodes in complex networks: Method from spreading probability viewpoint

NASA Astrophysics Data System (ADS)

Bao, Zhong-Kui; Ma, Chuang; Xiang, Bing-Bing; Zhang, Hai-Feng

2017-02-01

The problem of identifying influential nodes in complex networks has attracted much attention owing to its wide applications, including how to maximize the information diffusion, boost product promotion in a viral marketing campaign, prevent a large scale epidemic and so on. From spreading viewpoint, the probability of one node propagating its information to one other node is closely related to the shortest distance between them, the number of shortest paths and the transmission rate. However, it is difficult to obtain the values of transmission rates for different cases, to overcome such a difficulty, we use the reciprocal of average degree to approximate the transmission rate. Then a semi-local centrality index is proposed to incorporate the shortest distance, the number of shortest paths and the reciprocal of average degree simultaneously. By implementing simulations in real networks as well as synthetic networks, we verify that our proposed centrality can outperform well-known centralities, such as degree centrality, betweenness centrality, closeness centrality, k-shell centrality, and nonbacktracking centrality. In particular, our findings indicate that the performance of our method is the most significant when the transmission rate nears to the epidemic threshold, which is the most meaningful region for the identification of influential nodes.

Stormwater management impacts on urban stream water quality and quantity during and after development in Clarksburg, MD

NASA Astrophysics Data System (ADS)

Loperfido, J. V.; Noe, G. B.; Jarnagin, S.; Mohamoud, Y. M.; Van Ness, K.; Hogan, D. M.

2012-12-01

Urbanization and urban land use leads to degradation of local stream habitat and 'urban stream syndrome.' Best Management Practices (BMPs) are often used in an attempt to mitigate the impact of urban land use on stream water quality and quantity. Traditional development has employed stormwater BMPs that were placed in a centralized manner located either in the stream channel or near the riparian zone to treat stormwater runoff from large drainage areas; however, urban streams have largely remained impaired. Recently, distributed placement of BMPs throughout the landscape has been implemented in an attempt to detain, treat, and infiltrate stormwater runoff from smaller drainage areas near its source. Despite increasing implementation of distributed BMPs, little has been reported on the catchment-scale (1-10 km^2) performance of distributed BMPs and how they compare to centralized BMPs. The Clarksburg Special Protection Area (CSPA), located in the Washington, DC exurbs within the larger Chesapeake Bay watershed, is undergoing rapid urbanization and employs distributed BMPs on the landscape that treat small drainage areas with the goal of preserving high-quality stream resources in the area. In addition, the presence of a nearby traditionally developed (centralized BMPs) catchment and an undeveloped forested catchment makes the CSPA an ideal setting to understand how the best available stormwater management technology implemented during and after development affects stream water quality and quantity through a comparative watershed analysis. The Clarksburg Integrated Monitoring Partnership is a consortium of local and federal agencies and universities that conducts research in the CSPA including: monitoring of stream water quality, geomorphology, and biology; analysis of stream hydrological and water quality data; and GIS mapping and analysis of land cover, elevation change and BMP implementation data. Here, the impacts of urbanization on stream water quantity, geomorphology, and biology during development while implementing advanced sediment and erosion control BMPs are discussed. Also, effects of centralized versus distributed stormwater BMPs and land cover on stream water quantity and quality following suburban development are presented. This includes stream response to precipitation events, baseflow and stormflow export of water, and water chemistry data. Results from this work have informed land use planning at the local level and are being incorporated through adaptive management to maintain the high-quality stream resources in the CSPA. More generally, results from this work could inform urban development stakeholders on effective strategies to curtail urban stream syndrome.

Assessing the performance of centralized waiting lists for patients without a regular family physician using clinical-administrative data.

PubMed

Breton, Mylaine; Smithman, Mélanie Ann; Brousselle, Astrid; Loignon, Christine; Touati, Nassera; Dubois, Carl-Ardy; Nour, Kareen; Boivin, Antoine; Berbiche, Djamal; Roberge, Danièle

2017-01-05

With 4.6 million patients who do not have a regular family physician, Canada performs poorly compared to other OECD countries in terms of attachment to a family physician. To address this issue, several provinces have implemented centralized waiting lists to coordinate supply and demand for attachment to a family physician. Although significant resources are invested in these centralized waiting lists, no studies have measured their performance. In this article, we present a performance assessment of centralized waiting lists for unattached patients implemented in Quebec, Canada. We based our approach on the Balanced Scorecard method. A committee of decision-makers, managers, healthcare professionals, and researchers selected five indicators for the performance assessment of centralized waiting lists, including both process and outcome indicators. We analyzed and compared clinical-administrative data from 86 centralized waiting lists (GACOs) located in 14 regions in Quebec, from April 1, 2013, to March 31, 2014. During the study period, although over 150,000 patients were attached to a family physician, new requests resulted in a 30% median increase in patients on waiting lists. An inverse correlation of average strength was found between the rates of patients attached to a family physician and the proportion of vulnerable patients attached to a family physician meaning that as more patients became attached to an FP through GACOs, the proportion of vulnerable patients became smaller (r = -0.31, p < 0.005). The results showed very large performance variations both among GACOs of different regions and among those of a same region for all performance indicators. Centralized waiting lists for unattached patients in Quebec seem to be achieving their twofold objective of attaching patients to a family physician and giving priority to vulnerable patients. However, the demand for attachment seems to exceed the supply and there appears to be a tension between giving priority to vulnerable patients and attaching of a large number of patients. Results also showed heterogeneity in the performance of centralized waiting lists across Quebec. Finally, our findings suggest it is critical that similar mechanisms should use available data to identify the best strategies for reducing variations and improving performance.

Organizational fidelity to a medication management evidence-based practice in the treatment of schizophrenia.

PubMed

El-Mallakh, Peggy; Howard, Patricia B; Rayens, Mary Kay; Roque, Autumn P; Adkins, Sarah

2013-11-01

Organizational support is essential for successful implementation of evidence-based practice (EBP) in clinical settings. This 3-year study used a mixed qualitative and quantitative design to implement a medication management EBP in the treatment of schizophrenia in six community mental health clinics in a south-central state of the United States. Findings from organizational fidelity assessments indicate that support for EBP implementation was moderate. Organizational support was highest for prescriber access to relevant patient information at each medication visit, scheduling flexibility for patients' urgent problems, and availability of medication guidelines. Organizational support was lowest for medication availability and identification of treatment refractory patients. Findings suggest that leadership is essential to support successful implementation. Nurse educators can incorporate implementation research and leadership training into graduate nursing programs to facilitate successful EBP implementation in practice settings. Copyright 2013, SLACK Incorporated.

[Merging different biobanks under one roof : Benefits and constraints on the way to a centralized biobank using the example of the BMBH].

PubMed

Schmitt, S; Döllinger, C; Maier, A; Herpel, E; Schirmacher, P; Kirsten, R

2018-05-23

Founded in 1386, Heidelberg University is Germany's oldest and one of Europe's most reputable universities. As a scientific hub in Germany, Heidelberg is home to several internationally renowned medical research facilities that have an enormous demand for biomaterial samples and data-especially in the field of translational and cancer research.The main objective of the BMBF-funded project "BioMaterialBank Heidelberg" (BMBH) was the harmonization of local biobanking under the same administrative roof through the implementation of common and standardized project, data, and quality management procedures.In the very beginning, existing structures and processes of the participating biobanks in Heidelberg were identified and a common administrative structure with central representatives for IT and quality management (QM) was established to coordinate all BMBH activities.Over time, implementation of consented structures and processes took place, also revealing organizational challenges that had to be solved concerning, for example, differences in sample handling and the definition of consistent access regulations.We will discuss below these challenges as well as the opportunities of building a centralized biobank and show how issues can be resolved using the example of the BMBH.

Reduction in Central Line-Associated Bloodstream Infection Rates After Implementations of Infection Control Measures at a Level 3 Neonatal Intensive Care Unit.

PubMed

Dumpa, Vikramaditya; Adler, Bonny; Allen, Delena; Bowman, Deborah; Gram, Amy; Ford, Pat; Sannoh, Sulaiman

2016-01-01

Advances in neonatology led to survival of micro-preemies, who need central lines. Central line-associated bloodstream infection (CLABSI) causes prolonged hospitalization, morbidities, and mortality. Health care team education decreases CLABSIs. The objective was to decrease CLABSIs using evidence-based measures. The retrospective review compared CLABSI incidence during and after changes in catheter care. In April 2011, intravenous (IV) tubing changed from Interlink to Clearlink; IV tubing changing interval increased from 24 to 72 hours. CLABSIs increased. The following measures were implemented: July 2011, reeducation of neonatal intensive care staff on Clearlink; August 2011, IV tubing changing interval returned to 24 hours; September 2011, changed from Clearlink back to Interlink; November 2011, review of entire IV process and in-service on hand hygiene; December 2011, competencies on IV access for all nurses. CLABSIs were compared during and after interventions. Means were compared using the t test and ratios using the χ(2) test; P <.05. CLABSIs decreased from 4.4/1000 to 0/1000 catheter-days; P < .05. Evidence-based interventions reduced CLABSIs. © The Author(s) 2014.

Bearingless Flywheel Systems, Winding and Control Schemes, and Sensorless Control

NASA Technical Reports Server (NTRS)

Kascak, Peter E (Inventor); Jansen, Ralph H (Inventor); Trase, Larry M (Inventor); Dever, Timothy P (Inventor); Kraft, Thomas G (Inventor)

2016-01-01

Flywheel systems are disclosed that provide increased energy density and operational effectiveness. A first bearingless motor and a second bearingless motor may be configured to simultaneously suspend the central rotor in a radial direction and to rotate the central rotor. However, certain implementations may have one motor or more than two motors, depending on the design. A plurality of the flywheel systems may be collectively controlled to perform community energy storage with higher storage capacities than individual flywheel systems.

The Implementation of a Plant and Minor Property Accounting System for the Naval Postgraduate School.

DTIC Science & Technology

1987-09-01

Autmatic Data Processing iquipment CPU Central Procesing Unit DSA Date lase Administrator USU Data "aso Management system D&XC Defense Automation...ground? -How big is a certain piece of plant property (e.g., for shipment)? 2. Nxnected Data Base Volume The current inventory of NPS plant property...System, Automated Data TU I. 89aom so fg o - e In October 136 the aval Postgraduate School was directed to centralize the accounting and control of

Detection of a chikungunya outbreak in Central Italy, August to September 2017.

PubMed

Venturi, Giulietta; Di Luca, Marco; Fortuna, Claudia; Remoli, Maria Elena; Riccardo, Flavia; Severini, Francesco; Toma, Luciano; Del Manso, Martina; Benedetti, Eleonora; Caporali, Maria Grazia; Amendola, Antonello; Fiorentini, Cristiano; De Liberato, Claudio; Giammattei, Roberto; Romi, Roberto; Pezzotti, Patrizio; Rezza, Giovanni; Rizzo, Caterina

2017-09-01

An autochthonous chikungunya outbreak is ongoing near Anzio, a coastal town in the province of Rome. The virus isolated from one patient and mosquitoes lacks the A226V mutation and belongs to an East Central South African strain. As of 20 September, 86 cases are laboratory-confirmed. The outbreak proximity to the capital, its late summer occurrence, and diagnostic delays, are favouring transmission. Vector control, enhanced surveillance and restricted blood donations are being implemented in affected areas.

Analysis of central enterprise architecture elements in models of six eHealth projects.

PubMed

Virkanen, Hannu; Mykkänen, Juha

2014-01-01

Large-scale initiatives for eHealth services have been established in many countries on regional or national level. The use of Enterprise Architecture has been suggested as a methodology to govern and support the initiation, specification and implementation of large-scale initiatives including the governance of business changes as well as information technology. This study reports an analysis of six health IT projects in relation to Enterprise Architecture elements, focusing on central EA elements and viewpoints in different projects.

Environmental Impact Assessment in Norway--Understanding Implementation as a Function of Professional Culture?

ERIC Educational Resources Information Center

Emmelin, Lars

2001-01-01

Describes the environmental impact assessment (EIA) in Norway using a survey of the paradigm of environmental management carried out in the central and regional Norwegian environmental administrations. (Contains 22 references.) (Author/YDS)

Evaluating the Australian Traineeship System.

ERIC Educational Resources Information Center

Ryan, R. J.

1987-01-01

Describes the Australian Traineeship System (ATS), a program integrating formal education and employment designed to increase options for dropouts. Discusses problems involving the centrality of ATS's educational component and implementation of a program evaluation strategy. Includes two references. (MLH)

Implementing the Freight Transportation Data Architecture : Data Element Dictionary

DOT National Transportation Integrated Search

2015-01-01

NCFRP Report 9: Guidance for Developing a Freight Data Architecture articulates the value of establishing architecture for linking data across modes, subjects, and levels of geography to obtain essential information for decision making. Central to th...

Silicon graphene Bragg gratings.

PubMed

Capmany, José; Domenech, David; Muñoz, Pascual

2014-03-10

We propose the use of interleaved graphene sections on top of a silicon waveguide to implement tunable Bragg gratings. The filter central wavelength and bandwidth can be controlled changing the chemical potential of the graphene sections. Apodization techniques are also presented.

77 FR 13618 - Agency Information Collection Activities: Dominican Republic-Central America-United States Free...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-07

... States Free Trade Agreement with Costa Rica, the Dominican Republic, El Salvador, Guatemala, Honduras... president proclaimed the implementation dates as follows: El Salvador (3/1/06), Honduras (4/1/ 06...

75 FR 883 - Environmental Impact Statement; Maricopa County, AZ

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-06

...: Kenneth Davis, Senior Engineering Manager for Operations, Federal Highway Administration, 4000 N. Central..., 2009. Kenneth H. Davis, Senior Engineering Manager for Operations, Federal Highway Administration... Research, Planning and Construction. The regulations implementing Executive Order 12372 regarding...

Abiding by the sufficiency economy philosophy to develop the quality of life of teachers and educational personnel in the central region

NASA Astrophysics Data System (ADS)

Khumkhong, Tippawan

2018-01-01

This research aimed to 1) study the ideas and procedures of the Sufficiency Economy Philosophy (SEP) to make it fully implemented to develop the quality of life of teachers and educational personnel in the central region, 2) study the results of implementing the SEP and 3) offer some guidelines in implementing the SEP to develop the quality of life. The samples were the teachers and educational personnel, the cremation service welfare members of 2015 in 9 provinces of the central region namely Bangkok, Sing Buri, Saraburi, Chai Nat, Nonthaburi, Pathum Thani, Pha Nakhon Si Ayuttaya, Lop Buri and Ang Thong. The qualitative research's samples were the 6 key informants selected purposely, collected by depth-interview, analyzed using inductive method, checked by the methodological triangulation and the key informants. The quantitative research's samples were the 398 offered obtained by stratified random sampling having regard to the ratio, collected by questionnaire with the reliability value of 0.982, analyzed by percentage, mean and standard deviation. The findings were as follows: 1) As for the ideas towards the SEP and the ethical principles of Buddhism are one and the same thing. All levels of people can follow this philosophy. The procedures towards the SEP to develop the quality of life by performing in harmony with their daily lives regarding to the moderation, the reasonableness, building self-immunity with knowledge and ethical qualification. 2) The SEP helps develop the better quality of life, happiness, sound life, sound economy with great satisfaction of the living. 3) On offering some guidelines in implementing the SEP to develop the quality of life: 3.1) the performers must have good understanding in the philosophy and accept to bring it into use 3.2) lead a life according to the ethical principles of Buddhism or to the ones of the religion you believe. 3.3) members of the family had to cooperate in leading lives according to the SEP and 3.4) save money when having more than enough. 4) The teachers and educational personnel are able to implement the ideas offered at a high level.

Corporate social responsibility: Benefits for youth in hydropower development in Laos

NASA Astrophysics Data System (ADS)

Sparkes, Stephen

2014-04-01

The role of the state as regulator combined with policies on Corporate Social Responsibility (CSR) that go beyond legal requirements to establishing programmes that promote development and good international business practice is an emerging new paradigm. In this paper, the example of a state-owned company, Statkraft A.S. of Norway, and its recent hydropower investment in central Laos illustrates how policy, implementation and follow-up can lead to benefits for local communities in the impacted area of the Theun-Hinboun Expansion Project (THXP). Programmes include both support for and improvement of existing government education programmes, employment opportunities and specific programmes for youth. They have been designed to mitigate possible negative effects of the influx of workers and rapid socio-economic change in the affected area. Young people continue to have a central role in the implementation of these programmes as peer educators under the supervision of project staff and non-governmental organisations (NGOs).

Lost in translation? Theory, policy and practice in systems-based environmental approaches to obesity prevention in the Healthy Towns programme in England.

PubMed

Sautkina, Elena; Goodwin, Denise; Jones, Andy; Ogilvie, David; Petticrew, Mark; White, Martin; Cummins, Steven

2014-09-01

This paper explores how system-wide approaches to obesity prevention were 'theorised' and translated into practice in the 'Healthy Towns' programme implemented in nine areas in England. Semi-structured interviews with 20 informants, purposively selected to represent national and local programme development, management and delivery were undertaken. Results suggest that informants articulated a theoretical understanding of a system-wide approach to obesity prevention, but simplifying this complex task in the context of uncertainty over programme aims and objectives, and absence of a clear direction from the central government, resulted in local programmes relying on traditional multi-component approaches to programme delivery. The development of clear, practical guidance on implementation should form a central part of future system-wide approaches to obesity prevention. Copyright © 2014 Elsevier Ltd. All rights reserved.

Bio-inspired Optimal Locomotion Reconfigurability of Quadruped Rovers using Central Pattern Generators

NASA Astrophysics Data System (ADS)

Bohra, Murtaza

Legged rovers are often considered as viable solutions for traversing unknown terrain. This work addresses the optimal locomotion reconfigurability of quadruped rovers, which consists of obtaining optimal locomotion modes, and transitioning between them. A 2D sagittal plane rover model is considered based on a domestic cat. Using a Genetic Algorithm, the gait, pose and control variables that minimize torque or maximize speed are found separately. The optimization approach takes into account the elimination of leg impact, while considering the entire variable spectrum. The optimal solutions are consistent with other works on gait optimization, and are similar to gaits found in quadruped animals as well. An online model-free gait planning framework is also implemented, that is based on Central Pattern Generators is implemented. It is used to generate joint and control trajectories for any arbitrarily varying speed profile, and shown to regulate locomotion transition and speed modulation, both endogenously and continuously.

Upgrade of The Thermal Vacuum Data System at NASA/GSFC

NASA Technical Reports Server (NTRS)

Palmer, John; Powers, Edward I. (Technical Monitor)

2000-01-01

The Goddard Space Flight Center's new thermal vacuum data acquisition system is a networked client-sever application that enables lab operations crews to monitor all tests from a central location. The GSFC thermal vacuum lab consists of eleven chambers in Building 7 and one chamber in Building 10. The new data system was implemented for several reasons. These included the need for centralized data collection, more flexible and easier to use operator interface, greater data accessibility, a reduction in testing time and cost, and increased payload and personnel safety. Additionally, a new data system was needed for year-2000 compliance. This paper discusses the incorporation of the Thermal Vacuum Data System (TVDS) within the thermal vacuum lab at GSFC, its features and capabilities and lessons learned in its implementation. Additional topics include off-center (Internet) capability for remote monitoring and the role of TVDS in the efforts to automate thermal vacuum chamber operations.

Upgrade of the Thermal Vacuum Data System at NASA/GSFC

NASA Technical Reports Server (NTRS)

Palmer, John

2000-01-01

The Goddard Space Flight Center's new thermal vacuum data acquisition system is a networked client-sever application that enables lab operations crews to monitor all tests from a central location. The GSFC thermal vacuum lab consists of eleven chambers in Building 7 and one chamber in Building 10. The new data system was implemented for several reasons. These included the need for centralized data collection, more flexible and easier to use operator interface, greater data accessibility, a reduction in testing time and cost, and increased payload and personnel safety. Additionally, a new data system was needed for year-2000 compliance. This paper discusses the incorporation of the Thermal Vacuum Data System (TVDS) within the thermal vacuum lab at GSFC, its features and capabilities and lessons learned in its implementation. Additional topics include off-center (Internet) capability for remote monitoring and the role of TVDS in the efforts to automate thermal vacuum chamber operations.

