LPV Controller Interpolation for Improved Gain-Scheduling Control Performance

NASA Technical Reports Server (NTRS)

Wu, Fen; Kim, SungWan

2002-01-01

In this paper, a new gain-scheduling control design approach is proposed by combining LPV (linear parameter-varying) control theory with interpolation techniques. The improvement of gain-scheduled controllers can be achieved from local synthesis of Lyapunov functions and continuous construction of a global Lyapunov function by interpolation. It has been shown that this combined LPV control design scheme is capable of improving closed-loop performance derived from local performance improvement. The gain of the LPV controller will also change continuously across parameter space. The advantages of the newly proposed LPV control is demonstrated through a detailed AMB controller design example.

[Recommendations for the evaluation and follow-up of the continuous quality improvement].

PubMed

Maurellet-Evrard, S; Daunizeau, A

2013-06-01

Continual improvement of the quality in a medical laboratory is based on the implementation of tools for systematically evaluate the quality management system and its ability to meet the objectives defined. Monitoring through audit and management review, addressing complaints and nonconformities and performing client satisfaction survey are the key for the continual improvement.

Continuous Improvement through Baldridge in Education.

ERIC Educational Resources Information Center

Siri, Diane K.; Miller, Ruth

2001-01-01

Describes efforts of the Baldrige in Education Center and Quality Leadership Academy in Santa Cruz County, California, to support teacher and administrator efforts to improve student performance in selected schools through the use of continuous-improvement techniques adopted by many American corporations to improve product quality and increase…

The Integrated Joslin Performance Improvement/CME Program: A New Paradigm for Better Diabetes Care

ERIC Educational Resources Information Center

Brown, Julie A.; Beaser, Richard S.; Neighbours, James; Shuman, Jill

2011-01-01

Ongoing continuing medical education is an essential component of life-long learning and can have a positive influence on patient outcomes. However, some evidence suggests that continuing medical education has not fulfilled its potential as a performance improvement (PI) tool, in part due to a paradigm of CME that has focused on the quantity of…

Achieving continuous improvement in laboratory organization through performance measurements: a seven-year experience.

PubMed

Salinas, Maria; López-Garrigós, Maite; Gutiérrez, Mercedes; Lugo, Javier; Sirvent, Jose Vicente; Uris, Joaquin

2010-01-01

Laboratory performance can be measured using a set of model key performance indicators (KPIs). The design and implementation of KPIs are important issues. KPI results from 7 years are reported and their implementation, monitoring, objectives, interventions, result reporting and delivery are analyzed. The KPIs of the entire laboratory process were obtained using Laboratory Information System (LIS) registers. These were collected automatically using a data warehouse application, spreadsheets and external quality program reports. Customer satisfaction was assessed using surveys. Nine model laboratory KPIs were proposed and measured. The results of some examples of KPIs used in our laboratory are reported. Their corrective measurements or the implementation of objectives led to improvement in the associated KPIs results. Measurement of laboratory performance using KPIs and a data warehouse application that continuously collects registers and calculates KPIs confirmed the reliability of indicators, indicator acceptability and usability for users, and continuous process improvement.

Measuring, managing and maximizing performance of mineral processing plants

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

Bascur, O.A.; Kennedy, J.P.

1995-12-31

The implementation of continuous quality improvement is the confluence of Total Quality Management, People Empowerment, Performance Indicators and Information Engineering. The supporting information technologies allow a mineral processor to narrow the gap between management business objectives and the process control level. One of the most important contributors is the user friendliness and flexibility of the personal computer in a client/server environment. This synergistic combination when used for real time performance monitoring translates into production cost savings, improved communications and enhanced decision support. Other savings come from reduced time to collect data and perform tedious calculations, act quickly with fresh newmore » data, generate and validate data to be used by others. This paper presents an integrated view of plant management. The selection of the proper tools for continuous quality improvement are described. The process of selecting critical performance monitoring indices for improved plant performance are discussed. The importance of a well balanced technological improvement, personnel empowerment, total quality management and organizational assets are stressed.« less

Why Continuous Improvement Is a Poor Substitute for School Choice

ERIC Educational Resources Information Center

Rose, David C.; Rochester, J. Martin

2008-01-01

Efforts to introduce school choice have produced pressures on public schools to improve their performance. As a result, many public schools have embraced the total quality management principle of continuous improvement. In this article we explain that while this may be well intentioned, it may have perverse unintended consequences. A likely…

Methylphenidate Reduces State Anxiety During a Continuous Performance Test That Distinguishes Adult ADHD Patients From Controls.

PubMed

Bloch, Yuval; Aviram, Shai; Segev, Aviv; Nitzan, Uri; Levkovitz, Yechiel; Braw, Yoram; Mimouni Bloch, Aviva

2017-01-01

We hypothesized that patients with ADHD were typified by distress more than by functional difficulties. Thus, a decline in state anxiety while performing a cognitive task when taking methylphenidate would discriminate between ADHD patients and controls. State anxiety and cognitive performance on a continuous performance test were assessed in ADHD patients and controls with and without taking methylphenidate. State anxiety and cognitive performance improved from baseline in 36 ADHD adults after taking methylphenidate. In 25 controls, cognitive performance improved, but state anxiety did not abate after a recess. In two additional studies, 5 controls were evaluated at baseline and after receiving methylphenidate, and showed improvement in cognitive assessment but not in state anxiety. Five ADHD adults were assessed at baseline and after a recess, and showed no improvement. Our results support the hypothesis that adult ADHD patients are characterized by distress and the relief of this distress under effective therapy as expressed by a decline in state anxiety while they perform a cognitive task.

42 CFR 460.132 - Quality assessment and performance improvement plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

42 CFR 460.132 - Quality assessment and performance improvement plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Teaching Performance Improvement: An Opportunity for Continuing Medical Education

ERIC Educational Resources Information Center

Staker, Larry V.

2003-01-01

Practicing physicians generally are not engaged in either the methods of performance improvement for health care or the measurement and reporting of clinical outcomes. The principal reasons are lack of compensation for such work, the perception that the work of performance improvement adds no value and is a waste of time, the lack of knowledge and…

Systems of Continuing Education: Priority to District Health Personnel. Report of a WHO Expert Committee. Technical Report Series 803.

ERIC Educational Resources Information Center

World Health Organization, Geneva (Switzerland).

Continuing education systems can improve the performance of health workers in countries around the world and support the functioning of district health systems. Continuing education guides health personnel toward the principles and methods of primary health care and improves their work with the community and family to attain an adequate level of…

New PbSnTe heterojunction laser diode structures with improved performance

NASA Technical Reports Server (NTRS)

Fonstad, C. G.; Kasemset, D.; Hsieh, H. H.; Rotter, S.

1980-01-01

Several recent advances in the state-of-the-art of lead tin telluride double heterojunction laser diodes are summarized. Continuous Wave operation to 120 K and pulsed operation to 166 K with single, lowest order transverse mode emission to in excess of four times threshold at 80 K were achieved in buried stripe lasers fabricated by liquid phase epitaxy in the lattice-matched system, lead-tin telluride-lead telluride selenide. At the same time, liquid phase epitaxy was used to produce PbSnTe distributed feedback lasers with much broader continuous single mode tuning ranges than are available from Fabry-Perot lasers. The physics and philosophy behind these advances is as important as the structures and performance of the specific devices embodying the advances, particularly since structures are continually being evolved and the performance continues to be improved.

Continuous improvement in the Industrial and Management Systems Engineering programme at Kuwait University

NASA Astrophysics Data System (ADS)

Aldowaisan, Tariq; Allahverdi, Ali

2016-07-01

This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been applied to the results of four assessment tools and other data sources to improve performance. Important improvements include the need to reconsider two student outcomes as they were difficult to implement in courses. In addition, through benchmarking and the engagement of Alumni and Employers, key decisions were made to improve the curriculum and enhance employability.

42 CFR 460.136 - Internal quality assessment and performance improvement activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460...

Process safety improvement--quality and target zero.

PubMed

Van Scyoc, Karl

2008-11-15

Process safety practitioners have adopted quality management principles in design of process safety management systems with positive effect, yet achieving safety objectives sometimes remain a distant target. Companies regularly apply tools and methods which have roots in quality and productivity improvement. The "plan, do, check, act" improvement loop, statistical analysis of incidents (non-conformities), and performance trending popularized by Dr. Deming are now commonly used in the context of process safety. Significant advancements in HSE performance are reported after applying methods viewed as fundamental for quality management. In pursuit of continual process safety improvement, the paper examines various quality improvement methods, and explores how methods intended for product quality can be additionally applied to continual improvement of process safety. Methods such as Kaizen, Poke yoke, and TRIZ, while long established for quality improvement, are quite unfamiliar in the process safety arena. These methods are discussed for application in improving both process safety leadership and field work team performance. Practical ways to advance process safety, based on the methods, are given.

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

ERIC Educational Resources Information Center

Griffith, William S.

1981-01-01

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

Stem Cell Therapy to Improve Burn Wound Healing

DTIC Science & Technology

2017-03-01

Aim(s) • Perform Phase 1 Trial of Allogeneic MSCs in Burns • Perform Phase 2 Trial of Allogeneic MSCs in Burns • Collect Tissue Repository for...for safety/dose studies CY15 Goal – Continue Phase 1 and, Start Tissue Repository  Continue donors recruitment, screening and Bone Marrow Aspiration...1 Trial and Collect Tissue Repository  Continue donors recruitment, screening and Bone Marrow Aspiration as needed.  Continue patients screening

Sharing Collaborative Designs of Tobacco Cessation Performance Improvement CME Projects

ERIC Educational Resources Information Center

Mullikin, Elizabeth A.; Ales, Mary W.; Cho, Jane; Nelson, Teena M.; Rodrigues, Shelly B.; Speight, Mike

2011-01-01

Introduction: Performance Improvement Continuing Medical Education (PI CME) provides an important opportunity for CME providers to combine educational and quality health care improvement methodologies. Very few CME providers take on the challenges of planning this type of intervention because it is still a new practice and there are limited…

Building a Foundation of Continuous Improvement in a Rapidly Changing Environment: The Dartmouth-Hitchcock Value Institute Experience.

PubMed

McGrath, Susan P; Blike, George T

2015-10-01

A performance improvement competency development program, known as the Value Institute (VI), was established at Dartmouth-Hitchcock (D-H; Lebanon, New Hampshire) in 2011 to develop a performance improvement-focused workforce and systems capable of meeting the challenges of creating a sustainable health system. A tiered competency development program that provides patient safety, health care quality, and improvement science education, and an execution support infrastructure that enables access to performance improvement tools for all employees, comprise the core of the VI. At 20 months after the launch of the first VI classes, more than 10% of all employees were trained to the Yellow Belt level, and approximately 1.5% of all employees became advanced practitioners (Green Belts or Black Belts). Improvement projects have focused on both clinical and business process optimization, as well as regulatory and accreditation compliance and patient safety. Project savings during the two years of operation have exceeded the investment of resources to establish this long-term performance improvement capability by 2.5 times. The D-H VI model promotes multidisciplinary team-based learning, incremental skill development, and access to a common continuous improvement vocabulary and method for all employees-all key to building the teams and momentum needed for successful execution of improvement work and to maintain outcomes. Initial outcomes, represented by organizational spread, project execution status, participants' feedback scores, and return on investment estimates, suggest that robust team-based learning combined with coaching provides sufficient depth and breadth of learning and effective opportunities to gain practical experience in continuous improvement.

Analyzing the Interaction of Performance Appraisal Factors Using Interpretive Structural Modeling

ERIC Educational Resources Information Center

Manoharan, T. R.; Muralidharan, C.; Deshmukh, S. G.

2010-01-01

In today's changed environment where the economy and industry are driven by customers, business is open to worldwide competition. Manufacturing firms have looked at employee performance improvement as a means to succeed. These findings advocate setting up priorities for employee performance improvement. This requires a continuous improvement…

Continuous-variable measurement-device-independent quantum key distribution with virtual photon subtraction

NASA Astrophysics Data System (ADS)

Zhao, Yijia; Zhang, Yichen; Xu, Bingjie; Yu, Song; Guo, Hong

2018-04-01

The method of improving the performance of continuous-variable quantum key distribution protocols by postselection has been recently proposed and verified. In continuous-variable measurement-device-independent quantum key distribution (CV-MDI QKD) protocols, the measurement results are obtained from untrusted third party Charlie. There is still not an effective method of improving CV-MDI QKD by the postselection with untrusted measurement. We propose a method to improve the performance of coherent-state CV-MDI QKD protocol by virtual photon subtraction via non-Gaussian postselection. The non-Gaussian postselection of transmitted data is equivalent to an ideal photon subtraction on the two-mode squeezed vacuum state, which is favorable to enhance the performance of CV-MDI QKD. In CV-MDI QKD protocol with non-Gaussian postselection, two users select their own data independently. We demonstrate that the optimal performance of the renovated CV-MDI QKD protocol is obtained with the transmitted data only selected by Alice. By setting appropriate parameters of the virtual photon subtraction, the secret key rate and tolerable excess noise are both improved at long transmission distance. The method provides an effective optimization scheme for the application of CV-MDI QKD protocols.

Improvement of two-way continuous-variable quantum key distribution with virtual photon subtraction

NASA Astrophysics Data System (ADS)

Zhao, Yijia; Zhang, Yichen; Li, Zhengyu; Yu, Song; Guo, Hong

2017-08-01

We propose a method to improve the performance of two-way continuous-variable quantum key distribution protocol by virtual photon subtraction. The virtual photon subtraction implemented via non-Gaussian post-selection not only enhances the entanglement of two-mode squeezed vacuum state but also has advantages in simplifying physical operation and promoting efficiency. In two-way protocol, virtual photon subtraction could be applied on two sources independently. Numerical simulations show that the optimal performance of renovated two-way protocol is obtained with photon subtraction only used by Alice. The transmission distance and tolerable excess noise are improved by using the virtual photon subtraction with appropriate parameters. Moreover, the tolerable excess noise maintains a high value with the increase in distance so that the robustness of two-way continuous-variable quantum key distribution system is significantly improved, especially at long transmission distance.

Dissemination of performance information and continuous improvement: A narrative systematic review.

PubMed

Lemire, Marc; Demers-Payette, Olivier; Jefferson-Falardeau, Justin

2013-01-01

Developing a performance measure and reporting the results to support decision making at an individual level has yielded poor results in many health systems. The purpose of this paper is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations. A systematic data collection strategy that includes empirical and theoretical research published from 1980 to 2010, both qualitative and quantitative, was performed on Web of Science, Current Contents, EMBASE and MEDLINE. A narrative synthesis method was used to iteratively detail explicative processes that underlie the intervention. A classification and synthesis framework was developed, drawing on knowledge transfer and exchange (KTE) literature. The sample consisted of 114 articles, including seven systematic or exhaustive reviews. Results showed that dissemination in itself is not enough to produce improvement initiatives. Successful dissemination depends on various factors, which influence the way collective actors react to performance information such as the clarity of objectives, the relationships between stakeholders, the system's governance and the available incentives. This review was limited to the process of knowledge dissemination in health systems and its utilization by users at the health organization level. Issues related to improvement initiatives deserve more attention. Knowledge dissemination goes beyond better communication and should be considered as carefully as the measurement of performance. Choices pertaining to intervention should be continuously prompted by the concern to support organizational action. While considerable attention was paid to the public reporting of performance information, this review sheds some light on a more promising avenue for changes and improvements, notably in public health systems.

ThedaCare's business performance system: sustaining continuous daily improvement through hospital management in a lean environment.

PubMed

Barnas, Kim

2011-09-01

For 2003-2008, ThedaCare, a community health system in Wisconsin, achieved significant improvements in quality and the elimination of waste through the development of an improvement system, which included Value Stream analysis, rapid improvement events, and projects applied to specific processes. However, to meet its continuous daily improvement goals, particularly the goal of increasing productivity by 10% annually, ThedaCare needed to change the way its managers and leaders (in its hospital division) conduct and manage their daily work. Accordingly, it developed its Business Performance System (BPS) to achieve and sustain continuous daily improvement. BUILDING THE BPS: ThedaCare devised a multipart pilot project, consisting of "learning to see" and then, "problem solving." On completion of the 15-week alpha phase (6 units) in July 2009, the BPS was spread to the beta pilot (12 units; September 2009-January 2010) and then to cohort 3 (10 units; September 2010-January 2011). Each alpha unit improved performance on (1) the key driver metric of increasing productivity from 2008 to year-end 2009 (by 1%-11%) and (2) its respective safety/ quality drivers over the respective 2008 baselines. For 2010, improvements across the alpha, beta, and cohort 3 units were found for 11 of the 14 safety/quality drivers-85% of the 11 customer satisfaction drivers, 83% of 6 people engagement drivers; and 48% of 23 financial stewardship drivers. The tools developed for the BPS have enabled teams to see, prioritize, and pursue continuous daily improvement opportunities. Unit leaders now have a structured management reporting system to reduce variation in their management styles. Leaders all now follow leadership standard work, and their daily work is now consistently aligned with the hospital and system strategy.

A Study of Leadership and Continuous Improvement at Leadership Preparatory Academy

ERIC Educational Resources Information Center

Medina Araujo, Jacqueline

2013-01-01

This capstone project examines how an elementary school principal and her leadership team transformed Leadership Prep Academy in Capital City into a collaborative, high performing community school. This five-year process of continuous improvement involved engaging students, staff, parents, and members of the community in developing a culture of…

Management of Hypertension in Private Practice: A Randomized Controlled Trial in Continuing Medical Education.

ERIC Educational Resources Information Center

Gullion, David S.; And Others

1988-01-01

A randomized control trial was used to evaluate a physician education program designed to improve physician management of patients' hypertension, hypertension-related behaviors, and diastolic blood pressure. It was suggested that more intensive continuing medical education programs are needed to improve physician performance and patient outcome.…

What to Do about Jim?

ERIC Educational Resources Information Center

Jones, Joseph; Vari, T. J.

2017-01-01

The idea of conversations around performance reviews, and even more challenging improvement plans, is daunting. Even though the goal is to improve the employee's performance, difficult conversations don't automatically stimulate an environment and culture of continual growth. Establishing and systematizing professional dialogue in the workplace…

Improve strategic supplier performance using DMAIC to develop a Quality Improvement Plan

NASA Astrophysics Data System (ADS)

Jardim, Kevin P.

Supplier performance that meets the requirements of the customer has long plagued quality professionals. Despite the vast efforts by organizations to improve supplier performance, little has been done to standardize the plan to improve performance. This project presents a guideline and problem-solving strategy using a Define, Measure, Analyze, Improve, and Control (DMAIC) structured tool that will assist in the management and improvement of supplier performance. An analysis of benchmarked Quality Improvement Plans indicated that this topic needs more focus on how to accomplish improved supplier performance. This project is part of a growing body of supplier continuous improvement efforts. With the input of Zodiac Aerospace quality professionals this project's results provide a solution to Quality Improvement Plans and show objective evidence of its benefits. This project contributes to the future research on similar topics.

Does external evaluation of laboratories improve patient safety?

PubMed

Noble, Michael A

2007-01-01

Laboratory accreditation and External Quality Assessment (also called proficiency testing) are mainstays of laboratory quality assessment and performance. Both practices are associated with examples of improved laboratory performance. The relationship between laboratory performance and improved patient safety is more difficult to assess because of the many variables that are involved with patient outcome. Despite this difficulty, the argument to continue external evaluation of laboratories is too compelling to consider the alternative.

Developing Cost-Effective Dense Continuous SDC Barrier Layers for SOFCs

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

Nguyen, Hoang Viet P.; Hardy, John S.; Coyle, Christopher A.

Significantly improved performance during electrochemical testing of a cell with a dense continuous pulsed laser deposited (PLD) samarium doped ceria (SDC) layer spurred investigations into the fabrication of dense continuous SDC barrier layers by means of cost-effective deposition using screen printing which is amenable to industrial production of SOFCs. Many approaches to improve the SDC density have been explored including the use of powder with reduced particle sizes, inks with increased solids loading, and doping with sintering aids (1). In terms of sintering aids, dopants like Mo or binary systems of Mo+Cu or Fe+Co greatly enhance SDC sinterability. In fact,more » adding dopants to a screen printed, prefired, porous SDC layer made it possible to achieve a dense continuous barrier layer atop the YSZ electrolyte without sintering above 1200°C. Although the objective of fabricating a dense continuous layer was achieved, additional studies have been initiated to improve the cell performance. Underlying issues with constrained sintering and dopant-enhanced ceria-zirconia solid solubility are also addressed in this paper.« less

Measuring Performance Excellence: Key Performance Indicators for Institutions Accepted into the Academic Quality Improvement Program (AQIP)

ERIC Educational Resources Information Center

Ballard, Paul J.

2013-01-01

Given growing interest in accountability and outcomes, the North Central Association's Higher Learning Commission developed a new path for accreditation, the Academic Quality Improvement Program (AQIP). The goal is to infuse continuous improvement and quality in the culture of higher education, and to blend traditional accreditation with the…

Organizational learning and continuous quality improvement: examining the impact on nursing home performance.

PubMed

Rondeau, Kent V; Wagar, Terry H

2002-01-01

Interest is growing in learning more about the ability of total quality management and continuous quality improvement (TQM/CQI) initiatives to contribute to the performance of healthcare organizations. A major factor in the successful implementation of TQM/CQI is the seminal contribution of an organization's culture. Many implementation efforts have not succeeded because of a corporate culture that failed to stress broader organizational learning. This may help to explain why some TQM/CQI programs have been unsuccessful in improving healthcare organization performance. Organizational performance variables and organizational learning orientation were assessed in a sample of 181 Canadian long-term care organizations that had implemented a formal TQM/CQI program. Categorical regression analysis shows that, in the absence of a strong corporAte culture that stresses organizational learning and employee development, few performance enhancements are reported. The results of the assessment suggest that a TQM/CQI program without the backing of a strong organizational learning culture may be insufficient to achieve augmented organizational performance.

Quality assurance and quality improvement in U.S. clinical molecular genetic laboratories.

PubMed

Chen, Bin; Richards, C Sue; Wilson, Jean Amos; Lyon, Elaine

2011-04-01

A robust quality-assurance program is essential for laboratories that perform molecular genetic testing to maintain high-quality testing and be able to address challenges associated with performance or delivery of testing services as the use of molecular genetic tests continues to expand in clinical and public health practice. This unit discusses quality-assurance and quality-improvement considerations that are critical for molecular genetic testing performed for heritable diseases and conditions. Specific discussion is provided on applying regulatory standards and best practices in establishing/verifying test performance, ensuring quality of the total testing process, monitoring and maintaining personnel competency, and continuing quality improvement. The unit provides a practical reference for laboratory professionals to use in recognizing and addressing essential quality-assurance issues in human molecular genetic testing. It should also provide useful information for genetics researchers, trainees, and fellows in human genetics training programs, as well as others who are interested in quality assurance and quality improvement for molecular genetic testing. 2011 by John Wiley & Sons, Inc.

Improving Performance through HEI-Industry Engagements in the Built Environment

ERIC Educational Resources Information Center

Underwood, Jason; Williams, Aled; Thurairajah, Niraj

2009-01-01

The poor performance and inefficiencies of the construction industry are well recognized and documented. Through a variety of combined industry and government initiatives there has been a continual expression in the UK over the last decade of the urgent need to address the fragmented nature of the industry to improve its performance. A major…

Using Data to Drive Success in Educator Prep: Massachusetts and Endicott College Collaborate for Continuous Improvement

ERIC Educational Resources Information Center

Data Quality Campaign, 2016

2016-01-01

For educator preparation programs (EPPs) to produce effective teachers, they must engage in a process of continuous improvement using timely, high-quality information about the performance of their respective graduates in the classroom as measured by student outcomes. While states have the capacity to provide this information through their…

ICCD: interactive continuous collision detection between deformable models using connectivity-based culling.

PubMed

Tang, Min; Curtis, Sean; Yoon, Sung-Eui; Manocha, Dinesh

2009-01-01

We present an interactive algorithm for continuous collision detection between deformable models. We introduce multiple techniques to improve the culling efficiency and the overall performance of continuous collision detection. First, we present a novel formulation for continuous normal cones and use these normal cones to efficiently cull large regions of the mesh as part of self-collision tests. Second, we introduce the concept of "procedural representative triangles" to remove all redundant elementary tests between nonadjacent triangles. Finally, we exploit the mesh connectivity and introduce the concept of "orphan sets" to eliminate redundant elementary tests between adjacent triangle primitives. In practice, we can reduce the number of elementary tests by two orders of magnitude. These culling techniques have been combined with bounding volume hierarchies and can result in one order of magnitude performance improvement as compared to prior collision detection algorithms for deformable models. We highlight the performance of our algorithm on several benchmarks, including cloth simulations, N-body simulations, and breaking objects.

Continuous high PRF waveforms for challenging environments

NASA Astrophysics Data System (ADS)

Jaroszewski, Steven; Corbeil, Allan; Ryland, Robert; Sobota, David

2017-05-01

Current airborne radar systems segment the available time-on-target during each beam dwell into multiple Coherent Processing Intervals (CPIs) in order to eliminate range eclipsing, solve for unambiguous range, and increase the detection performance against larger Radar Cross Section (RCS) targets. As a consequence, these radars do not realize the full Signal-to-Noise Ratio (SNR) increase and detection performance improvement that is possible. Continuous High Pulse Repetition Frequency (HPRF) waveforms and processing enables the coherent integration of all available radar data over the full time-on-target. This can greatly increase the SNR for air targets at long range and/or with weak radar returns and significantly improve the detection performance against such targets. TSC worked with its partner KeyW to implement a Continuous HPRF waveform in their Sahara radar testbed and obtained measured radar data on both a ground vehicle target and an airborne target of opportunity. This experimental data was processed by TSC to validate the expected benefits of Continuous HPRF waveforms.

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

42 CFR 438.240 - Quality assessment and performance improvement program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Quality assessment and performance improvement program. 438.240 Section 438.240 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and...

42 CFR 494.110 - Condition: Quality assessment and performance improvement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Quality assessment and performance improvement. 494.110 Section 494.110 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS FOR COVERAGE FOR END-STAGE...

Performance improvement of eight-state continuous-variable quantum key distribution with an optical amplifier

NASA Astrophysics Data System (ADS)

Guo, Ying; Li, Renjie; Liao, Qin; Zhou, Jian; Huang, Duan

2018-02-01

Discrete modulation is proven to be beneficial to improving the performance of continuous-variable quantum key distribution (CVQKD) in long-distance transmission. In this paper, we suggest a construct to improve the maximal generated secret key rate of discretely modulated eight-state CVQKD using an optical amplifier (OA) with a slight cost of transmission distance. In the proposed scheme, an optical amplifier is exploited to compensate imperfection of Bob's apparatus, so that the generated secret key rate of eight-state protocol is enhanced. Specifically, we investigate two types of optical amplifiers, phase-insensitive amplifier (PIA) and phase-sensitive amplifier (PSA), and thereby obtain approximately equivalent improved performance for eight-state CVQKD system when applying these two different amplifiers. Numeric simulation shows that the proposed scheme can well improve the generated secret key rate of eight-state CVQKD in both asymptotic limit and finite-size regime. We also show that the proposed scheme can achieve the relatively high-rate transmission at long-distance communication system.

42 CFR § 414.1365 - Subcategories for the improvement activities performance category.

Code of Federal Regulations, 2010 CFR

2017-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive...

Weather related continuity and completeness on Deep Space Ka-band links: statistics and forecasting

NASA Technical Reports Server (NTRS)

Shambayati, Shervin

2006-01-01

In this paper the concept of link 'stability' as means of measuring the continuity of the link is introduced and through it, along with the distributions of 'good' periods and 'bad' periods, the performance of the proposed Ka-band link design method using both forecasting and long-term statistics has been analyzed. The results indicate that the proposed link design method has relatively good continuity and completeness characteristics even when only long-term statistics are used and that the continuity performance further improves when forecasting is employed. .

An Evaluation of the Evidence Base for Performance Feedback to Improve Teacher Praise Using CEC's Quality Indicators

ERIC Educational Resources Information Center

Sweigart, Chris A.; Collins, Lauren W.; Evanovich, Lauren L.; Cook, Sara Cothren

2016-01-01

Despite a rich body of empirical evidence that supports the use of teacher praise to improve student outcomes, it continues to be underused in practice. One method of ameliorating this problem is the use of performance feedback. Although some studies have indicated that the use of performance feedback is an effective approach for increasing…

Motivational Factors of Pay-for-Performance Plans in Educational Institutions: A Study of Select Private, Faith-Based Schools

ERIC Educational Resources Information Center

Wrobbel, Paul H.

2009-01-01

In the United States there is considerable focus on the need for continuous improvement in the quality of schools, including student achievement and teacher performance. Performance-based pay has been repeatedly suggested as a way to improve teaching in school systems. Therefore, a more thorough understanding of the differences in the perceptions…

Continuous counter-current chromatography for capture and polishing steps in biopharmaceutical production.

PubMed

Steinebach, Fabian; Müller-Späth, Thomas; Morbidelli, Massimo

2016-09-01

The economic advantages of continuous processing of biopharmaceuticals, which include smaller equipment and faster, efficient processes, have increased interest in this technology over the past decade. Continuous processes can also improve quality assurance and enable greater controllability, consistent with the quality initiatives of the FDA. Here, we discuss different continuous multi-column chromatography processes. Differences in the capture and polishing steps result in two different types of continuous processes that employ counter-current column movement. Continuous-capture processes are associated with increased productivity per cycle and decreased buffer consumption, whereas the typical purity-yield trade-off of classical batch chromatography can be surmounted by continuous processes for polishing applications. In the context of continuous manufacturing, different but complementary chromatographic columns or devices are typically combined to improve overall process performance and avoid unnecessary product storage. In the following, these various processes, their performances compared with batch processing and resulting product quality are discussed based on a review of the literature. Based on various examples of applications, primarily monoclonal antibody production processes, conclusions are drawn about the future of these continuous-manufacturing technologies. Copyright © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Factors Influencing Team Performance in a Continuous Quality Improvement Process in the Wisconsin Technical College System

ERIC Educational Resources Information Center

Pietz, Victoria Lynn

2014-01-01

Continuous Quality Improvement (CQI) programs are growing in popularity in higher education settings and a key component is the use of work groups, which require active employee involvement. The problem addressed in this research was the lack of employee engagement in the Quality Review Process (QRP), which is a statewide CQI model developed by…

Glucose Biosensors: An Overview of Use in Clinical Practice

PubMed Central

Yoo, Eun-Hyung; Lee, Soo-Youn

2010-01-01

Blood glucose monitoring has been established as a valuable tool in the management of diabetes. Since maintaining normal blood glucose levels is recommended, a series of suitable glucose biosensors have been developed. During the last 50 years, glucose biosensor technology including point-of-care devices, continuous glucose monitoring systems and noninvasive glucose monitoring systems has been significantly improved. However, there continues to be several challenges related to the achievement of accurate and reliable glucose monitoring. Further technical improvements in glucose biosensors, standardization of the analytical goals for their performance, and continuously assessing and training lay users are required. This article reviews the brief history, basic principles, analytical performance, and the present status of glucose biosensors in the clinical practice. PMID:22399892

Development of a Scintillation Detector and the Influence on Clinical Imaging

NASA Astrophysics Data System (ADS)

Panetta, Joseph Vincent

The detector is the functional unit within a Positron Emission Tomography (PET) scanner, serving to convert the energy of radiation emitted from a patient into positional information, and as such contributes significantly to the performance of the scanner. Excellent spatial resolution in continuous detectors that are thick has proven difficult to achieve using simple positioning algorithms, leading to research in the field to improve performance. This thesis aims to investigate the effect of modifications to the scintillation light spread within the bulk of the scintillator to improve performance, focusing on the use of laser induced optical barriers (LIOBs) etched within thick continuous crystals, and furthermore aims to translate the effect on detector performance to scanner quantitation in patient studies. The conventional continuous detector is first investigated by analyzing the various components of the detector as well as its limitations. It is seen that the performance of the detector is affected by a number of variables that either cannot be improved or may be improved only at the expense of greater complexity or computing time; these include the photodetector, the positioning algorithm, and Compton scatter in the detector. The performance of the detectors, however, is fundamentally determined by the light spread within the detector, and limited by the depth-dependence of the light spread and poor performance in the entrance region, motivating efforts to modify this aspect of the detector. The feasibility and potential of LIOBs to fine-tune this light spread and improve these limitations is then studied using both experiments and simulations. The behavior of the LIOBs in response to optical light is investigated, and the opacity of the etchings is shown to be dependent on the parameters of the etching procedure. Thick crystals were also etched with LIOBs in their entrance region in a grid pattern in order to improve the resolution in the entrance region. Measurements show an overall improvement in spatial resolution: the resolution in the etched region of the crystals is slightly improved (e.g., 0.8mm for a 25mm thick crystal), though in the unetched region, it is slightly degraded (e.g., 0.4mm for a 25mm thick crystal). While the depth-dependence of the response of the crystal is decreased, the depth-of-interaction (DOI) performance is degraded as well. Simulation studies informed by these measurements show that the properties of the LIOBs strongly affect the performance of the crystal, and ultimately further illustrate that trade-offs in spatial resolution, position sampling, and DOI resolution are inherent in varying the light spread using LIOBs in this manner; these may be used as a guide for future experiments. System Monte Carlo simulations were used to investigate the added benefit of improved detector spatial resolution and position sampling to the imaging performance of a whole-body scanner. These simulations compared the performance of scanners composed of conventional pixelated detectors to that of scanners using continuous crystals. Results showed that the improved performance (relative to that of 4-mm pixelated detectors) of continuous crystals with a 2-mm resolution, pertinent to both the etched 14mm thick crystal studied as well as potential designs with the etched 25mm thick crystal, increased the mean contrast recovery coefficient (CRC) of images by 22% for 5.5mm spheres. Last, a set of experiments aimed to test the correspondence between quantification in phantom and patient images using a lesion embedding methodology, so that any improvements determined using phantom studies may be understood clinically. The results show that the average CRC values for lesions embedded in the lung and liver agree well with those for lesions embedded in the phantom for all lesion sizes. In addition, the relative changes in CRC resulting from application of post-filters on the subject and phantom images are consistent within measurement uncertainty. This study shows that the improvements in CRC resulting from improved spatial resolution, measured using phantom studies in the simulations, are representative of improvements in quantitative accuracy in patient studies. While unmodified thick continuous detectors hold promise for both improved image quality and quantitation in whole-body imaging, excellent performance requires intensive hardware and computational solutions. Laser induced optical barriers offer the ability to modify the light spread within the scintillator to improve the intrinsic performance of the detector: while measurements with crystals etched with relatively transmissive etchings show a slight improvement in resolution, simulations show that the LIOBs may be fine-tuned to result in improved performance using relatively simple positioning algorithms. For systems in which DOI information is less important, and transverse resolution and sensitivity are paramount, etching thick detectors with this design, fine-tuned to the particular thickness of the crystal and application, is an interesting alternative to the standard detector design. (Abstract shortened by ProQuest.).

Furthering the quality agenda in Aboriginal community controlled health services: understanding the relationship between accreditation, continuous quality improvement and national key performance indicator reporting.

PubMed

Sibthorpe, Beverly; Gardner, Karen; McAullay, Daniel

2016-01-01

A rapidly expanding interest in quality in the Aboriginal-community-controlled health sector has led to widespread uptake of accreditation using more than one set of standards, a proliferation of continuous quality improvement programs and the introduction of key performance indicators. As yet, there has been no overarching logic that shows how they relate to each other, with consequent confusion within and outside the sector. We map the three approaches to the Framework for Performance Assessment in Primary Health Care, demonstrating their key differences and complementarity. There needs to be greater attention in both policy and practice to the purposes and alignment of the three approaches if they are to embed a system-wide focus that supports quality improvement at the service level.

How an educational improvement project improved the summative evaluation of medical students.

PubMed

Hoffman, K G; Brown, R Margaret A; Gay, J W; Headrick, L A

2009-08-01

At the University of Missouri-Columbia School of Medicine (USA) "commitment to improving quality and safety in healthcare" is one of eight key characteristics set as goals for our graduates. As educators, commitment to continuous improvement in the educational experience has been modelled through improvement of the Medical Student Performance Evaluation (MSPE) letter (formerly the Dean's letter). This educational improvement project decreased waste, increased collaboration and developed locally useful knowledge. By applying continuous improvement principles to the construction of the MSPE the overall efficiency of the process could be enhanced, and the MSPE committee was able to spend less cognitive energy on structure and format and focus more on the content of the letters. Four MSPE cycles have been completed using a new Web-based system; after each cycle, additional enhancements were identified and implemented. This work adds to the literature, as it describes the application of continuous improvement principles to an educational system.

Analysis of grating doublets for achromatic beam-splitting

PubMed Central

Pacheco, Shaun; Milster, Tom; Liang, Rongguang

2015-01-01

Achromatic beam-splitting grating doublets are designed for both continuous phase and binary phase gratings. By analyzing the sensitivity to lateral shifts between the two grating layers, it is shown that continuous-profile grating doublets are extremely difficult to fabricate. Achromatic grating doublets that have profiles with a constant first spatial derivative are significantly more resistant to lateral shifts between grating layers, where one design case showed a 17 times improvement in performance. Therefore, binary phase, multi-level phase, and blazed grating doublets perform significantly better than continuous phase grating doublets in the presence of a lateral shift between two grating layers. By studying the sensitivity to fabrication errors in the height of both grating layers, one grating layer height can be adjusted to maintain excellent performance over a large wavelength range if the other grating layer is fabricated incorrectly. It is shown in one design case that the performance of an achromatic Dammann grating doublet can be improved by a factor of 215 if the heights of the grating layers are chosen to minimize the performance change in the presence of fabrication errors. PMID:26368261

Nitrates for stable angina: a systematic review and meta-analysis of randomized clinical trials.

PubMed

Wei, Jiafu; Wu, Taixiang; Yang, Qing; Chen, Mao; Ni, Juan; Huang, Dejia

2011-01-07

To assess the effect (harms and benefits) of nitrates for stable angina. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Randomized controlled trials with both parallel and crossover design were included. The following outcome measures were evaluated: number of angina attacks weekly and nitroglycerin consumption, quality of life, total exercise duration, time to onset of angina and time to 1 mm ST depression. Fifty-one trials with 3595 patients meeting inclusion criteria were analyzed. Both intermittent and continuous regimens of nitrates lengthened exercise duration significantly by 31 and 53 s respectively. The number of angina attacks was significantly reduced by 2.89 episodes weekly for continuous administration and 1.5 episodes weekly for intermittent administration. With intermittent administration, increased dose provided with 21 s more length of exercise duration. With continuous administration, exercise duration was pronged more in low-dose group. Quality of life was not improved by continuous application of GTN patches and was similar between continuous and intermittent groups. In addition, 51.6% patients receiving nitrates complained with headache. Long-term administration of nitrates was beneficial for angina prophylaxis and improved exercise performance but might be ineffective for improving quality of life. With continuous regimen, low-dose nitrates were more effective than high-dose ones for improving exercise performance. By contrast, with intermittent regimen, high-dose nitrates were more effective. In addition, intermittent administration could bring zero-hour effect. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Improving Person-Job Congruence during the Classification Process: Item Development and Initial Testing of a Pictorial Interest Instrument

DTIC Science & Technology

2006-09-01

classification by making it applicant- centric while improving job satisfaction and performance , reducing attrition, and increasing continuation...produce greater job satisfaction , increase performance , and lengthen tenure. The difficulty the Navy faces is that enlisted applicants have limited work...P-J) fit. Empirically, job performance , employee satisfaction , and retention are contingent upon appropriately matching personnel with their desired

The Business Change Initiative: A Novel Approach to Improved Cost and Schedule Management

NASA Technical Reports Server (NTRS)

Shinn, Stephen A.; Bryson, Jonathan; Klein, Gerald; Lunz-Ruark, Val; Majerowicz, Walt; McKeever, J.; Nair, Param

2016-01-01

Goddard Space Flight Center's Flight Projects Directorate employed a Business Change Initiative (BCI) to infuse a series of activities coordinated to drive improved cost and schedule performance across Goddard's missions. This sustaining change framework provides a platform to manage and implement cost and schedule control techniques throughout the project portfolio. The BCI concluded in December 2014, deploying over 100 cost and schedule management changes including best practices, tools, methods, training, and knowledge sharing. The new business approach has driven the portfolio to improved programmatic performance. The last eight launched GSFC missions have optimized cost, schedule, and technical performance on a sustained basis to deliver on time and within budget, returning funds in many cases. While not every future mission will boast such strong performance, improved cost and schedule tools, management practices, and ongoing comprehensive evaluations of program planning and control methods to refine and implement best practices will continue to provide a framework for sustained performance. This paper will describe the tools, techniques, and processes developed during the BCI and the utilization of collaborative content management tools to disseminate project planning and control techniques to ensure continuous collaboration and optimization of cost and schedule management in the future.

Abuse Tolerance Improvements

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

Orendorff, Christopher J.; Nagasubramanian, Ganesan; Fenton, Kyle R.

As lithium-ion battery technologies mature, the size and energy of these systems continues to increase (> 50 kWh for EVs); making safety and reliability of these high energy systems increasingly important. While most material advances for lithium-ion chemistries are directed toward improving cell performance (capacity, energy, cycle life, etc.), there are a variety of materials advancements that can be made to improve lithium-ion battery safety. Issues including energetic thermal runaway, electrolyte decomposition and flammability, anode SEI stability, and cell-level abuse tolerance continue to be critical safety concerns. This report highlights work with our collaborators to develop advanced materials to improvemore » lithium-ion battery safety and abuse tolerance and to perform cell-level characterization of new materials.« less

Focused process improvement events: sustainability of impact on process and performance in an academic radiology department.

PubMed

Rosenkrantz, Andrew B; Lawson, Kirk; Ally, Rosina; Chen, David; Donno, Frank; Rittberg, Steven; Rodriguez, Joan; Recht, Michael P

2015-01-01

To evaluate sustainability of impact of rapid, focused process improvement (PI) events on process and performance within an academic radiology department. Our department conducted PI during 2011 and 2012 in CT, MRI, ultrasound, breast imaging, and research billing. PI entailed participation by all stakeholders, facilitation by the department chair, collection of baseline data, meetings during several weeks, definition of performance metrics, creation of an improvement plan, and prompt implementation. We explore common themes among PI events regarding initial impact and durability of changes. We also assess performance in each area pre-PI, immediately post-PI, and at the time of the current study. All PI events achieved an immediate improvement in performance metrics, often entailing both examination volumes and on-time performance. IT-based solutions, process standardization, and redefinition of staff responsibilities were often central in these changes, and participants consistently expressed improved internal leadership and problem-solving ability. Major environmental changes commonly occurred after PI, including a natural disaster with equipment loss, a change in location or services offered, and new enterprise-wide electronic medical record system incorporating new billing and radiology informatics systems, requiring flexibility in the PI implementation plan. Only one PI team conducted regular post-PI follow-up meetings. Sustained improvement was frequently, but not universally, observed: in the long-term following initial PI, measures of examination volume showed continued progressive improvements, whereas measures of operational efficiency remained stable or occasionally declined. Focused PI is generally effective in achieving performance improvement, although a changing environment influences the sustainability of impact. Thus, continued process evaluation and ongoing workflow modifications are warranted. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Nicotinic agonist-induced improvement of vigilance in mice in the 5-choice continuous performance test

PubMed Central

YOUNG, Jared W; MEVES, Jessica M; GEYER, Mark A

2012-01-01

Impaired attentional processing is prevalent in numerous neuropsychiatric disorders and may negatively impact other cognitive and functional domains. Nicotine – a nonspecific nicotinic acetylcholine receptor (nAChR) agonist – improves vigilance in healthy subjects and schizophrenia patients as measured by continuous performance tests (CPTs), but the nAChR mediating this effect remains unclear. Here we examine the effects of: a) nicotine; b) the selective α7 nAChR agonist PNU 282987; and c) the selective α4β2 nAChR agonist ABT-418 alone and in combination with scopolamine-induced disruption of mouse 5-choice (5C-)CPT performance. This task requires the inhibition of responses to non-target stimuli as well as active responses to target stimuli, consistent with human CPTs. C57BL/6N mice were trained to perform the 5C-CPT. Drug effects were examined in extended session and variable stimulus-duration challenges of performance. Acute drug effects on scopolamine-induced disruption in performance were also investigated. Nicotine and ABT-418 subtly but significantly improved performance of normal mice and attenuated scopolamine-induced disruptions in the 5C-CPT. PNU 282–987 had no effects on performance. The similarity of nicotine and ABT-418 effects provides support for an α4β2 nAChR mechanism of action for nicotine-induced improvement in attention/vigilance. Moreover, the data provide pharmacological predictive validation for the 5C-CPT because nicotine improved and scopolamine disrupted normal performance of the task, consistent with healthy humans in the CPT. Future studies using more selective agonists may result in more robust improvements in performance. PMID:23201359

42 CFR 475.104 - Requirements for demonstrating ability to perform review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... review. 475.104 Section 475.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.104 Requirements for demonstrating...

Effect of a performance improvement CME activity on management of patients with diabetes.

PubMed

Bird, Gary C; Marian, Kathy; Bagley, Bruce

2013-01-01

Primary care in the United States faces unprecedented challenges from an aging population and the accompanying prevalence of chronic disease. In response, continuing medical education (CME) initiatives have begun to adopt the principles of performance improvement (PI) into their design, although currently there is a dearth of evidence from national initiatives supporting the effectiveness of this methodology. The specific aim of this study was to demonstrate the value of a national PI-CME activity to improve the performance of physicians treating patients with diabetes. We analyzed data from the American Academy of Family Physicians' METRIC® PI-CME activity in a cohort of family physician learners. The study utilized the 3-stage design standard approved for PI-CME. Baseline and follow-up performance data across a range of clinical and systems-based measures were compared in aggregate. Data were assessed for 509 learners who completed the activity. Statistically significant changes occurred both for self-assessment of a range of practice aspects and for diabetes care measures. Learners recognized that the organization of their practices had improved, and mechanisms were in place for better staff feedback, as well as aspects of patient self-management. Based on the clinical data obtained from 11 538 patient charts, 6 out of 8 diabetes measures were significantly improved. The activity appears to have had a positive, measurable impact on the medical practice of learners and suggests that, when appropriately designed and executed, PI-CME on a national scale can be a useful vehicle to influence performance change in physicians and to inform future CME activities. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

An interval programming model for continuous improvement in micro-manufacturing

NASA Astrophysics Data System (ADS)

Ouyang, Linhan; Ma, Yizhong; Wang, Jianjun; Tu, Yiliu; Byun, Jai-Hyun

2018-03-01

Continuous quality improvement in micro-manufacturing processes relies on optimization strategies that relate an output performance to a set of machining parameters. However, when determining the optimal machining parameters in a micro-manufacturing process, the economics of continuous quality improvement and decision makers' preference information are typically neglected. This article proposes an economic continuous improvement strategy based on an interval programming model. The proposed strategy differs from previous studies in two ways. First, an interval programming model is proposed to measure the quality level, where decision makers' preference information is considered in order to determine the weight of location and dispersion effects. Second, the proposed strategy is a more flexible approach since it considers the trade-off between the quality level and the associated costs, and leaves engineers a larger decision space through adjusting the quality level. The proposed strategy is compared with its conventional counterparts using an Nd:YLF laser beam micro-drilling process.

A National Study Comparing Baldrige Core Values and Concepts with AACN Indicators of Quality: Facilitating CCNE-Baccalaureate Colleges of Nursing Move toward More Effective Continuous Performance Improvement Practices

ERIC Educational Resources Information Center

Mattin, Deborah C.

2013-01-01

The AACN has asked academic leaders to align the performance of their organizations to the prescribed standards within the "Essentials of Baccalaureate Education for Professional Nursing" Practice document and has provided indicators of quality suggestions for program enhancement as a means of promoting continuous performance…

U. S. light duty vehicle fleet emissions performance and the emissions impact of technology changes

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

Sabourin, M.; Platte, L

1988-01-01

This paper determines the level of improvement in Federal Test Procedure (FTP) exhaust emissions realized by typical in-use vehicles over the last twenty years as emission standards have become increasingly stringent. Furthermore, this paper explores the likelihood that in-use emission performance improvements will continue now that emission standards have stabilized.

Creating meaningful business continuity management programme metrics.

PubMed

Strong, Brian

2010-11-01

The popular axiom, 'what gets measured gets done', is often applied in the quality management and continuous improvement disciplines. This truism is also useful to business continuity practitioners as they continually strive to prove the value of their organisation's investment in a business continuity management (BCM) programme. BCM practitioners must also remain relevant to their organisations as executives focus on the bottom line and maintaining stakeholder confidence. It seems that executives always find a way, whether in a hallway or elevator, to ask BCM professionals about the company's level of readiness. When asked, they must be ready with an informed response. The establishment of a process to measure business continuity programme performance and organisational readiness has emerged as a key component of US Department of Homeland Security 'Voluntary Private Sector Preparedness (PS-Prep) Program' standards where the overarching goal is to improve private sector preparedness for disasters and emergencies. The purpose of this paper is two-fold: to introduce continuity professionals to best practices that should be considered when developing a BCM metrics programme as well as providing a case study of how a large health insurance company researched, developed and implemented a process to measure BCM programme performance and company readiness.

Organisational performance and business continuity management: a theoretical perspective and a case study.

PubMed

Sawalha, Ihab Hanna Salman

2013-01-01

This paper seeks to extend the research relating to the strategic view of business continuity management (BCM) to the context of organisational performance (OP). It discusses potential performance consequences resulting from applying BCM aspects/elements within an organisation. The paper contributes to the understanding of the role of BCM in OP by discussing how deployment of BCM key aspects/elements can improve OP. Two main issues are discussed: first, background to performance and the elements of OP; and secondly, the role of BCM in achieving optimised OP. These issues are significant, as they go further than the extant literature relating to the significance of BCM and its potential influence on OP. The study focuses on Jordanian banks as a case study and as a way of illustrating how BCM helps improve OP for those organisations facing performance shortcomings or difficulties.

Twelve tips to promote successful development of a learner performance dashboard within a medical education program.

PubMed

Boscardin, Christy; Fergus, Kirkpatrick B; Hellevig, Bonnie; Hauer, Karen E

2017-11-09

Easily accessible and interpretable performance data constitute critical feedback for learners that facilitate informed self-assessment and learning planning. To provide this feedback, there has been a proliferation of educational dashboards in recent years. An educational (learner) dashboard systematically delivers timely and continuous feedback on performance and can provide easily visualized and interpreted performance data. In this paper, we provide practical tips for developing a functional, user-friendly individual learner performance dashboard and literature review of dashboard development, assessment theory, and users' perspectives. Considering key design principles and maximizing current technological advances in data visualization techniques can increase dashboard utility and enhance the user experience. By bridging current technology with assessment strategies that support learning, educators can continue to improve the field of learning analytics and design of information management tools such as dashboards in support of improved learning outcomes.

The relevance of the alliance for CME competencies for planning, organizing, and sustaining an interorganizational educational collaborative.

PubMed

Balmer, Jann T; Bellande, Bruce J; Addleton, Robert L; Havens, Carol S

2011-01-01

The heightened demand for accountability, access, and quality performance from health care professionals has resulted in linkages between continuing education (CE), performance improvement (PI), and outcomes. CE health professionals must also expand their skills and abilities to design, implement, and measure CE activities consistent with these new expectations. In addition to administrative and meeting-planning activities, new competencies associated with educational consultation and performance coaching are needed. This article utilizes the Alliance competencies as the framework for discussion of the competencies of CE professionals and applies it to the unique setting of a collaborative. The CS2day initiative serves as an example of the application of these competencies in this environment. The framework of the Alliance competencies can serve as a guide and a tool for self-assessment, work design, and professional development at individual, organization, and systems levels. Continual reassessment of the Alliance competencies for CE in the health professions will be critical to the continued effectiveness of CE that is linked to performance improvement and outcomes for the CE professional and the health care professionals we serve. A collaborative can provide one option for meeting these new expectations for professional development for CE professionals and the creation of effective educational initiatives. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Building blocks for career advancement.