[Design and implementation of the ELSA-Brasil biobank: a prospective study in a Brazilian population].

PubMed

Pereira, Alexandre C; Bensenor, Isabela M; Fedeli, Ligia M; Castilhos, Cristina; Vidigal, Pedro G; Maniero, Viviane; Leite, Claudia M; Pimentel, Robercia A; Duncan, Bruce B; Mill, Jose Geraldo; Lotufo, Paulo A

2013-06-01

The Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) is a multicenter prospective cohort of civil servants designed to assess the determinants of chronic diseases, especially cardiovascular diseases and type 2 diabetes. The present article describes the main design and implementation points of the ELSA-Brasil biobank project. Economic, political, logistical and technological aspects of this study are characterized. Additionally, it discusses the final biorepository protocol and the facilities implemented to achieve this objective. The design and implementation process of the ELSA-Brasil biobank took three years to be performed. Both the central and local biobanks were built according to the best biorepository techniques, using different technological solutions for the distinct needs expected in this study.

Delphi Method Validation of a Procedural Performance Checklist for Insertion of an Ultrasound-Guided Internal Jugular Central Line.

PubMed

Hartman, Nicholas; Wittler, Mary; Askew, Kim; Manthey, David

2016-01-01

Placement of ultrasound-guided central lines is a critical skill for physicians in several specialties. Improving the quality of care delivered surrounding this procedure demands rigorous measurement of competency, and validated tools to assess performance are essential. Using the iterative, modified Delphi technique and experts in multiple disciplines across the United States, the study team created a 30-item checklist designed to assess competency in the placement of ultrasound-guided internal jugular central lines. Cronbach α was .94, indicating an excellent degree of internal consistency. Further validation of this checklist will require its implementation in simulated and clinical environments. © The Author(s) 2014.

Evaluation bias in objective response rate and disease control rate between blinded independent central review and local assessment: a study-level pooled analysis of phase III randomized control trials in the past seven years.

PubMed

Zhang, Jianrong; Zhang, Yiyin; Tang, Shiyan; Liang, Hengrui; Chen, Difei; Jiang, Long; He, Qihua; Huang, Yu; Wang, Xinyu; Deng, Kexin; Jiang, Shuhan; Zhou, Jiaqing; Xu, Jiaxuan; Chen, Xuanzuo; Liang, Wenhua; He, Jianxing

2017-12-01

In previous studies, complete-case implementation of blind independent central review has been considered unnecessary based on no sign of systematic bias between central and local assessments. In order to further evaluate its value, this study investigated evaluation status between both assessments in phase III trials of anti-cancer drugs for non-hematologic solid tumors. Eligible trials were searched in PubMed with the date of Jan 1, 2010 to Jun 30, 2017. We compared objective response rate (ORR) and disease control rate (DCR) between central and local assessments by study-level pooled analysis and correlation analysis. In pooled analysis, direct comparison was measured by the odds ratio (OR) of central-assessed response status to local-assessed response status; to investigate evaluation bias between central and local assessments, the above calculated OR between experimental (exp-) and control (con-) arms were compared, measured by the ratio of OR. A total of 28 included trials involving 17,466 patients were included (28 with ORR, 16 with DCR). Pooled analysis showed central assessment reported lower ORR and DCR than local assessment, especially in trials with open-label design, central-assessed primary endpoint, and positive primary endpoint outcome, respectively. However, this finding could be found in both experimental [exp-ORR: OR=0.81 (95% CI: 0.76-0.87), P<0.01, I 2 =11%; exp-DCR: OR=0.90 (0.81-1.01), P=0.07, I 2 =42%] and control arms [con-ORR: OR=0.79 (0.72-0.85), P<0.01, I 2 =17%; con-DCR: OR=0.94 (0.86-1.02), P=0.14, I 2 =12%]. No sign of evaluation bias between two assessments was indicated through further analysis [ORR: ratio of OR=1.02 (0.97-1.07), P=0.42, I 2 =0%; DCR: ratio of OR=0.98 (0.93-1.03), P=0.37, I 2 =0%], regardless of mask (open/blind), sample size, tumor type, primary endpoint (central-assessed/local-assessed), and primary endpoint outcome (positive/negative). Correlation analysis demonstrated a high-degree concordance between central and local assessments (exp-ORR, con-ORR, exp-DCR, con-DCR: r>0.90, P<0.01). Blind independent central review remained irreplaceable to monitor local assessment, but its complete-case implementation may be unnecessary.

Integrating Micro-computers with a Centralized DBMS: ORACLE, SEED AND INGRES

NASA Technical Reports Server (NTRS)

Hoerger, J.

1984-01-01

Users of ADABAS, a relational-like data base management system (ADABAS) with its data base programming language (NATURAL) are acquiring microcomputers with hopes of solving their individual word processing, office automation, decision support, and simple data processing problems. As processor speeds, memory sizes, and disk storage capacities increase, individual departments begin to maintain "their own" data base on "their own" micro-computer. This situation can adversely affect several of the primary goals set for implementing a centralized DBMS. In order to avoid this potential problem, these micro-computers must be integrated with the centralized DBMS. An easy to use and flexible means for transferring logic data base files between the central data base machine and micro-computers must be provided. Some of the problems encounted in an effort to accomplish this integration and possible solutions are discussed.

Knowledge Resources - A Knowledge Management Approach for Digital Ecosystems

NASA Astrophysics Data System (ADS)

Kurz, Thomas; Eder, Raimund; Heistracher, Thomas

The paper at hand presents an innovative approach for the conception and implementation of knowledge management in Digital Ecosystems. Based on a reflection of Digital Ecosystem research of the past years, an architecture is outlined which utilizes Knowledge Resources as the central and simplest entities of knowledge transfer. After the discussion of the related conception, the result of a first prototypical implementation is described that helps the transformation of implicit knowledge to explicit knowledge for wide use.

Spotlight on the Middle: Report of the Texas Task Force on Middle School Education. Executive Summary and State Board of Education Policy Statement on Middle Grade Education and Middle Grade Schools. Revised.

ERIC Educational Resources Information Center

Texas Education Agency, Austin.

This summary highlights implementation strategies from the full report for restructuring middle grade education in Texas. The task force was guided by a central theme--a vision of Texas schools using each other as resources and the campus planning process as a vehicle for implementing research-based concepts and practices in the middle grades.…

Under Construction: Benchmark Assessments and Common Core Math Implementation in Grades K-8. Formative Evaluation Cycle Report for the Math in Common Initiative, Volume 1

ERIC Educational Resources Information Center

Flaherty, John, Jr.; Sobolew-Shubin, Alexandria; Heredia, Alberto; Chen-Gaddini, Min; Klarin, Becca; Finkelstein, Neal D.

2014-01-01

Math in Common® (MiC) is a five-year initiative that supports a formal network of 10 California school districts as they implement the Common Core State Standards in mathematics (CCSS-M) across grades K-8. As the MiC initiative moves into its second year, one of the central activities that each of the districts is undergoing to support CCSS…

Implementation Of Conservation Policy Through The Protection Of Life Support System In The Karimunjawa National Park

NASA Astrophysics Data System (ADS)

Ariyani, Nur Anisa Eka; Kismartini

2018-02-01

The Karimunjawa National Park as the only one marine protected area in Central Java, managed by zonation system has decreased natural resources in the form of decreasing mangrove forest area, coral cover, sea biota population such as clams and sea cucumbers. Conservation has been done by Karimunjawa National Park Authority through protection of life support system activities in order to protect the area from degradation. The objective of the research is to know the implementation of protection and security activities of Karimunjawa National Park Authority for the period of 2012 - 2016. The research was conducted by qualitative method, processing secondary data from Karimunjawa National Park Authority and interview with key informants. The results showed that protection and security activities in The Karimunjawa National Park were held with three activities: pre-emptive activities, preventive activities and repressive activities. Implementation of conservation policy through protection of life support system is influenced by factors of policy characteristic, resource factor and environmental policy factor. Implementation of conservation policy need support from various parties, not only Karimunjawa National Park Authority as the manager of the area, but also need participation of Jepara Regency, Central Java Provinces, communities, NGOs, researchers, developers and tourism actors to maintain and preserve existing biodiversity. Improving the quality of implementors through education and training activities, the availability of the state budget annually and the support of stakeholders is essential for conservation.

Integration of human papillomavirus vaccination and cervical cancer screening in Latin America and the Caribbean.

PubMed

Franco, Eduardo L; Tsu, Vivien; Herrero, Rolando; Lazcano-Ponce, Eduardo; Hildesheim, Allan; Muñoz, Nubia; Murillo, Raul; Sánchez, Gloria Ines; Andrus, Jon Kim

2008-08-19

Despite substantial efforts to control cervical cancer by screening, most Latin American and Caribbean countries continue to experience incidence rates of this disease that are much higher than those of other Western countries. The implementation of universal human papillomavirus (HPV) vaccination for young adolescent women is the best prospect for changing this situation. Even though there are financial challenges to overcome to implement such a policy, there is broad political support in the region for adopting universal HPV vaccination. The costs of implementing this policy could be largely alleviated by changing cervical cancer control practices that rely on inefficient use of resources presently allocated to cytology screening. In view of the strong evidence base concerning cervical cancer prevention technologies in the region and the expected impact of vaccination on the performance of cytology, we propose a reformulation of cervical cancer screening policies to be based on HPV testing using validated methods followed by cytologic triage. This approach would serve as the central component of a system that plays the dual role of providing screening and surveillance as integrated and complementary activities sharing centralized resources and coordination.

Procedural and educational interventions to reduce ventilator-associated pneumonia rate and central line-associated blood stream infection rate.

PubMed

Kellie, Scott P; Scott, Michael J; Cavallazzi, Rodrigo; Wiemken, Tim L; Goss, Linda; Parker, Deanna; Saad, Mohamed

2014-01-01

Implementing best practice guidelines for ventilator-associated pneumonia (VAP) and central line-associated blood stream infection (CLA-BSI) has variable success. Our institution was concerned with high rates of VAP and CLA-BSI. This retrospective study was undertaken to see whether implementation of the below practices would reduce the rates of VAP and CLA-BSI without resorting to more expensive interventions such as subglottic endotracheal (ET) tube suctioning or silver-impregnated ET tubes. We utilized easily collectable data (standardized infection ratios [SIRs]) to rapidly assess whether interventions already in place were successful. This avoided cumbersome data collection and review. Retrospective data review calculated SIRs using National Healthcare Safety Network benchmarks. Rates and SIRs were compared using z tests with P values <.05 considered statistically significant. This data review attempted to examine the impact of education campaigns, staff meetings, in-services, physician checklist, nurse checklist, charge nurse checklist implementation, and chlorhexidine gluconate oral care addition to the VAP bundle. Additionally, central line insertion required nursing supervision, a checklist, and physician signature. The incidence rate of VAP went from 9.88 occurrences/1000 vent days in 2009 to 0 occurrences/1000 vent days in 2010 (P < .001). The CLA-BSI occurrences/1000 line days were 2.86 in 2009 and 0.97 in 2010 (P = .0187). The SIR for VAP was 4.12 in 2009 and 0 in 2010 (P < .001). For CLA-BSI, the SIR was 1.1 in 2009 and 0.37 in 2010 (P = .04). Efforts to improve physician, patient, and staff education, and checklist implementation resulted in a decrease in VAP and CLA-BSI. This study confirms the applicability of best practice guidelines and suggests a benefit to the use of checklists. We utilize a practical approach for examining the success of these changes.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved.

PubMed

Inrig, Stephen J; Tiro, Jasmin A; Melhado, Trisha V; Argenbright, Keith E; Craddock Lee, Simon J

2014-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. To better understand how to implement a decentralized regional delivery "hub & spoke" model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow's RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow's RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting.

Evaluating a De-Centralized Regional Delivery System for Breast Cancer Screening and Patient Navigation for the Rural Underserved

PubMed Central

Inrig, Stephen J.; Tiro, Jasmin A.; Melhado, Trisha V.; Argenbright, Keith E.; Craddock Lee, Simon J.

2017-01-01

Providing breast cancer screening services in rural areas is challenging due to the fractured nature of healthcare delivery systems and complex reimbursement mechanisms that create barriers to access for the under- and uninsured. Interventions that reduce structural barriers to mammography, like patient navigation programs, are effective and recommended, especially for minority and underserved women. Although the literature on rural healthcare is significant, the field lacks studies of adaptive service delivery models and rigorous evaluation of evidence-based programs that facilitate routine screening and appropriate follow-up across large geographic areas. Objectives To better understand how to implement a decentralized regional delivery “hub & spoke” model for rural breast cancer screening and patient navigation, we have designed a rigorous, structured, multi-level and mixed-methods evaluation based on Glasgow’s RE-AIM model (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Methods and Design The program is comprised of three core components: 1) Outreach to underserved women by partnering with county organizations; 2) Navigation to guide patients through screening and appropriate follow-up; and 3) Centralized Reimbursement to coordinate funding for screening services through a central contract with Medicaid Breast and Cervical Cancer Services (BCCS). Using Glasgow’s RE-AIM model, we will: 1) assess which counties have the resources and capacity to implement outreach and/or navigation components, 2) train partners in each county on how to implement components, and 3) monitor process and outcome measures in each county at regular intervals, providing booster training when needed. Discussion This evaluation strategy will elucidate how the heterogeneity of rural county infrastructure impacts decentralized service delivery as a navigation program expands. In addition to increasing breast cancer screening access, our model improves and maintains time to diagnostic resolution and facilitates timely referral to local cancer treatment services. We offer this evaluation approach as an exemplar for scientific methods to evaluate the translation of evidence-based federal policy into sustainable health services delivery in a rural setting. PMID:28713882

75 FR 18146 - South Central Idaho Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... operating principles and project proposals. DATES: The meeting will be held May 17, 2010 from 1:30 p.m.-3:30... specifically deal with Operating principles and project proposals that the RAC will use to implement the...

Smart sign ordering system : research implementation plan.

DOT National Transportation Integrated Search

2004-05-01

STATEMENT OF NEED: ODOT operates a Sign Shop to fabricate traffic and information signs. The Districts prepare and submit orders for : signs to the Central Office, where each order is checked against design specifications and standards. The Sign Shop...

Analysis of Selected Enhancements to the En Route Central Computing Complex

DOT National Transportation Integrated Search

1981-09-01

This report analyzes selected hardware enhancements that could improve the performance of the 9020 computer systems, which are used to provide en route air traffic control services. These enhancements could be implemented quickly, would be relatively...

Pod Nursing on a Medical/Surgical Unit: Implementation and Outcomes Evaluation

PubMed Central

Friese, Christopher R.; Grunawalt, Julie C.; Bhullar, Sara; Bihlmeyer, Karen; Chang, Robert; Wood, Winnie

2014-01-01

A medical/surgical unit at the University of Michigan Health System implemented a pod nursing model of care to improve efficiency and patient and staff satisfaction. One centralized station was replaced with 4 satellites and supplies were relocated next to patient rooms. Patients were assigned to 2 nurses who worked as partners. Three patient (satisfaction, call lights, and falls) and nurse (satisfaction and overtime) outcomes improved after implementation. Efforts should be focused on addressing patient acuity imbalances across assignments and strengthening communication among the health care team. Studies are needed to test the model in larger and more diverse settings. PMID:24662689

Integrating health-related quality of life into cross-national clinical trials.

PubMed

Cella, D F; Wiklund, I; Shumaker, S A; Aaronson, N K

1993-12-01

When planning to implement health-related quality of life (HRQL) assessment in a multinational clinical trial, there are at least four general considerations: the natural history of the disease or condition, the characteristics of the population, the treatment under consideration, and the structure and function of the clinical trial organization. Each of these considerations must be addressed simultaneously when planning, implementing and analysing a cross-national clinical trial. There are five relevant polar components of the natural history of a given disease or condition: (1) time frame (acute versus chronic); (2) life threat (yes versus no); (3) symptomatology (present versus absent); (4) symptom expression (episodic versus constant); and (5) functional impact (present versus absent). Differences in population characteristics, (e.g., age, conditions, co-morbidity), embedded within any cross-national trial, must be addressed conceptually prior to initiating the trial, methodologically when planning implementation, and statistically after the collection of the data. In terms of treatment, issues such as adverse and positive effects and timing of effects must be considered. The methods entailed in planning, implementing and analysing HRQL data will depend upon the degree of centralization of personnel and resources within any given clinical trial. The range of possibilities runs from complete centralization, in which all planning and coordination of data collection and transmittal is done by one office, to complete decentralization, in which the work is distributed to participating sites and interested investigators. Finally, successful implementation of HRQL data collection is enhanced by heightening awareness of the importance of, and value in, assessing HRQL in clinical trials.(ABSTRACT TRUNCATED AT 250 WORDS)

Primal-dual and forward gradient implementation for quantitative susceptibility mapping.

PubMed

Kee, Youngwook; Deh, Kofi; Dimov, Alexey; Spincemaille, Pascal; Wang, Yi

2017-12-01

To investigate the computational aspects of the prior term in quantitative susceptibility mapping (QSM) by (i) comparing the Gauss-Newton conjugate gradient (GNCG) algorithm that uses numerical conditioning (ie, modifies the prior term) with a primal-dual (PD) formulation that avoids this, and (ii) carrying out a comparison between a central and forward difference scheme for the discretization of the prior term. A spatially continuous formulation of the regularized QSM inversion problem and its PD formulation were derived. The Chambolle-Pock algorithm for PD was implemented and its convergence behavior was compared with that of GNCG for the original QSM. Forward and central difference schemes were compared in terms of the presence of checkerboard artifacts. All methods were tested and validated on a gadolinium phantom, ex vivo brain blocks, and in vivo brain MRI data with respect to COSMOS. The PD approach provided a faster convergence rate than GNCG. The GNCG convergence rate slowed considerably with smaller (more accurate) values of the conditioning parameter. Using a forward difference suppressed the checkerboard artifacts in QSM, as compared with the central difference. The accuracy of PD and GNCG were validated based on excellent correlation with COSMOS. The PD approach with forward difference for the gradient showed improved convergence and accuracy over the GNCG method using central difference. Magn Reson Med 78:2416-2427, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

A regional centralized microbiology service in Calgary for the rapid diagnosis of malaria.

PubMed

Church, Deirdre L; Lichtenfeld, Angelika; Elsayed, Sameer; Kuhn, Susan; Gregson, Daniel B

2003-06-01

A regional centralized laboratory service for the rapid diagnosis of malaria was implemented 3 years ago in May 1999 within the Division of Microbiology, Calgary Laboratory Services. To describe the design and performance of this unique microbiology laboratory service. Blood specimens must arrive at the central laboratory within 2 hours of collection. Thin blood smears are read and reported from suspected acute cases within 1 hour of receipt, 24 hours per day, 7 days a week, by trained and experienced microbiology technologists. All positive malaria smears are reviewed by a medical microbiologist and confirmed by polymerase chain reaction at a reference laboratory. Calgary Laboratory Services provides integrated laboratory services to the Calgary Health Region, an urban area of more than 1 million people. Performance of the service has been continuously monitored by measuring preanalytic and analytic test turnaround times, test accuracy, clinical relevance, and the results of proficiency testing. More than 90% of blood specimens for malaria from community locations have consistently arrived within 2 hours of collection, and hospitals have reached this target within the past year. Although polymerase chain reaction was more sensitive at detecting the presence of malaria, the expert microscopists were as accurate at determining the type of Plasmodium infection. More than 95% of all positive smear results are consistently reported within 2 hours of receipt of a blood specimen. Implementation of a regional centralized microbiology service has improved our ability to make a rapid and accurate diagnosis of malaria in this region.

Tools to manage the enterprise-wide picture archiving and communications system environment.

PubMed

Lannum, L M; Gumpf, S; Piraino, D

2001-06-01

The presentation will focus on the implementation and utilization of a central picture archiving and communications system (PACS) network-monitoring tool that allows for enterprise-wide operations management and support of the image distribution network. The MagicWatch (Siemens, Iselin, NJ) PACS/radiology information system (RIS) monitoring station from Siemens has allowed our organization to create a service support structure that has given us proactive control of our environment and has allowed us to meet the service level performance expectations of the users. The Radiology Help Desk has used the MagicWatch PACS monitoring station as an applications support tool that has allowed the group to monitor network activity and individual systems performance at each node. Fast and timely recognition of the effects of single events within the PACS/RIS environment has allowed the group to proactively recognize possible performance issues and resolve problems. The PACS/operations group performs network management control, image storage management, and software distribution management from a single, central point in the enterprise. The MagicWatch station allows for the complete automation of software distribution, installation, and configuration process across all the nodes in the system. The tool has allowed for the standardization of the workstations and provides a central configuration control for the establishment and maintenance of the system standards. This report will describe the PACS management and operation prior to the implementation of the MagicWatch PACS monitoring station and will highlight the operational benefits of a centralized network and system-monitoring tool.

Implementation of Change (IC).

DTIC Science & Technology

1980-06-30

4- co C\\J t ) t r) - 1 )C CC :r E 4-’ c) C- co cn a, ko r- co0 :3 -~ a)~ -D V) 0:3 4-2 CAA-SR-80-5 4-5. SUMMARY. The above discussion suggests that...MTOE documents frequently cost the Army resources; e.g., changes to components of sets, kits and outfits ( SKO ). On the other hand, failure to implement...either retraineo tn recruited to meet the qudlification requiremient. F-13 CAA-SR- KO -5 a. Central Assignment Procedures System (CAP III). Personnel

Implementation of a Research Information Management System in a Pediatric Hospital.

PubMed

Kissling, Alison D; Ballinger, Kimberly D

2018-01-01

Faculty publications have been collected in universities, health, and medical institutions for many years, and Cincinnati Children's is no exception. Since 1949, a yearly list of faculty publications was manually compiled using multiple data sources and disseminated by the Edward L. Pratt Research Library. Products to centralize faculty publication collection and analysis with bibliometric tools are growing in popularity. This article will review the collaborative decision to choose a Research Information Management System and the implementation process including successes, challenges, and future opportunities.

40 CFR 52.1221 - Classification of regions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Minnesota § 52.1221 Classification of regions. The Minnesota plan was evaluated on the basis of the following classifications: Air... Photochemical oxidants (hydrocarbons) Central Minnesota Intrastate II III III III III Southeast Minnesota-La...

40 CFR 52.1221 - Classification of regions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Minnesota § 52.1221 Classification of regions. The Minnesota plan was evaluated on the basis of the following classifications: Air... Photochemical oxidants (hydrocarbons) Central Minnesota Intrastate II III III III III Southeast Minnesota-La...

40 CFR 52.1221 - Classification of regions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Minnesota § 52.1221 Classification of regions. The Minnesota plan was evaluated on the basis of the following classifications: Air... Photochemical oxidants (hydrocarbons) Central Minnesota Intrastate II III III III III Southeast Minnesota-La...

Evaluation strategy : Puget Sound regional fare card : FY01 earmark evaluation

DOT National Transportation Integrated Search

2003-06-24

King County Metro Transit is the lead agency responsible for implementing the Central Puget Sound Regional Fare Coordination Project (RFC Project). The project features a smart card technology that will support and link the fare collection systems of...

78 FR 21581 - Revisions to the California State Implementation Plan, Santa Barbara County Air Pollution Control...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-11

... the transfer and dispensing of gasoline. We are proposing to approve local rules to regulate these... Fan-Type Central Furnaces and Small Water Heaters and SCAQMD Rule 461 Gasoline Transfer and Dispensing...

Patient Education in University Health Services: An Interdisciplinary Approach to Planning and Implementation.

ERIC Educational Resources Information Center

Bensley, Loren B., Jr.; Moffitt, Patrick B.

1978-01-01

This article looks at the patient education program and explains the role of the patient education intern at Central Michigan University. Included are helpful recommendations for persons interested in developing similar health education programs. (YG)

System design and architecture for the IDTO prototype : phase II demonstration site (central Florida).

DOT National Transportation Integrated Search

2015-05-01

This report documents the System Design and Architecture for the Phase II implementation of the Integrated Dynamic Transit Operations (IDTO) Prototype bundle within the Dynamic Mobility Applications (DMA) portion of the Connected Vehicle Program. Thi...

CBD Fare-Free Transit Service in Albany, New York

DOT National Transportation Integrated Search

1981-12-01

The report presents an evaluation of the impacts associated with the implementation of fare-free transit service in the Central Business District (CBD) of Albany, New York. The Albany demonstration began in November 1978; fares were eliminated for tr...

IVHS Denver Metro Area, Master Plan, Appendix A, Project Descriptions

DOT National Transportation Integrated Search

1994-02-01

THIS ACTIVITY INVOLVES THE CONCEPTUAL DESIGN, CONSTRUCTION AND IMPLEMENTATION OF A TRAFFIC OPERATIONS CENTER (TOC) FOR THE DENVER AREA. : ESTABLISHING A TOC IS CENTRAL TO THE SUCCESS OF IVHS IN THE DENVER AREA.ITS IMPORTANCE WILL CONTINUE BEYOND T...

Decentralized Modular Systems Versus Centralized Systems.

ERIC Educational Resources Information Center

Crossey, R. E.

Building design, planning, and construction programing for modular decentralized mechanical building systems are outlined in terms of costs, performance, expansion and flexibility. Design strategy, approach, and guidelines for implementing such systems for buildings are suggested, with emphasis on mechanical equipment and building element…

Failure to Rescue, Rescue Surgery and Centralization of Postoperative Complications: A Challenge for General and Acute Care Surgeons.

PubMed

Zago, Mauro; Bozzo, Samantha; Carrara, Giulia; Mariani, Diego

2017-01-01

To explore the current literature on the failure to rescue and rescue surgery concepts, to identify the key items for decreasing the failure to rescue rate and improve outcome, to verify if there is a rationale for centralization of patients suffering postoperative complications. There is a growing awareness about the need to assess and measure the failure to rescue rate, on institutional, regional and national basis. Many factors affect failure to rescue, and all should be individually analyzed and considered. Rescue surgery is one of these factors. Rescue surgery assumes an acute care surgery background. Measurement of failure to rescue rate should become a standard for quality improvement programs. Implementation of all clinical and organizational items involved is the key for better outcomes. Preparedness for rescue surgery is a main pillar in this process. Centralization of management, audit, and communication are important as much as patient centralization. Celsius.

Winner-take-all in a phase oscillator system with adaptation.

PubMed

Burylko, Oleksandr; Kazanovich, Yakov; Borisyuk, Roman

2018-01-11

We consider a system of generalized phase oscillators with a central element and radial connections. In contrast to conventional phase oscillators of the Kuramoto type, the dynamic variables in our system include not only the phase of each oscillator but also the natural frequency of the central oscillator, and the connection strengths from the peripheral oscillators to the central oscillator. With appropriate parameter values the system demonstrates winner-take-all behavior in terms of the competition between peripheral oscillators for the synchronization with the central oscillator. Conditions for the winner-take-all regime are derived for stationary and non-stationary types of system dynamics. Bifurcation analysis of the transition from stationary to non-stationary winner-take-all dynamics is presented. A new bifurcation type called a Saddle Node on Invariant Torus (SNIT) bifurcation was observed and is described in detail. Computer simulations of the system allow an optimal choice of parameters for winner-take-all implementation.

Eccentric correction for off-axis vision in central visual field loss.

PubMed

Gustafsson, Jörgen; Unsbo, Peter

2003-07-01

Subjects with absolute central visual field loss use eccentric fixation and magnifying devices to utilize their residual vision. This preliminary study investigated the importance of an accurate eccentric correction of off-axis refractive errors to optimize the residual visual function for these subjects. Photorefraction using the PowerRefractor instrument was used to evaluate the ametropia in eccentric fixation angles. Methods were adapted for measuring visual acuity outside the macula using filtered optotypes from high-pass resolution perimetry. Optical corrections were implemented, and the visual function of subjects with central visual field loss was measured with and without eccentric correction. Of the seven cases reported, five experienced an improvement in visual function in their preferred retinal locus with eccentric refraction. The main result was that optical correction for better image quality on the peripheral retina is important for the vision of subjects with central visual field loss, objectively as well as subjectively.

Practice-based research networks (PBRNs) are promising laboratories for conducting dissemination and implementation research.

PubMed

Heintzman, John; Gold, Rachel; Krist, Alexander; Crosson, Jay; Likumahuwa, Sonja; DeVoe, Jennifer E

2014-01-01

Dissemination and implementation science addresses the application of research findings in varied health care settings. Despite the potential benefit of dissemination and implementation work to primary care, ideal laboratories for this science have been elusive. Practice-based research networks (PBRNs) have a long history of conducting research in community clinical settings, demonstrating an approach that could be used to execute multiple research projects over time in broad and varied settings. PBRNs also are uniquely structured and increasingly involved in pragmatic trials, a research design central to dissemination and implementation science. We argue that PBRNs and dissemination and implementation scientists are ideally suited to work together and that the collaboration of these 2 groups will yield great value for the future of primary care and the delivery of evidence-based health care. © Copyright 2014 by the American Board of Family Medicine.

The Effect of the Leader in Me, a School-Wide Positive Behavior Intervention System (SW-PBIS), Based on Student Achievement and Office Discipline Referrals for Fifth Grade Students in a Rural Elementary School in North Central Washington State

ERIC Educational Resources Information Center

Miller, Christopher A.

2016-01-01

The purpose this study was to examine the implementation of The Leader in Me, a school-wide positive behavior intervention system (SW-PBIS), and analyze its impact on 5th grade students based on student achievement and office discipline referrals in a rural elementary school in North Central Washington state. The school was in the first year of…

Improving management decision processes through centralized communication linkages

NASA Technical Reports Server (NTRS)

Simanton, D. F.; Garman, J. R.

1985-01-01

Information flow is a critical element to intelligent and timely decision-making. At NASA's Johnson Space Center the flow of information is being automated through the use of a centralized backbone network. The theoretical basis of this network, its implications to the horizontal and vertical flow of information, and the technical challenges involved in its implementation are the focus of this paper. The importance of the use of common tools among programs and some future concerns related to file transfer, graphics transfer, and merging of voice and data are also discussed.

Development of a space-systems network testbed

NASA Technical Reports Server (NTRS)

Lala, Jaynarayan; Alger, Linda; Adams, Stuart; Burkhardt, Laura; Nagle, Gail; Murray, Nicholas

1988-01-01

This paper describes a communications network testbed which has been designed to allow the development of architectures and algorithms that meet the functional requirements of future NASA communication systems. The central hardware components of the Network Testbed are programmable circuit switching communication nodes which can be adapted by software or firmware changes to customize the testbed to particular architectures and algorithms. Fault detection, isolation, and reconfiguration has been implemented in the Network with a hybrid approach which utilizes features of both centralized and distributed techniques to provide efficient handling of faults within the Network.

Generation-based memory synchronization in a multiprocessor system with weakly consistent memory accesses

DOEpatents

Ohmacht, Martin

2017-08-15

In a multiprocessor system, a central memory synchronization module coordinates memory synchronization requests responsive to memory access requests in flight, a generation counter, and a reclaim pointer. The central module communicates via point-to-point communication. The module includes a global OR reduce tree for each memory access requesting device, for detecting memory access requests in flight. An interface unit is implemented associated with each processor requesting synchronization. The interface unit includes multiple generation completion detectors. The generation count and reclaim pointer do not pass one another.

Generation-based memory synchronization in a multiprocessor system with weakly consistent memory accesses

DOEpatents

Ohmacht, Martin

2014-09-09

In a multiprocessor system, a central memory synchronization module coordinates memory synchronization requests responsive to memory access requests in flight, a generation counter, and a reclaim pointer. The central module communicates via point-to-point communication. The module includes a global OR reduce tree for each memory access requesting device, for detecting memory access requests in flight. An interface unit is implemented associated with each processor requesting synchronization. The interface unit includes multiple generation completion detectors. The generation count and reclaim pointer do not pass one another.

Human papillomavirus prevalence and type-distribution, cervical cancer screening practices and current status of vaccination implementation in Central and Eastern Europe.

PubMed

Poljak, Mario; Seme, Katja; Maver, Polona J; Kocjan, Boštjan J; Cuschieri, Kate S; Rogovskaya, Svetlana I; Arbyn, Marc; Syrjänen, Stina

2013-12-31

We present a review of current cervical cancer screening practices, the implementation status of vaccination against human papillomaviruses (HPV) and available data concerning the burden of HPV infection and HPV type-specific distribution in 16 Central and Eastern European countries: Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia and the Former Yugoslav Republic (FYR) of Macedonia. Since published data were relatively scarce, two detailed surveys were conducted during August-October 2011 and in January 2013 to obtain relevant and updated information. The mean prevalence of HPV infection in 8610 women with normal cervical cytology from the region was 12.6%, with HPV16 being the most frequent HPV type. The overall HPV DNA prevalence in women with high-grade cervical lesions was 78.1%. HPV DNA was found in 86.6% of cervical cancers; the combined prevalence of HPV16/18 among HPV positive cases was 87.5%. The overall HPV DNA prevalence in genital warts and laryngeal papillomas was 94.8% and 95.2%, respectively, with HPV6 and HPV11 being the most frequent types. Opportunistic and organized cervical screening, mainly based on conventional cytology, is performed in nine and seven countries in the region, respectively, with the proposed age of the start of screening ranging from 20 to 30 years and the estimated coverage ranging from a few percent to over 70%. At least one of the current HPV prophylactic vaccines is registered in all Central and Eastern European countries except Montenegro. Only Bulgaria, Czech Republic, FYR Macedonia, Latvia, Romania and Slovenia have actually integrated HPV vaccination into their national immunization programme and currently provide routine vaccination free of charge to the primary target population. The key reasons for lack of implementation of HPV vaccination into the national immunization programme are high vaccine cost and negative public perception. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Central and Eastern Europe and Central Asia Region" Vaccine Volume 31, Supplement 7, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Copyright © 2013 Elsevier Ltd. All rights reserved.

Supply chain optimization at an academic medical center.

PubMed

Labuhn, Jonathan; Almeter, Philip; McLaughlin, Christopher; Fields, Philip; Turner, Benjamin

2017-08-01

A successful supply chain optimization project that leveraged technology, engineering principles, and a technician workflow redesign in the setting of a growing health system is described. With continued rises in medication costs, medication inventory management is increasingly important. Proper management of central pharmacy inventory and floor-stock inventory in automated dispensing cabinets (ADCs) can be challenging. In an effort to improve control of inventory costs in the central pharmacy of a large academic medical center, the pharmacy department implemented a supply chain optimization project in collaboration with the medical center's inhouse team of experts on process improvement and industrial engineering. The project had 2 main components: (1) upgrading and reconfiguring carousel technology within an expanded central pharmacy footprint to generate accurate floor-stock inventory replenishment reports, which resulted in efficiencies within the medication-use system, and (2) implementing a technician workflow redesign and algorithm to right-size the ADC inventory, which decreased inventory stockouts (i.e., incidents of depletion of medication stock) and improved ADC user satisfaction. Through a multifaceted approach to inventory management, the number of stockouts per month was decreased and ADC inventory was optimized, resulting in a one-time inventory cost savings of $220,500. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Epidemiology of paediatric meningitis in central Côte d'Ivoire after the implementation of Haemophilus influenzae type b vaccination.

PubMed

Touré, Fidèle S; Kouame, Samson; Tia, Honoré; Monemo, Pacôme; Cissé, Amadou; Diané, Bamourou; Becker, Sören L; Akoua-Koffi, Chantal

2017-07-01

Infectious meningitis accounts for enormous morbidity worldwide, but there is a paucity of data on its regional epidemiology in resource-constrained settings of sub-Saharan Africa. Here, we present a study on the aetiology of paediatric meningitis in central Côte d'Ivoire. Between June 2012 and December 2013, all cerebrospinal fluid (CSF) samples drawn at the University Teaching Hospital Bouaké were examined for the presence of bacterial and fungal pathogens. A causative agent was detected in 31 out of 833 CSF specimens (3.7%), with the most prevalent pathogens being Streptococcus pneumoniae (n=15) and Neisseria meningitidis (n=5). With the exception of neonates, these two bacteria were the most common agents in all age groups. Of note, only a single case of Haemophilus influenzae meningitis was detected. Hence, this study reports a considerable shift in the epidemiology of paediatric meningitis in central Côte d'Ivoire. Following the implementation of a nation-wide childhood vaccination programme against H. influenzae type b, this pathogen was much less frequently reported than in previous studies. The integration of specific vaccines against S. pneumoniae and N. meningitidis into the childhood vaccination programme in Côted'Ivoire holds promise to further reduce the burden due to infectious meningitis.

Development of a standardized Intranet database of formulation records for nonsterile compounding, Part 2.

PubMed

Haile, Michael; Anderson, Kim; Evans, Alex; Crawford, Angela

2012-01-01

In part 1 of this series, we outlined the rationale behind the development of a centralized electronic database used to maintain nonsterile compounding formulation records in the Mission Health System, which is a union of several independent hospitals and satellite and regional pharmacies that form the cornerstone of advanced medical care in several areas of western North Carolina. Hospital providers in many healthcare systems require compounded formulations to meet the needs of their patients (in particular, pediatric patients). Before a centralized electronic compounding database was implemented in the Mission Health System, each satellite or regional pharmacy affiliated with that system had a specific set of formulation records, but no standardized format for those records existed. In this article, we describe the quality control, database platform selection, description, implementation, and execution of our intranet database system, which is designed to maintain, manage, and disseminate nonsterile compounding formulation records in the hospitals and affiliated pharmacies of the Mission Health System. The objectives of that project were to standardize nonsterile compounding formulation records, create a centralized computerized database that would increase healthcare staff members' access to formulation records, establish beyond-use dates based on published stability studies, improve quality control, reduce the potential for medication errors related to compounding medications, and (ultimately) improve patient safety.