PubMed

Broomall, Thomas; Snyder, Bruce

2007-01-01

After attaining IAHSS certification, protective services officers at CCHMC continue on a Career Ladder Program designed to improve knowledge and performance and improve the chances of officer retention. That program is described in detail in this article.

Substance Use and Academic Performance among African American High School Students

ERIC Educational Resources Information Center

Williams, James Herbert; Davis, Larry E.; Johnson, Sharon D.; Williams, Trina R.; Saunders, Jeanne A.; Nebbitt, Von E.

2007-01-01

Academic performance among African American students continues to be a concern. Adolescent developmental research has identified numerous factors that affect academic performance. School-based intervention programs have focused on substance use prevention to improve academic performance. This study investigated to what extent family financial…

Using continuous process improvement methodology to standardize nursing handoff communication.

PubMed

Klee, Kristi; Latta, Linda; Davis-Kirsch, Sallie; Pecchia, Maria

2012-04-01

The purpose of this article was to describe the use of continuous performance improvement (CPI) methodology to standardize nurse shift-to-shift handoff communication. The goals of the process were to standardize the content and process of shift handoff, improve patient safety, increase patient and family involvement in the handoff process, and decrease end-of-shift overtime. This article will describe process changes made over a 4-year period as result of application of the plan-do-check-act procedure, which is an integral part of the CPI methodology, and discuss further work needed to continue to refine this critical nursing care process. Copyright © 2012 Elsevier Inc. All rights reserved.

20 CFR 666.120 - What are the procedures for negotiating annual levels of performance?

Code of Federal Regulations, 2010 CFR

2010-04-01

... performance for each core indicator and the customer satisfaction indicators. In negotiating these levels, the... customer satisfaction; (3) The extent to which the levels of performance promote continuous improvement and... Governor must reach agreement on levels of performance for each core indicator and the customer...

Influence of methylphenidate on motor performance and attention in children with developmental coordination disorder and attention deficit hyperactive disorder.

PubMed

Bart, Orit; Daniel, Liron; Dan, Orrie; Bar-Haim, Yair

2013-06-01

Individuals with attention deficit hyperactive disorder (ADHD) often have coexisting developmental coordination disorder (DCD). The positive therapeutic effect of methylphenidate on ADHD symptoms is well documented, but its effects on motor coordination are less studied. We assessed the influence of methylphenidate on motor performance in children with comorbid DCD and ADHD. Participants were 30 children (24 boys) aged 5.10-12.7 years diagnosed with both DCD and ADHD. Conners' Parent Rating Scale was used to reaffirm ADHD diagnosis and the Developmental Coordination Disorder Questionnaire was used to diagnose DCD. The Movement Assessment Battery for Children-2 and the online continuous performance test were administrated to all participants twice, with and without methylphenidate. The tests were administered on two separate days in a blind design. Motor performance and attention scores were significantly better with methylphenidate than without it (p<0.001 for improvement in the Movement Assessment Battery for Children-2 and p<0.006 for the online continuous performance test scores). The findings suggest that methylphenidate improves both attention and motor coordination in children with coexisting DCD and ADHD. More research is needed to disentangle the causality of the improvement effect and whether improvement in motor coordination is directly affected by methylphenidate or mediated by improvement in attention. Copyright © 2013 Elsevier Ltd. All rights reserved.

Steam generator tubing NDE performance

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

Henry, G.; Welty, C.S. Jr.

1997-02-01

Steam generator (SG) non-destructive examination (NDE) is a fundamental element in the broader SG in-service inspection (ISI) process, a cornerstone in the management of PWR steam generators. Based on objective performance measures (tube leak forced outages and SG-related capacity factor loss), ISI performance has shown a continually improving trend over the years. Performance of the NDE element is a function of the fundamental capability of the technique, and the ability of the analysis portion of the process in field implementation of the technique. The technology continues to improve in several areas, e.g. system sensitivity, data collection rates, probe/coil design, andmore » data analysis software. With these improvements comes the attendant requirement for qualification of the technique on the damage form(s) to which it will be applied, and for training and qualification of the data analysis element of the ISI process on the field implementation of the technique. The introduction of data transfer via fiber optic line allows for remote data acquisition and analysis, thus improving the efficiency of analysis for a limited pool of data analysts. This paper provides an overview of the current status of SG NDE, and identifies several important issues to be addressed.« less

Linking Competence Change and Organization Performance

ERIC Educational Resources Information Center

Boulay, David

2007-01-01

The notion of long term sustainable competitive advantage assumes that environment changes are engrained into organizations. Yet, the principles of continuous improvement suggest a shorter and shorter lifecycle of skills and knowledge that provides the sustainable advantage. Continuous change resulting from new ideas, practices, and technologies…

Assessing data and modeling needs for urban transport : an Australian perspective

DOT National Transportation Integrated Search

2000-04-01

Managing the transport assets of an urban economy and ensuring that change is in accordance with suitable performance measures requires continuing improvement in analytical power and empirical information. One crucial input for improving planning and...

Benchmarking--Measuring and Comparing for Continuous Improvement.

ERIC Educational Resources Information Center

Henczel, Sue

2002-01-01

Discussion of benchmarking focuses on the use of internal and external benchmarking by special librarians. Highlights include defining types of benchmarking; historical development; benefits, including efficiency, improved performance, increased competitiveness, and better decision making; problems, including inappropriate adaptation; developing a…

On the problem of solving the optimization for continuous space based on information distribution function of ant colony algorithm

NASA Astrophysics Data System (ADS)

Min, Huang; Na, Cai

2017-06-01

These years, ant colony algorithm has been widely used in solving the domain of discrete space optimization, while the research on solving the continuous space optimization was relatively little. Based on the original optimization for continuous space, the article proposes the improved ant colony algorithm which is used to Solve the optimization for continuous space, so as to overcome the ant colony algorithm’s disadvantages of searching for a long time in continuous space. The article improves the solving way for the total amount of information of each interval and the due number of ants. The article also introduces a function of changes with the increase of the number of iterations in order to enhance the convergence rate of the improved ant colony algorithm. The simulation results show that compared with the result in literature[5], the suggested improved ant colony algorithm that based on the information distribution function has a better convergence performance. Thus, the article provides a new feasible and effective method for ant colony algorithm to solve this kind of problem.

Total Quality Management Implementation Plan.

DTIC Science & Technology

1989-06-01

Quality Management Implementation Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Defense General...E 14. SUBJECT TERMS 15. NUMBER OF PAGES TOM (Total Quality Management ), Continuous Process Improvement,_________ Depot Operations, Supply Support 16

Continuous detection of weak sensory signals in afferent spike trains: the role of anti-correlated interspike intervals in detection performance.

PubMed

Goense, J B M; Ratnam, R

2003-10-01

An important problem in sensory processing is deciding whether fluctuating neural activity encodes a stimulus or is due to variability in baseline activity. Neurons that subserve detection must examine incoming spike trains continuously, and quickly and reliably differentiate signals from baseline activity. Here we demonstrate that a neural integrator can perform continuous signal detection, with performance exceeding that of trial-based procedures, where spike counts in signal- and baseline windows are compared. The procedure was applied to data from electrosensory afferents of weakly electric fish (Apteronotus leptorhynchus), where weak perturbations generated by small prey add approximately 1 spike to a baseline of approximately 300 spikes s(-1). The hypothetical postsynaptic neuron, modeling an electrosensory lateral line lobe cell, could detect an added spike within 10-15 ms, achieving near ideal detection performance (80-95%) at false alarm rates of 1-2 Hz, while trial-based testing resulted in only 30-35% correct detections at that false alarm rate. The performance improvement was due to anti-correlations in the afferent spike train, which reduced both the amplitude and duration of fluctuations in postsynaptic membrane activity, and so decreased the number of false alarms. Anti-correlations can be exploited to improve detection performance only if there is memory of prior decisions.

Kilogram-scale prexasertib monolactate monohydrate synthesis under continuous-flow CGMP conditions.

PubMed

Cole, Kevin P; Groh, Jennifer McClary; Johnson, Martin D; Burcham, Christopher L; Campbell, Bradley M; Diseroad, William D; Heller, Michael R; Howell, John R; Kallman, Neil J; Koenig, Thomas M; May, Scott A; Miller, Richard D; Mitchell, David; Myers, David P; Myers, Steven S; Phillips, Joseph L; Polster, Christopher S; White, Timothy D; Cashman, Jim; Hurley, Declan; Moylan, Robert; Sheehan, Paul; Spencer, Richard D; Desmond, Kenneth; Desmond, Paul; Gowran, Olivia

2017-06-16

Advances in drug potency and tailored therapeutics are promoting pharmaceutical manufacturing to transition from a traditional batch paradigm to more flexible continuous processing. Here we report the development of a multistep continuous-flow CGMP (current good manufacturing practices) process that produced 24 kilograms of prexasertib monolactate monohydrate suitable for use in human clinical trials. Eight continuous unit operations were conducted to produce the target at roughly 3 kilograms per day using small continuous reactors, extractors, evaporators, crystallizers, and filters in laboratory fume hoods. Success was enabled by advances in chemistry, engineering, analytical science, process modeling, and equipment design. Substantial technical and business drivers were identified, which merited the continuous process. The continuous process afforded improved performance and safety relative to batch processes and also improved containment of a highly potent compound. Copyright © 2017, American Association for the Advancement of Science.

Calf Muscle Performance Deficits Remain 7 Years After an Achilles Tendon Rupture.

PubMed

Brorsson, Annelie; Grävare Silbernagel, Karin; Olsson, Nicklas; Nilsson Helander, Katarina

2018-02-01

Optimizing calf muscle performance seems to play an important role in minimizing impairments and symptoms after an Achilles tendon rupture (ATR). The literature lacks long-term follow-up studies after ATR that describe calf muscle performance over time. The primary aim was to evaluate calf muscle performance and patient-reported outcomes at a mean of 7 years after ATR in patients included in a prospective, randomized controlled trial. A secondary aim was to evaluate whether improvement in calf muscle performance continued after the 2-year follow-up. Cohort study; Level of evidence, 2. Sixty-six subjects (13 women, 53 men) with a mean age of 50 years (SD, 8.5 years) were evaluated at a mean of 7 years (SD, 1 year) years after their ATR. Thirty-four subjects had surgical treatment and 32 had nonsurgical treatment. Patient-reported outcomes were evaluated with Achilles tendon Total Rupture Score (ATRS) and Physical Activity Scale (PAS). Calf muscle performance was evaluated with single-leg standing heel-rise test, concentric strength power heel-rise test, and single-legged hop for distance. Limb Symmetry Index (LSI = injured side/healthy side × 100) was calculated for side-to-side differences. Seven years after ATR, the injured side showed decreased values in all calf muscle performance tests ( P < .001-.012). Significant improvement in calf muscle performance did not continue after the 2-year follow-up. Heel-rise height increased significantly ( P = .002) between the 1-year (10.8 cm) and the 7-year (11.5 cm) follow-up assessments. The median ATRS was 96 (of a possible score of 100) and the median PAS was 4 (of a possible score of 6), indicating minor patient-reported symptoms and fairly high physical activity. No significant differences were found in calf muscle performance or patient-reported outcomes between the treatment groups except for the LSI for heel-rise repetitions. Continued deficits in calf muscle endurance and strength remained 7 years after ATR. No continued improvement in calf muscle performance occurred after the 2-year follow-up except for heel-rise height.

Lapse in Institutional Animal Care and Use Committee Continuing Reviews.

PubMed

Tsan, Min-Fu; Grabenbauer, Michael; Nguyen, Yen

2016-01-01

The United States federal animal welfare regulations and the Public Health Service Policy on Humane Care and Use of Laboratory Animals require that institutional animal care and use committees (IACUCs) conduct continuing reviews of all animal research activities. However, little is known about the lapse rate of IACUC continuing reviews, and how frequently investigators continue research activities during the lapse. It is also not clear what factors may contribute to an institution's lapse in IACUC continuing reviews. As part of the quality assurance program, the Department of Veterans Affairs (VA) has collected performance metric data for animal care and use programs since 2011. We analyzed IACUC continuing review performance data at 74-75 VA research facilities from 2011 through 2015. The IACUC continuing review lapse rates improved from 5.6% in 2011 to 2.7% in 2015. The rate of investigators continuing research activities during the lapse also decreased from 47.2% in 2012 to 7.4% in 2015. The type of IACUCs used and the size of animal research programs appeared to have no effect in facility's rates of lapse in IACUC continuing reviews. While approximately 80% of facilities reported no lapse in IACUC continuing reviews, approximately 14% of facilities had lapse rates of >10% each year. Some facilities appeared to be repeat offenders. Four facilities had IACUC lapse rates of >10% in at least 3 out of 5 years, suggesting a system problem in these facilities requiring remedial actions to improve their IACUC continuing review processes.

Cancer Care Ontario and integrated cancer programs: portrait of a performance management system and lessons learned.

PubMed

Cheng, Siu Mee; Thompson, Leslee J

2006-01-01

A performance management system has been implemented by Cancer Care Ontario (CCO). This system allows for the monitoring and management of 11 integrated cancer programs (ICPs) across the Province of Ontario. The system comprises of four elements: reporting frequency, reporting requirements, review meetings and accountability and continuous improvement activities. CCO and the ICPs have recently completed quarterly performance review exercises for the last two quarters of the fiscal year 2004-2005. The purpose of this paper is to address some of the key lessons learned. The paper provides an outline of the CCO performance management system. These lessons included: data must be valid and reliable; performance management requires commitments from both parties in the performance review exercises; streamlining performance reporting is beneficial; technology infrastructure which allows for cohesive management of data is vital for a sustainable performance management system; performance indicators need to stand up to scrutiny by both parties; and providing comparative data across the province is valuable. Critical success factors which would help to ensure a successful performance management system include: corporate engagement from various parts of an organization in the review exercises; desire to focus on performance improvement and avoidance of blaming; and strong data management systems. The performance management system is a practical and sustainable system that allows for performance improvement of cancer care services. It can be a vital tool to enhance accountability within the health care system. The paper demonstrates that the performance management system supports accountability in the cancer care system for Ontario, and reflects the principles of the provincial governments commitment to continuous improvement of healthcare.

Improving Academic Achievement through Continuous Assessment Methods: In the Case of Year Two Students of Animal and Range Sciences Department in Wolaita Sodo University, Ethiopia

ERIC Educational Resources Information Center

Sarka, Samuel; Lijalem, Tsegay; Shibiru, Tilaye

2017-01-01

The aim of this study was to assessing and implementing of continuous assessment to enhance academic performance of 2nd year Animal and Range Sciences department students in Wolaita sodo university; and to take action (train) to raise the academic performance to a desirable state. For the purpose of surveying the students' level of performance…

DPSC (Defense Personnel Support Center) Total Quality Management Master Plan

DTIC Science & Technology

1989-07-01

SUBTITLE 5. FUNDING NUMBERS DPSC Total Quality Management Master Plan 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) B. PERFORMING...quality supported solider, sailor, airman and marine. % j cl 1 14. SUBJECT TERMS I 1S. NUMBER OF PAGES TQM (Total Quality Management ), Continuous...THE COMMANDER ON TOTAL QUALITY MANAGEMENT i SECTION I INTRODUCTION 1 II CONCEPTS 6 TQM Basics 7 Continuous Process Improvement 7 DoD TQM Philosophy 9

Repeated recall as an intervention to improve memory performance in heart failure patients.

PubMed

Viveiros, Jennifer; Sethares, Kristen; Shapiro, Amy

2017-12-01

Up to 50% of heart failure patients demonstrate aspects of cognitive impairment, including memory deficit. Novel interventions are needed to address memory deficit among heart failure patients. The goal of this study was to evaluate the testing effect as an intervention to improve memory performance in heart failure patients. This was a randomized controlled clinical trial ( N=84) comparing the memory performance of heart failure patients with and without mild cognitive impairment after a repeated testing intervention. Memory performance was measured by verbal word pair associates recall scores, between attention control and experimental subjects. Patients had a mean age of 71.7 ± 13.3 years and similar baseline memory (immediate p=.79 and delayed p=.47). Overall, there were no significant differences in memory between experimental and control subjects, respectively (67.2±18.87 vs. 61.9±22.3, verbal word pair associates, t = -1.179, p=.24). In the final hierarchical regression model, age ( p=.018) and education ( p=.006) were significant predictors of memory performance, with the intervention approaching significance ( p=.079). Although not statistically significant, the intervention group reported better memory. Age and education continue to be significant contributors to memory performance in the heart failure population. Continued development of interventions to improve memory performance in heart failure patients is indicated.

Continuous cognitive improvement 1 year following successful kidney transplant.

PubMed

Harciarek, Michał; Biedunkiewicz, Bogdan; Lichodziejewska-Niemierko, Monika; Dębska-Ślizień, Alicja; Rutkowski, Bolesław

2011-06-01

Successful kidney transplantation was recently shown to lead to improvement in the cognitive performance of patients on chronic dialysis. To examine whether the early cognitive benefits of transplantation continue to develop over time, along with the patients' ongoing recovery, we addressed these questions in a prospective controlled study of 27 dialyzed patients who subsequently received a kidney transplant, 18 dialyzed patients awaiting kidney transplant, and 30 matched controls without kidney disease. Overall, successful kidney transplant contributed to a statistically significant improvement in performance on tests of motor/psychomotor speed, visual planning, memory, and abstract reasoning tested 1 year later. We also studied whether the cognitive performance of patients maintained on dialysis is stable or declines over time and found that it actually declined over this time even in adequately dialyzed patients. Measures of memory functions were particularly affected. This study indicates that the early beneficial effects of transplantation are not transient and were still evident 1 year following transplantation.

State-of-the-art of alkaline rechargeable batteries

NASA Astrophysics Data System (ADS)

Morioka, Y.; Narukawa, S.; Itou, T.

Alkaline rechargeable batteries represented by Ni-Cd and Ni-MH batteries are expanding their market, continuously meeting an increasing demand. Approximately 30 years have elapsed since the first sealed Ni-Cd battery was commercialized for consumer use, and the production of these alkaline batteries is still expanding. The high power performance and good cost performance of these batteries are the outstanding features, which are leading to new battery applications. Continuous R&D of many researchers and engineers has improved these features. Since first coming to the market in 1990, Ni-MH batteries have been extending their application as power sources for portable advanced information and communication equipment. Improvements in electrode materials and other components have increased the energy density of current Ni-MH batteries to values of 91 Wh/kg and 340 Wh/l. Recently, novel metallic alloys for hydrogen storage have been proposed to increase their capacity further, and further improvement in the performance of these batteries is expected.

Signature Tracking for Optimized Nutrition and Training (STRONG)

DTIC Science & Technology

2014-08-01

manufacture , use, or sell any patented invention that may relate to them. This report was cleared for public release by the 88th Air Base Wing Public...Opportunities for performance augmentation include continuous performance feedback for self- improvement and individualized training regimens in the...the application of advanced physical training methods used by elite athletes to improve fitness in Special Operators; such as functional weight

Chapter 24: Strategic Energy Management (SEM) Evaluation Protocol. The Uniform Methods Project: Methods for Determining Energy Efficiency Savings for Specific Measures

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

Stewart, James

Strategic energy management (SEM) focuses on achieving energy-efficiency improvements through systematic and planned changes in facility operations, maintenance, and behaviors (OM&B) and capital equipment upgrades in large energy-using facilities, including industrial buildings, commercial buildings, and multi-facility organizations such as campuses or communities. Facilities can institute a spectrum of SEM actions, ranging from a simple process for regularly identifying energy-savings actions, to establishing a formal, third-party recognized or certified SEM framework for continuous improvement of energy performance. In general, SEM programs that would be considered part of a utility program will contain a set of energy-reducing goals, principles, and practices emphasizingmore » continuous improvements in energy performance or savings through energy management and an energy management system (EnMS).« less

The Top Ten Trends.

ERIC Educational Resources Information Center

Bassi, Laurie J.; And Others

1996-01-01

Trends shaping the workplace are increased skill requirements; more educated, diverse work force; continued corporate restructuring; change in size and composition of training departments; instructional technology advances; new training delivery methods; focus on performance improvement; integrated high-performance work systems; companies becoming…

Activity gains after reconstructions of elbow extension in patients with tetraplegia.

PubMed

Wangdell, Johanna; Fridén, Jan

2012-05-01

Reconstruction of triceps function in persons with tetraplegia is an established surgical intervention. The purpose of this study was to investigate and evaluate patient perspective of gains in activity and satisfaction after surgical reconstruction of triceps function and subsequent rehabilitation. We studied the effects of surgery and rehabilitation in 14 persons (19 arms) treated with deltoid-to-triceps transfer. We used Canadian Occupational Performance Measurement standards to capture the performance and satisfaction of patient-identified activity goals. Follow-up was performed at 6 and 12 months postoperatively. To make group analyses, we classified activity goals according to the International Classification of Function, Disability, and Health categories of activities and participation, as well as relative to the position of the arm in space. Patients reported improvement in performance after surgery, and satisfaction was rated even higher. Improvement was seen in all types of activities that patients had prioritized. No single goal was rated lower at 12 months' follow-up than before surgery. The most common activity gains were related to "driving a wheelchair" and the ability to "reach out," each of which represented 20% of expressed goals. Although "driving a wheelchair" and "moving the body" (transfers) were common goals, the smallest improvements for both performance and satisfaction after 12 months were seen in these areas. We observed the highest performance improvement in the category of "writing" and the ability to "stretch out the arm when lying down." Improvement in activity continues over the first year after triceps reconstruction. Complex activities continue to improve over a longer period than simpler activities. We saw the highest improvement in activities performed without the aid of gravity and activities highly dependent on coordination. Such actions are difficult to compensate for by technique or skills, and therefore elbow extension is essential for performance. Therapeutic IV. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Improving Student Performance Using Nudge Analytics

ERIC Educational Resources Information Center

Feild, Jacqueline

2015-01-01

Providing students with continuous and personalized feedback on their performance is an important part of encouraging self regulated learning. As part of our higher education platform, we built a set of data visualizations to provide feedback to students on their assignment performance. These visualizations give students information about how they…

45 CFR 2516.810 - What types of evaluations are grantees and subgrantees required to perform?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SCHOOL-BASED SERVICE-LEARNING PROGRAMS...? All grantees and subgrantees are required to perform internal evaluations which are ongoing efforts to assess performance and improve quality. Grantees and subgrantees may, but are not required to, arrange...

42 CFR § 414.1355 - Improvement activities performance category.

Code of Federal Regulations, 2010 CFR

2017-10-01

... AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1355... comprises: (1) 15 percent of a MIPS eligible clinician's final score for MIPS payment year 2019 and for each...

Test/QA Plan for Verification of Semi-Continuous Ambient Air Monitoring Systems - Second Round

EPA Science Inventory

Test/QA Plan for Verification of Semi-Continuous Ambient Air Monitoring Systems - Second Round. Changes reflect performance of second round of testing at new location and with various changes to personnel. Additional changes reflect general improvements to the Version 1 test/QA...

Improvement in Ge Detector Cooling

DTIC Science & Technology

2008-09-01

RASA) Mark IV, is continually evolving. Cryocooler improvements in recent years have resulted in reduced size, reduced maintenance, improved...lifetime and integrity, improve performance, and resolve the need to procure and handle liquid nitrogen (LN2). Both cryocoolers offer advantages over...interval and lifetime have not yet been determined. Expected lifetimes for both cryocooler units are in excess of 50,000 hours. Both systems will be

Noise-enhanced CVQKD with untrusted source

NASA Astrophysics Data System (ADS)

Wang, Xiaoqun; Huang, Chunhui

2017-06-01

The performance of one-way and two-way continuous variable quantum key distribution (CVQKD) protocols can be increased by adding some noise on the reconciliation side. In this paper, we propose to add noise at the reconciliation end to improve the performance of CVQKD with untrusted source. We derive the key rate of this case and analyze the impact of the additive noise. The simulation results show that the optimal additive noise can improve the performance of the system in terms of maximum transmission distance and tolerable excess noise.

The Impact of Performance Measurement on Library and Information Services: A Decade of Experience.

ERIC Educational Resources Information Center

Willemse, John

Performance measurement at the University of South Africa (Unisa) library is integrated in its planning and review procedures and is continuously adapted and improved. This paper traces the development of performance measurement at Unisa over more than a decade. Performance measurement provides an indication of how good or bad the library is doing…

Advancements for continuous miners

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

Fiscor, S.

2007-06-15

Design changes and new technology make the modern continuous miner more user friendly. Two of the major manufacturers, Joy Mining Machinery and DBT, both based near Pittsburgh, PA, USA, have recently acquired other OEMs to offer a greater product line. Joy's biggest development in terms of improving cutting time is the FACEBOSS Control System which has an operator assistance element and Joy Surface Reporting Software (JSRP). Joy's WetHead continuous miners have excellent performance. DBT is researching ways to make the machines more reliable with new drive systems. It has also been experimenting with water sprays to improve dust suppression. 4more » photos.« less

Drivers of Dashboard Development (3-D): A Curricular Continuous Quality Improvement Approach.

PubMed

Shroyer, A Laurie; Lu, Wei-Hsin; Chandran, Latha

2016-04-01

Undergraduate medical education (UME) programs are seeking systematic ways to monitor and manage their educational performance metrics and document their achievement of external goals (e.g., Liaison Committee on Medical Education [LCME] accreditation requirements) and internal objectives (institution-specific metrics). In other continuous quality improvement (CQI) settings, summary dashboard reports have been used to evaluate and improve performance. The Stony Brook University School of Medicine UME leadership team developed and implemented summary dashboard performance reports in 2009 to document LCME standards/criteria compliance, evaluate medical student performance, and identify progress in attaining institutional curricular goals and objectives. Key performance indicators (KPIs) and benchmarks were established and have been routinely monitored as part of the novel Drivers of Dashboard Development (3-D) approach to curricular CQI. The systematic 3-D approach has had positive CQI impacts. Substantial improvements over time have been documented in KPIs including timeliness of clerkship grades, midclerkship feedback, student mistreatment policy awareness, and student satisfaction. Stakeholder feedback indicates that the dashboards have provided useful information guiding data-driven curricular changes, such as integrating clinician-scientists as lecturers in basic science courses to clarify the clinical relevance of specific topics. Gaining stakeholder acceptance of the 3-D approach required clear communication of preestablished targets and annual meetings with department leaders and course/clerkship directors. The 3-D approach may be considered by UME programs as a template for providing faculty and leadership with a CQI framework to establish shared goals, document compliance, report accomplishments, enrich communications, facilitate decisions, and improve performance.

How mental health nurses improve their critical thinking through problem-based learning.

PubMed

Hung, Tsui-Mei; Tang, Lee-Chun; Ko, Chen-Ju

2015-01-01

Critical thinking has been regarded as one of the most important elements for nurses to improve quality of patient care. The aim of this study was to use problem-based learning (PBL) as a method in a continuing education program to evaluate nurses' critical thinking skills. A quasiexperimental study design was carried out. The "Critical Thinking Disposition Inventory" in Chinese was used for data collection. The results indicated significant improvement after PBL continuous education, notably in the dimensions of systematic analysis and curiosity. Content analysis extracted four themes: (a) changes in linear thinking required, (b) logical and systematic thinking required performance improved, (3) integration of prior knowledge and clinical application, and (4) brainstorming learning strategy. The study supports PBL as a continuing education strategy for mental health nurses, and that systematic analysis and curiosity effectively facilitate the development of critical thinking.

A Hierarchical structure of key performance indicators for operation management and continuous improvement in production systems

PubMed Central

Kang, Ningxuan; Zhao, Cong; Li, Jingshan; Horst, John A.

2018-01-01

Key performance indicators (KPIs) are critical for manufacturing operation management and continuous improvement (CI). In modern manufacturing systems, KPIs are defined as a set of metrics to reflect operation performance, such as efficiency, throughput, availability, from productivity, quality and maintenance perspectives. Through continuous monitoring and measurement of KPIs, meaningful quantification and identification of different aspects of operation activities can be obtained, which enable and direct CI efforts. A set of 34 KPIs has been introduced in ISO 22400. However, the KPIs in a manufacturing system are not independent, and they may have intrinsic mutual relationships. The goal of this paper is to introduce a multi-level structure for identification and analysis of KPIs and their intrinsic relationships in production systems. Specifically, through such a hierarchical structure, we define and layer KPIs into levels of basic KPIs, comprehensive KPIs and their supporting metrics, and use it to investigate the relationships and dependencies between KPIs. Such a study can provide a useful tool for manufacturing engineers and managers to measure and utilize KPIs for CI. PMID:29398722

A Hierarchical structure of key performance indicators for operation management and continuous improvement in production systems.

PubMed

Kang, Ningxuan; Zhao, Cong; Li, Jingshan; Horst, John A

2016-01-01

Key performance indicators (KPIs) are critical for manufacturing operation management and continuous improvement (CI). In modern manufacturing systems, KPIs are defined as a set of metrics to reflect operation performance, such as efficiency, throughput, availability, from productivity, quality and maintenance perspectives. Through continuous monitoring and measurement of KPIs, meaningful quantification and identification of different aspects of operation activities can be obtained, which enable and direct CI efforts. A set of 34 KPIs has been introduced in ISO 22400. However, the KPIs in a manufacturing system are not independent, and they may have intrinsic mutual relationships. The goal of this paper is to introduce a multi-level structure for identification and analysis of KPIs and their intrinsic relationships in production systems. Specifically, through such a hierarchical structure, we define and layer KPIs into levels of basic KPIs, comprehensive KPIs and their supporting metrics, and use it to investigate the relationships and dependencies between KPIs. Such a study can provide a useful tool for manufacturing engineers and managers to measure and utilize KPIs for CI.

The ``Music'' of Light: Optical Resonances for Fun and Profit

NASA Astrophysics Data System (ADS)

Beausoleil, Raymond

Moore's Law has set great expectations that the performance/price ratio of commercially available semiconductor devices will continue to improve exponentially at least until the end of this decade. But the physics of the metal wires that connect the transistors on a silicon chip already places stringent limits on the performance of integrated circuits, making their continued dramatic improvement highly unlikely. In this talk, I will introduce the basic concept of an optical resonance in a microscopic dielectric cavity in the context of the same type of spatial boundary conditions that give each musical instrument its unique sound. Then I will illustrate applications of these resonances to information technology in a variety of forms and functions using examples from my own laboratory at HP, such as chip-scale optical networks, quantum bits based on spins in diamond, and ultrafast optical switches that could become the foundation for a new generation of optical computers. Our goal is to conduct advanced research that could precipitate an ``optical Moore's Law'' and allow exponential performance gains to continue through the end of the next decade.

Interval Running Training Improves Cognitive Flexibility and Aerobic Power of Young Healthy Adults.

PubMed

Venckunas, Tomas; Snieckus, Audrius; Trinkunas, Eugenijus; Baranauskiene, Neringa; Solianik, Rima; Juodsnukis, Antanas; Streckis, Vytautas; Kamandulis, Sigitas

2016-08-01

Venckunas, T, Snieckus, A, Trinkunas, E, Baranauskiene, N, Solianik, R, Juodsnukis, A, Streckis, V, and Kamandulis, S. Interval running training improves cognitive flexibility and aerobic power of young healthy adults. J Strength Cond Res 30(8): 2114-2121, 2016-The benefits of regular physical exercise may well extend beyond the reduction of chronic diseases risk and augmentation of working capacity, to many other aspects of human well-being, including improved cognitive functioning. Although the effects of moderate intensity continuous training on cognitive performance are relatively well studied, the benefits of interval training have not been investigated in this respect so far. The aim of the current study was to assess whether 7 weeks of interval running training is effective at improving both aerobic fitness and cognitive performance. For this purpose, 8 young dinghy sailors (6 boys and 2 girls) completed the interval running program with 200 m and 2,000 m running performance, cycling maximal oxygen uptake, and cognitive function was measured before and after the intervention. The control group consisted of healthy age-matched subjects (8 boys and 2 girls) who continued their active lifestyle and were tested in the same way as the experimental group, but did not complete any regular training. In the experimental group, 200 m and 2,000 m running performance and cycling maximal oxygen uptake increased together with improved results on cognitive flexibility tasks. No changes in the results of short-term and working memory tasks were observed in the experimental group, and no changes in any of the measured indices were evident in the controls. In conclusion, 7 weeks of interval running training improved running performance and cycling aerobic power, and were sufficient to improve the ability to adjust behavior to changing demands in young active individuals.

One hundred and fifty years of sprint and distance running – Past trends and future prospects

PubMed Central

Weiss, Martin; Newman, Alexandra; Whitmore, Ceri; Weiss, Stephan

2016-01-01

Abstract Sprint and distance running have experienced remarkable performance improvements over the past century. Attempts to forecast running performances share an almost similarly long history but have relied so far on relatively short data series. Here, we compile a comprehensive set of season-best performances for eight Olympically contested running events. With this data set, we conduct (1) an exponential time series analysis and (2) a power-law experience curve analysis to quantify the rate of past performance improvements and to forecast future performances until the year 2100. We find that the sprint and distance running performances of women and men improve exponentially with time and converge at yearly rates of 4% ± 3% and 2% ± 2%, respectively, towards their asymptotic limits. Running performances can also be modelled with the experience curve approach, yielding learning rates of 3% ± 1% and 6% ± 2% for the women's and men's events, respectively. Long-term trends suggest that: (1) women will continue to run 10–20% slower than men, (2) 9.50 s over 100 m dash may only be broken at the end of this century and (3) several middle- and long-distance records may be broken within the next two to three decades. The prospects of witnessing a sub-2 hour marathon before 2100 remain inconclusive. Our results should be interpreted cautiously as forecasting human behaviour is intrinsically uncertain. The future season-best sprint and distance running performances will continue to scatter around the trends identified here and may yield unexpected improvements of standing world records. PMID:26088705

Report: EPA’s Method for Calculating Air Toxics Emissions for Reporting Results Needs Improvement

EPA Pesticide Factsheets

Report #2004-P-00012, March 31, 2004. Although the methods by which air toxics emissions are estimated have improved substantially, unvalidated assumptions and other limitations underlying the NTI continue to impact its use as a GPRA performance measure.

A strategy for company improvement.

PubMed

Howley, L

2000-03-01

Strategies based on the kaizen methodology are designed to continuously improve company performance without the need for large capital investments. This article looks at how one company used simple kaizen principles to its advantage, achieving 67% increase in productivity and 10% reduction in the standard cost of product.

Performance improvements of binary diffractive structures via optimization of the photolithography and dry etch processes

NASA Astrophysics Data System (ADS)

Welch, Kevin; Leonard, Jerry; Jones, Richard D.

2010-08-01

Increasingly stringent requirements on the performance of diffractive optical elements (DOEs) used in wafer scanner illumination systems are driving continuous improvements in their associated manufacturing processes. Specifically, these processes are designed to improve the output pattern uniformity of off-axis illumination systems to minimize degradation in the ultimate imaging performance of a lithographic tool. In this paper, we discuss performance improvements in both photolithographic patterning and RIE etching of fused silica diffractive optical structures. In summary, optimized photolithographic processes were developed to increase critical dimension uniformity and featuresize linearity across the substrate. The photoresist film thickness was also optimized for integration with an improved etch process. This etch process was itself optimized for pattern transfer fidelity, sidewall profile (wall angle, trench bottom flatness), and across-wafer etch depth uniformity. Improvements observed with these processes on idealized test structures (for ease of analysis) led to their implementation in product flows, with comparable increases in performance and yield on customer designs.

Improving the breed - Shuttle development

NASA Technical Reports Server (NTRS)

Brand, V.

1985-01-01

An evaluation is made of design improvements that have been made to the Space Shuttle System, and the performance gains obtained; the most important of these stem from efforts to refine procedures for rendezvous with stricken satellites, in order to repair them. Ascent performance has been improved through Space Shuttle Main Engine thrust improvements and external tank weight reductions. On-orbit living convenience has been enhanced by the addition of small sleeping compartments and a galley. Greater flexibility has been obtained for reentry and landing maneuvers. Attention is given to problems which continue to be posed by the thermal protection tiles.

New PDC cutters improve drilling efficiency

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

Mensa-Wilmot, G.

1997-10-27

New polycrystalline diamond compact (PDC) cutters increase penetration rates and cumulative footage through improved abrasion, impact, interface strength, thermal stability, and fatigue characteristics. Studies of formation characterization, vibration analysis, hydraulic layouts, and bit selection continue to improve and expand PDC bit applications. The paper discusses development philosophy, performance characteristics and requirements, Types A, B, and C cutters, and combinations.

Modeling and simulation of continuous wave velocity radar based on third-order DPLL

NASA Astrophysics Data System (ADS)

Di, Yan; Zhu, Chen; Hong, Ma

2015-02-01

Second-order digital phase-locked-loop (DPLL) is widely used in traditional Continuous wave (CW) velocity radar with poor performance in high dynamic conditions. Using the third-order DPLL can improve the performance. Firstly, the echo signal model of CW radar is given. Secondly, theoretical derivations of the tracking performance in different velocity conditions are given. Finally, simulation model of CW radar is established based on Simulink tool. Tracking performance of the two kinds of DPLL in different acceleration and jerk conditions is studied by this model. The results show that third-order PLL has better performance in high dynamic conditions. This model provides a platform for further research of CW radar.

10 CFR 850.40 - Performance feedback.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Performance feedback. (a) The responsible employer must conduct periodic analyses and assessments of... reporting data. (b) To ensure that information is available to maintain and improve all elements of the CBDPP continuously, the responsible employer must give results of periodic analyses and assessments to...

10 CFR 850.40 - Performance feedback.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Performance feedback. (a) The responsible employer must conduct periodic analyses and assessments of... reporting data. (b) To ensure that information is available to maintain and improve all elements of the CBDPP continuously, the responsible employer must give results of periodic analyses and assessments to...

10 CFR 850.40 - Performance feedback.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Performance feedback. (a) The responsible employer must conduct periodic analyses and assessments of... reporting data. (b) To ensure that information is available to maintain and improve all elements of the CBDPP continuously, the responsible employer must give results of periodic analyses and assessments to...

10 CFR 850.40 - Performance feedback.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Performance feedback. (a) The responsible employer must conduct periodic analyses and assessments of... reporting data. (b) To ensure that information is available to maintain and improve all elements of the CBDPP continuously, the responsible employer must give results of periodic analyses and assessments to...

10 CFR 850.40 - Performance feedback.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Performance feedback. (a) The responsible employer must conduct periodic analyses and assessments of... reporting data. (b) To ensure that information is available to maintain and improve all elements of the CBDPP continuously, the responsible employer must give results of periodic analyses and assessments to...

Research possibilities? No! Needs for research to make PV solar energy utilization broadly competitive

NASA Technical Reports Server (NTRS)

Wolf, M.

1982-01-01

The historical progression of efficiency improvements, cost reductions, and performance improvements in modules and photovoltaic systems are described. The potential for future improvements in photovoltaic device efficiencies and cost reductions continues as device concepts, designs, processes, and automated production capabilities mature. Additional step-function improvements can be made as today's simpler devices are replaced by more sophisticated devices.

Promoting Accountability and Continual Improvement: A Review of the Respective Roles of Performance Measurement, Auditing, Evaluation, and Reporting.

ERIC Educational Resources Information Center

Reid, William

1999-01-01

Provides a synthesis of the literature pertaining to the principles and practices of performance measurement, auditing, evaluation, and reporting. Discusses how bringing these elements together in a performance management system can be achieved through refinement of strategic direction, reporting on key measures, and periodic, systematic…

32 CFR 644.462 - Performance of restoration work by district engineer-extension of time.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 4 2013-07-01 2013-07-01 false Performance of restoration work by district engineer-extension of time. 644.462 Section 644.462 National Defense Department of Defense (Continued... Leasehold Improvements § 644.462 Performance of restoration work by district engineer—extension of time...

Expanding Educators' Contributions to Continuous Quality Improvement of American Board of Medical Specialties Maintenance of Certification.

PubMed

Nora, Lois Margaret; Pouwels, Mellie Villahermosa; Irons, Mira

2016-01-01

The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.

Clustering-based urbanisation to improve enterprise information systems agility

NASA Astrophysics Data System (ADS)

Imache, Rabah; Izza, Said; Ahmed-Nacer, Mohamed

2015-11-01

Enterprises are daily facing pressures to demonstrate their ability to adapt quickly to the unpredictable changes of their dynamic in terms of technology, social, legislative, competitiveness and globalisation. Thus, to ensure its place in this hard context, enterprise must always be agile and must ensure its sustainability by a continuous improvement of its information system (IS). Therefore, the agility of enterprise information systems (EISs) can be considered today as a primary objective of any enterprise. One way of achieving this objective is by the urbanisation of the EIS in the context of continuous improvement to make it a real asset servicing enterprise strategy. This paper investigates the benefits of EISs urbanisation based on clustering techniques as a driver for agility production and/or improvement to help managers and IT management departments to improve continuously the performance of the enterprise and make appropriate decisions in the scope of the enterprise objectives and strategy. This approach is applied to the urbanisation of a tour operator EIS.

Fine Arts Instruction as a Predictor of School Performance in South Carolina

ERIC Educational Resources Information Center

Doyle, Sharon T.

2013-01-01

Budget constraints, political will, narrowed curricula, and a continued emphasis on high-stakes testing in public schools have resulted in a continued loss of instruction in fine arts. Fine arts instruction is known to improve student achievement, but the contribution to achievement in the elementary schools after accounting for demographic…

Can continuous scans in orthogonal planes improve diagnostic performance of shear wave elastography for breast lesions?

PubMed

Yang, Pan; Peng, Yulan; Zhao, Haina; Luo, Honghao; Jin, Ya; He, Yushuang

2015-01-01

Static shear wave elastography (SWE) is used to detect breast lesions, but slice and plane selections result in discrepancies. To evaluate the intraobserver reproducibility of continuous SWE, and whether quantitative elasticities in orthogonal planes perform better in the differential diagnosis of breast lesions. One hundred and twenty-two breast lesions scheduled for ultrasound-guided biopsy were recruited. Continuous SWE scans were conducted in orthogonal planes separately. Quantitative elasticities and histopathology results were collected. Reproducibility in the same plane and diagnostic performance in different planes were evaluated. The maximum and mean elasticities of the hardest portion, and standard deviation of whole lesion, had high inter-class correlation coefficients (0.87 to 0.95) and large areas under receiver operation characteristic curve (0.887 to 0.899). Without loss of accuracy, sensitivities had increased in orthogonal planes compared with single plane (from 73.17% up to 82.93% at most). Mean elasticity of whole lesion and lesion-to-parenchyma ratio were significantly less reproducible and less accurate. Continuous SWE is highly reproducible for the same observer. The maximum and mean elasticities of the hardest portion and standard deviation of whole lesion are most reliable. Furthermore, the sensitivities of the three parameters are improved in orthogonal planes without loss of accuracies.

Five training sessions improves 3000 meter running performance.

PubMed

Riiser, A; Ripe, S; Aadland, E

2015-12-01

The primary aim of the present study was to evaluate the effect of two weeks of endurance training on 3000-meter running performance. Secondary we wanted to assess the relationship between baseline running performance and change in running performance over the intervention period. We assigned 36 military recruits to a training group (N.=28) and a control group. The training group was randomly allocated to one of three sub-groups: 1) a 3000 meter group (test race); 2) a 4x4-minutes high-intensity interval group; 3) a continuous training group. The training group exercised five times over a two-week period. The training group improved its 3000 meter running performance with 50 seconds (6%) compared to the control group (P=0.003). Moreover, all sub-groups improved their performance by 37 to 73 seconds (4-8%) compared to the control group (P<0.037). There was a significant relationship between pretest performance and improvement from pre- to post-test (ρ=-0.65, P<0.001) in the training group. We conclude that five endurance training sessions improved 3000 meter running performance and the slowest runners achieved the greatest improvement in running performance.

An exploratory survey of methods used to develop measures of performance

NASA Astrophysics Data System (ADS)

Hamner, Kenneth L.; Lafleur, Charles A.

1993-09-01

Nonmanufacturing organizations are being challenged to provide high-quality products and services to their customers, with an emphasis on continuous process improvement. Measures of performance, referred to as metrics, can be used to foster process improvement. The application of performance measurement to nonmanufacturing processes can be very difficult. This research explored methods used to develop metrics in nonmanufacturing organizations. Several methods were formally defined in the literature, and the researchers used a two-step screening process to determine the OMB Generic Method was most likely to produce high-quality metrics. The OMB Generic Method was then used to develop metrics. A few other metric development methods were found in use at nonmanufacturing organizations. The researchers interviewed participants in metric development efforts to determine their satisfaction and to have them identify the strengths and weaknesses of, and recommended improvements to, the metric development methods used. Analysis of participants' responses allowed the researchers to identify the key components of a sound metrics development method. Those components were incorporated into a proposed metric development method that was based on the OMB Generic Method, and should be more likely to produce high-quality metrics that will result in continuous process improvement.

Taking stock of pay-for-performance: a candid assessment from the front lines.

PubMed

Damberg, Cheryl L; Raube, Kristiana; Teleki, Stephanie S; Dela Cruz, Erin

2009-01-01

Pay-for-performance (P4P) has been widely adopted, but it remains unclear how providers are responding and whether results are meeting expectations. Physician organizations involved in the California Integrated Healthcare Association's (IHA) P4P program reported having increased physician-level performance feedback and accountability, speeded up information technology adoption, and sharpened their organizational focus and support for improvement in response to P4P; however, after three years of investment, these changes had not translated into breakthrough quality improvements. Continued monitoring is required to determine whether early investments made by physician organizations provide a basis for greater improvements in the future.

Coherent attacking continuous-variable quantum key distribution with entanglement in the middle

NASA Astrophysics Data System (ADS)

Zhang, Zhaoyuan; Shi, Ronghua; Zeng, Guihua; Guo, Ying

2018-06-01

We suggest an approach on the coherent attack of continuous-variable quantum key distribution (CVQKD) with an untrusted entangled source in the middle. The coherent attack strategy can be performed on the double links of quantum system, enabling the eavesdropper to steal more information from the proposed scheme using the entanglement correlation. Numeric simulation results show the improved performance of the attacked CVQKD system in terms of the derived secret key rate with the controllable parameters maximizing the stolen information.

Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

PubMed

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-06-01

To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.

Management Systems, Patient Quality Improvement, Resource Availability, and Substance Abuse Treatment Quality

PubMed Central

Fields, Dail; Roman, Paul M; Blum, Terry C

2012-01-01

Objective To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data Sources/Study Setting Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). Study Design The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Data Collection Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007–2008. Principal Findings Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Conclusions Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. PMID:22098342

Continuous quality improvement for the clinical decision unit.

PubMed

Mace, Sharon E

2004-01-01

Clinical decision units (CDUs) are a relatively new and growing area of medicine in which patients undergo rapid evaluation and treatment. Continuous quality improvement (CQI) is important for the establishment and functioning of CDUs. CQI in CDUs has many advantages: better CDU functioning, fulfillment of Joint Commission on Accreditation of Healthcare Organizations mandates, greater efficiency/productivity, increased job satisfaction, better performance improvement, data availability, and benchmarking. Key elements include a database with volume indicators, operational policies, clinical practice protocols (diagnosis specific/condition specific), monitors, benchmarks, and clinical pathways. Examples of these important parameters are given. The CQI process should be individualized for each CDU and hospital.

Hesitations in continuous tracking induced by a concurrent discrete task

NASA Technical Reports Server (NTRS)

Klapp, S. T.; Kelly, P. A.; Netick, A.

1985-01-01

Subjects performed a continuous visually-guided pursuit tracking task with the right hand. From time to time (intervals averaging 30 sec) an auditory tone appeared signaling the subjects to perform a discrete response with the left hand. The presence of this tone was frequently associated with a hesitation in right-hand tracking which lasted 1/3 sec or longer. The rate of occurrence of these hesitations was about the same when the left-hand response involved a choice between competing responses as when the left hand responded in a predetermined direction. Hesitations occurred for three different mechanical tracking manipulanda using different controlling muscles, and appeared to be due to freezing rather than to relaxation of muscular action. The rate of occurrence of hesitations declined with practice, and this improvement in right-hand performance was accompanied by an improvement in performance of the concurrent left-hand response. The presence of hesitations, and their reduction with practice, can be interpreted within several viewpoints.

Quick and continuous improvement through kaizen blitz.

PubMed

McNichols, T; Hassinger, R; Bapst, G W

1999-05-01

It is our objective to provide you with a step-by-step approach to conducting a kaizen blitz within two days and describe how to achieve dramatic performance improvement with employee buy-in through this process. Kaizen blitz has been used dozens of times by the authors, and in some instances the same area has been blitzed as many as four times, with significant improvements each and every time. Employees have even taken it on themselves to conduct informal blitzes as a continuing improvement effort after a formal blitz has been conducted in their area. Blitzes can succeed in a variety of environments. The morning after the employees of one company attended this presentation, they self initiated a mini-blitz and discovered opportunities for improvement that they enthusiastically presented to management.

A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors.

PubMed

Toohey, Kellie; Pumpa, Kate L; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S; Semple, Stuart

2016-01-01

The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group ( n  = 8) or the continuous low to moderate intensity training group ( n  = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05-0.61, p  ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43-4.63] ES 0.50, p  ≤ 0.01) with the LVHIIT group demonstrating greater improvements. These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.

A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors

PubMed Central

Pumpa, Kate L.; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S.; Semple, Stuart

2016-01-01

Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Methods Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group (n = 8) or the continuous low to moderate intensity training group (n = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Results Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05–0.61, p ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43–4.63] ES 0.50, p ≤ 0.01) with the LVHIIT group demonstrating greater improvements. Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings. PMID:27781180

An Update on Modern Approaches to Localized Esophageal Cancer

PubMed Central

Welsh, James; Amini, Arya; Likhacheva, Anna; Erasmus, Jeremy; Gomez, Daniel; Davila, Marta; Mehran, Reza J; Komaki, Ritsuko; Liao, Zhongxing; Hofstetter, Wayne L; Bhutani, Manoop; Ajani, Jaffer A

2014-01-01

Esophageal cancer treatment continues to be a topic of wide debate. Based on improvements in chemotherapy drugs, surgical techniques, and radiotherapy advances, esophageal cancer treatment approaches are becoming more specific to the stage of the tumor and the overall performance status of the patient. While surgery continues to be the standard treatment option for localized disease, the current direction favors multimodality treatment including both radiation and chemotherapy with surgery. In the next few years, we will continue to see improvements in radiation techniques and proton treatment, with more minimally invasive surgical approaches minimizing postoperative side effects, and the discovery of molecular biomarkers to help deliver more specifically targeted medication to treat esophageal cancers. PMID:21365188

76 FR 50474 - Special Demonstration Programs-National Technical Assistance Projects To Improve Employment...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

... its vocational rehabilitation (VR) programs. We intend the priority to increase the transfer... the field of rehabilitation that have national significance and to improve the performance of State VR... Technical Assistance and Continuing Education (TACE) centers, and State VR agencies. For example, the...

Sleep-Dependent Learning and Motor-Skill Complexity

ERIC Educational Resources Information Center

Kuriyama, Kenichi; Stickgold, Robert; Walker, Matthew P.

2004-01-01

Learning of a procedural motor-skill task is known to progress through a series of unique memory stages. Performance initially improves during training, and continues to improve, without further rehearsal, across subsequent periods of sleep. Here, we investigate how this delayed sleep-dependent learning is affected when the task characteristics…

Microwave and continuous flow technologies in drug discovery.

PubMed

Sadler, Sara; Moeller, Alexander R; Jones, Graham B

2012-12-01

Microwave and continuous flow microreactors have become mainstream heating sources in contemporary pharmaceutical company laboratories. Such technologies will continue to benefit from design and engineering improvements, and now play a key role in the drug discovery process. The authors review the applications of flow- and microwave-mediated heating in library, combinatorial, solid-phase, metal-assisted, and protein chemistries. Additionally, the authors provide a description of the combination of microwave and continuous flow platforms, with applications in the preparation of radiopharmaceuticals and in drug candidate development. Literature reviewed is chiefly 2000 - 2012, plus key citations from earlier reports. With the advent of microwave irradiation, reactions that normally took days to complete can now be performed in a matter of minutes. Coupled with the introduction of continuous flow microreactors, pharmaceutical companies have an easy way to improve the greenness and efficiency of many synthetic operations. The combined force of these technologies offers the potential to revolutionize discovery and manufacturing processes.

Interpreting incremental value of markers added to risk prediction models.

PubMed

Pencina, Michael J; D'Agostino, Ralph B; Pencina, Karol M; Janssens, A Cecile J W; Greenland, Philip

2012-09-15

The discrimination of a risk prediction model measures that model's ability to distinguish between subjects with and without events. The area under the receiver operating characteristic curve (AUC) is a popular measure of discrimination. However, the AUC has recently been criticized for its insensitivity in model comparisons in which the baseline model has performed well. Thus, 2 other measures have been proposed to capture improvement in discrimination for nested models: the integrated discrimination improvement and the continuous net reclassification improvement. In the present study, the authors use mathematical relations and numerical simulations to quantify the improvement in discrimination offered by candidate markers of different strengths as measured by their effect sizes. They demonstrate that the increase in the AUC depends on the strength of the baseline model, which is true to a lesser degree for the integrated discrimination improvement. On the other hand, the continuous net reclassification improvement depends only on the effect size of the candidate variable and its correlation with other predictors. These measures are illustrated using the Framingham model for incident atrial fibrillation. The authors conclude that the increase in the AUC, integrated discrimination improvement, and net reclassification improvement offer complementary information and thus recommend reporting all 3 alongside measures characterizing the performance of the final model.

Case base classification on digital mammograms: improving the performance of case base classifier

NASA Astrophysics Data System (ADS)

Raman, Valliappan; Then, H. H.; Sumari, Putra; Venkatesa Mohan, N.

2011-10-01

Breast cancer continues to be a significant public health problem in the world. Early detection is the key for improving breast cancer prognosis. The aim of the research presented here is in twofold. First stage of research involves machine learning techniques, which segments and extracts features from the mass of digital mammograms. Second level is on problem solving approach which includes classification of mass by performance based case base classifier. In this paper we build a case-based Classifier in order to diagnose mammographic images. We explain different methods and behaviors that have been added to the classifier to improve the performance of the classifier. Currently the initial Performance base Classifier with Bagging is proposed in the paper and it's been implemented and it shows an improvement in specificity and sensitivity.

Ergonomics, quality and continuous improvement--conceptual and empirical relationships in an industrial context.

PubMed

Eklund, J

1997-10-01

This paper reviews the literature comparing the fields of ergonomics and quality, mainly in an industrial context, including mutual influences, similarities and differences. Relationships between ergonomics and the factors: work conditions, product design, ISO 9000, continuous improvements and TQM are reviewed in relation to the consequence, application, and process domains. The definitions of ergonomics and quality overlap substantially. Quality deficiencies, human errors and ergonomics problems often have the same cause, which in many cases can be traced to the design of work, workplace and environment e.g. noise, light, postures, loads, pace and work content. In addition, the possibility of performing to a high standard at work is an important prerequisite for satisfaction and well-being. Contradictions between the two fields have been identified in the view of concepts such as standardization, reduction of variability and copying of best practice, requiring further research. The field of quality would gain by incorporating ergonomics knowledge, especially in the areas of work design and human capability, since these factors are decisive for human performance and also therefore the performance of the systems involved. The field of ergonomics, on the other hand, would benefit from developing a stronger emphasis on methodologies and structures for improvement processes, including a clearer link with leadership and company strategies. Just as important is a further development of practicable participative ergonomics methods and tools for use at workplaces by the workers themselves, in order to integrate the top-down and the bottom-up processes and achieve better impact. Using participative processes for problem-solving and continuous improvement, focusing ergonomics and quality jointly has a great potential for improving working conditions and quality results simultaneously, and satisfying most of the interested parties.

Pay-for-Performance: New Developments and Issues. Working Paper 2007-05

ERIC Educational Resources Information Center

Cannon, Mark D.

2007-01-01

Intense competitive pressure and the need for continual improvements have led to a burgeoning interest in and use of pay-for-performance programs. This paper explores the increased use of pay-for-performance, drawing examples from healthcare, education, and the government. Suggestions are made as to how best to implement pay-for-performance…

A tailored educational intervention improves doctor's performance in managing depression: a randomized controlled trial.

PubMed

Shirazi, Mandana; Lonka, Kirsti; Parikh, Sagar V; Ristner, Gunilla; Alaeddini, Farshid; Sadeghi, Majid; Wahlstrom, Rolf

2013-02-01

To assess the effects of a tailored and activating educational intervention, based on a three-stage modified Prochaska model of readiness-to-change, on the performance of general physicians in primary care (GPs) regarding management of depressive disorders. Parallel group, randomized control trial. Primary hypothesis was that performance would improve by 20 percentage units in the intervention arm. The setting was primary care in southern Tehran. The participants were 192 GPs stratified on stage of readiness-to-change, sex, age and work experience. The intervention was a 2-day interactive workshop for a small group of GPs' at a higher stage of readiness-to-change ('intention') and a 2-day interactive large group meeting for those with lower propensity to change ('attitude') at the pre-assessment. GPs in the control arm participated in a standard educational programme on the same topic. The main outcome measures were validated tools to assess GPs' performance by unannounced standardized patients, regarding diagnosis and treatment of depressive disorders. The assessments were made 2 months before and 2 months after the intervention. GPs in the intervention arm significantly improved their overall mean scores for performance regarding both diagnosis, with an intervention effect of 14 percentage units (P = 0.007), and treatment and referral, with an intervention effect of 20 percentage units (P < 0.0001). The largest improvement after the intervention appeared in the small group: 30 percentage units for diagnosis (P = 0.027) and 29 percentage units for treatment and referral (P < 0.0001). Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development. © 2011 Blackwell Publishing Ltd.

Accreditation of ambulatory facilities.

PubMed

Urman, Richard D; Philip, Beverly K

2014-06-01

With the continued growth of ambulatory surgical centers (ASC), the regulation of facilities has evolved to include new standards and requirements on both state and federal levels. Accreditation allows for the assessment of clinical practice, improves accountability, and better ensures quality of care. In some states, ASC may choose to voluntarily apply for accreditation from a recognized organization, but in others it is mandated. Accreditation provides external validation of safe practices, benchmarking performance against other accredited facilities, and demonstrates to patients and payers the facility's commitment to continuous quality improvement. Copyright © 2014 Elsevier Inc. All rights reserved.

Managing hospital quality performance in two related areas: patient care and customer service.

PubMed

Dwore, R B

1993-01-01

The Joint Commission on Accreditation of Healthcare Organization's new emphasis on continuous quality improvement provides hospitals with an opportunity to enhance both customer service as well as patient care. Both are expected by patients and delivered by providers. Patient care is the core product; customer service augments it by adding value and providing the opportunity for a competitive advantage. This article discusses issues for administrators to consider before including customer service as a component of continuous quality improvement and then presents methods for bringing about change.

Your Audit and Financial Controls.

ERIC Educational Resources Information Center

Hatch, Mary B.; And Others

Audits should be performed on school accounting systems because they are required by law and they provide independent reviews of school financial procedures and suggestions for improvement. A licensed certified public accountant, public accountant, or an accountant who has met the Continuation of Education requirement should perform the audit.…

Overuse Injury Assessment Model

DTIC Science & Technology

2007-08-01

and reduce injuries is a continual challenge. Military researchers face challenges to develop better equipment, improve training regimens, and...performed and calculate biomechanical metrics for each activity. Hardware Challenges • Sampling the sensors sufficiently fast • Having adequate bandwidth...second is that the injury rate increases rapidly initially and, third, that the injury rate continues to climb as the cumulative distance increases

Students' Learning Performance and Transitions in Different Learning Pathways to Higher Vocational Education

ERIC Educational Resources Information Center

Biemans, Harm; Mariën, Hans; Fleur, Erik; Tobi, Hilde; Nieuwenhuis, Loek; Runhaar, Piety

2016-01-01

To improve students' transitions between successive educational levels, continuing learning pathways are being designed and implemented in many countries. This study was carried out to examine the effects of the Green Lycea (GL) as critical cases of continuing learning pathways in vocational education in The Netherlands. The GL were compared with…

Methods for accurate cold-chain temperature monitoring using digital data-logger thermometers

NASA Astrophysics Data System (ADS)

Chojnacky, M. J.; Miller, W. M.; Strouse, G. F.

2013-09-01

Complete and accurate records of vaccine temperature history are vital to preserving drug potency and patient safety. However, previously published vaccine storage and handling guidelines have failed to indicate a need for continuous temperature monitoring in vaccine storage refrigerators. We evaluated the performance of seven digital data logger models as candidates for continuous temperature monitoring of refrigerated vaccines, based on the following criteria: out-of-box performance and compliance with manufacturer accuracy specifications over the range of use; measurement stability over extended, continuous use; proper setup in a vaccine storage refrigerator so that measurements reflect liquid vaccine temperatures; and practical methods for end-user validation and establishing metrological traceability. Data loggers were tested using ice melting point checks and by comparison to calibrated thermocouples to characterize performance over 0 °C to 10 °C. We also monitored logger performance in a study designed to replicate the range of vaccine storage and environmental conditions encountered at provider offices. Based on the results of this study, the Centers for Disease Control released new guidelines on proper methods for storage, handling, and temperature monitoring of vaccines for participants in its federally-funded Vaccines for Children Program. Improved temperature monitoring practices will ultimately decrease waste from damaged vaccines, improve consumer confidence, and increase effective inoculation rates.

Effects of auditory radio interference on a fine, continuous, open motor skill.

PubMed

Lazar, J M; Koceja, D M; Morris, H H

1995-06-01

The effects of human speech on a fine, continuous, and open motor skill were examined. A tape of auditory human radio traffic was injected into a tank gunnery simulator during each training session for 4 wk. of training for 3 hr. a week. The dependent variables were identification time, fire time, kill time, systems errors, and acquisition errors. These were measured by the Unit Conduct Of Fire Trainer (UCOFT). The interference was interjected into the UCOFT Tank Table VIII gunnery test. A Solomon four-group design was used. A 2 x 2 analysis of variance was used to assess whether interference gunnery training resulted in improvements in interference posttest scores. During the first three weeks of training, the interference group committed 106% more systems errors and 75% more acquisition errors than the standard group. The interference training condition was associated with a significant improvement from pre- to posttest of 44% in over-all UCOFT scores; however, when examined on the posttest the standard training did not improve performance significantly over the same period. It was concluded that auditory radio interference degrades performance of this fine, continuous, open motor skill, and interference training appears to abate the effects of this degradation.

An evaluation of internal medicine residency continuity clinic redesign to a 50/50 outpatient-inpatient model.

PubMed

Wieland, Mark L; Halvorsen, Andrew J; Chaudhry, Rajeev; Reed, Darcy A; McDonald, Furman S; Thomas, Kris G

2013-08-01

There have been recent calls for improved internal medicine outpatient training, yet assessment of clinical and educational variables within existing models is lacking. To assess the impact of clinic redesign from a traditional weekly clinic model to a 50/50 outpatient-inpatient model on clinical and educational outcomes. Pre-intervention and post-intervention study intervals, comparing the 2009-2010 and 2010-2011 academic years. Ninety-six residents in a Primary Care Internal Medicine site of a large academic internal medicine residency program who provide care for > 13,000 patients. Continuity clinic redesign from a traditional weekly clinic model to a 50/50 model characterized by 50 % outpatient and 50 % inpatient experiences scheduled in alternating 1 month blocks, with twice weekly continuity clinic during outpatient months and no clinic during inpatient months. 1) Clinical outcomes (panel size, patient visits, adherence with chronic disease and preventive service guidelines, continuity of care, patient satisfaction, and perceived safety/teamwork in clinic); 2) Educational outcomes (attendance at teaching conference, resident and faculty satisfaction, faculty assessment of resident clinic performance, and residents' perceived preparedness for outpatient management). Redesign was associated with increased mean panel size (120 vs. 137.6; p ≤ 0.001), decreased continuity of care (63 % vs. 48 % from provider perspective; 61 % vs. 51 % from patient perspective; p ≤  0.001 for both; team continuity was preserved), decreased missed appointments (12.5 % vs. 10.9 %; p ≤  0.01), improved perceived safety and teamwork (3.6 vs. 4.1 on 5-point scale; p ≤  0.001), improved mean teaching conference attendance (57.1 vs. 64.4; p ≤  0.001), improved resident clinic performance (3.6 vs. 3.9 on 5-point scale; p ≤  0.001), and little change in other outcomes. Although this model requires further study in other settings, these results suggest that a 50/50 model may allow residents to manage more patients while enhancing the climate of teamwork and safety in the continuity clinic, compared to traditional models. Future work should explore ways to preserve continuity of care within this model.

Effects of Armodafinil on Simulated Driving and Self-Report Measures in Obstructive Sleep Apnea Patients prior to Treatment with Continuous Positive Airway Pressure

PubMed Central

Kay, Gary G.; Feldman, Neil

2013-01-01

Study Objectives: Obstructive sleep apnea (OSA) has been associated with an increased risk of motor vehicle crashes. This driving risk can be reduced (≥ 50%) by treatment with continuous positive airway pressure (CPAP). However residual excessive daytime sleepiness (EDS) can persist for some patients who regularly use CPAP. The current study was designed to assess the effect of armodafinil on simulated driving performance and subsequent CPAP treatment compliance in newly diagnosed OSA patients with EDS during a 2-week “waiting period” prior to initiation of CPAP. Methods: Sixty-nine newly diagnosed OSA patients, awaiting CPAP therapy, were randomized (1:1) to placebo or armodafinil (150 mg/day) treatment. Simulated driving tests and self-report measures were completed at baseline, after 2 weeks of drug treatment, and following 6 weeks of CPAP treatment. CPAP compliance was evaluated at the end of 6 weeks of CPAP. Results: Compared to placebo, armodafinil improved simulated driving safety performance in OSA patients awaiting CPAP therapy (p = 0.03). Improvement was seen in lane position deviation (p = 0.002) and number of lane excursions (p = 0.02). Improvement was also observed on measures of sleepiness using the Epworth Sleepiness Scale (ESS) and sleep related quality of life. Following 6 weeks of CPAP, there was also significant improvement observed on multiple measures of simulated driving performance. CPAP compliance did not differ between armodafinil-treated and placebo-treated patients (p = 0.80). Conclusions: Armodafinil was found to improve simulated driving performance in OSA patients with EDS prior to initiation of CPAP. Treatment with armodafinil showed no effect on subsequent CPAP compliance. Citation: Kay GG; Feldman N. Effects of armodafinil on simulated driving and self-report measures in obstructive sleep apnea patients prior to treatment with continuous positive airway pressure. J Clin Sleep Med 2013;9(5):445-454. PMID:23674935

Circadian rhythms of hydraulic conductance and growth are enhanced by drought and improve plant performance

PubMed Central

Caldeira, Cecilio F.; Jeanguenin, Linda; Chaumont, François; Tardieu, François

2014-01-01

Circadian rhythms enable plants to anticipate daily environmental variations, resulting in growth oscillations under continuous light. Because plants daily transpire up to 200% of their water content, their water status oscillates from favourable during the night to unfavourable during the day. We show that rhythmic leaf growth under continuous light is observed in plants that experience large alternations of water status during an entrainment period, but is considerably buffered otherwise. Measurements and computer simulations show that this is due to oscillations of plant hydraulic conductance and plasma membrane aquaporin messenger RNA abundance in roots during continuous light. A simulation model suggests that circadian oscillations of root hydraulic conductance contribute to acclimation to water stress by increasing root water uptake, thereby favouring growth and photosynthesis. They have a negative effect in favourable hydraulic conditions. Climate-driven control of root hydraulic conductance therefore improves plant performances in both stressed and non-stressed conditions. PMID:25370944

JPRS Report, Science & Technology, Europe, FRG: Official Report om Multiyear Research Funding, Trends

DTIC Science & Technology

1988-08-23

research institutions. The special recognition of performance and the chal- lenge to top performance in research, development, and innovation will...continue to be a central concern of the federal government. Top performances , the achievement of internationally recognized breakthroughs, and suc...government places on improving busi- ness framework conditions for more growth and employ- ment, for strengthening the power of performance , com

42 CFR 401.705 - Eligibility criteria for qualified entities.

Code of Federal Regulations, 2014 CFR

2014-10-01

.... (iv) Designing, and continuously improving the format of performance reports on providers and... subpart address the methodological concerns regarding sample size and reliability that have been expressed...

42 CFR 401.705 - Eligibility criteria for qualified entities.

Code of Federal Regulations, 2013 CFR

2013-10-01

.... (iv) Designing, and continuously improving the format of performance reports on providers and... subpart address the methodological concerns regarding sample size and reliability that have been expressed...

42 CFR 401.705 - Eligibility criteria for qualified entities.

Code of Federal Regulations, 2012 CFR

2012-10-01

.... (iv) Designing, and continuously improving the format of performance reports on providers and... subpart address the methodological concerns regarding sample size and reliability that have been expressed...

Drivers' misjudgement of vigilance state during prolonged monotonous daytime driving.

PubMed

Schmidt, Eike A; Schrauf, Michael; Simon, Michael; Fritzsche, Martin; Buchner, Axel; Kincses, Wilhelm E

2009-09-01

To investigate the effects of monotonous daytime driving on vigilance state and particularly the ability to judge this state, a real road driving study was conducted. To objectively assess vigilance state, performance (auditory reaction time) and physiological measures (EEG: alpha spindle rate, P3 amplitude; ECG: heart rate) were recorded continuously. Drivers judged sleepiness, attention to the driving task and monotony retrospectively every 20 min. Results showed that prolonged daytime driving under monotonous conditions leads to a continuous reduction in vigilance. Towards the end of the drive, drivers reported a subjectively improved vigilance state, which was contrary to the continued decrease in vigilance as indicated by all performance and physiological measures. These findings indicate a lack of self-assessment abilities after approximately 3h of continuous monotonous daytime driving.

Prior sleep with zolpidem enhances the effect of caffeine or modafinil during 18 hours continuous work.

PubMed

Batéjat, Denise; Coste, Olivier; Van Beers, Pascal; Lagarde, Didier; Piérard, Christophe; Beaumont, Maurice

2006-05-01

Continuous military operations may disrupt sleep-wakefulness cycles, resulting in impaired performance and fatigue. We assessed the treatment efficacy of a hypnotic-psychostimulant combination to maintain sleep quality, performance, and alertness during a 42-h simulated military operation. A 6-h prophylactic sleep period with zolpidem (ZOL) followed by a 18-h continuous work period with administration at midway of 300 mg of slow release caffeine (CAF) or 200 mg of modafinil (MOD) was performed by eight healthy male subjects. Performance level was assessed with a reaction time test, a memory search test, a dual task, an attention test, and a computerized Stroop test. Cortical activation level was evaluated by the Critical Flicker Frequency test. Subjective sleepiness was evaluated using a visual analog scale and questionnaires. Effects of drugs on prophylactic and recovery sleep were also quantified from EEG recordings. CAF and MOD maintained performance and alertness throughout the 18-h work period. As shown by EEG recordings, ZOL improved prophylactic sleep without any deleterious effect on performance immediately after waking. As a result of its positive effects on prophylactic sleep, a lower pressure for slow wave sleep during recovery sleep was observed; nevertheless, zolpidem did not enhance the effects of either psychostimulant on performance. MOD and CAF may be of value in promoting performance and wakefulness during shiftwork or military operations while zolpidem improves prophylactic sleep quality without any deleterious effect after waking. We concluded that a zolpidem/ caffeine or modafinil combination could be useful in a context of environmental conditions not conducive to sleep.

Endurance and sprint benefits of high-intensity and supramaximal interval training.

PubMed

Cicioni-Kolsky, Daniel; Lorenzen, Christian; Williams, Morgan David; Kemp, Justin Guy

2013-01-01

This study examined the effect of two different interval training programs-high-intensity interval training (HIT) and supramaximal interval training (SMIT)-on measures of sprint and endurance performance. Physically active individuals (Females: n=32; age 19.3, s=2.2 years; mass 67.6, s=9.1 kg; stature 172.7, s=6.6 cm. Males: n=23; age 20.0, s=2.7 years; mass 71.3, s=8.3 kg; stature 176.6, s=5.8 cm) completed pre-testing that comprised (1) 3000 m time-trial, (2) 40 m sprint, and (3) repeated sprint ability (RSA-6×40 m sprints, 24 s active recovery) performance. Participants were then matched for average 3000 m running velocity (AV) and randomly assigned to one of three groups: (i) HIT, n=19, 4 min at 100% AV, 4 min passive recovery, 4-6 bouts per session; (ii) SMIT, n=20, 30 s at 130% AV, 150 s passive recovery, 7-12 bouts per session; and (iii) control group, n=16, 30 min continuous running at 75% AV. Groups trained three times per week for six weeks. When time to complete each test were compared among groups: (i) improvements in 3000 m time trial performance were greater following SMIT than continuous running, and (ii) improvements in 40 m sprint and RSA performance were greater following SMIT than HIT and continuous running. In addition, a gender effect was observed for the 3000 m time trial only, where females changed more following the training intervention than males. In summary, for concurrent improvements in endurance, sprint and repeated sprint performance, SMIT provides the greatest benefits for physically active individuals.

Improved neurocognitive test performance in both arms of the SMART study: impact of practice effect

PubMed Central

Grund, Birgit; Wright, Edwina J.; Brew, Bruce J.; Price, Richard W.; Roediger, Mollie P.; Bain, Margaret P.; Hoy, Jennifer F.; Shlay, Judith C.; Vjecha, Michael J.; Robertson, Kevin R.

2013-01-01

We evaluated factors associated with improvement in neurocognitive performance in 258 HIV-infected adults with baseline CD4 lymphocyte counts above 350 cells/mm3 randomized to intermittent, CD4-guided antiretroviral therapy (ART) (128 participants) versus continuous therapy (130) in the Neurology substudy of the Strategies for Management of Antiretroviral Therapy trial. Participants were enrolled in Australia, North America, Brazil, and Thailand, and neurocognitive performance was assessed by a five-test battery at baseline and month 6. The primary outcome was change in the quantitative neurocognitive performance z score (QNPZ-5), the average of the z scores of the five tests. Associations of the 6-month change in test scores with ART use, CD4 cell counts, HIV RNA levels, and other factors were determined using multiple regression models. At baseline, median age was 40 years, median CD4 cell count was 513 cells/mm3, 88 % had plasma HIV RNA ≤400 copies/mL, and mean QNPZ-5 was −0.68. Neurocognitive performance improved in both treatment groups by 6 months; QNPZ-5 scores increased by 0.20 and 0.13 in the intermittent and continuous ART groups, respectively (both P<0.001 for increase and P=0.26 for difference). ART was used on average for 3.6 and 5.9 out of the 6 months in the intermittent and continuous ART groups, respectively, but the increase in neurocognitive test scores could not be explained by ART use, changes in CD4, or plasma HIV RNA, which suggests a practice effect. The impact of a practice effect after 6 months emphasizes the need for a control group in HIV studies that measure intervention effects using neurocognitive tests similar to ours. PMID:23943468

Personal Development Plans: Insights from a Case Based Approach

ERIC Educational Resources Information Center

Greenan, Peter

2016-01-01

Purpose: In light of contemporary shifts away from annual appraisals, this study aims to explore the implications of using a personal development plan (PDP) as a means of focussing on continuous feedback and development to improve individual performance and ultimately organisational performance. Design/methodology/approach: Data were collected…

Using ROI to Demonstrate Performance Value in the Public Sector

ERIC Educational Resources Information Center

Phillips, Jack J.; Phillips, Patti

2009-01-01

The demand for accountability through measurement continues to increase. Although much progress has been made, it remains an issue that challenges even the most sophisticated and progressive performance improvement function. This article provides an overview of best practices in the return-on-investment process and describes how applying these…

Adaptive proximate time-optimal servomechanisms - Continuous time case

NASA Technical Reports Server (NTRS)

Workman, M. L.; Kosut, R. L.; Franklin, G. F.

1987-01-01

A Proximate Time-Optimal Servo (PTOS) is developed, along with conditions for its stability. An algorithm is proposed for adapting the PTOS (APTOS) to improve performance in the face of uncertain plant parameters. Under ideal conditions APTOS is shown to be uniformly asymptotically stable. Simulation results demonstrate the predicted performance.

Development of Key Performance Indicators for the Engineering Technology Education Programs in Taiwan

ERIC Educational Resources Information Center

Lee, Lung-Sheng; Lai, Chun-Chin

2004-01-01

In comparison with engineering, engineering technology is more practical and purposeful. The engineering technology education programs in Taiwan have been mainly offered in 56 universities/colleges of technology (UTs/CTs) and are anticipated to continuously improve their performance to prepare quality engineering technologists. However, it is…

Procedural Memory Consolidation in the Performance of Brief Keyboard Sequences

ERIC Educational Resources Information Center

Duke, Robert A.; Davis, Carla M.

2006-01-01

Using two sequential key press sequences, we tested the extent to which subjects' performance on a digital piano keyboard changed between the end of training and retest on subsequent days. We found consistent, significant improvements attributable to sleep-based consolidation effects, indicating that learning continued after the cessation of…

The Mediating Effect of Kaizen between Total Quality Management (TQM) and Business Performance

NASA Astrophysics Data System (ADS)

Shan, Ang Wei; Fauzi Ahmad, Mohd; Hisyamudin Muhd Nor, Nik

2016-11-01

Every customer preference is different but yet important. The global market is shifting rapidly, organizations are needed to continuously identify new opportunity to obtain competitive advantages. Literature suggested that manufacturing companies are needed to differentiate themselves through emphasize on quality and continuous improvement in product and services as a crucial part to secure and success in the future. The Total Quality Management (TQM) practices has developed a strong bearing on growth and competitiveness in market. Therefore, a proper continuous improvement (Kaizen) practice is needed to eliminate waste and value added in production to remain competitiveness and retained the potential customer. However, based on the previous study it had indicated an inconsistent result between TQM and BP. Besides that, researcher also less emphasized on mediator in previous work. Therefore, the purpose of this paper is to recommend the relationship between TQM and business performance with a mediator's effect of Kaizen. This proposed model attempt to create knowledge to both academician and company players to acquire a better understanding among the TQM and Kaizen practices. Consequently, the Structural Equation Modelling (SEM) techniques is applying to identify and evaluate the relationship among TQM, Kaizen, and business performance in developing a new TQM model.

Talking about the Automobile Braking System

NASA Astrophysics Data System (ADS)

Xu, Zhiqiang

2017-12-01

With the continuous progress of society, the continuous development of the times, people’s living standards continue to improve, people continue to improve the pursuit. With the rapid development of automobile manufacturing, the car will be all over the tens of thousands of households, the increase in car traffic, a direct result of the incidence of traffic accidents. Brake system is the guarantee of the safety of the car, its technical condition is good or bad, directly affect the operational safety and transportation efficiency, so the brake system is absolutely reliable. The requirements of the car on the braking system is to have a certain braking force to ensure reliable work in all cases, light and flexible operation. Normal braking should be good performance, in addition to a foot sensitive, the emergency brake four rounds can not be too long, not partial, not ring.

A performance evaluation model for the Stock Point Logistics Integrated Communication Environment (SPLICE)

NASA Astrophysics Data System (ADS)

Schmidt, J. B.

1985-09-01

This thesis investigates ways of improving the real-time performance of the Stockpoint Logistics Integrated Communication Environment (SPLICE). Performance evaluation through continuous monitoring activities and performance studies are the principle vehicles discussed. The method for implementing this performance evaluation process is the measurement of predefined performance indexes. Performance indexes for SPLICE are offered that would measure these areas. Existing SPLICE capability to carry out performance evaluation is explored, and recommendations are made to enhance that capability.

Status of molten carbonate fuel cell technology development

NASA Astrophysics Data System (ADS)

Parsons, E. L., Jr.; Williams, M. C.; George, T. J.

The MCFC technology has been identified by the DOE as a promising product for commercialization. Development of the MCFC technology supports the National Energy Strategy. Review of the status of the MCFC technology indicates that the MCFC technology developers are making rapid and significant progress. Manufacturing facility development and extensive testing is occurring. Improvements in performance (power density), lower costs, improved packaging, and scale up to full height are planned. MCFC developers need to continue to be responsive to end-users in potential markets. It will be market demands for the correct product definition which will ultimately determine the character of MCFC power plants. There is a need for continued MCFC product improvement and multiple product development tests.

Participatory design in lean production: which contribution from employees? For what end?

PubMed

Perez Toralla, M S; Falzon, P; Morais, A

2012-01-01

The proponents of lean production have pointed to the positive effects of the work organization on employees in terms of autonomy, enhanced skills and empowerment mainly by their participation into the continuous improvement of work process. But studies that have examined this issue suggest that the increase in autonomy is not sufficient to compensate for increases work intensity. Participatory design has grown extensively in manufacturing since the 1980's under the impulsion of the Scandinavian socio-technical system approach and it's central in the model of lean production performance. Its main objectives are to improve quality, increase productivity and safety through employee's participation to the reduction of non-value added activities, such as defined by lean production. In the line of the studies on participatory design and continuous improvement the present study examines the functioning of work groups, based on the kaizen model, the aim of which was to improve the proportion of "value-added activities" and working conditions, essentially physical constraints. The main results are consistent with the literature and show that accelerated forms of re-conception activities give employees limited room for maneuver to elaborate solutions based on the analysis of the real activity. This study is part of a broader initiative that goes in the direction of continuous improvement of the design process itself so that it integrates the real constraints of work and propose changes bases on work as it actually takes place, beyond pre-established performance goals bases on the reduction of "non added value activities".

Gaining customer knowledge: obtaining and using customer judgments for hospitalwide quality improvement.

PubMed

Nelson, E C; Caldwell, C; Quinn, D; Rose, R

1991-03-01

Customer knowledge is an essential feature of hospitalwide quality improvement. All systems and processes have customers. The aim is to use customer knowledge and voice of the customer measurement to plan, design, improve, and monitor these systems and processes continuously. In this way, the hospital stands the best chance of meeting customers' needs and, hopefully, delivering services that are so outstanding that customers will be surprised and delighted. There are many methods, both soft and hard, that can be used to increase customer knowledge. One useful strategy is to use a family of quality measures that reflect the voice of the customer. These measures can generate practical and powerful customer knowledge information that is essential to performing strategic planning, deploying quality policy, designing new services, finding targets for improvements, and monitoring those continuous improvements based on customers' judgments.

Development of Plant Control Diagnosis Technology and Increasing Its Applications

NASA Astrophysics Data System (ADS)

Kugemoto, Hidekazu; Yoshimura, Satoshi; Hashizume, Satoru; Kageyama, Takashi; Yamamoto, Toru

A plant control diagnosis technology was developed to improve the performance of plant-wide control and maintain high productivity of plants. The control performance diagnosis system containing this technology picks out the poor performance loop, analyzes the cause, and outputs the result on the Web page. Meanwhile, the PID tuning tool is used to tune extracted loops from the control performance diagnosis system. It has an advantage of tuning safely without process changes. These systems are powerful tools to do Kaizen (continuous improvement efforts) step by step, coordinating with the operator. This paper describes a practical technique regarding the diagnosis system and its industrial applications.

Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery.

PubMed

Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke

2015-12-01

Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

Preformed amide-containing biopolymer for improving the environmental performance of synthesized urea–formaldehyde in agro-fiber composites

Treesearch

Altaf H. Basta; Houssni El-Saied; Jerrold E. Winandy; Ronald Sabo

2011-01-01

Investigations have continued for production high performance agro-based composites using environmentally acceptable approaches. This study examines the role of adding amide-containing biopolymers during synthesis of urea–formaldehyde (UF) on properties of adhesive produced, especially its adhesion potential. The environmental performance of UF-resin synthesized in the...

Improving indoor air quality through the use of continual multipoint monitoring of carbon dioxide and dew point.

PubMed

Bearg, D W

1998-09-01

This article summarizes an approach for improving the indoor air quality (IAQ) in a building by providing feedback on the performance of the ventilation system. The delivery of adequate quantities of ventilation to all building occupants is necessary for the achievement of good IAQ. Feedback on the performance includes information on the adequacy of ventilation provided, the effectiveness of the distribution of this air, the adequacy of the duration of operation of the ventilation system, and the identification of leakage into the return plenum, either of outdoor or supply air. Keeping track of ventilation system performance is important not only in terms of maintaining good IAQ, but also making sure that this system continues to perform as intended after changes in building use. Information on the performance of the ventilation system is achieved by means of an automated sampling system that draws air from multiple locations and delivers it to both a carbon dioxide monitor and dew point sensor. The use of single shared sensors facilitates calibration checks as well as helps to guarantee data integrity. This approach to monitoring a building's ventilation system offers the possibility of achieving sustainable performance of this important aspect of good IAQ.

42 CFR 460.140 - Additional quality assessment activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) Quality Assessment and Performance Improvement § 460.140 Additional quality...

Significant accomplishments, 2009

DOT National Transportation Integrated Search

2009-01-01

BTS data is vital to improve transportation decision : making, as well as evaluations of performance and : what works in the nations transportation systems. : As BTS continues its course of producing relevant, : accurate, and timely transpor...

A Prototype Tool to Enable Farmers to Measure and Improve the Welfare Performance of the Farm Animal Enterprise: The Unified Field Index

PubMed Central

Colditz, Ian G.; Ferguson, Drewe M.; Collins, Teresa; Matthews, Lindsay; Hemsworth, Paul H.

2014-01-01

Simple Summary Benchmarking is a tool widely used in agricultural industries that harnesses the experience of farmers to generate knowledge of practices that lead to better on-farm productivity and performance. We propose, by analogy with production performance, a method for measuring the animal welfare performance of an enterprise and describe a tool for farmers to monitor and improve the animal welfare performance of their business. A general framework is outlined for assessing and monitoring risks to animal welfare based on measures of animals, the environment they are kept in and how they are managed. The tool would enable farmers to continually improve animal welfare. Abstract Schemes for the assessment of farm animal welfare and assurance of welfare standards have proliferated in recent years. An acknowledged short-coming has been the lack of impact of these schemes on the welfare standards achieved on farm due in part to sociological factors concerning their implementation. Here we propose the concept of welfare performance based on a broad set of performance attributes of an enterprise and describe a tool based on risk assessment and benchmarking methods for measuring and managing welfare performance. The tool termed the Unified Field Index is presented in a general form comprising three modules addressing animal, resource, and management factors. Domains within these modules accommodate the principle conceptual perspectives for welfare assessment: biological functioning; emotional states; and naturalness. Pan-enterprise analysis in any livestock sector could be used to benchmark welfare performance of individual enterprises and also provide statistics of welfare performance for the livestock sector. An advantage of this concept of welfare performance is its use of continuous scales of measurement rather than traditional pass/fail measures. Through the feedback provided via benchmarking, the tool should help farmers better engage in on-going improvement of farm practices that affect animal welfare. PMID:26480317

EGU2013 SM1.4/GI1.6 session: "Improving seismic networks performances: from site selection to data integration"

NASA Astrophysics Data System (ADS)

Pesaresi, D.; Busby, R.

2013-08-01

The number and quality of seismic stations and networks in Europe continually improves, nevertheless there is always scope to optimize their performance. In this session we welcomed contributions from all aspects of seismic network installation, operation and management. This includes site selection; equipment testing and installation; planning and implementing communication paths; policies for redundancy in data acquisition, processing and archiving; and integration of different datasets including GPS and OBS.

Why small and medium chemical companies continue to pose severe environmental risks in rural China.

PubMed

He, Guizhen; Zhang, Lei; Mol, Arthur P J; Wang, Tieyu; Lu, Yonglong

2014-02-01

In China, rural chemical SMEs are often believed to still largely operate below the sustainability radar. This paper investigates to what extent and how chemical SMEs are already experiencing pressure to improve their environmental performance, using an in-depth case study in Jasmine County, Hebei province. The results show that local residents had rather low trust in the environmental improvement promises made by the enterprises and the local government, and disagreed with the proposed improvement plans. Although the power of local residents to influence decision making remained limited, the chemical SMEs started to feel increasing pressures to clean up their business, from governments, local communities and civil society, and international value chain stakeholders. Notwithstanding these mounting pressures chemical SME's environmental behavior and performance has not changed radically for the better. The strong economic ties between local county governments and chemical SMEs continue to be a major barrier for stringent environmental regulation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Improved Low Temperature Performance of Supercapacitors

NASA Technical Reports Server (NTRS)

Brandon, Erik J.; West, William C.; Smart, Marshall C.; Gnanaraj, Joe

2013-01-01

Low temperature double-layer capacitor operation enabled by: - Base acetonitrile / TEATFB salt formulation - Addition of low melting point formates, esters and cyclic ethers center dot Key electrolyte design factors: - Volume of co-solvent - Concentration of salt center dot Capacity increased through higher capacity electrodes: - Zeolite templated carbons - Asymmetric cell designs center dot Continuing efforts - Improve asymmetric cell performance at low temperature - Cycle life testing Motivation center dot Benchmark performance of commercial cells center dot Approaches for designing low temperature systems - Symmetric cells (activated carbon electrodes) - Symmetric cells (zeolite templated carbon electrodes) - Asymmetric cells (lithium titanate/activated carbon electrodes) center dot Experimental results center dot Summary

Experimental investigation of control/display augmentation effects in a compensatory tracking task

NASA Technical Reports Server (NTRS)

Garg, Sanjay; Schmidt, David K.

1988-01-01

The effects of control/display augmentation on human performance and workload have been investigated for closed-loop, continuous-tracking tasks by a real-time, man-in-the-loop simulation study. The experimental results obtained indicate that only limited improvement in actual tracking performance is obtainable through display augmentation alone; with a very high level of display augmentation, tracking error will actually deteriorate. Tracking performance improves when status information is furnished for reasonable levels of display quickening; again, very high quickening levels lead to tracking error deterioration due to the incompatibility between the status information and the quickened signal.

Improving Service Delivery in a County Health Department WIC Clinic: An Application of Statistical Process Control Techniques

PubMed Central

Boe, Debra Thingstad; Parsons, Helen

2009-01-01

Local public health agencies are challenged to continually improve service delivery, yet they frequently operate with constrained resources. Quality improvement methods and techniques such as statistical process control are commonly used in other industries, and they have recently been proposed as a means of improving service delivery and performance in public health settings. We analyzed a quality improvement project undertaken at a local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic to reduce waiting times and improve client satisfaction with a walk-in nutrition education service. We used statistical process control techniques to evaluate initial process performance, implement an intervention, and assess process improvements. We found that implementation of these techniques significantly reduced waiting time and improved clients' satisfaction with the WIC service. PMID:19608964

Quality management of human resources. Providers should begin by focusing on education, performance management, and reward systems.

PubMed

Blair, C S; Fordyce, M; Barney, S M

1993-10-01

For a quality management transformation to occur, a healthcare organization must focus on education and development, performance management, and recognition and reward systems during the first years of implementation. Education and development are perhaps the most important human resource management functions when implementing quality management principles and processes because behavioral changes will be required at all organizational levels. Specific programs that support an organization's quality management effort will vary but should include the conceptual, cultural, and technical aspects of quality management. The essence of quality management is to always satisfy the customer and to continuously improve the services and products the organization offers. The approach to performance management should therefore rely on customer feedback and satisfaction. An organization committed to quality management should base its performance management approach on customer orientation, process improvement, employee involvement, decision making with data, and continuous improvement. Managers and trustees are being challenged to provide innovative recognition and reward systems that reinforce the values and behaviors consistent with quality management. Such systems must also be aligned with the behaviors and outcomes that support the philosophy, mission, and values of the Catholic healthcare ministry. The following components should be considered for a recognition and reward system: base pay, incentives, benefits, and nonmonetary rewards.

Year End Progress Report on Rattlesnake Improvements

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

Wang, Yaqi; DeHart, Mark David; Gleicher, Frederick Nathan

Rattlesnake is a MOOSE-based radiation transport application developed at INL to support modern multi-physics simulations. At the beginning of the last year, Rattlesnake was able to perform steady-state, transient and eigenvalue calculations for the multigroup radiation transport equations. Various discretization schemes, including continuous finite element method (FEM) with discrete ordinates method (SN) and spherical harmonics expansion method (PN) for the self-adjoint angular flux (SAAF) formulation, continuous FEM (CFEM) with SN for the least square (LS) formulation, diffusion approximation with CFEM and discontinuous FEM (DFEM), have been implemented. A separate toolkit, YAKXS, for multigroup cross section management was developed to supportmore » Rattlesnake calculations with feedback both from changes in the field variables, such as fuel temperature, coolant density, and etc., and in isotope inventory. The framework for doing nonlinear diffusion acceleration (NDA) within Rattlesnake has been set up, and both NDA calculations with SAAF-SN-CFEM scheme and Monte Carlo with OpenMC have been performed. It was also used for coupling BISON and RELAP-7 for the full-core multiphysics simulations. Within the last fiscal year, significant improvements have been made in Rattlesnake. Rattlesnake development was migrated into our internal GITLAB development environment at the end of year 2014. Since then total 369 merge requests has been accepted into Rattlesnake. It is noted that the MOOSE framework that Rattlesnake is based on is under continuous developments. Improvements made in MOOSE can improve the Rattlesnake. It is acknowledged that MOOSE developers spent efforts on patching Rattlesnake for the improvements made on the framework side. This report will not cover the code restructuring for better readability and modularity and documentation improvements, which we have spent tremendous effort on. It only details some of improvements in the following sections.« less

Year in review : 2005.

DOT National Transportation Integrated Search

2006-01-01

Improving the productivity and mobility of the national highway transportation system are : key goals of the Federal Highway Administration (FHWA). During 2005, FHWAs : Long-Term Pavement Performance (LTPP) program continued to work toward these g...

Strength training for athletes: does it really help sports performance?

PubMed

McGuigan, Michael R; Wright, Glenn A; Fleck, Steven J

2012-03-01

The use of strength training designed to increase underlying strength and power qualities in elite athletes in an attempt to improve athletic performance is commonplace. Although the extent to which strength and power are important to sports performance may vary depending on the activity, the associations between these qualities and performance have been well documented in the literature. The purpose of this review is to provide a brief overview of strength training research to determine if it really helps improve athletic performance. While there is a need for more research with elite athletes to investigate the relationship between strength training and athletic performance, there is sufficient evidence for strength training programs to continue to be an integral part of athletic preparation in team sports.

Randomised prospective parallel trial of therapeutic versus subtherapeutic nasal continuous positive airway pressure on simulated steering performance in patients with obstructive sleep apnoea

PubMed Central

Hack, M.; Davies, R.; Mullins, R.; Choi, S. J.; Ramdassingh-Dow, S.; Jenkinson, C.; Stradling, J.

2000-01-01

BACKGROUND—Obstructive sleep apnoea (OSA) impairs vigilance and may lead to an increased rate of driving accidents. In uncontrolled studies accident rates and simulated steering performance improve following treatment with nasal continuous positive airway pressure (NCPAP). This study seeks to confirm the improvement in steering performance in a randomised controlled trial using subtherapeutic NCPAP as a control treatment.
METHODS—Fifty nine men with OSA (Epworth Sleepiness Score (ESS) of ⩾10, and ⩾10/h dips in SaO2 of >4% due to OSA) received therapeutic or subtherapeutic NCPAP (≈1 cm H2O) for one month. Simulated steering performance over three 30-minute "drives" was quantified as: standard deviation (SD) of road position, deterioration in SD across the drive, length of drive before "crashing", and number of off-road events. The reaction times to peripheral target stimuli during the drive were also measured.
RESULTS—Subtherapeutic NCPAP did not improve overnight >4% SaO2 dips/h compared with baseline values, thus acting as a control. The SD of the steering position improved from 0.36 to 0.21 on therapeutic NCPAP, and from 0.35 to 0.30 on subtherapeutic NCPAP (p = 0.03). Deterioration in SD of the steering position improved from 0.18to 0.06 SD/h with therapeutic NCPAP and worsened from 0.18 to 0.24 with subtherapeutic NCPAP (p = 0.04). The reaction time to target stimuli was quicker after therapeutic than after subtherapeutic NCPAP (2.3 versus 2.7 seconds, p = 0.04).
CONCLUSIONS—Therapeutic NCPAP improves steering performance and reaction time to target stimuli in patients with OSA, lending further support to the hypothesis that OSA impairs driving, increases driving accident rates, and that these improve following treatment with NCPAP.

 PMID:10679542

A comprehensive approach for diagnosing opportunities for improving the performance of a WWTP.

PubMed

Silva, C; Matos, J Saldanha; Rosa, M J

2016-12-01

High quality services of wastewater treatment require a continuous assessment and improvement of the technical, environmental and economic performance. This paper demonstrates a comprehensive approach for benchmarking wastewater treatment plants (WWTPs), using performance indicators (PIs) and indices (PXs), in a 'plan-do-check-act' cycle routine driven by objectives. The performance objectives herein illustrated were to diagnose the effectiveness and energy performance of an oxidation ditch WWTP. The PI and PX results demonstrated an effective and reliable oxidation ditch (good-excellent performance), and a non-reliable UV disinfection (unsatisfactory-excellent performance) related with influent transmittance and total suspended solids. The energy performance increased with the treated wastewater volume and was unsatisfactory below 50% of plant capacity utilization. The oxidation ditch aeration performed unsatisfactorily and represented 38% of the plant energy consumption. The results allowed diagnosing opportunities for improving the energy and economic performance considering the influent flows, temperature and concentrations, and for levering the WWTP performance to acceptable-good effectiveness, reliability and energy efficiency. Regarding the plant reliability for fecal coliforms, improvement of UV lamp maintenance and optimization of the UV dose applied and microscreen recommissioning were suggested.

A business case for quality improvement in addiction treatment: evidence from the NIATx collaborative.

PubMed

Quanbeck, Andrew R; Madden, Lynn; Edmundson, Eldon; Ford, James H; McConnell, K John; McCarty, Dennis; Gustafson, David H

2012-01-01

The Network for the Improvement of Addiction Treatment (NIATx) promotes treatment access and retention through a customer-focused quality improvement model. This paper explores the issue of the "business case" for quality improvement in addiction treatment from the provider's perspective. The business case model developed in this paper is based on case examples of early NIATx participants coupled with a review of the literature. Process inefficiencies indicated by long waiting times, high no-show rates, and low continuation rates cause underutilization of capacity and prevent optimal financial performance. By adopting customer-focused practices aimed at removing barriers to treatment access and retention, providers may be able to improve financial performance, increase staff retention, and gain long-term strategic advantage.

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

A Program Manager's Guide for Program Improvement in Ongoing Psychological Health and Traumatic Brain Injury Programs.

PubMed

Ryan, Gery W; Farmer, Carrie M; Adamson, David M; Weinick, Robin M

2014-01-01

Between 2001 and 2011, the U.S. Department of Defense has implemented numerous programs to support service members and their families in coping with the stressors from a decade of the longstanding conflicts in Iraq and Afghanistan. These programs, which address both psychological health and traumatic brain injury (TBI), number in the hundreds and vary in their size, scope, and target population. To ensure that resources are wisely invested and maximize the benefits of such programs, RAND developed a tool to help assess program performance, consider options for improvement, implement solutions, then assess whether the changes worked, with the intention of helping those responsible for managing or implementing programs to conduct assessments of how well the program is performing and to implement solutions for improving performance. Specifically, the tool is intended to provide practical guidance in program improvement and continuous quality improvement for all programs.

Kaiser Permanente's performance improvement system, Part 1: From benchmarking to executing on strategic priorities.

PubMed

Schilling, Lisa; Chase, Alide; Kehrli, Sommer; Liu, Amy Y; Stiefel, Matt; Brentari, Ruth

2010-11-01

By 2004, senior leaders at Kaiser Permanente, the largest not-for-profit health plan in the United States, recognizing variations across service areas in quality, safety, service, and efficiency, began developing a performance improvement (PI) system to realizing best-in-class quality performance across all 35 medical centers. MEASURING SYSTEMWIDE PERFORMANCE: In 2005, a Web-based data dashboard, "Big Q," which tracks the performance of each medical center and service area against external benchmarks and internal goals, was created. PLANNING FOR PI AND BENCHMARKING PERFORMANCE: In 2006, Kaiser Permanente national and regional continued planning the PI system, and in 2007, quality, medical group, operations, and information technology leaders benchmarked five high-performing organizations to identify capabilities required to achieve consistent best-in-class organizational performance. THE PI SYSTEM: The PI system addresses the six capabilities: leadership priority setting, a systems approach to improvement, measurement capability, a learning organization, improvement capacity, and a culture of improvement. PI "deep experts" (mentors) consult with national, regional, and local leaders, and more than 500 improvement advisors are trained to manage portfolios of 90-120 day improvement initiatives at medical centers. Between the second quarter of 2008 and the first quarter of 2009, performance across all Kaiser Permanente medical centers improved on the Big Q metrics. The lessons learned in implementing and sustaining PI as it becomes fully integrated into all levels of Kaiser Permanente can be generalized to other health care systems, hospitals, and other health care organizations.

High Intensity Interval Training in Handcycling: The Effects of a 7 Week Training Intervention in Able-bodied Men

PubMed Central

Schoenmakers, Patrick; Reed, Kate; Van Der Woude, Luc; Hettinga, Florentina J.

2016-01-01

Introduction: In lower body endurance training, quantities of both moderate intensity continuous training (MICT) and high intensity interval training (HIIT) can lead to an improved physiological capacity and performance. Limited research is available regarding the endurance and muscular capacity of the upper body, and how training contributes to improvements in performance capacity is still unknown. The aim of the current study was to evaluate the effects of HIIT and MICT on the physiological capacity and handcycling performance of able-bodied men in a well-controlled laboratory setting. Methods: Twenty four recreationally active men (22 ± 2 years; 1.84 ± 0.04 m; 79 ± 10 kg) were matched on incremental handcycling pre-test performance (peakPO) and then randomly assigned to HIIT, MICT, or a non-training control group (CON, 3 × n = 8). Participants in HIIT completed 14 interval training sessions, performing 4 × 4 min intervals at 85% heart rate reserve (%HRR), and seven continuous training sessions at 55 %HRR (every 2nd training session of the week). Participants in MICT performed 21 training sessions of 30 min at 55 %HRR. After the intervention, changes in peak oxygen uptake (peakVO2) and peak power output (peakPO) were compared within and between HIIT, MICT and CON. Results: The average external training load per training session did not differ between MICT and HIIT (p = 0.713). Improvements after HIIT in peakVO2 (22.2 ± 8.1%) and peakPO (47.1 ± 20.7%) were significantly larger compared with MICT and CON (p < 0.001). Improvements after MICT in peakVO2 (10.7 ± 12.9%) and peakPO (32.2 ± 8.1%) were higher compared to CON (p < 0.001). Higher improvement after HIIT occurred despite training 22% less time than MICT. No significant changes were found in CON. Discussion: As in lower body endurance sports, HIIT proved to be very effective in improving the physiological and performance capacity of upper body exercise. Whilst physiological capacity in both training groups improved significantly compared with CON, the present study shows that peakVO2 and peakPO improved more after HIIT than after MICT in able-bodied men. It is advised to include HIIT into training regimes of recreational and competitive handcyclists to improve the upper body endurance capacity. PMID:28066268

High Intensity Interval Training in Handcycling: The Effects of a 7 Week Training Intervention in Able-bodied Men.