Design of Spiking Central Pattern Generators for Multiple Locomotion Gaits in Hexapod Robots by Christiansen Grammar Evolution

PubMed Central

Espinal, Andres; Rostro-Gonzalez, Horacio; Carpio, Martin; Guerra-Hernandez, Erick I.; Ornelas-Rodriguez, Manuel; Sotelo-Figueroa, Marco

2016-01-01

This paper presents a method to design Spiking Central Pattern Generators (SCPGs) to achieve locomotion at different frequencies on legged robots. It is validated through embedding its designs into a Field-Programmable Gate Array (FPGA) and implemented on a real hexapod robot. The SCPGs are automatically designed by means of a Christiansen Grammar Evolution (CGE)-based methodology. The CGE performs a solution for the configuration (synaptic weights and connections) for each neuron in the SCPG. This is carried out through the indirect representation of candidate solutions that evolve to replicate a specific spike train according to a locomotion pattern (gait) by measuring the similarity between the spike trains and the SPIKE distance to lead the search to a correct configuration. By using this evolutionary approach, several SCPG design specifications can be explicitly added into the SPIKE distance-based fitness function, such as looking for Spiking Neural Networks (SNNs) with minimal connectivity or a Central Pattern Generator (CPG) able to generate different locomotion gaits only by changing the initial input stimuli. The SCPG designs have been successfully implemented on a Spartan 6 FPGA board and a real time validation on a 12 Degrees Of Freedom (DOFs) hexapod robot is presented. PMID:27516737

Correlated-Data Fusion and Cooperative Aiding in GNSS-Stressed or Denied Environments

NASA Astrophysics Data System (ADS)

Mokhtarzadeh, Hamid

A growing number of applications require continuous and reliable estimates of position, velocity, and orientation. Price requirements alone disqualify most traditional navigation or tactical-grade sensors and thus navigation systems based on automotive or consumer-grade sensors aided by Global Navigation Satellite Systems (GNSS), like the Global Positioning System (GPS), have gained popularity. The heavy reliance on GPS in these navigation systems is a point of concern and has created interest in alternative or back-up navigation systems to enable robust navigation through GPS-denied or stressed environments. This work takes advantage of current trends for increased sensing capabilities coupled with multilayer connectivity to propose a cooperative navigation-based aiding system as a means to limit dead reckoning error growth in the absence of absolute measurements like GPS. Each vehicle carries a dead reckoning navigation system which is aided by relative measurements, like range, to neighboring vehicles together with information sharing. Detailed architectures and concepts of operation are described for three specific applications: commercial aviation, Unmanned Aerial Vehicles (UAVs), and automotive applications. Both centralized and decentralized implementations of cooperative navigation-based aiding systems are described. The centralized system is based on a single Extended Kalman Filter (EKF). A decentralized implementation suited for applications with very limited communication bandwidth is discussed in detail. The presence of unknown correlation between the a priori state and measurement errors makes the standard Kalman filter unsuitable. Two existing estimators for handling this unknown correlation are Covariance Intersection (CI) and Bounded Covariance Inflation (BCInf) filters. A CI-based decentralized estimator suitable for decentralized cooperative navigation implementation is proposed. A unified derivation is presented for the Kalman filter, CI filter, and BCInf filter measurement update equations. Furthermore, characteristics important to the proper implementation of CI and BCInf in practice are discussed. A new covariance normalization step is proposed as necessary to properly apply CI or BCInf. Lastly, both centralized and decentralized implementations of cooperative aiding are analyzed and evaluated using experimental data in the three applications. In the commercial aviation study aircraft are simulated to use their Automatic Dependent Surveillance - Broadcast (ADS-B) and Traffic Collision Avoidance System (TCAS) systems to cooperatively aid their on board INS during a 60 min GPS outage in the national airspace. An availability study of cooperative navigation as proposed in this work around representative United States airports is performed. Availabilities between 70-100% were common at major airports like LGA and MSP in a 30 nmi radius around the airport during morning to evening hours. A GPS-denied navigation system for small UAVs based on cooperative information sharing is described. Experimentally collected flight data from 7 small UAV flights are played-back to evaluate the performance of the navigation system. The results show that the most effective of the architectures can lead to 5+ minutes of navigation without GPS maintaining position errors less than 200 m (1-sigma). The automotive case study considers 15 minutes of automotive traffic (2,000 + vehicles) driving through a half-mile stretch of highway without access to GPS. Automotive radar coupled with Dedicated Short Range Communication (DSRC) protocol are used to implement cooperative aiding to a low-cost 2-D INS on board each vehicle. The centralized system achieves an order of magnitude reduction in uncertainty by aggressively aiding the INS on board each vehicle. The proposed CI-based decentralized estimator is demonstrated to be conservative and maintain consistency. A quantitative analysis of bandwidth requirements shows that the proposed decentralized estimator falls comfortably within modern connectivity capabilities. A naive implementation of the high-performance centralized estimator is also achievable, but it was demonstrated to be burdensome, nearing the bandwidth limits.

76 FR 25407 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... INFORMATION CONTACT: Assistant Director, Compliance Outreach & Implementation, Office of Foreign Assets... their organizations on a worldwide basis with the objective of denying their businesses and agents... of the Central Intelligence Agency, the Director of the Federal Bureau of Investigation, the...

Conflicting Interests in Higher Education.

ERIC Educational Resources Information Center

Rhoades, Gary

1983-01-01

Considers five major interests at stake in higher education: social justice, competence, academic freedom, autonomy/accountability, and decentralization/centralization. Suggests that the implementation of conflicting interests is less a matter of the relation between the state and higher education than of relations between the academic profession…

Implementation of retrofit BMPs in a suburban watershed via economic incentives

EPA Science Inventory

Urban stormwater is typically conveyed to centralized infrastructure, and there is great potential for reducing stormwater runoff quantity through decentralization. In this case we hypothesize that smaller-scale retrofit best management practices (BMPs) such as rain gardens and r...

32 CFR 154.2 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... , Director of Central Intelligence Directive (DCID) 1/14 2 and regulations of the National Security Agency. 1... Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE SECURITY DEPARTMENT OF DEFENSE PERSONNEL SECURITY PROGRAM REGULATION General Provisions § 154.2 Applicability. (a) This part implements the...

Application Transparent HTTP Over a Disruption Tolerant Smartnet

DTIC Science & Technology

2014-09-01

American Standard Code for Information Interchange BP Bundle Protocol BPA bundle protocol agent CLA convergence layer adapters CPU central processing...forwarding them through the plugin pipeline. The initial version of the DTNInput plugin uses the BBN Spindle bundle protocol agent ( BPA ) implementation

76 FR 39263 - Antidumping and Countervailing Duty Proceedings: Electronic Filing Procedures; Administrative...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-06

... resulting from the Department's implementation of an electronic filing and documents management program... regulations that is entitled ``IA ACCESS Handbook On Electronic Filing Procedures'' (``IA ACCESS Handbook... management program named Import Administration Antidumping and Countervailing Duty Centralized Electronic...

Coping with Multiple Innovations in Schools: An Exploratory Study.

ERIC Educational Resources Information Center

Wallace, Mike

1991-01-01

Reviews small-scale, exploratory research into British schools' management of concurrent educational reform innovations generated by government, local education authorities, and the schools themselves. Describes changing innovations patterns, key factors influencing their adoption and implementation, the central management strategies employed, and…

The Australian Bibliographic Network--An Introduction.

ERIC Educational Resources Information Center

Hannan, Chris

1982-01-01

Focuses on the centralized, online, shared-cataloging facility of the Australian Bibliographic Network operated by the National Library of Australia. Existing automated library systems in Australia, selection and implementation of Washington Library Network software, comparison of Australian and U.S. automation, and projections for future…

Michael Sadler and the German Connection.

ERIC Educational Resources Information Center

Higginson, J. H.

1990-01-01

Chronicles works of Michael Sadler who compared British and German educational systems, emphasizing Germany's contributions in technical education. Presents Sadler's 1912 recommendations--eight lessons premised upon powerful centralized government's ability to implement policy. Reflects on how World War I and Nazism influenced Sadler's thought and…

7 CFR 2003.18 - Functional organization of RHS.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Property Management Division, and Single Family Housing Centralized Servicing Center in St. Louis, Mo. (i... credit reports, and, site development. (ii) Multi-Family Housing Portfolio Management Division. Headed by... the management and servicing of the nationwide Multi-Family Housing programs. The Division implements...

Bologna 2010. The Moment of Truth?

ERIC Educational Resources Information Center

Veiga, Amelia

2012-01-01

Government policies are central factors shaping the environment of higher education institutions. European governments have included in their higher education political strategies the principal goal of implementing the European Higher Education Area (EHEA). The perceptions that key actors of higher education institutions (HEIs) have about…

40 CFR 52.2571 - Classification of regions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2571 Classification of regions. The Wisconsin plan was evaluated on the basis of the following classifications: Air... Duluth (Minnesota)-Superior (Wisconsin) Interstate I II III III III North Central Wisconsin Intrastate II...

40 CFR 52.2571 - Classification of regions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2571 Classification of regions. The Wisconsin plan was evaluated on the basis of the following classifications: Air... Duluth (Minnesota)-Superior (Wisconsin) Interstate I II III III III North Central Wisconsin Intrastate II...

40 CFR 52.2571 - Classification of regions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Wisconsin § 52.2571 Classification of regions. The Wisconsin plan was evaluated on the basis of the following classifications: Air... Duluth (Minnesota)-Superior (Wisconsin) Interstate I II III III III North Central Wisconsin Intrastate II...

Report on functional requirements and software architecture for the IDTO prototype phase 2 : central Florida demonstration.

DOT National Transportation Integrated Search

2015-05-01

This report documents the System Requirements and Architecture for the Phase 2 implementation of the Integrated Dynamic Transit Operations (IDTO) Prototype bundle within the Dynamic Mobility Applications (DMA) portion of the Connected Vehicle Program...

Who are the innovators? Nursing homes implementing culture change.

PubMed

Grabowski, David C; Elliot, Amy; Leitzell, Brigitt; Cohen, Lauren W; Zimmerman, Sheryl

2014-02-01

A key directive of the Affordable Care Act of 2010 is to transform both institutional and community-based long-term care into a more person-centered system. In the nursing home industry, the culture change movement is central to this shift in philosophy. If policymakers are to further encourage implementation of culture change, they need to better understand the factors associated with implementation. Using logistic regression (N = 16,835), we examined the extent to which resident, facility, and state characteristics relate to a nursing home being identified by experts as having implemented culture change over the period 2004 through 2011. At baseline, the 291 facilities that were later identified by experts to have implemented culture change were more often nonprofit-owned, larger in size, and had fewer Medicaid and Medicare residents. Implementers also had better baseline quality with fewer health-related survey deficiencies and greater licensed practical nurse and nurse aide staffing. States experienced greater culture change implementation when they paid a higher Medicaid per diem. To date, nursing home culture change has been implemented differentially by higher resource facilities, and nursing homes have been responsive to state policy factors when implementing culture change.

Effect of an institutional development plan for user participation on professionals' knowledge, practice, and attitudes. A controlled study

PubMed Central

2011-01-01

Background Governments in several countries attempt to strengthen user participation through instructing health care organisations to plan and implement activities such as user representation in administrational boards, improved information to users, and more individual user participation in clinical work. The professionals are central in implementing initiatives to enhance user participation in organisations, but no controlled studies have been conducted on the effect on professionals from implementing institutional development plans. The objective was to investigate whether implementing a development plan intending to enhance user participation in a mental health hospital had any effect on the professionals' knowledge, practice, or attitudes towards user participation. Methods This was a non-randomized controlled study including professionals from three mental health hospitals in Central Norway. A development plan intended to enhance user participation was implemented in one of the hospitals as a part of a larger re-organizational process. The plan included i.e. establishing a patient education centre and a user office, purchasing of user expertise, appointing contact professionals for next of kin, and improving of the centre's information and the professional culture. The professionals at the intervention hospital thus constituted the intervention group, while the professionals at two other hospitals participated as control group. All professionals were invited to answer the Consumer Participation Questionnaire (CPQ) and additional questions, focusing on knowledge, practice, and attitudes towards user participation, two times with a 16 months interval. Results A total of 438 professionals participated (55% response rate). Comparing the changes in the intervention group with the changes in the control group revealed no statistically significant differences at a 0.05 level. The implementation of the development plan thus had no measurable effect on the professionals' knowledge, practice, or attitudes at the intervention hospital, compared to the control hospitals. Conclusion This is the first controlled study on the effect on professionals from implementing a development plan to enhance user participation in a mental health hospital. The plan had no effect on professionals' knowledge, practice, or attitudes. This can be due to the quality of the development plan, the implementation process, and/or the suitability of the outcome measures. PMID:22047466

A cross sectional study on nursing process implementation and associated factors among nurses working in selected hospitals of Central and Northwest zones, Tigray Region, Ethiopia.

PubMed

Baraki, Zeray; Girmay, Fiseha; Kidanu, Kalayou; Gerensea, Hadgu; Gezehgne, Dejen; Teklay, Hafte

2017-01-01

The nursing process is a systematic method of planning, delivering, and evaluating individualized care for clients in any state of health or illness. Many countries have adopted the nursing process as the standard of care to guide nursing practice; however, the problem is its implementation. If nurses fail to carry out the necessary nursing care through the nursing process; the effectiveness of patient progress may be compromised and can lead to preventable adverse events. This study was aimed to assess the implementation of nursing process and associated factors among nurses working in selected hospitals of central and northwest zones of Tigray, Ethiopia, 2015. A cross sectional observational study design was utilized. Data was collected from 200 participants using structured self-administered questionnaire which was contextually adapted from standardized, reliable and validated measures. The data were entered using Epi Info version 7 and analyzed using SPSS version 20 software. Data were summarized and described using descriptive statistics and multivariate logistic regression was used to determine the relationship of independent and dependent variable. Then, finally, data were presented in tables, graphs, frequency percentage of different variables. Seventy (35%) of participants have implemented nursing process. Different factors showed significant association. Nurses who worked in a stressful atmosphere of the workplace were 99% less likely to implement the nursing process than nurses who worked at a very good atmosphere. The nurses with an educational level of BSc. Degree were 6.972 times more likely to implement the nursing process than those who were diploma qualified. Nurses with no consistent material supply to use the nursing process were 95.1% less likely to implement the nursing process than nurses with consistent material supply. The majority of the participants were not implementing the nursing process properly. There are many factors that hinder them from applying the nursing process of which level of education, knowledge of nurses, skill of nurses, atmosphere of the work place, shortage of material supply to use the nursing process and high number of patient load were scientifically significant for the association test.

Effect of an institutional development plan for user participation on professionals' knowledge, practice, and attitudes. A controlled study.

PubMed

Rise, Marit By; Grimstad, Hilde; Solbjør, Marit; Steinsbekk, Aslak

2011-11-02

Governments in several countries attempt to strengthen user participation through instructing health care organisations to plan and implement activities such as user representation in administrational boards, improved information to users, and more individual user participation in clinical work. The professionals are central in implementing initiatives to enhance user participation in organisations, but no controlled studies have been conducted on the effect on professionals from implementing institutional development plans. The objective was to investigate whether implementing a development plan intending to enhance user participation in a mental health hospital had any effect on the professionals' knowledge, practice, or attitudes towards user participation. This was a non-randomized controlled study including professionals from three mental health hospitals in Central Norway. A development plan intended to enhance user participation was implemented in one of the hospitals as a part of a larger re-organizational process. The plan included i.e. establishing a patient education centre and a user office, purchasing of user expertise, appointing contact professionals for next of kin, and improving of the centre's information and the professional culture. The professionals at the intervention hospital thus constituted the intervention group, while the professionals at two other hospitals participated as control group. All professionals were invited to answer the Consumer Participation Questionnaire (CPQ) and additional questions, focusing on knowledge, practice, and attitudes towards user participation, two times with a 16 months interval. A total of 438 professionals participated (55% response rate). Comparing the changes in the intervention group with the changes in the control group revealed no statistically significant differences at a 0.05 level. The implementation of the development plan thus had no measurable effect on the professionals' knowledge, practice, or attitudes at the intervention hospital, compared to the control hospitals. This is the first controlled study on the effect on professionals from implementing a development plan to enhance user participation in a mental health hospital. The plan had no effect on professionals' knowledge, practice, or attitudes. This can be due to the quality of the development plan, the implementation process, and/or the suitability of the outcome measures.

Patient safety initiatives in Central and Eastern Europe: A mixed methods approach by the LINNEAUS collaboration on patient safety in primary care

PubMed Central

Godycki-Cwirko, Maciek; Esmail, Aneez; Dovey, Susan; Wensing, Michel; Parker, Dianne; Kowalczyk, Anna; Błaszczyk, Honorata; Kosiek, Katarzyna

2015-01-01

ABSTRACT Background: Despite patient safety being recognized as an important healthcare issue in the European Union, there has been variable implementation of patient safety initiatives in Central and Eastern Europe (CEE). Objective: To assess the status of patient safety initiatives in countries in CEE; to describe a process of engagement in Poland, which can serve as a template for the implementation of patient safety initiatives in primary care. Methods: A mixed methods design was used. We conducted a review of literature focusing on publications from CEE, an inventory of patient safety initiatives in CEE countries, interviews with key informants, international survey, review of national reporting systems, and pilot demonstrator project in Poland with implementation of patient safety toolkits assessment. Results: There was no published patient safety research from Albania, Belarus, Greece, Latvia, Lithuania, Romania, or Russia. Nine papers were found from Bulgaria, Croatia, the Czech Republic, Poland, Serbia, and Slovenia. In most of the CEE countries, patient safety had been addressed at the policy level although the focus was mainly in hospital care. There was a dearth of activity in primary care. The use of patient improvement strategies was low. Conclusion: International cooperation as exemplified in the demonstrator project can help in the development and implementation of patient safety initiatives in primary care in changing the emphasis away from a blame culture to one where greater emphasis is placed on improvement and learning. PMID:26339839

What does semantic tiling of the cortex tell us about semantics?

PubMed

Barsalou, Lawrence W

2017-10-01

Recent use of voxel-wise modeling in cognitive neuroscience suggests that semantic maps tile the cortex. Although this impressive research establishes distributed cortical areas active during the conceptual processing that underlies semantics, it tells us little about the nature of this processing. While mapping concepts between Marr's computational and implementation levels to support neural encoding and decoding, this approach ignores Marr's algorithmic level, central for understanding the mechanisms that implement cognition, in general, and conceptual processing, in particular. Following decades of research in cognitive science and neuroscience, what do we know so far about the representation and processing mechanisms that implement conceptual abilities? Most basically, much is known about the mechanisms associated with: (1) feature and frame representations, (2) grounded, abstract, and linguistic representations, (3) knowledge-based inference, (4) concept composition, and (5) conceptual flexibility. Rather than explaining these fundamental representation and processing mechanisms, semantic tiles simply provide a trace of their activity over a relatively short time period within a specific learning context. Establishing the mechanisms that implement conceptual processing in the brain will require more than mapping it to cortical (and sub-cortical) activity, with process models from cognitive science likely to play central roles in specifying the intervening mechanisms. More generally, neuroscience will not achieve its basic goals until it establishes algorithmic-level mechanisms that contribute essential explanations to how the brain works, going beyond simply establishing the brain areas that respond to various task conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Development and implementation of a pharmacist-run comprehensive medication review program in Wisconsin.

PubMed

Schoenrock, Danielle L; Hartkopf, Katherine; Boeckelman, Carrie

2016-12-01

The development and implementation of a centralized, pharmacist-run population health program were pursued within a health system to increase patient exposure to comprehensive medication reviews (CMRs) and improve visit processes. Program implementation included choosing appropriate pilot pharmacy locations, developing a feasible staffing model, standardizing the workflow, and creating a patient referral process. The impact on patient exposure, specific interventions, and the sustainability of the program were evaluated over a seven-month period. A total of 96 CMRs were scheduled during the data collection period. Attendance at scheduled CMRs was 54% (52 visits); there were 25 cancellations (26%) and 19 no-shows (20%). Since program implementation, there has been more than a twofold increase (2.08) in the number of CMRs completed within the health system. On average, all aspects of each patient visit took 1.78 hours to complete. Pharmacists spent 28% of scheduled time on CMR tasks and 72% of time on telephone calls and technical tasks to maintain appointments. A pharmacist-run CMR program helped to elevate the role of the community pharmacist in a health system and to improve patient exposure to CMRs. Sustaining a centralized CMR program requires support from other members of the health-system team so that pharmacists can spend more time providing patient care and less time on the technical tasks involved. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Translating Theory Into Practice: Implementing a Program of Assessment.

PubMed

Hauer, Karen E; O'Sullivan, Patricia S; Fitzhenry, Kristen; Boscardin, Christy

2018-03-01

A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school. A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement. Implementation incorporated stakeholder engagement, use of multiple assessment tools, design of a coaching program, and creation of a learner performance dashboard. The assessment team monitors adherence to principles defining the program of assessment and gathers and responds to regular feedback from key stakeholders, including faculty, staff, and students. Next steps include systematically collecting evidence for validity of individual assessments and the program overall. Iterative review of student performance data informs curricular improvements. The program of assessment also highlights technology needs that will be addressed with information technology experts. The outcome ultimately will entail showing evidence of validity that the program produces physicians who engage in lifelong learning and provide high-quality patient care.

Dedicated Operating Room Teams and Clinical Outcomes in an Enhanced Recovery after Surgery Pathway for Colorectal Surgery.

PubMed

Grant, Michael C; Hanna, Andrew; Benson, Andrew; Hobson, Deborah; Wu, Christopher L; Yuan, Christina T; Rosen, Michael; Wick, Elizabeth C

2018-03-01

Our aim was to determine whether the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery after Surgery (ERAS) program. Enhanced Recovery after Surgery programs involve the application of bundled best practices to improve the value of perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. Development of dedicated teams of anesthesia providers was a component of ERAS implementation. Intraoperative provider team networks (surgeons, anesthesiologists, and certified registered nurse anesthetists) were developed for all cases before and after implementation of colorectal ERAS. Four measures of centrality were analyzed in each network based on case assignments, and these measures were correlated with both rates of process measure compliance and clinical outcomes. Enhanced Recovery after Surgery provider teams led to a decrease in the closeness of anesthesiologists (p = 0.04) and significant increase in the clustering coefficient of certified registered nurse anesthetists (p = 0.005) compared with the pre-ERAS network. There was no significant change in centrality among surgeons (p = NS for all measures). Enhanced Recovery after Surgery designation among anesthesiologists and nurse anesthetists-whereby individual providers received an in-service on protocol elements and received compliance data was strongly associated with high compliance (>0.6 of measures; p < 0.001 for each group). In addition, high compliance was associated with a significant reduction in length of stay (p < 0.01), surgical site infection (p < 0.002), and morbidity (p < 0.009). Dedicated operating room teams led to increased centrality among anesthesia providers, which in turn not only increased compliance, but also improved several clinical outcomes. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Circuit-Detour Design and Implementation - Enhancing the Southern California's Seismic Network Reliability through Redundant Network Paths

NASA Astrophysics Data System (ADS)

Watkins, M.; Busby, R.; Rico, H.; Johnson, M.; Hauksson, E.

2003-12-01

We provide enhanced network robustness by apportioning redundant data communications paths for seismic stations in the field. By providing for more than one telemetry route, either physical or logical, network operators can improve availability of seismic data while experiencing occasional network outages, and also during the loss of key gateway interfaces such as a router or central processor. This is especially important for seismic stations in sparsely populated regions where a loss of a single site may result in a significant gap in the network's monitoring capability. A number of challenges arise in the application of a circuit-detour mechanism. One requirement is that it fits well within the existing framework of our real-time system processing. It is also necessary to craft a system that is not needlessly complex to maintain or implement, particularly during a crisis. The method that we use for circuit-detours does not require the reconfiguration of dataloggers or communications equipment in the field. Remote network configurations remain static, changes are only required at the central site. We have implemented standardized procedures to detour circuits on similar transport mediums, such as virtual circuits on the same leased line; as well as physically different communications pathways, such as a microwave link backed up by a leased line. The lessons learned from these improvements in reliability, and optimization efforts could be applied to other real-time seismic networks. A fundamental tenant of most seismic networks is that they are reliable and have a high percentage of real-time data availability. A reasonable way to achieve these expectations is to provide alternate means of delivering data to the central processing sites, with a simple method for utilizing these alternate paths.

Mapping and Analyzing Stakeholders in China's Essential Drug System by Using a Circular Model: Who We Should Deal with Next?

PubMed

Shao, Hui; Li, Shixue; Xu, Lingzhong; Yang, Shuang; Thomas, Nicholas J; Mir, Mohammed Umer; Guo, Zhen; Ning, Bo; Shi, Lizheng

2015-05-01

To predict the prospects of the essential drug system by using the Stakeholder Impact Index (SII) and evaluate the current performance of each main stakeholder and suggested dangerous stakeholders and dormant stakeholders. A Delphi method was used, involving 36 experts with experience in implementation and evaluation of the essential drug policy, to construct the circular model as well as evaluate the performance of each stakeholder. The central government was a dominant stakeholder of the whole essential drug system. The provincial governments were definitive stakeholders, whereas local governments and medical institutions were dependent stakeholders. Furthermore, media and drug stores were dormant stakeholders and pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders. Patients, community residents, and medical insurance programs were discretionary stakeholders. The SII for the essential drug system was positive (SII proj ⁎ = 2.72). The overall anticipation of the essential drug policy is optimistic. Letting definitive stakeholders (provincial governments) having more autonomy can efficiently accelerate the pace of implementation of the essential drug policy in the current situation. Central government, however, also needs to construct an experience exchange platform with the aim of building versatile methods for running the essential drug system in all provinces. Pharmaceutical manufacturers and delivery enterprises were dangerous stakeholders for the essential drug policy. Because of their potential threat to the implementation of the policy, the central government should motivate them to support the construction of the essential drug system spontaneously. In that case, provincial governments need to construct a fair, balanced, and self-stabilized bidding platform. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Peer-to-peer Cooperative Scheduling Architecture for National Grid Infrastructure

NASA Astrophysics Data System (ADS)

Matyska, Ludek; Ruda, Miroslav; Toth, Simon

For some ten years, the Czech National Grid Infrastructure MetaCentrum uses a single central PBSPro installation to schedule jobs across the country. This centralized approach keeps a full track about all the clusters, providing support for jobs spanning several sites, implementation for the fair-share policy and better overall control of the grid environment. Despite a steady progress in the increased stability and resilience to intermittent very short network failures, growing number of sites and processors makes this architecture, with a single point of failure and scalability limits, obsolete. As a result, a new scheduling architecture is proposed, which relies on higher autonomy of clusters. It is based on a peer to peer network of semi-independent schedulers for each site or even cluster. Each scheduler accepts jobs for the whole infrastructure, cooperating with other schedulers on implementation of global policies like central job accounting, fair-share, or submission of jobs across several sites. The scheduling system is integrated with the Magrathea system to support scheduling of virtual clusters, including the setup of their internal network, again eventually spanning several sites. On the other hand, each scheduler is local to one of several clusters and is able to directly control and submit jobs to them even if the connection of other scheduling peers is lost. In parallel to the change of the overall architecture, the scheduling system itself is being replaced. Instead of PBSPro, chosen originally for its declared support of large scale distributed environment, the new scheduling architecture is based on the open-source Torque system. The implementation and support for the most desired properties in PBSPro and Torque are discussed and the necessary modifications to Torque to support the MetaCentrum scheduling architecture are presented, too.

Rapid reduction of central line infections in hospitalized pediatric oncology patients through simple quality improvement methods.

PubMed

Choi, Sung W; Chang, Lawrence; Hanauer, David A; Shaffer-Hartman, Jacqueline; Teitelbaum, Daniel; Lewis, Ian; Blackwood, Alex; Akcasu, Nur; Steel, Janell; Christensen, Joy; Niedner, Matthew F

2013-02-01

Pediatric hematology-oncology (PHO) patients are at significant risk for developing central line-associated bloodstream infections (CLA-BSIs) due to their prolonged dependence on such catheters. Effective strategies to eliminate these preventable infections are urgently needed. In this study, we investigated the implementation of bundled central line maintenance practices and their effect on hospital-acquired CLA-BSIs. CLA-BSI rates were analyzed within a single-institution's PHO unit between January 2005 and June 2011. In May 2008, a multidisciplinary quality improvement team developed techniques to improve the PHO unit's safety culture and implemented the use of catheter maintenance practices tailored to PHO patients. Data analysis was performed using time-series methods to evaluate the pre- and post-intervention effect of the practice changes. The pre-intervention CLA-BSI incidence was 2.92 per 1,000-patient days (PD) and coagulase-negative Staphylococcus was the most prevalent pathogen (29%). In the post-intervention period, the CLA-BSI rate decreased substantially (45%) to 1.61 per 1,000-PD (P < 0.004). Early on, blood and marrow transplant (BMT) patients had a threefold higher CLA-BSI rate compared to non-BMT patients (P < 0.033). With additional infection control countermeasures added to the bundled practices, BMT patients experienced a larger CLA-BSI rate reduction such that BMT and non-BMT CLA-BSI rates were not significantly different post-intervention. By adopting and effectively implementing uniform maintenance catheter care practices, learning multidisciplinary teamwork, and promoting a culture of patient safety, the CLA-BSI incidence in our study population was significantly reduced and maintained. Copyright © 2012 Wiley Periodicals, Inc.

Decreasing troponin turnaround time in the emergency department using the central laboratory: A process improvement study.

PubMed

Boelstler, Arlene M; Rowland, Ralph; Theoret, Jennifer; Takla, Robert B; Szpunar, Susan; Patel, Shraddha P; Lowry, Andrew M; Pena, Margarita E

2015-03-01

To implement collaborative process improvement measures to reduce emergency department (ED) troponin turnaround time (TAT) to less than 60min using central laboratory. This was an observational, retrospective data study. A multidisciplinary team from the ED and laboratory identified opportunities and developed a new workflow model. Process changes were implemented in ED patient triage, staffing, lab collection and processing. Data collected included TAT of door-to-order, order-to-collect, collect-to-received, received-to-result, door-to-result, ED length of stay, and hemolysis rate before (January-August, 2011) and after (September 2011-June 2013) process improvement. After process improvement and implementation of the new workflow model, decreased median TAT (in min) was seen in door-to-order (54 [IQR43] vs. 11 [IQR20]), order-to-collect (15 [IQR 23] vs. 10 [IQR12]), collect-to-received (6 [IQR8] vs. 5 [IQR5]), received-to-result (30 [IQR12] vs. 24 [IQR11]), and overall door-to-result (117 [IQR60] vs. 60 [IQR40]). A troponin TAT of <60min was realized beginning in May 2012 (59 [IQR39]). Hemolysis rates decreased (14.63±0.74 vs. 3.36±1.99, p<0.0001), as did ED length of stay (5.87±2.73h vs. 5.15±2.34h, p<0.0001). Conclusion Troponin TAT of <60min using a central laboratory was achieved with collaboration between the ED and the laboratory; additional findings include a decreased ED length of stay. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Prevalence of normal weight central obesity among Thai healthcare providers and their association with CVD risk: a cross-sectional study.

PubMed

Thaikruea, Lakkana; Thammasarot, Jiraporn

2016-11-16

This study aims to determine the prevalence of health personnel with normal weight central obesity and to investigate whether this group had higher cardiovascular disease (CVD) risk factors than those of the people with normal weight and without central obesity. A waist-to-height ratio was calculated as waist circumference (at umbilical level) in cm divided by height in cm. The central obesity cut-off level was 0.5. The body mass index was calculated as weight in kg divided by height in meters squared. The obesity cut-off level was 25 kg/m 2 . The prevalence of health personnel with normal weight central obesity was 15.4% (499 out of 3235). When compare this group to 1787 health personnel who had normal weight and without central obesity, they were 2.03 times (95% CI of adjusted OR; 1.62 to 2.54) more likely to have at least one CVD factor. The waist-to-height ratio cut-off value of 0.5 can be used as a self-assessment tool for central obesity without the need for a standard measuring tape. It is feasible to be implemented in screening or self-monitoring for the general population.

A Review of Medical and Substance Use Co-Morbidities in Central Asian Prisons: Implications for HIV Prevention and Treatment

PubMed Central

Polonsky, Maxim; Kerimi, Nina; Mamyrov, Mirlan; Dvoryak, Sergey; Altice, Frederick L.

2013-01-01

Background HIV incidence in Central Asia is rising rapidly. People who inject drugs (PWIDs) contribute greatest to the epidemic, with more than a quarter of all HIV cases being in the criminal justice system (CJS). This review assembled and aggregated recent data on drug-related health problems and respective healthcare services in the CJS of Central Asia and the Republic of Azerbaijan. Methods Online databases and published literature (peer-reviewed and grey) were reviewed. Additionally, prison officials in the 6 countries were invited to participate in a survey and prison administrators from Kazakhstan, Kyrgyzstan and Tajikistan completed it. Results The data on conditions and healthcare in Central Asian prisons are inconsistent and lack unbiased details. Reporting is primarily based on “official” disease registries, which markedly underestimate prevalence. Even these limited data, however, indicate that HIV prevalence and drug-related health problems are high, concentrated and, in some countries, rising rapidly. Only some of the range of HIV prevention interventions recommended by international organizations have been implemented in the region with two of the crucial interventions, needle and syringe exchange programs (NSP) and opioid substitution therapy (OST), only available in Kyrgyzstan prisons, with Tajikistan implementing a pilot NSP and contemplating introduction of prison-based OST. Conclusions Despite deficiencies in routine health reporting and insufficient HIV sentinel surveillance undertaken in prisons, the data available on the concentration of HIV within at-risk populations in prisons indicate a necessity to broaden the range and increase the scale the scale of HIV prevention and treatment services. PMID:23932844

Head and neck cancer burden and preventive measures in Central and South America.

PubMed

Perdomo, Sandra; Martin Roa, Guillermo; Brennan, Paul; Forman, David; Sierra, Mónica S

2016-09-01

Central and South America comprise one of the areas characterized by high incidence rates for head and neck cancer. We describe the geographical and temporal trends in incidence and mortality of head and neck cancers in the Central and South American region in order to identify opportunities for intervention on the major identified risk factors: tobacco control, alcohol use and viral infections. We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries and cancer deaths from the WHO mortality database for 18 countries. Age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 person-years were estimated. Brazil had the highest incidence rates for oral and pharyngeal cancer in the region for both sexes, followed by Cuba, Uruguay and Argentina. Cuba had the highest incidence and mortality rates of laryngeal cancer in the region for males and females. Overall, males had rates about four times higher than those in females. Most countries in the region have implemented WHO recommendations for both tobacco and alcohol public policy control. Head and neck squamous-cell cancer (HNSCC) incidence and mortality rates in the Central and South America region vary considerably across countries, with Brazil, Cuba, French Guyana, Uruguay and Argentina experiencing the highest rates in the region. Males carry most of the HNSCC burden. Improvement and implementation of comprehensive tobacco and alcohol control policies as well as the monitoring of these factors are fundamental to prevention of head and neck cancers in the region. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

75 FR 14255 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... FURTHER INFORMATION CONTACT: Assistant Director, Compliance Outreach & Implementation, Office of Foreign... worldwide basis, with the objective of denying their businesses and agents access to the U.S. financial... Secretary of the Treasury consults with the Attorney General, the Director of the Central Intelligence...

75 FR 36474 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-25

... FURTHER INFORMATION CONTACT: Assistant Director, Compliance Outreach & Implementation, Office of Foreign... worldwide basis, with the objective of denying their businesses and agents access to the U.S. financial... Secretary of the Treasury consults with the Attorney General, the Director of the Central Intelligence...

Collective Bargaining As an Instrument of Change.

ERIC Educational Resources Information Center

Ayers, Steven V.

1998-01-01

The Hilton Central School District, New York, utilized the collective bargaining process to create a financial incentive that would motivate teachers to achieve a baseline level of technological competency. Describes the negotiated agreement, results obtained during the initial year of implementation, and future plans. (MLF)

Accessibility Considerations for Hybrid Courses

ERIC Educational Resources Information Center

Behling, Kirsten

2017-01-01

This chapter explores the central questions and issues that faculty and administrators need to consider when designing and implementing hybrid courses to ensure that all students, including those with disabilities, have equal access. The author offers resources on faculty development programs, accessibility checklists, and online resources on…

Educational Organization, School Localization and the Process of Urbanization in Sweden.

ERIC Educational Resources Information Center

Andrae, Annika

Traditionally Sweden's educational system has been highly centralized; physical characteristics, administrative factors, and teacher qualifications have been generally standardized as have curriculums, though local implementation has been afforded considerable freedom. In 1971 the upper secondary school (9-12) consolidated three previously…

7 CFR 274.3 - Retailer management.

Code of Federal Regulations, 2012 CFR

2012-01-01

... retailer, and it must include acceptable privacy and security features. Such systems shall only be... terminals that are capable of relaying electronic transactions to a central database computer for... specifications prior to implementation of the EBT system to enable third party processors to access the database...

WATERSHED CENTRAL: AN INTEGRATED WATERSHED ASSESSMENT AND MANAGEMENT PROJECT

EPA Science Inventory

The Clean Water Act (CWA) requires that States develop and implement pollution reduction targets for impaired or threatened waters often referred to as total maximum daily loads (TMDLs). State and local governments are faced with a broad range of technical, economic and political...

A bill to make technical corrections to the Western and Central Pacific Fisheries Convention Implementation Act, and for other purposes.

THOMAS, 111th Congress

Sen. Inouye, Daniel K. [D-HI

2009-12-10

Senate - 09/20/2010 Placed on Senate Legislative Calendar under General Orders. Calendar No. 574. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

40 CFR 52.1521 - Classification of regions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New Hampshire § 52.1521 Classification of regions. The New Hampshire plan was evaluated on the basis of the following classifications... Ozone Androscoggin Valley Interstate IA IA III III III Central New Hampshire Intrastate III III III III...

40 CFR 52.1521 - Classification of regions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New Hampshire § 52.1521 Classification of regions. The New Hampshire plan was evaluated on the basis of the following classifications... Ozone Androscoggin Valley Interstate IA IA III III III Central New Hampshire Intrastate III III III III...

40 CFR 52.1521 - Classification of regions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New Hampshire § 52.1521 Classification of regions. The New Hampshire plan was evaluated on the basis of the following classifications... Ozone Androscoggin Valley Interstate IA IA III III III Central New Hampshire Intrastate III III III III...

Teachers' Professional Development in Schools: Rhetoric versus Reality

ERIC Educational Resources Information Center

Gemeda, Fekede Tuli; Fiorucci, Massimiliano; Catarci, Marco

2014-01-01

Across the country of Ethiopia, a centrally planned and prescribed professional development programme was implemented in schools, with the intention of enhancing teachers' knowledge, skills and disposition, thereby improving student learning and achievement. This article explores and describes the lived experiences of teachers involved in…

The Validity of Educational Disadvantage Policy Indicators

ERIC Educational Resources Information Center

Driessen, Geert

2017-01-01

Many countries have implemented policies to prevent or combat educational disadvantage associated with socioeconomic factors in the students' home environment. Under such policies, educational institutions generally receive extra support from the central or local government. The support is normally based on indicators available in the home…

Modelling exclusive meson pair production at hadron colliders

NASA Astrophysics Data System (ADS)

Harland-Lang, L. A.; Khoze, V. A.; Ryskin, M. G.

2014-04-01

We present a study of the central exclusive production of light meson pairs, concentrating on the region of lower invariant masses of the central system and/or meson transverse momentum, where perturbative QCD cannot be reliably applied. We describe in detail a phenomenological model, using the tools of Regge theory, that may be applied with some success in this regime, and we present the new, publicly available, Dime Monte Carlo (MC) implementation of this for , and production. The MC implementation includes a fully differential treatment of the survival factor, which in general depends on all kinematic variables, as well as allows for the so far reasonably unconstrained model parameters to be set by the user. We present predictions for the Tevatron and LHC, discuss and estimate the size of the proton-dissociative background, and show how future measurements may further test this Regge-based approach, as well as the soft hadronic model required to calculate the survival factor, in particular in the presence of tagged protons.

The future of UK healthcare: problems and potential solutions to a system in crisis.

PubMed

Montgomery, H E; Haines, A; Marlow, N; Pearson, G; Mythen, M G; Grocott, M P W; Swanton, C

2017-08-01

The UK's Health System is in crisis, central funding no longer keeping pace with demand. Traditional responses-spending more, seeking efficiency savings or invoking market forces-are not solutions. The health of our nation demands urgent delivery of a radical new model, negotiated openly between public, policymakers and healthcare professionals. Such a model could focus on disease prevention, modifying health behaviour and implementing change in public policy in fields traditionally considered unrelated to health such as transport, food and advertising. The true cost-effectiveness of healthcare interventions must be balanced against the opportunity cost of their implementation, bolstering the central role of NICE in such decisions. Without such action, the prognosis for our healthcare system-and for the health of the individuals it serves-may be poor. Here, we explore such a new prescription for our national health. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Using artificial intelligence to automate remittance processing.

PubMed

Adams, W T; Snow, G M; Helmick, P M

1998-06-01

The consolidated business office of the Allegheny Health Education Research Foundation (AHERF), a large integrated healthcare system based in Pittsburgh, Pennsylvania, sought to improve its cash-related business office activities by implementing an automated remittance processing system that uses artificial intelligence. The goal was to create a completely automated system whereby all monies it processed would be tracked, automatically posted, analyzed, monitored, controlled, and reconciled through a central database. Using a phased approach, the automated payment system has become the central repository for all of the remittances for seven of the hospitals in the AHERF system and has allowed for the complete integration of these hospitals' existing billing systems, document imaging system, and intranet, as well as the new automated payment posting, and electronic cash tracking and reconciling systems. For such new technology, which is designed to bring about major change, factors contributing to the project's success were adequate planning, clearly articulated objectives, marketing, end-user acceptance, and post-implementation plan revision.