PubMed

Schoenmakers, Patrick; Reed, Kate; Van Der Woude, Luc; Hettinga, Florentina J

2016-01-01

Introduction: In lower body endurance training, quantities of both moderate intensity continuous training (MICT) and high intensity interval training (HIIT) can lead to an improved physiological capacity and performance. Limited research is available regarding the endurance and muscular capacity of the upper body, and how training contributes to improvements in performance capacity is still unknown. The aim of the current study was to evaluate the effects of HIIT and MICT on the physiological capacity and handcycling performance of able-bodied men in a well-controlled laboratory setting. Methods: Twenty four recreationally active men (22 ± 2 years; 1.84 ± 0.04 m; 79 ± 10 kg) were matched on incremental handcycling pre-test performance (peakPO) and then randomly assigned to HIIT, MICT, or a non-training control group (CON, 3 × n = 8). Participants in HIIT completed 14 interval training sessions, performing 4 × 4 min intervals at 85% heart rate reserve (%HRR), and seven continuous training sessions at 55 %HRR (every 2nd training session of the week). Participants in MICT performed 21 training sessions of 30 min at 55 %HRR. After the intervention, changes in peak oxygen uptake (peakVO 2 ) and peak power output (peakPO) were compared within and between HIIT, MICT and CON. Results: The average external training load per training session did not differ between MICT and HIIT ( p = 0.713). Improvements after HIIT in peakVO 2 (22.2 ± 8.1%) and peakPO (47.1 ± 20.7%) were significantly larger compared with MICT and CON ( p < 0.001). Improvements after MICT in peakVO 2 (10.7 ± 12.9%) and peakPO (32.2 ± 8.1%) were higher compared to CON ( p < 0.001). Higher improvement after HIIT occurred despite training 22% less time than MICT. No significant changes were found in CON. Discussion: As in lower body endurance sports, HIIT proved to be very effective in improving the physiological and performance capacity of upper body exercise. Whilst physiological capacity in both training groups improved significantly compared with CON, the present study shows that peakVO 2 and peakPO improved more after HIIT than after MICT in able-bodied men. It is advised to include HIIT into training regimes of recreational and competitive handcyclists to improve the upper body endurance capacity.

Improving the Audio Game-Playing Performances of People with Visual Impairments through Multimodal Training

ERIC Educational Resources Information Center

Balan, Oana; Moldoveanu, Alin; Moldoveanu, Florica; Nagy, Hunor; Wersenyi, Gyorgy; Unnporsson, Runar

2017-01-01

Introduction: As the number of people with visual impairments (that is, those who are blind or have low vision) is continuously increasing, rehabilitation and engineering researchers have identified the need to design sensory-substitution devices that would offer assistance and guidance to these people for performing navigational tasks. Auditory…

Human Factors Tools for Improving Simulation Activities in Continuing Medical Education

ERIC Educational Resources Information Center

Seagull, F. Jacob

2012-01-01

Human factors (HF) is a discipline often drawn upon when there is a need to train people to perform complex, high-stakes tasks and effectively assess their performance. Complex tasks often present unique challenges for training and assessment. HF has developed specialized techniques that have been effective in overcoming several of these…

Effect of Teaching Races for Understanding in Youth Sailing on Performance, Knowledge, and Adherence

ERIC Educational Resources Information Center

Morales-Belando, María Trinidad; Arias-Estero, José L.

2017-01-01

Purpose: The purpose of this study was to know whether an intervention using an adaptation of the teaching games for understanding approach (named teaching races for understanding [TRfU]) led participants to improve skill execution, decision making, race performance, race involvement, race knowledge, enjoyment, intention to continue practicing…

Development of a 10 Ah, Prismatic, Lithium-Ion Cell for NASA/GSFC

NASA Technical Reports Server (NTRS)

Stein, Brian; Baker, John W.; George, Douglas S.; Isaacs, Nathan D.; Shah, Pinakin M.; Rao, Gopalakrishna M.; Day, John H. (Technical Monitor)

2001-01-01

MSA's 10 Ah Li-ion cell is a rugged design suitable for the stringent requirements of aerospace applications. Eighteen cells demonstrate consistent cycling performance over a wide range of rates and temperatures. The cell passes qualification requirements for vibration survivability technology improvements at MSA continue to enhance cell performance.

The Relevance of the Alliance for CME Competencies for Planning, Organizing, and Sustaining an Interorganizational Educational Collaborative

ERIC Educational Resources Information Center

Balmer, Jann T.; Bellande, Bruce J.; Addleton, Robert L.; Havens, Carol S.

2011-01-01

The heightened demand for accountability, access, and quality performance from health care professionals has resulted in linkages between continuing education (CE), performance improvement (PI), and outcomes. CE health professionals must also expand their skills and abilities to design, implement, and measure CE activities consistent with these…

Workplace Literacy: Its Role in High Performance Organizations. ERIC Digest No. 158.

ERIC Educational Resources Information Center

Imel, Susan

In a high performance work organization (HPWO), employee basic skills are just one of many components. HPWOs feature the following: they have flatter organizational structures, have work done by teams of highly skilled workers, and have a focus on quality, customer service, and continuous improvement. The collaborative approach to workplace…

Balancing Risk? First Year Performing Arts Students' Experience of a Community Arts Event

ERIC Educational Resources Information Center

Hains-Wesson, Rachael; Campbell, Angela

2014-01-01

This study examines participants' responses to first year students' street performances as a non-placement work-integrated learning (WIL) activity over a two year period. The purpose of the study was to determine: (1) community perception, (2) continuous improvement, and (3) future needs. Data was collected through surveying participants'…

Schools: The Evidence on Academies, Resources and Pupil Performance. Paper No. EA023

ERIC Educational Resources Information Center

McNally, Sandra

2015-01-01

England's performance in international tests of student achievement continues to be disappointing. Further improvement is essential not only for students' themselves but also for economic growth. This briefing considers the impact of Academies, school spending and teacher quality. Research evidence suggests that it is right to protect school…

Early Boost and Slow Consolidation in Motor Skill Learning

ERIC Educational Resources Information Center

Hotermans, Christophe; Peigneux, Philippe; de Noordhout, Alain Maertens; Moonen, Gustave; Maquet, Pierre

2006-01-01

Motor skill learning is a dynamic process that continues covertly after training has ended and eventually leads to delayed increments in performance. Current theories suggest that this off-line improvement takes time and appears only after several hours. Here we show an early transient and short-lived boost in performance, emerging as early as…

Impact of Performance Improvement Continuing Medical Education on Cardiometabolic Risk Factor Control: The COSEHC Initiative

PubMed Central

Joyner, JaNae; Moore, Michael A.; Simmons, Debra R.; Forrest, Brian; Yu-Isenberg, Kristina; Piccione, Ron; Caton, Kirt; Lackland, Daniel T.; Ferrario, Carlos M.

2016-01-01

Introduction The Consortium for Southeastern Hypertension Control (COSEHC) implemented a study to assess benefits of a performance improvement continuing medical education (PI CME) activity focused on cardiometabolic risk factor management in primary care patients. Methods Using the plan-do-study-act (PDSA) model as the foundation, this PI CME activity aimed at improving practice gaps by integrating evidence-based clinical interventions, physician-patient education, processes of care, performance metrics, and patient outcomes. The PI CME intervention was implemented in a group of South Carolina physician practices, while a comparable physician practice group served as a control. Performance outcomes at 6 months included changes in patients’ cardiometabolic risk factor values and control rates from baseline. We also compared changes in diabetic, African American, the elderly (> 65 years), and female patient subpopulations and in patients with uncontrolled risk factors at baseline. Results Only women receiving health care by intervention physicians showed a statistical improvement in their cardiometabolic risk factors as evidenced by a −3.0 mg/dL and a −3.5 mg/dL decrease in mean LDL cholesterol and non-HDL cholesterol, respectively, and a −7.0 mg/dL decrease in LDL cholesterol among females with uncontrolled baseline LDL cholesterol values. No other statistical differences were found. Discussion These data demonstrate that our PI CME activity is a useful strategy in assisting physicians to improve their management of cardiometabolic control rates in female patients with abnormal cholesterol control. Other studies that extend across longer PI CME PDSA periods may be needed to demonstrate statistical improvements in overall cardiometabolic treatment goals in men, women, and various subpopulations. PMID:24648361

Light-induced lattice expansion leads to high-efficiency perovskite solar cells

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

Tsai, Hsinhan; Asadpour, Reza; Blancon, Jean-Christophe

Hybrid-perovskite based high-performance optoelectronic devices and clues from their operation has led to the realization that light-induced structural dynamics play a vital role on their physical properties, device performance and stability. Here, we report that continuous light illumination leads to a uniform lattice expansion in hybrid perovskite thin-films, which is critical for obtaining high-efficiency photovoltaic devices. Correlated, in-situ structural and device characterizations reveal that light-induced lattice expansion significantly benefits the performances of a mixed-cation pure-halide planar device, boosting the power conversion efficiency from 18.5% to 20.5%. This is a direct consequence of the relaxation of local lattice strains during latticemore » expansion, which results in the reduction of the energetic barriers at the perovskite/contact interfaces in devices, thus improving the open circuit voltage and fill factor. The light-induced lattice expansion stabilizes these high-efficiency photovoltaic devices under continuous operation of full-spectrum 1-Sun illumination for over 1500 hours. One Sentence Summary: Light-induced lattice expansion improves crystallinity, relaxes lattice strain, which enhances photovoltaic performance in hybrid perovskite device.« less

Breakthrough: Better Fiber for Better Products

ScienceCinema

Griffith, George; Garnier, John

2018-01-08

Researchers at Idaho National Laboratory have developed a cost-effective method for the continuous production of alpha silicon carbide fiber. The exceptionally strong, lightweight fiber could enable significant performance improvements in many everyday products.

Assessment of S-NPP VIIRS On-Orbit Radiometric Calibration and Performance

NASA Technical Reports Server (NTRS)

Xiong, Xiaoxiong; Butler, James; Chiang, Kwofu; Efremova, Boryana; Fullbright, Jon; Lei, Ning; McIntire, Jeff; Oudrari, Hassan; Wang, Zhipeng; Wu, Aisheng

2016-01-01

The VIIRS instrument on board the S-NPP spacecraft has successfully operated for more than four years since its launch in October, 2011. Many VIIRS environmental data records (EDR) have been continuously generated from its sensor data records (SDR) with improved quality, enabling a wide range of applications in support of users in both the operational and research communities. This paper provides a brief review of sensor on-orbit calibration methodologies for both the reflective solar bands (RSB) and the thermal emissive bands (TEB) and an overall assessment of their on-orbit radiometric performance using measurements from instrument on-board calibrators (OBC) as well as regularly scheduled lunar observations. It describes and illustrates changes made and to be made for calibration and data quality improvements. Throughout the mission, all of the OBC have continued to operate and function normally, allowing critical calibration parameters used in the data production systems to be derived and updated. The temperatures of the on-board blackbody (BB) and the cold focal plane assemblies are controlled with excellent stability. Despite large optical throughput degradation discovered shortly after launch in several near and short-wave infrared spectral bands and strong wavelength dependent solar diffuser degradation, the VIIRS overall performance has continued to meet its design requirements. Also discussed in this paper are challenging issues identified and efforts to be made to further enhance the sensor calibration and characterization, thereby maintaining or improving data quality.

Variable Camber Continuous Aerodynamic Control Surfaces and Methods for Active Wing Shaping Control

NASA Technical Reports Server (NTRS)

Nguyen, Nhan T. (Inventor)

2016-01-01

An aerodynamic control apparatus for an air vehicle improves various aerodynamic performance metrics by employing multiple spanwise flap segments that jointly form a continuous or a piecewise continuous trailing edge to minimize drag induced by lift or vortices. At least one of the multiple spanwise flap segments includes a variable camber flap subsystem having multiple chordwise flap segments that may be independently actuated. Some embodiments also employ a continuous leading edge slat system that includes multiple spanwise slat segments, each of which has one or more chordwise slat segment. A method and an apparatus for implementing active control of a wing shape are also described and include the determination of desired lift distribution to determine the improved aerodynamic deflection of the wings. Flap deflections are determined and control signals are generated to actively control the wing shape to approximate the desired deflection.

Performance improvement CME for quality: challenges inherent to the process.

PubMed

Vakani, Farhan Saeed; O'Beirne, Ronan

2015-01-01

The purpose of this paper is to discuss the perspective debates upon the real-time challenges for a three-staged Performance Improvement Continuing Medical Education (PI-CME) model, an innovative and potential approach for future CME, to inform providers to think, prepare and to act proactively. In this discussion, the challenges associated for adopting the American Medical Association's three-staged PI-CME model are reported. Not many institutions in USA are using a three-staged performance improvement model and then customizing it to their own healthcare context for the specific targeted audience. They integrate traditional CME methods with performance and quality initiatives, and linking with CME credits. Overall the US health system is interested in a structured PI-CME model with the potential to improve physicians practicing behaviors. Knowing the dearth of evidence for applying this structured performance improvement methodology into the design of CME activities, and the lack of clarity on challenges inherent to the process that learners and providers encounter. This paper establishes all-important first step to render the set of challenges for a three-staged PI-CME model.

Reflective Thinking and Emotional Intelligence as Predictive Performance Factors in Problem-Based Learning Situations

ERIC Educational Resources Information Center

Mitchell-White, Kathleen

2010-01-01

Continued improvement of the training and preparation of Federal Bureau of Investigation (FBI) special agents is critical to the organization's ability to protect the national security of the United States. Too little attention has been paid to the factors that improve new agent trainees' (NATs) ability to learn and succeed in their training…

Improving the performance of a filling line based on simulation

NASA Astrophysics Data System (ADS)

Jasiulewicz-Kaczmarek, M.; Bartkowiak, T.

2016-08-01

The paper describes the method of improving performance of a filling line based on simulation. This study concerns a production line that is located in a manufacturing centre of a FMCG company. A discrete event simulation model was built using data provided by maintenance data acquisition system. Two types of failures were identified in the system and were approximated using continuous statistical distributions. The model was validated taking into consideration line performance measures. A brief Pareto analysis of line failures was conducted to identify potential areas of improvement. Two improvements scenarios were proposed and tested via simulation. The outcome of the simulations were the bases of financial analysis. NPV and ROI values were calculated taking into account depreciation, profits, losses, current CIT rate and inflation. A validated simulation model can be a useful tool in maintenance decision-making process.

Business Case Analysis: Continuous Integrated Logistics Support-Targeted Allowance Technique (CILS-TAT)

DTIC Science & Technology

2013-06-01

In this research, we examine the Naval Sea Logistics Command s Continuous Integrated Logistics Support Targeted Allowancing Technique (CILS TAT) and... the feasibility of program re-implementation. We conduct an analysis of this allowancing method s effectiveness onboard U.S. Navy Ballistic Missile...Defense (BMD) ships, measure the costs associated with performing a CILS TAT, and provide recommendations concerning possible improvements to the

Multifunctional Thermal Structures Using Cellular Contact-Aided Complaint Mechanisms

DTIC Science & Technology

2016-10-31

control . During this research effort, designs of increasing sophistication consistently outstripped the ability to fabricate them. Basic questions...using   non -­dimensional  models   In continuing design research , a topology optimization approach was crafted to maximize the thermal performance of the...methods could conceivably produce the elegant but complex material and geometric designs contemplated. Continued research is needed to improve the

Multifunctional Thermal Structures Using Cellular Contract-Aided Complaint Mechanisms

DTIC Science & Technology

2017-01-26

control . During this research effort, designs of increasing sophistication consistently outstripped the ability to fabricate them. Basic questions...using   non -­dimensional  models   In continuing design research , a topology optimization approach was crafted to maximize the thermal performance of the...methods could conceivably produce the elegant but complex material and geometric designs contemplated. Continued research is needed to improve the

An evaluation of continuous emissions monitoring systems for improving industrial boiler efficiency

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

Eckerlin, H.M.; Hall, R.C.

1996-12-31

An experimental evaluation of currently available continuous emissions monitoring systems has been conducted at an industrial boiler facility. The analyzers used in the study represented a range of sensors and sampling systems. The performance of three systems was monitored and compared over a six-month period. Careful records were also kept on installation, calibration and maintenance requirements. Research results suggest that (at present) the close-coupled extractive systems using a zirconium oxide sensor (for O{sub 2}) and a catalytic combustibles sensor (for CO/combustibles) offer the most reliable, trouble-free performance. The project also provided valuable insights on a variety of issues relating tomore » the continuous monitoring of emissions from industrial boilers.« less

An evaluation of continuous emissions monitoring systems for improving industrial boiler efficiency

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

Eckerlin, H.M.; Hall, R.C.

1996-05-01

An experimental evaluation of currently available continuous emissions monitoring systems has been conducted at an industrial boiler facility. The analyzers used in the study represented a range of sensors and sampling systems. The performance of three systems was monitored and compared over a six-month period. Careful records were also kept on installation, calibration and maintenance requirements. Research results suggest that (at present) the close-coupled extractive systems using a zirconium oxide sensor (for O{sub 2}) and a catalytic combustibles sensor (for CO/combustibles) offer the most reliable, trouble-free performance. The project also provided valuable insights on a variety of issues relating tomore » the continuous monitoring of emissions from industrial boilers.« less

Incorporating sprint training with endurance training improves anaerobic capacity and 2,000-m Erg performance in trained oarsmen.

PubMed

Stevens, Alexander W J; Olver, Terry T; Lemon, Peter W R

2015-01-01

A 2,000-m time-trial performance, aerobic capacity, and anaerobic capacity were assessed in 16 trained oarsmen after sprint interval training (SIT) replaced a portion of an endurance-based training program (EBTSIT) vs. an endurance-based program alone (EBTAlone). The EBTSIT involved 10 SIT sessions over 4 weeks, in addition to 12 continuous exercise sessions, 2 anaerobic threshold exercise sessions, and 4 strength training sessions. The EBTAlone consisted of 20 continuous, 6 anaerobic threshold, 2 interval exercise sessions, and 8 strength training sessions. Time-trial performance (2,000-m erg performance) improved with EBTSIT (baseline = 414.6 ± 18.5, post = 410.6 ± 17.5 seconds; p < 0.001) but only approached significance in EBTAlone (baseline = 413.0 ± 27.7, post = 411.4 ± 27.9 seconds; p = 0.06). In a 60-second "all-out" anaerobic capacity test, peak power output (PPO) increased significantly with EBTSIT (PPO: EBTSIT: baseline = 566 ± 82, post = 623 ± 60 W; p = 0.02) but not with EBTAlone (EBTAlone: baseline = 603 ± 81, post = 591 ± 123 W; p = 0.59). Changes in average power output (APO) also approached significance (p = 0.07) (APO: EBTSIT: baseline = 508 ± 48, post = 530 ± 52 W; EBTAlone: baseline = 532 ± 55, post = 533 ± 68 W). Neither group experienced any change in aerobic capacity ((Equation is included in full-text article.)or ventilatory threshold; p ≥ 0.16). We conclude that replacing a portion of EBT with SIT can improve both 2,000-m erg performance and anaerobic capacity, while maintaining aerobic fitness in trained oarsmen. Incorporating SIT within endurance training programs may be useful during periods of low-volume training, to improve performance without sacrificing aerobic capacity.

Task and work performance on Skylab missions 2, 3, and 4: Time and motion study: Experiment M151

NASA Technical Reports Server (NTRS)

Kubis, J. F.; Mclaughlin, E. J.; Jackson, J. M.; Rusnak, R.; Mcbride, G. H.; Saxon, S. V.

1977-01-01

Human task performance was evaluated under weightlessness conditions during long duration space flight in order to study the characteristics of the adaptation function. Results show that despite pronounced variability in training schedules and in initial reaction to the Skylab environment, in-flight task performance was relatively equivalent among Skylab crews, and behavioral performance continued to improve from beginning to end of all missions.

AMOLED (active matrix OLED) functionality and usable lifetime at temperature

NASA Astrophysics Data System (ADS)

Fellowes, David A.; Wood, Michael V.; Prache, Olivier; Jones, Susan

2005-05-01

Active Matrix Organic Light Emitting Diode (AMOLED) displays are known to exhibit high levels of performance, and these levels of performance have continually been improved over time with new materials and electronics design. eMagin Corporation developed a manually adjustable temperature compensation circuit with brightness control to allow for excellent performance over a wide temperature range. Night Vision and Electronic Sensors Directorate (US Army) tested the performance and survivability of a number of AMOLED displays in a temperature chamber over a range from -55°C to +85°C. Although device performance of AMOLEDs has always been its strong suit, the issue of usable display lifetimes for military applications continues to be an area of discussion and research. eMagin has made improvements in OLED materials and worked towards the development of a better understanding of usable lifetime for operation in a military system. NVESD ran luminance degradation tests of AMOLED panels at 50°C and at ambient to characterize the lifetime of AMOLED devices. The result is a better understanding of the applicability of AMOLEDs in military systems: where good fits are made, and where further development is needed.

Updated CCPS Investigation Guidelines book.

PubMed

Philley, J; Pearson, K; Sepeda, A

2003-11-14

Incident investigation standards and performance criteria continue to improve. In recognition, the Center for Chemical Process Safety (CCPS) undertook a major project to upgrade and update the Incident Investigation Guidelines originally published in 1992. These significantly expanded guidelines provide a practical resource for effective investigation of process-related incidents, and reflect changes in good practices and expectations of regulators. This paper highlights the content of the new guidelines with special emphasis on what is new and improved. Entirely new chapters address the topics of legal considerations, the near-miss event, and continuous improvement of the investigation system. The objective of the guidelines is to allow chemical process organizations to develop and implement an incident investigation management system that is effective in identifying underlying causes.

Improving the professionalism of post-certification teacher through academic supervision in vocational schools

NASA Astrophysics Data System (ADS)

Satyawati, Sophia Tri; Widyanto, I. Putu; Suemy

2017-03-01

This paper examines the principal's efforts in improving the professionalism of post-certification teachers through academic supervision in vocational school. The certification of educators is expected to improve the professionalism of teachers, there are significant changes between the before and after receiving the certificate of educators. One of the efforts made by the principal on increasing the professionalism of teachers is to carry out academic supervision completely and continuously. This paper examines about how principals at vocational schools carry out the programmed academic supervision, and continuing through mentoring, evaluation and coaching. Academic supervision is performed by individual supervision techniques which includes: classroom or practical visit, classroom or practical observation, individual meetings, inter-class or practical places visit, and self-assessment.

2016 American College of Rheumatology (ACR) - European League Against Rheumatism (EULAR) Criteria for Minimal, Moderate and Major Clinical Response for Juvenile Dermatomyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative

PubMed Central

Rider, Lisa G.; Aggarwal, Rohit; Pistorio, Angela; Bayat, Nastaran; Erman, Brian; Feldman, Brian M.; Huber, Adam M.; Cimaz, Rolando; Cuttica, Rubén J.; de Oliveira, Sheila Knupp; Lindsley, Carol B.; Pilkington, Clarissa A.; Punaro, Marilyn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen, Annet; Dressler, Frank; Magalhaes, Claudia Saad; Constantin, Tamás; Davidson, Joyce E.; Magnusson, Bo; Russo, Ricardo; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A.; Miller, Frederick W.; Vencovsky, Jiri; Ruperto, Nicolino

2017-01-01

Objective Develop response criteria for juvenile dermatomyositis (JDM). Methods We analyzed the performance of 312 definitions that used core set measures (CSM) from either the International Myositis Assessment and Clinical Studies Group (IMACS) or the Pediatric Rheumatology International Trials Organization (PRINTO) and were derived from natural history data and a conjoint-analysis survey. They were further validated in the PRINTO trial of prednisone alone compared to prednisone with methotrexate or cyclosporine and the Rituximab in Myositis trial. Experts considered 14 top-performing candidate criteria based on their performance characteristics and clinical face validity using nominal group technique at a consensus conference. Results Consensus was reached for a conjoint analysis–based continuous model with a Total Improvement Score of 0-100, using absolute percent change in CSM with thresholds for minimal (≥30 points), moderate (≥45), and major improvement (≥70). The same criteria were chosen for adult dermatomyositis/polymyositis with differing thresholds for improvement. The sensitivity and specificity were 89% and 91-98% for minimal, 92-94% and 94-99% for moderate, and 91-98% and 85-85% for major improvement, respectively, in JDM patient cohorts using the IMACS and PRINTO CSM. These criteria were validated in the PRINTO trial for differentiating between treatment arms for minimal and moderate improvement (P=0.009–0.057) and in the Rituximab trial for significantly differentiating the physician rating of improvement (P<0.006). Conclusion The response criteria for JDM was a conjoint analysis–based model using a continuous improvement score based on absolute percent change in CSM, with thresholds for minimal, moderate, and major improvement. PMID:28382787

2016 American College of Rheumatology (ACR) - European League Against Rheumatism (EULAR) Criteria for Minimal, Moderate and Major Clinical Response for Juvenile Dermatomyositis: An International Myositis Assessment and Clinical Studies Group/Paediatric Rheumatology International Trials Organisation Collaborative Initiative

PubMed Central

Rider, Lisa G.; Aggarwal, Rohit; Pistorio, Angela; Bayat, Nastaran; Erman, Brian; Feldman, Brian M.; Huber, Adam M.; Cimaz, Rolando; Cuttica, Rubén J.; de Oliveira, Sheila Knupp; Lindsley, Carol B.; Pilkington, Clarissa A.; Punaro, Marilyn; Ravelli, Angelo; Reed, Ann M.; Rouster-Stevens, Kelly; van Royen, Annet; Dressler, Frank; Magalhaes, Claudia Saad; Constantin, Tamás; Davidson, Joyce E.; Magnusson, Bo; Russo, Ricardo; Villa, Luca; Rinaldi, Mariangela; Rockette, Howard; Lachenbruch, Peter A.; Miller, Frederick W.; Vencovsky, Jiri; Ruperto, Nicolino

2017-01-01

Objective Develop response criteria for juvenile dermatomyositis (JDM). Methods We analyzed the performance of 312 definitions that used core set measures (CSM) from either the International Myositis Assessment and Clinical Studies Group (IMACS) or the Pediatric Rheumatology International Trials Organization (PRINTO) and were derived from natural history data and a conjoint-analysis survey. They were further validated in the PRINTO trial of prednisone alone compared to prednisone with methotrexate or cyclosporine and the Rituximab in Myositis trial. Experts considered 14 top-performing candidate criteria based on their performance characteristics and clinical face validity using nominal group technique at a consensus conference. Results Consensus was reached for a conjoint analysis–based continuous model with a Total Improvement Score of 0-100, using absolute percent change in CSM with thresholds for minimal (≥30 points), moderate (≥45), and major improvement (≥70). The same criteria were chosen for adult dermatomyositis/polymyositis with differing thresholds for improvement. The sensitivity and specificity were 89% and 91-98% for minimal, 92-94% and 94-99% for moderate, and 91-98% and 85-85% for major improvement, respectively, in JDM patient cohorts using the IMACS and PRINTO CSM. These criteria were validated in the PRINTO trial for differentiating between treatment arms for minimal and moderate improvement (P=0.009–0.057) and in the Rituximab trial for significantly differentiating the physician rating of improvement (P<0.006). Conclusion The response criteria for JDM was a conjoint analysis–based model using a continuous improvement score based on absolute percent change in CSM, with thresholds for minimal, moderate, and major improvement. PMID:28382778

Nanofiber reinforcement of a geopolymer matrix for improved composite materials mechanical performance

NASA Astrophysics Data System (ADS)

Rahman, AKM Samsur

Geopolymers have the potential to cross the process performance gap between polymer matrix and ceramic matrix composites (CMC), enabling high temperature capable composites that are manufactured at relatively low temperatures. Unfortunately, the inherently low toughness of these geopolymers limits the performance of the resulting fiber reinforced geopolymer matrix composites. Toughness improvements in composites can be addressed through the adjustments in the fiber/matrix interfacial strength and through the improvements in the inherent toughness of the constituent materials. This study investigates the potential to improve the inherent toughness of the geopolymer matrix material through the addition of nanofillers, by considering physical dimensions, mechanical properties, reinforcing capability and interfacial bond strength effects. A process optimization study was first undertaken to develop the ability to produce consistent, neat geopolymer samples, a critical precursor to producing nano-filled geopolymer for toughness evaluation. After that, single edge notched bend beam fracture toughness and un-notched beam flexural strength were evaluated for silicon carbide, alumina and carbon nanofillers reinforced geopolymer samples treated at various temperatures in reactive and inert environments. Toughness results of silicon carbide and carbon nanofillers reinforced geopolymers suggested that with the improved baseline properties, high aspect ratio nanofillers with high interfacial bond strength are the most capable in further improving the toughness of geopolymers. Among the high aspect ratio nanofillers i.e. nanofibers, 2vol% silicon carbide whicker (SCW) showed the highest improvement in fracture toughness and flexural strength of ~164% & ~185%, respectively. After heat treatment at 650 °C, SCW reinforcement was found to be effective, with little reduction in the performance, while the performance of alumina nanofiber (ANF) reinforced geopolymer significantly reduced. By means of SEM, EDS and X-ray diffraction techniques, it was found that the longer and stronger SCW is more capable of reinforcing the microstructurally inhomogeneous geopolymer than the smaller diameter, shorter ANF. After heat treatment at 760 °C, the effectiveness of SCW as reinforcement in both fracture toughness and flexural strength was reduced by ~89% and ~43%, respectively, while, the ANF filled materials performed worse than the neat geopolymer. A strong interaction was suggested between ANF and geopolymer at high temperature by means of chemical reactions and diffusion. SEM & X-ray diffraction results suggested the formation of Al4C3 on the SCW surface, which could reduce the interface strength between SCW and geopolymer. Therefore it is suggested that the interface strength should be as high as required for load transfer and crack bridging. Finally, to investigate the potential synergy of a nano-filled matrix material and the fiber/matrix interface toughening mechanism of a continuous fiber composite, composite specimens were produced and tested. Flexural and shear strengths of Nextel 610 continuous fiber reinforced 2vol% SCW filled geopolymer matrix composites were investigated. Specimens were produced with cleaned Nextel fiber and with carbon-coated fibers to investigate the combinations of nano-filled matrix with continuous reinforcement that is well bonded (cleaned fiber) versus poorly bonded (carbon-coated fiber) to the matrix. The results showed that flexural strength of cleaned and coated fiber composites improved by ~35% and ~21% respectively, while shear strength of the similar composite systems improved by ~39.5% and ~24%. The results verified the effectiveness of SCW in toughening not only the neat geopolymer, but also continuous fiber reinforced geopolymer matrix composites.

LTTP: 1999 Year in Review

DOT National Transportation Integrated Search

2002-12-13

Improving the productivity and mobility of the national highway transportation system is a key goal of the Federal Highway Administration (FHWA). During 1999, FHWA's Long Term Pavement Performance (LTPP) program continued to work toward these goals t...

Vision Hampton Roads : economic performance measures, 2010 DASHBOARD.

DOT National Transportation Integrated Search

2010-01-01

Mission: Provide leadership to focus on the strategic issues that will improve Hampton Roads' competitive position in the global economy. : Goal: With proper foresight, continuous planning and dynamic economic development, Hampton Roads will be recog...

POLLUTION PREVENTION METHODS IN THE SURFACE COATING INDUSTRY

EPA Science Inventory

The surface coating industry is rapidly changing to meet environmental and economic pressures. Some of the changes include new formulations which meet environmental regulations, higher performance finishes with improved properties, continued development of solventless technologie...

The efficacy of a continuous quality improvement (CQI) method in a radiological department. Comparison with non-CQI control material.

PubMed

Laurila, J; Standertskjöld-Nordenstam, C G; Suramo, I; Tolppanen, E M; Tervonen, O; Korhola, O; Brommels, M

2001-01-01

To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00-22:00 and a radiographer was moved from the morning shift to 15:00-22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

PubMed

Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

2014-07-01

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (p<0.001). Since 2010, the quarterly rate of severe PPH has not exceeded the upper control limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Cardiorespiratory dynamics measured from continuous ECG monitoring improves detection of deterioration in acute care patients: A retrospective cohort study

PubMed Central

Clark, Matthew T.; Calland, James Forrest; Enfield, Kyle B.; Voss, John D.; Lake, Douglas E.; Moorman, J. Randall

2017-01-01

Background Charted vital signs and laboratory results represent intermittent samples of a patient’s dynamic physiologic state and have been used to calculate early warning scores to identify patients at risk of clinical deterioration. We hypothesized that the addition of cardiorespiratory dynamics measured from continuous electrocardiography (ECG) monitoring to intermittently sampled data improves the predictive validity of models trained to detect clinical deterioration prior to intensive care unit (ICU) transfer or unanticipated death. Methods and findings We analyzed 63 patient-years of ECG data from 8,105 acute care patient admissions at a tertiary care academic medical center. We developed models to predict deterioration resulting in ICU transfer or unanticipated death within the next 24 hours using either vital signs, laboratory results, or cardiorespiratory dynamics from continuous ECG monitoring and also evaluated models using all available data sources. We calculated the predictive validity (C-statistic), the net reclassification improvement, and the probability of achieving the difference in likelihood ratio χ2 for the additional degrees of freedom. The primary outcome occurred 755 times in 586 admissions (7%). We analyzed 395 clinical deteriorations with continuous ECG data in the 24 hours prior to an event. Using only continuous ECG measures resulted in a C-statistic of 0.65, similar to models using only laboratory results and vital signs (0.63 and 0.69 respectively). Addition of continuous ECG measures to models using conventional measurements improved the C-statistic by 0.01 and 0.07; a model integrating all data sources had a C-statistic of 0.73 with categorical net reclassification improvement of 0.09 for a change of 1 decile in risk. The difference in likelihood ratio χ2 between integrated models with and without cardiorespiratory dynamics was 2158 (p value: <0.001). Conclusions Cardiorespiratory dynamics from continuous ECG monitoring detect clinical deterioration in acute care patients and improve performance of conventional models that use only laboratory results and vital signs. PMID:28771487

Cardiorespiratory dynamics measured from continuous ECG monitoring improves detection of deterioration in acute care patients: A retrospective cohort study.

PubMed

Moss, Travis J; Clark, Matthew T; Calland, James Forrest; Enfield, Kyle B; Voss, John D; Lake, Douglas E; Moorman, J Randall

2017-01-01

Charted vital signs and laboratory results represent intermittent samples of a patient's dynamic physiologic state and have been used to calculate early warning scores to identify patients at risk of clinical deterioration. We hypothesized that the addition of cardiorespiratory dynamics measured from continuous electrocardiography (ECG) monitoring to intermittently sampled data improves the predictive validity of models trained to detect clinical deterioration prior to intensive care unit (ICU) transfer or unanticipated death. We analyzed 63 patient-years of ECG data from 8,105 acute care patient admissions at a tertiary care academic medical center. We developed models to predict deterioration resulting in ICU transfer or unanticipated death within the next 24 hours using either vital signs, laboratory results, or cardiorespiratory dynamics from continuous ECG monitoring and also evaluated models using all available data sources. We calculated the predictive validity (C-statistic), the net reclassification improvement, and the probability of achieving the difference in likelihood ratio χ2 for the additional degrees of freedom. The primary outcome occurred 755 times in 586 admissions (7%). We analyzed 395 clinical deteriorations with continuous ECG data in the 24 hours prior to an event. Using only continuous ECG measures resulted in a C-statistic of 0.65, similar to models using only laboratory results and vital signs (0.63 and 0.69 respectively). Addition of continuous ECG measures to models using conventional measurements improved the C-statistic by 0.01 and 0.07; a model integrating all data sources had a C-statistic of 0.73 with categorical net reclassification improvement of 0.09 for a change of 1 decile in risk. The difference in likelihood ratio χ2 between integrated models with and without cardiorespiratory dynamics was 2158 (p value: <0.001). Cardiorespiratory dynamics from continuous ECG monitoring detect clinical deterioration in acute care patients and improve performance of conventional models that use only laboratory results and vital signs.

Can outcome-based continuing medical education improve performance of immigrant physicians?

PubMed

Castel, Orit Cohen; Ezra, Vered; Alperin, Mordechai; Nave, Rachel; Porat, Tamar; Golan, Avivit Cohen; Vinker, Shlomo; Karkabi, Khaled

2011-01-01

Immigrant physicians are a valued resource for physician workforces in many countries. Few studies have explored the education and training needs of immigrant physicians and ways to facilitate their integration into the health care system in which they work. Using an educational program developed for immigrant civilian physicians working in military primary care clinics at the Israel Defence Force, we illustrate how an outcome-based CME program can address practicing physicians' needs for military-specific primary care education and improve patient care. Following an extensive needs assessment, a 3-year curriculum was developed. The curriculum was delivered by a multidisciplinary educational team. Pre/post multiple-choice examinations, objective structured clinical examinations (OSCE), and end-of-program evaluations were administered for curriculum evaluation. To evaluate change in learners' performance, data from the 2003 (before-program) and 2006 (after-program) work-based assessments were retrieved retrospectively. Change in the performance of program participants was compared with that of immigrant physicians who did not participate in the program. Out of 28 learners, 23 (82%) completed the program. Learners did significantly better in the annual post-tests compared with the pretests (p <.01) and improved their OSCE scores (p <.001). Most program graduates (90%) rated overall satisfaction as very good or excellent. In comparison with nonparticipants, program graduates performed better on work-based assessments (Cohen's d =.63). Our intensive, outcome-based, longitudinal CME program has yielded encouraging results. Other medical educators, facing the challenge of integrating immigrant physicians to fit their health care system, may consider adapting our approach. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

The effectiveness of robotic training depends on motor task characteristics.

PubMed

Marchal-Crespo, Laura; Rappo, Nicole; Riener, Robert

2017-12-01

Previous research suggests that the effectiveness of robotic training depends on the motor task to be learned. However, it is still an open question which specific task's characteristics influence the efficacy of error-modulating training strategies. Motor tasks can be classified based on the time characteristics of the task, in particular the task's duration (discrete vs. continuous). Continuous tasks require movements without distinct beginning or end. Discrete tasks require fast movements that include well-defined postures at the beginning and the end. We developed two games, one that requires a continuous movement-a tracking task-and one that requires discrete movements-a fast reaching task. We conducted an experiment with thirty healthy subjects to evaluate the effectiveness of three error-modulating training strategies-no guidance, error amplification (i.e., repulsive forces proportional to errors) and haptic guidance-on self-reported motivation and learning of the continuous and discrete games. Training with error amplification resulted in better motor learning than haptic guidance, besides the fact that error amplification reduced subjects' interest/enjoyment and perceived competence during training. Only subjects trained with error amplification improved their performance after training the discrete game. In fact, subjects trained without guidance improved the performance in the continuous game significantly more than in the discrete game, probably because the continuous task required greater attentional levels. Error-amplifying training strategies have a great potential to provoke better motor learning in continuous and discrete tasks. However, their long-lasting negative effects on motivation might limit their applicability in intense neurorehabilitation programs.

Developing a pain management program through continuous improvement strategies.

PubMed

Woodward, Dora

2005-01-01

Pain affects more than one third of cancer patients in the early stages of their disease, dramatically rising above 70% in the advanced stages. Numerous studies have been conducted in the pursuit of cancer pain relief, yet the prevalence of pain persists. This article focuses on a pain management program, developed by a performance improvement team, which addressed the inadequacies of current pain management. Performance improvement activities are described through the process of assessment, planning, implementation, and evaluation of the pain management program. This pain management program is uniquely derived from a unit core value that all staff is responsible and accountable for pain management.

Application of flywheel battery in mobile power station

NASA Astrophysics Data System (ADS)

Wang, Xinggui; Zhang, Bing; Li, Xiaoying; Sun, Xiaojing

2013-03-01

The flywheel battery is used to the mobile station for continuous power supply, once the commercial power or other independent power supply is outage or failure, the flywheel battery will provide uninterrupted power supply during the switch to the commercial power and the diesel generator sets, ensuring the power supply system is continuous and maintaining the performance and parameters of the power supply which will not influence or discontinuous change because of commercial power failure. Simulation results show that the flywheel battery used to the mobile station can effectively improve the performance of the mobile power station system.

Quality of Care Improves for Patients with Diabetes in Medicare Shared Savings Accountable Care Organizations: Organizational Characteristics Associated with Performance.

PubMed

Fraze, Taressa K; Lewis, Valerie A; Tierney, Emily; Colla, Carrie H

2017-12-06

Accountable care organizations (ACOs), a primary care-centric delivery and payment model, aim to promote integrated population health, which may improve care for those with chronic conditions such as diabetes. Research has shown that, overall, the ACO model is effective at reducing costs, but there is substantial variation in how effective different types of ACOs are at impacting costs and improving care delivery. This study examines how ACO organizational characteristics - such as composition, staffing, care management, and experiences with health reform - were associated with quality of care delivered to patients with diabetes. Secondary data were analyzed retrospectively to examine Medicare Shared Savings Program (MSSP) ACOs' performance on diabetes metrics in the first 2 years of ACO contracts. Ordinary least squares was used to analyze 162 MSSP ACOs with publicly available performance data and the National Survey of ACOs. ACOs improved performance significantly for patients with diabetes between contract years 1 and 2. In year 1, also having a private payer contract and an increased number of services within the ACO were positively associated with performance, while having a community health center or a hospital were negatively associated with performance. Better performance in year 1 was negatively associated with improved performance in year 2. This study found that ACOs substantively improved diabetes management within initial contract years. ACOs may need different types of support throughout their contracts to ensure continued improvements in performance.

Current Calibration Efforts and Performance of the HST Space Telescope Imaging Spectrograph: Echelle Flux Calibration, the BAR5 Occulter, and Lamp Lifetimes

NASA Astrophysics Data System (ADS)

Monroe, TalaWanda R.; Aloisi, Alessandra; Debes, John H.; Jedrzejewski, Robert I.; Lockwood, Sean A.; Peeples, Molly S.; Proffitt, Charles R.; Riley, Allyssa; Walborn, Nolan R.

2016-06-01

The variety of operating modes of the Space Telescope Imaging Spectrograph (STIS) on the Hubble Space Telescope (HST) continues to allow STIS users to obtain unique, high quality observations and cutting-edge results 19 years after its installation on HST. STIS is currently the only instrument available to the astronomy community that allows high spectral and spatial resolution spectroscopy in the FUV and NUV, including echelle modes. STIS also supports solar-blind imaging in the FUV. In the optical, STIS provides long-slit, first-order spectra that take advantage of HST's superb spatial resolution, as well as several unique unfiltered coronagraphic modes, which continue to benefit the exoplanet and debris-disk communities. The STIS instrument team monitors the instrument’s health and performance over time to characterize the effects of radiation damage and continued use of the detectors and optical elements. Additionally, the STIS team continues to improve the quality of data products for the user community. We present updates on efforts to improve the echelle flux calibration of overlapping spectral orders due to changes in the grating blaze function since HST Servicing Mission 4, and efforts to push the contrast limit and smallest inner working angle attainable with the coronagraphic BAR5 occulter. We also provide updates on the performance of the STIS calibration lamps, including work to maintain the accuracy of the wavelength calibration for all modes.

Performance test of Ti/Au bilayer TES microcalorimeter in combination with continuous ADR

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

Ishisaki, Y.; Akamatsu, H.; Hoshino, A.

2009-12-16

Performance test of a Ti/Au bilayer TES microcalorimeter has been made in combination with a continuous adiabatic demagnetization refrigerator (CADR). The CADR has four stages of ADR to produce continuous cooling by recycling them in dedicated order, and is cryogen-free utilizing a 4K-GM refrigerator. We installed a Ti/Au bilayer TES microcalorimeter and 420-series SQUID array to readout the X-ray signal on the 1st (coldest) stage of the CADR. We successfully operated the CADR at temperature of 120 mK in continuous mode more than 27 hr, however, FWHM energy resolution of the TES microcalorimeter was degraded to 45 eV at 6more » keV, as compared to 10 eV when measured in a dilution refrigerator. This is mainly because the temperature stability was not good enough (about 0.6 mK) and the operation temperature was not sufficiently lower than the transition temperature T{sub c} = 135mK of the TES. We operated the TES microcalorimeter at the operation temperature of 105 mK in one-shot mode and the resolution was improved to 30 eV. We also found that the operating point of the TES was affected by the magnetic field of the 3rd and 4th ADR recycle. More complete shielding of the magnetic field is essential for further improvement of the performance of the TES microcalorimeter.« less

Toward Realism in Human Performance Simulation

DTIC Science & Technology

2004-01-01

toward the development of improved human-like performance of synthetic agents. However, several serious problems continue to challenge researchers and... developers . Developers have insufficient behavioral knowledge. To date, models of emotivity and behavior that have been commercialized still tend...Bindiganavale, 1999). There has even been significant development of architectures to produce animated characters that react appropriately to a small

Cognitive Readiness Assessment and Reporting: An Open Source Mobile Framework for Operational Decision Support and Performance Improvement

ERIC Educational Resources Information Center

Heric, Matthew; Carter, Jenn

2011-01-01

Cognitive readiness (CR) and performance for operational time-critical environments are continuing points of focus for military and academic communities. In response to this need, we designed an open source interactive CR assessment application as a highly adaptive and efficient open source testing administration and analysis tool. It is capable…

Influence of Teaching Games for Understanding on Game Performance, Knowledge, and Variables Related to Adherence in Youth Sailing

ERIC Educational Resources Information Center

Morales-Belando, Maria Trinidad; Arias-Estero, Jose L.

2017-01-01

Purpose: To determine whether a TGfU intervention improved participants' decision-making, skill execution, game performance, game involvement, game knowledge, enjoyment, perceived competence, and intention to continue practicing sailing. Method: Participants were 19 sailors (age: M = 8.44, SD = 1.24 years old). This study followed a mixed-methods…

An Integrated Approach for Conducting a Behavioral Systems Analysis

ERIC Educational Resources Information Center

Diener, Lori H.; McGee, Heather M.; Miguel, Caio F.

2009-01-01

The aim of this paper is to illustrate how to conduct a Behavioral Systems Analysis (BSA) to aid in the design of targeted performance improvement interventions. BSA is a continuous process of analyzing the right variables to the right extent to aid in planning and managing performance at the organization, process, and job levels. BSA helps to…

Science Teachers' Utilisation of Innovative Strategies for Teaching Senior School Science in Ilorin, Nigeria

ERIC Educational Resources Information Center

Oyelekan, Oloyede Solomon; Igbokwe, Emoyoke Faith; Olorundare, Adekunle Solomon

2017-01-01

Efforts have been made to improve science teaching in secondary schools in Nigeria, yet, students continue to perform poorly in science subjects. Many innovative teaching strategies have been developed by educators and found to impact significantly on students' academic performance when utilised. Hence, this study was aimed at examining science…

Sustainable MSD prevention: management for continuous improvement between prevention and production. Ergonomic intervention in two assembly line companies.

PubMed

Caroly, S; Coutarel, F; Landry, A; Mary-Cheray, I

2010-07-01

To increase output and meet customers' needs, companies have turned to the development of production management systems: Kaizen, one piece flow, Kanban, etc. The aim of such systems is to accelerate decisions, react to environmental issues and manage various productions. In the main, this type of management system has led to the continuous improvement of production performance. Consequently, such production management systems can have unexpected negative effects on operators' health and safety. Conversely, regulation and control systems focusing on work-related risks have obliged firms to implement health and safety management systems such as OHSAS 18001. The purpose of this type of system, also based on continuous improvement, is to reduce risks, facilitate work-related activities and identify solutions in terms of equipment and tools. However, the prevention actions introduced through health and safety systems often result in other unexpected and unwanted effects on production. This paper shows how companies can improve the way they are run by taking into account both types of management system. Copyright 2010 Elsevier Ltd. All rights reserved.

Amphetamine improves mouse and human attention in the 5-choice continuous performance test.

PubMed

MacQueen, David A; Minassian, Arpi; Kenton, Johnny A; Geyer, Mark A; Perry, William; Brigman, Jonathan L; Young, Jared W

2018-05-31

Non-medical use of prescription stimulants amongst college students is common, with claims of cognitive and academic benefits. The mechanism, magnitude, and pervasiveness of the cognitive enhancing effects of stimulants in healthy adults remain poorly understood however. The present study determined the effects of dextroamphetamine (D-amp) on the 5-choice continuous performance test (5C-CPT) of attention in healthy young adult humans and mice. A mixed gender sample received placebo (n = 29), 10 (n = 17) or 20 mg D-amp (n = 25) in a double-blind fashion before 5C-CPT testing. In addition, male C57BL/6J mice were trained on a touchscreen adaptation of the 5C-CPT and tested after receiving saline or D-amp (0.1, 0.3, 1.0 mg/kg; n = 8/dose). In humans, D-amp significantly improved 5C-CPT performance. Both doses improved signal detection driven by increased hit rate (reduced omissions). Both doses also improved response accuracy and reduced hit reaction time (HRT) variability. In mice, similar effects (improved signal detection, hit rate, and response accuracy) were observed at the moderate dose (0.3 mg/kg). In contrast to human participants however, no effect on HRT variability was detected in mice, with no effect on HRT in either species. Human 5C-CPT performance was consistent with prior studies and consistent with alternative CPT paradigms. The performance of C57BL/6J mice on the touchscreen 5C-CPT mirrored performance of this strain on 5-hole operant chambers. Importantly, comparable facilitation of attention with D-amp was observed in both species. The 5C-CPT provides a cross-species paradigm by which the cognitive enhancing properties of stimulants and the neural underpinnings of attention can be assessed. Copyright © 2018. Published by Elsevier Ltd.

Army Research Laboratory (ARL) 2009 Annual Review

DTIC Science & Technology

2009-01-01

shooting performance simulator with a high - speed weapon tracking system that provides real-time continuous weapon aim point data . This 13-acre...HMMVV’s (humvees), helicopter and plane parts and in new Navy DDX and DDG ships . As a result of the high performance and low weight of composite...improve Soldier-system performance . a high -resolution understanding of the Soldier’s Dr. Laurel Allender Director for Human Research and

Making Connections for Youth in Washington State: The Role of Data in Developing Sound Public Policy. CEDR Working Paper No. 2010-1.0

ERIC Educational Resources Information Center

Goldhaber, Dan

2010-01-01

The details of school reform in Washington State continue to evolve, but the unprecedented performance demands that it and NCLB place on schools are unlikely to disappear any time soon. The same is true of the large gap that exists between today's performance and tomorrow's aspirations. By any measure, significant improvements in performance now…

Loglines. May - June 2012

DTIC Science & Technology

2012-06-01

GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND...8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR...challenges, our commitment to reduce costs even as we continue to improve performance , and DLA’s enduring partnerships within and external to the Defense

Experiments with a Supersonic Multi-Channel Radial Diffuser.

DTIC Science & Technology

1980-09-01

unlimited. 17 . DISTRIBUTION STATEMENT (o the *bsta~c entered nRItok 20, it dffttt Iton, Report) IS. SUPPLEMENTARY NOTES 19. KEY WORDS (Continue o...Improvements 17 VI SIGNIFICANT TEST RESULTS 20 1. General Considerations 20 2. Typical Radial Diffuser Performance 20 3. Flow Stability Experiments 22 VIII...Adjustments Indicated 39 16 Comparison of the Single Channel Performances for Two Extreme Channel Geometries 40 17 Typical Radial Diffuser Performance

The effect of simulated weightlessness on performance and mood

NASA Technical Reports Server (NTRS)

Rosenberg, Bonnie

1988-01-01

The performance results of the bedrest study at Ames were not what were expected. The Air Combat Maneuvering performance test was tested to assure its reliability. However, the results from this study show a continued increase in performance. One would assume that scores would become constant if not decrease by the first days of bedrest because an inverted position would affect performance. It is also interesting to observe that while the subject's moods deteriorated, their performance improved. Although the performance results were surprising, the mood results were as expected.