Communication Needs Assessment for Distributed Turbine Engine Control

NASA Technical Reports Server (NTRS)

Culley, Dennis E.; Behbahani, Alireza R.

2008-01-01

Control system architecture is a major contributor to future propulsion engine performance enhancement and life cycle cost reduction. The control system architecture can be a means to effect net weight reduction in future engine systems, provide a streamlined approach to system design and implementation, and enable new opportunities for performance optimization and increased awareness about system health. The transition from a centralized, point-to-point analog control topology to a modular, networked, distributed system is paramount to extracting these system improvements. However, distributed engine control systems are only possible through the successful design and implementation of a suitable communication system. In a networked system, understanding the data flow between control elements is a fundamental requirement for specifying the communication architecture which, itself, is dependent on the functional capability of electronics in the engine environment. This paper presents an assessment of the communication needs for distributed control using strawman designs and relates how system design decisions relate to overall goals as we progress from the baseline centralized architecture, through partially distributed and fully distributed control systems.

Implementation Pearls from a New Guidebook on Improving Medication Use and Outcomes with Clinical Decision Support

PubMed Central

Sirajuddin, Anwar M; Osheroff, Jerome A.; Sittig, Dean F.; Chuo, John; Velasco, Ferdinand; Collins, David A.

2012-01-01

Effective clinical decision support (CDS) is essential for addressing healthcare performance improvement imperatives, but care delivery organizations (CDO) typically struggle with CDS deployment. Ensuring safe and effective medication delivery to patients is a central focus of CDO performance improvement efforts, and this article provides an overview of best-practice strategies for applying CDS to these goals. The strategies discussed are drawn from a new guidebook, co-published and co-sponsored by more than a dozen leading organizations. Developed by scores of CDS implementers and experts, the guidebook outlines key steps and success factors for applying CDS to medication management. A central thesis is that improving outcomes with CDS interventions requires that the CDS five rights be addressed successfully. That is, the interventions must deliver the right information, to the right person, in the right format, through the right channel, at the right point in workflow. This paper provides further details about these CDS five rights, and highlights other important strategies for successful CDS programs. PMID:19894486

Improved Fast Centralized Retransmission Scheme for High-Layer Functional Split in 5G Network

NASA Astrophysics Data System (ADS)

Xu, Sen; Hou, Meng; Fu, Yu; Bian, Honglian; Gao, Cheng

2018-01-01

In order to satisfy the varied 5G critical requirements and the virtualization of the RAN hardware, a two-level architecture for 5G RAN has been studied in 3GPP 5G SI stage. The performance of the PDCP-RLC split option and intra-RLC split option, two mainly concerned options for high layer functional split, exist an ongoing debate. This paper firstly gives an overview of CU-DU split study work in 3GPP. By the comparison of implementation complexity, the standardization impact and system performance, our evaluation result shows the PDCP-RLC split Option outperforms the intra-RLC split option. Aiming to how to reduce the retransmission delay during the intra-CU inter-DU handover, the mainly drawback of PDCP-RLC split option, this paper proposes an improved fast centralized retransmission solution with a low implementation complexity. Finally, system level simulations show that the PDCP-RLC split option with the proposed scheme can significantly improve the UE’s experience.

A simple low-computation-intensity model for approximating the distribution function of a sum of non-identical lognormals for financial applications

NASA Astrophysics Data System (ADS)

Messica, A.

2016-10-01

The probability distribution function of a weighted sum of non-identical lognormal random variables is required in various fields of science and engineering and specifically in finance for portfolio management as well as exotic options valuation. Unfortunately, it has no known closed form and therefore has to be approximated. Most of the approximations presented to date are complex as well as complicated for implementation. This paper presents a simple, and easy to implement, approximation method via modified moments matching and a polynomial asymptotic series expansion correction for a central limit theorem of a finite sum. The method results in an intuitively-appealing and computation-efficient approximation for a finite sum of lognormals of at least ten summands and naturally improves as the number of summands increases. The accuracy of the method is tested against the results of Monte Carlo simulationsand also compared against the standard central limit theorem andthe commonly practiced Markowitz' portfolio equations.

The tuberculosis program of Catalonia's Central Health Region (1986-1993).

PubMed

Miret-Cuadras, P; Gonzalez-Fernandez, P; Lopez-Sanmartin, J L; Martin-Ramos, A; Pina Gutierrez, J M

1997-04-01

Catalonia's Central Health Region antituberculosis program, which began in 1985. To evaluate the cooperation of health staff and the program's effectiveness after 8 years. The following data from the nominal notifications and the expanded case reports were processed: epidemiological, clinical and treatment data, each patient's end results and the outcome of the contact investigation. The implementation of the program was evaluated by means of the number of notifications and contact investigations received, and its effectiveness was assessed by the percentage of sputum smear positive cases having completed treatment. There was an increase in the number of patients with an expanded case report (from 74% to 100%), with a final notification (from 61% to 99%) and with contact investigation (from 29% to 79%). The sputum smear positive cases who completed the treatment after 1990 exceeded 85%. The implementation of the program in the Region's health system is good and is improving in parallel with the control of the disease.

Social networks and community prevention coalitions.

PubMed

Feinberg, Mark E; Riggs, Nathaniel R; Greenberg, Mark T

2005-07-01

This study investigates the links between community readiness and the social networks among participants in Communities That Care (CTC), community-based prevention coalitions. The coalitions targeted adolescent behavior problems through community risk factor assessments, prioritization of risk factors, and selection/implementation of corresponding evidence-based family, school, and community programs. Key leaders (n = 219) in 23 new CTC sites completed questionnaires focusing on community readiness to implement CTC and the respondents' personal, work, and social organization links to other key leaders in the community. Outside technical assistants also completed ratings of each community's readiness and early CTC functioning. Measures of network cohesion/integration were positively associated with readiness, while centralization was negatively associated. These results suggest that non-centralized networks in which ties between members are close and direct may be an indicator of community readiness. In addition, we found different associations between readiness and different domains of social relations. EDITORS' STRATEGIC IMPLICATIONS: The authors present the promising practice of using social network analysis to characterize the functioning of local prevention coalitions and their readiness to implement a community-based prevention initiative. Researchers and community planners will benefit from the lessons in this article, which capitalizes on a large sample and multiple informants. This work raises interesting questions about how to combine the promotion of coalition functioning while simultaneously encouraging diversity of coalition membership.

Piloting a nationally disseminated, interactive human subjects protection program for community partners: unexpected lessons learned from the field.

PubMed

Solomon, Stephanie; Bullock, Sherita; Calhoun, Karen; Crosby, Lori; Eakin, Brenda; Franco, Zeno; Hardwick, Emily; Holland, Samuel; Leinberger-Jabari, Andrea; Newton, Gail; Odell, Jere; Paberzs, Adam; Spellecy, Ryan

2014-04-01

Funders, institutions, and research organizations are increasingly recognizing the need for human subjects protections training programs for those engaged in academic research. Current programs tend to be online and directed toward an audience of academic researchers. Research teams now include many nonacademic members, such as community partners, who are less likely to respond to either the method or the content of current online trainings. A team at the CTSA-supported Michigan Institute for Clinical and Health Research at the University of Michigan developed a pilot human subjects protection training program for community partners that is both locally implemented and adaptable to local contexts, yet nationally consistent and deliverable from a central administrative source. Here, the developers of the program and the collaborators who participated in the pilot across the United States describe 10 important lessons learned that align with four major themes: The distribution of the program, the implementation of the program, the involvement of community engagement in the program, and finally lessons regarding the content of the program. These lessons are relevant to anyone who anticipates developing or improving a training program that is developed in a central location and intended for local implementation. © 2014 Wiley Periodicals, Inc.

Piloting a Nationally Disseminated, Interactive Human Subjects Protection Program for Community Partners: Unexpected Lessons Learned from the Field

PubMed Central

Bullock, Sherita; Calhoun, Karen; Crosby, Lori; Eakin, Brenda; Franco, Zeno; Hardwick, Emily; Leinberger‐Jabari, Andrea; Newton, Gail; Odell, Jere; Paberzs, Adam; Spellecy, Ryan

2014-01-01

Abstract Funders, institutions, and research organizations are increasingly recognizing the need for human subjects protections training programs for those engaged in academic research. Current programs tend to be online and directed toward an audience of academic researchers. Research teams now include many nonacademic members, such as community partners, who are less likely to respond to either the method or the content of current online trainings. A team at the CTSA‐supported Michigan Institute for Clinical and Health Research at the University of Michigan developed a pilot human subjects protection training program for community partners that is both locally implemented and adaptable to local contexts, yet nationally consistent and deliverable from a central administrative source. Here, the developers of the program and the collaborators who participated in the pilot across the United States describe 10 important lessons learned that align with four major themes: The distribution of the program, the implementation of the program, the involvement of community engagement in the program, and finally lessons regarding the content of the program. These lessons are relevant to anyone who anticipates developing or improving a training program that is developed in a central location and intended for local implementation. PMID:24720349

Implementation of a Collaborative Series of Classroom-Based Undergraduate Research Experiences Spanning Chemical Biology, Biochemistry, and Neurobiology

PubMed Central

Kowalski, Jennifer R.; Hoops, Geoffrey C.; Johnson, R. Jeremy

2016-01-01

Classroom undergraduate research experiences (CUREs) provide students access to the measurable benefits of undergraduate research experiences (UREs). Herein, we describe the implementation and assessment of a novel model for cohesive CUREs focused on central research themes involving faculty research collaboration across departments. Specifically, we implemented three collaborative CUREs spanning chemical biology, biochemistry, and neurobiology that incorporated faculty members’ research interests and revolved around the central theme of visualizing biological processes like Mycobacterium tuberculosis enzyme activity and neural signaling using fluorescent molecules. Each CURE laboratory involved multiple experimental phases and culminated in novel, open-ended, and reiterative student-driven research projects. Course assessments showed CURE participation increased students’ experimental design skills, attitudes and confidence about research, perceived understanding of the scientific process, and interest in science, technology, engineering, and mathematics disciplines. More than 75% of CURE students also engaged in independent scientific research projects, and faculty CURE contributors saw substantial increases in research productivity, including increased undergraduate student involvement and academic outputs. Our collaborative CUREs demonstrate the advantages of multicourse CUREs for achieving increased faculty research productivity and traditional CURE-associated student learning and attitude gains. Our collaborative CURE design represents a novel CURE model for ongoing laboratory reform that benefits both faculty and students. PMID:27810870

The use of UNIX in a real-time environment

NASA Technical Reports Server (NTRS)

Luken, R. D.; Simons, P. C.

1986-01-01

This paper describes a project to evaluate the feasibility of using commercial off-the-shelf hardware and the UNIX operating system, to implement a real-time control and monitor system. A functional subset of the Checkout, Control and Monitor System was chosen as the test bed for the project. The project consists of three separate architecture implementations: a local area bus network, a star network, and a central host. The motivation for this project stemmed from the need to find a way to implement real-time systems, without the cost burden of developing and maintaining custom hardware and unique software. This has always been accepted as the only option because of the need to optimize the implementation for performance. However, with the cost/performance of today's hardware, the inefficiencies of high-level languages and portable operating systems can be effectively overcome.

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

Gorentla Venkata, Manjunath; Graham, Richard L; Ladd, Joshua S

This paper describes the design and implementation of InfiniBand (IB) CORE-Direct based blocking and nonblocking broadcast operations within the Cheetah collective operation framework. It describes a novel approach that fully ofFLoads collective operations and employs only user-supplied buffers. For a 64 rank communicator, the latency of CORE-Direct based hierarchical algorithm is better than production-grade Message Passing Interface (MPI) implementations, 150% better than the default Open MPI algorithm and 115% better than the shared memory optimized MVAPICH implementation for a one kilobyte (KB) message, and for eight mega-bytes (MB) it is 48% and 64% better, respectively. Flat-topology broadcast achieves 99.9% overlapmore » in a polling based communication-computation test, and 95.1% overlap for a wait based test, compared with 92.4% and 17.0%, respectively, for a similar Central Processing Unit (CPU) based implementation.« less

Determination of Radioactive Risks Associated with the Operation of a Nuclear Plant; EVALUATION DES RISQUES RADIOACTIFS LIES AU FONTIONNEMENT D'UNE INSTALLATION NUCLEAIRE

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

Laie, J.M.; Doury, A.

1960-01-01

Numerous problems which are posed by the evaluation of the radioactive risks linked to the working of a nuclear plant are new problems that have not yet been satisfactorily solved. In these conditions this study must be considered only as a preliminary approach whose essential aims include development and synthesis of the existing data and rapid determination of conservative and usable orders of greatness for the security factors, both for normal working and in the case of an accident. The most probable typical accidents are reviewed together with the nature of the resulting risks and the principal factors on whichmore » these risks depend. Among these factors, one of the most important is atmospheric diffusion, which is studied in some detail using the analytic model by Sutton. A logical graphical presentation is made, increasing ths flexibility in the use of the results and presenting the responsible authorities with a flexible, practical, and rapid means of evaluating the risks involved starting from a sufficiently general system of initial and simultaneously valid conditions (types of accident, atmospheric conditions). (auth)« less

Uranium mining in France

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

White, L.

Since the onset of the first ''oil shock'' in 1974, France has pursued a policy of steadily increasing energy independence based on nuclear power for generation of electricity. In 1973, nuclear reactors supplied only 8% of France's electrical power. A strong development effort lifted the nuclear share to 23% in 1980, to 66% in 1985, and the plan is to raise the total to 75% by 1990. In 1976, Cogema (Compagnie Generale des Matieres Nucleaires) was organized from the production division of France's Commissariat a l'Energie Atomique (CEA) to handle fuel supply and spent fuel reprocessing for the expanding industrymore » (see subsequent article on Cogema). In parallel with growth of the French nuclear power, Cogema has become a world leader in all aspects of the fuel cycle, providing services not only domestically but internationally as well. As a uranium mining company, Cogema has steadily developed domestic and foreign sources of supply, and over the years it has maintained the world's strongest uranium exploration effort throughout the ups and downs of the market. As a result, the company has become the world's leading uranium supplier, with about 20% of total production contributed either by its domestic mining divisions or overseas subsidiaries.« less

What supervisors want to know about decentralization.

PubMed

Boissoneau, R; Belton, P

1991-06-01

Many organizations in various industries have tended to move away from strict centralization, yet some centralization is still vital to top management. With 19 of the 22 executives interviewed favoring or implementing some form of decentralization, it is probable that traditionally centralized organizations will follow the trend and begin to decentralize their organizational structures. The incentives and advantages of decentralization are too attractive to ignore. Decentralization provides responsibility, clear objectives, accountability for results, and more efficient and effective decision making. However, one must remember that decentralization can be overextended and that centralization is still viable in certain functions. Finding the correct balance between control and autonomy is a key to decentralization. Too much control and too much autonomy are the primary reasons for decentralization failures. In today's changing, competitive environment, structures must be continuously redefined, with the goal of finding an optimal balance between centralization and decentralization. Organizations are cautioned not to seek out and install a single philosopher-king to impose unified direction, but to unify leadership goals, participation, style, and control to develop improved methods of making all responsible leaders of one mind about the organization's needs and goals.

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

Bromberger, Seth A.; Klymko, Christine F.; Henderson, Keith A.

Betweenness centrality is a graph statistic used to nd vertices that are participants in a large number of shortest paths in a graph. This centrality measure is commonly used in path and network interdiction problems and its complete form requires the calculation of all-pairs shortest paths for each vertex. This leads to a time complexity of O(jV jjEj), which is impractical for large graphs. Estimation of betweenness centrality has focused on performing shortest-path calculations on a subset of randomly- selected vertices. This reduces the complexity of the centrality estimation to O(jSjjEj); jSj < jV j, which can be scaled appropriatelymore » based on the computing resources available. An estimation strategy that uses random selection of vertices for seed selection is fast and simple to implement, but may not provide optimal estimation of betweenness centrality when the number of samples is constrained. Our experimentation has identi ed a number of alternate seed-selection strategies that provide lower error than random selection in common scale-free graphs. These strategies are discussed and experimental results are presented.« less

LaRC local area networks to support distributed computing

NASA Technical Reports Server (NTRS)

Riddle, E. P.

1984-01-01

The Langley Research Center's (LaRC) Local Area Network (LAN) effort is discussed. LaRC initiated the development of a LAN to support a growing distributed computing environment at the Center. The purpose of the network is to provide an improved capability (over inteactive and RJE terminal access) for sharing multivendor computer resources. Specifically, the network will provide a data highway for the transfer of files between mainframe computers, minicomputers, work stations, and personal computers. An important influence on the overall network design was the vital need of LaRC researchers to efficiently utilize the large CDC mainframe computers in the central scientific computing facility. Although there was a steady migration from a centralized to a distributed computing environment at LaRC in recent years, the work load on the central resources increased. Major emphasis in the network design was on communication with the central resources within the distributed environment. The network to be implemented will allow researchers to utilize the central resources, distributed minicomputers, work stations, and personal computers to obtain the proper level of computing power to efficiently perform their jobs.

Transfer function-derived central pressure and cardiovascular disease events: the Framingham Heart Study.

PubMed

Mitchell, Gary F; Hwang, Shih-Jen; Larson, Martin G; Hamburg, Naomi M; Benjamin, Emelia J; Vasan, Ramachandran S; Levy, Daniel; Vita, Joseph A

2016-08-01

Relations between central pulse pressure (PP) or pressure amplification and major cardiovascular disease (CVD) events are controversial. Estimates of central aortic pressure derived using radial artery tonometry and a generalized transfer function may better predict CVD risk beyond the predictive value of brachial SBP. Augmentation index, central SBP, central PP, and central-to-peripheral PP amplification were evaluated using radial artery tonometry and a generalized transfer function as implemented in the SphygmoCor device (AtCor Medical, Itasca, Illinois, USA). We used proportional hazards models to examine relations between central hemodynamics and first-onset major CVD events in 2183 participants (mean age 62 years, 58% women) in the Framingham Heart Study. During median follow-up of 7.8 (limits 0.2-8.9) years, 149 participants (6.8%) had an incident event. Augmentation index (P = 0.6), central aortic systolic pressure (P = 0.20), central aortic PP (P = 0.24), and PP amplification (P = 0.15) were not related to CVD events in multivariable models that adjusted for age, sex, brachial cuff systolic pressure, use of antihypertensive therapy, total and high-density lipoprotein cholesterol concentrations, smoking, and presence of diabetes. In a model that included standard risk factors, model fit was improved (P = 0.03) when brachial systolic pressure was added after central, whereas model fit was not improved (P = 0.30) when central systolic pressure was added after brachial. After considering standard risk factors, including brachial cuff SBP, augmentation index, central PP and PP amplification derived using radial artery tonometry, and a generalized transfer function were not predictive of CVD risk.

Implementation of targeted medication adherence interventions within a community chain pharmacy practice: The Pennsylvania Project.

PubMed

Bacci, Jennifer L; McGrath, Stephanie Harriman; Pringle, Janice L; Maguire, Michelle A; McGivney, Melissa Somma

2014-01-01

To identify facilitators and barriers to implementing targeted medication adherence interventions in community chain pharmacies, and describe adaptations of the targeted intervention and organizational structure within each individual pharmacy practice. Qualitative study. Central and western Pennsylvania from February to April 2012. Rite Aid pharmacists staffed at the 118 Pennsylvania Project intervention sites. Qualitative analysis of pharmacists' perceptions of facilitators and barriers experienced, targeted intervention and organizational structure adaptations implemented, and training and preparation prior to implementation. A total of 15 key informant interviews were conducted from February to April 2012. Ten pharmacists from "early adopter" practices and five pharmacists from "traditionalist" practices were interviewed. Five themes emerged regarding the implementation of targeted interventions, including all pharmacists' need to understand the relationship of patient care programs to their corporation's vision; providing individualized, continual support and mentoring to pharmacists; anticipating barriers before implementation of patient care programs; encouraging active patient engagement; and establishing best practices regarding implementation of patient care services. This qualitative analysis revealed that there are a series of key steps that can be taken before the execution of targeted interventions that may promote successful implementation of medication therapy management in community chain pharmacies.