Real-time improvement of continuous glucose monitoring accuracy: the smart sensor concept.

PubMed

Facchinetti, Andrea; Sparacino, Giovanni; Guerra, Stefania; Luijf, Yoeri M; DeVries, J Hans; Mader, Julia K; Ellmerer, Martin; Benesch, Carsten; Heinemann, Lutz; Bruttomesso, Daniela; Avogaro, Angelo; Cobelli, Claudio

2013-04-01

Reliability of continuous glucose monitoring (CGM) sensors is key in several applications. In this work we demonstrate that real-time algorithms can render CGM sensors smarter by reducing their uncertainty and inaccuracy and improving their ability to alert for hypo- and hyperglycemic events. The smart CGM (sCGM) sensor concept consists of a commercial CGM sensor whose output enters three software modules, able to work in real time, for denoising, enhancement, and prediction. These three software modules were recently presented in the CGM literature, and here we apply them to the Dexcom SEVEN Plus continuous glucose monitor. We assessed the performance of the sCGM on data collected in two trials, each containing 12 patients with type 1 diabetes. The denoising module improves the smoothness of the CGM time series by an average of ∼57%, the enhancement module reduces the mean absolute relative difference from 15.1 to 10.3%, increases by 12.6% the pairs of values falling in the A-zone of the Clarke error grid, and finally, the prediction module forecasts hypo- and hyperglycemic events an average of 14 min ahead of time. We have introduced and implemented the sCGM sensor concept. Analysis of data from 24 patients demonstrates that incorporation of suitable real-time signal processing algorithms for denoising, enhancement, and prediction can significantly improve the performance of CGM applications. This can be of great clinical impact for hypo- and hyperglycemic alert generation as well in artificial pancreas devices.

A benchmarking program to reduce red blood cell outdating: implementation, evaluation, and a conceptual framework.

PubMed

Barty, Rebecca L; Gagliardi, Kathleen; Owens, Wendy; Lauzon, Deborah; Scheuermann, Sheena; Liu, Yang; Wang, Grace; Pai, Menaka; Heddle, Nancy M

2015-07-01

Benchmarking is a quality improvement tool that compares an organization's performance to that of its peers for selected indicators, to improve practice. Processes to develop evidence-based benchmarks for red blood cell (RBC) outdating in Ontario hospitals, based on RBC hospital disposition data from Canadian Blood Services, have been previously reported. These benchmarks were implemented in 160 hospitals provincewide with a multifaceted approach, which included hospital education, inventory management tools and resources, summaries of best practice recommendations, recognition of high-performing sites, and audit tools on the Transfusion Ontario website (http://transfusionontario.org). In this study we describe the implementation process and the impact of the benchmarking program on RBC outdating. A conceptual framework for continuous quality improvement of a benchmarking program was also developed. The RBC outdating rate for all hospitals trended downward continuously from April 2006 to February 2012, irrespective of hospitals' transfusion rates or their distance from the blood supplier. The highest annual outdating rate was 2.82%, at the beginning of the observation period. Each year brought further reductions, with a nadir outdating rate of 1.02% achieved in 2011. The key elements of the successful benchmarking strategy included dynamic targets, a comprehensive and evidence-based implementation strategy, ongoing information sharing, and a robust data system to track information. The Ontario benchmarking program for RBC outdating resulted in continuous and sustained quality improvement. Our conceptual iterative framework for benchmarking provides a guide for institutions implementing a benchmarking program. © 2015 AABB.

Performance improvement of high repetition rate electro-optical cavity-dumped Nd:GdVO4 laser

NASA Astrophysics Data System (ADS)

Yu, X.; Wang, C.; Ma, Y. F.; Chen, F.; Yan, R. P.; Li, X. D.

2012-02-01

We improved the electro-optical cavity-dumped Nd:GdVO4 laser performance at high repetition rates by employing continuous-grown GdVO4/Nd:GdVO4 composite crystal under 879 nm diode-laser pumping. A constant 3.8 ns duration pulsed laser was obtained and the repetition rate could reach up to 100 kHz with a maximum average output power of 13.1 W and a slope efficiency of 56.4%, corresponding to a peak power of 34.4 kW.

Using a balanced scorecard to improve the performance of an emergency department.

PubMed

Huang, Shu-Hsin; Chen, Ping-Ling; Yang, Ming-Chin; Chang, Wen-Yin; Lee, Haw-Jenn

2004-01-01

The performance of the emergency department significantly improved after implementing the balanced scorecard including hours of continuing education attended by the staff, staff job satisfaction, the rate of incomplete laboratory tests within 30 minutes, the average monthly inappropriate return rate, and hospital profit. The results can assist administrators plan for the future. Although this was a pilot program for implementing a balanced scorecard in an emergency department, the indicators used in this study may also be reasonable for a hospital that has limited resources.

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

Walters, William; Hyde, Embriette R.; Berg-Lyons, Donna

ABSTRACT Designing primers for PCR-based taxonomic surveys that amplify a broad range of phylotypes in varied community samples is a difficult challenge, and the comparability of data sets amplified with varied primers requires attention. Here, we examined the performance of modified 16S rRNA gene and internal transcribed spacer (ITS) primers for archaea/bacteria and fungi, respectively, with nonaquatic samples. We moved primer bar codes to the 5′ end, allowing for a range of different 3′ primer pairings, such as the 515f/926r primer pair, which amplifies variable regions 4 and 5 of the 16S rRNA gene. We additionally demonstrated that modifications tomore » the 515f/806r (variable region 4) 16S primer pair, which improves detection ofThaumarchaeotaand clade SAR11 in marine samples, do not degrade performance on taxa already amplified effectively by the original primer set. Alterations to the fungal ITS primers did result in differential but overall improved performance compared to the original primers. In both cases, the improved primers should be widely adopted for amplicon studies. ImportanceWe continue to uncover a wealth of information connecting microbes in important ways to human and environmental ecology. As our scientific knowledge and technical abilities improve, the tools used for microbiome surveys can be modified to improve the accuracy of our techniques, ensuring that we can continue to identify groundbreaking connections between microbes and the ecosystems they populate, from ice caps to the human body. It is important to confirm that modifications to these tools do not cause new, detrimental biases that would inhibit the field rather than continue to move it forward. We therefore demonstrated that two recently modified primer pairs that target taxonomically discriminatory regions of bacterial and fungal genomic DNA do not introduce new biases when used on a variety of sample types, from soil to human skin. This confirms the utility of these primers for maintaining currently recommended microbiome research techniques as the state of the art.« less

5 CFR 412.401 - Continuing executive development.

Code of Federal Regulations, 2011 CFR

2011-01-01

... participation in short-term and longer-term experiences, meet organizational needs for leadership, managerial improvement, and organizational results; (2) Address enhancement of existing executive competencies and such other competencies as will strengthen the executive's performance; (3) Outline developmental...

77 FR 3242 - Comprehensive Centers Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... believe the centers must focus on helping SEAs (1) create sustainable organizational structures and... organizational structures and effective performance management systems, building staff expertise within those... for evaluating and continuously improving organizational structures and processes; c. Draws on the...

INDIRECT MEASUREMENT OF BIOLOGICAL ACTIVITY TO MONITOR NATURAL ATTENUATION

EPA Science Inventory

The remediation of ground water contamination by natural attenuation, specifically biodegradation, requires continual monitoring. This research is aimed at improving methods for evaluating the long-term performance of Monitored Natural Attenuation (MNA), specifically changes in ...

The Impact of School Improvement Grants on Achievement: Plans for a National Evaluation Using a Regression Discontinuity Design

ERIC Educational Resources Information Center

Deke, John; Dragoset, Lisa

2015-01-01

Does receipt of School Improvement Grants (SIG) funding to implement a school intervention model have an impact on outcomes for low-performing schools? This study answers this question using a regression discontinuity design (RDD) that exploits cutoff values on the continuous variables used to define SIG eligibility tiers, comparing outcomes in…

HSE training and competence assessment in the geophysical industry

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

Covil, M.W.; Soethout, J.A.; Reynolds, G.

1996-11-01

This paper looks at the efforts of the seismic geophysical industry to continually improve it`s health, safety and environmental performance, and in particular to improve the HSE behavior and understanding of individuals within the industry. Specifically it deals with the HSE training and assessment of competence of individuals in relation to their job responsibilities, based on best industry practice.

Business Case Analysis: Continuous Integrated Logistics Support-Targeted Allowance Technique (CILS-TAT)

DTIC Science & Technology

2013-05-30

In this research, we examine the Naval Sea Logistics Command’s Continuous Integrated Logistics Support-Targeted Allowancing Technique (CILS-TAT) and... the feasibility of program re-implementation. We conduct an analysis of this allowancing method’s effectiveness onboard U.S. Navy Ballistic Missile...Defense (BMD) ships, measure the costs associated with performing a CILS-TAT, and provide recommendations concerning possible improvements to the

A candidate concept for display of forward-looking wind shear information

NASA Technical Reports Server (NTRS)

Hinton, David A.

1989-01-01

A concept is proposed which integrates forward-look wind shear information with airplane performance capabilities to predict future airplane energy state as a function of range. The information could be displayed to a crew either in terms of energy height or airspeed deviations. The anticipated benefits of the proposed display information concept are: (1) a wind shear hazard product that scales directly to the performance impact on the airplane and that has intuitive meaning to flight crews; (2) a reduction in flight crew workload by automatic processing of relevant hazard parameters; and (3) a continuous display of predicted airplane energy state if the approach is continued. Such a display may be used to improve pilot situational awareness or improve pilot confidence in wind shear alerts generated by other systems. The display is described and the algorithms necessary for implementation in a simulation system are provided.

On-line early fault detection and diagnosis of municipal solid waste incinerators

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

Zhao Jinsong; Huang Jianchao; Sun Wei

A fault detection and diagnosis framework is proposed in this paper for early fault detection and diagnosis (FDD) of municipal solid waste incinerators (MSWIs) in order to improve the safety and continuity of production. In this framework, principal component analysis (PCA), one of the multivariate statistical technologies, is used for detecting abnormal events, while rule-based reasoning performs the fault diagnosis and consequence prediction, and also generates recommendations for fault mitigation once an abnormal event is detected. A software package, SWIFT, is developed based on the proposed framework, and has been applied in an actual industrial MSWI. The application shows thatmore » automated real-time abnormal situation management (ASM) of the MSWI can be achieved by using SWIFT, resulting in an industrially acceptable low rate of wrong diagnosis, which has resulted in improved process continuity and environmental performance of the MSWI.« less

FY17 Status Report on NEAMS Neutronics Activities

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

Lee, C. H.; Jung, Y. S.; Smith, M. A.

2017-09-30

Under the U.S. DOE NEAMS program, the high-fidelity neutronics code system has been developed to support the multiphysics modeling and simulation capability named SHARP. The neutronics code system includes the high-fidelity neutronics code PROTEUS, the cross section library and preprocessing tools, the multigroup cross section generation code MC2-3, the in-house meshing generation tool, the perturbation and sensitivity analysis code PERSENT, and post-processing tools. The main objectives of the NEAMS neutronics activities in FY17 are to continue development of an advanced nodal solver in PROTEUS for use in nuclear reactor design and analysis projects, implement a simplified sub-channel based thermal-hydraulic (T/H)more » capability into PROTEUS to efficiently compute the thermal feedback, improve the performance of PROTEUS-MOCEX using numerical acceleration and code optimization, improve the cross section generation tools including MC2-3, and continue to perform verification and validation tests for PROTEUS.« less

Continuous Human Action Recognition Using Depth-MHI-HOG and a Spotter Model

PubMed Central

Eum, Hyukmin; Yoon, Changyong; Lee, Heejin; Park, Mignon

2015-01-01

In this paper, we propose a new method for spotting and recognizing continuous human actions using a vision sensor. The method is comprised of depth-MHI-HOG (DMH), action modeling, action spotting, and recognition. First, to effectively separate the foreground from background, we propose a method called DMH. It includes a standard structure for segmenting images and extracting features by using depth information, MHI, and HOG. Second, action modeling is performed to model various actions using extracted features. The modeling of actions is performed by creating sequences of actions through k-means clustering; these sequences constitute HMM input. Third, a method of action spotting is proposed to filter meaningless actions from continuous actions and to identify precise start and end points of actions. By employing the spotter model, the proposed method improves action recognition performance. Finally, the proposed method recognizes actions based on start and end points. We evaluate recognition performance by employing the proposed method to obtain and compare probabilities by applying input sequences in action models and the spotter model. Through various experiments, we demonstrate that the proposed method is efficient for recognizing continuous human actions in real environments. PMID:25742172

Preventive intervention in diabetes: a new model for continuing medical education.

PubMed

Beaser, Richard S; Brown, Julie A

2013-04-01

Competence and skills in overcoming clinical inertia for diabetes treatment, and actually supporting and assisting the patient through adherence and compliance (as opposed to just reiterating what they "should" be doing and then assigning them the blame if they fail) is a key component to success in addressing diabetes, and to date it is a component that has received little formal attention. To improve and systematize diabetes care, it is critical to move beyond the "traditional" continuing medical education (CME) model of imparting knowledge as the entirety of the educational effort, and move toward a focus on Performance Improvement CME. This new approach does not just teach new information but also provides support for improvements where needed most within practice systems based on targeted data-based on self-assessments for the entire system of care. Joslin data conclude that this new approach will benefit support, clinical, and office teams as well as the specialist. In short, the Performance Improvement CME structure reflects the needed components of the successful practice today, particularly for chronic conditions such as diabetes, including the focus on interdisciplinary team care and on quality improvement, which is becoming more and more aligned with reimbursement schemes, public and private, in the U.S. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Program/Project Management Resources: A collection of 50 bibliographies focusing on continual improvement, reinventing government, and successful project management

NASA Technical Reports Server (NTRS)

Michaels, Jeffrey

1994-01-01

These Program/Project Management Resource Lists were originally written for the NASA project management community. Their purpose was to promote the use of the NASA Headquarters Library Program/Project Management Collection funded by NASA Headquarters Code FT, Training & Development Division, by offering introductions to the management topics studied by today's managers. Lists were also written at the request of NASA Headquarters Code T, Office of Continual improvements, and at the request of NASA members of the National Performance Review. This is the second edition of the compilation of these bibliographies; the first edition was printed in March 1994.

Continuous positive airway pressure improves gait control in severe obstructive sleep apnoea: A prospective study

PubMed Central

Wuyam, Bernard; Pépin, Jean-Louis; Marillier, Mathieu; Tamisier, Renaud; Pérennou, Dominic; Verges, Samuel

2018-01-01

Study aim Severe obstructive sleep apnoea (OSA) can lead to neurocognitive alterations, including gait impairments. The beneficial effects of continuous positive airway pressure (CPAP) on improving excessive daytime sleepiness and daily functioning have been documented. However, a demonstration of CPAP treatment efficacy on gait control is still lacking. This study aims to test the hypothesis that CPAP improves gait control in severe OSA patients. Material and methods In this prospective controlled study, twelve severe OSA patients (age = 57.2±8.9 years, body mass index = 27.4±3.1 kg·m-2, apnoea-hypopnoea index = 46.3±11.7 events·h-1) and 10 healthy matched subjects were included. Overground gait parameters were recorded at spontaneous speed and stride time variability, a clinical marker of gait control, was calculated. To assess the role of executive functions in gait and postural control, a dual-task paradigm was applied using a Stroop test as secondary cognitive task. All assessments were performed before and after 8 weeks of CPAP treatment. Results Before CPAP treatment, OSA patients had significantly larger stride time variability (3.1±1.1% vs 2.1±0.5%) and lower cognitive performances under dual task compared to controls. After CPAP treatment, stride time variability was significantly improved and no longer different compared to controls. Cognitive performance under dual task also improved after CPAP treatment. Conclusion Eight weeks of CPAP treatment improves gait control of severe OSA patients, suggesting morphological and functional cerebral improvements. Our data provide a rationale for further mechanistic studies and the use of gait as a biomarker of OSA brain consequences. PMID:29474363

Real-time Kinematic Positioning of INS Tightly Aided Multi-GNSS Ionospheric Constrained PPP

PubMed Central

Gao, Zhouzheng; Shen, Wenbin; Zhang, Hongping; Niu, Xiaoji; Ge, Maorong

2016-01-01

Real-time Precise Point Positioning (PPP) technique is being widely applied for providing precise positioning services with the significant improvement on satellite precise products accuracy. With the rapid development of the multi-constellation Global Navigation Satellite Systems (multi-GNSS), currently, about 80 navigation satellites are operational in orbit. Obviously, PPP performance is dramatically improved with all satellites compared to that of GPS-only PPP. However, the performance of PPP could be evidently affected by unexpected and unavoidable severe observing environments, especially in the dynamic applications. Consequently, we apply Inertial Navigation System (INS) to the Ionospheric-Constrained (IC) PPP to overcome such drawbacks. The INS tightly aided multi-GNSS IC-PPP model can make full use of GNSS and INS observations to improve the PPP performance in terms of accuracy, availability, continuity, and convergence speed. Then, a set of airborne data is analyzed to evaluate and validate the improvement of multi-GNSS and INS on the performance of IC-PPP. PMID:27470270

Real-time Kinematic Positioning of INS Tightly Aided Multi-GNSS Ionospheric Constrained PPP.

PubMed

Gao, Zhouzheng; Shen, Wenbin; Zhang, Hongping; Niu, Xiaoji; Ge, Maorong

2016-07-29

Real-time Precise Point Positioning (PPP) technique is being widely applied for providing precise positioning services with the significant improvement on satellite precise products accuracy. With the rapid development of the multi-constellation Global Navigation Satellite Systems (multi-GNSS), currently, about 80 navigation satellites are operational in orbit. Obviously, PPP performance is dramatically improved with all satellites compared to that of GPS-only PPP. However, the performance of PPP could be evidently affected by unexpected and unavoidable severe observing environments, especially in the dynamic applications. Consequently, we apply Inertial Navigation System (INS) to the Ionospheric-Constrained (IC) PPP to overcome such drawbacks. The INS tightly aided multi-GNSS IC-PPP model can make full use of GNSS and INS observations to improve the PPP performance in terms of accuracy, availability, continuity, and convergence speed. Then, a set of airborne data is analyzed to evaluate and validate the improvement of multi-GNSS and INS on the performance of IC-PPP.

Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice

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

Leong, Cheng Nang; Shakespeare, Thomas Philip; North Coast Cancer Institute, Coffs Harbour

2006-12-01

Purpose: There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. Methods and Materials: The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scoresmore » were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. Results: Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. Conclusion: An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence.« less

Improved functionality of graphene and carbon nanotube hybrid foam architecture by UV-ozone treatment

NASA Astrophysics Data System (ADS)

Wang, Wei; Ruiz, Isaac; Lee, Ilkeun; Zaera, Francisco; Ozkan, Mihrimah; Ozkan, Cengiz S.

2015-04-01

Optimization of the electrode/electrolyte double-layer interface is a key factor for improving electrode performance of aqueous electrolyte based supercapacitors (SCs). Here, we report the improved functionality of carbon materials via a non-invasive, high-throughput, and inexpensive UV generated ozone (UV-ozone) treatment. This process allows precise tuning of the graphene and carbon nanotube hybrid foam (GM) transitionally from ultrahydrophobic to hydrophilic within 60 s. The continuous tuning of surface energy can be controlled by simply varying the UV-ozone exposure time, while the ozone-oxidized carbon nanostructure maintains its integrity. Symmetric SCs based on the UV-ozone treated GM foam demonstrated enhanced rate performance. This technique can be readily applied to other CVD-grown carbonaceous materials by taking advantage of its ease of processing, low cost, scalability, and controllability.Optimization of the electrode/electrolyte double-layer interface is a key factor for improving electrode performance of aqueous electrolyte based supercapacitors (SCs). Here, we report the improved functionality of carbon materials via a non-invasive, high-throughput, and inexpensive UV generated ozone (UV-ozone) treatment. This process allows precise tuning of the graphene and carbon nanotube hybrid foam (GM) transitionally from ultrahydrophobic to hydrophilic within 60 s. The continuous tuning of surface energy can be controlled by simply varying the UV-ozone exposure time, while the ozone-oxidized carbon nanostructure maintains its integrity. Symmetric SCs based on the UV-ozone treated GM foam demonstrated enhanced rate performance. This technique can be readily applied to other CVD-grown carbonaceous materials by taking advantage of its ease of processing, low cost, scalability, and controllability. Electronic supplementary information (ESI) available. See DOI: 10.1039/c4nr06795a

Development of a Monte Carlo Simulation for APD-Based PET Detectors Using a Continuous Scintillating Crystal

NASA Astrophysics Data System (ADS)

Clowes, P.; Mccallum, S.; Welch, A.

2006-10-01

We are currently developing a multilayer avalanche photodiode (APD)-based detector for use in positron emission tomography (PET), which utilizes thin continuous crystals. In this paper, we developed a Monte Carlo-based simulation to aid in the design of such detectors. We measured the performance of a detector comprising a single thin continuous crystal (3.1 mm times 9.5 mm times 9.5 mm) of lutetium yttrium ortho-silicate (LYSO) and an APD array (4times4) elements; each element 1.6 mm2 and on a 2.3 mm pitch. We showed that a spatial resolution of better than 2.12 mm is achievable throughout the crystal provided that we adopt a Statistics Based Positioning (SBP) Algorithm. We then used Monte Carlo simulation to model the behavior of the detector. The accuracy of the Monte Carlo simulation was verified by comparing measured and simulated parent datasets (PDS) for the SBP algorithm. These datasets consisted of data for point sources at 49 positions uniformly distributed over the detector area. We also calculated the noise in the detector circuit and verified this value by measurement. The noise value was included in the simulation. We show that the performance of the simulation closely matches the measured performance. The simulations were extended to investigate the effect of different noise levels on positioning accuracy. This paper showed that if modest improvements could be made in the circuit noise then positioning accuracy would be greatly improved. In summary, we have developed a model that can be used to simulate the performance of a variety of APD-based continuous crystal PET detectors

Idaho National Laboratory Integrated Safety Management System FY 2013 Effectiveness Review and Declaration Report

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

Hunt, Farren

2013-12-01

Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for Fiscal Year (FY) 2014. Results of the FY 2013 annual effectiveness review demonstrate that the INL’s ISMS program is “Effective” and continually improving and shows signs of being significantly strengthened. Although there have been unacceptable serious events in themore » past, there has also been significant attention, dedication, and resources focused on improvement, lessons learned and future prevention. BEA’s strategy of focusing on these improvements includes extensive action and improvement plans that include PLN 4030, “INL Sustained Operational Improvement Plan, PLN 4058, “MFC Strategic Excellence Plan,” PLN 4141, “ATR Sustained Excellence Plan,” and PLN 4145, “Radiological Control Road to Excellence,” and the development of LWP 20000, “Conduct of Research.” As a result of these action plans, coupled with other assurance activities and metrics, significant improvement in operational performance, organizational competence, management oversight and a reduction in the number of operational events is being realized. In short, the realization of the fifth core function of ISMS (feedback and continuous improvement) and the associated benefits are apparent.« less

Constructing an adaptive care model for the management of disease-related symptoms throughout the course of multiple sclerosis--performance improvement CME.

PubMed

Miller, Aaron E; Cohen, Bruce A; Krieger, Stephen C; Markowitz, Clyde E; Mattson, David H; Tselentis, Helen N

2014-01-01

Symptom management remains a challenging clinical aspect of MS. To design a performance improvement continuing medical education (PI CME) activity for better clinical management of multiple sclerosis (MS)-related depression, fatigue, mobility impairment/falls, and spasticity. Ten volunteer MS centers participated in a three-stage PI CME model: A) baseline assessment; B) practice improvement CME intervention; C) reassessment. Expert faculty developed performance measures and activity intervention tools. Designated MS center champions reviewed patient charts and entered data into an online database. Stage C data were collected eight weeks after implementation of the intervention and compared with Stage A baseline data to measure change in performance. Aggregate data from the 10 participating MS centers (405 patient charts) revealed performance improvements in the assessment of all four MS-related symptoms. Statistically significant improvements were found in the documented assessment of mobility impairment/falls (p=0.003) and spasticity (p<0.001). For documentation of care plans, statistically significant improvements were reported for fatigue (p=0.007) and mobility impairment/falls (p=0.040); non-significant changes were noted for depression and spasticity. Our PI CME interventions demonstrated performance improvement in the management of MS-related symptoms. This PI CME model (available at www.achlpicme.org/ms/toolkit) offers a new perspective on enhancing symptom management in patients with MS.

Analysing the performance of in vitro fertilization clinics in the United Kingdom.

PubMed

Mohammed, Mohammed A; Leary, Christine

2006-09-01

During the past century, the manufacturing industry has achieved major successes in improving the quality of its products. An essential factor in these successes has been the use of Walter A. Shewhart's pioneering work in the economic control of variation, which culminated in the development of a simple yet powerful theory of variation, which classifies variation as having a common or special cause and thus guides the user to the most appropriate action to effect improvement. Using publicly available performance data, which includes percentage of live births and multiple births, for in vitro fertilization (IVF) clinics in the United Kingdom, we show a central role for Shewhart's approach in moving away from the limitations and controversies associated with performance league tables towards data analyses to support continual improvement. We outline strategies for dealing with common and special causes of variation in IVF clinic performance data.

Heart failure services in the United Kingdom: rethinking the machine bureaucracy.

PubMed

Hawkins, Nathaniel M; Wright, David J; Capewell, Simon

2013-01-20

Poor outcomes and poor uptake of evidence based therapies persist for patients with heart failure in the United Kingdom. We offer a strategic analysis of services, defining the context, organization and objectives of the service, before focusing on implementation and performance. Critical flaws in past service development and performance are apparent, a consequence of failed performance management, policy and political initiative. The barriers to change and potential solutions are common to many health care systems. Integration, information, financing, incentives, innovation and values: all must be challenged and improved if heart failure services are to succeed. Modern healthcare requires open adaptive systems, continually learning and improving. The system also needs controls. Performance indicators should be simple, clinically relevant, and outcome focused. Heart failure presents one of the greatest opportunities to improve symptoms and survival with existing technology. To do so, heart failure services require radical reorganization. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A Program Manager’s Guide for Program Improvement in Ongoing Psychological Health and Traumatic Brain Injury Programs. The RAND Toolkit, Volume 4

DTIC Science & Technology

2014-01-01

Hughes EFX, Boerstler H, O’Connor EJ. “Assessing the Impact of Continuous Quality Improvement/ Total Quality Management : Concept versus...facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity. Gery...RAND Program Manager’s Guide helps managers assess program performance, consider options for improvement, implement solutions, then assess whether the

Fine tuning GPS clock estimation in the MCS

NASA Technical Reports Server (NTRS)

Hutsell, Steven T.

1995-01-01

With the completion of a 24 operational satellite constellation, GPS is fast approaching the critical milestone, Full Operational Capability (FOC). Although GPS is well capable of providing the timing accuracy and stability figures required by system specifications, the GPS community will continue to strive for further improvements in performance. The GPS Master Control Station (MCS) recently demonstrated that timing improvements are always composite Clock, and hence, Kalman Filter state estimation, providing a small improvement to user accuracy.

The use of self-modeling to improve the swimming performance of spina bifida children.

PubMed Central

Dowrick, P W; Dove, C

1980-01-01

The use of edited videotape replay (which showed only "positive" behaviors) to improve the water skills of three spina bifida children, aged 5 to 10 years was examined. A multiple baseline across subjects design was used, and behavioral changes were observed to occur in close association with intervention. One child was given successive reapplications of videotaped self-modeling with continuing improvements. It appears that a useful practical technique has been developed. PMID:6988381

Comparison of Kasai Autocorrelation and Maximum Likelihood Estimators for Doppler Optical Coherence Tomography

PubMed Central

Chan, Aaron C.; Srinivasan, Vivek J.

2013-01-01

In optical coherence tomography (OCT) and ultrasound, unbiased Doppler frequency estimators with low variance are desirable for blood velocity estimation. Hardware improvements in OCT mean that ever higher acquisition rates are possible, which should also, in principle, improve estimation performance. Paradoxically, however, the widely used Kasai autocorrelation estimator’s performance worsens with increasing acquisition rate. We propose that parametric estimators based on accurate models of noise statistics can offer better performance. We derive a maximum likelihood estimator (MLE) based on a simple additive white Gaussian noise model, and show that it can outperform the Kasai autocorrelation estimator. In addition, we also derive the Cramer Rao lower bound (CRLB), and show that the variance of the MLE approaches the CRLB for moderate data lengths and noise levels. We note that the MLE performance improves with longer acquisition time, and remains constant or improves with higher acquisition rates. These qualities may make it a preferred technique as OCT imaging speed continues to improve. Finally, our work motivates the development of more general parametric estimators based on statistical models of decorrelation noise. PMID:23446044

Status of nickel/zinc and nickel/iron battery technology for electric vehicle applications

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

Yao, N.P.; Christianson, C.C.; Elliott, R.C.

1980-01-01

Significant progress in nickel/zinc and nickel/iron technology has been made towards achieving the battery technical performance goals necessary for widespread use of these battery systems in electric vehicle applications. This progress is reviewed. Nickel/zinc module test data have shown a specific energy of nearly 70 Whr/kg and a specific power of 130 W/kg. However, cycle life improvements are still needed (presently demonstrated capability of 120 cycles) and are expected to be demonstrated during 1980. Nickel/iron modules have demonstrated a specific energy of nearly 50 Wh/kg and a specific power of 100 W/kg. Indications are that improved performance in these areasmore » can be shown during 1980. Nickel/iron modules cycle lives of 300 have been achieved during early 1980 and testing continues. Energy efficiency has been improved from less than 50% to over 65%. Cost reduction (both initial and operating) continues to receive major emphasis at developers of both nickel/zinc and nickel/iron batteries in order to achieve the lowest possible life cycle cost to the battery user.« less

Using rapid-scan EPR to improve the detection limit of quantitative EPR by more than one order of magnitude.

PubMed

Möser, J; Lips, K; Tseytlin, M; Eaton, G R; Eaton, S S; Schnegg, A

2017-08-01

X-band rapid-scan EPR was implemented on a commercially available Bruker ELEXSYS E580 spectrometer. Room temperature rapid-scan and continuous-wave EPR spectra were recorded for amorphous silicon powder samples. By comparing the resulting signal intensities the feasibility of performing quantitative rapid-scan EPR is demonstrated. For different hydrogenated amorphous silicon samples, rapid-scan EPR results in signal-to-noise improvements by factors between 10 and 50. Rapid-scan EPR is thus capable of improving the detection limit of quantitative EPR by at least one order of magnitude. In addition, we provide a recipe for setting up and calibrating a conventional pulsed and continuous-wave EPR spectrometer for rapid-scan EPR. Copyright © 2017 Elsevier Inc. All rights reserved.

Renewing focus on family planning service quality globally.

PubMed

Hancock, Nancy L; Stuart, Gretchen S; Tang, Jennifer H; Chibwesha, Carla J; Stringer, Jeffrey S A; Chi, Benjamin H

2016-01-01

Reducing the global unmet need for contraception is currently a priority for many governments, multi-lateral initiatives, non-governmental organizations, and donors. Evidence strongly suggests that the provision of quality family planning services can increase uptake, prevalence, and continuation of contraception. While an accepted framework to define the components of family planning service quality exists, translating this framework into assessment tools that are accessible, easily utilized, and valid for service providers has remained a challenge. We propose new approaches to improve the standardization and accessibility of family planning service quality assessment tools to simplify family planning service quality evaluation. With easier approaches to program evaluation, quality improvements can be performed more swiftly to help increase uptake and continuation of contraception to improve the health of women and their families.

Continuous real time measurement of pavement quality during construction.

DOT National Transportation Integrated Search

2010-12-01

Intelligent Compaction has been investigated as a means of improving the quality of asphalt pavements during their : construction. The long term performance of an asphalt pavement is directly related to its load bearing capability and : is determined...

An evaluation of dense graded asphalt-rubber concrete in Minnesota. Final report

DOT National Transportation Integrated Search

1991-11-01

The Minnesota Department of Transportation is continually investigating ways to improve the cold temperature performance of its asphalt concrete pavements. One reported method is to modify the asphalt binder with ground reclaimed automobile and truck...

48 CFR 1827.302 - Policy. (NASA supplements paragraphs (a), (b), (c), (d), (e), (f), (g), and (i)).

Code of Federal Regulations, 2014 CFR

2014-10-01

... invention, discovery, improvement, or innovation made in the performance of work under any NASA contract or..., expeditious development, and continued availability for the benefit of the scientific, industrial, and...

48 CFR 1827.302 - Policy. (NASA supplements paragraphs (a), (b), (c), (d), (e), (f), (g), and (i)).

Code of Federal Regulations, 2012 CFR

2012-10-01

... invention, discovery, improvement, or innovation made in the performance of work under any NASA contract or..., expeditious development, and continued availability for the benefit of the scientific, industrial, and...

48 CFR 1827.302 - Policy. (NASA supplements paragraphs (a), (b), (c), (d), (e), (f), (g), and (i)).

Code of Federal Regulations, 2013 CFR

2013-10-01

... invention, discovery, improvement, or innovation made in the performance of work under any NASA contract or..., expeditious development, and continued availability for the benefit of the scientific, industrial, and...

48 CFR 1827.302 - Policy. (NASA supplements paragraphs (a), (b), (c), (d), (e), (f), (g), and (i)).

Code of Federal Regulations, 2011 CFR

2011-10-01

... invention, discovery, improvement, or innovation made in the performance of work under any NASA contract or..., expeditious development, and continued availability for the benefit of the scientific, industrial, and...

Performance and accountability : challenges facing the Department of Transportation

DOT National Transportation Integrated Search

2001-02-14

For surface transportation safety, DOT continues to face challenges in improving the safety of highways and pipelines. While the Department of Transportation appears to be making progress on some initiatives to reduce the number of large truck crashe...

Improving HIV outcomes in resource-limited countries: the importance of quality indicators.

PubMed

Ahonkhai, Aima A; Bassett, Ingrid V; Ferris, Timothy G; Freedberg, Kenneth A

2012-11-24

Resource-limited countries increasingly depend on quality indicators to improve outcomes within HIV treatment programs, but indicators of program performance suitable for use at the local program level remain underdeveloped. Using the existing literature as a guide, we applied standard quality improvement (QI) concepts to the continuum of HIV care from HIV diagnosis, to enrollment and retention in care, and highlighted critical service delivery process steps to identify opportunities for performance indicator development. We then identified existing indicators to measure program performance, citing examples used by pivotal donor agencies, and assessed their feasibility for use in surveying local program performance. Clinical delivery steps without existing performance measures were identified as opportunities for measure development. Using National Quality Forum (NQF) criteria as a guide, we developed measurement concepts suitable for use at the local program level that address existing gaps in program performance assessment. This analysis of the HIV continuum of care identified seven critical process steps providing numerous opportunities for performance measurement. Analysis of care delivery process steps and the application of NQF criteria identified 24 new measure concepts that are potentially useful for improving operational performance in HIV care at the local level. An evidence-based set of program-level quality indicators is critical for the improvement of HIV care in resource-limited settings. These performance indicators should be utilized as treatment programs continue to grow.

Phosphatidylserine containing omega-3 Fatty acids may improve memory abilities in nondemented elderly individuals with memory complaints: results from an open-label extension study.

PubMed

Vakhapova, Veronika; Cohen, Tzafra; Richter, Yael; Herzog, Yael; Kam, Yossi; Korczyn, Amos D

2014-01-01

The present study is an open-label extension (OLE) aimed at evaluating the effect of 100 mg/day of phosphatidylserine enriched with docosahexaenoic acid (PS-DHA) on cognitive performance in nondemented elderly individuals with memory complaints. From the participants who completed the core study, 122 continued with a 15-week OLE. Efficacy was assessed using a computerized tool and the Clinical Global Impression of Change (CGI-C) rating scale. A significant improvement in sustained attention and memory recognition was observed in the PS-DHA naïve group, while the PS-DHA continuers maintained their cognitive status. Additionally, a significant improvement in CGI-C was observed in the naïve group. The results demonstrate that consumption of 100 mg/day of PS-DHA might be associated with improving or maintaining cognitive status in elderly subjects with memory complaints.

Satellite-tracking and Earth dynamics research programs

NASA Technical Reports Server (NTRS)

1982-01-01

The activities carried out by the Smithsonian Astrophysical Observatory (SAO) are described. The SAO network continued to track LAGEOS at highest priority for polar motion and Earth rotation studies, and for other geophysical investigations, including crustal dynamics, Earth and ocean tides, and the general development of precision orbit determination. The network performed regular tracking of several other retroreflector satellites including GEOS-1, GEOS-3, BE-C, and Starlette for refined determinations of station coordinates and the Earth's gravity field and for studies of solid Earth dynamics. A major program in laser upgrading continued to improve ranging accuracy and data yield. This program includes an increase in pulse repetition rate from 8 ppm to 30 ppm, a reduction in laser pulse width from 6 nsec to 2 to 3 nsec, improvements in the photoreceiver and the electronics to improve daylight ranging, and an analog pulse detection system to improve range noise and accuracy. Data processing hardware and software are discussed.

Knowledge Management Capabilities and Organizational Performance: An Investigation into the Effects of Knowledge Infrastructure and Processes on Organizational Performance

ERIC Educational Resources Information Center

Cho, Taejun

2011-01-01

Knowledge is one of the most important assets for surviving in the modern business environment. The effective management of that asset mandates continuous adaptation by organizations, and requires employees to strive to improve the company's work processes. Organizations attempt to coordinate their unique knowledge with traditional means as well…

Massachusetts Charter Public Schools: Best Practices Using Data to Improve Student Achievement in Springfield. White Paper No. 142

ERIC Educational Resources Information Center

Candal, Cara Stillings

2016-01-01

Recent studies continue to shine light on high-performing charter schools. While Boston-area charter schools--a concentrated group of high-performers--garner more attention than others, many excellent schools outside of Boston have been quietly chipping away at the achievement gap between advantaged and disadvantaged students. One of these schools…

The Impact of Literacy Intervention on Academic Performance of Third Grade At-Risk Students

ERIC Educational Resources Information Center

Williams, Vernita

2015-01-01

Third grade at-risk students in Wilson County Schools, Wilson, NC continuously perform below the state average on the North Carolina Third Grade Reading End-of-Grade test. Leaders in the Wilson County Schools school district implemented a literacy pull-out intervention program for third grade at-risk students as a strategy to improve reading…

A trial of scheduled deep brain stimulation for Tourette syndrome: moving away from continuous deep brain stimulation paradigms.

PubMed

Okun, Michael S; Foote, Kelly D; Wu, Samuel S; Ward, Herbert E; Bowers, Dawn; Rodriguez, Ramon L; Malaty, Irene A; Goodman, Wayne K; Gilbert, Donald M; Walker, Harrison C; Mink, Jonathan W; Merritt, Stacy; Morishita, Takashi; Sanchez, Justin C

2013-01-01

To collect the information necessary to design the methods and outcome variables for a larger trial of scheduled deep brain stimulation (DBS) for Tourette syndrome. We performed a small National Institutes of Health-sponsored clinical trials planning study of the safety and preliminary efficacy of implanted DBS in the bilateral centromedian thalamic region. The study used a cranially contained constant-current device and a scheduled, rather than the classic continuous, DBS paradigm. Baseline vs 6-month outcomes were collected and analyzed. In addition, we compared acute scheduled vs acute continuous vs off DBS. A university movement disorders center. Five patients with implanted DBS. A 50% improvement in the Yale Global Tic Severity Scale (YGTSS) total score. RESULTS Participating subjects had a mean age of 34.4 (range, 28-39) years and a mean disease duration of 28.8 years. No significant adverse events or hardware-related issues occurred. Baseline vs 6-month data revealed that reductions in the YGTSS total score did not achieve the prestudy criterion of a 50% improvement in the YGTSS total score on scheduled stimulation settings. However, statistically significant improvements were observed in the YGTSS total score (mean [SD] change, -17.8 [9.4]; P=.01), impairment score (-11.3 [5.0]; P=.007), and motor score (-2.8 [2.2]; P=.045); the Modified Rush Tic Rating Scale Score total score (-5.8 [2.9]; P=.01); and the phonic tic severity score (-2.2 [2.6]; P=.04). Continuous, off, and scheduled stimulation conditions were assessed blindly in an acute experiment at 6 months after implantation. The scores in all 3 conditions showed a trend for improvement. Trends for improvement also occurred with continuous and scheduled conditions performing better than the off condition. Tic suppression was commonly seen at ventral (deep) contacts, and programming settings resulting in tic suppression were commonly associated with a subjective feeling of calmness. This study provides safety and proof of concept that a scheduled DBS approach could improve motor and vocal tics in Tourette syndrome. Refinements in neurostimulator battery life, outcome measure selection, and flexibility in programming settings can be used to enhance outcomes in a future larger study. Scheduled stimulation holds promise as a potential first step for shifting movement and neuropsychiatric disorders toward more responsive neuromodulation approaches. clinicaltrials.gov Identifier: NCT01329198.

Soldier Dimension in Battle. Volume I.

DTIC Science & Technology

1983-01-01

actions that could be undertaken to improve soldier performance. r.r TAB j.9 I 1, Lt tAnrC&il O ML ~ -- . J TABLE OF CONTENTS Volume 1 - Final Report 1... Analysis 1-49 Criteria Develomnt for the Soldier Dimension 1-59 Soldier Performance in Continuous Operations 1-60 Leadershin Role 1-60 ART? Data Develonment...have also emphasized the importance of cognitive-behaviorism, situational analysis , and systems theory because of our focus on human performance

Effects of Neurofeekback Training on EEG, Continuous Performance Task (CPT), and ADHD Symptoms in ADHD-prone College Students.

PubMed

Ryoo, Manhee; Son, Chongnak

2015-12-01

This study explored the effects of neurofeedback training on Electroencephalogram (EEG), Continuous Performance Task (CPT) and ADHD symptoms in ADHD prone college students. Two hundred forty seven college students completed Korean Version of Conners' Adult ADHD Rating Scales (CAARS-K) and Korean Version of Beck Depression Inventory (K-BDI). The 16 participants who ranked in the top 25% of CAARS-K score and had 16 less of K-BDI score participated in this study. Among them, 8 participants who are fit for the research schedule were assigned to neurofeedback training group and 8 not fit for the research schedule to the control group. All participants completed Adult Attention Deficiency Questionnaire, CPT and EEG measurement at pretest. The neurofeedback group received 15 neurofeedback training sessions (5 weeks, 3 sessions per week). The control group did not receive any treatment. Four weeks after completion of the program, all participants completed CAARS-K, Adult Attention Deficiency Questionnaire, CPT and EEG measurement for post-test. The neurofeedback group showed more significant improvement in EEG, CPT performance and ADHD symptoms than the control group. The improvements were maintained at follow up. Neurofeedback training adjusted abnormal EEG and was effective in improving objective and subjective ADHD symptoms in ADHD prone college students.

On-Orbit Performance of the Helioseismic and Magnetic Imager Instrument onboard the Solar Dynamics Observatory

NASA Astrophysics Data System (ADS)

Hoeksema, J. T.; Baldner, C. S.; Bush, R. I.; Schou, J.; Scherrer, P. H.

2018-03-01

The Helioseismic and Magnetic Imager (HMI) instrument is a major component of NASA's Solar Dynamics Observatory (SDO) spacecraft. Since commencement of full regular science operations on 1 May 2010, HMI has operated with remarkable continuity, e.g. during the more than five years of the SDO prime mission that ended 30 September 2015, HMI collected 98.4% of all possible 45-second velocity maps; minimizing gaps in these full-disk Dopplergrams is crucial for helioseismology. HMI velocity, intensity, and magnetic-field measurements are used in numerous investigations, so understanding the quality of the data is important. This article describes the calibration measurements used to track the performance of the HMI instrument, and it details trends in important instrument parameters during the prime mission. Regular calibration sequences provide information used to improve and update the calibration of HMI data. The set-point temperature of the instrument front window and optical bench is adjusted regularly to maintain instrument focus, and changes in the temperature-control scheme have been made to improve stability in the observable quantities. The exposure time has been changed to compensate for a 20% decrease in instrument throughput. Measurements of the performance of the shutter and tuning mechanisms show that they are aging as expected and continue to perform according to specification. Parameters of the tunable optical-filter elements are regularly adjusted to account for drifts in the central wavelength. Frequent measurements of changing CCD-camera characteristics, such as gain and flat field, are used to calibrate the observations. Infrequent expected events such as eclipses, transits, and spacecraft off-points interrupt regular instrument operations and provide the opportunity to perform additional calibration. Onboard instrument anomalies are rare and seem to occur quite uniformly in time. The instrument continues to perform very well.

Sleep disturbance and neurobehavioral performance among postpartum women.

PubMed

Insana, Salvatore P; Williams, Kayla B; Montgomery-Downs, Hawley E

2013-01-01

Sleep disturbances cause neurobehavioral performance and daytime functioning impairments. Postpartum women experience high levels of sleep disturbance. Thus, the study objective was to describe and explore the relation between neurobehavioral performance and sleep among women during the early postpartum period. Longitudinal field-based study. There were 70 primiparous women and nine nulliparous women in a control group. None. During their first 12 postpartum weeks, 70 primiparous women wore continuous wrist actigraphy to objectively monitor their sleep. Each morning they self-administered the psychomotor vigilance test (PVT) to index their neurobehavioral performance. Nine nulliparous women in a control group underwent the same protocol for 12 continuous weeks. Postpartum PVT mean reciprocal (1/RT) reaction time did not differ from that of women in the control group at postpartum week 2, but then worsened over time. Postpartum slowest 10% 1/RT PVT reaction time was significantly worse than that of women in the control group at all weeks. Despite improvements in postpartum sleep, neurobehavioral performance continued to worsen from week 2 through the end of the study. Across the first 12 postpartum weeks, PVT measures were more frequently associated with percent sleep compared with total sleep time, highlighting the deleterious consequences of sleep disruption on maternal daytime functioning throughout the early postpartum period. Worsened maternal neurobehavioral performance across the first 12 postpartum weeks may have been influenced by the cumulative effects of sleep disturbance. These results can inform future work to identify the particular sleep profiles that could be primary intervention targets to improve daytime functioning among postpartum women, and indicate need for further research on the effectiveness of family leave policies. The time when postpartum women return to control-level daytime functioning is unknown.

The effect of methylphenidate on sustained attention among adolescents with attention-deficit hyperactivity disorder.

PubMed

Lufi, Dubi; Bassin-Savion, Shiry; Rubel, Lilach

2015-01-01

Twenty-seven adolescents diagnosed as having attention-deficit hyperactivity disorder (ADHD) were tested twice with a computerized MATH-CPT (mathematics continuous performance test). In one administration, the participants took medication (methylphenidate, MPH) 1.5 hr before being tested. In another administration, the MATH-CPT was administered without the medication. Treatment with MPH improved the "overall attention level" and in measures of "reaction time" and "impulsivity." MPH did not improve the performance in the four measures of sustained attention. Knowing that treatment with MPH does not improve sustained attention can be helpful in reaching a decision of whether or not a child should be treated with MPH.

Development of a business plan for women's health services, using Malcolm Baldrige Performance Excellence Criteria.

PubMed

Caramanica, L; Maxwell, S; Curry, S

2000-06-01

A new process for business planning at Hartford Hospital was needed to achieve critical business results. This article describes the Hospital's use of the Malcolm Baldrige Performance Excellence Criteria as a way to standardize and improve business planning. Women's Health Services is one of Hartford Hospital's "centers for excellence" and one of the first to use these criteria to improve its service. Staff learned how to build their business plan upon a set of core values and concepts such as customer-driven quality, leadership that sets high expectations, continuous improvement and learning, valuing employees, faster response to market demands, management by fact, and a long-range view of the future.

Flexibility training in preadolescent female athletes: Acute and long-term effects of intermittent and continuous static stretching.

PubMed

Donti, Οlyvia; Papia, Konstantina; Toubekis, Argyris; Donti, Anastasia; Sands, William A; Bogdanis, Gregory C

2018-07-01

This study compared the acute and long-term effects of intermittent and continuous static stretching training on straight leg raise range of motion (ROM). Seventy-seven preadolescent female gymnasts were divided into a stretching (n = 57), and a control group (n = 20). The stretching group performed static stretching of the hip extensors of both legs, three times per week for 15 weeks. One leg performed intermittent (3 × 30 s with 30 s rest) while the other leg performed continuous stretching (90 s). ROM pre- and post-stretching was measured at baseline, on weeks 3, 6, 9, 12, 15 and after 2 weeks of detraining. ROM was increased during both intermittent and continuous stretching training, but remained unchanged in the control group. Intermittent stretching conferred a larger improvement in ROM compared to both continuous stretching and control from week 3, until the end of training, and following detraining (p = 0.045 to 0.001 and d = 0.80 to 1.41). During detraining, ROM after the intermittent protocol decreased (p = 0.001), while it was maintained after the continuous protocol (p = 0.36). Acute increases in ROM following the intermittent stretching were also larger than in the continuous (p = 0.038). Intermittent stretching was more effective than continuous, for both long-term and acute ROM enhancement in preadolescent female athletes.

COLLABORATE©, Part IV: Ramping Up Competency-Based Performance Management.

PubMed

Treiger, Teresa M; Fink-Samnick, Ellen

The purpose of this fourth part of the COLLABORATE© article series provides an expansion and application of previously presented concepts pertaining to the COLLABORATE paradigm of professional case management practice. The model is built upon a value-driven foundation that: PRIMARY PRACTICE SETTING(S):: Applicable to all health care sectors where case management is practiced. As an industry, health care continues to evolve. Terrain shifts and new influences continually surface to challenge professional case management practice. The need for top-performing and nimble professionals who are knowledgeable and proficient in the workplace continues to challenge human resource departments. In addition to care setting knowledge, professional case managers must continually invest in their practice competence toolbox to grow skills and abilities that transcend policies and processes. These individuals demonstrate agility in framing (and reframing) their professional practice to facilitate the best possible outcomes for their clients. Therefore, the continued emphasis on practice competence conveyed through the performance management cycle is an essential ingredient to performance management focused on customer service excellence and organizational improvement. Professional case management transcends professional disciplines, educational levels, and practice settings. Business objectives continue to drive work process and priorities in many practice settings. However, competencies that align with regulatory and accreditation requirements should be the critical driver for consistent, high-quality case management practice. Although there is inherent value in what various disciplines bring to the table, this advanced model unifies behind case management's unique, strengths-based identity instead of continuing to align within traditional divisions (e.g., discipline, work setting, population served). This model fosters case management's expanding career advancement opportunities.

Development of a continuous broad-energy-spectrum electron source

NASA Technical Reports Server (NTRS)

Adamo, R. C.; Nanevicz, J. E.

1985-01-01

The development of a practical prototype, large-area, continuous-spectrum, multienergy electron source to simulate the lower energy (approx = 1 to 30 keV) portion of the geosynchronous orbit electron environment was investigated. The results of future materials-charging tests using this multienergy source should significantly improve the understanding of actual in-orbit charging processes and should help to resolve some of the descrepancies between predicted and observed spacecraft materials performance.

Recent Enhancements to the National Transonic Facility

NASA Technical Reports Server (NTRS)

Kilgore, W. A.; Balakrishna, S.; Bobbitt, C. W.; Underwood, P.