Concept of Integrated Information Systems of Rail Transport

NASA Astrophysics Data System (ADS)

Siergiejczyk, Mirosław; Gago, Stanisław

This paper will present a need to create integrated information systems of the rail transport and their links with other means of public transportation. IT standards will be discussed that are expected to create the integrated information systems of the rail transport. Also the main tasks will be presented of centralized information systems, the concept of their architecture, business processes and their implementation as well as the proposed measures to secure data. A method shall be proposed to implement a system to inform participants of rail transport in Polish conditions.

75 FR 65554 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

..., Compliance Outreach & Implementation, Office of Foreign Assets Control, Department of the Treasury... their businesses and agents access to the U.S. financial system and the benefits of trade and..., the Director of the Central Intelligence Agency, the Director of the Federal Bureau of Investigation...

76 FR 23644 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-27

...: Assistant Director, Compliance Outreach & Implementation, Office of Foreign Assets Control, Department of... objective of denying their businesses and agents access to the U.S. financial system and the benefits of... the Attorney General, the Director of the Central Intelligence Agency, the Director of the Federal...

75 FR 20425 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

...: Assistant Director, Compliance Outreach & Implementation, Office of Foreign Assets Control, Department of... their businesses and agents access to the U.S. financial system and the benefits of trade and..., the Director of the Central Intelligence Agency, the Director of the Federal Bureau of Investigation...

75 FR 24773 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-05

... Director, Compliance Outreach & Implementation, Office of Foreign Assets Control, Department of the... their businesses and agents access to the U.S. financial system and the benefits of trade and..., the Director of the Central Intelligence Agency, the Director of the Federal Bureau of Investigation...

Inservice Teacher Education in Nigeria: A Case Study.

ERIC Educational Resources Information Center

Esu, Akon E. O.

1991-01-01

Examines the current status of in-service teacher education in Nigeria, indicating three approaches: the central office approach; the long vacation program; and the Associateship Certificate in Education distance learning approach. Recommendations for planning and implementing in-service teacher education programs in Nigeria are noted. (SM)

A Strategy for Promoting Educational Reform in Developing Countries.

ERIC Educational Resources Information Center

Abdel-Halim, A. El-Mahdi; Shaker, Paul

Educational reform in developing countries, specifically in Saudi Arabia, will be facilitated if certain strategies are employed when implementing educational change. Problems which restrict reform tend to be a culture which opposes change, staffing, finances, a shortage of relevant learning materials, excessive centralization of authority,…

Imagination in Education

ERIC Educational Resources Information Center

Vaillancourt Menton, Maureen

2015-01-01

Imagination in Education was a qualitative inquiry that explored the effects the implementation of the Common Core State Standards (CCSS) had on imagination within high school cultures. The central question for this study was: How do New York City Department of Education (NYC DOE) high school principals conceptualize imagination within their…

Bioinstrumentation: A Project-Based Engineering Course

ERIC Educational Resources Information Center

Kyle, Aaron M.; Jangraw, David C.; Bouchard, Matthew B.; Downs, Matthew E.

2016-01-01

This paper presents the development, implementation, and assessment of a project-based Bioinstrumentation course. All course lectures and hands-on laboratory activities are related to a central project theme: a cardiac pacemaker. The students create a benchtop cardiac pacemaker by applying instrumentation knowledge acquired in the course to each…

How Six States Are Implementing Principal Evaluation Systems. Integrated Leadership Development Initiative (ILDI)

ERIC Educational Resources Information Center

Mattson Almanzán, Heather; Sanders, Nancy; Kearney, Karen

2011-01-01

Research and professional leadership standards identify specific ways in which principals directly influence school organization and community relationships and exert less direct, but critically important, influence on teaching quality and instructional effectiveness. Principals' roles are central to supporting and supervising teachers'…

Differentiating Language Arts in Belize

ERIC Educational Resources Information Center

Cook, Pamela R.

2009-01-01

Purpose: There is limited amount of research that constitutes non-traditional curricula implemented within an institutionalized context of developing countries. An attempt is made in this project to gain a clearer understanding of a non-traditional early learning program within an orphanage campus setting of Ladyville, Belize, Central America.…

REVERSE AUCTION RESULTS FOR IMPLEMENTATION OF DECENTRALIZED RETROFIT BEST MANAGEMENT PRACTICES IN A SMALL URBAN WATERSHED (CINCINNATI OH)

EPA Science Inventory

Although urban stormwater is typically conveyed to centralized infrastructure, there is great potential for reducing stormwater runoff quantity through decentralization. In this case we hypothesize that smaller-scale retrofit best management practices (BMPs) such as rain gardens ...

Conservation and sediment yield on the Fort Cobb reservoir watershed

USDA-ARS?s Scientific Manuscript database

Prior to about 1950, conservation practices on the Fort Cobb Reservoir watershed in West-Central Oklahoma were few and mostly demonstration type projects. Extensive soil conservation measures were implemented in the second half of the 20th century. Fortuitously, the U.S. Geological Survey collecte...

State of Texas ITS architectures and deployment plans : West Central Texas region, executive summary

DOT National Transportation Integrated Search

2004-09-17

The Federal Highway Administration (FHWA) issued a final rule to implement Section 5206(e) of the Transportation Equity Act for the 21st Century (TEA-21) in January of 2001. This final rule requires that Intelligent Transportation System (ITS) projec...

The Information Society: Friendly to Families by Design or by Accident?

ERIC Educational Resources Information Center

Mirabelli, Alan

Optimistic, "computopian" scenarios of the new information age emphasize the possibility of radically reversing the central tendencies of industrialization through the implementation of computer technologies that increase the ability to recognize and accommodate the needs of individuals. Pessimistic, dystopian scenarios, in contrast,…

Benefits of a comprehensive quality program for cryopreserved PBMC covering 28 clinical trials sites utilizing an integrated, analytical web-based portal

PubMed Central

Ducar, Constance; Smith, Donna; Pinzon, Cris; Stirewalt, Michael; Cooper, Cristine; McElrath, M. Juliana; Hural, John

2014-01-01

The HIV Vaccine Trials Network (HVTN) is a global network of 28 clinical trial sites dedicated to identifying an effective HIV vaccine. Cryopreservation of high-quality peripheral blood mononuclear cells (PBMC) is critical for the assessment of vaccine-induced cellular immune functions. The HVTN PBMC Quality Management Program is designed to ensure viable PBMC are processed, stored and shipped for clinical trial assays from all HVTN clinical trial sites. The program has evolved by developing and incorporating best practices for laboratory and specimen quality and implementing automated, web-based tools. These tools allow the site-affiliated processing laboratories and the central Laboratory Operations Unit to rapidly collect, analyze and report PBMC quality data. The HVTN PBMC Quality Management Program includes five key components: 1) Laboratory Assessment, 2) PBMC Training and Certification, 3) Internal Quality Control, 4) External Quality Control (EQC), and 5) Assay Specimen Quality Control. Fresh PBMC processing data is uploaded from each clinical site processing laboratory to a central HVTN Statistical and Data Management Center database for access and analysis on a web portal. Samples are thawed at a central laboratory for assay or specimen quality control and sample quality data is uploaded directly to the database by the central laboratory. Four year cumulative data covering 23,477 blood draws reveals an average fresh PBMC yield of 1.45×106 ±0.48 cells per milliliter of useable whole blood. 95% of samples were within the acceptable range for fresh cell yield of 0.8–3.2×106 cells/ml of usable blood. Prior to full implementation of the HVTN PBMC Quality Management Program, the 2007 EQC evaluations from 10 international sites showed a mean day 2 thawed viability of 83.1% and recovery of 67.5%. Since then, four year cumulative data covering 3338 specimens used in immunologic assays shows that 99.88% had acceptable viabilities (>66%) for use in cellular assays (mean, 91.46% ±4.5%), and 96.2% had acceptable recoveries (50%–130%) with a mean of recovery of 85.8% ±19.12% of the originally cryopreserved cells. EQC testing revealed that since August 2009, failed recoveries dropped from 4.1% to 1.6% and failed viabilities dropped from 1.0% to 0.3%. The HVTN PBMC quality program provides for laboratory assessment, training and tools for identifying problems, implementing corrective action and monitoring for improvements. These data support the benefits of implementing a comprehensive, web-based PBMC quality program for large clinical trials networks. PMID:24709391

Spatial Collaboration Model among Local Governments in Ratubangnegoro Region in the Boundary Area of Central Java and East Java Provinces, Indonesia

NASA Astrophysics Data System (ADS)

Wahyono, H.; Wahdah, L.

2018-02-01

In Indonesia, according to Law No. 23/2014 on Local Government, a local government can conduct cooperation with other local governments that are based on considerations of efficiency and effectiveness of public services and mutual benefit, in order to improve people's welfare. Such cooperation can be categorized into mandatory and voluntary cooperation. Cooperation shall be developed jointly between the adjacent areas for the implementation of government affairs which have cross-local government externalities; and the provision of public services more efficient if managed together. One of the parts of the area that is directly related to the implementation of the policy liabilities of inter-local government cooperation which is mandated is the he province boundary areas. The public management of the provincial boundary areas is different from the central province area. While the central province area considers only their own interests, the management of boundary development must consider the neighboring regions. On one hand, the area is influenced only by its own province policy, while on the other influenced by neighboring regions. Meanwhile, a local government tends to resist the influence and intervention of neighboring regions. Likewise, neighboring local governments also tend to resist the influence and intervention of other local governments. Therefore, when interacting on the boundary, inter-local government interaction is not only the potential for cooperation, but also conflict-prone regions. One of the boundary area provinces attempt to implement the collaborative planning approach is the boundary area of Central Java Province and East Java Province, which is known as Ratubangnegoro Region. Ratubangnegoro region is one of the strategic areas of both provinces. In order to the interaction between the region could take place, there are regencies in the region have formed and joined the Inter-Local Government Cooperation Agency (BKAD-Badan Kerjasama Antar Daerah) Ratubangnegoro. Based on the explanation, this article explains the institutional model of collaborative planning contained in BKAD Ratubangnegoro. The model is much more complex, because it involves two different levels of government, provincial and regency government hierarchies. Institutional model of cooperation in the regency boundary area should be different from that of between provinces. The results of this are expected to be input from related parties of the inter-regional cooperation institution, particularly cooperation in the area of the provincial boundary with the province, which is implemented by the regencies contained therein.

Acute Sheehan's syndrome presenting as central diabetes insipidus.

PubMed

Robalo, Raquel; Pedroso, Célia; Agapito, Ana; Borges, Augusta

2012-11-06

Sheehan's syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. Improvements in obstetrical care have significantly reduced its incidence in developed countries, but postpartum pituitary infarction remains a common cause of hypopituitarism in developing countries. We report a case of severe postpartum haemorrhage followed by headache, central diabetes insipidus and failure to lactate, which prompted us to investigate and identify both anterior and posterior pituitary deficiency compatible with Sheehan's syndrome. A timely diagnosis allowed us to implement an adequate treatment and follow-up plan, which are known to improve clinical status and patient outcome.

Revisiting the social cost of carbon.

PubMed

Nordhaus, William D

2017-02-14

The social cost of carbon (SCC) is a central concept for understanding and implementing climate change policies. This term represents the economic cost caused by an additional ton of carbon dioxide emissions or its equivalent. The present study presents updated estimates based on a revised DICE model (Dynamic Integrated model of Climate and the Economy). The study estimates that the SCC is $31 per ton of CO 2 in 2010 US$ for the current period (2015). For the central case, the real SCC grows at 3% per year over the period to 2050. The paper also compares the estimates with those from other sources.

Revisiting the social cost of carbon

NASA Astrophysics Data System (ADS)

Nordhaus, William D.

2017-02-01

The social cost of carbon (SCC) is a central concept for understanding and implementing climate change policies. This term represents the economic cost caused by an additional ton of carbon dioxide emissions or its equivalent. The present study presents updated estimates based on a revised DICE model (Dynamic Integrated model of Climate and the Economy). The study estimates that the SCC is 31 per ton of CO2 in 2010 US for the current period (2015). For the central case, the real SCC grows at 3% per year over the period to 2050. The paper also compares the estimates with those from other sources.

Implementing health care reform: implications for performance of public hospitals in central Ethiopia.

PubMed

Manyazewal, Tsegahun; Matlakala, Mokgadi C

2018-06-01

Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia. The reform documents were reviewed to assess the nature and targets of the reform for interpretive analysis. Adopting dimensions of health system performance as the theoretical framework, a self-administered questionnaire was developed. Consenting health care professionals who have been involved in the reform from inception to implementation filled the questionnaire. Cronbach's alpha was measured to ensure internal consistency of the instrument. Descriptive statistics, weighted median score, χ 2 , and Mann-Whitney U and Kruskal-Wallis tests were used for data analysis. s Despite implementation of the reform, the health care system in public hospitals was still fragmented as confirmed by 50% of respondents. Limited effects were reported in favour of quality (48%), access (50%), efficiency (51%), sustainability (53%), and equity (61%) of care, while poor effects were reported in patient-provider (41%) and provider-management (32%) interactions. Though there was substantial gain in infrastructure and workspace, stewardship of health care resources was less benefited. The predominant hindrances of the reform were the working environment (adjusted Odds Ratio (aOR) = 2.27, 95% confidence interval (CI): 1.15-4.47), financial resources (aOR = 3.54, 95%CI = 1.97-6.33), management (aOR = 2.27, 95% CI = 1.15-4.47), and information technology system (aOR = 3.15, 95% CI = 1.57-6.32). s The Ethiopian health care reform has laid the groundwork for health system improvement, but progress was slow and the health care delivery system was still fragile. Healthcare reform efforts in such settings are feasible, but with regular mapping of programmatic outcomes and bringing a common understanding of the reform among stakeholders.

Implementation of continuous-variable quantum key distribution with composable and one-sided-device-independent security against coherent attacks.

PubMed

Gehring, Tobias; Händchen, Vitus; Duhme, Jörg; Furrer, Fabian; Franz, Torsten; Pacher, Christoph; Werner, Reinhard F; Schnabel, Roman

2015-10-30

Secret communication over public channels is one of the central pillars of a modern information society. Using quantum key distribution this is achieved without relying on the hardness of mathematical problems, which might be compromised by improved algorithms or by future quantum computers. State-of-the-art quantum key distribution requires composable security against coherent attacks for a finite number of distributed quantum states as well as robustness against implementation side channels. Here we present an implementation of continuous-variable quantum key distribution satisfying these requirements. Our implementation is based on the distribution of continuous-variable Einstein-Podolsky-Rosen entangled light. It is one-sided device independent, which means the security of the generated key is independent of any memoryfree attacks on the remote detector. Since continuous-variable encoding is compatible with conventional optical communication technology, our work is a step towards practical implementations of quantum key distribution with state-of-the-art security based solely on telecom components.

Implementation of continuous-variable quantum key distribution with composable and one-sided-device-independent security against coherent attacks

PubMed Central

Gehring, Tobias; Händchen, Vitus; Duhme, Jörg; Furrer, Fabian; Franz, Torsten; Pacher, Christoph; Werner, Reinhard F.; Schnabel, Roman

2015-01-01

Secret communication over public channels is one of the central pillars of a modern information society. Using quantum key distribution this is achieved without relying on the hardness of mathematical problems, which might be compromised by improved algorithms or by future quantum computers. State-of-the-art quantum key distribution requires composable security against coherent attacks for a finite number of distributed quantum states as well as robustness against implementation side channels. Here we present an implementation of continuous-variable quantum key distribution satisfying these requirements. Our implementation is based on the distribution of continuous-variable Einstein–Podolsky–Rosen entangled light. It is one-sided device independent, which means the security of the generated key is independent of any memoryfree attacks on the remote detector. Since continuous-variable encoding is compatible with conventional optical communication technology, our work is a step towards practical implementations of quantum key distribution with state-of-the-art security based solely on telecom components. PMID:26514280

Integrated flight/propulsion control system design based on a centralized approach

NASA Technical Reports Server (NTRS)

Garg, Sanjay; Mattern, Duane L.; Bullard, Randy E.

1989-01-01

An integrated flight/propulsion control system design is presented for the piloted longitudinal landing task with a modern, statically unstable, fighter aircraft. A centralized compensator based on the Linear Quadratic Gaussian/Loop Transfer Recovery methodology is first obtained to satisfy the feedback loop performance and robustness specificiations. This high-order centralized compensator is then partitioned into airframe and engine sub-controllers based on modal controllability/observability for the compensator modes. The order of the sub-controllers is then reduced using internally-balanced realization techniques and the sub-controllers are simplified by neglecting the insignificant feedbacks. These sub-controllers have the advantage that they can be implemented as separate controllers on the airframe and the engine while still retaining the important performance and stability characteristics of the full-order centralized compensator. Command prefilters are then designed for the closed-loop system with the simplified sub-controllers to obtain the desired system response to airframe and engine command inputs, and the overall system performance evaluation results are presented.

Electrical resistivity structure at the North-Central Turkey inferred from three-dimensional magnetotellurics

NASA Astrophysics Data System (ADS)

Özaydın, Sinan; Tank, Sabri Bülent; Karaş, Mustafa

2018-03-01

Magnetotelluric data analyses and three-dimensional modeling techniques were implemented to investigate the crustal electrical structure in the North-Central Turkey, along a 190-km-long profile crossing Çankırı Basin, İzmir-Ankara-Erzincan Suture Zone and Central Pontides. In this area, the segment of the North Anatolian Fault (NAF) shows 280-km-long restraining bend, where it was near the focus of the hazardous 1943 Tosya Earthquake (M: 7.6). Structure around the NAF exhibits resistive characteristics at both sides of the fault reaching to at least 25 km of depth. Fluids below the brittle-ductile transition were not detected which will nucleate earthquakes in the area. This resistive structure implies an asperity zone of the NAF, which was ruptured in 1943. The presence of a fluid-bearing upwelling conductive anomaly in Central Pontides may suggest that beneath the deep brittle crust, there may exists a fluid-enriched conductive forearc region, which may have caused by a prograde source related to paleo-tectonic processes.

Central Upwind Scheme for a Compressible Two-Phase Flow Model

PubMed Central

Ahmed, Munshoor; Saleem, M. Rehan; Zia, Saqib; Qamar, Shamsul

2015-01-01

In this article, a compressible two-phase reduced five-equation flow model is numerically investigated. The model is non-conservative and the governing equations consist of two equations describing the conservation of mass, one for overall momentum and one for total energy. The fifth equation is the energy equation for one of the two phases and it includes source term on the right-hand side which represents the energy exchange between two fluids in the form of mechanical and thermodynamical work. For the numerical approximation of the model a high resolution central upwind scheme is implemented. This is a non-oscillatory upwind biased finite volume scheme which does not require a Riemann solver at each time step. Few numerical case studies of two-phase flows are presented. For validation and comparison, the same model is also solved by using kinetic flux-vector splitting (KFVS) and staggered central schemes. It was found that central upwind scheme produces comparable results to the KFVS scheme. PMID:26039242

Central upwind scheme for a compressible two-phase flow model.

PubMed

Ahmed, Munshoor; Saleem, M Rehan; Zia, Saqib; Qamar, Shamsul

2015-01-01

In this article, a compressible two-phase reduced five-equation flow model is numerically investigated. The model is non-conservative and the governing equations consist of two equations describing the conservation of mass, one for overall momentum and one for total energy. The fifth equation is the energy equation for one of the two phases and it includes source term on the right-hand side which represents the energy exchange between two fluids in the form of mechanical and thermodynamical work. For the numerical approximation of the model a high resolution central upwind scheme is implemented. This is a non-oscillatory upwind biased finite volume scheme which does not require a Riemann solver at each time step. Few numerical case studies of two-phase flows are presented. For validation and comparison, the same model is also solved by using kinetic flux-vector splitting (KFVS) and staggered central schemes. It was found that central upwind scheme produces comparable results to the KFVS scheme.

Effect of care management program structure on implementation: a normalization process theory analysis.

PubMed

Holtrop, Jodi Summers; Potworowski, Georges; Fitzpatrick, Laurie; Kowalk, Amy; Green, Lee A

2016-08-15

Care management in primary care can be effective in helping patients with chronic disease improve their health status, however, primary care practices are often challenged with implementation. Further, there are different ways to structure care management that may make implementation more or less successful. Normalization process theory (NPT) provides a means of understanding how a new complex intervention can become routine (normalized) in practice. In this study, we used NPT to understand how care management structure affected how well care management became routine in practice. Data collection involved semi-structured interviews and observations conducted at 25 practices in five physician organizations in Michigan, USA. Practices were selected to reflect variation in physician organizations, type of care management program, and degree of normalization. Data were transcribed, qualitatively coded and analyzed, initially using an editing approach and then a template approach with NPT as a guiding framework. Seventy interviews and 25 observations were completed. Two key structures for care management organization emerged: practice-based care management where the care managers were embedded in the practice as part of the practice team; and centralized care management where the care managers worked independently of the practice work flow and was located outside the practice. There were differences in normalization of care management across practices. Practice-based care management was generally better normalized as compared to centralized care management. Differences in normalization were well explained by the NPT, and in particular the collective action construct. When care managers had multiple and flexible opportunities for communication (interactional workability), had the requisite knowledge, skills, and personal characteristics (skill set workability), and the organizational support and resources (contextual integration), a trusting professional relationship (relational integration) developed between practice providers and staff and the care manager. When any of these elements were missing, care management implementation appeared to be affected negatively. Although care management can introduce many new changes into delivery of clinical practice, implementing it successfully as a new complex intervention is possible. NPT can be helpful in explaining differences in implementing a new care management program with a view to addressing them during implementation planning.

Doing implementation research on health governance: a frontline researcher's reflexive account of field-level challenges and their management.

PubMed

Patel, Gupteswar; Garimella, Surekha; Scott, Kerry; Mondal, Shinjini; George, Asha; Sheikh, Kabir

2017-11-15

Implementation Research (IR) in and around health systems comes with unique challenges for researchers including implementation, multi-layer governance, and ethical issues. Partnerships between researchers, implementers, policy makers and community members are central to IR and come with additional challenges. In this paper, we elaborate on the challenges faced by frontline field researchers, drawing from experience with an IR study on Village Health Sanitation and Nutrition Committees (VHSNCs). The IR on VHSNC took place in one state/province in India over an 18-month research period. The IR study had twin components; intervention and in-depth research. The intervention sought to strengthen the VHSNC functioning, and concurrently the research arm sought to understand the contextual factors, pathways and mechanism affecting VHSNC functions. Frontline researchers were employed for data collection and a research assistant was living in the study sites. The frontline research assistant experienced a range of challenges, while collecting data from the study sites, which were documented as field memos and analysed using inductive content analysis approach. Due to the relational nature of IR, the challenges coalesced around two sets of relationships (a) between the community and frontline researchers and (b) between implementers and frontline researchers. In the community, the frontline researcher was viewed as the supervisor of the intervention and was perceived by the community to have power to bring about beneficial changes with public services and facilities. Implementers expected help from the frontline researcher in problem-solving in VHSNCs, and feedback on community mobilization to improve their approaches. A concerted effort was undertaken by the whole research team to clarify and dispel concerns among the community and implementers through careful and constant communication. The strategies employed were both managerial, relational and reflexive in nature. Frontline researchers through their experiences shape the research process and its outcome and they play a central role in the research. It demonstrates that frontline researcher resilience is very crucial when conducting health policy and systems research.

77 FR 15596 - Privacy Act; Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-16

... DEPARTMENT OF DEFENSE Office of the Secretary [Docket ID DoD-2012-OS-0032] 32 CFR Part 322 Privacy... levels of government. List of Subjects in 32 CFR Part 322 Privacy. Accordingly, 32 CFR part 322 is amended as follows: PART 322--NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICE 0 1. The authority...

76 FR 22615 - Privacy Act; Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... DEPARTMENT OF DEFENSE Office of the Secretary [Docket ID: DoD-2011-OS-0003] 32 CFR Part 322... Part 322 Privacy. Accordingly, 32 CFR part 322 is amended as follows: PART 322--NATIONAL SECURITY AGENCY/CENTRAL SECURITY SERVICE PROGRAM 0 1. The authority citation for 32 CFR part 322.7 continues to...

75 FR 61574 - Unblocking of Specially Designated Nationals and Blocked Persons Pursuant To the Foreign...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-05

... & Implementation, U.S. Department of the Treasury, Office of Foreign Assets Control, Washington, DC 20220, tel... and their organizations on a worldwide basis, with the objective of denying their businesses and... the Central Intelligence Agency, the Director of the Federal Bureau of Investigation, the...

75 FR 65554 - Additional Designations, Foreign Narcotics Kingpin Designation Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... Outreach & Implementation, Office of Foreign Assets Control, Department of the Treasury, Washington, DC... objective of denying their businesses and agents access to the U.S. financial system and to the benefits of... with the Attorney General, the Director of the Central Intelligence Agency, the Director of the Federal...

75 FR 42487 - Supplementary Identifying Information of Previously-Designated Individual, Foreign Narcotics...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... Director, Compliance Outreach & Implementation, Office of Foreign Assets Control, Department of the... their businesses and agents access to the U.S. financial system and the benefits of trade and..., the Director of the Central Intelligence Agency, the Director of the Federal Bureau of Investigation...

75 FR 52692 - Approval and Promulgation of Implementation Plans; New Mexico; Interstate Transport of Pollution...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... an indication of potential variability in future projections due to differences in actual meteorology... maintaining attainment of the NAAQS at these locations if there are adverse variations in meteorology or... the Central Regional Air Planning Association (CENRAP) modeling of 2002 emissions and meteorology.\\22...

Guiding District Implementation of Common Core State Standards: Innovation Configuration Maps

ERIC Educational Resources Information Center

Roy, Patricia; Killion, Joellen

2011-01-01

Leadership Networks are regional and content-specific networks focused on the preparation of college- and career-ready students. Each network includes teacher leaders, school administrators, central office staff, regional cooperatives, and institutes of higher education. Network members work collaboratively to focus their efforts on regional needs…

40 CFR 52.1671 - Classification of regions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) New York § 52.1671 Classification of regions. The New York plans were evaluated on the basis of the following classifications: Air... II III III III Central New York Intrastate I II III I I Genesee-Finger Lakes Intrastate II II III III...

Thermal integrity profiling for augered cast-in-place piles – implementation plan : summary.

DOT National Transportation Integrated Search

2017-09-01

Auger-cast-in-place (ACIP) piles are created when an auger the diameter and length of the desired pile is drilled into the ground. Concrete is pumped through the central axis of the auger as it is withdrawn, pulling up excavated soil as concrete fill...

Students, Learning, Assessment and Technology: A Campus-Wide Merger.

ERIC Educational Resources Information Center

Thompson, Gary; Hoskisson, Dale; Brauner, Carolyn; Christensen, Val

In order to achieve its goal to improve learning and ensure success of students, Valley City State University (VCSU) implemented a comprehensive and multidimensional agenda for institutional change. A central component, Improving Learning with Technology (ILT), involves integration of learning and assessment that is facilitated by, and contingent…

Curriculum Approaches in Language Teaching: Forward, Central, and Backward Design

ERIC Educational Resources Information Center

Richards, Jack C.

2013-01-01

The development and implementation of language teaching programs can be approached in several different ways, each of which has different implications for curriculum design. Three curriculum approaches are described and compared. Each differs with respect to when issues related to input, process, and outcomes, are addressed. Forward design starts…

Marketing and Market Research for Adult and Continuing Education.

ERIC Educational Resources Information Center

Buckmaster, Annette

Marketing is an essential part of conducting a continuing education program, but marketing consists of more than just promotion. According to Kotler, exchange is the central concept underlying marketing. Marketing involves understanding, planning, implementing, and controlling this exchange. The exchange situation contains all the elements of the…

Centralization for Equity: A Fair Price?

ERIC Educational Resources Information Center

Malkiewich, Chris; McEwen, John

This paper analyzes educational finance reforms initiated in Ontario. It outlines the changes in governance, funding, and curriculum and states that reforms were implemented without proper support and forethought, resulting in chaos. The report details how the rise of a conservative government in the province led to a desire to reduce taxation and…

Implementing Knowledge Management as a Strategic Initiative

DTIC Science & Technology

2003-12-01

Quality Management (TQM); Development Metrics Standards; Philosophy Hierarchical, Centralized or Decentralized; Sociolinguistics ...disciplines of operations research, logic, psychology, philosophy, sociolinguistics , management science, management information science, organizational...needs of customers for America and its Allies.” (CECOM AC Strategic Plan, 2001) Given the mission and vision statements, an organization needs to

Curriculum Differentiation for Handwriting and Occupational Therapy/Teacher Partnership: Collaboration or Conflict?

ERIC Educational Resources Information Center

Patton, Sandra; Hutton, Eve; MacCobb, Siobhan

2015-01-01

Collaborative practice between health and education professionals is considered central to the implementation of inclusion policies and best practice to support children with special educational needs (SEN). However, in Ireland, barriers to collaborative practice between occupational therapists and teachers include limited contact in practice…

Developing a Scale on "Factors Regarding Curriculum Alignment"

ERIC Educational Resources Information Center

Bay, Erdal

2016-01-01

"Curriculum alignment" is the compatibility between a country's centralized curriculum determined by the ministry of education and what teachers do during the teaching process. However, it is observed that teachers do not exactly implement the curriculum. The purpose of this study is to develop a scale that will determine the factors…

48 CFR 217.7505 - Limitations on price increases.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Limitations on price... Acquisition of Replenishment Parts 217.7505 Limitations on price increases. This section provides implementing... award, on a sole source basis, a contract for any centrally managed replenishment part when the price of...

The Strategic Value of HRD in Lean Strategy Implementation

ERIC Educational Resources Information Center

Alagaraja, Meera; Egan, Toby

2013-01-01

Central to the relevance of HRD is the inclusion of HRD professionals and functions in organizational strategy. Understanding how HRD units and professionals contribute to or hinder organizational strategy is important for the field. We describe an organizational case in which a systemic strategic initiative involving "Lean strategy" is deployed…

Inquiry through Modeling: Exploring the Tensions between Natural & Sexual Selection Using Crickets

ERIC Educational Resources Information Center

Bouwma-Gearhart, Jana; Bouwma, Andrew

2015-01-01

The "Next Generation Science Standards" (NGSS Lead States, 2013) recommend that science courses engage communities of students in scientific practices that include building accurate conceptual models of phenomena central to the understanding of scientific disciplines. We offer a set of activities, implemented successfully at both the…

A Policy-Based Approach to Technology Systems

ERIC Educational Resources Information Center

Kuhn, Robert M.; Brookes, Kimberly H.; Bellos, Nephellie

2008-01-01

Discussions with a central IT organization about integration with existing systems on campus, support costs for the new implementation, and total cost of ownership frequently become adversarial. Simmons College, a small college in Boston with an enrollment of approximately 1,900 undergraduate and 2,800 graduate students, reframed these issues in…

Assessing the Complexity of Students' Knowledge in Chemistry

ERIC Educational Resources Information Center

Bernholt, Sascha; Parchmann, Ilka

2011-01-01

Current reforms in the education policy of various countries are intended to produce a paradigm shift in the educational system towards an outcome orientation. After implementing educational standards as normative objectives, the development of test procedures that adequately reflect these targets and standards is a central problem. This paper…

Interdisciplinary, Application-Oriented Tutorials: Design, Implementation, and Evaluation

ERIC Educational Resources Information Center

Herman, Carolyn; Casiday, Rachel E.; Deppe, Roberta K.; Gilbertson, Michelle; Spees, William M.; Holten, Dewey; Frey, Regina F.

2005-01-01

Fifteen application-oriented chemical tutorials were developed out of which thirteen are currently in use in the general chemistry lab rotary curriculum for chemistry students at Washington University from 1998 to 2000. The central philosophy of the tutorial that the students learn to combine information from variety of sources like science…

Endogenous and costly institutional deterrence

Treesearch

David C. Kingsley; Thomas C. Brown

2014-01-01

Modern economies rely on central-authority institutions to regulate individual behaviour. Despite the importance of such institutions little is known about their formation within groups. In a public good experiment, groups selected the level of deterrence implemented by the institution, knowing that the administrative costs of the institution rose with the level of...

IMPLEMENTATION OF A TWO-WAY INTERACTIVE ATMOSPHERIC AND ECOLOGICAL MODEL AND ITS APPLICATION TO THE CENTRAL UNITED STATES. (R824993)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Biological Sciences Curriculum Study Newsletter Number 39, BSCS Biology: A World View.

ERIC Educational Resources Information Center

Clark, George M.

Included are progress reports from forty-two countries, ranging from accounts of complete adaptation and implementation of Biological Sciences Curriculum Study (BSCS) materials to notes of preliminary contact with BSCS programs. Countries represented are: Afganistan, Argentina, Australia, Bolivia, Brazil, Canada, Central America, Ceylon, Chile,…

Quantifying spatial and temporal variability of methane emissions from a complex area source: case study of a central Indiana landfill

EPA Science Inventory

strengths, limitations, and uncertainties of these two approaches. Because US landfills are highly-engineered and composed of daily, intermediate, and final cover areas with differing thicknesses, composition, and implementation of gas recovery, we also expected different emissi...

Community College Selective Enrollment and the Challenge to Open Access

ERIC Educational Resources Information Center

Morris, David Brian

2012-01-01

The open access mission is central to the community college role and mission in higher education. Although initially implemented by four-year colleges and universities, adoption of formal enrollment management initiatives in community colleges is on the increase. Admission, matriculation, retention, and persistence are affected by enrollment…

The Career Advancement Portfolio. Advancement for Low-Wage Workers

ERIC Educational Resources Information Center

Jobs for the Future, 2006

2006-01-01

Jobs for the Future created the "Career Advancement Portfolio" as central to its commitment to developing, implementing, and advocating for models, strategies, and policies that enable adults to advance toward economic self-sufficiency for themselves and their families. The "Portfolio" brings together the most innovative workforce development…

Dialogue and Training. 1975.

ERIC Educational Resources Information Center

Fritz, Gerhard; Kern, Ulrich, Ed.

Information on the German Foundation for International Development (DSE) and DSE's program events for 1975 are presented. (DSE is one of the central institutions in the Federal Republic of Germany charged with the implementation of development policy measures. Established in 1959, the objective of the DSE is to foster relations between the Federal…

Implementing Guided Pathways: Early Insights from the AACC Pathways Colleges

ERIC Educational Resources Information Center

Jenkins, Davis; Lahr, Hana; Fink, John

2017-01-01

Across the United States, a growing number of colleges are redesigning their programs and student support services according to the "guided pathways" model. Central to this approach are efforts to clarify pathways to program completion, career advancement, and further education. Equally essential are efforts to help students explore…

Administrative Practices as Institutional Identity: Bureaucratic Impediments to HE "Internationalisation" Policy in Japan

ERIC Educational Resources Information Center

Poole, Gregory S.

2016-01-01

This paper explores how bureaucracy impedes the implementation of higher education (HE) policy at Japanese universities. Administrative systems employ Weberian legal-rational bureaucratic practices that are central to the institutional identity of a university. Rather than the means to internationalisation and reform in general, these systems…

Collaborations among Diverse Support Areas for Hybrid Success

ERIC Educational Resources Information Center

Haggar, Faye; Kelley, Bruce; Chen, Weichao

2017-01-01

Successful implementation of hybrid courses typically demands collaboration among diverse support areas on campus. This article examines these collaborations through the lens of Badrul Khan's theory of managing blended learning support. Also discussed is the central role that faculty developers can play in connecting these support areas to ensure…

Measurement Science and Training.

ERIC Educational Resources Information Center

Bunderson, C. Victor

The need for training and retraining is a central element in current discussions about the economy of the United States. This paper is designed to introduce training practitioners to some new concepts about how measurement science can provide a new framework for assessing progress and can add new discipline to the development, implementation, and…

78 FR 77557 - Releasing Information; General Provisions; Accounting and Reporting Requirements; Reports of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-24

..., including controls for maintaining the confidentiality of borrower information. The system of internal... develop and implement an effective system of internal controls over the central data repository to ensure..., and maintain an effective system of internal controls over the data included in the report of accounts...

Environments for Fostering Effective Critical Thinking in Geotechnical Engineering Education (Geo-EFFECTs)

ERIC Educational Resources Information Center

Pierce, Charles E.; Gassman, Sarah L.; Huffman, Jeffrey T.

2013-01-01

This paper describes the development, implementation, and assessment of instructional materials for geotechnical engineering concepts using the Environments for Fostering Effective Critical Thinking (EFFECTs) pedagogical framework. The central learning goals of engineering EFFECTs are to (i) improve the understanding and retention of a specific…

Serving Distant Learners through Instructional Technologies.

ERIC Educational Resources Information Center

Drea, John T.; Armistead, L. Pendleton

John Wood Community College (JWCC) serves a district population of approximately 90,000 in a predominantly rural section of west-central Illinois. In an effort to address the needs of the rural long-distance learner, JWCC has implemented a variety of instructional delivery techniques. Since its inception, JWCC has contracted with other area…

An Implemented Strategy for Campus Connectivity and Cooperative Computing.

ERIC Educational Resources Information Center

Halaris, Antony S.; Sloan, Lynda W.

1989-01-01

ConnectPac, a software package developed at Iona College to allow a computer user to access all services from a single personal computer, is described. ConnectPac uses mainframe computing to support a campus computing network, integrating personal and centralized computing into a menu-driven user environment. (Author/MLW)

Using eLearning to Build Workforce Capacity among Business Professionals

ERIC Educational Resources Information Center

Carruth, Paul J.; Carruth, Ann K.

2012-01-01

In the current evolving economic environment, developing and implementing effective processes to improve the skills and capability of employees are seen as central to improving individual, organizational and national performance and global competitiveness. Recognizing that universities and colleges are critical to their state's growth and economic…

Improving the Textbook Adoption Process in Taiwan

ERIC Educational Resources Information Center

Ho, Hsuan-fu; Hsu, Ying-tsun

2011-01-01

Textbooks were centrally selected in Taiwan until 1996 when the government commissioned its Textbook Liberalization Reform. Although this policy received complements from scholars and the general public, it encounters many unexpected problems in its implementation. The aims of this research are thus to identify the major criteria used by…

41 CFR 105-53.142 - Office of Public Affairs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Office of Public Affairs... Central Offices § 105-53.142 Office of Public Affairs. The Office of Public Affairs, headed by the Associate Administrator for Public Affairs, is responsible for the planning, implementation, and...

Developing, Implementing, and Assessing an Early Alert System

ERIC Educational Resources Information Center

Tampke, Dale R.

2013-01-01

Early alert systems offer institutions systematic approaches to identifying and intervening with students exhibiting at-risk behaviors. Many of these systems rely on a common format for student referral to central receiving point. Systems at larger institutions often use web-based technology to allow for a scalable (available campus wide) approach…

The Role of Private Sector Management in Public Education.

ERIC Educational Resources Information Center

Doyle, Denis P.

1994-01-01

The school system's uniformity is clearly a liability in the modern era. Today's schools need entrepreneurship, not change by rule, regulation, and statute. The central issue of entrepreneurship is not risk-taking, but innovative, implementation methods. Eventually, using private contractors to improve the management of instructional services will…

Negotiating Neoliberal Multiculturalism: Mapuche Workers in the Chilean State

ERIC Educational Resources Information Center

Park, Yun-Joo; Richards, Patricia

2007-01-01

A central component of neoliberal multiculturalism in contemporary Latin America is an increase in indigenous individuals who work for the state, implementing indigenous policy at the municipal, regional and national levels. We explore the consequences of the inclusion of these individuals by analyzing the experiences of Mapuche state workers in…