2003-01-01

The National Transonic Facility continues to make enhancements to provide quality data in a safe, efficient and cost effective method for aerodynamic ground testing. Recent enhancements discussed in this paper include the restoration of reliability and improved performance of the heat exchanger systems resulting in the expansion of the NTF air operations envelope. Additionally, results are presented from a continued effort to reduce model dynamics through the use of a new stiffer balance and sting

Effects of high intensity interval versus moderate continuous training on markers of ventilatory and cardiac efficiency in coronary heart disease patients.

PubMed

Cardozo, Gustavo G; Oliveira, Ricardo B; Farinatti, Paulo T V

2015-01-01

We tested the hypothesis that high intensity interval training (HIIT) would be more effective than moderate intensity continuous training (MIT) to improve newly emerged markers of cardiorespiratory fitness in coronary heart disease (CHD) patients, as the relationship between ventilation and carbon dioxide production (VE/VCO2 slope), oxygen uptake efficiency slope (OUES), and oxygen pulse (O2P). Seventy-one patients with optimized treatment were randomly assigned into HIIT (n = 23, age = 56 ± 12 years), MIT (n = 24, age = 62 ± 12 years), or nonexercise control group (CG) (n = 24, age = 64 ± 12 years). MIT performed 30 min of continuous aerobic exercise at 70-75% of maximal heart rate (HRmax), and HIIT performed 30 min sessions split in 2 min alternate bouts at 60%/90% HRmax (3 times/week for 16 weeks). No differences among groups (before versus after) were found for VE/VCO2 slope or OUES (P > 0.05). After training the O2P slope increased in HIIT (22%, P < 0.05) but not in MIT (2%, P > 0.05), while decreased in CG (-20%, P < 0.05) becoming lower versus HIIT (P = 0.03). HIIT was more effective than MIT for improving O2P slope in CHD patients, while VE/VCO2 slope and OUES were similarly improved by aerobic training regimens versus controls.

The Role of Efficient XML Interchange (EXI) in Navy Wide-Area Network (WAN) Optimization

DTIC Science & Technology

2015-03-01

compress, and re-encrypt data to continue providing optimization through compression; however, that capability requires careful consideration of...optimization 23 of encrypted data requires a careful analysis and comparison of performance improvements and IA vulnerabilities. It is important...Contained EXI capitalizes on multiple techniques to improve compression, and they vary depending on a set of EXI options passed to the codec

Continuation of research into software for space operations support: Conversion of the display manager to X Windows/Motif, volume 2

NASA Technical Reports Server (NTRS)

Collier, Mark D.; Killough, Ronnie; Martin, Nancy L.

1990-01-01

NASA is currently using a set of applications called the Display Builder and Display Manager. They run on Concurrent systems and heavily depend on the Graphic Kernel System (GKS). At this time however, these two applications would more appropriately be developed in X Windows, in which a low X is used for all actual text and graphics display and a standard widget set (such as Motif) is used for the user interface. Use of the X Windows will increase performance, improve the user interface, enhance portability, and improve reliability. Prototype of X Window/Motif based Display Manager provides the following advantages over a GKS based application: improved performance by using a low level X Windows, display of graphic and text will be more efficient; improved user interface by using Motif; Improved portability by operating on both Concurrent and Sun workstations; and Improved reliability.

Improving patients' home cooking - A case series of participation in a remote culinary coaching program.

PubMed

Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

2017-08-01

This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p < 0.01) and self-efficacy to perform various culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.

Continuous multiword recognition performance of young and elderly listeners in ambient noise

NASA Astrophysics Data System (ADS)

Sato, Hiroshi

2005-09-01

Hearing threshold shift due to aging is known as a dominant factor to degrade speech recognition performance in noisy conditions. On the other hand, cognitive factors of aging-relating speech recognition performance in various speech-to-noise conditions are not well established. In this study, two kinds of speech test were performed to examine how working memory load relates to speech recognition performance. One is word recognition test with high-familiarity, four-syllable Japanese words (single-word test). In this test, each word was presented to listeners; the listeners were asked to write the word down on paper with enough time to answer. In the other test, five continuous word were presented to listeners and listeners were asked to write the word down after just five words were presented (multiword test). Both tests were done in various speech-to-noise ratios under 50-dBA Hoth spectrum noise with more than 50 young and elderly subjects. The results of two experiments suggest that (1) Hearing level is related to scores of both tests. (2) Scores of single-word test are well correlated with those of multiword test. (3) Scores of multiword test are not improved as speech-to-noise ratio improves in the condition where scores of single-word test reach their ceiling.

Day-to-day care in palliative sedation: survey of nurses' experiences with decision-making and performance.

PubMed

Arevalo, Jimmy J; Rietjens, Judith A; Swart, Siebe J; Perez, Roberto S G M; van der Heide, Agnes

2013-05-01

Continuous palliative sedation has been the focus of extensive international debates in the field of end-of-life decision making. Although nurses may be important participants in the performance of continuous palliative sedation, research has focused primarily on the role and experience of physicians. Nurses' experiences differ from that of physicians; they more often describe that continuous palliative sedation is used with the intention of hastening death and to have experienced serious emotional burden. Therefore, it is important to understand the experience of nurses in continuous palliative sedation. To describe nurses' experiences with the decision-making and performance of continuous palliative sedation in terminally ill patients. Cross-sectional study. In 2008, a structured questionnaire was sent to 576 nurses in six professional home care organizations, ten units for palliative care in nursing homes and in-patient hospices and seven hospitals in the western region of the Netherlands. Respondents provided information about the last patient receiving continuous palliative sedation whom they had cared for. Two-hundred seventy-seven questionnaires were returned and 199 (71.84%) reported a case of continuous palliative sedation. Nurses felt involved in the decision to use sedation in 84% of cases, albeit to a lesser extent in home care (68.75%, p=0.002). They agreed with the performance of continuous palliative sedation in 95.97% of cases and they proposed the use of continuous palliative sedation in 16.16%. Nurses were present at the start of sedation in 81.40% of cases and reported physicians to be present in 45.22%. In 72.77%, arrangements had been made among caregivers about the coordination of health care regarding the sedation. Nurses seem to play an important role in the use of continuous sedation. This role is mainly supportive toward physicians and patients during the decision-making process, but shifts to an active performance of sedation, particularly in settings where they explicitly participate as members of a team. Nurses could develop the practice of palliative sedation by anticipating procedural obstacles in the performance of continuous palliative sedation. We recommend them to become more active participants in the decision-making to improve the care of patients receiving continuous palliative sedation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Seismic performance of steel pipe pile to cap beam moment resisting connections.

DOT National Transportation Integrated Search

2013-01-01

This research, a joint effort between AUTC and North Carolina State University, is a continuation of an ngoing project that investigated bridge and marine structure : design practices, aiming to identify improved connection design approaches to produ...

Metric Development for Continuous Process Improvement

DTIC Science & Technology

2011-03-01

observable ( Cropley , 1998). All measurement is done within a context (Morse, 2003), which is shaped by a purpose, existing knowledge, capabilities, and...performance: metrics for entrepreneurship and strategic management research. Cheltenham, UK: Edward Elgar, 2006. Print. 9. Cropley , D. H., “Towards

Human resources management and firm performance: The differential role of managerial affective and continuance commitment.

PubMed

Gong, Yaping; Law, Kenneth S; Chang, Song; Xin, Katherine R

2009-01-01

In this study, the authors developed a dual-concern (i.e., maintenance and performance) model of human resources (HR) management. The authors identified commonly examined HR practices that apply to the middle manager level and classified them into the maintenance- and performance-oriented HR subsystems. The authors found support for the 2-factor model on the basis of responses from 2,148 managers from 463 firms operating in China. Regression results indicate that the performance-oriented HR subsystems had a positive relationship with firm performance and that the relationship was mediated by middle managers' affective commitment to the firm. The maintenance-oriented HR subsystems had a positive relationship with middle managers' continuance commitment but not with their affective commitment and firm performance. This study contributes to the understanding of how HR practices relate to firm performance and offers an improved test of the argument that valuable and firm-specific HR provide a source of competitive advantage. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

A study on the effects of some reinforcers to improve performance of employees in a retail industry.

PubMed

Raj, John Dilip; Nelson, John Abraham; Rao, K S P

2006-11-01

Two field experiments were conducted in the Business Information Technology Department of a major retail industry to analyze the impact of positive task performance reinforcers. The employees were divided into two broad groups - those performing complex tasks and those performing relatively simpler tasks. The first group was further divided into two subgroups, one being reinforced with money and paid leave and the other with feedback. Both the subgroups showed a significant improvement in performance behavior. However, feedback had a stronger effect on task performance even after the reinforcement was withdrawn. The second group of employees was allowed to choose reinforcers of their liking. Two simple techniques, a casual dress code and flexible working hours chosen by them, had a positive effect on their performance, which continued even after 6 months into the intervention. Besides, the procedure for the second group required no monetary or work-time loss to the employer.

International Space Station Major Constituent Analyzer On-Orbit Performance

NASA Technical Reports Server (NTRS)

Gardner, Ben D.; Erwin, Phillip M.; Thoresen, Souzan; Wiedemann, Rachel; Matty, Chris

2015-01-01

The Major Constituent Analyzer is a mass spectrometer based system that measures the major atmospheric constituents on the International Space Station. A number of limited-life components require periodic change-out, including the ORU 02 analyzer and the ORU 08 Verification Gas Assembly. Improvements to ion pump operation and ion source tuning have improved lifetime performance of the current ORU 02 design. The most recent ORU 02 analyzer assemblies, as well as ORU 08, have operated nominally. For ORU 02, the ion source filaments and ion pump lifetime continue to be key determinants of MCA performance and logistical support. Monitoring several key parameters provides the capacity to monitor ORU health and properly anticipate end of life.

A Community Health Worker "logic model": towards a theory of enhanced performance in low- and middle-income countries.

PubMed

Naimoli, Joseph F; Frymus, Diana E; Wuliji, Tana; Franco, Lynne M; Newsome, Martha H

2014-10-02

There has been a resurgence of interest in national Community Health Worker (CHW) programs in low- and middle-income countries (LMICs). A lack of strong research evidence persists, however, about the most efficient and effective strategies to ensure optimal, sustained performance of CHWs at scale. To facilitate learning and research to address this knowledge gap, the authors developed a generic CHW logic model that proposes a theoretical causal pathway to improved performance. The logic model draws upon available research and expert knowledge on CHWs in LMICs. Construction of the model entailed a multi-stage, inductive, two-year process. It began with the planning and implementation of a structured review of the existing research on community and health system support for enhanced CHW performance. It continued with a facilitated discussion of review findings with experts during a two-day consultation. The process culminated with the authors' review of consultation-generated documentation, additional analysis, and production of multiple iterations of the model. The generic CHW logic model posits that optimal CHW performance is a function of high quality CHW programming, which is reinforced, sustained, and brought to scale by robust, high-performing health and community systems, both of which mobilize inputs and put in place processes needed to fully achieve performance objectives. Multiple contextual factors can influence CHW programming, system functioning, and CHW performance. The model is a novel contribution to current thinking about CHWs. It places CHW performance at the center of the discussion about CHW programming, recognizes the strengths and limitations of discrete, targeted programs, and is comprehensive, reflecting the current state of both scientific and tacit knowledge about support for improving CHW performance. The model is also a practical tool that offers guidance for continuous learning about what works. Despite the model's limitations and several challenges in translating the potential for learning into tangible learning, the CHW generic logic model provides a solid basis for exploring and testing a causal pathway to improved performance.

Improving near-peer teaching quality in anatomy by educating teaching assistants: An example from Sweden.

PubMed

Johansson, Ellen; Holmin, Tobias E; Johansson, Bengt R; Braide, Magnus

2018-02-14

Peer-assisted learning has gained momentum in a variety of disciplines, including medical education. In Gothenburg, Sweden, medical students who have finished their compulsory anatomy courses have the option of working as teaching assistants (TAs). Teaching assistants provide small group teaching sessions as a complement to lectures given by faculty. Previously, TAs were left to handle the role as junior teachers by themselves, but since 2011, a continuation course in anatomy has been developed with the aim of providing the TAs better anatomy knowledge and guidance for teaching. The course was designed to comprise 7.5 ECTS credits (equivalent to 5 weeks of full-time studies), and today all TAs are required to take this course before undertaking their own teaching responsibilities. This study aims to compare course evaluations of TA teaching before and after the introduction of the anatomy continuation course, in order to understand how students perceived teaching performed by self-learned versus trained TAs. The results of this study demonstrate that there was a trend towards better teaching performed by trained TAs. The variability in rankings decreased significantly after the introduction of the continuation course. This was mainly due to an improvement among the TAs with the lowest levels of performance. In addition to comparing student rankings, TAs were interviewed regarding their experiences and perceptions within the continuation course. The course was generally positively regarded. The TAs described a sense of cohesion and appreciation since the institute invested in a course dedicated specifically for them. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

Promoting Strong ISO 50001 Outcomes with Supportive National Infrastructure

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

McKane, Aimee, T.; Siciliano, Graziella; de los Reyes, Pamela

The ISO 50001 standard is a key mechanism for reducing greenhouse gas emissions and improving energy efficiency globally. An increasing number of companies are seeking certification, creating the need for personnel that are competent to conduct ISO 50001 certification audits. The growth of ISO 50001 is expected to accelerate as more companies integrate ISO 50001 into their corporate sustainability strategies and supplier requirements. Robust implementation of ISO 50001 represents an important tool for countries with climate change mitigation goals. Because of its dual focus on continual improvement of an organization’s energy management system (EnMS) and its energy performance improvement, ISOmore » 50001 requires skills of both implementers and certification auditors that are not well-supported by current credentials and training. This paper describes an effort to address skill gaps of certification auditors, a critical factor to ensure that ISO 50001 implementations are robust and result in continued energy performance improvement. A collaboration of governments through the Energy Management Working Group (EMWG), formerly under Global Superior Energy Performance (GSEP), has formed to build workforce capacity for ISO 50001 certification audits. The EMWG is leading the development of an internationally-relevant certification scheme for ISO 50001 Lead Auditor that meets requirements for ISO/IEC 17024 accreditation and ISO 50003 for defining ISO 50001 Lead Auditor competency. Wider availability of competent ISO 50001 Lead Auditors will ultimately increase the impact and market value of ISO 50001 certification and improve consistency of ISO 50001 certification outcomes by establishing a standardized and high level of knowledge and skills globally.« less

Improving Hepatitis C Identification: Technology Alone Is Not the Answer.

PubMed

Nitsche, Bruce; Miller, Sara C; Giorgio, Margaret; Berry, Carolyn A; Muir, Andrew

2017-09-01

An estimated 3 to 5 million Americans are chronically infected with hepatitis C virus (HCV), and approximately 75% of those persons were born between 1945 and 1965 (the so-called baby boomer generation). Because of the largely asymptomatic nature of HCV, up to 50% of those infected are unaware of their disease. Risk-based testing has been largely ineffective. Based on prevalence data, the Centers for Disease Control and Prevention and other organizations recommend a onetime HCV antibody test for all baby boomers. However, uptake of this recommendation requires significant changes in clinical practice for already busy primary care clinicians. We studied the effectiveness of a quality improvement initiative based on continuous audit and feedback combined with education for improving testing in alignment with guidelines; the control group was a cohort of clinicians whose only reminder was an institution-wide electronic health record prompt. Our data show improved testing rates among all clinician groups, but more significant improvement occurred among providers who received continuous feedback about their clinical performance coupled with education.

Rapid core measure improvement through a "business case for quality".

PubMed

Perlin, Jonathan B; Horner, Stephen J; Englebright, Jane D; Bracken, Richard M

2014-01-01

Incentives to improve performance are emerging as revenue or financial penalties are linked to the measured quality of service provided. The HCA "Getting to Green" program was designed to rapidly increase core measure performance scores. Program components included (1) the "business case for quality"-increased awareness of how quality drives financial performance; (2) continuous communication of clinical and financial performance data; and (3) evidence-based clinical protocols, incentives, and tools for process improvement. Improvement was measured by comparing systemwide rates of adherence to national quality measures for heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and surgical care (SCIP) to rates from all facilities reporting to the Centers for Medicare and Medicaid Services (CMS). As of the second quarter of 2011, 70% of HCA total measure set composite scores were at or above the 90th percentile of CMS scores. A test of differences in regression coefficients between the CMS national average and the HCA average revealed significant differences for AMI (p = .001), HF (p = .012), PN (p < .001), and SCIP (p = .015). This program demonstrated that presentation of the financial implications of quality, transparency in performance data, and clearly defined goals could cultivate the desire to use improvement tools and resources to raise performance. © 2012 National Association for Healthcare Quality.

Process Improvements in Training Device Acceptance Testing: A Study in Total Quality Management

DTIC Science & Technology

1990-12-12

Quality Management , a small group of Government and industry specialists examined the existing training device acceptance test process for potential improvements. The agreed-to mission of the Air Force/Industry partnership was to continuously identify and promote implementable approaches to minimize the cost and time required for acceptance testing while ensuring that validated performance supports the user training requirements. Application of a Total Quality process improvement model focused on the customers and their requirements, analyzed how work was accomplished, and

Evaluation of a stereoscopic camera-based three-dimensional viewing workstation for ophthalmic surgery.

PubMed

Bhadri, Prashant R; Rowley, Adrian P; Khurana, Rahul N; Deboer, Charles M; Kerns, Ralph M; Chong, Lawrence P; Humayun, Mark S

2007-05-01

To evaluate the effectiveness of a prototype stereoscopic camera-based viewing system (Digital Microsurgical Workstation, three-dimensional (3D) Vision Systems, Irvine, California, USA) for anterior and posterior segment ophthalmic surgery. Institutional-based prospective study. Anterior and posterior segment surgeons performed designated standardized tasks on porcine eyes after training on prosthetic plastic eyes. Both anterior and posterior segment surgeons were able to complete tasks requiring minimal or moderate stereoscopic viewing. The results indicate that the system provides improved ergonomics. Improvements in key viewing performance areas would further enhance the value over a conventional operating microscope. The performance of the prototype system is not at par with the planned commercial system. With continued development of this technology, the three- dimensional system may be a novel viewing system in ophthalmic surgery with improved ergonomics with respect to traditional microscopic viewing.

Sigma Metrics Across the Total Testing Process.

PubMed

Charuruks, Navapun

2017-03-01

Laboratory quality control has been developed for several decades to ensure patients' safety, from a statistical quality control focus on the analytical phase to total laboratory processes. The sigma concept provides a convenient way to quantify the number of errors in extra-analytical and analytical phases through the defect per million and sigma metric equation. Participation in a sigma verification program can be a convenient way to monitor analytical performance continuous quality improvement. Improvement of sigma-scale performance has been shown from our data. New tools and techniques for integration are needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Performance improvement: one model to reduce length of stay.

PubMed

Chisari, E; Mele, J A

1994-01-01

Dedicated quality professionals are tired of quick fixes, Band-Aids, and other first-aid strategies that offer only temporary relief of nagging problems rather than a long-term cure. Implementing strategies that can produce permanent solutions to crucial problems is a challenge confronted by organizations striving for continuous performance improvement. One vehicle, driven by data and customer requirements, that can help to solve problems and sustain success over time is the storyboard. This article illustrates the use of the storyboard as the framework for reducing length of stay--one of the most important problems facing healthcare organizations today.

Minimizing mixing intensity to improve the performance of rice straw anaerobic digestion via enhanced development of microbe-substrate aggregates.

PubMed

Kim, Moonkyung; Kim, Byung-Chul; Choi, Yongju; Nam, Kyoungphile

2017-12-01

The aim of this work was to study the effect of the differential development of microbe-substrate aggregates at different mixing intensities on the performance of anaerobic digestion of rice straw. Batch and semi-continuous reactors were operated for up to 50 and 300days, respectively, under different mixing intensities. In both batch and semi-continuous reactors, minimal mixing conditions exhibited maximum methane production and lignocellulose biodegradability, which both had strong correlations with the development of microbe-substrate aggregates. The results implied that the aggregated microorganisms on the particulate substrate played a key role in rice straw hydrolysis, determining the performance of anaerobic digestion. Increasing the mixing speed from 50 to 150rpm significantly reduced the methane production rate by disintegrating the microbe-substrate aggregates in the semi-continuous reactor. A temporary stress of high-speed mixing fundamentally affected the microbial communities, increasing the possibility of chronic reactor failure. Copyright © 2017 Elsevier Ltd. All rights reserved.

Continuous Firefly Algorithm for Optimal Tuning of Pid Controller in Avr System

NASA Astrophysics Data System (ADS)

Bendjeghaba, Omar

2014-01-01

This paper presents a tuning approach based on Continuous firefly algorithm (CFA) to obtain the proportional-integral- derivative (PID) controller parameters in Automatic Voltage Regulator system (AVR). In the tuning processes the CFA is iterated to reach the optimal or the near optimal of PID controller parameters when the main goal is to improve the AVR step response characteristics. Conducted simulations show the effectiveness and the efficiency of the proposed approach. Furthermore the proposed approach can improve the dynamic of the AVR system. Compared with particle swarm optimization (PSO), the new CFA tuning method has better control system performance in terms of time domain specifications and set-point tracking.

Accelerating plant breeding.

PubMed

De La Fuente, Gerald N; Frei, Ursula K; Lübberstedt, Thomas

2013-12-01

The growing demand for food with limited arable land available necessitates that the yield of major food crops continues to increase over time. Advances in marker technology, predictive statistics, and breeding methodology have allowed for continued increases in crop performance through genetic improvement. However, one major bottleneck is the generation time of plants, which is biologically limited and has not been improved since the introduction of doubled haploid technology. In this opinion article, we propose to implement in vitro nurseries, which could substantially shorten generation time through rapid cycles of meiosis and mitosis. This could prove a useful tool for speeding up future breeding programs with the aim of sustainable food production. Copyright © 2013 Elsevier Ltd. All rights reserved.

Development of Laser Propulsion and Tracking System for Laser-Driven Micro-Airplane

NASA Astrophysics Data System (ADS)

Ishikawa, Hiroyasu; Kajiwara, Itsuro; Hoshino, Kentaro; Yabe, Takashi; Uchida, Shigeaki; Shimane, Yoshichika

2004-03-01

The purposes of this paper are to improve the control performance of the developed laser tracking system and to develop an integrated laser propulsion/tracking system for realizing a continuous flight and control of the micro-airplane. The laser propulsion is significantly effective to achieve the miniaturization and lightening of the micro-airplane. The laser-driven micro-airplane has been studied with a paper-craft airplane and YAG laser, resulting in a successful glide of the airplane. In the next stage of the laser-driven micro-airplane development, the laser tracking is expected as key technologies to achieve continuous propulsion. Furthermore, the laser propulsion system should be combined with the laser tracking system to supply continuous propulsion. Experiments are carried out to evaluate the performance of the developed laser tracking system and integrated laser propulsion/tracking system.

Total Quality Management Implementation Plan: Defense Depot, Ogden

DTIC Science & Technology

1989-07-01

NUMBERS Total Quality Management Implementation Plan Defense Depot Ogden 6. AUTHOR(S) 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...PAGES TQM (Total Quality Management ), Continuous Process Improvement, Depot Operations, Process Action Teams 16. PRICE CODE 17. SECURITY...034 A Message From The Commander On Total Quality Management i fully support the DLA aoproacii to Total Quality Management . As stated by General

Creating a New Learning Community: A Case Study of School Leaders' Perceptions of the Baldrige Criteria for Performance Excellence and Their Implementation in a Suburban School District

ERIC Educational Resources Information Center

Adams, Denean

2013-01-01

The Baldrige Criteria for Performance Excellence (Baldrige categories) are increasingly being used throughout the health, education, and business sectors to drive continuous improvement in quality organizations. In each industry, specific categories are available to assist in identifying quality practices deployed throughout an organization. The…

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis.

PubMed

Ng, G K B; Leung, G K K; Johnston, J M; Cowling, B J

2013-10-01

The objectives of this review were to identify factors that influence implementation of hospital accreditation programmes and to assess the impact of the accreditation process on quality improvement in public hospitals. Two electronic databases, Medline (OvidSP) and PubMed, were systematically searched. "Public hospital", "hospital accreditation", and "quality improvement" were used as the search terms. A total of 348 citations were initially identified. After critical appraisal and study selection, 26 articles were included in the review. The data were extracted and analysed using a SWOT (strengths, weaknesses, opportunities, threats) analysis. Increased staff engagement and communication, multidisciplinary team building, positive changes in organisational culture, and enhanced leadership and staff awareness of continuous quality improvement were identified as strengths. Weaknesses included organisational resistance to change, increased staff workload, lack of awareness about continuous quality improvement, insufficient staff training and support for continuous quality improvement, lack of applicable accreditation standards for local use, and lack of performance outcome measures. Opportunities included identification of improvement areas, enhanced patient safety, additional funding, public recognition, and market advantage. Threats included opportunistic behaviours, funding cuts, lack of incentives for participation, and a regulatory approach to mandatory participation. By relating the findings to the operational issues of accreditation, this review discussed the implications for successful implementation and how accreditation may drive quality improvement. These findings have implications for various stakeholders (government, the public, patients and health care providers), when it comes to embarking on accreditation exercises.

Integrating Continuing Professional Development With Health System Reform: Building Pillars of Support.

PubMed

Davis, David A; Rayburn, William F

2016-01-01

Clinical failures sparked a widespread desire for health system reform at the beginning of the 21st century, but related efforts have resulted in changes that are either slow or nonexistent. In response, academic medicine has moved in two directions: (1) system-wide reform using electronic health records, practice networks, and widespread data applications (a macro pathway); and (2) professional development of individual clinicians through continuous performance improvement (a micro pathway). Both pathways exist to improve patient care and population health, yet each suffers from limitations in widespread implementation. The authors call for a better union between these two parallel pathways through four pillars of support: (1) an acknowledgment that both pathways are essential to each other and to the final outcome they intend to achieve, (2) a strong faculty commitment to educate about quality improvement and patient safety at all education levels, (3) a reengineering of tools for professional development to serve as effective change agents, and (4) the development of standards to sustain this alignment of pathways. With these pillars of support integrating continuing professional development with health system reform, the authors envision a better functioning system, with improved metrics and value to enhance patient care and population health.

42 CFR 438.218 - Enrollee information.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Enrollee information. 438.218 Section 438.218... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Structure and Operation Standards § 438.218 Enrollee information. The requirements that States must meet under...

42 CFR 438.218 - Enrollee information.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Enrollee information. 438.218 Section 438.218... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Structure and Operation Standards § 438.218 Enrollee information. The requirements that States must meet under...

42 CFR 438.218 - Enrollee information.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Enrollee information. 438.218 Section 438.218... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Structure and Operation Standards § 438.218 Enrollee information. The requirements that States must meet under...

42 CFR 438.218 - Enrollee information.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Enrollee information. 438.218 Section 438.218... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS MANAGED CARE Quality Assessment and Performance Improvement Structure and Operation Standards § 438.218 Enrollee information. The requirements that States must meet under...

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

42 CFR 438.206 - Availability of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

Semiannual Report: Oct 1, 2000 - Mar 31, 2001

EPA Pesticide Factsheets

Semiannual Report #EPA-350-K-01-001, May, 2001. Our new structure provides a solid foundation for the OIG's efforts to continuously improve its performance, and I am certain that it will greatly enhance our ability to be agents of positive change.

Exemplary Care and Learning Sites: A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting

PubMed Central

Ogrinc, Greg; Hoffman, Kimberly G.; Stevenson, Katherine M.; Shalaby, Marc; Beard, Albertine S.; Thörne, Karin E.; Coleman, Mary T.; Baum, Karyn D.

2016-01-01

Problem Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting. Approach From 2008–2012, an iterative, interactive process was used to develop the ECLS model and its core elements—patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement. In 2012–2013, a three-part feasibility test of the model, including a site self-assessment, an independent review of each site’s ratings, and implementation case stories, was conducted at six clinical teaching sites (in the United States and Sweden). Outcomes Site leaders reported the ECLS model provided a systematic approach toward improving patient (and population) outcomes, system performance, and professional development. Most sites found it challenging to incorporate the patients and families element. The trainee element was strong at four sites. The leadership and data elements were self-assessed as the most fully developed. The health professionals element exhibited the greatest variability across sites. Next Steps The next test of the model should be prospective, linked to clinical and educa tional outcomes, to evaluate whether it helps care delivery teams, educators, and patients and families take action to achieve better patient (and population) outcomes, system performance, and professional development. PMID:26760058

The 25 mA continuous-wave surface-plasma source of H{sup −} ions

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

Belchenko, Yu., E-mail: belchenko@inp.nsk.su; Gorbovsky, A.; Sanin, A.

The ion source with the Penning geometry of electrodes producing continuous-wave beam of H{sup −} ions with current up to 25 mA was developed. Several improvements were introduced to increase source intensity, reliability, and lifetime. The collar around the emission aperture increases the electrons filtering. The apertures’ diameters of the ion-optical system electrodes were increased to generate the beam with higher intensity. An optimization of electrodes’ temperature was performed.

Tissue lesion created by HIFU in continuous scanning mode

NASA Astrophysics Data System (ADS)

Fan, Tingbo; Liu, Zhenbo; Zhang, Dong

2012-09-01

The lesion formation was numerically and experimentally investigated by the continuous scanning mode. Simulations were presented based on the combination of Khokhlov-Zabolotskaya-Kuznetov (KZK) equation and bio-heat equation. Measurements were performed on porcine liver tissues using a 1.01 MHz single-element focused transducer at various acoustic powers, confirmed the predicted results. Controlling of the peak temperature and lesion by the scanning speed may be exploited for improvement of efficiency in HIFU therapy.

Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system: Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system

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

Stickel, Jonathan J.; Adhikari, Birendra; Sievers, David A.

Converting abundant lignocellulosic biomass to sugars as fungible precursors to fuels and chemicals has the potential to diversify the supply chain for those products, but further process improvements are needed to achieve economic viability. In the current work, process intensification of the key enzymatic hydrolysis unit operation is demonstrated by means of a membrane reactor system that was operated continuously. Lignocellulosic biomass (pretreated corn stover) and buffered enzyme solution were fed to a continuously stirred-tank reactor, and clarified sugar solution was withdrawn via a commercial tubular ultrafiltration membrane. The membrane permeance decline and membrane cleaning efficacy were studied and didmore » not vary significantly when increasing fraction insoluble solids (FIS) from 2.5% to 5%. Continuous enzymatic hydrolysis was successfully operated for more than 80 h. A model for the reactor system was able to predict dynamic behavior that was in reasonable agreement with experimental results. The modeled technical performance of anticipated commercial batch and continuous enzymatic hydrolysis processes were compared and showed that continuous operation would provide at least twice the volumetric productivity for the conditions studied. Further improvements are anticipated by better membrane selection and by increasing FIS.« less

Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system: Continuous enzymatic hydrolysis of lignocellulosic biomass in a membrane-reactor system

DOE PAGES

Stickel, Jonathan J.; Adhikari, Birendra; Sievers, David A.; ...

2018-02-21

Converting abundant lignocellulosic biomass to sugars as fungible precursors to fuels and chemicals has the potential to diversify the supply chain for those products, but further process improvements are needed to achieve economic viability. In the current work, process intensification of the key enzymatic hydrolysis unit operation is demonstrated by means of a membrane reactor system that was operated continuously. Lignocellulosic biomass (pretreated corn stover) and buffered enzyme solution were fed to a continuously stirred-tank reactor, and clarified sugar solution was withdrawn via a commercial tubular ultrafiltration membrane. The membrane permeance decline and membrane cleaning efficacy were studied and didmore » not vary significantly when increasing fraction insoluble solids (FIS) from 2.5% to 5%. Continuous enzymatic hydrolysis was successfully operated for more than 80 h. A model for the reactor system was able to predict dynamic behavior that was in reasonable agreement with experimental results. The modeled technical performance of anticipated commercial batch and continuous enzymatic hydrolysis processes were compared and showed that continuous operation would provide at least twice the volumetric productivity for the conditions studied. Further improvements are anticipated by better membrane selection and by increasing FIS.« less

[Risk management in anesthesia and critical care medicine].

PubMed

Eisold, C; Heller, A R

2017-03-01

Throughout its history, anesthesia and critical care medicine has experienced vast improvements to increase patient safety. Consequently, anesthesia has never been performed on such a high level as it is being performed today. As a result, we do not always fully perceive the risks involved in our daily activity. A survey performed in Swiss hospitals identified a total of 169 hot spots which endanger patient safety. It turned out that there is a complex variety of possible errors that can only be tackled through consistent implementation of a safety culture. The key elements to reduce complications are continuing staff education, algorithms and standard operating procedures (SOP), working according to the principles of crisis resource management (CRM) and last but not least the continuous work-up of mistakes identified by critical incident reporting systems.

Does adding clinical data to administrative data improve agreement among hospital quality measures?

PubMed

Hanchate, Amresh D; Stolzmann, Kelly L; Rosen, Amy K; Fink, Aaron S; Shwartz, Michael; Ash, Arlene S; Abdulkerim, Hassen; Pugh, Mary Jo V; Shokeen, Priti; Borzecki, Ann

2017-09-01

Hospital performance measures based on patient mortality and readmission have indicated modest rates of agreement. We examined if combining clinical data on laboratory tests and vital signs with administrative data leads to improved agreement with each other, and with other measures of hospital performance in the nation's largest integrated health care system. We used patient-level administrative and clinical data, and hospital-level data on quality indicators, for 2007-2010 from the Veterans Health Administration (VA). For patients admitted for acute myocardial infarction (AMI), heart failure (HF) and pneumonia we examined changes in hospital performance on 30-d mortality and 30-d readmission rates as a result of adding clinical data to administrative data. We evaluated whether this enhancement yielded improved measures of hospital quality, based on concordance with other hospital quality indicators. For 30-d mortality, data enhancement improved model performance, and significantly changed hospital performance profiles; for 30-d readmission, the impact was modest. Concordance between enhanced measures of both outcomes, and with other hospital quality measures - including Joint Commission process measures, VA Surgical Quality Improvement Program (VASQIP) mortality and morbidity, and case volume - remained poor. Adding laboratory tests and vital signs to measure hospital performance on mortality and readmission did not improve the poor rates of agreement across hospital quality indicators in the VA. Efforts to improve risk adjustment models should continue; however, evidence of validation should precede their use as reliable measures of quality. Published by Elsevier Inc.

Key Factors for a High-Quality Peritoneal Dialysis Program — The Role of the PD Team and Continuous Quality Improvement

PubMed Central

Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

2014-01-01

The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. PMID:24962961

Maternal physical activity mode and fetal heart outcome.

PubMed

May, Linda E; Suminski, Richard R; Berry, Andrew; Langaker, Michelle D; Gustafson, Kathleen M

2014-07-01

Maternal leisure-time physical activity (LTPA) improves cardiac autonomic function in the fetus. The specific physical activity attributes (e.g., mode) that produce this benefit are not well understood. To determine if more time spent performing non-continuous LTPA during pregnancy is significantly associated with lower fetal heart rate (HR) and increased heart rate variability (HRV). This paper presents a retrospective analysis of previously reported data. Fetal magnetocardiograms (MCG) were recorded from 40 pregnant women at 36-wk gestational age. Metrics of fetal HR and HRV, self-reported min of continuous and non-continuous LTPA performed during the 3-months preceding the 36-wk assessment point and covariates (maternal weight change pre to 36-wk, age, and resting HR and fetal activity state during MCG recordings. Positive correlations were significant (p<0.05) between min of continuous LTPA, the time domain metrics that describe fetal overall HRV, short-term HRV and a frequency domain metric that reflects vagal activity. Time spent in non-continuous LTPA was positively correlated (p<0.05) with two HRV metrics that reflect fetal overall HRV. In the multiple regression analyses, minutes of non-continuous LTPA remained associated with fetal vagal activity (p<0.05) and the relationships between minutes of non-continuous LTPA and fetal overall HRV (p<0.005) persisted. These data suggest non-continuous physical activity provides unique benefits to the fetal autonomic nervous system that may give the fetus an adaptive advantage. Further studies are needed to understand the physiological mechanisms and long-term health effects of physical activity (both non-continuous and continuous) performed during pregnancy to both women and their offspring. Copyright © 2014 Elsevier Ltd. All rights reserved.

Development of a cloud-based application for the Fracture Liaison Service model of care.

PubMed

Holzmueller, C G; Karp, S; Zeldow, D; Lee, D B; Thompson, D A

2016-02-01

The aims of this study are to develop a cloud-based application of the Fracture Liaison Service for practitioners to coordinate the care of osteoporotic patients after suffering primary fractures and provide a performance feedback portal for practitioners to determine quality of care. The application provides continuity of care, improved patient outcomes, and reduced medical costs. The purpose of this study is to describe the content development and functionality of a cloud-based application to broadly deploy the Fracture Liaison Service (FLS) to coordinate post-fracture care for osteoporotic patients. The Bone Health Collaborative developed the FLS application in 2013 to support practitioners' access to information and management of patients and provide a feedback portal for practitioners to track their performance in providing quality care. A five-step protocol (identify, inform, initiate, investigate, and iterate) organized osteoporotic post-fracture care-related tasks and timelines for the application. A range of descriptive data about the patient, their medical condition, therapies and care, and current providers can be collected. Seven quality of care measures from the National Quality Forum, The Joint Commission, and the Centers for Medicare and Medicaid Services can be tracked through the application. There are five functional areas including home, tasks, measures, improvement, and data. The home, tasks, and data pages are used to enter patient information and coordinate care using the five-step protocol. Measures and improvement pages are used to enter quality measures and provide practitioners with continuous performance feedback. The application resides within a portal, running on a multitenant, private cloud-based Avedis enterprise registry platform. All data are encrypted in transit and users access the application using a password from any common web browser. The application could spread the FLS model of care across the US health care system, provide continuity of care, effectively manage osteoporotic patients, improve outcomes, and reduce medical costs.

Application of Lean Healthcare methodology in a urology department of a tertiary hospital as a tool for improving efficiency.

PubMed

Boronat, F; Budia, A; Broseta, E; Ruiz-Cerdá, J L; Vivas-Consuelo, D

To describe the application of the Lean methodology as a method for continuously improving the efficiency of a urology department in a tertiary hospital. The implementation of the Lean Healthcare methodology in a urology department was conducted in 3 phases: 1) team training and improvement of feedback among the practitioners, 2) management by process and superspecialisation and 3) improvement of indicators (continuous improvement). The indicators were obtained from the Hospital's information systems. The main source of information was the Balanced Scorecard for health systems management (CUIDISS). The comparison with other autonomous and national urology departments was performed through the same platform with the help of the Hospital's records department (IASIST). A baseline was established with the indicators obtained in 2011 for the comparative analysis of the results after implementing the Lean Healthcare methodology. The implementation of this methodology translated into high practitioner satisfaction, improved quality indicators reaching a risk-adjusted complication index (RACI) of 0.59 and a risk-adjusted mortality rate (RAMR) of 0.24 in 4 years. A value of 0.61 was reached with the efficiency indicator (risk-adjusted length of stay [RALOS] index), with a savings of 2869 stays compared with national Benchmarking (IASIST). The risk-adjusted readmissions index (RARI) was the only indicator above the standard, with a value of 1.36 but with progressive annual improvement of the same. The Lean methodology can be effectively applied to a urology department of a tertiary hospital to improve efficiency, obtaining significant and continuous improvements in all its indicators, as well as practitioner satisfaction. Team training, management by process, continuous improvement and delegation of responsibilities has been shown to be the fundamental pillars of this methodology. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Feasibility of a real-time hand hygiene notification machine learning system in outpatient clinics.

PubMed

Geilleit, R; Hen, Z Q; Chong, C Y; Loh, A P; Pang, N L; Peterson, G M; Ng, K C; Huis, A; de Korne, D F

2018-04-09

Various technologies have been developed to improve hand hygiene (HH) compliance in inpatient settings; however, little is known about the feasibility of machine learning technology for this purpose in outpatient clinics. To assess the effectiveness, user experiences, and costs of implementing a real-time HH notification machine learning system in outpatient clinics. In our mixed methods study, a multi-disciplinary team co-created an infrared guided sensor system to automatically notify clinicians to perform HH just before first patient contact. Notification technology effects were measured by comparing HH compliance at baseline (without notifications) with real-time auditory notifications that continued till HH was performed (intervention I) or notifications lasting 15 s (intervention II). User experiences were collected during daily briefings and semi-structured interviews. Costs of implementation of the system were calculated and compared to the current observational auditing programme. Average baseline HH performance before first patient contact was 53.8%. With real-time auditory notifications that continued till HH was performed, overall HH performance increased to 100% (P < 0.001). With auditory notifications of a maximum duration of 15 s, HH performance was 80.4% (P < 0.001). Users emphasized the relevance of real-time notification and contributed to technical feasibility improvements that were implemented in the prototype. Annual running costs for the machine learning system were estimated to be 46% lower than the observational auditing programme. Machine learning technology that enables real-time HH notification provides a promising cost-effective approach to both improving and monitoring HH, and deserves further development in outpatient settings. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

High-rate hydrogenotrophic methanogenesis for biogas upgrading: the role of anaerobic granules.

PubMed

Xu, Heng; Gong, Shufen; Sun, Yuanzi; Ma, Hailing; Zheng, Mingyue; Wang, Kaijun

2015-01-01

Hydrogenotrophic methanogenesis has been proved to be a feasible biological method for biogas upgrading. To improve its performance, the feasibility of typical anaerobic granules as the inoculum was investigated in both batch and continuous experiments. The results from batch experiments showed that glucose-acclimated granules seemed to perform better than granules acclimated to acidified products (AP, i.e. acetate, propionate and ethanol) in in situ biogas upgrading systems and a slightly higher H2 consumption rate (1.5 mmol H2 g VSS(-1) h(-1)) was obtained for glucose-acclimated granules. For AP-acclimated granules, the inhibition on anaerobic digestion and pH increase (up to 9.55±0.16) took place, and the upgrading performance was adversely affected. In contrast, better performance for AP-acclimated granules was observed in ex situ systems, possibly due to their higher hydrogenotrophic methanogenic activities (HMA). Moreover, when gas-liquid mass transfer limitations were alleviated, the upgrading performance was significantly improved (three-fold) for both glucose-acclimated and AP-acclimated granules. The HMA of anaerobic granules could be further enhanced to improve biogas upgrading performance via continuous cultivation with H2/CO2 as the sole substrate. During the three months' cultivation, secondary granulation and microbial population shift were observed, but anaerobic granules still remained intact and their HMA increased from 0.2 to 0.6 g COD g VSS(-1) d(-1). It indicated that the formation of hydrogenotrophic methanogenic granules, a new type of anaerobic granules specialized for high-rate hydrogenotrophic methanogenesis and biogas upgrading, might be possible. Conclusively, anaerobic granules showed great potential for biogas upgrading.

Evaluation of an institutional project to improve venous thromboembolism prevention.

PubMed

Minami, Christina A; Yang, Anthony D; Ju, Mila; Culver, Eckford; Seifert, Kathryn; Kreutzer, Lindsey; Halverson, Terri; O'Leary, Kevin J; Bilimoria, Karl Y

2016-12-01

Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures. A retrospective observational study. NMH, an 885-bed academic medical center in Chicago, Illinois PATIENTS: Inpatients admitted to NMH from January 1, 2013 to May 1, 2013 and from October 1, 2014 to April 1, 2015 were eligible for evaluation. Using the define-measure-analyze-improve-control (DMAIC) process-improvement methodology, a multidisciplinary team implemented and iteratively improved 15 data-driven interventions in 4 broad areas: (1) electronic medical record (EMR) alerts, (2) education initiatives, (3) new EMR order sets, and (4) other EMR changes. The Joint Commission's 6 core measures and the Surgical Care Improvement Project (SCIP) SCIP-VTE-2 measure. Based on 3103 observations (1679 from January 1, 2013 to May 1, 2013, and 1424 from October 1, 2014 to April 1, 2015), performance on the core measures improved. Performance on measure 1 (chemoprophylaxis) improved from 82.5% to 90.2% on medicine services, and from 94.4% to 97.6% on surgical services. The largest improvements were seen in measure 4 (platelet monitoring), with a performance increase from 76.7% adherence to 100%, and measure 5 (warfarin discharge instructions), with a performance increase from 27.4% to 88.8%. A systematic hospital-wide DMAIC project improved VTE prophylaxis measure performance. Sustained performance has been observed, and novel control mechanisms for continued performance surveillance have been embedded in the hospital system. Journal of Hospital Medicine 2016;11:S29-S37. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

FUEL-FLEXIBLE GASIFICATION-COMBUSTION TECHNOLOGY FOR PRODUCTION OF H2 AND SEQUESTRATION-READY CO2

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

George Rizeq; Janice West; Arnaldo Frydman

Further development of a combustion Large Eddy Simulation (LES) code for the design of advanced gaseous combustion systems is described in this sixth quarterly report. CFD Research Corporation (CFDRC) is developing the LES module within the parallel, unstructured solver included in the commercial CFD-ACE+ software. In this quarter, in-situ adaptive tabulation (ISAT) for efficient chemical rate storage and retrieval was implemented and tested within the Linear Eddy Model (LEM). ISAT type 3 is being tested so that extrapolation can be performed and further improve the retrieval rate. Further testing of the LEM for subgrid chemistry was performed for parallel applicationsmore » and for multi-step chemistry. Validation of the software on backstep and bluff-body reacting cases were performed. Initial calculations of the SimVal experiment at Georgia Tech using their LES code were performed. Georgia Tech continues the effort to parameterize the LEM over composition space so that a neural net can be used efficiently in the combustion LES code. A new and improved Artificial Neural Network (ANN), with log-transformed output, for the 1-step chemistry was implemented in CFDRC's LES code and gave reasonable results. This quarter, the 2nd consortium meeting was held at CFDRC. Next quarter, LES software development and testing will continue. Alpha testing of the code will continue to be performed on cases of interest to the industrial consortium. Optimization of subgrid models will be pursued, particularly with the ISAT approach. Also next quarter, the demonstration of the neural net approach, for multi-step chemical kinetics speed-up in CFD-ACE+, will be accomplished.« less

Experiment facilities for life science experiments in space.

PubMed

Uchida, Satoko

2004-11-01

To perform experiments in microgravity environment, there should be many difficulties compared with the experiments on ground. JAXA (Japan Aerospace Exploration Agency) has developed various experiment facilities to perform life science experiments in space, such as Cell Culture Kit, Thermo Electric Incubator, Free Flow Electrophoresis Unit, Aquatic Animal Experiment Unit, and so on. The first experiment facilities were flown on Spacelab-J mission in 1992, and they were improved and modified for the 2nd International Microgravity Laboratory (IML-2) mission in 1994. Based on these experiences, some of them were further improved and flown on another missions. These facilities are continuously being improved for the International Space Station use, where high level functions and automatic operations will be required.

Design of an unified chassis controller for rollover prevention, manoeuvrability and lateral stability

NASA Astrophysics Data System (ADS)

Yoon, Jangyeol; Yim, Seongjin; Cho, Wanki; Koo, Bongyeong; Yi, Kyongsu

2010-11-01

This paper describes a unified chassis control (UCC) strategy to prevent vehicle rollover and improve both manoeuvrability and lateral stability. Since previous researches on rollover prevention are only focused on the reduction of lateral acceleration, the manoeuvrability and lateral stability cannot be guaranteed. For this reason, it is necessary to design a UCC controller to prevent rollover and improve lateral stability by integrating electronic stability control, active front steering and continuous damping control. This integration is performed through switching among several control modes and a simulation is performed to validate the proposed method. Simulation results indicate that a significant improvement in rollover prevention, manoeuvrability and lateral stability can be expected from the proposed UCC system.

Test and evaluation of the HIDEC engine uptrim algorithm

NASA Technical Reports Server (NTRS)

Ray, R. J.; Myers, L. P.

1986-01-01

The highly integrated digital electronic control (HIDEC) program will demonstrate and evaluate the improvements in performance and mission effectiveness that result from integrated engine-airframe control systems. Performance improvements will result from an adaptive engine stall margin mode, a highly integrated mode that uses the airplane flight conditions and the resulting inlet distortion to continuously compute engine stall margin. When there is excessive stall margin, the engine is uptrimmed for more thrust by increasing engine pressure ratio (EPR). The EPR uptrim logic has been evaluated and implemented into computer simulations. Thrust improvements over 10 percent are predicted for subsonic flight conditions. The EPR uptrim was successfully demonstrated during engine ground tests. Test results verify model predictions at the conditions tested.

Engineering MoSx/Ti/InP Hybrid Photocathode for Improved Solar Hydrogen Production

NASA Astrophysics Data System (ADS)

Li, Qiang; Zheng, Maojun; Zhong, Miao; Ma, Liguo; Wang, Faze; Ma, Li; Shen, Wenzhong

2016-07-01

Due to its direct band gap of ~1.35 eV, appropriate energy band-edge positions, and low surface-recombination velocity, p-type InP has attracted considerable attention as a promising photocathode material for solar hydrogen generation. However, challenges remain with p-type InP for achieving high and stable photoelectrochemical (PEC) performances. Here, we demonstrate that surface modifications of InP photocathodes with Ti thin layers and amorphous MoSx nanoparticles can remarkably improve their PEC performances. A high photocurrent density with an improved PEC onset potential is obtained. Electrochemical impedance analyses reveal that the largely improved PEC performance of MoSx/Ti/InP is attributed to the reduced charge-transfer resistance and the increased band bending at the MoSx/Ti/InP/electrolyte interface. In addition, the MoSx/Ti/InP photocathodes function stably for PEC water reduction under continuous light illumination over 2 h. Our study demonstrates an effective approach to develop high-PEC-performance InP photocathodes towards stable solar hydrogen production.

Engineering MoSx/Ti/InP Hybrid Photocathode for Improved Solar Hydrogen Production

PubMed Central

Li, Qiang; Zheng, Maojun; Zhong, Miao; Ma, Liguo; Wang, Faze; Ma, Li; Shen, Wenzhong

2016-01-01

Due to its direct band gap of ~1.35 eV, appropriate energy band-edge positions, and low surface-recombination velocity, p-type InP has attracted considerable attention as a promising photocathode material for solar hydrogen generation. However, challenges remain with p-type InP for achieving high and stable photoelectrochemical (PEC) performances. Here, we demonstrate that surface modifications of InP photocathodes with Ti thin layers and amorphous MoSx nanoparticles can remarkably improve their PEC performances. A high photocurrent density with an improved PEC onset potential is obtained. Electrochemical impedance analyses reveal that the largely improved PEC performance of MoSx/Ti/InP is attributed to the reduced charge-transfer resistance and the increased band bending at the MoSx/Ti/InP/electrolyte interface. In addition, the MoSx/Ti/InP photocathodes function stably for PEC water reduction under continuous light illumination over 2 h. Our study demonstrates an effective approach to develop high-PEC-performance InP photocathodes towards stable solar hydrogen production. PMID:27431993

Engineering MoSx/Ti/InP Hybrid Photocathode for Improved Solar Hydrogen Production.

PubMed

Li, Qiang; Zheng, Maojun; Zhong, Miao; Ma, Liguo; Wang, Faze; Ma, Li; Shen, Wenzhong

2016-07-19

Due to its direct band gap of ~1.35 eV, appropriate energy band-edge positions, and low surface-recombination velocity, p-type InP has attracted considerable attention as a promising photocathode material for solar hydrogen generation. However, challenges remain with p-type InP for achieving high and stable photoelectrochemical (PEC) performances. Here, we demonstrate that surface modifications of InP photocathodes with Ti thin layers and amorphous MoSx nanoparticles can remarkably improve their PEC performances. A high photocurrent density with an improved PEC onset potential is obtained. Electrochemical impedance analyses reveal that the largely improved PEC performance of MoSx/Ti/InP is attributed to the reduced charge-transfer resistance and the increased band bending at the MoSx/Ti/InP/electrolyte interface. In addition, the MoSx/Ti/InP photocathodes function stably for PEC water reduction under continuous light illumination over 2 h. Our study demonstrates an effective approach to develop high-PEC-performance InP photocathodes towards stable solar hydrogen production.

On the use of controls for subsonic transport performance improvement: Overview and future directions

NASA Technical Reports Server (NTRS)

Gilyard, Glenn; Espana, Martin

1994-01-01

Increasing competition among airline manufacturers and operators has highlighted the issue of aircraft efficiency. Fewer aircraft orders have led to an all-out efficiency improvement effort among the manufacturers to maintain if not increase their share of the shrinking number of aircraft sales. Aircraft efficiency is important in airline profitability and is key if fuel prices increase from their current low. In a continuing effort to improve aircraft efficiency and develop an optimal performance technology base, NASA Dryden Flight Research Center developed and flight tested an adaptive performance seeking control system to optimize the quasi-steady-state performance of the F-15 aircraft. The demonstrated technology is equally applicable to transport aircraft although with less improvement. NASA Dryden, in transitioning this technology to transport aircraft, is specifically exploring the feasibility of applying adaptive optimal control techniques to performance optimization of redundant control effectors. A simulation evaluation of a preliminary control law optimizes wing-aileron camber for minimum net aircraft drag. Two submodes are evaluated: one to minimize fuel and the other to maximize velocity. This paper covers the status of performance optimization of the current fleet of subsonic transports. Available integrated controls technologies are reviewed to define approaches using active controls. A candidate control law for adaptive performance optimization is presented along with examples of algorithm operation.

Los Alamos radiation transport code system on desktop computing platforms

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

Briesmeister, J.F.; Brinkley, F.W.; Clark, B.A.

The Los Alamos Radiation Transport Code System (LARTCS) consists of state-of-the-art Monte Carlo and discrete ordinates transport codes and data libraries. These codes were originally developed many years ago and have undergone continual improvement. With a large initial effort and continued vigilance, the codes are easily portable from one type of hardware to another. The performance of scientific work-stations (SWS) has evolved to the point that such platforms can be used routinely to perform sophisticated radiation transport calculations. As the personal computer (PC) performance approaches that of the SWS, the hardware options for desk-top radiation transport calculations expands considerably. Themore » current status of the radiation transport codes within the LARTCS is described: MCNP, SABRINA, LAHET, ONEDANT, TWODANT, TWOHEX, and ONELD. Specifically, the authors discuss hardware systems on which the codes run and present code performance comparisons for various machines.« less

Developing a Performance Brain Training™ approach for baseball: a process analysis with descriptive data.

PubMed

Sherlin, Leslie H; Larson, Noel C; Sherlin, Rebecca M

2013-03-01

Neurofeedback may be useful for improving sports performance but few studies have examined this potential. Here we present data of five development players from a major league baseball team. The aims were to evaluate the feasibility of conducting sessions within a professional organization, assess changes in quantitative electroencephalograph (QEEG), NeuroPerformance Profile™, and report qualitative self-report data before and after brain training. The EEG was recorded with 19 electrodes for 20 min of baseline conditions and approximately 21 min of a continuous performance test. The fast Fourier transform analysis provided average cross-spectral matrices for bands delta (1-3.5 Hz), theta (4-7.5 Hz), alpha (8-12 Hz), low beta (13-16 Hz), beta 1 (13-21 Hz), beta 2 (22-32 Hz), and gamma (32-45 Hz) from the pre and post intervention evaluations in the baseline condition of eyes open. The continuous performance test metrics included the errors of omission, errors of commission, response time and response time variability. The 9 scales of the NeuroPerformance Profile™ were examined. The QEEG data, CPT data and NeuroPerformance Profile™ data were all compared between the pre and post 15 sessions of brain training using a within subject paired t test design corrected for multiple comparisons using false discovery rate method. Following brain training, comparative QEEG, CPT and NeuroPerformance Profile™ analyses illustrated significant differences. The QEEG findings of all participants illustrated significant changes within the training parameters but also across other frequency bands and electrode sites. Overall, the positive findings in both objective and subjective measures suggest further inquiry into the utility of brain training for performance enhancement with the specific application of sport is warranted. Particularly QEEG and CPT gains were noted in the areas that correspond to client self-report data demonstrating improvement in attention, decreased intrusive thought patterns and improvements in sleep patterns.

Westinghouse Hanford Company health and safety performance report. Fourth quarter calendar year 1994

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

Lansing, K.A.

1995-03-01

Detailed information pertaining to As Low As Reasonably Achievable/Contamination Control Improvement Project (ALARA/CCIP) activities are outlined. Improved commitment to the WHC ALARA/CCIP Program was experienced throughout FY 1994. During CY 1994, 17 of 19 sitewide ALARA performance goals were completed on or ahead of schedule. Estimated total exposure by facility for CY 1994 is listed in tables by organization code for each dosimeter frequency. Facilities/areas continue to utilize the capabilities of the RPR tracking system in conjunction with the present site management action-tracking system to manage deficiencies, trend performance, and develop improved preventive efforts. Detailed information pertaining to occupational injuries/illnessesmore » are provided. The Industrial Safety and Hygiene programs are described which have generated several key initiatives that are believed responsible for improved safety performance. A breakdown of CY 1994 occupational injuries/illnesses by type, affected body group, cause, job type, age/gender, and facility is provided. The contributing experience of each WHC division/department in attaining this significant improvement is described along with tables charting specific trends. The Radiological Control Program is on schedule to meet all RL Site Management System milestones and program commitments.« less

The effect of various parameters of large scale radio propagation models on improving performance mobile communications

NASA Astrophysics Data System (ADS)

Pinem, M.; Fauzi, R.

2018-02-01

One technique for ensuring continuity of wireless communication services and keeping a smooth transition on mobile communication networks is the soft handover technique. In the Soft Handover (SHO) technique the inclusion and reduction of Base Station from the set of active sets is determined by initiation triggers. One of the initiation triggers is based on the strong reception signal. In this paper we observed the influence of parameters of large-scale radio propagation models to improve the performance of mobile communications. The observation parameters for characterizing the performance of the specified mobile system are Drop Call, Radio Link Degradation Rate and Average Size of Active Set (AS). The simulated results show that the increase in altitude of Base Station (BS) Antenna and Mobile Station (MS) Antenna contributes to the improvement of signal power reception level so as to improve Radio Link quality and increase the average size of Active Set and reduce the average Drop Call rate. It was also found that Hata’s propagation model contributed significantly to improvements in system performance parameters compared to Okumura’s propagation model and Lee’s propagation model.

Dynamic, continuous multitasking training leads to task-specific improvements but does not transfer across action selection tasks

NASA Astrophysics Data System (ADS)

Bender, Angela D.; Filmer, Hannah L.; Naughtin, Claire K.; Dux, Paul E.

2017-12-01

The ability to perform multiple tasks concurrently is an ever-increasing requirement in our information-rich world. Despite this, multitasking typically compromises performance due to the processing limitations associated with cognitive control and decision-making. While intensive dual-task training is known to improve multitasking performance, only limited evidence suggests that training-related performance benefits can transfer to untrained tasks that share overlapping processes. In the real world, however, coordinating and selecting several responses within close temporal proximity will often occur in high-interference environments. Over the last decade, there have been notable reports that training on video action games that require dynamic multitasking in a demanding environment can lead to transfer effects on aspects of cognition such as attention and working memory. Here, we asked whether continuous and dynamic multitasking training extends benefits to tasks that are theoretically related to the trained tasks. To examine this issue, we asked a group of participants to train on a combined continuous visuomotor tracking task and a perceptual discrimination task for six sessions, while an active control group practiced the component tasks in isolation. A battery of tests measuring response selection, response inhibition, and spatial attention was administered before and immediately after training to investigate transfer. Multitasking training resulted in substantial, task-specific gains in dual-task ability, but there was no evidence that these benefits generalized to other action control tasks. The findings suggest that training on a combined visuomotor tracking and discrimination task results in task-specific benefits but provides no additional value for untrained action selection tasks.

U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA) ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) PROGRAM: MERCURY CONTINUOUS EMISSION MONITORS

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) Environmental Technology Verification (ETV) program evaluates the performance of innovative air, water, pollution prevention and monitoring technologies that have the potential to improve human health and the environment. This techn...

The evolution of commercial launch vehicles : fourth quarter 2001 Quarterly Launch Report

DOT National Transportation Integrated Search

2001-01-01

Launch vehicle performance continues to constantly improve, in large part to meet the demands of an increasing number of larger satellites. Current vehicles are very likely to be changed from last year's versions and are certainly not the same as one...

Case Studies of Two High-Poverty High-Performing Schools

ERIC Educational Resources Information Center

Gehrke, Lori R.

2010-01-01

The existing literature on learning organizations emphasize that leadership and strong organizational culture are central to their successful development. Whereas schools continue to face government control, accountability, and financial restraints, they are also working diligently to engage in ongoing school improvement practices to provide…

Q-FANSTM for general aviation aircraft

NASA Technical Reports Server (NTRS)

Worobel, R.; Mayo, M. G.

1973-01-01

Continued growth of general aviation over the next 10 to 15 years is dependent on continuing improvement in aircraft safety, utility, performance and cost. Moreover, these advanced aircraft will need to conform to expected government regulations controlling propulsion system emissions and noise levels. An attractive compact low noise propulsor concept, the Q-FANTM when matched to piston, rotary combustion, or gas turbine engines opens up the exciting prospect of new, cleaner airframe designs for the next generation of general aviation aircraft which will provide these improvements and meet the expected noise and pollution restriction of the 1980 time period. New Q-FAN methodology which was derived to predict Q-FAN noise, weight and cost is presented. Based on this methodology Q-FAN propulsion system performance, weight, noise, and cost trends are discussed. Then the impact of this propulsion system type on the complete aircraft is investigated for several representative aircraft size categories. Finally, example conceptual designs for Q-FAN/engine integration and aircraft installations are presented.

Turbine Engine Clearance Control Systems: Current Practices and Future Directions

NASA Astrophysics Data System (ADS)

Lattime, Scott B.; Steinetz, Bruce M.

2002-09-01

Improved blade tip sealing in the high pressure compressor (HPC) and high pressure turbine (HPT) can provide dramatic reductions in specific fuel consumption (SFC), time-on-wing, compressor stall margin, and engine efficiency as well as increased payload and mission range capabilities. Maintenance costs to overhaul large commercial gas turbine engines can easily exceed 1M. Engine removal from service is primarily due to spent exhaust gas temperature (EGT) margin caused mainly by the deterioration of HPT components. Increased blade tip clearance is a major factor in hot section component degradation. As engine designs continue to push the performance envelope with fewer parts and the market drives manufacturers to increase service life, the need for advanced sealing continues to grow. A review of aero gas turbine engine HPT performance degradation and the mechanisms that promote these losses are discussed. Benefits to the HPT due to improved clearance management are identified. Past and present sealing technologies are presented along with specifications for next generation engine clearance control systems.

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare.

PubMed

Price, Alex; Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-02-01

Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. Copyright © 2017 Longwoods Publishing.

Turbine Engine Clearance Control Systems: Current Practices and Future Directions

NASA Technical Reports Server (NTRS)

Lattime, Scott B.; Steinetz, Bruce M.

2002-01-01

Improved blade tip sealing in the high pressure compressor (HPC) and high pressure turbine (HPT) can provide dramatic reductions in specific fuel consumption (SFC), time-on-wing, compressor stall margin, and engine efficiency as well as increased payload and mission range capabilities. Maintenance costs to overhaul large commercial gas turbine engines can easily exceed $1M. Engine removal from service is primarily due to spent exhaust gas temperature (EGT) margin caused mainly by the deterioration of HPT components. Increased blade tip clearance is a major factor in hot section component degradation. As engine designs continue to push the performance envelope with fewer parts and the market drives manufacturers to increase service life, the need for advanced sealing continues to grow. A review of aero gas turbine engine HPT performance degradation and the mechanisms that promote these losses are discussed. Benefits to the HPT due to improved clearance management are identified. Past and present sealing technologies are presented along with specifications for next generation engine clearance control systems.

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

PubMed Central

Schwartz, Robert; Cohen, Joanna; Manson, Heather; Scott, Fran

2017-01-01

Context: Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. Objective: The objective was to adapt and apply Shortell et al.'s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. Methods: In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. Results: A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. Conclusion: The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework's stated facilitators and barriers. PMID:28277203

Investigation of the Effect of Oil Modification on Critical Characteristics of Asphalt Binders

NASA Astrophysics Data System (ADS)

Golalipour, Amir

Thermally induced cracking of asphalt pavement continues to be a serious issue in cold climate regions as well as in areas which experience extreme daily temperature differentials. Low temperature cracking of asphalt pavements is attributed to thermal stresses and strains developed during cooling cycles. Improving asphalt binder low temperature fracture and stiffness properties continues to be a subject of particular concern. Therefore, significant amount of research has been focused on improving asphalt binder properties through modification. In recent years, wide ranges of oil based modifications have been introduced to improve asphalt binder performance, especially at the low service temperatures. Although, significant use of these oils is seen in practice, knowledge of the fundamental mechanisms of oil modification and their properties for achieving optimum characteristics is limited. Hence, this study focuses on better understanding of the effect of oil modifiers which would help better material selection and achieve optimum performance in terms of increasing the life span of pavements. In this study, the effect of oil modification on the rheological properties of the asphalt binder is investigated. To examine the effect of oil modification on binder characteristics, low temperature properties as well as high temperature performance of oil modified binders were evaluated. It is found that oils vary in their effects on asphalt binder performance. However, for all oils used in the study, adding an oil to binder can improve binder low temperature performance, and this result mainly attributed to the softening effect. In addition to that, a simple linear model is proposed to predict the performance grade of oil modified binder based on the properties of its constituents at high and low temperatures. Another part of this study focuses on the oil modification effect on asphalt binder thermal strain and stresses. A viscoelastic analytical procedure is combined with experimentally derived failure stress and strain envelopes to determine the controlling failure mechanism, strain tolerance or critical stress, in thermal cracking of oil modified binders. The low temperature failure results depict that oil modification has a good potential of improving the cracking resistance of asphalt binders during thermal cycles.

Telecom technology based continuous wave terahertz photomixing system with 105 decibel signal-to-noise ratio and 3.5 terahertz bandwidth.

PubMed

Göbel, Thorsten; Stanze, Dennis; Globisch, Björn; Dietz, Roman J B; Roehle, Helmut; Schell, Martin

2013-10-15

A modified photoconductive receiver significantly improves the performance of photomixing-based continuous wave (cw) THz systems driven at the optical telecommunication wavelength of 1.5 μm. The achieved signal-to-noise ratio of 105 dB at 100 GHz and 70 dB at 1 THz, both for an integration time of 200 ms, are to our knowledge the highest numbers reported in literature for any optoelectronic cw THz system, including classical setups operating at 800 nm. The developed receiver allows for combining low cost and high performance in one system for the first time to our knowledge.

Role of physical countermaneuvers in the management of orthostatic hypotension: efficacy and biofeedback augmentation

NASA Technical Reports Server (NTRS)

Bouvette, C. M.; McPhee, B. R.; Opfer-Gehrking, T. L.; Low, P. A.

1996-01-01

OBJECTIVE: To evaluate the efficacy of various physical countermaneuvers in reducing orthostatic hypotension and its associated symptoms and to assess the efficacy of biofeedback training in enhancing the effectiveness of physical countermaneuvers. MATERIAL AND METHODS: In nine study subjects with neurogenic orthostatic hypotension, four training sessions on physical countermaneuvers were performed after tilt-up, three with visual feedback on the effect of physical countermaneuvers on blood pressure and other cardiovascular variables. Blood pressure change and orthostatic symptoms during tilt-up were determined, as were the changes in total peripheral resistance, stroke index, and heart rate. RESULTS: The five female and four male patients had a mean age of 53 years and a mean duration of symptoms of 4.2 years. On an orthostatic symptom scale of 0 to 10, these patients had a mean symptom score of 7.3. The increment in systolic blood pressure was better for some maneuvers (such as leg crossing and a combination) than others (such as neck flexion and abdominal contraction). Three patterns of responses to biofeedback were found. Simple maneuvers such as squatting did not improve with training; visual feedback was needed for maneuvers such as thigh contraction, and performance declined without biofeedback; the third pattern, seen in maneuvers such as leg crossing, showed continued improvement with training, even without biofeedback. A survey at 3 to 4 months after training revealed continued use of physical maneuvers (3.8 +/- 3.1 per day), increased standing time with each episode of presyncopal symptoms (8.3 +/- 5.8 minutes), and continued global symptomatic improvement. Total peripheral resistance, but not heart rate or stroke index, showed significant regression with blood pressure improvement. CONCLUSION: Physical countermaneuvers are efficacious in reducing orthostatic hypotension, can be augmented by use of biofeedback, and may significantly improve the functional outcome. The major mechanism of improvement is an increase in total peripheral resistance, presumably by reducing the vascular capacitance.

A multi-institutional quality improvement initiative to transform education for chronic illness care in resident continuity practices.

PubMed

Stevens, David P; Bowen, Judith L; Johnson, Julie K; Woods, Donna M; Provost, Lloyd P; Holman, Halsted R; Sixta, Constance S; Wagner, Ed H

2010-09-01

There is a gap between the need for patient-centered, evidence-based primary care for the large burden of chronic illness in the US, and the training of resident physicians to provide that care. To improve training for residents who provide chronic illness care in teaching practice settings. US teaching hospitals were invited to participate in one of two 18-month Breakthrough Series Collaboratives-either a national Collaborative, or a subsequent California Collaborative-to implement the Chronic Care Model (CCM) and related curriculum changes in resident practices. Most practices focused on patients with diabetes mellitus. Educational redesign strategies with related performance measures were developed for curricular innovations anchored in the CCM. In addition, three clinical measures-HbA1c <7%, LDL <100 mg/dL, and blood pressure

A Multi-Institutional Quality Improvement Initiative to Transform Education for Chronic Illness Care in Resident Continuity Practices

PubMed Central

Bowen, Judith L.; Johnson, Julie K.; Woods, Donna M.; Provost, Lloyd P.; Holman, Halsted R.; Sixta, Constance S.; Wagner, Ed H.

2010-01-01

BACKGROUND There is a gap between the need for patient-centered, evidence-based primary care for the large burden of chronic illness in the US, and the training of resident physicians to provide that care. OBJECTIVE To improve training for residents who provide chronic illness care in teaching practice settings. DESIGN US teaching hospitals were invited to participate in one of two 18-month Breakthrough Series Collaboratives—either a national Collaborative, or a subsequent California Collaborative—to implement the Chronic Care Model (CCM) and related curriculum changes in resident practices. Most practices focused on patients with diabetes mellitus. Educational redesign strategies with related performance measures were developed for curricular innovations anchored in the CCM. In addition, three clinical measures—HbA1c <7%, LDL <100 mg/dL, and blood pressure ≤130/80—and three process measures—retinal and foot examinations, and patient self-management goals—were tracked. PARTICIPANTS Fifty-seven teams from 37 self-selected teaching hospitals committed to implement the CCM in resident continuity practices; 41 teams focusing on diabetes improvement participated over the entire duration of one of the Collaboratives. INTERVENTIONS Teaching-practice teams—faculty, residents and staff—participated in Collaboratives by attending monthly calls and regular 2-day face-to-face meetings with the other teams. The national Collaborative faculty led calls and meetings. Each team used rapid cycle quality improvement (PDSA cycles) to implement the CCM and curricular changes. Teams reported education and clinical performance measures monthly. RESULTS Practices underwent extensive redesign to establish CCM elements. Education measures tracked substantial development of CCM-related learning. The clinical and process measures improved, however inconsistently, during the Collaboratives. CONCLUSIONS These initiatives suggest that systematic practice redesign for implementing the CCM along with linked educational approaches are achievable in resident continuity practices. Improvement of clinical outcomes in such practices is daunting but achievable. PMID:20737232

Effects of high intensity training and continuous endurance training on aerobic capacity and body composition in recreationally active runners.

PubMed

Hottenrott, Kuno; Ludyga, Sebastian; Schulze, Stephan

2012-01-01

The aim of the study was to examine the effects of two different training programs (high-intensity-training vs. continuous endurance training) on aerobic power and body composition in recreationally active men and women and to test whether or not participants were able to complete a half marathon after the intervention period. Thirty-four recreational endurance runners were randomly assigned either to a Weekend-Group (WE, n = 17) or an After-Work- Group (AW, n = 17) for a 12 week-intervention period. WE weekly completed 2 h 30 min of continuous endurance running composed of 2 sessions on the weekend. In contrast, AW performed 4 30 min sessions of high intensity training and an additional 30 min endurance run weekly, always after work. During an exhaustive treadmill test aerobic power was measured and heart rate was continuously recorded. Body composition was assessed using bio-impedance. Following the intervention period all subjects took part in a half-marathon. AW significantly improved peak oxygen uptake (VO2 peak) from 36.8 ± 4.5 to 43.6 ± 6.5 [mL.min(-1).kg(-1)], velocity at lactate threshold (VLT) from 9.7 ± 2.2 to 11.7 ± 1.8 [km.h(-1)] and visceral fat from 5.6 ± 2.2 to 4.7 ± 1.9 In WE VO2 peak signifi-cantly increased from 38.8 ± 5.0 to 41.5 ± 6.0 [mL.min(-1).kg(-1)], VLT from 9.9 ± 1.3 to 11.2 ± 1.7 [km.h(-1)] and visceral fat was reduced from 5.7 ± 2.1 to 5.4 ± 1.9 (p < 0.01). Only the improvements of VO2 peak were significantly greater in AW compared with WE (pre/post group interaction: F=15.4, p = 0.01, η(2) = 0.36). Both groups completed a half marathon with no significant differences in performance (p = 0.63). Short, intensive endurance training sessions of about 30 min are effective in improving aerobic fitness in recreationally active runners. Key pointsContinuous endurance training and high intensity training lead to significant improvements of aerobic capacity and body compositionBoth training methods enable recreationally active runners to finish a half-marathonHigh intensity training is favorable to improve VO2 peak.

Flight experience of Solar Mesosphere Explorer's two nickel-cadmium batteries

NASA Technical Reports Server (NTRS)

Faber, J.

1985-01-01

The performance of the power system on the solar mesosphere explorer (SME) since launch is discussed. Predictions for continued operation for the rest of the project mission are also discussed. The SME satellite's power system was characterized by both insufficient loading and excessive battery charging during the first year of the mission. These conditions affected battery performance and jeopardized the long-term mission. Increased loading on selected orbits has improved battery performance. Long term projections indicate steadily increasing temperatures for the remainder of the mission.

Early boost and slow consolidation in motor skill learning.

PubMed

Hotermans, Christophe; Peigneux, Philippe; Maertens de Noordhout, Alain; Moonen, Gustave; Maquet, Pierre

2006-01-01

Motorskill learning is a dynamic process that continues covertly after training has ended and eventually leads to delayed increments in performance. Current theories suggest that this off-line improvement takes time and appears only after several hours. Here we show an early transient and short-lived boost in performance, emerging as early as 5-30 min after training but no longer observed 4 h later. This early boost is predictive of the performance achieved 48 h later, suggesting its functional relevance for memory processes.

GPS vertical axis performance enhancement for helicopter precision landing approach

NASA Technical Reports Server (NTRS)

Denaro, Robert P.; Beser, Jacques

1986-01-01

Several areas were investigated for improving vertical accuracy for a rotorcraft using the differential Global Positioning System (GPS) during a landing approach. Continuous deltaranging was studied and the potential improvement achieved by estimating acceleration was studied by comparing the performance on a constant acceleration turn and a rough landing profile of several filters: a position-velocity (PV) filter, a position-velocity-constant acceleration (PVAC) filter, and a position-velocity-turning acceleration (PVAT) filter. In overall statistics, the PVAC filter was found to be most efficient with the more complex PVAT performing equally well. Vertical performance was not significantly different among the filters. Satellite selection algorithms based on vertical errors only (vertical dilution of precision or VDOP) and even-weighted cross-track and vertical errors (XVDOP) were tested. The inclusion of an altimeter was studied by modifying the PVAC filter to include a baro bias estimate. Improved vertical accuracy during degraded DOP conditions resulted. Flight test results for raw differential results excluding filter effects indicated that the differential performance significantly improved overall navigation accuracy. A landing glidepath steering algorithm was devised which exploits the flexibility of GPS in determining precise relative position. A method for propagating the steering command over the GPS update interval was implemented.

Effect of core strength and endurance training on performance in college students: randomized pilot study.

PubMed

Schilling, Jim F; Murphy, Jeff C; Bonney, John R; Thich, Jacob L

2013-07-01

Core training continues to be emphasized with the proposed intent of improving athletic performance. The purpose of this investigation was to discover if core isometric endurance exercises were superior to core isotonic strengthening exercises and if either influenced specific endurance, strength, and performance measures. Ten untrained students were randomly assigned to core isometric endurance (n = 5) and core isotonic strength training (n = 5). Each performed three exercises, two times per week for six weeks. A repeated measures ANOVA was used to compare the measurements for the dependent variables and significance by bonferroni post-hoc testing. The training protocols were compared using a 2 × 3 mixed model ANOVA. Improvement in trunk flexor and extensor endurance (p < 0.05) along with squat and bench press strength (p < 0.05) occurred with the strength group. Improvement in trunk flexor and right lateral endurance (p < 0.05) along with strength in the squat (p < 0.05) were found with the endurance group. Neither training protocol claimed superiority and both were ineffective in improving performance. Published by Elsevier Ltd.

Visit, revamp, and revitalize your business plan: Part 2.

PubMed

Waldron, David

2011-01-01

The diagnostic imaging department strives for the highest quality outcomes in imaging quality, in diagnostic reporting, and in providing a caring patient experience while also satisfying the needs of referring physicians. Understand how tools such as process mapping and concepts such as Six Sigma and Lean Six Sigma can be used to facilitate quality improvements and team building, resulting in staff led process improvement initiatives. Discover how to integrate a continuous staff management cycle to implement process improvements,capture the promised performance improvements, and achieve a culture change away from the "way it has always been done".

Learning to integrate versus inhibiting information is modulated by age.

PubMed

Cappelletti, Marinella; Pikkat, Helen; Upstill, Emily; Speekenbrink, Maarten; Walsh, Vincent

2015-02-04

Cognitive training aiming at improving learning is often successful, but what exactly underlies the observed improvements and how these differ across the age spectrum are currently unknown. Here we asked whether learning in young and older people may reflect enhanced ability to integrate information required to perform a cognitive task or whether it may instead reflect the ability to inhibit task-irrelevant information for successful task performance. We trained 30 young and 30 aging human participants on a numerosity discrimination task known to engage the parietal cortex and in which cue-integration and inhibitory abilities can be distinguished. We coupled training with parietal, motor, or sham transcranial random noise stimulation, known for modulating neural activity. Numerosity discrimination improved after training and was maintained long term, especially in the training + parietal stimulation group, regardless of age. Despite the quantitatively similar improvement in the two age groups, the content of learning differed remarkably: aging participants improved more in inhibitory abilities, whereas younger subjects improved in cue-integration abilities. Moreover, differences in the content of learning were reflected in different transfer effects to untrained but related abilities: in the younger group, improvements in cue integration paralleled improvements in continuous quantity (time and space), whereas in the elderly group, improvements in numerosity-based inhibitory abilities generalized to other measures of inhibition and corresponded to a decline in space discrimination, possibly because conflicting learning resources are used in numerosity and continuous quantity processing. These results indicate that training can enhance different, age-dependent cognitive processes and highlight the importance of identifying the exact processes underlying learning for effective training programs. Copyright © 2015 the authors 0270-6474/15/352213-13$15.00/0.

The 10 Building Blocks of High-Performing Primary Care

PubMed Central

Bodenheimer, Thomas; Ghorob, Amireh; Willard-Grace, Rachel; Grumbach, Kevin

2014-01-01

Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care. The building blocks include 4 foundational elements—engaged leadership, data-driven improvement, empanelment, and team-based care—that assist the implementation of the other 6 building blocks—patient-team partnership, population management, continuity of care, prompt access to care, comprehensiveness and care coordination, and a template of the future. The building blocks, which represent a synthesis of the innovative thinking that is transforming primary care in the United States, are both a description of existing high-performing practices and a model for improvement. PMID:24615313

The 10 building blocks of high-performing primary care.

PubMed

Bodenheimer, Thomas; Ghorob, Amireh; Willard-Grace, Rachel; Grumbach, Kevin

2014-01-01

Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care. The building blocks include 4 foundational elements-engaged leadership, data-driven improvement, empanelment, and team-based care-that assist the implementation of the other 6 building blocks-patient-team partnership, population management, continuity of care, prompt access to care, comprehensiveness and care coordination, and a template of the future. The building blocks, which represent a synthesis of the innovative thinking that is transforming primary care in the United States, are both a description of existing high-performing practices and a model for improvement.

Monitoring how changes in pedagogical practices have improved student interest and performance for an introductory biochemistry course.

PubMed

Karamanos, Yannis; Couturier, Catherine; Boutin, Viviane; Mysiorek, Caroline; Matéos, Aurélie; Berger, Sylvie

2018-04-01

This study describes feedback on the effects of changes introduced in our teaching practices for an introductory biochemistry course in the Life Sciences curriculum. Students on this course have diverse educational qualifications and are taught in large learning groups, creating challenges for the management of individual learning. We used the constructive alignment principle, refining the learning contract and re-drafting the teaching program to introduce active learning and an organization of activities that promotes the participation of all the students and helps their understanding. We also created teaching resources available through the university virtual work environment. Our research aimed to measure the effects of those changes on the students' success. Monitoring of the student performance showed a continuous increase in the percentage of students who passed the course, from 2.13% to 33.5% in 4 years. Analysis of student perceptions highlighted that the teaching methodology was greatly appreciated by the students, whose attendance also improved. The recent introduction of clickers-questions constituted a complementary leverage. The active involvement of the students and better results for summative assessments are altogether a strong motivation for teaching staff to continue to make improvements.

Kaizen: a process improvement model for the business of health care and perioperative nursing professionals.

PubMed

Tetteh, Hassan A

2012-01-01

Kaizen is a proven management technique that has a practical application for health care in the context of health care reform and the 2010 Institute of Medicine landmark report on the future of nursing. Compounded productivity is the unique benefit of kaizen, and its principles are change, efficiency, performance of key essential steps, and the elimination of waste through small and continuous process improvements. The kaizen model offers specific instruction for perioperative nurses to achieve process improvement in a five-step framework that includes teamwork, personal discipline, improved morale, quality circles, and suggestions for improvement. Published by Elsevier Inc.

Landsat-8 Operational Land Imager (OLI) radiometric performance on-orbit

USGS Publications Warehouse

Morfitt, Ron; Barsi, Julia A.; Levy, Raviv; Markham, Brian L.; Micijevic, Esad; Ong, Lawrence; Scaramuzza, Pat; Vanderwerff, Kelly

2015-01-01

Expectations of the Operational Land Imager (OLI) radiometric performance onboard Landsat-8 have been met or exceeded. The calibration activities that occurred prior to launch provided calibration parameters that enabled ground processing to produce imagery that met most requirements when data were transmitted to the ground. Since launch, calibration updates have improved the image quality even more, so that all requirements are met. These updates range from detector gain coefficients to reduce striping and banding to alignment parameters to improve the geometric accuracy. This paper concentrates on the on-orbit radiometric performance of the OLI, excepting the radiometric calibration performance. Topics discussed in this paper include: signal-to-noise ratios that are an order of magnitude higher than previous Landsat missions; radiometric uniformity that shows little residual banding and striping, and continues to improve; a dynamic range that limits saturation to extremely high radiance levels; extremely stable detectors; slight nonlinearity that is corrected in ground processing; detectors that are stable and 100% operable; and few image artifacts.

Physiological Indicators of Workload in a Remotely Piloted Aircraft Simulation

DTIC Science & Technology

2015-10-01

Aviation Psychology, 21(2), 105-122. Deci , E. L., & Ryan , R. M. (1991). Intrinsic motivation and self - determination in human behavior. In R. Steers...rankings (Martens, 1975). Furthermore, individuals have a tendency to challenge themselves in an effort to develop competence and prove self - determination ... Deci & Ryan , 1991). So, when presented with performance feedback, people are motivated to continuously improve their own performance, and beat the

Periodically-Scheduled Controller Analysis using Hybrid Systems Reachability and Continuization

DTIC Science & Technology

2015-12-01

tools to verify specifications for hybrid automata do not perform well on such periodically scheduled models. This is due to a combination of the large...an additive nondeterministic input. Reachability tools for hybrid automata can better handle such systems. We further improve the analysis by...formally as a hybrid automaton. However, reachability tools to verify specifications for hybrid automata do not perform well on such periodically

Smoking and Soldier Performance: A Literature Review

DTIC Science & Technology

1986-06-01

should improve soldier performance and *military operations. On the other hand, the effects of smoking ron endurance and health appear to be primarily bad...from smoking may provide much of the "reinforcement" that causes people to continue to smoke in the face of indisputable deleterious effects on health ... health and behavior are fairly well understood. Although there are contradictory findings related to both long-term and immediate effects of smoking

Design and Performance Analysis of a new Rotary Hydraulic Joint

NASA Astrophysics Data System (ADS)

Feng, Yong; Yang, Junhong; Shang, Jianzhong; Wang, Zhuo; Fang, Delei

2017-07-01

To improve the driving torque of the robots joint, a wobble plate hydraulic joint is proposed, and the structure and working principle are described. Then mathematical models of kinematics and dynamics was established. On the basis of this, dynamic simulation and characteristic analysis are carried out. Results show that the motion curve of the joint is continuous and the impact is small. Moreover the output torque of the joint characterized by simple structure and easy processing is large and can be rotated continuously.

Graphene-based battery electrodes having continuous flow paths

DOEpatents

Zhang, Jiguang; Xiao, Jie; Liu, Jun; Xu, Wu; Li, Xiaolin; Wang, Deyu

2014-05-24

Some batteries can exhibit greatly improved performance by utilizing electrodes having randomly arranged graphene nanosheets forming a network of channels defining continuous flow paths through the electrode. The network of channels can provide a diffusion pathway for the liquid electrolyte and/or for reactant gases. Metal-air batteries can benefit from such electrodes. In particular Li-air batteries show extremely high capacities, wherein the network of channels allow oxygen to diffuse through the electrode and mesopores in the electrode can store discharge products.

[E-learning and the continuing professional development in medicine].

PubMed

De Fiore, Luca

2010-06-01

E-learning is widely used in continuing medical education but three main problems still face health decision makers: the substantial heterogeneity among the characteristics of the web-based educational projects; the concerns about the e-learning effectiveness; the variety of outcomes used to evaluate the effectiveness. Systematic reviews suggest e-learning has effectiveness similar to traditional educational methods.The attention should now be given to how and when can we use e-learning to improve the health workers' performance and better healthcare.

Basis for the development of sustainable optimisation indicators for activated sludge wastewater treatment plants in the Republic of Ireland.

PubMed

Gordon, G T; McCann, B P

2015-01-01

This paper describes the basis of a stakeholder-based sustainable optimisation indicator (SOI) system to be developed for small-to-medium sized activated sludge (AS) wastewater treatment plants (WwTPs) in the Republic of Ireland (ROI). Key technical publications relating to best practice plant operation, performance audits and optimisation, and indicator and benchmarking systems for wastewater services are identified. Optimisation studies were developed at a number of Irish AS WwTPs and key findings are presented. A national AS WwTP manager/operator survey was carried out to verify the applied operational findings and identify the key operator stakeholder requirements for this proposed SOI system. It was found that most plants require more consistent operational data-based decision-making, monitoring and communication structures to facilitate optimised, sustainable and continuous performance improvement. The applied optimisation and stakeholder consultation phases form the basis of the proposed stakeholder-based SOI system. This system will allow for continuous monitoring and rating of plant performance, facilitate optimised operation and encourage the prioritisation of performance improvement through tracking key operational metrics. Plant optimisation has become a major focus due to the transfer of all ROI water services to a national water utility from individual local authorities and the implementation of the EU Water Framework Directive.

Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders.

PubMed

Roux, Paul; Passerieux, Christine; Fleury, Marie-Josée

2016-12-01

Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life. © The Royal College of Psychiatrists 2016.

Extra-analytical quality indicators and laboratory performances.

PubMed

Sciacovelli, Laura; Aita, Ada; Plebani, Mario

2017-07-01

In the last few years much progress has been made in raising the awareness of laboratory medicine professionals about the effectiveness of quality indicators (QIs) in monitoring, and improving upon, performances in the extra-analytical phases of the Total Testing Process (TTP). An effective system for management of QIs includes the implementation of an internal assessment system and participation in inter-laboratory comparison. A well-designed internal assessment system allows the identification of critical activities and their systematic monitoring. Active participation in inter-laboratory comparison provides information on the performance level of one laboratory with respect to that of other participating laboratories. In order to guarantee the use of appropriate QIs and facilitate their implementation, many laboratories have adopted the Model of Quality Indicators (MQI) proposed by Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) of IFCC, since 2008, which is the result of international consensus and continuous experimentation, and updating to meet new, constantly emerging needs. Data from participating laboratories are collected monthly and reports describing the statistical results and evaluating laboratory data, utilizing the Six Sigma metric, issued regularly. Although the results demonstrate that the processes need to be improved upon, overall the comparison with data collected in 2014 shows a general stability of quality levels and that an improvement has been achieved over time for some activities. The continuous monitoring of QI data allows identification all possible improvements, thus highlighting the value of participation in the inter-laboratory program proposed by WG-LEPS. The active participation of numerous laboratories will guarantee an ever more significant State-of-the-Art, promote the reduction of errors and improve quality of the TTP, thus guaranteeing patient safety. Copyright © 2017. Published by Elsevier Inc.

High-intensity interval training and athletic performance in Taekwondo athletes.

PubMed

Monks, Lynne; Seo, Myong-Won; Kim, Hyun-Bae; Jung, Hyun C; Song, Jong K

2017-10-01

The purpose of this study was to determine the effects of high-intensity interval training (HIIT) on athletic performance in Taekwondo athletes. Thirty-three male and female collegiate Taekwondo athletes were randomly divided into a HIIT group (N.=16) or a high-intensity continuous running (HICR) group (N.=17). The HIIT group undertook training of high-intensity sprints interspersed with active rest periods whilst the HICR group participated in high-intensity running for a continuous period. Both groups completed 11 sessions over 4 weeks. Physique, body composition, Wingate anaerobic test and VO2max test were measured. The vertical jump test, agility T-test and sit-ups were used to assess physical fitness. Repeated measures ANCOVAs with sex as a covariate were applied and significant level was set at 0.05. Following 11 sessions of training, significant improvements in anaerobic peak power (P<0.05), relative peak power (P<0.05), and mean power (P<0.05) were observed only in HIIT group compared to HICR group. A greater improvement of aerobic capacity was observed in HIIT group (8.8%) compared to the HICR group (1.7%). In relation to physical fitness, the HIIT group improved in the vertical jump while the HICR group did not change. Both the HIIT and HICR groups showed greater improvements in T-test and sit-ups during the intervention period. This study shows the effectiveness of eleven sessions of HIIT in producing significant improvements in anaerobic capacity relevant to successful Taekwondo competition performance in collegiate Taekwondo athletes. This could inform the future planning of Taekwondo athletes' pre-competition training, specifically the influence of training intensity on anaerobic capacity.

Comparison of detectability in step-and-shoot mode and continuous mode digital tomosynthesis systems

NASA Astrophysics Data System (ADS)

Lee, Changwoo; Han, Minah; Baek, Jongduk

2017-03-01

Digital tomosynthesis system has been widely used in chest, dental, and breast imaging. Since the digital tomosynthesis system provides volumetric images from multiple projection data, structural noise inherent in X-ray radiograph can be reduced, and thus signal detection performance is improved. Currently, tomosynthesis system uses two data acquisition modes: step-and-shoot mode and continuous mode. Several studies have been conducted to compare the system performance of two acquisition modes with respect to spatial resolution and contrast. In this work, we focus on signal detectability in step-and-shoot mode and continuous mode. For evaluation, uniform background is considered, and eight spherical objects with diameters of 0.5, 0.8, 1, 2, 3, 5, 8, 10 mm are used as signals. Projection data with and without spherical objects are acquired in step-and-shoot mode and continuous mode, respectively, and quantum noise are added. Then, noisy projection data are reconstructed by FDK algorithm. To compare the detection performance of two acquisition modes, we calculate task signal-to-noise ratio (SNR) of channelized Hotelling observer with Laguerre-Gauss channels for each spherical object. While the task-SNR values of two acquisition modes are similar for spherical objects larger than 1 mm diameter, step-and-shoot mode yields higher detectability for small signal sizes. The main reason of this behavior is that small signal is more affected by X-ray tube motion blur than large signal. Our results indicate that it is beneficial to use step-and-shoot data acquisition mode to improve the detectability of small signals (i.e., less than 1 mm diameter) in digital tomosynthesis systems.

Continuous uniformly finite time exact disturbance observer based control for fixed-time stabilization of nonlinear systems with mismatched disturbances

PubMed Central

Liu, Chongxin; Liu, Hang

2017-01-01

This paper presents a continuous composite control scheme to achieve fixed-time stabilization for nonlinear systems with mismatched disturbances. The composite controller is constructed in two steps: First, uniformly finite time exact disturbance observers are proposed to estimate and compensate the disturbances. Then, based on adding a power integrator technique and fixed-time stability theory, continuous fixed-time stable state feedback controller and Lyapunov functions are constructed to achieve global fixed-time system stabilization. The proposed control method extends the existing fixed-time stable control results to high order nonlinear systems with mismatched disturbances and achieves global fixed-time system stabilization. Besides, the proposed control scheme improves the disturbance rejection performance and achieves performance recovery of nominal system. Simulation results are provided to show the effectiveness, the superiority and the applicability of the proposed control scheme. PMID:28406966

How to reconcile the multiculturalist and universalist approaches to science education

NASA Astrophysics Data System (ADS)

Hansson, Sven Ove

2017-06-01

The "multiculturalist" and "universalist" approaches to science education both fail to recognize the strong continuities between modern science and its forerunners in traditional societies. Various fact-finding practices in indigenous cultures exhibit the hallmarks of scientific investigations, such as collectively achieved rationality, a careful distinction between facts and values, a search for shared, well-founded judgments in empirical matters, and strivings for continuous improvement of these judgments. Prominent examples are hunters' discussions when tracking a prey, systematic agricultural experiments performed by indigenous farmers, and remarkably advanced experiments performed by craftspeople long before the advent of modern science. When the continuities between science and these prescientific practices are taken into account, it becomes obvious that the traditional forms of both multiculturalism and universalism should be replaced by a new approach that dissolves the alleged conflict between adherence to modern science and respect for traditional cultures.

Cardiac surgery report cards: comprehensive review and statistical critique.

PubMed

Shahian, D M; Normand, S L; Torchiana, D F; Lewis, S M; Pastore, J O; Kuntz, R E; Dreyer, P I

2001-12-01

Public report cards and confidential, collaborative peer education represent distinctly different approaches to cardiac surgery quality assessment and improvement. This review discusses the controversies regarding their methodology and relative effectiveness. Report cards have been the more commonly used approach, typically as a result of state legislation. They are based on the presumption that publication of outcomes effectively motivates providers, and that market forces will reward higher quality. Numerous studies have challenged the validity of these hypotheses. Furthermore, although states with report cards have reported significant decreases in risk-adjusted mortality, it is unclear whether this improvement resulted from public disclosure or, rather, from the development of internal quality programs by hospitals. An additional confounding factor is the nationwide decline in heart surgery mortality, including states without quality monitoring. Finally, report cards may engender negative behaviors such as high-risk case avoidance and "gaming" of the reporting system, especially if individual surgeon results are published. The alternative approach, continuous quality improvement, may provide an opportunity to enhance performance and reduce interprovider variability while avoiding the unintended negative consequences of report cards. This collaborative method, which uses exchange visits between programs and determination of best practice, has been highly effective in northern New England and in the Veterans Affairs Administration. However, despite their potential advantages, quality programs based solely on confidential continuous quality improvement do not address the issue of public accountability. For this reason, some states may continue to mandate report cards. In such instances, it is imperative that appropriate statistical techniques and report formats are used, and that professional organizations simultaneously implement continuous quality improvement programs. The statistical methodology underlying current report cards is flawed, and does not justify the degree of accuracy presented to the public. All existing risk-adjustment methods have substantial inherent imprecision, and this is compounded when the results of such patient-level models are aggregated and used inappropriately to assess provider performance. Specific problems include sample size differences, clustering of observations, multiple comparisons, and failure to account for the random component of interprovider variability. We advocate the use of hierarchical or multilevel statistical models to address these concerns, as well as report formats that emphasize the statistical uncertainty of the results.

[Study of continuous quality improvement for clinical laboratory processes via the platform of Hospital Group].

PubMed

Song, Wenqi; Shen, Ying; Peng, Xiaoxia; Tian, Jian; Wang, Hui; Xu, Lili; Nie, Xiaolu; Ni, Xin

2015-05-26

The program of continuous quality improvement in clinical laboratory processes for complete blood count (CBC) was launched via the platform of Beijing Children's Hospital Group in order to improve the quality of pediatric clinical laboratories. Fifteen children's hospitals of Beijing Children's Hospital group were investigated using the method of Chinese adapted continuous quality improvement with PDCA (Plan-Do-Check-Action). The questionnaire survey and inter-laboratory comparison was conducted to find the existing problems, to analyze reasons, to set forth quality targets and to put them into practice. Then, targeted training was conducted to 15 children's hospitals and the second questionnaire survey, self examinations by the clinical laboratories was performed. At the same time, the Group's online internal quality control platform was established. Overall effects of the program were evaluated so that lay a foundation for the next stage of PDCA. Both quality of control system documents and CBC internal quality control scheme for all of clinical laboratories were improved through this program. In addition, standardization of performance verification was also improved, especially with the comparable verification rate of precision and internal laboratory results up to 100%. In terms of instrument calibration and mandatory diagnostic rates, only three out of the 15 hospitals (20%) failed to pass muster in 2014 from 46.67% (seven out of the 15 hospitals) in 2013. The abnormal data of intraday precision variance coefficients of the five CBC indicator parameters (WBC, RBC, Hb, Plt and Hct) of all the 15 laboratories accounted for 1.2% (2/165) in 2014, a marked decrease from 9.6% (14/145) in 2013. While the number of the hospitals using only one horizontal quality control object for daily quality control has dropped to three from five. The 15 hospitals organized a total of 263 times of training in 2014 from 101 times in 2013, up 160%. The quality improvement program for the clinical laboratories launched via the Hospital Group platform can promote the joint development of the pediatric clinical laboratory discipline of all the member hospitals with remarkable improvement results, and the experience is recommendable for further rollout.

Use of SCALE Continuous-Energy Monte Carlo Tools for Eigenvalue Sensitivity Coefficient Calculations

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

Perfetti, Christopher M; Rearden, Bradley T

2013-01-01

The TSUNAMI code within the SCALE code system makes use of eigenvalue sensitivity coefficients for an extensive number of criticality safety applications, such as quantifying the data-induced uncertainty in the eigenvalue of critical systems, assessing the neutronic similarity between different critical systems, and guiding nuclear data adjustment studies. The need to model geometrically complex systems with improved fidelity and the desire to extend TSUNAMI analysis to advanced applications has motivated the development of a methodology for calculating sensitivity coefficients in continuous-energy (CE) Monte Carlo applications. The CLUTCH and Iterated Fission Probability (IFP) eigenvalue sensitivity methods were recently implemented in themore » CE KENO framework to generate the capability for TSUNAMI-3D to perform eigenvalue sensitivity calculations in continuous-energy applications. This work explores the improvements in accuracy that can be gained in eigenvalue and eigenvalue sensitivity calculations through the use of the SCALE CE KENO and CE TSUNAMI continuous-energy Monte Carlo tools as compared to multigroup tools. The CE KENO and CE TSUNAMI tools were used to analyze two difficult models of critical benchmarks, and produced eigenvalue and eigenvalue sensitivity coefficient results that showed a marked improvement in accuracy. The CLUTCH sensitivity method in particular excelled in terms of efficiency and computational memory requirements.« less

Incorporating yoga into an intense physical therapy program in someone with Parkinson's disease: a case report.

PubMed

Moriello, Gabriele; Denio, Christopher; Abraham, Megan; DeFrancesco, Danielle; Townsley, Jill

2013-10-01

The purpose of this case report was to document outcomes following an intense exercise program integrating yoga with physical therapy exercise in a male with Parkinson's disease. The participant performed an intense 1½-hour program (Phase A) incorporating strengthening, balance, agility and yoga exercises twice weekly for 12 weeks. He then completed a new home exercise program developed by the researchers (Phase B) for 12 weeks. His score on the Parkinson's Disease Questionnaire improved 16 points while his score on the High Level Mobility Assessment tool improved 11 points. There were also improvements in muscle length of several lower extremity muscles, in upper and lower extremity muscle strength, in dynamic balance and he continues to work full time 29 months later. There were no improvements in thoracic posture or aerobic power. This intense program was an effective dose of exercise for someone with Parkinson's disease and allowed him to continue to participate in work, leisure, and community activities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Leadership versus management: translating pharmacists' abilities into quality performance.

PubMed

Reeder, C E

2005-03-01

To describe the quality gap in health care as it was referred to in the Institute of Medicine's reports, to try to harness pharmacy's potential to improve the quality of drug therapy, and to provide insight into the elusive leadership, management, and dynamics of change. Current health care is nowhere near ideal. Successful quality initiatives have included establishing a "culture of quality" (promoting a learning organization), having good leadership, and developing strong management. Ideally, all of these concepts must be applied concurrently for the best results because using only one will not spirit medicine across the gap. To close the gap, pharmacists need to understand various types of change and select a change mechanism that will continuously improve care. Optimizing drug therapy is both a great challenge and a great opportunity for pharmacy. AMCP's Framework for Quality Drug Therapy is a continuous quality improvement model that gives us the tools to plan, implement, and evaluate strategies to improve the quality of patient care and cross the "quality chasm."

Improvement of ruthenium based decarboxylation of carboxylic acids

USDA-ARS?s Scientific Manuscript database

The removal of oxygen atoms from biobased carboxylic acids is an attractive route to provide the drop in replacement feedstocks that industry needs to continue to provide high performance products. Through the use of ruthenium catalysis, an efficient method where this process can be accomplished on ...

The Benefits of Improving Indoor Environmental Quality

ERIC Educational Resources Information Center

Lamping, Jerry

2012-01-01

As school funding levels nationwide continue to plummet amid public demands for increased student performance, an expanding body of research in the field of indoor environmental quality (IEQ) is providing greater statistical validity about the relationship between environmental conditions in school facilities and student achievement. Since the…

An Examination of Principal Job Satisfaction

ERIC Educational Resources Information Center

Pengilly, Michelle M.

2010-01-01

As education continues to succumb to deficits in budgets and increasingly high levels of student performance to meet the federal and state mandates, the quest to sustain and retain successful principals is imperative. The National Association of School Boards (1999) portrays effective principals as "linchpins" of school improvement and…

Principal Preparedness: Superintendent Perceptions of New Principals

ERIC Educational Resources Information Center

Cray, Martha; Weiler, Spencer C.

2011-01-01

National advocacy groups have undertaken significant efforts to define the performance capacities needed by principals to lead schools in this era of continuous improvement and accountability. There has been little articulation between the core skills essential to new principals and the leadership capacities of experienced peers. This study…

Theodore High School: Positive Attitudes

ERIC Educational Resources Information Center

Rourke, James; Boone, Elizabeth

2009-01-01

"You have a choice every day regarding the attitude you will embrace for that day," observes Theodore (Alabama) High School's Web site, effecting the faculty and staff members' belief that raised expectations lead to improved student performance. "Your attitude will make or break our school...," the site continues. "The…

The Relationship among Principal Mentoring and Job Satisfaction and Retention

ERIC Educational Resources Information Center

Washington-Bass, Kendra

2013-01-01

Principal turnover, especially in the most challenging schools, continues be a major problem within the reform movement to improve student performance in public education (Béteille, Kalogrides, & Loeb, 2012; Conley & Cooper, 2011; Hull, 2012). Dwindling financial resources, increased accountability measures, and the increased complexity of…

Rois Langner | NREL

Science.gov Websites

engineer in the Commercial Buildings Research Group at NREL since 2010. Her research efforts have focused optimize building design and performance for military and large commercial buildings. She has also worked continual energy improvement, and more recently is working to support the small commercial building sector

Assessment of Student Professional Outcomes for Continuous Improvement

ERIC Educational Resources Information Center

Keshavarz, Mohsen; Baghdarnia, Mostafa

2013-01-01

This article describes a method for the assessment of professional student outcomes (performance-type outcomes or soft skills). The method is based upon group activities, research on modern electrical engineering topics by individual students, classroom presentations on chosen research topics, final presentations, and technical report writing.…

Professional Development through Organizational Assessment: Using APPA's Facilities Management Evaluation Program

ERIC Educational Resources Information Center

Medlin, E. Lander; Judd, R. Holly

2013-01-01

APPA's Facilities Management Evaluation Program (FMEP) provides an integrated system to optimize organizational performance. The criteria for evaluation not only provide a tool for organizational continuous improvement, they serve as a compelling leadership development tool essential for today's facilities management professional. The senior…

International quality improvement initiatives.

PubMed

Hickey, Patricia A; Connor, Jean A; Cherian, Kotturathu M; Jenkins, Kathy; Doherty, Kaitlin; Zhang, Haibo; Gaies, Michael; Pasquali, Sara; Tabbutt, Sarah; St Louis, James D; Sarris, George E; Kurosawa, Hiromi; Jonas, Richard A; Sandoval, Nestor; Tchervenkov, Christo I; Jacobs, Jeffery P; Stellin, Giovanni; Kirklin, James K; Garg, Rajnish; Vener, David F

2017-12-01

Across the globe, the implementation of quality improvement science and collaborative learning has positively affected the care and outcomes for children born with CHD. These efforts have advanced the collective expertise and performance of inter-professional healthcare teams. In this review, we highlight selected quality improvement initiatives and strategies impacting the field of cardiovascular care and describe implications for future practice and research. The continued leveraging of technology, commitment to data transparency, focus on team-based practice, and recognition of cultural norms and preferences ensure the success of sustainable models of global collaboration.

Monolayer graphene-insulator-semiconductor emitter for large-area electron lithography

NASA Astrophysics Data System (ADS)

Kirley, Matthew P.; Aloui, Tanouir; Glass, Jeffrey T.

2017-06-01

The rapid adoption of nanotechnology in fields as varied as semiconductors, energy, and medicine requires the continual improvement of nanopatterning tools. Lithography is central to this evolving nanotechnology landscape, but current production systems are subject to high costs, low throughput, or low resolution. Herein, we present a solution to these problems with the use of monolayer graphene in a graphene-insulator-semiconductor (GIS) electron emitter device for large-area electron lithography. Our GIS device displayed high emission efficiency (up to 13%) and transferred large patterns (500 × 500 μm) with high fidelity (<50% spread). The performance of our device demonstrates a feasible path to dramatic improvements in lithographic patterning systems, enabling continued progress in existing industries and opening opportunities in nanomanufacturing.

Ultrastable Silicon Cavity in a Continuously Operating Closed-Cycle Cryostat at 4 K

NASA Astrophysics Data System (ADS)

Zhang, W.; Robinson, J. M.; Sonderhouse, L.; Oelker, E.; Benko, C.; Hall, J. L.; Legero, T.; Matei, D. G.; Riehle, F.; Sterr, U.; Ye, J.

2017-12-01

We report on a laser locked to a silicon cavity operating continuously at 4 K with 1 ×10-16 instability and a median linewidth of 17 mHz at 1542 nm. This is a tenfold improvement in short-term instability, and a 1 04 improvement in linewidth, over previous sub-10-K systems. Operating at low temperatures reduces the thermal noise floor and, thus, is advantageous toward reaching an instability of 10-18, a long-sought goal of the optical clock community. The performance of this system demonstrates the technical readiness for the development of the next generation of ultrastable lasers that operate with an ultranarrow linewidth and long-term stability without user intervention.

Implementing quality/productivity improvement initiatives in an engineering environment

NASA Technical Reports Server (NTRS)

Ruda, R. R.

1985-01-01

Quality/Productivity Improvement (QPI) initiatives in the engineering environment at McDonnell Douglas-Houston include several different, distinct activities, each having its own application, yet all targeted toward one common goal - making continuous improvement a way of life. The chief executive and the next two levels of management demonstrate their commitment to QPI with hands-on involvement in several activities. Each is a member of a QPI Council which consists of six panels - Participative Management, Communications, Training, Performance/Productivity, Human Resources Management and Strategic Management. In addition, each manager conducts Workplace Visits and Bosstalks, to enhance communications with employees and to provide a forum for the identification of problems - both real and perceived. Quality Circles and Project Teams are well established within McConnel Douglas as useful and desirable employee involvement teams. The continued growth of voluntary membership in the circles program is strong evidence of the employee interest and management support that have developed within the organization.

Improving Continuity of Care via the Discharge Summary

PubMed Central

Sakaguchi, Farrant H.; Lenert, Leslie A.

2015-01-01

Discharge summaries (DCS) frequently fail to improve the continuity of care. A chart review of 188 DCS was performed to identify specific components that could be improved through health information technology. Medication reconciliations were analyzed for completeness and for medical reasoning. Documentation of pending results and follow-up details were analyzed. Patient preferences, patient goals, and the handover tone were noted. Patients were discharged on an average of 9.8 medications, only 3% of medication reconciliations were complete and medical reasoning was frequently absent. There were 358 pending results in 188 hospital discharges though only 14% were mentioned in the DCS. Documentation of clear, timely follow-up was present for less than 50% of patients. Patient preferences, patient goals, and lessons learned were rarely included. A handover tone was in only 17% of the DCS. Evaluating the DCS as a clinical handover is novel but information for safe handovers is frequently missing. PMID:26958250

SEER*Educate: Use of Abstracting Quality Index Scores to Monitor Improvement of All Employees.

PubMed

Potts, Mary S; Scott, Tim; Hafterson, Jennifer L

2016-01-01

Integral parts of the Seattle-Puget Sound's Cancer Surveillance System registry's continuous improvement model include the incorporation of SEER*Educate into its training program for all staff and analyzing assessment results using the Abstracting Quality Index (AQI). The AQI offers a comprehensive measure of overall performance in SEER*Educate, which is a Web-based application used to personalize learning and diagnostically pinpoint each staff member's place on the AQI continuum. The assessment results are tallied from 6 abstracting standards within 2 domains: incidence reporting and coding accuracy. More than 100 data items are aligned to 1 or more of the 6 standards to build an aggregated score that is placed on a continuum for continuous improvement. The AQI score accurately identifies those individuals who have a good understanding of how to apply the 6 abstracting standards to reliably generate high quality abstracts.

Providing safe surgery for neonates in sub-Saharan Africa.

PubMed

Ameh, Emmanuel A; Ameh, Nkeiruka

2003-07-01

Advances in neonatal intensive care, total parenteral nutrition and improvements in technology have led to a greatly improved outcome of neonatal surgery in developed countries. In many parts of sub-Saharan Africa, however, neonatal surgery continues to pose wide-ranging challenges. Delivery outside hospital, delayed referral, poor transportation, and lack of appropriate personnel and facilities continue to contribute to increased morbidity and mortality in neonates, particularly under emergency situations. Antenatal supervision and hospital delivery needs to be encouraged in our communities. Adequate attention needs to be paid to providing appropriate facilities for neonatal transport and support and training of appropriate staff for neonatal surgery. Neonates with surgical problems should be adequately resuscitated before referral where necessary but surgery should not be unduly delayed. Major neonatal surgery should as much as possible be performed by those trained to operate on neonates. Appropriate research and international collaboration is necessary to improve neonatal surgical care in the environment.

Cognitive impairments in former patients with work-related stress complaints - one year later.

PubMed

Eskildsen, Anita; Andersen, Lars Peter; Pedersen, Anders Degn; Andersen, Johan Hviid

2016-11-01

Patients on sick leave due to work-related stress often present with cognitive impairments. The aim of this prospective cohort study was to examine the long-term consequences of prolonged work-related stress in terms of cognitive functioning one year after initial professional care seeking. We tested a group of patients with work-related stress with a comprehensive neuropsychological test battery at two occasions, one year apart. At both time points, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the one-year follow-up. When adjusting for practice effects, patients improved on measures of prospective memory and processing speed. However, patients continued to perform worse than controls on all tests, though only half of the comparisons reached statistical significance. The effect sizes of the differences between the two groups at one-year follow-up were small to medium. In conclusion, former patients with prolonged work-related stress improved, but they continued to perform worse than controls after one year. In the acute phase, the largest impairments were related to executive function and mental speed but at follow-up memory impairments also became apparent.

Achieving and Validating the 1-centimeter Orbit: JASON-1 Precision Orbit Determination Using GPS, SLR, DORIS and Altimeter data

NASA Technical Reports Server (NTRS)

Luthcke, Scott B.; Zelensky, Nikita P.; Rowlands, David D.; Lemoine, Frank G.; Williams, Teresa A.

2003-01-01

Jason-1, launched on December 7, 2001, is continuing the time series of centimeter level ocean topography observations as the follow-on to the highly successful TOPEX/POSEIDON (T/P) radar altimeter satellite. The precision orbit determination (POD) is a critical component to meeting the ocean topography goals of the mission. Jason-1 is no exception and has set a 1 cm radial orbit accuracy goal, which represents a factor of two improvement over what is currently being achieved for T/P. The challenge to precision orbit determination (POD) is both achieving the 1 cm radial orbit accuracy and evaluating and validating the performance of the 1 cm orbit. Fortunately, Jason-1 POD can rely on four independent tracking data types including near continuous tracking data from the dual frequency codeless BlackJack GPS receiver. In addition, to the enhanced GPS receiver, Jason-1 carries significantly improved SLR and DORIS tracking systems along with the altimeter itself. We demonstrate the 1 cm radial orbit accuracy goal has been achieved using GPS data alone in a reduced dynamic solution. It is also shown that adding SLR data to the GPS-based solutions improves the orbits even further. In order to assess the performance of these orbits it is necessary to process all of the available tracking data (GPS, SLR, DORIS and altimeter crossover differences) as either dependent or independent of the orbit solutions. It was also necessary to compute orbit solutions using various combinations of the four available tracking data in order to independently assess the orbit performance. Towards this end, we have greatly improved orbits determined solely from SLR+DORIS data by applying the reduced dynamic solution strategy. In addition, we have computed reduced dynamic orbits based on SLR, DORIS and crossover data that are a significant improvement over the SLR and DORIS based dynamic solutions. These solutions provide the best performing orbits for independent validation of the GPS-based reduced dynamic orbits.

[Using Interdisciplinary Cooperation to Improve the Rate of Proper Performance of a Hand Exercise Among Hemodialysis Patients With Arteriovenous Fistula Construction].

PubMed

Hsiao, Ya-Hsin; Shin, Miao-Ling; Huang, Cyong-Pei; Chen, Siang-Jyun; Huang, Tsuey-Yuan

2017-06-01

Patients who undergo new arteriovenous fistula (AVF) construction as part of their hemodialysis treatment program are required to perform hand exercises properly in order to maintain AVF function. However, poor performance of these hand exercises currently results in the failure of many patients to preserve AVF function. To increase the rate of performing this hand exercise properly from 55% to 80%. A comprehensive investigation identified the following five main problems: (a) Insufficient muscular endurance; (b) Resistance was not labeled on the ball; (c) Difficulties with maintaining a grip on the ball during the exercise; (d) Lack of standardized education procedures; and (e) Nurses lack latest knowledge on the hand exercise. The strategies used to improve the situation included: (a) Interdisciplinary team cooperation with physiotherapists to design individualized resistance training regimens; (b) Exercise tool improvement; (c) Standardized AVF care; (d) Continuous education for nursing staffs; and (e) Seed teacher program for hand exercise. The rate of proper hand exercise performance increased from 55% to 93%. This nursing project involved an interdisciplinary team that included physiotherapists in order to successfully improve the rate at which the hand exercise was performed properly. This positive experience may be applied to other hemodialysis departments in the treatment of patients with AVF.

Assessing Electronic Cigarette-Related Tweets for Sentiment and Content Using Supervised Machine Learning

PubMed Central

Cole-Lewis, Heather; Varghese, Arun; Sanders, Amy; Schwarz, Mary; Pugatch, Jillian

2015-01-01

Background Electronic cigarettes (e-cigarettes) continue to be a growing topic among social media users, especially on Twitter. The ability to analyze conversations about e-cigarettes in real-time can provide important insight into trends in the public’s knowledge, attitudes, and beliefs surrounding e-cigarettes, and subsequently guide public health interventions. Objective Our aim was to establish a supervised machine learning algorithm to build predictive classification models that assess Twitter data for a range of factors related to e-cigarettes. Methods Manual content analysis was conducted for 17,098 tweets. These tweets were coded for five categories: e-cigarette relevance, sentiment, user description, genre, and theme. Machine learning classification models were then built for each of these five categories, and word groupings (n-grams) were used to define the feature space for each classifier. Results Predictive performance scores for classification models indicated that the models correctly labeled the tweets with the appropriate variables between 68.40% and 99.34% of the time, and the percentage of maximum possible improvement over a random baseline that was achieved by the classification models ranged from 41.59% to 80.62%. Classifiers with the highest performance scores that also achieved the highest percentage of the maximum possible improvement over a random baseline were Policy/Government (performance: 0.94; % improvement: 80.62%), Relevance (performance: 0.94; % improvement: 75.26%), Ad or Promotion (performance: 0.89; % improvement: 72.69%), and Marketing (performance: 0.91; % improvement: 72.56%). The most appropriate word-grouping unit (n-gram) was 1 for the majority of classifiers. Performance continued to marginally increase with the size of the training dataset of manually annotated data, but eventually leveled off. Even at low dataset sizes of 4000 observations, performance characteristics were fairly sound. Conclusions Social media outlets like Twitter can uncover real-time snapshots of personal sentiment, knowledge, attitudes, and behavior that are not as accessible, at this scale, through any other offline platform. Using the vast data available through social media presents an opportunity for social science and public health methodologies to utilize computational methodologies to enhance and extend research and practice. This study was successful in automating a complex five-category manual content analysis of e-cigarette-related content on Twitter using machine learning techniques. The study details machine learning model specifications that provided the best accuracy for data related to e-cigarettes, as well as a replicable methodology to allow extension of these methods to additional topics. PMID:26307512

Assessing Electronic Cigarette-Related Tweets for Sentiment and Content Using Supervised Machine Learning.

PubMed

Cole-Lewis, Heather; Varghese, Arun; Sanders, Amy; Schwarz, Mary; Pugatch, Jillian; Augustson, Erik

2015-08-25

Electronic cigarettes (e-cigarettes) continue to be a growing topic among social media users, especially on Twitter. The ability to analyze conversations about e-cigarettes in real-time can provide important insight into trends in the public's knowledge, attitudes, and beliefs surrounding e-cigarettes, and subsequently guide public health interventions. Our aim was to establish a supervised machine learning algorithm to build predictive classification models that assess Twitter data for a range of factors related to e-cigarettes. Manual content analysis was conducted for 17,098 tweets. These tweets were coded for five categories: e-cigarette relevance, sentiment, user description, genre, and theme. Machine learning classification models were then built for each of these five categories, and word groupings (n-grams) were used to define the feature space for each classifier. Predictive performance scores for classification models indicated that the models correctly labeled the tweets with the appropriate variables between 68.40% and 99.34% of the time, and the percentage of maximum possible improvement over a random baseline that was achieved by the classification models ranged from 41.59% to 80.62%. Classifiers with the highest performance scores that also achieved the highest percentage of the maximum possible improvement over a random baseline were Policy/Government (performance: 0.94; % improvement: 80.62%), Relevance (performance: 0.94; % improvement: 75.26%), Ad or Promotion (performance: 0.89; % improvement: 72.69%), and Marketing (performance: 0.91; % improvement: 72.56%). The most appropriate word-grouping unit (n-gram) was 1 for the majority of classifiers. Performance continued to marginally increase with the size of the training dataset of manually annotated data, but eventually leveled off. Even at low dataset sizes of 4000 observations, performance characteristics were fairly sound. Social media outlets like Twitter can uncover real-time snapshots of personal sentiment, knowledge, attitudes, and behavior that are not as accessible, at this scale, through any other offline platform. Using the vast data available through social media presents an opportunity for social science and public health methodologies to utilize computational methodologies to enhance and extend research and practice. This study was successful in automating a complex five-category manual content analysis of e-cigarette-related content on Twitter using machine learning techniques. The study details machine learning model specifications that provided the best accuracy for data related to e-cigarettes, as well as a replicable methodology to allow extension of these methods to additional topics.

High performance millimeter-wave microstrip circulators and isolators

NASA Technical Reports Server (NTRS)

Shih, Ming; Pan, J. J.

1990-01-01

Millimeter wave systems, phased array antennas, and high performance components all require wideband circulators (and isolators) to perform diplexing and switching, to improve isolation and Voltage Standing Wave Ratio (VSWR), and to construct IMPATT diode reflection amplifiers. Presently, most of the millimeter-wave circulators and isolators are available in the configurations of waveguide or stripline, both of which suffer from the shortcomings of bulky size/weight, narrow bandwidth, and poor compatibility with monolithic millimeter-wave integrated circuits (MMIC). MMW microstrip circulators/isolators can eliminate or improve these shortcomings. Stub-tuned microstrip circulator configuration were developed utilizing the electromagnetic fields perturbation technique, the adhesion problems of microstrip metallization on new ferrite substrate were overcome, the fabrication, assembly, packaging techniques were improved, and then successfully designed, fabricated a Ka band circulator which has isolation and return loss of greater than 16dB, insertion loss less than 0.7dB. To assess the steady and reliable performance of the circulator, a temperature cycling test was done over the range of -20 to +50 C for 3 continuous cycles and found no significant impact or variation of circulator performance.

Case study evaluating Just-In-Time Teaching and Peer Instruction using clickers in a quantum mechanics course

NASA Astrophysics Data System (ADS)

Sayer, Ryan; Marshman, Emily; Singh, Chandralekha

2016-12-01

Just-in-Time Teaching (JiTT) is an instructional strategy involving feedback from students on prelecture activities in order to design in-class activities to build on the continuing feedback from students. We investigate the effectiveness of a JiTT approach, which included in-class concept tests using clickers in an upper-division quantum mechanics course. We analyze student performance on prelecture reading quizzes, in-class clicker questions answered individually, and clicker questions answered after group discussion, and compare those performances with open-ended retention quizzes administered after all instructional activities on the same concepts. In general, compared to the reading quizzes, student performance improved when individual clicker questions were posed after lectures that focused on student difficulties found via electronic feedback. The performance on the clicker questions after group discussion following individual clicker question responses also showed improvement. We discuss some possible reasons for the improved performance at various stages, e.g., from prelecture reading quizzes to postlecture clicker questions, and from individual to group clicker questions.

Teaching crucial skills: An electrocardiogram teaching module for medical students.

PubMed

Chudgar, Saumil M; Engle, Deborah L; Grochowski, Colleen O'Connor; Gagliardi, Jane P

2016-01-01

Medical student performance in electrocardiogram (ECG) interpretation at our institution could be improved. Varied resources exist to teach students this essential skill. We created an ECG teaching module (ECGTM) of 75 cases representing 15 diagnoses to improve medical students' performance and confidence in ECG interpretation. Students underwent pre- and post-clerkship testing to assess ECG interpretation skills and confidence and also end-of-clinical-year testing in ECG and laboratory interpretation. Performance was compared for the years before and during ECGTM availability. Eighty-four percent of students (total n=101) reported using the ECGTM; 98% of those who used it reported it was useful. Students' performance and confidence were higher on the post-test. Students with access to the ECGTM (n=101) performed significantly better than students from the previous year (n=90) on the end-of-year ECG test. The continuous availability of an ECGTM was associated with improved confidence and ability in ECG interpretation. The ECGTM may be another available tool to help students as they learn to read ECGs. Copyright © 2016 Elsevier Inc. All rights reserved.

IARC monographs: 40 years of evaluating carcinogenic hazards to humans.

PubMed

Pearce, Neil; Blair, Aaron; Vineis, Paolo; Ahrens, Wolfgang; Andersen, Aage; Anto, Josep M; Armstrong, Bruce K; Baccarelli, Andrea A; Beland, Frederick A; Berrington, Amy; Bertazzi, Pier Alberto; Birnbaum, Linda S; Brownson, Ross C; Bucher, John R; Cantor, Kenneth P; Cardis, Elisabeth; Cherrie, John W; Christiani, David C; Cocco, Pierluigi; Coggon, David; Comba, Pietro; Demers, Paul A; Dement, John M; Douwes, Jeroen; Eisen, Ellen A; Engel, Lawrence S; Fenske, Richard A; Fleming, Lora E; Fletcher, Tony; Fontham, Elizabeth; Forastiere, Francesco; Frentzel-Beyme, Rainer; Fritschi, Lin; Gerin, Michel; Goldberg, Marcel; Grandjean, Philippe; Grimsrud, Tom K; Gustavsson, Per; Haines, Andy; Hartge, Patricia; Hansen, Johnni; Hauptmann, Michael; Heederik, Dick; Hemminki, Kari; Hemon, Denis; Hertz-Picciotto, Irva; Hoppin, Jane A; Huff, James; Jarvholm, Bengt; Kang, Daehee; Karagas, Margaret R; Kjaerheim, Kristina; Kjuus, Helge; Kogevinas, Manolis; Kriebel, David; Kristensen, Petter; Kromhout, Hans; Laden, Francine; Lebailly, Pierre; LeMasters, Grace; Lubin, Jay H; Lynch, Charles F; Lynge, Elsebeth; 't Mannetje, Andrea; McMichael, Anthony J; McLaughlin, John R; Marrett, Loraine; Martuzzi, Marco; Merchant, James A; Merler, Enzo; Merletti, Franco; Miller, Anthony; Mirer, Franklin E; Monson, Richard; Nordby, Karl-Cristian; Olshan, Andrew F; Parent, Marie-Elise; Perera, Frederica P; Perry, Melissa J; Pesatori, Angela Cecilia; Pirastu, Roberta; Porta, Miquel; Pukkala, Eero; Rice, Carol; Richardson, David B; Ritter, Leonard; Ritz, Beate; Ronckers, Cecile M; Rushton, Lesley; Rusiecki, Jennifer A; Rusyn, Ivan; Samet, Jonathan M; Sandler, Dale P; de Sanjose, Silvia; Schernhammer, Eva; Costantini, Adele Seniori; Seixas, Noah; Shy, Carl; Siemiatycki, Jack; Silverman, Debra T; Simonato, Lorenzo; Smith, Allan H; Smith, Martyn T; Spinelli, John J; Spitz, Margaret R; Stallones, Lorann; Stayner, Leslie T; Steenland, Kyle; Stenzel, Mark; Stewart, Bernard W; Stewart, Patricia A; Symanski, Elaine; Terracini, Benedetto; Tolbert, Paige E; Vainio, Harri; Vena, John; Vermeulen, Roel; Victora, Cesar G; Ward, Elizabeth M; Weinberg, Clarice R; Weisenburger, Dennis; Wesseling, Catharina; Weiderpass, Elisabete; Zahm, Shelia Hoar

2015-06-01

Recently, the International Agency for Research on Cancer (IARC) Programme for the Evaluation of Carcinogenic Risks to Humans has been criticized for several of its evaluations, and also for the approach used to perform these evaluations. Some critics have claimed that failures of IARC Working Groups to recognize study weaknesses and biases of Working Group members have led to inappropriate classification of a number of agents as carcinogenic to humans. The authors of this Commentary are scientists from various disciplines relevant to the identification and hazard evaluation of human carcinogens. We examined criticisms of the IARC classification process to determine the validity of these concerns. Here, we present the results of that examination, review the history of IARC evaluations, and describe how the IARC evaluations are performed. We concluded that these recent criticisms are unconvincing. The procedures employed by IARC to assemble Working Groups of scientists from the various disciplines and the techniques followed to review the literature and perform hazard assessment of various agents provide a balanced evaluation and an appropriate indication of the weight of the evidence. Some disagreement by individual scientists to some evaluations is not evidence of process failure. The review process has been modified over time and will undoubtedly be altered in the future to improve the process. Any process can in theory be improved, and we would support continued review and improvement of the IARC processes. This does not mean, however, that the current procedures are flawed. The IARC Monographs have made, and continue to make, major contributions to the scientific underpinning for societal actions to improve the public's health.

Deviation Management: Key Management Subsystem Driver of Knowledge-Based Continuous Improvement in the Henry Ford Production System.

PubMed

Zarbo, Richard J; Copeland, Jacqueline R; Varney, Ruan C

2017-10-01

To develop a business subsystem fulfilling International Organization for Standardization 15189 nonconformance management regulatory standard, facilitating employee engagement in problem identification and resolution to effect quality improvement and risk mitigation. From 2012 to 2016, the integrated laboratories of the Henry Ford Health System used a quality technical team to develop and improve a management subsystem designed to identify, track, trend, and summarize nonconformances based on frequency, risk, and root cause for elimination at the level of the work. Programmatic improvements and training resulted in markedly increased documentation culminating in 71,641 deviations in 2016 classified by a taxonomy of 281 defect types into preanalytic (74.8%), analytic (23.6%), and postanalytic (1.6%) testing phases. The top 10 deviations accounted for 55,843 (78%) of the total. Deviation management is a key subsystem of managers' standard work whereby knowledge of nonconformities assists in directing corrective actions and continuous improvements that promote consistent execution and higher levels of performance. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Anticipation of Monetary Reward Can Attenuate the Vigilance Decrement

PubMed Central

Grosso, Mallory; Liu, Guanyu; Mitko, Alex; Morris, Rachael; DeGutis, Joseph

2016-01-01

Motivation and reward can have differential effects on separate aspects of sustained attention. We previously demonstrated that continuous reward/punishment throughout a sustained attention task improves overall performance, but not vigilance decrements. One interpretation of these findings is that vigilance decrements are due to resource depletion, which is not overcome by increasing overall motivation. However, an alternative explanation is that as one performs a continuously rewarded task there are less potential gains/losses as the task progresses, which could decrease motivation over time, producing a vigilance decrement. This would predict that keeping future gains/losses consistent throughout the task would reduce the vigilance decrement. In the current study, we examined this possibility by comparing two versions (continuous-small loss vs. anticipate-large loss) of a 10-minute gradual onset continuous performance task (gradCPT), a challenging go/no-go sustained attention task. Participants began each task with the potential to keep $18. In the continuous-small-loss version, small monetary losses were accrued continuously throughout the task for each error. However, in the anticipate-large-loss version, participants lost all $18 if they erroneously responded to one target that always appeared toward the end of the vigil. Typical vigilance decrements were observed in the continuous-small-loss condition. In the anticipate-large-loss condition, vigilance decrements were reduced, particularly when the anticipate-large loss condition was completed second. This suggests that the looming possibility of a large loss can attenuate the vigilance decrement and that this attenuation may occur most consistently after sufficient task experience. We discuss these results in the context of current theories of sustained attention. PMID:27472785

Hospital-wide education committees and high-quality residency training : A qualitative study.

PubMed

Silkens, Milou E W M; Slootweg, Irene A; Scherpbier, Albert J J A; Heineman, Maas Jan; Lombarts, Kiki M J M H

2017-12-01

High-quality residency training is of utmost importance for residents to become competent medical specialists. Hospital-wide education committees have been adopted by several healthcare systems to govern postgraduate medical education and to support continuous quality improvement of residency training. To understand the functioning and potential of such committees, this study examined the mechanisms through which hospital-wide education committees strive to enable continuous quality improvement in residency training. Focus group studies with a constructivist grounded theory approach were performed between April 2015 and August 2016. A purposeful sample of hospital-wide education committees led to seven focus groups. Hospital-wide education committees strived to enable continuous quality improvement of residency training by the following mechanisms: creating an organization-wide quality culture, an organization-wide quality structure and by collaborating with external stakeholders. However, the committees were first and foremost eager to claim a strategic position within the organization they represent. All identified mechanisms were interdependent and ongoing. From a governance perspective, the position of hospital-wide education committees in the Netherlands is uniquely contributing to the call for institutional accountability for the quality of residency training. When implementing hospital-wide education committees, shared responsibility of the committees and the departments that actually provide residency training should be addressed. Although committees vary in the strategies they use to impact continuous quality improvement of residency training, they increasingly have the ability to undertake supporting actions and are working step by step to contribute to high-quality postgraduate medical education.

Feasibility of a virtual learning collaborative to implement an obesity QI project in 29 pediatric practices.

PubMed

John, Tamara; Morton, Michaela; Weissman, Mark; O'Brien, Ellen; Hamburger, Ellen; Hancock, Yolandra; Moon, Rachel Y

2014-04-01

Quality improvement (QI) activities are required to maintain board certification in pediatrics. However, because of lack of training and resources, pediatricians may feel overwhelmed by the need to implement QI activities. Pediatricians also face challenges when caring for overweight and obese children. To create a virtual (online) QI learning collaborative through which pediatric practices could easily develop and implement a continuous QI process. Prospective cohort. Pediatric practices that were part of the Children's National Health Network were invited to participate, with the option to receive continuing medical education and maintenance of certification credits. s) Practices conducted baseline and monthly chart audits, participated in educational webinars and selected monthly practice changes, using Plan-Do-Study-Act cycles. Practices reported activities monthly and periodic feedback was provided to practices about their performance. s) Improvement in (i) body mass index (BMI) percentile documentation, (ii) appropriate nutritional and activity counseling and (iii) follow-up management for high-risk patients. Twenty-nine practices (120 providers) participated, and 24 practices completed all program activities. Monthly chart audits demonstrated continuous improvement in documentation of BMI, abnormal weight diagnosis, nutrition and activity screening and counseling, weight-related health messages and follow-up management of overweight and obese patients. Impact of QI activities on visit duration and practice efficiency was minimal. A virtual learning collaborative was successful in providing a framework for pediatricians to implement a continuous QI process and achieve practice improvements. This format can be utilized to address multiple health issues.

IMPROVED TUBULARS FOR BETTER ECONOMICS IN DEEP GAS WELL DRILLING USING MICROWAVE TECHNOLOGY

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

Dinesh Agrawal; Paul Gigl; Mahlon Dennis

2005-03-01

The main objective of the research program has been to improve the rate-of-penetration in deep hostile environments by improving the life cycle and performance of coiled-tubing, an important component of a deep well drilling system for oil and gas exploration, by utilizing the latest developments in the microwave materials technology. Originally, it was proposed to accomplish this by developing an efficient and economically viable continuous microwave process to sinter continuously formed/extruded steel powder for the manufacture of seamless coiled tubing and other tubular products. However, based on the results and faced with insurmountable difficulties in the extrusion and de-waxing processes,more » the approach of achieving the goals of the program has been slightly changed. In the continuation proposal an approach of microwave sintering combined with Cold Isostatic Press (CIP) and joining (by induction or microwave) is adopted. This process can be developed into a semi-continuous sintering process if the CIP can produce parts fast enough to match the microwave sintering rates. Originally, the entire program was spread over three phases with the following goals: Phase I: Demonstration of the feasibility concept of continuous microwave sintering process for tubular steel products. Phase II: Design, building and testing of a prototype microwave system which shall be combined with a continuous extruder for steel tubular objects. Phase III: Execution of the plan for commercialization of the technology by one of the industrial partners. However, since some of the goals of the phase I were not completed, an extension of nine months was granted and we continued extrusion experiments, designed and built semicontinuous microwave sintering unit.« less

Robotic path-finding in inverse treatment planning for stereotactic radiosurgery with continuous dose delivery

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

Vandewouw, Marlee M., E-mail: marleev@mie.utoronto

Purpose: Continuous dose delivery in radiation therapy treatments has been shown to decrease total treatment time while improving the dose conformity and distribution homogeneity over the conventional step-and-shoot approach. The authors develop an inverse treatment planning method for Gamma Knife® Perfexion™ that continuously delivers dose along a path in the target. Methods: The authors’ method is comprised of two steps: find a path within the target, then solve a mixed integer optimization model to find the optimal collimator configurations and durations along the selected path. Robotic path-finding techniques, specifically, simultaneous localization and mapping (SLAM) using an extended Kalman filter, aremore » used to obtain a path that travels sufficiently close to selected isocentre locations. SLAM is novelly extended to explore a 3D, discrete environment, which is the target discretized into voxels. Further novel extensions are incorporated into the steering mechanism to account for target geometry. Results: The SLAM method was tested on seven clinical cases and compared to clinical, Hamiltonian path continuous delivery, and inverse step-and-shoot treatment plans. The SLAM approach improved dose metrics compared to the clinical plans and Hamiltonian path continuous delivery plans. Beam-on times improved over clinical plans, and had mixed performance compared to Hamiltonian path continuous plans. The SLAM method is also shown to be robust to path selection inaccuracies, isocentre selection, and dose distribution. Conclusions: The SLAM method for continuous delivery provides decreased total treatment time and increased treatment quality compared to both clinical and inverse step-and-shoot plans, and outperforms existing path methods in treatment quality. It also accounts for uncertainty in treatment planning by accommodating inaccuracies.« less

Object tracking based on harmony search: comparative study

NASA Astrophysics Data System (ADS)

Gao, Ming-Liang; He, Xiao-Hai; Luo, Dai-Sheng; Yu, Yan-Mei

2012-10-01

Visual tracking can be treated as an optimization problem. A new meta-heuristic optimal algorithm, Harmony Search (HS), was first applied to perform visual tracking by Fourie et al. As the authors point out, many subjects are still required in ongoing research. Our work is a continuation of Fourie's study, with four prominent improved variations of HS, namely Improved Harmony Search (IHS), Global-best Harmony Search (GHS), Self-adaptive Harmony Search (SHS) and Differential Harmony Search (DHS) adopted into the tracking system. Their performances are tested and analyzed on multiple challenging video sequences. Experimental results show that IHS is best, with DHS ranking second among the four improved trackers when the iteration number is small. However, the differences between all four reduced gradually, along with the increasing number of iterations.

Test and evaluation of the HIDEC engine uptrim algorithm. [Highly Integrated Digital Electronic Control for aircraft

NASA Technical Reports Server (NTRS)

Ray, R. J.; Myers, L. P.

1986-01-01

The highly integrated digital electronic control (HIDEC) program will demonstrate and evaluate the improvements in performance and mission effectiveness that result from integrated engine-airframe control systems. Performance improvements will result from an adaptive engine stall margin mode, a highly integrated mode that uses the airplane flight conditions and the resulting inlet distortion to continuously compute engine stall margin. When there is excessive stall margin, the engine is uptrimmed for more thrust by increasing engine pressure ratio (EPR). The EPR uptrim logic has been evaluated and implemente into computer simulations. Thrust improvements over 10 percent are predicted for subsonic flight conditions. The EPR uptrim was successfully demonstrated during engine ground tests. Test results verify model predictions at the conditions tested.

Improving Vacuum Cleaners

NASA Technical Reports Server (NTRS)

1997-01-01

Under a Space Act Agreement between the Kirby company and Lewis Research Center, NASA technology was applied to a commercial vacuum cleaner product line. Kirby engineers were interested in advanced operational concepts, such as particle flow behavior and vibration, critical factors to improve vacuum cleaner performance. An evaluation of the company 1994 home care system, the Kirby G4, led to the refinement of the new G5 and future models. Under the cooperative agreement, Kirby had access to Lewis' holography equipment, which added insight into how long a vacuum cleaner fan would perform, as well as advanced computer software that can simulate the flow of air through fans. The collaboration resulted in several successes including fan blade redesign and continuing dialogue on how to improve air-flow traits in various nozzle designs.

Bosch CO2 Reduction System Development

NASA Technical Reports Server (NTRS)

Holmes, R. F.; King, C. D.; Keller, E. E.

1976-01-01

Development of a Bosch process CO2 reduction unit was continued, and, by means of hardware modifications, the performance was substantially improved. Benefits of the hardware upgrading were demonstrated by extensive unit operation and data acquisition in the laboratory. This work was accomplished on a cold seal configuration of the Bosch unit.

Using Multiple Robust Parameter Design Techniques to Improve Hyperspectral Anomaly Detection Algorithm Performance

DTIC Science & Technology

2009-03-01

Set negative pixel values = 0 (remove bad pixels) -------------- [m,n] = size(data_matrix_new); for i =1:m for j= 1:n if...everything from packaging toothpaste to high speed fluid dynamics. While future engagements will continue to require the development of specialized

Exploring a National Book-Gifting Scheme: Parents' and Children's Reactions

ERIC Educational Resources Information Center

Wray, David; Medwell, Jane

2015-01-01

Several early learning programmes have targeted children's reading, particularly their relationships with books. One, Bookstart, provided free books to babies attending their eighth-month health check at local clinics. Study of this programme suggested that it led to an improvement in language performance upon school entry. Booktime continues from…

Total Quality Management: A Selected Bibliography

DTIC Science & Technology

1992-03-01

Total Quality Management (TQM) in the Department of Defense is a strategy for continuously improving performance at every level, and in all areas of...reflects selected books, documents, periodical articles, and videos on the subject of Total Quality Management (TQM) in the collection of the U.S. Army War College Library.

Cross-Ethnic Measurement Equivalence of Measures of Depression, Social Anxiety, and Worry

ERIC Educational Resources Information Center

Hambrick, James P.; Rodebaugh, Thomas L.; Balsis, Steve; Woods, Carol M.; Mendez, Julia L.; Heimberg, Richard G.

2010-01-01

Although study of clinical phenomena in individuals from different ethnic backgrounds has improved over the years, African American and Asian American individuals continue to be underrepresented in research samples. Without adequate psychometric data about how questionnaires perform in individuals from different ethnic samples, findings from both…

76 FR 72220 - Incorporation of Risk Management Concepts in Regulatory Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-22

... and support the adoption of improved designs or processes. \\1\\ A deterministic approach to regulation... longstanding goal to move toward more risk-informed, performance- based approaches in its regulatory programs... regulatory approach that would continue to ensure the safe and secure use of nuclear material. As part of...

Intercity passenger rail : Amtrak's financial crisis threatens continued viability : statement of Phyllis F. Scheinberg

DOT National Transportation Integrated Search

1997-04-01

Amtrak is still in a financial crisis despite the fact that its financial : performance (as measured by net losses)2 has improved over the last 2 : years. At the end of fiscal year 1994, Amtraks net loss was about $1.1 : billion (in 1996 dollars)....

Carbohydrate Loading.

ERIC Educational Resources Information Center

Csernus, Marilyn

Carbohydrate loading is a frequently used technique to improve performance by altering an athlete's diet. The objective is to increase glycogen stored in muscles for use in prolonged strenuous exercise. For two to three days, the athlete consumes a diet that is low in carbohydrates and high in fat and protein while continuing to exercise and…

Value-Added Merit Pay.

ERIC Educational Resources Information Center

Twomey, Daniel F.

The purpose of merit pay is to reward employees for their accomplishments and motivate them to continue improving. Critics of merit pay say the increased extrinsic motivation that it prompts is more than offset by the decrease in intrinsic motivation. Supporters of performance-based pay claim several benefits of the practice. This study addressed…

Holistic Mentoring and Coaching to Sustain Organizational Change and Innovation

ERIC Educational Resources Information Center

Hollywood, Kathryn G.; Blaess, Donna A.; Santin, Claudia; Bloom, Lisa

2016-01-01

Collaborative problem solving, creativity, innovation, and continuously improved performance outcomes are the normative expectations for organizations in the early 21st century. At the same time, workers seek not only equitable compensation for their efforts, but also opportunities for professional growth and development as well as acknowledgement…

NCLB--Year for Change

ERIC Educational Resources Information Center

Odland, Jerry

2007-01-01

Much debate continues about whether the 2001 No Child Left Behind Act (NCLB) has actually improved the academic achievement level of poorly performing students or only created yet another layer of government oversight to an already heavily burdened public school system. Drafted in 2001 and signed into law in January 2002, NCLB provided the…

U.S. Department of Education Federal Student Aid Five-Year Plan, 2006-2010

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

This document reflects Federal Student Aid's solid progress in meeting strategic objectives since becoming a Performance-Based Organization. Specifically, the plan addresses continuing efforts to increase program integrity, improve customer service and achieve measurable results in the management and administration of the Title IV student…

42 CFR 438.207 - Assurances of adequate capacity and services.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Team-Based Learning in a Physical Therapy Gross Anatomy Course

ERIC Educational Resources Information Center

Killins, Anita M.

2015-01-01

As medical knowledge grows exponentially and healthcare systems continue to utilize interdisciplinary care, it is essential that physical therapy (PT) graduates be prepared to practice efficiently and effectively on healthcare teams. Team-based learning (TBL) is a teaching pedagogy used in medicine to improve academic performance and teamwork…

20 CFR 663.500 - What is the purpose of this subpart?

Code of Federal Regulations, 2010 CFR

2010-04-01

... emphasizes informed customer choice, system performance, and continuous improvement. The eligible provider process is part of the strategy for achieving these goals. Local Boards, in partnership with the State... population groups are served, States and local areas should administer the eligible provider process in a...

Continuous glucose monitoring: 40 years, what we've learned and what's next.

PubMed

Gifford, Raeann

2013-07-22

After 40 years of research and development, today continuous glucose monitoring (CGM) is demonstrating the benefit it provides for millions with diabetes. To provide in vivo accuracy, new permselective membranes and mediated systems have been developed to prevent enzyme saturation and to minimize interference signals. Early in vivo implanted sensor research clearly showed that the foreign body response was a more difficult issue to overcome. Understanding the biological interface and circumventing the inflammatory response continue to drive development of a CGM sensor with accuracy and reliability performance suitable in a closed-loop artificial pancreas. Along with biocompatible polymer development, other complimentary algorithm and data analysis techniques have improved the performance of commercial systems significantly. For example, the mean average relative difference of Dexcom's CGM system improved from 26 to 14% and its use-life was extended from 3 to 7 d. Significant gains in usability, including size, flexibility, insertion, calibration, and data interface, have been incorporated into new generations of commercial CGM systems. Besides Medtronic, Dexcom, and Abbott, other major players are also investing in CGM. Becton Dickinson is conducting clinical trials with an optical galactose glucose binding system. Development of fully implanted sensor systems fulfills the desire for a discreet, reliable CGM system. Research continues to find innovative ways to help make living with diabetes easier and more normal, and new segments are being pursued (intensive care unit, surgery, behavior modification) in which CGM is being utilized. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Impractical CME programs: Influential parameters in Iran.

PubMed

Faghihi, Seyed Aliakbar; Khankeh, Hamid Reza; Hosseini, Seyed Jalil; Soltani Arabshahi, Seyed Kamran; Faghih, Zahra; Shirazi, Mandana

2017-01-01

Background: Traditional approaches in Continuing Medical Education (CME) appear to be ineffective in any improvement of the patients' care, reducing the medical errors, and/or altering physicians' behaviors. However, they are still executed by the CME providers, and are popular among the majority of the physicians. In this study, we aimed to explore the parameters involved in the degree of effectiveness of CME program in Iran. Methods: In this study, 31 participants, consisting of general practitioners, CME experts and providers were recruited to participate in in-depth interviews and field observations concerning experiences with CME. Application was made of the qualitative paradigm along with the qualitative content analysis, using grounded theory data analysis methodology (constant comparative analysis). Results: Based on the participants' experiences, the insufficient consistency between the training program contents and the demands of GPs, in addition to the non-beneficiary programs for the physicians and the non-comprehensive educational designs, created a negative attitude to the continuing education among physicians. This could be defined by an unrealistic continuing education program, which is the main theme here. Conclusion: Impracticable continuing education has created a negative attitude toward the CME programs among physicians so much that they consider these programs less important, resulting in attending the said programs without any specific aim: they dodge absenteeism just to get the credit points. Evidently, promoting CME programs to improve the performance of the physicians requires factual needs assessment over and above adaptation of the contents to the physicians' performance.

Impractical CME programs: Influential parameters in Iran

PubMed Central

Faghihi, Seyed Aliakbar; Khankeh, Hamid Reza; Hosseini, Seyed Jalil; Soltani Arabshahi, Seyed Kamran; Faghih, Zahra; Shirazi, Mandana

2017-01-01

Background: Traditional approaches in Continuing Medical Education (CME) appear to be ineffective in any improvement of the patients’ care, reducing the medical errors, and/or altering physicians' behaviors. However, they are still executed by the CME providers, and are popular among the majority of the physicians. In this study, we aimed to explore the parameters involved in the degree of effectiveness of CME program in Iran. Methods: In this study, 31 participants, consisting of general practitioners, CME experts and providers were recruited to participate in in-depth interviews and field observations concerning experiences with CME. Application was made of the qualitative paradigm along with the qualitative content analysis, using grounded theory data analysis methodology (constant comparative analysis). Results: Based on the participants’ experiences, the insufficient consistency between the training program contents and the demands of GPs, in addition to the non-beneficiary programs for the physicians and the non-comprehensive educational designs, created a negative attitude to the continuing education among physicians. This could be defined by an unrealistic continuing education program, which is the main theme here. Conclusion: Impracticable continuing education has created a negative attitude toward the CME programs among physicians so much that they consider these programs less important, resulting in attending the said programs without any specific aim: they dodge absenteeism just to get the credit points. Evidently, promoting CME programs to improve the performance of the physicians requires factual needs assessment over and above adaptation of the contents to the physicians’ performance. PMID:28638813

Optimization of chemical compositions in low-carbon Al-killed enamel steel produced by ultra-fast continuous annealing

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

Dong, Futao, E-mail: dongft@sina.com; Du, Linxiu; Liu, Xianghua

2013-10-15

The influence of Mn,S and B contents on microstructural characteristics, mechanical properties and hydrogen trapping ability of low-carbon Al-killed enamel steel was investigated. The materials were produced and processed in a laboratory and the ultra-fast continuous annealing processing was performed using a continuous annealing simulator. It was found that increasing Mn,S contents in steel can improve its hydrogen trapping ability which is attributed by refined ferrite grains, more dispersed cementite and added MnS inclusions. Nevertheless, it deteriorates mechanical properties of steel sheet. Addition of trace boron results in both good mechanical properties and significantly improved hydrogen trapping ability. The boronmore » combined with nitrogen segregating at grain boundaries, cementite and MnS inclusions, provides higher amount of attractive hydrogen trapping sites and raises the activation energy for hydrogen desorption from them. - Highlights: • We study microstructures and properties in low-carbon Al-killed enamel steel. • Hydrogen diffusion coefficients are measured to reflect fish-scale resistance. • Manganese improves hydrogen trapping ability but decrease deep-drawing ability. • Boron improves both hydrogen trapping ability and deep-drawing ability. • Both excellent mechanical properties and fish-scale resistance can be matched.« less

Improvements of PKU PMECRIS for continuous hundred hours CW proton beam operation

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

Peng, S. X., E-mail: sxpeng@pku.edu.cn; Ren, H. T.; Zhang, T.

2016-02-15

In order to improve the source stability, a long term continuous wave (CW) proton beam experiment has been carried out with Peking University compact permanent magnet 2.45 GHz ECR ion source (PKU PMECRIS). Before such an experiment a lot of improvements and modifications were completed on the source body, the Faraday cup and the PKU ion source test bench. At the beginning of 2015, a continuous operation of PKU PMECRIS for 306 h with more than 50 mA CW beam was carried out after success of many short term tests. No plasma generator failure or high voltage breakdown was observedmore » during that running period and the proton source reliability is near 100%. Total beam availability, which is defined as 35-keV beam-on time divided by elapsed time, was higher than 99% [S. X. Peng et al., Chin. Phys. B 24(7), 075203 (2015)]. A re-inspection was performed after another additional 100 h operation (counting time) and no obvious sign of component failure was observed. Counting the previous source testing time together, this PMECRs longevity is now demonstrated to be greater than 460 h. This paper is mainly concentrated on the improvements for this long term experiment.« less

Experimental investigation of nozzle/plume aerodynamics at hypersonic speeds

NASA Technical Reports Server (NTRS)

Bogdanoff, David W.; Cambier, Jean-Luc

1993-01-01

Work continued on the improvement of 16-Inch Shock Tunnel. This comprised studies of ways of improving driver gas ignition, an improved driver gas mixing system, an axial translation system for the driver tube, improved diaphragm materials (carbon steel vs. stainless steel), a copper liner for the part of the driven tube near the nozzle, the use of a buffer gas between the driver and driven gases, the use of N2O in the driven tube, the use of a converging driven tube, operation of the facility as a non-reflected shock tunnel and expansion tube, operation with heated hydrogen or helium driver gas, the use of detonations in the driver and the construction of an enlarged test section. Maintenance and developmental work continued on the scramjet combustor continued. New software which greatly speeds up data analysis has been written and brought on line. In particular, software which provides very rapid generation of model surface heat flux profiles has been brought on line. A considerable amount of theoretical work was performed in connection with upgrading the 16 Inch Shock Tunnel Facility. A one-dimensional Godunov code for very high velocities and any equation of state is intended to add viscous effects in studying the operation of the Shock Tunnel and also of two-stage light gas guns.

Communities’ Strategic Opportunities Through Broken Window Repair and Global Commons Improvements

DTIC Science & Technology

2014-06-01

5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Program Executive Office (Integrated...Warfare Systems),16107 Benedict Court,Woodbridge,VA,22191-4302 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND...identified six priorities, areas of focus: continue to focus on institutional reform; re-evaluate our military’s force planning construct ; preparing for a

Study of ultra-low emittance design for SPEAR3

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

Wang, M. -H.; Huang, X.; Safranek, J.

2015-09-17

Since its 2003 construction, the SPEAR3 synchrotron light source at SLAC has continuously improved its performance by raising beam current, top-off injection, and smaller emittance. This makes SPEAR3 one of the most productive light sources in the world. Now, to further enhance the performance of SPEAR3, we are looking into the possibility of converting SPEAR3 to an ultra-low emittance storage ring within its site constraint.

Performance Evaluation of an Improved GC-MS Method to Quantify Methylmercury in Fish.

PubMed

Watanabe, Takahiro; Kikuchi, Hiroyuki; Matsuda, Rieko; Hayashi, Tomoko; Akaki, Koichi; Teshima, Reiko

2015-01-01

Here, we set out to improve our previously developed methylmercury analytical method, involving phenyl derivatization and gas chromatography-mass spectrometry (GC-MS). In the improved method, phenylation of methylmercury with sodium tetraphenylborate was carried out in a toluene/water two-phase system, instead of in water alone. The modification enabled derivatization at optimum pH, and the formation of by-products was dramatically reduced. In addition, adsorption of methyl phenyl mercury in the GC system was suppressed by co-injection of PEG200, enabling continuous analysis without loss of sensitivity. The performance of the improved analytical method was independently evaluated by three analysts using certified reference materials and methylmercury-spiked fresh fish samples. The present analytical method was validated as suitable for determination of compliance with the provisional regulation value for methylmercury in fish, set in the Food Sanitation haw.